Dr. Sam Lam Plastic Surgery Forum

Hi Dr Lam,

I am depressed about the appearance of my face. I need your advise on makeover to make me good looking. Please help.Link to my picture http://www.realself.com/question/eyes-e ... metric-fix

I really need advise how to improve my appearance to look and need your advise . I am 32 and never had a girlfriend and girls get turned off looking at me. I have recently lost 40 pounds and weighed in at 172 pounds. I think that I need the following done just to look attractive:-

1. Smartlipo for double chin
2. Lip Reduction
3. Getting the eyebrows waxed
4. Smartlipo for man boobs( Please send me your email address to send a picture)
5. Getting my lower eyelids raised to remove the scleral show


Thanks for your help.

hi,
i am sorry about your situation. a few things regarding your procedures below:

1. Smartlipo for double chin IF YOU ARE LOSING WEIGHT THEN WAIT UNTIL YOU GET DOWN TO THE SIZE YOU WANT AND YOU MAY NOT NEED THIS.
2. Lip Reduction I CAN SEE HOW THIS COULD HELP YOU IF YOU ARE INTERESTED. THIS IS MY SPECIALTY.
3. Getting the eyebrows waxed OK, MAKES SENSE (SEE BELOW FOR OTHER COMMENTS).
4. Smartlipo for man boobs( Please send me your email address to send a picture) I DO NOT DO BODY WORK SO I CAN'T HELP YOU WITH THIS.
5. Getting my lower eyelids raised to remove the scleral show FIND AN OCULOPLASTIC SURGEON WHO IS BOARD CERTIFIED AND FELLOWSHIP TRAINED TO HELP YOU WITH THIS.

In general, some cosmetic surgery can help you but a lot of what you need will be good grooming (good stylist), getting your body into shape, improving your self confidence, new clothes, etc. Women are attracted to men who are comfortable in their own skin. No matter how good your appearance is, if you do not have self confidence and are comfortable with yourself that will not help you. However, cosmetic procedures may help you feel a lot better about yourself and than can be a good start but you need everything else that I mentioned to attract the opposite sex. Sorry for the dating advice but thought I would throw that in.

Thanks for the reply. I can weigh 160 and have the double chin. I used to weigh 160 and still have the double chin. I am 172 and have a lot in the double chin area No idea why. What do you suggest to do for the lips? My current lip appearance gives me an angry look.

in that case liposuction would probably help. i would consider reducing both upper and lower lips a bit to make them look less ethnic in appearance. if you are interested, just give my office a call: 972-312-8188.
best,
sml

Here's what the flaws on your face are: large space between nose and upper lip, bulbous nose, very weak jawline, weak cheekbones, lip size, lower lids, and fat underneath the chin. I would recommend you to get all of these fixed (with the exception of the space between nose and upper lip) and grow a goatee/beard of some sort to hide that space between your upper lip and nose. I know this is harsh, but it had to be said by someone or else you wouldn't know what to do next. I believe Dr. Lam performs most of the surgeries that I mentioned can help you. DO not get your upper lip reduced(only lower) because that would just increase the space between your nose and upper lip. Also, get your hair fixed by a hair stylist.

thank you for contributing. i would ask that the participants refrain from dispensing medical advice on here and leave that to me if possible. i do not believe a conservative upper lip reduction will lead to a longer upper lip appearance. the risk of doing an isolated lower lip is that the upper lip will look more protuberant.

WantBetterLooks wrote:Here's what the flaws on your face are: large space between nose and upper lip, bulbous nose, very weak jawline, weak cheekbones, lip size, lower lids, and fat underneath the chin. I would recommend you to get all of these fixed (with the exception of the space between nose and upper lip) and grow a goatee/beard of some sort to hide that space between your upper lip and nose. I know this is harsh, but it had to be said by someone or else you wouldn't know what to do next. I believe Dr. Lam performs most of the surgeries that I mentioned can help you. DO not get your upper lip reduced(only lower) because that would just increase the space between your nose and upper lip. Also, get your hair fixed by a hair stylist.

