LAM FACIAL PLASTICS

I am a 36 yr old female. Over the past year and a half I have had 3 full face ipl/rf (fotofacial) treatments (with a syneron aurora)for sunspots and freckles. I have pale white skin that burns easily and freckles easily too.The first 2 times I had good results. Though I had a few hyperpigmentation spots on my forehead and chin.

But the last time I had it done., which was 6 months ago now(sep 08),I got 2 burns on my face, Now 6 months later my face has white scar like spots (small and round)on it in several different spots. I also have a few indentation(pock like) marks. My pores look larger and my neck has gotten saggy (around my jawline) and loose looking. Could the sagginess and loose skin be due to fat loss? I have always looked young for my age so this alarming to me! Also do you think things will improve with time? I`m very upset and concerned.

I can send you a before and after pic if you'd like. Just tell me where to send it.
Thank you.

Although I am a fat grafting specialist, I am not one to comment on injuries following IPL. I think it is dangerous for me to suggest that you did or did not have such a consequence. If there are pock marks, that should not be fixed with fat. As I always say, fat is a live graft and must be treated with respect. Fat can be used to restore overall balance and fat loss whether due to aging and/or IPL, as I have done it for both. I think IPL fat loss that can be documented through photographs in a short time frame (weeks to months) makes sense that a result of such a kind was due to an intense IPL. The thing that I don't get is fat loss over several years that is most likely due to aging. I can document in my patients fat loss almost every single year due to aging. Granted usually not significantly noticeable until 2 to 3 years have gone by but my fat grafting pulls someone back typically 10 to 20 years so the further aging is usually not detectable in most cases. okay, sorry, i was just making some general comments here that i think the readership should know. in your case, if you are suffering such fat loss and you are done with your fat loss (that is hard to say when. take consistent photos), then i could be able to help you so long as the fat transfer is done safely as mentioned above.
love and respect,
sml

Thank you for your quick responce Dr Lam. I have sent you a picture of me taken last year before ipl and pictures taken of me today. Maybe it's all in my mind... you can see what you think. I sent them to your e mail. Thank you.

i didn't get them. send them as a PM to this forum. i won't comment if you had an IPL injury but will comment if a fat transfer would help your situation overall with or without regard to IPL as a causative reason.
love/respect,
sml

ok, sorry, i found them in my spam folder. again, i can't comment on your photos from a perspective of IPL injury since this forum is not meant to give you conjecture about your situation, which is impossible for me to truly comment. it is also very hard to gauge differences between makeup photos in different lighting then and closeup non-smiling photos with different lighting now. i can say you have do have some hollowness of the face. that is common in people after 35 but that may be new for you. i just can't comment here. sagginess from IPL? hmmm. i doubt it but anything is possible. sorry to not be precise in my comments. i just can't be. with being heavier at 35-36, i am always afraid of doing fat transfer due to the risk of further weight gain. i would say as far as fat transfer goes, i would definitely wait a year or more and also follow your weight status. stay safe first and foremost.
best,
sml

Dr lam,
I am not asking you to make a comment either way as to ipl causing my fat loss. Thank you for looking at my pictures. Now when you refer to seeing some hollowness in my face are you referring to my cheeks?? Because after looking over pictures of myself from years past I see that I have always looked that way.

Thanks again for your time and honesty. It is appreciated.

yes, exactly, the cheeks. glad i could help!

Hi Dr Lam!

It's so good to be back, I missed you badly!
I read this thread with interest. You got me thinking with your comment concerning the tricky aspect of fat grafting in someone in his/her thirties because of some possible, natural weight gain.

It made me wonder... what age do you consider, then, as ideal for a fat graft?
Is it one of those procedures that should be thought of when the loss of fat has become really obvious and/or that the patient is, say, forty years old or more?... or is it something that you think people could benefit from having even before it becomes an obvious problem (the fat loss, I mean)?
In other words, does the fat graft in some ways work in preventing ageing? (the way botox use is not just a quick fix but can work as a preventive measure / good method to significantly slow ageing).

Would your advice change if the patient was someone prone to weight changes? regardless of the patient's specific age?
Or would you advice against it when the patient is specifically prone to weight changes and in his/her twenty-thirties?

What about people whose weight remains steady?

Say, my case. You know I plan to eventually have a fat grafting done with you. One day in the future. I honestly don' think (hope not to be delusional and wrong ) it's needed yet. But one day I plan to. I wonder though when would be a good age to start thinking of it.
And I wonder about the weight issue. Does it change anything that my weight is extremely stable?
I have weighed the same ever since I was 14 years old, I am almost 36 right now. The exact same weight. I have at most gained 3 pounds or lost temporarily (due to stress or specific problems) the same amount of weight - but I never gained more than three pounds and each time I lost weight for stress reasons, I got the weight back to my normal weight almost immediately. Considering that, and the genetics of my family (quite normal and steady weight of all my relatives throughout decades), from both sides, I'd say it is very unlikely that I would gain significative weight in my face (unless something really serious happened to me, hope not!). In such a case, would you still be reluctant to perform fat grafting by fear of some eventual weight gain?

