Bruising after injectable aesthetic procedures is common. Some bruises persist for months because of individual metabolism and injection depth. Foremed Legend AstraPico uses a 290 ps selective photoacoustic effect to fragment dermal pigment with minimal heat, offering a precise option for chronic infraorbital bruising.

Patient Profile

Chief complaint: An infraorbital bruise that had persisted for months after an injection and had not improved with home care.

Examination: A sharply demarcated blue-purple patch under the lower eyelid without ulceration or acute inflammation. The periocular skin was thin and otherwise normal.

Challenge: Periocular skin is only about 0.5 mm thick, while hemosiderin from an old bruise lies in the dermis. Energy must be precisely controlled to protect the epidermis and nearby ocular structures.

Treatment Rationale

Old bruises contain dermal hemosiderin derived from hemoglobin. Photoacoustic shock fragments the particles and accelerates macrophage clearance. AstraPico's 290 ps pulse width and 1.4 GW peak power provide selective photomechanical action with little thermal injury. Treatment followed a low-energy, non-overlapping scanning approach with strict periocular safety boundaries.

Protocol

Device: Foremed Legend AstraPico.

Parameters: 1064 nm, 8 mm spot, 3 Hz, 0.8 J/cm².

Technique: A single even scanning pass covered the bruise without overlap, staying at least 2 mm from the eyelid margin and avoiding the globe.

Results

Immediately after treatment: The bruise visibly lightened, with only mild erythema and no epidermal whitening, bleeding, or edema.

Six-hour follow-up: The bruise had fully resolved. Skin was smooth without pigment abnormality, swelling, redness, or stinging, and the patient could resume normal social activity.

Practical Points

1. Use 1064 nm for adequate depth. A large 8 mm spot with low 0.8 J/cm² fluence provides gentle, uniform action; 3 Hz reduces short-term energy accumulation.

2. Hold the handpiece perpendicular, maintain the eyelid-margin safety distance, move continuously, and avoid overlapping or stationary pulses.

3. The endpoint is immediate color reduction with mild erythema. Epidermal whitening or marked swelling requires immediate stopping and cooling.

Clinical Summary

One AstraPico session produced complete resolution of chronic post-injection infraorbital bruising within six hours. The 290 ps photoacoustic effect targets pigment while minimizing heat, making the protocol suitable for delicate periocular skin.

Treating Physician

Physician: Dr. Wu Dan, Laben Medical Aesthetic Clinic, Taizhou.

Background: Master's degree in dermatology from Ruijin Hospital, Shanghai Jiao Tong University, with expertise in minimally invasive aesthetics, facial rejuvenation, injection design, and complication management.

Foremed Legend

Foremed Legend Medical Technology focuses on the design, development, and clinical application of advanced energy-based aesthetic medical devices. Its portfolio includes picosecond laser, long-pulsed laser, IPL, photoacoustic skin imaging, and cold-air therapy systems.