Dr. Sam Lam Plastic Surgery Forum

Hello Dr.Lam,

I've been receiving many recommendations on you in the forums that I visted for Lip procedures. My lips are juat a little bigger than I want them to be and the shape isn't what I want, so I was thinking of getting a lip reduction from you and also since you can't reshape the lips by reducing it I was thinking of getting custom shaped lip implants, is it possible for you to get these ? Any suggestions ?

I also want a rhinoplasty but I want only my nostrils to be operated on so do you do V-Y advancments and wedge and sill excisions ?

Hope to hear from you soon,

Thank You.

First, as far as lip implants, perhaps this answer will be clear: NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO. if you want to read why lip implants no matter how customized is a true nightmare, please watch my video log on why i don't use lip implants, i.e., at least solid ones. i have my girls feel these disasters almost EVERY DAY.

as far as lip reductions, i can trim it non-uniformly so that i can shape your lip well. of course, i would have to see you to make that decision.

for the nose, V-Ys for alar bases lead to unfavorable scarring unless the smile line is relatively deep. this concept is too difficult for non-surgeons who are reading this to get. however, basically, you pull the alar base in by closing down a y shape that creates a scar into the smile line. not great unless you have the right anatomy. the sill works well to reduce the nostril distance like what you would get with a V-Y but at a compromise in nasal shape so most likely you might need a combined Sheen flap alar-base reduction. also, many people either don't need an alar base or would have things worsened if it were performed. also, you might need other areas done instead of or along with alar base to create an aesthetically balanced nose. impossible to relate to you unless we have a consultation, preferably in person.
best,
sml

Thanks for your responce Dr.L , since you have been honest enough and ethical to say no to my decision for lip implants I really think you'd be a really good surgeon for me.

Since implants are out of the question do you think having a permanent injection could change the shape of my lips.

I think the shape is crucial, they look like two big pieces of watermelon to me.

What techniques do you perform where nostrils are concerned ?
I really don't care about the scars they would be a fair trade to me for smaller nostrils.

as far as your lips already looking like watermelons, i am reading that to mean that they are too big so further injections to shape them would only make them look worse. they sound as if a reduction is necessary. i would have to see you to make decisions what would be the best course for you. if they are not too big and you want shape, that is what i do for all lips. i design them with shape. watch my video in the press videos section when I was on Good Morning Texas to understand how I design and shape lips.

As far as nostril reduction, I would truly have to see if you are a candidate. If your central tip is much larger than your nostrils, reducing the nostrils will actually make your nose look much larger. I know that sounds crazy but proportion and artistry are critical. What may seem obvious to you may not be when I do my analysis.

That being said, I use two major techniques to reduce the nostril:
1. a nasal sill reduction to reduce the nostril size itself. however, this can round the outer edge of the nostril more so i would have to see whether you are a candidate. i oftentimes combine this with a Sheen (see below). fortunately, the recovery for this is minimal.
2. a Sheen flap so that i can reduce the flare of the nostril without creating the Michael/Janet Jackson cut-off look, i.e., the curvature of the nose to where it attaches on the face is preserved.

I watched the video on Youtube. You've got a great sence of humour !
My lips are large and they almost don't have a shape, a little like the duck !
But I understand that a lip reduction can't help me get the shape I want only less volume, so I was thinking maybe planning on getting an agressive reduction and then have injections for the shape, so I can end up with the right size and shape too.

Any thoughts ?

that is possible but i just want to have a HAPPY PATIENT. that is more important than anything else. that route will cost a bit more so we would have to figure out first whether you are a reasonable candidate for such a course of action. have you sent me a PM with your photos yet?
best,
sml