Dr. Sam Lam Plastic Surgery Forum

Hi Dr. Lam,

Thanks for answering all my questions that nobody else could. This has been a real treat for me. I have a couple of final questions to ask for today. Here they are:
1. I have always had bags under my eyes since I was born. What causes this and will they ever go away. They make me look tired. I think babies look cute with them, but not as adults.
2. I have very dark circles under my eyes and hollow under my eye area.The skin is very thin, does this cause my nasolabial folds to look more prominent, because it seems connected. I don't mind nasolabial folds, I have watched your video, but if you saw me, you would agree that mine definately were worth treating and still are,. They were deep!!
3. I had juvederm injected into my folds, can I get radiesse that would be used under my eyes injected as a touch up in my NL folds even though there is juvederm in it.
4. I watched your video on artefill? Do you really think it lasts 10 years or longer in people?
5. What do you think about juvederm? I hear you speak about all other products but not that one unless I missed it.
6. If I do get the hollow area under my area treated with either juvederm or resyaline, how deep do they inject the needle. Do they inject only at the rim.
I have been filled with knowledge today so I thank you. Amy

your answers are in all caps below:
1. I have always had bags under my eyes since I was born. What causes this and will they ever go away. They make me look tired. I think babies look cute with them, but not as adults.
MOST BAGS ARE NOT BAGS BUT HOLLOWNESS UNDER THE BAGS (WATCH MY VIDEO LOG ON BAGS, BALLOONS, AND SHORELINES TO BETTER UNDERSTAND MY PHILOSOPHY). HOWEVER, SOMETIMES A BAG IS A BAG. IN THAT CASE, IT CAN BE REMOVED. I DO NOT BELIEVE IN CUTTING IT OUT VIA A SKIN INCISION (WATCH MY VIDEO LOG ON SAFE STRATEGIES FOR THE LOWER EYELID). SOMETIMES IF YOU ARE YOUNG, THEY ARE A REFLECTION OF ABNORMAL THYROID DISEASE OR ALLERGY, WHICH SHOULD BE TESTED OUT BEFORE UNDERGOING A PROCEDURE. OF COURSE, A CLINICAL EXAM AND HISTORY CAN HELP SOMEONE JUDGE IF THESE TESTS ARE NECESSARY. NEXT, IF YOU DO FAT GRAFTING TO THE AREA, THE RESULT IS "PERMANENT" BUT YOU WILL CONTINUE TO AGE. IN GENERAL, YOU WILL ALWAYS LOOK BETTER WITH THE FAT GRAFTING.
2. I have very dark circles under my eyes and hollow under my eye area.The skin is very thin, does this cause my nasolabial folds to look more prominent, because it seems connected. I don't mind nasolabial folds, I have watched your video, but if you saw me, you would agree that mine definately were worth treating and still are,. They were deep!!
I DO NOT BELIEVE IN MOST CASES THEY ARE CONNECTED. ALSO, IT IS NOT THE DEPTH OF THE NLF THAT MATTERS, BUT THE SHAPE AND RELATIONSHIP TO THE FACE. I CAN PROMISE YOU THAT I DO NOT AGREE WITH OVER 80% OF PATIENTS WHO "THINK" THEIR FOLDS ARE DEEP. I CAN SHOW YOU COUNTLESS PHOTOS WHERE CORRECTING THE VOLUME ERASES THE WAY YOU SEE YOUR FOLDS (BUT NOT THE FOLD THEMSELVES). I KNOW I AM ONE OF THE FEW PEOPLE WHO REALLY GET THIS. IT IS A TIRELESS CRUSADE TO GET OTHER DOCS TO UNDERSTAND THE FUTILITY IN FILLING NLFS IN 90 PLUS PERCENT OF PEOPLE.
3. I had juvederm injected into my folds, can I get radiesse that would be used under my eyes injected as a touch up in my NL folds even though there is juvederm in it.
I GUESS YOU DON'T KNOW MY OPINION ABOUT RADIESSE UNDER THE EYES BUT I ABSOLUTELY HATE IT THERE. PLEASE WATCH MY VIDEO LECTURES ON FILLERS TO HEAR MY PHILOSOPHY MORE INDEPTH. I THINK RADIESSE IS GOD AWFUL UNDER THE EYES AND WAY TOO RISKY. SURE, A FEW PHYSICIANS OUT THERE GET GOOD RESULTS BUT I WOULD NOT TAKE A CHANCE IN PUTTING IT THERE. I THINK RADIESSE IS A GREAT FILLER FOR VERY DEEP NLF FOLDS. HOWEVER, BEFORE YOU BLOW MORE CASH TO FILL A FOLD, I WOULD ENCOURAGE YOU TO MAKE THE RIGHT JUDGMENT. OFTENTIMES, AS I SAID, WHAT YOU THINK LOOKS BAD REALLY DOESN'T. YOU NEED SKILLED EYES AND GOOD JUDGMENT.
4. I watched your video on artefill? Do you really think it lasts 10 years or longer in people?
NO IDEA. ARTEFILL IN ITS CURRENT INCARNATION HAS ONLY BEEN ON THE COSMETIC MARKET FOR ABOUT A YEAR. BEFORE THAT, IT WAS ARTECOLL, THEN BEFORE THAT ARTEPLAST. I WON'T BE USING IT FOR ALL OF THE REASONS THAT I HAVE ENUMERATED IN MY VIDEO.
5. What do you think about juvederm? I hear you speak about all other products but not that one unless I missed it.
PLEASE READ MY ANSWER THAT I JUST GAVE TO YOU IN THE OTHER POSTING FOR A DETAILED RESPONSE.
6. If I do get the hollow area under my area treated with either juvederm or resyaline, how deep do they inject the needle. Do they inject only at the rim.
AGAIN, PLEASE READ THE OTHER POST. YES, ONLY THE RIM BUT REMEMBER I DO FILL THE ANTERIOR CHEEK, ETC. THAT BLENDS WITH THE RIM EFFECTIVELY.