LAM FACIAL PLASTICS

Hi Dr Lam,
I've a few queries that i hope you can help me:
Q1)When you doing the cheeks, do you just inject fillers on the anterior cheeks and the outer cheeks as well? What's the difference if you just do the anterior cheek only?

Q2)As for the eye area to look less tired and more rested,can we just do the outer eye area but not the tear trough area?what is the effect if only outer eye area is being filled only:D

Have a Good Weekend

Q1)When you doing the cheeks, do you just inject fillers on the anterior cheeks and the outer cheeks as well? What's the difference if you just do the anterior cheek only?
YES, I DO THAT AT TIMES WHEN I AM TRYING ARCHITECTURALLY TO NARROW THE FACE. FOR EXAMPLE, SOMEONE HAS A RELATIVELY WIDE FACE, I WOULD DO THAT ON THAT INDIVIDUAL, I.E., NOT PUT FAT IN THE OUTER CHEEK. ALSO MANY KOREANS, SOME VIETNAMESE, AND FEW CHINESE HAVE A WIDE FLARED CHEEK BONE (OUTER CHEEK) THAT I DON'T PUT FAT IN OR PUT VERY LITTLE FAT IN TO CREATE A SLIMMING EFFECT TO THAT AREA. THAT IS PART OF MY DESIGN WORK. ALSO, I HAVE PEOPLE THAT HAVE UGLY CHEEK IMPLANTS AND DON'T WANT THEM REMOVED SO I FILL THE ANTERIOR CHEEK ONLY TO OFFSET THE UGLINESS. I RATHER FILL THE OUTER CHEEK AND CREATE A NICE CONVEX HIGHLIGHT BUT IN THE EXCEPTIONS ABOVE, I DON'T.

Q2)As for the eye area to look less tired and more rested,can we just do the outer eye area but not the tear trough area?what is the effect if only outer eye area is being filled only:D
HMM, THAT IS AN ODD REQUEST. USUALLY AS WE HOLLOW THE WORST IS IN THE TEAR TROUGH AND SOMETIMES THE OUTER EYE IS NOT HOLLOW AT ALL SO I DON'T FILL IT VERY MUCH IN CERTAIN CIRCUMSTANCES. SOMETIMES THE HOLLOWNESS IS WAY OUTSIDE NEAR THE OUTER EYELID AREA CALLED THE "LATERAL CANTHUS". I FREQUENTLY FILL THAT AREA TO ACHIEVE BALANCE IN THE LOWER EYELID. OF COURSE, THERE ARE ALWAYS EXCEPTIONS SO I WOULD HAVE TO SEE YOUR EYELID AND FACE TO TELL YOU THE ANSWER TO YOUR PARTICULAR SITUATION. IN GENERAL, YOUR REQUEST IS ODD BUT I WOULD NEED TO MAKE SURE THAT I WOULD HELP YOU RATHER THAN HURT YOU IN DOING YOUR REQUEST.
best,
sml

Thanks for your prompt and professional reply.As for the odd request,i've experienced filling up my tear trough and outer eyelid area but it created an undesired dark circles and lumpy eye area.
So im skeptical having to inject the tear trough.
Q1)But can one achieve an at least a 10years younger look using fillers,but not injecting the eye area,instead inject on cheeks and buccal area if necessary?


rgds,
Desky

the lumpy result is 100% technique. that is why i go deep with cannulas for both fillers and fat. i really see consistently smooth results. that being said, yes in many cases, you can look a lot better even if i don't hit the lower rim BUT I NEED TO SEE YOU to make that decision. in most cases, i would still recommend my doing it. simply put, i am much better. sorry for the arrogance, but i know your fears. i have seen too many bad results under the eye (but not from me.)

Hi Dr Lam,usually do you need to dissolve the previous fillers first if its a different brand name compare to the new filler you going to inject on same area? can they be mixed?

Have a gd day

if you are going to add fillers on top of fillers, you should be fine. no need to dissolve unless the previous work is bad. then i would not refill the same day o/w you will dissolve my fillers at the same time plus, i need to see how much is filler and how much is you. ideally for those who live in dallas, i wait 5 to 7 days so that any small swelling will not be present. for out of town individuals, i usually would inject it the following day if i had to dissolve the previous work. remember if your previous work is fine, then i can add to it without dissolving.

hi dr Lam,
noticed there are 2 ways of injecting fillers.
One is to inject more superficially but afterwhich your face will swell and bruise for at least 5 days.Another type is to inject deeper,hence no swelling and minimal downtime.

For a layman like me,I just wonder if the 2nd example is done by a more experienced doctor? and the fillers in the 2nd eg. will last longer since it's being injected deeper into our skin?

regards,
Desky

i don't think a deeper injection would lead to less bruising. i think the # of passes can lead to more bruising. the depth can affect how smooth the result is. sometimes deep injections can last longer sometimes actually less long. longevity is more dependent on the product (perlane instead of restylane) and areas with less movement (cheeks versus smile lines). i go deeper depending on the area i am hitting. very deep - lower eyelids (for smoothness), medium depth - cheeks and chin, right near the skin when i am trying to lift a ligament (malar septum prejowl) or crease (fold or scar).
best,
sml

do fillers have a 'dwn time' even though there's no bruising and swelling after injecting? when will the face be the look we want,like how much time the fillers need to settle under our skin?



Thanks Dr Lam!Have a good weekend

everyone one is different. because sometimes you really need 20 to 30 cc of fat, the filler result can actually look better immediately after injection since the swelling can make up for the difference between fat and a limited filler. however, in many cases people only notice the swelling and are concerned. i would say minus bruising the swelling with volume-based fillers may have a 2 to 3 day "recovery" that really typically is not that bad.
best,
sml

Wishing you a joyous xmas and a wonderful year ahead!!

thank you! you too!!!

Happy New Year to you Dr Lam!

In order to fill up the cheeks to look a decade younger,how much fllers will you normally inject to consider minus the swelling effect and be enough?

Is 2 bottles of restylane enough for both cheeks?


Cheers,
Desky

it depends on how old you are, how i place it and where i place it. i know how to get a result in a cheek with half a syringe each that most doctors cannot get even with 1 syringe a side. can't give all my secrets out here!

Dr Lam,
I've done fillers on cheeks before but noticed that the laughing lines(the line from corner of nose down to outer lips) still obvious and also the lines from lips to chin is obvious too.

Q. Does this means that the cheek has not been fully filled up? ie..not enough fillers in cheek hence the lines are still obvious?

hope u can help me answer my query.

cheers,
desky