Dr. Sam Lam Plastic Surgery Forum

Dear Dr Lam, Your web site is impressive - but I wonder why you do not show your case studies in profile and 3/4 view? After all the head is a 3D object and what looks good front on may look different from the side! Also, I suppose your patients have a choice about their pics being publicised, does it bother you if a patient wants to remain private?

Just curious.
LBC

hi,
good questions. the reason most of my fat transfers are shot from a frontal view is that is how we see each other. at times, i have certain requests that i follow to make sure that my patient's requests are adhered to. and finally, 3/4 views actually can show fat results a bit better because of the dimensionality. perhaps i should incorporate that more. i just have an overwhelming number of photos and also many times when a patient comes back in i just shoot their frontal view for lack of time. but i think i shall begin to shoot more 3/4 post shots. of course, every patient that comes in for a procedure has 5 views preoperative shot standard (frontal 3/4 left, profile left, 3/4 right, profile right) plus additional shots as needed (base view for rhinoplasty, animation for botox, etc.) i am NEVER bothered when a patient wants to remain private. it is their right to do so. thank you for the kind suggestion and question.
best,
sml

Thank you for your thoughtful answer.

Still on the subject of photos, I also don't see any 'reference photos', by which I mean pictures of patients when they were younger used as a guide to desired outcome, while they are quite common on some sites. I can see that what matters really is that the final outcome doesn't look drastically different from the patient in their present incarnation, but I wondered to what extent you use old photos in your work. Don't people come to you saying 'I want to look like this again'? Do you ask people to bring you such photos?

One more - if I may -to what extent do you let people tell you what they want, as opposed to you telling them what's good for them?! Sorry if my questions seem cheeky, it's not how I mean them. I'm just interested as it seems to me that communication is the crux of your profession and I wonder how you manage it all.

Thank you for your time and an interesting forum.

LBC

i always try to use old photos. i have a special section of this website that has them. go under "resources", then "learning modules" then "facial rejuvenation" and slide down halfway. you will see a few examples of results with their old photos. the reason i don't have more old photos on this site is several things: people don't always bring in old photos; they are usually very poor quality and hard for me to show you anything with them; to be honest, it is a lot of work to find them in the chart, scan them in then post them. i spend 2 to 3 hours already per day on this site so i guess i have gotten a bit lazy. i will try to remember to do that.

yes, i listen to my patients. always. however, if i feel as if they are going to waste their money or don't see things the way they should, i need to inform them of what would most help them. if you want to see my algorithm for how i approach patients, please watch my video log on how to make safe and effective strategies for plastic surgery decisions. you can find it in my video log section.
best,
sml

Dear Dr. Lam,

I've been thinking about this question, specifically the suggestion that you include our old photos. I am not certain this would be all that helpful, despite it making sense to me that some might think it would.

I am a f/g, plasma, Botox veteran (completely thrilled with results) and the photos I brought to you last year all used optimal, or enhancing light and postures. The photos you take of me never make me look as good as I do with flash. They're not meant to.

I appreciate your approach to before and afters and when I say appreciate, I mean understand the science. I look at my before and afters (with controls) and I see clear improvement. I could walk out into your waiting area and have someone take a flash photo, post it here and readers might think I'd just shaved another 10 years off. (compared with control photo moments prior)

The only way this could work to your specs., that is scientific accuracy and honesty, would be if you'd taken my photo in THAT ROOM (lol, can we just eat cupcakes in there next time?? Dr. L knows how I dislike having my photo taken there) with same light and controls, 10-15 years ago.

Thoughts, Dr. L? Thanks.

I tell you what. I am actually working on a time machine... Valid points. thanks for the input.

I have a time machine and let me tell you, the grammatical confusion it causes is almost not worth it. Try talking about what you are going to do last year..

My point about the old photos was not that they should be regarded as an empirical reference - I agree, only photos taken in a controlled, consistent environment can be that. Trying to make someone look like they did in a particular light/pose etc is fraught with pitfalls. I think Dr Lam will agree with me though, that the old photos we like of ourselves are clues to him as to the features we like to think we have/ had. Maybe these features can be 'returned' to us, maybe not, but they are pertinent in a poetic sense, relating to the artistic side of a cosmetic endeavour and the desires of the patient.

That's all!

yes, agreed. that is why i ask for them from every patient who is going to have facial rejuvenation with me and i make a color copy of them in their chart.
best,
sml