Dissolving treatments

Because Cutis is the draining centre for all complex treatment reactions in Queensland. Our dermatologists sit on the AMET Emergency Board, & we consult for Laser Clinics Australia. 

Our team of dermatologists & nurse injectors are the go-to clinicians for all the bad things that can & do happen with treatments.

If it is not acute, namely if it’s not in an artery, leave it 12-14 days. You would be surprised how many cases settle down with time. 

Your injector can guide you as to their protocols, soft tissue massage can settle lumps if it’s within 7-10 days from it was performed.  

Yes, we do several times a week. We have skills needed to perform this treatment correctly. If you had treatment injections at another clinic and are unhappy with the results, we can help. 

You could start by knowing what product was placed, the date it was done, & if possible, the amount in mls. or syringes. It helps. 

• Overfilled lips
• Overfilled cheeks
• Overfilled creases and wrinkles
• Uneven results, lumps under the skin
• Tiny lumps beneath the skin
• Prolonged swelling e.g., tear troughs / under eyes
• Tyndall (blue tear troughs)

Your first point of contact is your injector. They will either action the event or move it up the chain. They may contact AMET response advice network, & if appropriate they will personally contact our specialist dermatologists. From there things move very quickly.

If your injector requires some advice, their first point of contact is usually the supervising physician. 

Hyaluronic acid treatments get broken down by an enzyme called hyaluronidase or Hyalse. This enzyme comes in an ampoule & requires mixing. All injectors will have this enzyme in their fridge. 

1-3 depending on the clinical scenario. Small foci of HA treatments only require one session. Granulomas & arterial occlusion will require between 2-4 sessions. Spacing between sessions depends on the clinical indication. Resistant areas include the tear troughs.

Our nurse injectors are super experienced. Our consultant dermatologists are involved in:

• Complex cases of granulomas, inflections, & weird reactions
• Emergency reversal of treatment in an artery
• Management of treatment nodules resistant to hyaluronidase that may necessitate the use of anti-inflammatory agents &/or chemotherapy

Cutis Dermatology Brisbane is the tertiary referral centre for treatments complications in Queensland.

If you are allergic to bee stings, you will probably react with hyaluronidase (as bee & certain wasp stings have this enzyme). 

• If you have an anaphylactic reaction to bee stings requiring adrenaline, this procedure cannot be performed in rooms. It must be done in a hospital by an allergist with resuscitation facilities nearby. Dermatologists are awful at managing blocked airways due to swelling.

• If you just get swelling, we will cover you with anti-inflammatories & antihistamines prior to the procedure. You may swell up, but only for 12 to 24 hours. Hopefully.

If it’s a small area, for example a nodule on the lip or a focal area of treatment, there’s minimal recovery time. If you have a high volume of treatment, you can be bruised & swollen for a few days. Our injectors will warn you prior to the procedure.

Tyndall is very common. Our injectors see cases from other clinics at least 3-4 times a day. It is due to the scattering of light through the skin in areas such as the undereye, though it can occur if-

1. treatment is placed too superficially. 
2. treatment is placed deep but migrates. 
3. A treatment with a high concentration of hyaluronic acid is used 

For TT or tear trough treatment, the only way to treat Tyndall is to dissolve the treatment under your eyes. You may require between 1-3+ sessions, spaced 10-14 days apart. 

You might, however our injectors are very careful in product placement & selection. If you have thin skin, there is every chance you will Tyndall again. 

In cases like these, our dermatologists can work around this with a wash of hyper dilute collagen stimulating treatments. They don’t Tyndall, but they take 3-4 months to have optimal results. 

Yup, in theory. We are however very careful in placing the dissolving agent within a specified area. The amount needed depends on the clinical picture. 

The more focused & dilute the hyaluronidase, the more treatments required. 

10-21 days later, after everything settles. Remember if you Tyndall with treatment under your eyes, it may be because your skin in that area is very thin. 

Our injectors will guide you through the correct product, placement & candidate selection. 

Possibly, but probably not. 

It depends on:

The type of treatment used

• Whether you have a true ‘allergy’ or just a cross reaction
• Your immune system & health 
• Your anatomy & histology (eg. thin skin in the TT area as discussed prior)
• The product placement (depth, amount etc.)

Possibly, but probably not. 

We suggest you see our nurse injectors. They are very experienced in reversing treatments. For more complex treatment reversal, you can see our senior procedural dermatologists.