Dr. Sam Lam Plastic Surgery Forum

Dear Doctor
A) What do you prefer as filler for the cheek area (only to slightly fill them): PMMA (polymetacrylate sp?) OR reticulated hyaluronic acid? Which one is the safest? Which product would you choose yourself? Or none of these?
B) Some dermatologists use lypolitic substances to dissolve small fatty areas/"bags" in the undereye area. Do you think that is a safe procedure??

Hugs!

A) What do you prefer as filler for the cheek area (only to slightly fill them): PMMA (polymetacrylate sp?) OR reticulated hyaluronic acid? Which one is the safest? Which product would you choose yourself? Or none of these?
"reticulated"???? cross-linked you mean??? all HAs are cross-linked but perlane is cross-linked more for greater durability but too thick around the eyes. i like perlane and restylane. if you want to know why i don't use PMMA, please watch the video log entitled, "Why I Don't Use Artefill". It says it all. You guys use Metacril down in South America. I like that product even less than Artefill. At least Artefill has some bovine collagen to allow the beads to gradually be ingrown by your own tissue as the bovine collagen dissipates. Metacril is just a solid brick of PMMA. So if I don't like Artefill, you can figure what I think about Metacril.
B) Some dermatologists use lypolitic substances to dissolve small fatty areas/"bags" in the undereye area. Do you think that is a safe procedure??
NO, NO, NO, NO. 4 CASES OF BLINDNESS IN CALIFORNIA. DO I MAKE MYSELF CLEAR???? NO! You are talking about Lipodissolve (deoxycholate, etc.). Okay for the body. Not okay behind the eye's orbital septum. Don't do it.

Great!! I mean, of course it is not great that those procedures or products are out there (and that people are not warned enough), what I am is that I feel relieved, because I suspected you were against PMMA injections and the lypodissolving substances too! :) A friend of mine had been wanting to get fillers and the doctor had suggested the use of PMMA for cheeks and some lipolytic substance for some undereye bags. When I heard about it I told my friend to not go ahead and cancel the appointment, that I thought it was just too risky. I personally only have used Restylane and Botox and suggested her to go for simple Restylane and find a doc who would suggest a way to use the filler injected in a way that it would fill in areas that would get to conceal the "bags", versus "dissolving" them.
But since I am no expert, and was not totally sure that the substances you spoke of and the ones she was suggested were the same, I wanted to double check with you. Now I feel happy I told her adamantly to not go ahead with the appointment. :) I will show her your post and then the video. I was not sure the substances you we were speaking of were the same, because of the brand names being different.
Thanks :):)

one more thing: not to frighten you, you really need to go to a respected doctor and make sure that the Restylane is real. I have had 2 cases of "fake restylane" from South America that I have had to fix. Let me clarify: not Restylane that I injected because I only use real products but I am talking about unethical doctors who are buying fake Restylane, which in the U.S. is a crime punishable by jail time. Recently, the fake botox in 2005 that led to 4 people on respiratories for months and near death led to a calvary of arrests with doctors going to jail for 2 years a piece. Go to a doctor with a good reputation. If you are not certain, make him show you the box of Restylane and correspond it with Medicis' inventory. I am only telling you this because I am also worried about how injectables are done outside of the U.S.

Thanks for the warning and reminder.
Thank God, in my country, in particular, the Health services are a lot more strict than in others and that happens only rarely... and usually in cities by the frontier with the other countries.

Personally, I go to two docs, one writes the prescription, calls the lab and then makes YOU go pick the product directly from the laboratory that imports the product, so you see yourself it is the original product, you get the whole sealed packaging, etc. and then have to bring in the product with you to the derm's office, where the package is opened in front of you, where the date and procedure are written in the box, where the used syringue is discarded and where you leave with the box of the product + the info so you have with you the proof of what you had injected, and, written there, how much, when, etc.

The other is one that gets himself the products from the laboratories but is very adamant about using "original" products that are opened there in front of you, etc.

Thanks anyway, that sort of reminder is always good, not just for me but so I say this to others, because others might not find all these things as things so obvious to be concerned about.

Hugs!

to me that is amazing!!! i don't even do that. but my patients trust me here to only use real products. thanks for sharing.