Complications in Cosmetic Dermatology: Crafting Cures Ganesh S Pai
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1Complications in Cosmetic Dermatology Crafting Cures2
3Complications in Cosmetic Dermatology Crafting Cures
Editor Ganesh S Pai MD DVD Former Director, Professor, and Head of Dermatology Recipient of Professor KC Kandhari Lifetime Achievement Award (2016) President, Dermacon 2015, Mangalore National President, Indian Association of Dermatologists, Venereologists, and Leprologists (2000) Teaching Faculty in 5 Continent Congress, Dermatologic Aesthetic Surgery International League, and International Master Course on Aesthetic Science Foreword Venkataram Mysore
4
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Complications in Cosmetic Dermatology: Crafting Cures
First Edition: 2016
9789385891878
Printed at
5Dedicated to
My mother Shanta, who at the age of 94, is able to witness the publication of this book and feel proud of her son; to my late father Professor M Srinivas Pai, who instilled values and discipline in me
My children, Hema, a gynecologist, and Harsha, an ophthalmologist, who have grown to be young leaders in their specialties, and my son-in-law Prashant, an accomplished anesthetist
My three granddaughters, Neha, Deeksha, and Nilima, who have filled my world with joy and innocent chatter
My daughter-in-law, Anusha, who has shared the burden of scrutinizing and organizing the chapters with painstaking detail
Above all, my wife Lata, who has been through the ups and downs in my career.6
7Contributors
EDITOR
  • Ganesh S Pai MD DVD
  • Former Director, Professor, and Head of Dermatology
  • Recipient of Professor KC Kandhari Lifetime Achievement Award (2016)
  • President, Dermacon 2015, Mangalore
  • National President, Indian Association of Dermatologists, Venereologists, and Leprologists (2000)
  • Teaching Faculty in 5 Continent Congress, Dermatologic Aesthetic Surgery International League, and International Master Course on Aesthetic Science
CONTRIBUTING AUTHORS
  • Sanjeev J Aurangabadkar MD
  • Consultant Dermatologist
  • Department of Dermatology
  • Skin and Laser Clinic
  • Hyderabad, Telangana, India
  • Madura Chandraiah MD FRGUHS
  • Consultant Dermatologist
  • Department of Dermatology
  • Cutis Academy of Cutaneous Sciences
  • Bengaluru, Karnataka, India
  • Rajetha Damisetty MD
  • Consultant Dermatologist
  • Department of Dermatology
  • Mohana Skin and Hair Clinic
  • Hyderabad, Telangana, India
  • Rajul Davda MD
  • Consultant Dermatologist
  • Department of Dermatology
  • Skin Secrets
  • Mumbai, Maharashtra, India
  • Sanjay Dubey MD
  • Consultant Dermatologist
  • Department of Dermatology
  • Maharshi Vitiligo Centre
  • Indore, Madhya Pradesh, India
  • Anil Ganjoo MD
  • Consultant Dermatologist
  • Department of Dermatology
  • Skinnovation Clinics
  • New Delhi, India
  • Shikhar Ganjoo MD
  • Assistant Professor
  • Department of Dermatology and STD, SGT Medical College,
  • Hospital and Research Institute
  • Gurgaon, Haryana, India
  • Kiran Godse MD DVD FRCP
  • Professor, Department of
  • Dermatology, DY Patil Hospital
  • Mumbai, Maharashtra, India
  • K Narendra Kamath MD DVD FAAD
  • Consultant Dermatologist
  • Department of Dermatology
  • Cutis Clinic
  • Mangalore, Karnataka, India
  • 8Vaishalee Kirane DVD DNB
  • Dermatologist and Trichologist
  • Skin and Hair Clinic
  • Pune, Maharashtra, India
  • Malavika Kohli MD
  • Medical Director
  • Department of Dermatology
  • Skin Secrets
  • Mumbai, Maharashtra, India
  • Amit Luthra MD
  • Consultant Dermatologist
  • Department of Dermatology
  • Ishira Skin Clinic
  • Delhi, India
  • Aditya Mahajan MD FCPS DDV
  • Consultant Dermatologist
  • Department of Dermatology
  • Dr Mahajan's Skin, Hair and Laser Clinic
  • Mumbai, Maharashtra, India
  • Hema Mallya MS
  • Consultant Obstetrician and Gynecologist
  • Department of Gynecology
  • Derma Care
  • Mangalore, Karnataka, India
  • Prashant Mallya MD
  • Anesthetist
  • Department of Anesthesia
  • Yenepoya Super Speciality Hospital
  • Mangalore, Karnataka, India
  • Narmada Matang DVD
  • Consultant Dermatologist
  • Department of Dermatology
  • Neo Skin and Cosmetic Clinic
  • Mumbai, Maharashtra, India
  • Venkataram Mysore MD DNB
  • DipRCPath FRCP FISHRS
  • President, IADVL
  • Director, Venkat Charmalaya–Center for Advanced Dermatology
  • Bengaluru, Karnataka, India
  • Umashankar Nagaraju MD
  • Consultant Dermatologist
  • Department of Dermatology
  • Dermavision
  • Bengaluru, Karnataka, India
  • Sudhir Nayak UK MD DDVL
  • Assistant Professor
  • Department of Dermatology, Venereology, and Leprosy
  • Kasturba Medical College
  • Manipal, Karnataka, India
  • Anusha H Pai MD
  • Consultant Dermatologist
  • Department of Dermatology
  • Derma Care
  • Mangalore, Karnataka, India
  • Harsha S Pai MS
  • Consultant Ophthalmologist
  • Department of Ophthalmology
  • Alpha Laser and Surgical Centre
  • Mangalore, Karnataka, India
  • Vindhya A Pai MD
  • Dermatologist
  • Department of Dermatology
  • Kasturba Medical College and Hospital
  • Mangalore, Karnataka, India
  • Sathish B Pai MD DVD
  • Professor and Head
  • Department of Dermatology, Venereology, and Leprosy
  • Kasturba Medical College and Hospital
  • Manipal, Karnataka, India
  • Narendra Patwardhan MD DV DVD
  • Consultant Dermatologist
  • Shreeyash Hospital
