Thank you for your question.
You state very clearly in your question that you went for Restylane injection 4 days prior
and that when you had it placed on your cheek, there was no problem but then when the injection
was performed on the forehead, you stated that there was pain.
Later that day, a white patch appeared and now it would appear it’s like a bruise and
you contacted the provider of this treatment and you where advised that this was normal
and you presented this question for review.
Well, certainly I can assist you with this question.
I’m a board certified cosmetic surgeon and a fellowship trained oculofacial plastic and
reconstructive surgeon.
Fillers are a very big part of my practice.
I use a lot of Restylane, Juvederm, Voluma in my practice and I would have to say I’ve
been in practice over 20 years in Manhattan and Long Island.
I would say that the description of your experience where you had pain and you had an area patch
of white is very consistent with what we call vascular occlusion.
That’s one of the things we worry the most about when it comes to the use of injectable
fillers is whether or not when we are placing these fillers, can we be directly embolizing
or placing the material into a vessel or is there enough pressure where there is occlusion
of vessels.
This really requires immediate attention.
Several days has gone by so acute options have been probably exhausted but at the same
time, there may be an opportunity to use some hyaluronidase or some type of enzyme to dissolve
the filler material and to undergo other potential procedures depending on the diagnosis.
There are possible benefit to hyperbaric oxygen treatment and other modalities to stimulate
or I should say increase the circulation, increase the oxygen content in the tissue.
I have no intention to alarm you but the description you provided certainly is not normal.
I would not think that an area becoming white and painful and normal after doing an injectable
treatment.
I always tell my patients that I am available to them 24 hours a day and if I got this report,
with due respect to what may have been reported to your provider, I would say that this is
something I need to see and not just state as is typical.
A proper physical examination is very important and it is possible that you may have had an
acute event and now that the event is behind you but without proper physical examination,
it is very difficult to make that assessment.
But I would again very aggressively recommend that you seek attention immediately whether
with the doctor who provided the treatment or another doctor but this is something you
shouldn’t have further delay.
So I hope that was helpful, I wish you the best of luck and thank you for your question!