LAM FACIAL PLASTICS

Hi,
Thanks for your blog question. I understand your financial constraints, and I appreciate the limitations of proceeding based on these issues. However, remember that whenever I approach a patient, I always focus primarily on what would actually create a wonderful result for that person period irrespective of monetary concerns, then back down to less than perfect options based on a smaller budget.

Here are my thoughts first on the "surgical" portion, i.e., upper eyelid, fat grafting, and plasma resurfacing. Let's first talk about my perception of upper eyelid surgery. As a standalone procedure, I think this operation is something that is problematic. Yes, 99% of plastic surgeons out there do upper eyelid alone or with a browlift. As you recall from our consultation, this matter is very difficult for me to explain to someone even someone who has already traversed all 1350 pages of my website because initially it is so counter-intuitive. The real problem that occurs with the upper eyelid is deflation and not descent (in the majority of cases) or excessive skin and fat. When one simply removes skin (and God forbid fat too), the eyelid crease moves up too far in most cases and looks unnatural or not like it did when it was more youthful when it was fuller and LOWER. Most people think I am crazy to make a perceptually "heavy" upper eyelid heavier by adding fat to it. But, instead, I am truly converting that eyelid into the full, round convexity of a youthful eyelid. In summary, in order to make an eyelid look less hanging without doing fat grafting, you need to take a lot of skin and (argh!!! fat), which I think makes someone look different and to be honest not truly refreshed. I am a very principled surgeon who derives tremendous pleasure out of making someone look better. Money is not my objective so in the majority of cases I will simply say no if the option is wrong for you. Here is a selfish reason too: I want you to be happy and I can't perform a procedure for you in which you will most likely be unhappy with me.

Okay, this is not all hopeless. Here are my suggestions. Please start with Botox since it is a simple, painless (if I do it) office procedure that will be able to make you look a lot less tired (and help achieve the objective that the upper eyelid procedure that you should NOT do in isolation would try to do and fail) and also at the same time start to provide LONG-TERM benefits in reducing wrinkling and making your skin better. Read my Botox tutorial ([url]http://www.lamfacialplastics.com/learning-modules/botox-plano-dallas-texas3.html[/url]) to understand the long-term benefits of botox not just the short term gains.

Is that it? No, I would have you consider spending a little on Restylane and Perlane but NOT the way that all the other guys do it, i.e., uselessly filling lines and folds but to create the beautiful volume and shape of youth as I simulate what I would do with fat grafting. My results are simply tremendous. Please view my before and after photos with injectable fillers to understand what I can do: [url]http://www.lamfacialplastics.com/before--after-gallery/sculptra-restylane-dallas-perlane.html[/url]

Further, you should watch the time when I was on Good Morning Texas last month (on 9/7/07) [you can either go to the Press videos section or pop open my media center] to understand how I view injectable fillers as a great preview or alternative to fat grafting. If you did the whole shabang of fillers, the cost would be $2000 similar to what you would pay for an upper eyelid but also you would get a tremendous benefit versus one that would be something that I would not be proud to perform for you, most likely. We can also back down on the cost for smaller fills as well. Most Restylane and Perlane fillers last between 6 to 12 months the way that I put them in and where I put them in. They can last considerably shorter in the lips and around the mouth.

We can also offer financing through Care Credit. Just check out the link entitled "Financing Options" under the main menu's "Contact" tab (far right). Bottom line, I would love to meet with you again to decide what options would be appropriate for you. Just wanted to go over the basic principles of how I approach patients for rejuvenation that may or may not apply to you but in most cases it does. If you are out of town, you can call 888-866-3388 for a repeat phone consultation. If you are in town, you can call 972-312-8188 for another in person consultation: I won't charge you for that second consult.

Btw, surgically I am already booked three months in advance. I may have 1 or 2 days left before Christmas but I think everything is pretty much gone. For fillers, I can probably squeeze you in but I would book that appointment sooner than later.

Look forward to hearing back from you,
SML