LAM FACIAL PLASTICS

Hi Dr. Lam,

I hope you, your mom, and your staff had a great Thanksgiving holiday! This year my mom, sister, and I roasted a turkey that actually WASN'T dry and rock-hard like in previous years...

Anyway, the three of us drove up to Dallas and spoke with you about fat grafting for my mom (and KTP for our skin redness). Since there were so many of us, my mom didn't get to ask you as many things as she wanted to ask you now that she is seriously considering getting facial fat grafting. So, here are her (many) questions and concerns:


1) Side Effects

From reading your forums and talking to you, I know right after the surgery there is about a weeks worth of swelling and bruising in the face. Does this swelling and bruising also apply to the areas where you extract the fat? How would you rate the post-op pain on a scale of 1-10, with 10 being the most painful? And, what is your worst case scenario in terms of how long the swelling and bruising and distorted look last? How long does it generally take for the fat to sort of..."mold" into your skin and look natural?

If my mom were to get the procedure done, it would most likely be in mid-January. However, we are planning to move to Taiwan in late-February for about half a year. Would she look somewhat normal by then? And would it be safe to travel and be away from you? Basically, I just want to know that if she gets this procedure done, she'll be okay (and presentable) if she goes somewhere else for a long time with no access to you in case something happens.

She felt really confident about the procedure after talking to your mom, but after looking at some post-op videos on your website, she chickened out a bit!


2) Long Term Effects

Approximately how long would the results from the fat grafting last? Why do some people say that fat will just get reabsorbed when you say the fat graft can have permanent results? My mom is also concerned about whether different parts of her face will re-absorb the fat at different rates...like if one cheek absorbed it more than the other and she ended up looking like a lumpy weirdo.

And what would happen if she gained weight? It's unlikely that she would because my grandparents are rather thin and gaunt, but if she does gain weight, would it make her face look too large? And if she lost weight, would the fat grafts start to protrude unnaturally? My mom also has (what I think is) an irrational fear that the extra fat in her face after surgery would increase the gravitational pull on her skin and cause it to sag even more with time.

I also noticed that your before and afters are mostly people who are 2-3 years out from surgery. How come there aren't any that are, say, 5 years out? Or 10 years out?

I know that if my mom got the fat graft at age 50, it would make her look like she was 40 and she'd start aging at age "40" even though she was actually 50. So, does that mean in another 10 years, when she's actually 60 but looks "50" (assuming she ages at her natural rate), she's going to have to get another fat graft to keep her looking a decade younger? And how do these touch ups work? Would they be like the first fat graft? Or could they just be injected like you would inject Botox?


Whew! Okay, sorry, those were a lot of questions! I hope they don't take out too much time from your day to answer!

Julie

1) Side Effects

From reading your forums and talking to you, I know right after the surgery there is about a weeks worth of swelling and bruising in the face. Does this swelling and bruising also apply to the areas where you extract the fat? How would you rate the post-op pain on a scale of 1-10, with 10 being the most painful? And, what is your worst case scenario in terms of how long the swelling and bruising and distorted look last? How long does it generally take for the fat to sort of..."mold" into your skin and look natural?
FAT GRAFTING IS SIMPLY NOT A PAINFUL PROCEDURE. OBVIOUSLY, WE ALL HAVE DIFFERENT PAIN TOLERANCES BUT IT IS NOT PAINFUL. THE AREAS WHERE THE FAT IS EXTRACTED ARE IN THE LOW NUMBERS BUT CAN BE A BIT MORE SORE LIKE YOU WORKED OUT AT THE GYM FOR A COUPLE OF DAYS BUT IT DOES NOT HURT IN THE CLASSIC SENSE. FACELIFTS ON THE OTHER HAND CAN BE QUITE SORE FOR 3 TO 4 DAYS. WE ARE NOT TALKING ABOUT THAT. HOW LONG IS RECOVERY? IMPOSSIBLE FOR ME TO SAY BECAUSE WE ALL HAVE DIFFERENT EXPECTATIONS. MY WORST CASE SCENARIO WAS A LADY WHO WAS UPSET AT ME AT 4 WEEKS BECAUSE SHE THOUGHT SHE WAS TOO SWOLLEN. SHE SENT ME AN APOLOGY AT 6 WEEKS. MOST PEOPLE DON'T LIKE HOW SWOLLEN IT IS FOR 2 WEEKS, BUT I CAN'T PROMISE YOU EXPECTATIONS. WE ALL DIFFER IN EXPECTATIONS. REMEMBER WHAT I SAID, YOUR MOTHER WILL PROBABLY NOT LIKE IT FOR 1 TO 2 WEEKS THEN AT 4 TO 6 WEEKS WORRY THAT IT LOOKS GOOD BUT MAY GO DOWN AND IT MOST LIKELY WILL, THEN COULD BE DISAPPOINTED AT 3 TO 4 MONTHS WHEN THE SWELLING IS DOWN BUT THE RESULT HAS NOT KICKED IN AND START TO INCREASINGLY LIKE THE RESULT FROM 6 MONTHS TO 18 MONTHS AND THEN IT WILL PLATEAU THEREAFTER.

