Dr. Sam Lam Plastic Surgery Forum

Hi Dr. Lam,
I am Asian, 27 year old female. Weight stabilized since teen years. Went in to do a full face Fraxel for acne scars (which, in hindsight, were minor and didn't really require laser but was convinced by the derm to do it) and am now 1.5 years later, left with distorted skin texture (looks wrinkly and pores are bigger), indentations all over the face that look like acne scars where i never had acne scars before. My skin is also red all over from broken blood vessels. Not only this, but my face has atrophied too.

I used to have great cheekbones, but due to fat atrophy, one of them is completely gone, and the other cheekbone is significantly decreased in size. My cheeks have hollowed and I look much older than I did before. Before I did the laser, people would tell me I looked like I was 22, 23, and now people just always ask me "Are you tired? You look so tired?".

What are my prospects as a candidate? I've sent you pictures.

i am sorry to hear of your situation. i don't have a clear answer for you in terms of what you can do. skin texture is not an easy thing to fix. doing more lasers to fix the skin problem may not be your desired solution and it may not work as well on asian skin either. as far as the fat loss, you can do a fat transfer but in your age group i would not recommend it just to limit the chance that it would not age well for you as your metabolism changes. sometimes when we are faced with difficult things without easy answers we can open up our perspective on our plight. as viktor frankl, the holocaust survivor, has stated, "when all freedoms are taken from you, you have one freedom left, your attitude." when we are depressed about something, people sense that and oftentimes what they see is not fat loss or tiredness but a depressed, angry person inside. when you begin to forgive the person who did the procedure and more importantly forgive yourself for doing the procedure the first step of real healing will begin. i am sorry that i do not have a great answer for you to fix your situation but hopefully some of my suggestions will not be taken negatively but are meant to help one in the process of healing.
best,
sml

Hi Dr. Lam,

Since the last message, I've tried to plump myself up by eating more to see if I could get face back to its former self just by getting fat.

My face has indeed plumped up but I don't think I can ever look the way I did before without surgery, it looks like the fat loss from Fraxel is permanent.

I'm trying to forgive myself and trying to accept the mistake and move on but one of the main obstacles (amongst others) is that my cheeks have deflated unevenly. It would be one thing if I still had symmetry in my face, I could try to create a new identity (it seems like that is the only way I'll be able to move forward... is to shed my old identity and create a new one with the altered face...) but my cheekbones are noticeably uneven.

Please take a look at the pictures I've sent you. Can you tell me whether it's possible for me to do a fat transfer just to the one cheek to even my face out? I know you said that you don't like to do fat transfers on a 27 year old but if its just treated as a cheek augmentation, what do you think?

My parents are still thin. My mom actually has her great cheekbones still, there's been no fat loss in her face, just sagging of the jowls. What other information do you need to assess the possibility?

i would honestly perhaps use a permanent product like artefill which at least would not have metabolic issues with weight changes especially if i am just doing one area. that is what i would recommend in your case. you would need a skin test for that first (28 days before at a minimum). for a small area of deficit, it would be much cheaper and possibly safer in your case.
best,
sml