Dr. Sam Lam Plastic Surgery Forum

You've mentioned that occasionally you do touch-ups. When you do these is it more of adding fat to specific areas of the cheek that need more fullness and then leaving other areas untouched or would you add fat all over again the entire area again. Like do you ever do "spot treatments" so to speak?

yes, when i have a baseline fat transfer then i do spot treatments as needed. here is how it works: some patients think they need a touchup but i believe that they will be overfilled. some patients are happy with the results, and i am not. i think they could use more. it is interesting that 80% of touch ups, the patients are actually happy and i am not. i know when it would be safe and when it would not be to perform a fat transfer. an example of something unsafe is someone that has an 80% fill under the eyes and wants no bone exposed there. i find this to be unsafe in many cases. i had a lady recently that i thought her anterior cheek and under eyes did not hit a "tipping point" where when i looked at her i just said wow! in that case, i offered her a free touch up. it has to look good about 20 feet away when you walk in my door and at 5 feet away as a secondary occasion. i honestly do not judge my work at 3 inches. however, that is how people judge my work to try to get the result "better". as the 5% rule video states, it is intended to get the overall picture to a wow. if i don't get there, then a touch up is important. if i have gotten there and am now facing a 10% improvement, i generally recommend restylane because it is far safer than risk an overfill. i will guide you on what i see. hope that helps. to outline the complexity of my thinking in a short response is difficult. just understand that i stand behind my work and very few people need touch ups.
best,
sml

Thanks for your response. Where is this 5% video you mention. I'm not sure I completely understand what you are saying.

first watch all of these videos:
http://www.lamfacialplastics.com/galler ... uvenation/

more specifically these:
http://www.lamfacialplastics.com/galler ... rgery.html

http://www.lamfacialplastics.com/galler ... c.flv.html

http://www.lamfacialplastics.com/galler ... s.flv.html

best,
sml