Dr. Sam Lam Plastic Surgery Forum

I am in my mid thirties and want to know if I am too young for fat injections. I have two children and have gone through my fat phases twice now. I fluctuate in my weight by 5 to 10 pounds at any given time, and I am concerened that this procedure will make me look fat. Busy mom tired of looking tired.

Hi Denise,
You have a good question. You are an ideal candidate for fat grafting. Oftentimes after a couple of children, women accelerate their fat loss around the eyes even in their 30s despite gaining some fat in their lower face. Fat grafting helps restore the lost balance to the face and oftentimes makes one look less "fat" if you will be de-emphasizing the heavier jawline in some patients.

Unfortunately, there are too many women undergoing unnecessary browlifts and facelifts in their 30s. Besides being more invasive, these techniques I have found to be unnecessary and more so detrimental. Ofentimes, what you may think looks better by holding 2 fingers and lifting your brow up really represents a DEFLATION rather than descent. Fortunately, fat grafting which is entirely incisionless can be undertaken in an hour or so to truly bring you back 5 to 10 years depending on when you looked your best. By matching your old photographs whenever you looked the best, I can get you closer to your ideal without taking your identity away from you. It is important that you begin by reviewing your old photographs so that you can see the evolution of change.

In fact, most women do not like their faces in their early to mid twenties because it looks too round, which is due to baby fat. Most women like their face the most in their early 30s when they have lost the baby fat and looked more sculpted but not hollow yet. After a few kids in one's late 30s, you look slightly hollow around the eyes making you look more tired. Then you gain a few pounds and the jawline looks heavier. The trick is not to move you from a bottom heavy triangle back to a full circle but back to the inverted triangle that resembles the heart-shaped face of one's early 30s. Remember that aging is different in most people so if you have a lot of sun, especially prior to the age of 20, you will have more facial aging in your 30s than someone else of your comparable age. Therefore, it is important to understand that everyone ages differently.

Finally, you don't have to have fat grafting. The way that I use fillers is entirely different than most physicians who use fillers to fill smile lines, which oftentimes is not the problem. I use it to fill around the eyes, cheeks, and jawlines using a method I developed that is entirely painless and even with needles, as I use soft cannulas instead which provide a much smoother result and far less chance of any bruising (which also I can manage with my laser at a week if need be). It is about a day to 3 days of downtime compared with 7 to 10 days for fat grafting. Hope that helps. If you have more questions, please let me know.
Thanks,
sml

Baby fat my butt! I don't understand why people arbitrarily pick a certain amount of deterioration as actually desirable. None of it is. Dr. Lam I came across you from videos on Youtube. And I liked how you seemed to have the right idea of focusing on the shape of the face rather than much more minor things like wrinkles and folds that other people seems to obsess over. But I wondered why you were mostly looking at photos of people in their 30s. If you took things a little further you would be right on track. Most people experience significant volume loss through their 20s. It is much more significant in men. By 23, mine is pretty noticeable in pictures. By 26 it was unbearable. I was biting the side of my mouth and couldn't make facial expressions properly. Most doctors didn't want to work on me seriously because of my age, which makes no sense to me. I could have probably been restored to looking pretty good I did end up getting some fat transfers in CT but she didn't really finish the job. I wear a mask now wherever I go, but I haven't given up. I was hoping maybe you would turn out to not be an old age worshiper like the rest of this society, but, as I feared, that appears not to be the case. At 16 or 17 I was a good looking MAN, not a baby. Unlike Michael Jackson, I don't want to look like anyone else, just to have that strong functioning face I used to have, to match my body that looks better than most 18 year olds(except the terribly shriveled hands - of course the 2 things most people would see).

Of course, if you can scientifically prove on the other hand that some of the lost volume is indeed 'baby fat' , please do. I sure hope no young women with beautiful thick faces stumble across your post and go on diets so they can look old way before their time like these 'supermodels' we see

No seriously, let's have an intelligent discussion on this topic.


Thanks.

Those are very interesting comments. You really don't get my perspective in the least bit. I am not saying that I am not attracted to 20-something year old women. I am saying that WOMEN who hit their 40s and beyond often like their face the most in their early 30s. Not all the time. But the majority of the cases they are. The number one reason women fear fat grafting is that they are scared of looking fat. Since I use old photos to preserve identity, I don't want them to look back at their 20 something year old face and say "That's not what I want." I am very in tune with the female perspective. Remember most of my fat grafting cases are performed in women over 40 years of age. Of course, I do men and women of all ages.

In fact, I have to perform fat grafting on a 25 year old in the coming weeks who had liposuction of her cheeks at 21. That is very sad. I would never have done that. Also, I just met a beautiful 29 year old woman who wants to do fat grafting and in her case, I can see where I can make some improvements. Some people lose enough volume in their 20s, usually due to excessive sun damage that they would merit fat grafting. In those cases, I would consider doing it.

Also, remember that fat grafting is a permanent option and also a live graft. When a woman gets pregnant, she can have distortion during that time. I have incredible responsibility to inform my patients of that fact. In fact, I mentioned that to the two young ladies with whom I recently had a consultation. Further, fat grafting is a live graft. If you gain weight as you age, you can also have an inappropriately larger face. I am always cognizant when I deal with a younger patient to make sure that that is what they want for the rest of their life. Fortunately, we do lose facial volume so that is a good safety parameter.

As you do, I hope that models in their 20s STOP having their fat suctioned out of their buccal area, as they do on extreme makeover. That kills me. I totally agree with you that a fuller face can look quite pretty. I am attracted to a full young face. However, most WOMEN are not. In order to be a good surgeon, not only do I have to be technically good nor artistically good but also be empathic with my patients' perspectives.

If I have failed to be empathetic with your perspective, I apologize. I hope you find the right plastic surgeon to help you make you feel and look your best.

I'm glad to hear that that is how you feel. I realize that in a service industry you have to please the customer(even though, like I said, a lot of doctors aren't very good in that department so I am glad you are), but some education can go a long a way. I feel that most women only think the emaciated look looks good because they are fed that all their lives.

It's just how I used to think those competition bodybuilders looked good, but they don't. Muscle is good, but a person isn't supposed to look like a muscle chart. The stuff over the top is there for a reason. I was so dumb I figured your cheek was mainly made out of muscle too. I don't think that most people in our culture realize that fat actually has structural functions in the body. Tans dont' look good either - you can see that they are unhealthy.

So it is one of my missions in life to educate people, and try to help make the world a prettier place.

I find it quite interesting that you think the fat loss is due to sun damage. I wouldn't have thought that. I mean I know that that is supposed to be the cause of a lot of skin deterioration like lines. I guess one thing I still am not clear on is if the fat is considered part of the skin or if some of it is and some is considered separate.

In my case, I think a lot of it is from trying to be too lean to 'cut up' but don't know for sure.

Also, I just wanted to add that above I wasn't trying to say that women can't look good in their 30's because they certainly can. However, I must say I don't know if i have ever seen a man over 25 who looked very good, and that is what I most have a hard time with.

So I guess you are saying then that you don't think you could treat me?

Thanks.

Not that I could not treat you. I just want happy patients who would be happy with me. I thought I had offended you. Perhaps I did not. Obviously, this forum is only a running dialogue for the benefit of the public. It is a poor substitute for a personal consultation. I would have to meet with you personally so both you and I could make that determination. I always look at plastic surgery as a a relationship. I would like both parties to have mutual respect and care for each other before deciding to move forward.
best,
sml