Dr. Sam Lam Plastic Surgery Forum

Hi Dr Lam,
sorry for all the questions but I have a long way to travel, so trying to get as much covered as possible.
In addition to cheeks and eyes I am in need of fat around my chin, jaw and temples - you can see my veins in my temples....I know you typically do not like doing temples but when the skin has thined as much as mine has is fat a good vehicle to fix? thermage also left me with significant fat loss on and around my chin plus marrionette lines and poc marks. My undertanding is fat will not correct the marrionette lines but Can Fat minimize the lines? how long is the wait betwen fat and silicone?
And how does the silicone stay in the place it was injected vs floating away?

thx

sorry for all the questions but I have a long way to travel, so trying to get as much covered as possible.
In addition to cheeks and eyes I am in need of fat around my chin, jaw and temples - you can see my veins in my temples....I know you typically do not like doing temples but when the skin has thined as much as mine has is fat a good vehicle to fix?
YES, I DO TEMPLES ALL THE TIME. I AM JUST MORE CONSERVATIVE WITH VOLUMES. AND YES, CHIN, JAW ARE CRITICAL. ABSOLUTELY CRITICAL.

thermage also left me with significant fat loss on and around my chin plus marrionette lines and poc marks. My undertanding is fat will not correct the marrionette lines but Can Fat minimize the lines?
NO. FAT IS TOO SOFT TO MAKE THAT CHANGE. GREAT FOR CONTOUR. BAD FOR FOLDS. I USE SILICONE AS A PERMANENT INJECTABLE FOR THOSE LINES OR PERLANE AS A SHORTER FIX. NO SOLID IMPLANTS, WHICH FEEL AND LOOK UNNATURAL.

how long is the wait betwen fat and silicone?
MINIMUM ONE MONTH IF WE ARE TALKING FOLDS. BUT IF YOU ARE FROM FAR AWAY I WOULD JUST WAIT 3 MONTHS OR SO FOR MOST OF THE SWELLING TO BE GONE AND SO THAT I CAN GET A GOOD READ OF WHAT IS LEFT TO DO FOR LINES. I GENERALLY STILL NEED 2 TO 3 ROUNDS TO GET THE JOB DONE.

And how does the silicone stay in the place it was injected vs floating away?
SAME WAY THAT FAT DOES BUT I HAVE TO BE EVEN MORE DILIGENT. TINY DROPLETS ARE PLACED AND COLLAGEN KEEPS EACH PARTICLE IN POSITION. THAT IS WHY THERE IS A MINIMUM OF ONE MONTH BETWEEN SERIAL INJECTIONS WITH SILICONE. IF YOU SQUIRT BIG VOLUMES IN SHORT PERIODS THAT IS WHEN YOU HAVE A PROBLEM. I DON'T SEE THOSE ISSUES BECAUSE OF THE SERIAL APPROACH.
no problem with the questions. if you have more questions, i shall answer them. i am a BIG-TIME EDUCATOR. i want you to have no more questions left before you schedule a procedure with me. don't worry, ask away!
that is why i am here.
best,
sml