Dr. Sam Lam Plastic Surgery Forum

Hi Dr. Lam! I accidentally found you on a YouTube video and found your theory very logical to me! I started with Cystic Acne when I was 15 and have occasional outbreaks now, just not as bad as I did back then. I am 35 now. Back in February I had Co2 Laser Resurfacing done on my whole face. I was told I would notice dramatic results, but on my scarring area, it would probably take another hard hit on those particular areas.
It is now the end of November and I don't notice any real difference, other than creases were smoothed out around my mouth areas and the scars that were really 'shiny' are no longer shiny.
Under my eyes took the hardest hit *I think* as even without makeup today you can see the red/pink streaks that were heavier after all the old skin ex foliated from the initial surgery.
My scarring are (in appearance) a range of small pock marks to long burn like scars, mainly underneath my cheekbone down to my jawline towards my chin.
Do you think a fat graft for these would help? Im frustrated in part of spending money on something that I really shouldn't have, because this is a major emotional issue for me. This is a battle I have fought heavily with for nearly 20 years. I have been teased and made fun of because of something that I have no control over. How awesome it would be to have skin without ruts and pocks and cystic scars that doesn't look like a mole has been building a trail under it. I appreciate hearing your opinion and suggestions.
Thank you!
Kandlo

Well, I am so glad you found my videos. I just filmed a video testimonial of a lady who just underwent 2 silicone micro treatments with me and is very happy. I personally do not think CO2 does that much for acne scarring. Why? Because I used to do it. Although many people are scared of using silicone droplets, I have found it very effective in my hands with very good results. Please explore my before and after gallery to understand this process more. Even after one treatment, you will already see a nice change in most cases. However, if your condition is moderate you may need 2 to 3 treatments. In really severe cases, you may need 4 to 5 (but generally unlikely). You need to wait a month between treatments and the treatments are done as an office procedure. You can fly back out the same time. You will feel a slight sting with each treatment. Usually if you don't bruise (majority do not), you will have minimal to no recovery involved. You must wait a month before a 2nd treatment. The cost is $700 per time. I hope that helps.
Best,
SML

Thank you Dr. Lam! I will check out the site! Is the silicone that you inject permanent or is it something that will need to be redone after a certain amount of time goes by and is it contained? I know the scare with Silicone from years gone by and have heard that they are using it again for breast augmentation. But I have also heard about 'pump' parties where they inject silicone directly into their bodies. Thank you again for responding! Have a nice day!

HI,
1. silicone is permanent
2. silicone used in breast augmentation is totally different. it is solid not liquid so i would like to make that clear.
3. i don't know anything about "pump parties" but honestly they sound frightening. i am injecting tiny very controlled amounts as a licensed physician over multiple sessions to get a good result. anything else sounds quite dangerous to me, especially with words like "pump" "party" and self injections.
best,
sml

How does the Silicone stay contained in the area without leaking within the body? At your session, will this include all of the areas for $700? Do you have before/after pictures of an acne scar patient that you have performed this procedure on? I saw the fat grafting patients, but may have missed the acne scarred section. Thanks again!

The way that the silicone stays put is by putting only very tiny droplets a little at a time and waiting a full month before retreating. During that month, the silicone is being walled off by surrounding collagen to keep it in place. That is the proposed mechanism. I have not seen it shift with that technique. That is why I wait a month between micro treatments.

As far as before and afters, I have tons. Go under the "Resources" tab and click on the first entry "Before and After Gallery" then slide halfway down until you see the entry "Acne Scarring" then click on it. You will see my results. They are not perfect but a nice improvement.
Best,
SML

I did find them thank you! I can see improvements in them. Are these after one treatment or more? Are the before/After pics all same amount of treatments in between photos? Would it be possible for me to send you my own photos of my skin and have your opinion on them? The photos I have viewed are a little different from mine. I was told before by a Plastic Surgeon that because my scarring is under my cheekbones, that it's all about reflective lighting. His idea was to cut an incision down the scar, re-sew it together creating a different angle of the scar? But after having a second opinion, the 2nd plastic surgeon suggested not.
Thank you for your time.

Each photo is different. They range from 1 to 5 treatments with an average of 2 to 3 in most of them. In most cases I do not believe in cutting out scars. I don't think that helps but only causes more scarring. Remember the tissue with the scarring is already abnormal and healing is oftentimes poor so cutting it out can lead to variable degrees of scarring that at times can be worse. If you send me a photograph, I would have to charge you a formal consultation fee of $75 so I would need a credit card for that. You can send it to drlam@lamfacialplastics.com. All fees are applied toward any service you may have with me. The reason that I do not charge for this forum is that I am doing this as a public service for the community at large.
best,
SML