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Electrolysis, the only permanent hair removal method |
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Dear Bette: I may be asked to remove some hairs on upper and lower lips that have been enlarged by silicon injections. Are there any precautions that I should be aware of? And, what about removing hairs from breasts with implants? It is always best, when confronting situations like you have described, to ask the patient to provide you with the name of the physician who performed the procedure, then write, email, or phone that physician and ask his or her opinion directly. To make sure you are legally covered, it would be best to have the patient bring a note from the doctor saying that electrolysis is safe to perform in those areas. Silicone injections are performed by needle where small increments of silicone drops are injected to the desired area. Although it is not currently approved for injection by the FDA, it is still legal to use silicone oils “off-label” for cosmetic treatments by a physician. A lot of controversy surrounds the injection of silicon. Minor complications inherent to the procedure include erythema, redness, edema, inflammation, swelling, hematomas and ecchymoses, pain and dyschromia. Major complications range from infections and necrosis to telangiectasias and alteration of skin texture and consistency, possibly even facial disfigurement. If it is silicon and not collagen or Restalyn®, my advice would be not to work on the case at all. You would not want any side effects to be perceived as a result of electrolysis treatments. I recently had a patient who dropped her treatments for several months, then when she returned, I was surprised to see that the hair was not under her chin as it had been originally, (I had done a hair density measurement so I knew exactly where it had been) but was all over the front of her chin and along her jaw line. I was shocked to say the least. Then when I inquired about her four-month absence from treatments, she explained that her plastic surgeon in Costa Rica had recommended waiting for four months to resume electrolysis treatments. He explained to her that he was literally lifting her entire layer of skin from its foundation and moving it upward. He told her that it would take some time for it to heal and reattach to the tissue beneath and during that time, stretching and pulling it was not advisable. We all know that good insertions require a certain amount of stretching to the skin, so I found him to be very knowledgeable, knowing that electrolysis would be contraindicated. He also mentioned that her skin would be healing and he did not want to “stress” it with too many healing assignments all at one time. I imagine he was concerned about sterile procedures being followed, to avoid any complications. To answer your question about silicon injections directly, no, I have not done electrolysis on a patient who had lips augmented with silicon. I have, however, treated the upper lips of clients who have had collagen injections, fat injections, and other types of lip augmentation. All those went well, but I treated each of them months after the procedures had been completed. I have also worked on clients who have had both silicon and saline breast augmentation implants. The only problem I encountered was with a client who had very large implants. I was treating her right axilla and her breast drooped slightly into the armpit area when she lay on her back. Using the single-handed epilation method, the forceps must be flipped upward while doing an insertion. She picked that moment to sneeze and grabbed for her nose with the arm I was working under. This caused the forceps to slightly stab her breast. She was very concerned that her implant had been ruptured. It had not. However, because the skin was broken, she did have some redness and swelling for a few days. I checked with a physician friend of mine who assured me that any implants, of which he had knowledge, were inserted under existing mammary tissue and sometimes even under the muscle, and therefore would not even be in the vicinity of the needle or forceps. But incidents like this are why it is important to carry malpractice insurance and to get a signed note from the patient’s physician stating it is safe to perform the treatment. It would also be advisable to have the patient sign a general disclaimer as well. It is always best to check with
your malpractice insurance company and follow their instructions. Without your input, this column would not be possible. So please keep those questions coming. |
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