Dr, Do you agree with the flaws in the above post? I missed the above post for some odd reason. I am very unhappy with my looks. Please let me know if you agree. Can you fix the jawline and cheek by fat implants?

hi,
first, i should not have allowed another person to post their opinions on here. this web site is intended for me to respond to someone else's questions and only me. second, i can only improve someone's looks one or two notches. i cannot make someone into a supermodel. third, fat grafting is much safer in someone mid-30s and beyond who has stable weight. if you are early 20s, then fat is not a great option for you in general because i want it to age well for you. obviously, everything is a case by case analysis.
best,
sml

dr. lam wrote:hi,
first, i should not have allowed another person to post their opinions on here. this web site is intended for me to respond to someone else's questions and only me. second, i can only improve someone's looks one or two notches. i cannot make someone into a supermodel. third, fat grafting is much safer in someone mid-30s and beyond who has stable weight. if you are early 20s, then fat is not a great option for you in general because i want it to age well for you. obviously, everything is a case by case analysis.
best,
sml

I am 32 years old. Can you do fat grafting for cheek, jaw, nabial fold and tear trough? Will I need lower lid surgery if you fill the tear trough? Do I need a facelift?

Do you do smart lipo for the chin? Can you fix the nose withough a complete rhinoplasty?


I weigh 162 pounds now and still have bit of double chin. Do you think my jawline will be great if lose more weight and lose the double chin completely?

I am 32 years old. Can you do fat grafting for cheek, jaw, nabial fold and tear trough? Will I need lower lid surgery if you fill the tear trough? Do I need a facelift? IF YOUR WEIGHT IS STABLE AND REMAINS STABLE THEN FAT GRAFTING CAN BE AN OPTION. TYPICALLY IT IS NOT THAT EFFECTIVE FOR THE NASOLABIAL FOLD AREA. FILLERS ARE STILL BETTER. TYPICALLY IF I FILL IT YOU WILL MOST LIKELY NOT NEED LOWER EYELID SURGERY. FACELIFT IN A 32 YEAR OLD? ALMOST NEVER. DOES NOT MAKE SENSE.

Do you do smart lipo for the chin? Can you fix the nose withough a complete rhinoplasty? NO, I DO NOT DO SMART LIPO. I PREFER TO DO A DIRECT LIPECTOMY IN WHICH I REMOVE THE FAT UNDER DIRECT VISUALIZATION. I FIND LIPO IN GENERAL INDISCRIMINATE WHEN REMOVING FAT UNLESS SOME KIND OF LIFTING PROCEDURE IS PERFORMED THE SAME TIME TO SUPPORT ANY MUSCLE EXPOSURE THAT CAN OCCUR WITH OVER LIPOSUCTION. THE MUSCLES I AM TALKING ABOUT ARE THE PLATYSMAL BANDS THAT CAN SHOW UP AFTER A LIPO WITHOUT PROPER SUPPORT TO THE NECK. DIRECT LIPECTOMY ALMOST ENTIRELY AVOIDS THIS RISK. NOSES ARE ALL DIFFERENT. SOME NOSES ARE EASIER TO ACCOMPLISH EXCELLENT RESULTS (THINNER SKIN AND THICKER CARTILAGE). SOME ARE HARDER TO IMPROVE IF YOU HAVE VERY THICK SKIN AND FLIMSY CARTILAGES UNLESS YOU HAVE AN UNDERPROJECTED NOSE THAT NEEDS TO BE AUGMENTED THEN THE CARTILAGE CAN BE AUGMENTED (INCREASED WITH GRAFTS) TO PUSH OUT THROUGH THE THICK SKIN TO MAKE A DIFFERENCE. IN OTHER WORDS, THESE GENERAL QUESTIONS ARE IMPOSSIBLE TO ANSWER BECAUSE EVERYTHING IS DEPENDENT ON YOUR ANATOMY.


