LAM FACIAL PLASTICS

Dear Dr. Lam,

First of all, I thank you so much for making it possible to ask my questions here.

Following two IPL's, I suffered fat loss throughout the face but the most devastating thing to me has been the damage around the eyes. Not only has the fat loss altered the shape of my eyes (creating extra folds at the inner corner of the eyes) but it has created deep creases in between the lash line and the upper eyelid on both eyes. As strange as it sounds, it's hard to tell where my natural upper lid rests since there are so many deep deep lines in between. It has made me very sad. Additionally, the lower lids are very wrinkled and the upper brow junction is baggy.

I know that you're the world's expert on reconstruction of the Asian face and eyes (I am Asian). Could fat grafting be done between the lash line and the natural upper lid crease? Can fat be grafted to the lower lids or must a blepharoplasty be performed? I know these questions may sound ridiculous and entail something quite risky but I'd like to think that if fat was destroyed in these areas, the addition of it-without the cutting of skin-might be a way to address the deformities that have resulted. Forgive me if I am asking for the impossible or asking something so absurd that it's unbelievable. I just want to know if I should retain any hope of looking normal again. I thank you so much for considering my questions and again, I thank you for the invaluable forum you have created here for everyone.

thank you for the compliments. as far as injecting fat between the crease and the lash line for the upper lid or between the lash line and the bony rim for the lower eyelid, the answer is no. i had a doc whom i have been warning for years not to do it and now he is showing me disasters with fat starting to become visible there. stay safe first. also, i would have to see you to see whether that is even necessary. i know that you are convinced of certain things but i will give you 2 things that you don't have: 1) an unbiased, neutral objective observer perspective, i.e., how someone else sees you, 2) an educated and artistic eye. those 2 things are critical so that i can help you and get you out of your own mental anxiety and depression. not everything is fixable and not everything is WORTH fixing. please go under "1.consult" after the before tab and watch the video on corrective surgery.
best,
sml

Dear Dr. Lam,

I'm astounded and thankful that you answered so quickly and I am truly grateful for your expert professional advice. Thank you for thinking of my safety.

Is there anything that could be done to mitigate the appearance of damage to the eyes in this situation (that is, if you have determined that some aspect of the damage is both fixable and worth fixing)? Brow lift? Fat grafting below the brow? Fat grafting to the upper cheek to maybe take the focus off the eyes? Anything?

Thank you so much for answering the last two questions and for considering this last one. I so appreciate your willingness to share your incredible knowledge and experience here.

Dr. Lam,

I am 42 yrs old & considering fat transfer under my eyes and perhaps for the nasolabial folds that are beginning to appear. I have consulted with an excellent surgeon already and he has explained that typically only 20% to 40% of the fat "takes" or is permanent and follow-up injections are needed. However, it seems that almost none of your patients ever require follow-up. Why is that? The surgeon I have mentioned is located in Houston where I live so I would like to have him perform my fat transfer procedures but after learning of you and your work, the trip(s) to Dallas/Plano would be worth it especially if I never needed a follow-up treatment. So why is it that your success rate is so much higher? Also, if I traveled to your office, how many days would you recommend I remain in your area before traveling home as I know you see patients just days after surgery.

Thanks for your time and all of the inspiration you and your website offers.

first, i can't guarantee you don't need a touchup. just about 90 plus percent don't need one. also, i offer a touchup without a charge if you need it because most likely you won't. technique is everything. but beyond technique is artistry to shape a face appropriately making a woman more feminine in shape and a man more masculine. typically, my out of town fat transfer patients stay about 1 to 2 days. if you are here for 5 days i can laser down any bruising. most don't have much bruising. hope that helps. if you want to schedule a consult and/or procedure, please contact constanze@lamfacialplastics.com or marcy@lamfacialplastics.com.
best,
sml

Dear Dr. Lam,

I don't mean to be impertinent here as that is that last thing I'd want to be. I'm very grateful for the opportunity to even ask questions. My second question to you was quickly followed by another by someone named Vee. You had answered her question and perhaps mine was overlooked. I'm not certain.

You had recommended that I watch your video on corrective surgery and I did! I would actually be so elated if my perception were slightly distorted or even completely wrong and my eyes weren't as bad off as I see them. My question, if I might be so privileged to ask again, was that in the event that you determined that some aspect of the IPL damage around my eyes was both fixable and worth fixing, what are possible options to mitigate the appearance of damage around the eyes (i.e. crepiness, deep creases and wrinkles, sagging skin where previously there was no extra skin all due to fat loss)? For instance, would you do any or all of the following: fat transfer to the brow junction, upper blepharoplasty, lower blepharoplasty, maybe even fat grafting to the upper cheeks to draw attention away from the eyes?

Perhaps it's hard to say without seeing me in person. Nonetheless, even if this question must go unanswered due to too many unknowns, I thank you for this forum and so appreciate the time outside of your already very long day that you invest into helping and educating others like myself.

sorry that i missed your question. i didn't see it. fat transfer will most likely help your eyes and cheek area to fill it out including the brow, upper eyelid, and lower eyelid. however, i do not believe in cutting away the lower eyelid skin to tighten. too much risk to change the eyelid shape contour, which can then be unfixable. if the upper eyelid is a bit crepey, i can trim a small amount of skin but i really would need to see it to make a decision. i know that IPL may have caused it but I use plasma to tighten the skin and botox to manage wrinkles. we can talk more about that when i meet you in the future. hope that helps!
best,
sml

Thank you, Dr. Lam! Yes, your explanation did help and it gives me much hope. I look forward to meeting you in person!