Dr. Sam Lam Plastic Surgery Forum

Hi Dr. Lam--

First, thank you for such an informative website--it is certainly very impressive. You may have answered this question in previous posts, but I was wondering if it is possible for you to give the patient a "preview" of sorts of what fat grafting would accomplish in the lower eyelid/cheek junction and upper cheeks using fillers such as Radiesse and Restylane? Obviously this would be temporary and therefore not as cost-effective in the long-run, but I think it would ensure that the doctor and patient are both on the same page as far as desires. Have you done this, or are you willing to do this? Many thanks!

Mickey D

Hi,
No, I don't think anyone has asked me exactly what you did. But, it is a great question, as I actually use the term "preview" all the time in my lectures and consultations regarding how I use fillers.

Since I use it as a preview, I am not a big fan of using Radiesse since it really messes up when and how I can use fat grafting. In order to make my fat grafting possible in a short or long time after the preview with fillers I use exclusively Perlane and Restylane fillers, which are both hyaluronic acid based products. The reason I prefer to use these fillers instead of Radiesse is that I can dissolve and reverse them whenever you are ready to pursue fat grafting. That makes it much easier for me to know that the product is gone before I put a permanent filler in there as a substitute.

I know how to use 2 to 4 syringes of these fillers to really accurately simulate fat grafting. Also, when you are slightly swollen in the first 2 to 4 days, you will have a better understanding of how fat would look like since I have to create a result for the face with only 2 to 4 syringes of fillers whereas I would use 35 to 50 syringes of fat. Most people that try to smear fillers everywhere don't get maximal simulation of fat. I know strategically zones that I can hit to give you a maximal result with my fillers and thereby still help you preview fat grafting.

Most people do not opt to do the fillers since they are an extra cost that is unnecessary if you understand what I do through the videos and extensive before and after gallery, as well as indepth discussion using your old photographs. Here are the types of people that I do fillers for instead of fat grafting:
1. People that want a preview and are still having a hard time grasping what fat grafting can do for them.
2. People that have a party, social event, wedding or other affair that they need to look good for in less than 2 weeks time.
3. People that cannot take a week to 10 days off from work.
4. People that cannot afford the cost of fat grafting right now and want to try something on to get them over the next year until they can afford the fat grafting.
5. People that don't want any type of "surgery" even though fat grafting is incisionless.
hope that helps,
sml