Dr. Sam Lam Plastic Surgery Forum

Hi Dr Lam!

I've watched your video about creating a balanced cheeks - it was very informative, thank you! I found the section about blending away the "stripe" of the lower cheek to be most interesting.

I'm curious to know if injecting fat or fillers to the cheek actually creates a mild cheek-lift? Compared to the Endotine midface-lift where (as you know) the fat pad is released and repositioned back to a more youthful position, how can a similar effect be achieved with adding volume?

In the instance where a person has heavy lower cheeks and a prominent nasiolabial fold, how do you add volume without making the person appear to be storing walnuts in their mouth & cheeks? (I refer to Fergie the pop singer - I understand if you cannot elaborate on this Dr Lam! However, to me, she appears to be filled in the cheek area, but it doesn't give her that "triangle effect". She looks distorted and overly full in the whole face).

Does the malar fat pad move down due to gravity over the years? Or does muscle lose tone too? Or is overall volume loss in the upper cheek responsible for making the sagging cheek pad look worse?

Thanks so much Dr Lam

ANSWERS ARE IN ALL CAPS FOLLOWING THE QUESTIONS:
I'm curious to know if injecting fat or fillers to the cheek actually creates a mild cheek-lift? Compared to the Endotine midface-lift where (as you know) the fat pad is released and repositioned back to a more youthful position, how can a similar effect be achieved with adding volume?
MUCH BETTER. I SIMPLY DO NOT BELIEVE IN MIDFACE LIFTS EVEN THOUGH I WROTE A BOOK ON THEM YEARS AGO. IN THE VIDEO, RETHINKING GRAVITY (GO TO THE FAT GRAFTING PROCEDURES PAGE AND CLICK ON THE VIDEO LINK AT THE BOTTOM OF THE PAGE) YOU WILL SEE WHY I SIMPLY DO NOT BELIEVE IN THEM AT ALL. WE DO NOT SUFFER MIDFACIAL DESCENT BUT WEIGHT GAIN AND LOSS IN THE CHEEK, OR A COMBINATION OF BOTH. LIFTING A CHEEK SIMPLY DOES NOT CREATE A VOLUMETRIC RESULT THAT IS A TRUE REFLECTION OF AGING. I EVEN DID A 3 WAY BLINDED STUDY ABOUT 9 YEARS AGO AND FOUND THAT MIDFACE LIFTS DO NOT CHANGE THE NASOLABIAL FOLD EITHER, AT LEAST NOT IN THE LONG RUN.

In the instance where a person has heavy lower cheeks and a prominent nasiolabial fold, how do you add volume without making the person appear to be storing walnuts in their mouth & cheeks? (I refer to Fergie the pop singer - I understand if you cannot elaborate on this Dr Lam! However, to me, she appears to be filled in the cheek area, but it doesn't give her that "triangle effect". She looks distorted and overly full in the whole face).
A FAT CHEEK IS UGLY. AN OVERWEIGHT WOMAN WITH A SAGGING HEAVY CHEEK IS ALSO NOT ATTRACTIVE. THE ARTISTRY IS TO BLEND THE UPPER CENTRAL CHEEK TO BALANCE THE LOWER CHEEK. THAT IS WHERE A GOOD EYE, RESTRAINT, JUDGMENT, AND EXPERIENCE WILL HELP. I HAD A LADY WHO HAD A FAT TRANSFER DONE CHEAPER THAN ME AND CAME BACK IN TEARS. HER FAT WAS PLACED PRECISELY WHERE I WOULD NOT HAVE IN HER BECAUSE SHE IS ASIAN. IT MADE HER FACE LOOK SQUARER, MORE MASCULINE AND FATTER. I LITERALLY DIVIDE THE CHEEK INTO ABOUT 8 SUBZONES: ANTERIOR HIGH CHEEK, ANTERIOR MAIN CHEEK, LATERAL CHEEK, EXTENDED LATERAL CHEEK, SUBZYGOMATIC BACKFILL, CENTRAL BUCCAL, MEDIAL BUCCAL HOLLOW, EXTENDED BUCCAL. SO YOU SEE THE ART IS PUTTING JUST THE RIGHT AMOUNT IN THE RIGHT PLACE IN THE RIGHT COMBINATION.

Does the malar fat pad move down due to gravity over the years? Or does muscle lose tone too? Or is overall volume loss in the upper cheek responsible for making the sagging cheek pad look worse?
WATCH MY VIDEO AGAIN ON RETHINKING GRAVITY. IT WILL ANSWER THOSE QUESTIONS.
Thanks so much Dr Lam
Aussie-jane

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Joined: Sat Feb 14, 2009 10:03 pm