I weigh 162 pounds now and still have bit of double chin. Do you think my jawline will be great if lose more weight and lose the double chin completely?

dr. lam wrote:I am 32 years old. Can you do fat grafting for cheek, jaw, nabial fold and tear trough? Will I need lower lid surgery if you fill the tear trough? Do I need a facelift? IF YOUR WEIGHT IS STABLE AND REMAINS STABLE THEN FAT GRAFTING CAN BE AN OPTION. TYPICALLY IT IS NOT THAT EFFECTIVE FOR THE NASOLABIAL FOLD AREA. FILLERS ARE STILL BETTER. TYPICALLY IF I FILL IT YOU WILL MOST LIKELY NOT NEED LOWER EYELID SURGERY. FACELIFT IN A 32 YEAR OLD? ALMOST NEVER. DOES NOT MAKE SENSE.

Do you do smart lipo for the chin? Can you fix the nose withough a complete rhinoplasty? NO, I DO NOT DO SMART LIPO. I PREFER TO DO A DIRECT LIPECTOMY IN WHICH I REMOVE THE FAT UNDER DIRECT VISUALIZATION. I FIND LIPO IN GENERAL INDISCRIMINATE WHEN REMOVING FAT UNLESS SOME KIND OF LIFTING PROCEDURE IS PERFORMED THE SAME TIME TO SUPPORT ANY MUSCLE EXPOSURE THAT CAN OCCUR WITH OVER LIPOSUCTION. THE MUSCLES I AM TALKING ABOUT ARE THE PLATYSMAL BANDS THAT CAN SHOW UP AFTER A LIPO WITHOUT PROPER SUPPORT TO THE NECK. DIRECT LIPECTOMY ALMOST ENTIRELY AVOIDS THIS RISK. NOSES ARE ALL DIFFERENT. SOME NOSES ARE EASIER TO ACCOMPLISH EXCELLENT RESULTS (THINNER SKIN AND THICKER CARTILAGE). SOME ARE HARDER TO IMPROVE IF YOU HAVE VERY THICK SKIN AND FLIMSY CARTILAGES UNLESS YOU HAVE AN UNDERPROJECTED NOSE THAT NEEDS TO BE AUGMENTED THEN THE CARTILAGE CAN BE AUGMENTED (INCREASED WITH GRAFTS) TO PUSH OUT THROUGH THE THICK SKIN TO MAKE A DIFFERENCE. IN OTHER WORDS, THESE GENERAL QUESTIONS ARE IMPOSSIBLE TO ANSWER BECAUSE EVERYTHING IS DEPENDENT ON YOUR ANATOMY.


I weigh 162 pounds now and still have bit of double chin. Do you think my jawline will be great if lose more weight and lose the double chin completely?

Thanks Doctor. I really appreciate your help. Couple more of questions-

1. I got a 11 in middle of my brows. Can fat transfer fix that?
2. My eyebrows are asymetric. Anyway to fix it?
3. I like to do the fat transfer in your office in Dallas. How does it work? I assume that I cannot fly back after the procedure and need some to stay in Dallas. Do you recommend a hotel near by so I can stay? How long do you think I need to stay in Dallas? Do I need to bring a friend or I can come alone?

1. I got a 11 in middle of my brows. Can fat transfer fix that?
NO, THAT IS A BOTOX ISSUE. IF BOTOX CAN BREAK YOUR HABIT, THEN YOU WILL OVER TIME LOSE YOUR 11.
2. My eyebrows are asymetric. Anyway to fix it?
I ALWAYS SAY THE TWO SIDES OF THE BODY ARE NOT THE SAME AND CAN NEVER BE MADE THE SAME. ASYMMETRY IS AN ELUSIVE GOAL.
3. I like to do the fat transfer in your office in Dallas. How does it work? I assume that I cannot fly back after the procedure and need some to stay in Dallas. Do you recommend a hotel near by so I can stay? How long do you think I need to stay in Dallas? Do I need to bring a friend or I can come alone?
YES, WE WILL HELP YOU COORDINATE YOUR TRAVELS INCLUDING VERY REASONABLE HOTELS THAT HAVE FREE SHUTTLE SERVICE TO AND FROM MY OFFICE. IF YOU ARE NOT FLYING IN FROM OVERSEAS I WOULD SAY YOU COULD JUST STAY A COUPLE OF DAYS SINCE WITH FAT GRAFTING THERE ARE NO INCISIONS OR BANDAGES TO WORRY ABOUT. FOR OVERSEAS PATIENTS, SOMETIMES IT IS EASIER TO STAY A FEW DAYS JUST BECAUSE IT CAN BE TAXING TO MAKE SUCH A LONG RETURN FLIGHT BACK SO SOON. YES, YOU SHOULD BRING A FRIEND IF POSSIBLE. O/W YOU WOULD HAVE TO PAY FOR A NURSE TO STAY WITH YOU IMMEDIATELY AFTER THE PROCEDURE. JUST HAVE TO FOLLOW THE RULES OF MY SURGERY CENTER. IF YOU ARE INTERESTED, JUST CALL MY OFFICE FOR THE FASTEST SERVICE 972-312-8188 DURING BUSINESS HOURS 9-5 M-F CDT.
best,
sml

