Dr. Sam Lam Plastic Surgery Forum

Hi Dr.Lam,

I had fat grafting about a year and a half ago for my orbital rims. I'm currently 25 years old and have hereditary hollows. i didn't need fat grafting anywhere else. i'm male. i had this done before i was aware of you. The fat graft wasn't very good it only lasted about six months. I have two questions.

1) if i come to you to have fat grafting can you perform this on me having had prior work with somebody else? I say this because i still think a little of the previous graft is still there.

2) I have a really (good?) metabolism, i can't put on or lose weight i'm always stable but i'm very lean. Does metabolism affect the ability of the graft to stay in the body?

Thanks for your time!

1) if i come to you to have fat grafting can you perform this on me having had prior work with somebody else? I say this because i still think a little of the previous graft is still there.
YES, I CAN. THAT SHOULD NOT BE AN ISSUE IF THE RESULT HAS FADED SO LONG AS THE RESULT IS NOT LUMPY OR BAD THEN THERE IS NO ISSUE WITH MY REDOING IT. I DO HAVE A CONCERN OF WHY I AM DOING SUCH A YOUNG GENTLEMAN. AS YOU AGE, YOU WILL GAIN WEIGHT AND IT MAY SHOW UP UNDER THE EYES IF WE FILL IT UP TOO MUCH. I AM ALWAYS CONCERNED DOING A FAT TRANSFER ON SOMEONE THAT YOUNG AND TRYING TO TOP IT OFF. ALSO, MEN TEND TO HOLD MY FAT A LITTLE LESS WELL THAN WOMEN. HOWEVER, I THINK MEN LOOK BETTER A BIT GAUNT (NOT TOO MUCH). I JUST WANT TO MAKE SURE THAT I ALSO DO NOT DISAPPOINT YOU. I HAVE 2 SERIAL PHOTOS OF MEN IN MY SERIAL PHOTOS OF FAT GRAFTING SECTION. YOU WILL SEE THAT THEY BOTH HAVE A RELATIVELY HOLLOWER LOWER EYELID THAN MY FEMALE PATIENTS FOLLOWING FAT TRANSFER BUT THEY BOTH LOOK FANTASTIC. THE SECOND CASE WAS A CORRECTIVE ONE TO MANAGE AN OVERDONE FACE. IF YOU GO TO MY BEFORE AND AFTER CATEGORY, YOU WILL SEE THE "NEW" SECTION TO SEE THESE RESULTS. THEY ARE REALISTIC. MY GOAL IS TO OFFER REALISTIC EXPECTATIONS, ESPECIALLY FOR GENTLEMAN. SOMETIMES WE SO FOCUS ON THE LOWER EYELID HOLLOW THAT IS ALL WE SEE. WE DO NOT SEE HOW THE FACE AS A COMPOSITE CAN LOOK BETTER BY ACHIEVING BETTER BLENDING. BUT AT 25, I AM NOT TOO CERTAIN WHAT I AM BANKING ON. JUST WANT TO BE APPROPRIATE WITH YOU.

2) I have a really (good?) metabolism, i can't put on or lose weight i'm always stable but i'm very lean. Does metabolism affect the ability of the graft to stay in the body?
IN A WAY, YES. IN A WAY, NO. I HAVE DONE PEOPLE THAT WERE CRAZY WITH METABOLISM AND NOT HAD A PROBLEM WITH IT. CHECK OUT CASE #3. I HAD TO HARVEST FAT FROM 6 SITES TO HAVE ENOUGH TO DO THE JOB PROPERLY. SHE IS SHOWN 2 YEARS OUT AND HOLDING WELL. OBVIOUSLY, NO GUARANTEES. IN CASE #7, THE FAT WAS SO WATERY AND IN A WORD, CRAPPY, (NEVER SEEN IT LIKE THAT) THAT I THOUGHT MAN, I AM NOT GOING TO GET ANY RESULTS. HOWEVER, THAT FAT ALSO HELD BEAUTIFULLY. SHE IS WELL OVER 2 YEARS OUT.
best,
sml