LAM FACIAL PLASTICS

Dear Dr. Lam,

I recently had a buccal fat removal that I wasn't entirely happy about (though it did make my face thinner...); is there any way to "reverse" this procedure to some degree? I don't want to look as chubby as I originally did, but some more fat back in my cheek hollows would be nice. I know there's no way to replace the buccal pad itself, but are there ways of inject fat back into the cheek that at least mimic the look of the buccal sucking pad? Thanks so much, and have a great one!

P.S. On a semi-related note, my nasolabials also became much worse after the fat removal...some surgeons have suggested that I inject this area with fat. I know you're against injecting fat into lines...can you explain why this isn't such a good idea? (I tried browsing around the site but couldn't find the blurb. )

Best,
GY

yes, i can put fat back into the buccal area. in general, i do not like just putting fat into one area of the face. i have done it before to correct previous surgery done elsewhere. in general, fat harvested from the belly/thighs is different fat and very robust, i.e., you should not lose the fat. also, that fat could be more sensitive to weight fluctuations. therefore, when i do fat transfer in most cases i prefer to do it more evenly than just filling a hole. however, i would have to see your situation to make that judgment. yes, i do put fat into lines during almost every case but fat is too soft to lift the physical line up and make a consistent difference there. i put fat into lines in order to soften the transition from an augmented cheek to the upper lip but not to get rid of the line, which is very hard to consistently achieve with fat. hope that helps.
best,
sml

Thanks so much for your prompt reply! Would you happen to know how long the fat graft will last, and the percentage, approximately? Additionally, would you mind if I sent you a pm with my pics for a virtual evaluation? What bothers me is not just the slightly sunken/sagging cheeks from the buccal fat removal, but also the jowling that's beginning near my mouth. This makes my entire face look wide and square (more so in real life than in the pictures, since my camera seems to make things look "skinnier" than they actually are) and to the point where I can't put my hair behind my ears! What would your suggestion be for these droopy "chunks"? Minilipo?

Thanks again, and hope to see you in the future.

Best,
G

honestly, your words you wrote to me in a PM, "if it ain't broke, don't fix it" holds true in this situation. based on the photos, i would be hesitant to do anything. you are young, you have a full face, i don't want to do selective fat transfer. i honestly don't think it would be safe in the long run. you also don't have a discernible deformity that i can see. not to make you upset, but you might consider reading the book The Broken Mirror about self-identity issues. Again, if you are offended, I'm sorry but I want to stay safe with you.
best,
sml

Thanks! I understand. It's definitely not just my imagination though, as my family has commented on the sightly "sunken" look after my bfr--this is actually more evident when I talk or move my face vs. holding my head still for pictures. I definitely had a cuter look before the buccal fat pad came out, and I kind of miss that, which is why I was wondering if it was possible to put the fat back in. Is there really no hope? Maybe an in person consult would be more demonstrative in showing the problems I'm talkng about, but if you're certain, then I acquiesce to your opinion. Have a great one!

I really think in your situation, adding fat might not be a good idea given all the reasons I enumerated. I am not talking about short term safety but long term safety. I select my patients very carefully. I can see you in consultation but my answer most likely will be no. Have you seen the following video and blog? Please read and watch them:

lamfacialplastics.com/lfp-blog/questions/lam-facial-plastics/life-in-perspective-part-1-of-4-your-past/801

lamfacialplastics.com/plastic_surgery/dallas/content/view/1703/425/

i hope that is a good start.
best,
sml

Thanks agin! I visited the links, and understand what you're trying to say. Just one final question: what would be the safety concerns of adding fat now? More sagging later? That is, are the safety concerns about my age alone (i.e., I shouldn't get any fat grafting in my twenties)? I know I mentioned not adding any fat to the upper cheeks, but as you may have noticed in the pictures, I really do have very little anterior projection in those areas. So if I decided to at another time, would it be reasonable to add fat to the anterior region of my face? Hopefully this will be my final post (I know you must be busy!!!)--thanks once more, and have a great week!

yes, it is your age and also the fact the fat i put in there is "selective" to fill a hole, which i am against. i tend to do full face fat transfers that allow me to blend the fat. i am always afraid that by just putting some fat in the buccal area that it might grow disproportionate to the other fat since it is from the belly and done in isolation. if you were in your 30s and i had other areas of fat loss it would be reasonable. also looking at your photos, i do not see any need for buccal or anterior cheek fills IN YOUR CASE. give it 10 years, then we can talk. sorry that i can't help you, but to be honest your face does not need anything.

best,
sml