  • Pune, Maharashtra, India
  • Pavan R Rangaraj MD
  • Consultant Dermatologist
  • Department of Dermatology
  • Cutis Academy of Cutaneous Sciences
  • Bengaluru, Karnataka, India
  • Avitus JR Prasad MBBS DDVL DM
  • Chief Laser Surgeon
  • SP Derma Center
  • Madurai, Tamil Nadu, India
  • Savitha AS MD DNB
  • Assistant Professor
  • Department of Dermatology
  • Sapthagiri Institute of Medical Sciences
  • Bengaluru, Karnataka, India
  • Chaithra Shenoy MD
  • Consultant Dermatologist
  • Department of Dermatology
  • Cutis Academy of Cutaneous Sciences
  • Bengaluru, Karnataka, India
  • Chandrashekar B Shivanna MD DNB
  • Medical Director
  • Department of Dermatology
  • Cutis Academy of Cutaneous Sciences
  • Bengaluru, Karnataka, India
  • Kuldeep Singh MD MSMcH
  • Senior Consultant
  • Department of Plastic, Reconstructive and Aesthetic Surgery
  • Indraprastha Apollo Hospitals
  • New Delhi, India
  • Simal Soin MD
  • Consultant Dermatologist
  • Department of Dermatology
  • Aayna Clinic
  • New Delhi, India
  • Dhepe N Vishwanath MD FAAD Fellow ASDS ASLMS EADV ISHRS IADVL ACSI
  • Medical Director
  • Department of Dermatology
  • Skin City
  • Mumbai, Maharashtra, India
9Foreword
Dermatosurgery is usually a safe surgical practice, however complications do occur and are an important part of dermatosurgical practice. The adage “there cannot be a surgery without complications” holds true for dermatosurgery too. And in these days of consumer activism, complications have assumed a vital part of the practice. However, complications are also opportunities to learn—they teach humility and teach a surgeon to get wiser and better. They teach the surgeon how not to do surgery, and also when not to do surgery.
It is, therefore, refreshing to see a book on this subject—and who better than Dr Pai to author such a book? Dr Pai combines the old generation skills of empathy and clinical dermatological knowledge with new generation skill of procedural excellence and entrepreneurship. He was one of the first dermatologists to make the transition from arm chair dermatology to interventional dermatology, and, therefore, he has seen them all! He also has the necessary teaching experience and communication skills to author a book on such a vital subject.
The book fills a void and occupies a niche. The book has included complications of all procedures—esthetic, surgical, and laser. It is a great guide to the beginner as well as the experienced. The authors are all highly experienced dermatologists from all parts of India and the book is, therefore, a mine field of information. I have no doubt that this book will be greatly appreciated by all dermatosurgeons.
Venkataram Mysore MD DNB DipRCPath FRCP FISHRS
President, Indian Association of Dermatologists, Venereologists, and Leprologists
Director, Venkat Charmalaya – Center for Advanced Dermatology
Bengaluru, Karnataka, India10
11Preface
This book took over a year to complete and is unusual from other books on lasers and cosmetology. It guides aspiring dermatologists towards safe shores; errors of judgment made by authors early in their careers, mistakes by fellow professionals which ended up in our offices, and unpredictable outcomes that occurred despite best attention all features in this book.
The authors are leaders in their chapters and emphasis has been made on practical concepts. Tips guide us from cookbook to kitchen with useful suggestions; salvaging good end results from possible disasters have been demonstrated.
When you begin your long journey in the world of lasers and cosmetology, there will be headwinds and foggy windshields which will make the journey troublesome.
Keep this book in the co-driver seat to make your journey safe and comfortable. In this day of demanding patients, we have to walk a tight rope between adulation and their litiginous bent of mind.
It is the fervent hope of our authors that this book will steer your careers to success.
Ganesh S Pai12
13Acknowledgements
I would like to thank all the authors for their painstaking efforts to produce chapters which harped on management of complications. It was a difficult assignment as a lot of effort was required to sift through complications and chronicle the results. Only cosmetologists with a large patient base and a bedrock of dermatology experience could compile data for such chapters provided they would set apart time for the project.
I would like to thank Dr Anusha Pai, who sifted through all the written material, arranged the photographs, and scrutinized the references.
A thank you to my teachers and colleagues of yesteryears and my former postgraduates who are the next generation of leaders in our chosen field. Indeed some of them are contributors to the chapters.
A special thanks to Jaypee Brothers Medical Publishers (P) Ltd., New Delhi, for bringing out this valuable book, especially Dr Neeraj Choudhary, who was the epitome of politeness and understanding in every meeting and telephonic conversation.
My thanks to Miss Bhavyashree for methodically organizing the write-ups and communication.
Thanks to all our patients who have enriched our knowledge of laser applications and helped refine our techniques. And finally to our readers, the large numbers of dermatologists in the length and breadth of our land. I hope they find it useful and enthuse us to bring out the next edition in future.141516