Hi Kristy - Just getting to take a look at the photos. I do see the raised area on her chin with a border appearing to be irregular. Very interesting. Is this apparent anywhere else on her skin or body? I believe it's important to look at duration of the problem - when it occured and how long it lasted, is it reoccurring and how so? An analysis of exactly what the client is applying to her skin is important also and you've mentioned Tretinoin, is she using that in combination with various other acids at the current time? If not, when and how long she did use the retinoic acid is important. Initially, it seems that the raised areas may be due to increased fluids in that area, a swelling, and is there a coverup preventing the display of redness in the photos? She appears to display a fair amount of surface vascularity occuring on her cheeks seen in the last photo you sent. Her chin displays redness. She appears to have a prediposition to sensitivity from what I can see. I would try taking her back to calming and pH balanced products, no ingredients known to be sensitizing, and treat breakouts locally with anti-inflammatory/antibacterial ingredients/modalities, but no acids. Followup no less than monthly (in fact bi-weekly at first) would be good, just for a look/see or calming treatment. Those are my thoughts, but it's always very diffucult to truly evaluate the problem without more in-depth information.