Dr. Sam Lam Plastic Surgery Forum

Hello. I am a young woman who, at 21 years of age suffered a burn trauma to the face that left me with deep scars due to tissue loss. Upon seeking treatment i consulted with and recieved artefill from an inexperienced, selfish doctor who, while somewhat providing improvment also created an, obvious to me, assymetry. Only a small portion of my face holds this substance as i halted the treatment knowing my injury and knowing he was not injecting directly into that. Indeed, it is a very small portion of artefill in my face. I would like to have it REMOVED, whether scar or not, i am young and want my face back. Where the scar as well as the artefill is has left my face disproportionate . After having the artefill surgically removed, i beleive it is best to have fat transfer. Yes, it is a big enough scar(really a contour deformity with actual fat loss) to warrant so. My question is, is there any hope for me? I am veryo young, heal well, and would do ANYTHING to even just have the slight deformity from artefill corrected. Please help me. Right now i am saving money so i can, hopefully in the near future,have this corrected ( or at least improved visually). Do you have experience removing permanent fillers? Have any of these operations been successful? Thank you for your time. Hopefully i can find a surgeon that will help me someday soon.

hmm this is a hard one:
1. it is very hard to remove artefill without creating more scar and deformity. i can do that for the lips and have done that but have not for the face.
2. fat grafting is not the answer for you for 2 reasons. you are too young and fat is terrible for filling facial holes. dangerous. it CANNOT be treated lke a bioinert substance like artefill. it will gain blood supply and create contour issues if you use it like a bioinert substance. that is very important. PLEASE DO NOT DO FAT. if anyone knows fat i do. i do one almost every day. you are NOT a candidate. stay safe.
i don't have something that i can do for you but you can check out my blog and type in "life in perspective" and read about "the past". it will help your mind in a powerful way. i wish i could help you but it sounds very hard to do at least in my hands.
best,
sml

Thank you Dr. lam for answering my question. One day, when I have the money and resource, i would like to see you in person so you may evaluate my situation. Although your answer was basically 'i cannot help you", i dont feel that would be true given you see the damage in life. I fact it is not holes i have in my face, but contour deformities from loss of tissue and fat. As for the artefill, im willing to take a risk to have some IMPROVEMENT at least. Believe it or not, your honest answer has not deterred me at all, in fact it has encouraged me that you would be the first person i consult with! No matter the time or pace, I will have what is mine again.

Thanks again for your time and honesty!
P.S. Could you explain to me, if you do not mind, the logic behind why fat can be used in older people and not younger people? With it being a more permanent solution in either the old or young what deters me from using it at this point in tme? Just curious to know!

the big problem is in young women who have very fast metabolism that can slow with aging and then you can gain weight in your face. second, if you have not had children yet, there is a risk for temporary fullness in the face that does not look good. in general, i put little fat in younger poeple in areas that are usually not programmed for weight gain so i can do younger people but i need to do a formal consultation. in your situation, it is to fix a hole which IMHO is an absolutely dangerous no no as explained before.
best,
sml