dr. lam wrote:1. I got a 11 in middle of my brows. Can fat transfer fix that?
NO, THAT IS A BOTOX ISSUE. IF BOTOX CAN BREAK YOUR HABIT, THEN YOU WILL OVER TIME LOSE YOUR 11.
2. My eyebrows are asymetric. Anyway to fix it?
I ALWAYS SAY THE TWO SIDES OF THE BODY ARE NOT THE SAME AND CAN NEVER BE MADE THE SAME. ASYMMETRY IS AN ELUSIVE GOAL.
3. I like to do the fat transfer in your office in Dallas. How does it work? I assume that I cannot fly back after the procedure and need some to stay in Dallas. Do you recommend a hotel near by so I can stay? How long do you think I need to stay in Dallas? Do I need to bring a friend or I can come alone?
YES, WE WILL HELP YOU COORDINATE YOUR TRAVELS INCLUDING VERY REASONABLE HOTELS THAT HAVE FREE SHUTTLE SERVICE TO AND FROM MY OFFICE. IF YOU ARE NOT FLYING IN FROM OVERSEAS I WOULD SAY YOU COULD JUST STAY A COUPLE OF DAYS SINCE WITH FAT GRAFTING THERE ARE NO INCISIONS OR BANDAGES TO WORRY ABOUT. FOR OVERSEAS PATIENTS, SOMETIMES IT IS EASIER TO STAY A FEW DAYS JUST BECAUSE IT CAN BE TAXING TO MAKE SUCH A LONG RETURN FLIGHT BACK SO SOON. YES, YOU SHOULD BRING A FRIEND IF POSSIBLE. O/W YOU WOULD HAVE TO PAY FOR A NURSE TO STAY WITH YOU IMMEDIATELY AFTER THE PROCEDURE. JUST HAVE TO FOLLOW THE RULES OF MY SURGERY CENTER. IF YOU ARE INTERESTED, JUST CALL MY OFFICE FOR THE FASTEST SERVICE 972-312-8188 DURING BUSINESS HOURS 9-5 M-F CDT.
best,
sml

Doctor , One of my the other plastic surgeon mentioned that I have retruded cheek bones and
he doubts injectable filler or fat injection is the way to go in your case because of the amount I would need. Thoughts?

Also, Can you just use some filler like Juverderm to see how I look like before doing something more invasive like fat transfer? Can the filler solve my scleral show,lower eyelid, issue? I want to lose 20 more pounds? WIll this be an issue?

1. very very few people need cheek implants in my opinion. all they do is add more bone exposure. i do not find this to be the case with chins. someone with a really retruded chin needs an implant over fat grafting.
2. yes, you can do juvederm first. sometimes though with fillers in place it becomes progressively harder to do fat as more and more filler occupies the area and you then have to try to dissolve it all.
3. as you know, the ONE big risk with fat grafting is weight gain and loss. the real risk is weight gain afterward in which you look too full. if you are planning fat transfer i typically say do it before you lose weight for the risk that you will gain it afterward. typically, if you lose some weight like 15 pounds you don't lose a lot of the fat in your face since i take it from the belly or elsewhere that is more resistant to loss. if you have issues with your weight, forget fat grafting. it is not as safe.
4. scleral show is hard to correct. it may help or you may need eyelid surgery to fix that. not an easy thing to fix in general.
best,
sml