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After an endoscopic procedure my doctor is treating dark spots with a skin lightening treatment. Is this common?

Q:

I had an endoscopic brow, mid and facelift Dec 3, 2013...now 5 weeks later, I still have some yellowish bruising along my jaw line and temples. I also have some rather disturbing dark spots behind my left ear that goes down onto my neck. They are not open wounds. My doctor is treating it as "stains" with a skin lightening treatment. Is this common?

A:

O Kay,

 The normal color of a bruise is purpley red then, it changes to a yellow green appearance in Caucasians. It then slowly dissipates or goes away over several weeks. If blood pools then sometimes it is degraded by the body leaving behind a brown discoloration called hemosiderin. These hemosiderin spots/ deposits can often be a ablated by a laser if necessary.

 It sounds like you had allot of bruising with your procedure and it is slowly going away. Consider addressing your concerns first with your surgeon. If you are not satisfied consider a second option from an ASAPS Member in your are. Best,

 

Gary R Culbertson, MD, FACS

A:

O.Kay,

The facelift procedure that you had can cause significant bruising.  The resolution of this process varies from person to person.  It sounds as if your bruising in the temple and jaw line is resolving and should not be an issue.  The dark spots behind the ear could  be due to the same process or develop into hemosiderin spots.  These sometimes resolve slowly over time and if not lasers could be helpful, but skin lightening will not for this problem.  However, your doctor may be treating you for something else on the skin service which may be helpful.  You are still in the very early period of your healing period so you may want to be patient with your doctor. Good luck

A:

Lightening treatment are an appropriate course of action for what you have described. What you have is most likely Post-inflammatory Hyperpigmentation (PIH). This can be treated in a variety of ways. Many of my patients have had good results from using a "bleaching cream" with the active ingredient Hydroquinone 4%. Lasers are can offer very good results as well. Hope this information helps you. 

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