If my mom were to get the procedure done, it would most likely be in mid-January. However, we are planning to move to Taiwan in late-February for about half a year. Would she look somewhat normal by then? And would it be safe to travel and be away from you? Basically, I just want to know that if she gets this procedure done, she'll be okay (and presentable) if she goes somewhere else for a long time with no access to you in case something happens.
YES, 60% OF MY FAT GRAFTING FLIES IN AND LEAVES WITHIN A DAY OR SO. I JUST DID A GENTLEMAN WHO CAME FROM AUSTRALIA LAST WEEK WHO LEFT 2 DAYS LATER. THE BEAUTY OF FAT TRANSFER IS THERE ARE NO INCISIONS, NO CUTTING, NO BANDAGES, AND REALLY NO AFTER CARE. I THINK SHE SHOULD (NO GUARANTEES) LOOK PRESENTABLE BY LATE FEBRUARY.

She felt really confident about the procedure after talking to your mom, but after looking at some post-op videos on your website, she chickened out a bit!
GOOD, IF SHE CAN'T HANDLE HAVING SOME SWELLING FOR 1 TO 2 WEEKS, THEN SHE SHOULD NOT GO THROUGH IT. SHE NEEDS TO FIGURE WHETHER 2 TO 3 WEEKS OF SWELLING WITHOUT ANY REAL DISCOMFORT IS WORTH 20 YEARS OF LOOKING BETTER. THAT IS A TRADE OFF THAT MUST BE REAL IN HER MIND OR SHE SHOULD NOT DO IT. MY GOAL WITH THOSE RECOVERY VIDEOS IS BALD HONESTY, IN YOUR FACE RECOVERY VIDEOS SO THAT THERE IS NO MISTAKING WHAT A RECOVERY CONSTITUTES. I RATHER YOU GET UPSET WITH ME BEFORE YOU DECIDE THAN AFTER. FULL DISCLOSURE IS ESSENTIAL TO A TRUSTING RELATIONSHIP.

BTW, I AM ALREADY BOOKED OUT INTO MID-JANUARY. I HAD 3 BOOKINGS TODAY. I WILL PROBABLY BE BOOKED INTO FEBRUARY WTHIN 1 TO 2 WEEKS. IF YOU REALLY NEED MID-JANUARY I WOULDN'T WAIT PAST THIS WEEK. I MAY ALREADY BE INTO LATE JANUARY. CHECK WITH MARCY OR CONSTANZE ON THAT. LOOKING FORWARD TO TAKE CARE OF YOU WHEN YOU ARE READY.
ALL THE BEST,
SML

Dr. Lam, I hope you won't mind my slipping in here to tell how much I love the KTP. (mentioned above in thread) I might like to have one here in my home!

13 mos. ago, you zapped a spot for me, a spot that had become the bane of my morning routine. You cautioned that it might return. It's still well gone. Thank you.

Best!

so glad to hear that. it is a great laser for red issues in particular.

so glad to hear that. it is a great laser for red issues in particular.