Dr. Sam Lam Plastic Surgery Forum

Hi Dr. Lam,

I sent the photos via PM, but wasn't sure if they were "sent" as they were still in my outbox several hours later. I went ahead and re-sent the email to your office email (as per Marcy) just in case there was a glitch with the board (or I did something wrong).

Just wanted to apologize for the duplicate email.

Sincerely,
Tracy Ayers

Hi,
No problem. I got both sets. Here is my assessment:
1. You are a good candidate for mole removal for two reasons: the mole is large enough to attract some mild attention (although you are beautiful and really the mole is not terribly ugly at least in my opinion) and second it is in a fantastic location for me to remove it. What I do is that I hide the excision in the smile line by only "undermining" or releasing the cheek skin side and advancing the outer skin toward the line. That way the line does not migrate or get distorted but the tension on the incision is minimized. If this makes no sense, I'll draw it out for you when you come here.
2. Okay, now about the emergency mole situation. I'll be frank with you, DON'T DO IT BEFORE THE GIRL'S WEEKEND. I can't promise there is no lingering redness or mild scarring that could RUIN your weekend. Is it a high likelihood? NO. But I don't like to take chances on anyone. If you read me the riot act and still want it done, I'll look at my schedule. But truly I need to respect my time and my staff's. Consider that I spend 3 hours of my private time a day answering questions and helping people, I really can't make my crazy days crazier. Also, remember that I really would recommend waiting until after your girl's weekend out. Just enjoy your weekend, AND REST ASSURED YOUR GIRLFRIENDS DON'T CARE ABOUT YOUR MOLE AND DON'T THINK THAT IT MAKES YOU LOOK BAD. I DON'T. SERIOUSLY. LET'S REMOVE IT IN SEPTEMBER UNLESS A SPOT OPENS UP.
best,
sml

Dr. Lam,
Thank you so very much for your reply to my question on the forum. I appreciate it. You are kind to compliment me and I appreciate your honesty about the "worst case scenario". I'm sure I sound a little crazy with my "emergency" mole removal request! But, thanks for being so understanding and kind.

I honestly cannot explain to you how awful I have been feeling lately about this mole. It's very unlike me. The photo does not really show how protruding the mole is, which is part of what I hate about it. Because it's light/flesh colored, it sort of looks like a big pimple. I was going to take another picture from a different angle to demonstrate, but I've taken enough of your time already.

I truly do want to be respectful of your time and so how about we just leave it like this: If there is a cancellation which would allow me to come in on Monday or Tuesday, and you can do it without disrupting your day, perhaps I could be called to take that spot. I think I would be very pleased with the results given I would have about a month to heal. If not, then I'll just see you in September.

Thanks again for all your help,
Tracy Ayers

worst case scenario is call my mole hotline. just dial "911" and ask for my mole removal emergency responder.

[quote="dr. lam"]worst case scenario is call my mole hotline. just dial "911" and ask for my mole removal emergency responder.[/quote]

That's funny!

I saw that Sarah Jessica Parker had her trademark mole removed yesterday - so I thought maybe that was a sign. Ha!!

Dr. Lam,
When I'm there for the mole removal can you also laser off a couple of small sun spots on my face? And, if I decide to have another mole on my face removed that same day, do I need to send you more pictures? Not sure if you can see it clearly in the pictures I sent, but it's on the opposite side of my face as the other one but closer to my nose, about an inch or so below my eye. I was thinking it may not be a good location for removal due to the location, but I'd really be curious to hear what you thought. This one doesn't bother me currently, but there is a chance I will want it removed later. Having them done at the same time might make the most sense because I'm coming from out of town.

Also, my under eye area is a problem for me. Wrinkles are not a big issue (I don't mind them) but the bags and splotchy skin color that is visible if I'm not wearing make up is something I'd like to address. My dad has the same problem. What procedure do you have that may address this? I'm new to all this so I didn't even know what section to look under on your web site. Would fat grafting be the best choice or is there another procedure?

Thanks!
Tracy

hi tracy,
1. i would discourage removing the other mole unless it bothered you because there is always a risk benefit ratio in everything that i do. it will not be partially hidden in a smile line so even though i am sure that it will heal well, i don't take mole removal lightly. however, if you want it done, i would be more than happy to accommodate.
2. as far as the tired look or hollow eyes, looking at your photos, you don't look that bad. i think fat transfer may be too expensive and too big a procedure. however, i might change my mind when i see you in person. there is a tendency that photographs on a digital camera really make my interpretation off. you can also do simply restylane to buy you a year or two before the fat transfer. again, let me take a look to make that decision with you in person. you can look at my "before and after" gallery on "injectable fillers". that can be done in the office easily. i have many examples of 30 somethings as low as 29 years old a couple 31 year olds. crazy right? until you see my work.
3. splotchy skin color probably needs a light bleaching product. again, let me see you to decide.
best,
sml

Dr. Lam,
Thanks so much for your reply. I agree about the other mole. It is not in a great area - probably not as easy to "hide" the scar. My dermatologist said she could shave it so at least it would be flush with my skin but I'm not sure how I feel about that. The other one she removed about a year ago left a mark. Fortunately, it's in a dimple so it's not a huge deal, but it's still a noticeable mark.

I know I don't look that bad in the photo, but wait until you see me without makeup! (Thank you, Lancome!) Seriously, I'm totally fine with just discussing my options with you in person. I trust your opinion on the best procedure for me or just opting to wait a couple years. I watched your video about getting the most 'bang for your buck' and I appreciate that you don't just do whatever the client wants to make a profit. It sounds like you really think about what is in the best interest of the patient. That's awesome! And, even if I just have the one larger mole removed I will be THRILLED! I'm very excited!

Thanks again,
Tracy

good. i'm glad you are going to trust me. i am a bit the cosmetic nazi. (just kidding. hope that did not offend anyone out there.)
look forward to meet you.
sml

Hi Dr. Lam,
I'm looking forward to meeting you and your staff in just a few weeks and wanted to ask a quick question. Besides the mole we've already talked about (in my smile line area), there is one right on the top of my lip (right at the point) that I also think I'd like you to look at. I know excision might not be the best route, because it's in such an obvious area and the scar may be hard to hide. So my question is - Do you do shaving of moles also? I'd much rather have it done by you than a dermatologist. Just curious if there would be time for this on the visit that I already have scheduled? I figure since I'll be there I should have a couple removed, if you think they are good candidates for removal. I think you'll agree that at least two need to go.

Let me know if you need a picture or just want to discuss all this the day of my appointment. Thanks!!

Sincerely,
Tracy

usually upper lip moles heal the best when excised not shaved but i'll see you to decide. don't worry, i'll take care of it.
sml

Awesome. Thanks! I'm really looking forward to having them removed.

great!