Again, I don't think I will have it soon but am curious as of when (age) I should start considering it (although I sure hope to have something else done soon -botox, say- to get to meet you somehow soon! ) and whether or not my (apparent) genetics could make me a better or worse candidate at my late thirties or early forties... or when.

Hugssssssssssss.
Missed being around!!!!!!!!!!!!!!!!!!!!!!

It made me wonder... what age do you consider, then, as ideal for a fat graft?
IDEALLY, 40 PLUS BUT I DO MANY IN THEIR 30S. RARELY IN THEIR 20S.
Is it one of those procedures that should be thought of when the loss of fat has become really obvious and/or that the patient is, say, forty years old or more?... or is it something that you think people could benefit from having even before it becomes an obvious problem (the fat loss, I mean)?
NOT NECESSARILY. I SAY LET THE PUNISHMENT FIT THE CRIME. THAT IS, THE GOOD THING IS THAT I PUT LESS FAT INTO A YOUNGER PERSON BECAUSE THEY NEED LESS SO THERE IS A NATURAL SAFETY FACTOR BUILT IN THERE. PLUS, I TEND TO PUT FAT IN AREAS THAT YOU WON'T ACCUMULATE IT OVER TIME, E.G., OUTER JOWL AND LOWER CENTRAL CHEEK. MOST PEOPLE SIMPLY DO NOT KNOW IF THEY NEED IT BECAUSE THEY CAN'T SEE IF THEY NEED IT. I CAN. THAT IS WHY I HELP PEOPLE SEE IF THEY ARE A CANDIDATE OR NOT BASED ON MY EYE.
In other words, does the fat graft in some ways work in preventing ageing? (the way botox use is not just a quick fix but can work as a preventive measure / good method to significantly slow ageing).
IT DOES NOT PREVENT AGING LIKE BOTOX BUT IT REVERSES IT ALMOST PERMANENTLY MINUS ONGOING AGING. IN OTHER WORDS, I RESET THE CLOCK BACK LIKE 10 YEARS OR 20 YEARS DEPENDING ON YOUR AGE AND THEN YOU START AGING AGAIN FROM THERE.
Would your advice change if the patient was someone prone to weight changes? regardless of the patient's specific age?
Or would you advice against it when the patient is specifically prone to weight changes and in his/her twenty-thirties?
IF THEY ARE PRONE TO WEIGHT CHANGES LIKE ON THE ORDER OF 30 POUNDS OR MORE, THEN THEY ARE NOT A GOOD CANDIDATE FOR FAT GRAFTING AT ANY AGE UNTIL A LONG TIME LIKE 2 YEARS THAT THEY HAVE NOT GAINED THE WEIGHT BACK OR LONGER OR THEY HAD A SUCCESSFUL LAP BAND PLUS OR MINUS HORMONAL ASSISTANCE. I SIMPLY DON'T TRUST SOMEONE NOT TO GAIN THE WEIGHT BACK. IF THEY ARE HEAVIER BUT NOT REALLY HEAVY, I LIKE TO DO IT WHEN THEY ARE TOWARD THE HEAVIER SIDE SO THAT I RATHER THEM PARTIALLY LOSE MY RESULT AS THEY LOSE WEIGHT AND PUT SOME RESTYLANE IN TO STENT THE AREAS A BIT DURING LEAN TIMES THEN HAVE THEM LOOK FAT IF THEY THIN THEMSELVES DOWN TO BONE THIN AND THEN ACCIDENTALLY BLOW UP IN WEIGHT.
WATCH THIS VIDEO:
http://www.lamfacialplastics.com/plasti ... eo_id,506/
What about people whose weight remains steady?
PERFECT!!!!
Say, my case. You know I plan to eventually have a fat grafting done with you. One day in the future. I honestly don' think (hope not to be delusional and wrong ) it's needed yet. But one day I plan to. I wonder though when would be a good age to start thinking of it.
USUALLY MID TO LATE 30S AND BEYOND.
And I wonder about the weight issue. Does it change anything that my weight is extremely stable?
NO, THAT'S GREAT!
I have weighed the same ever since I was 14 years old, I am almost 36 right now. The exact same weight. I have at most gained 3 pounds or lost temporarily (due to stress or specific problems) the same amount of weight - but I never gained more than three pounds and each time I lost weight for stress reasons, I got the weight back to my normal weight almost immediately. Considering that, and the genetics of my family (quite normal and steady weight of all my relatives throughout decades), from both sides, I'd say it is very unlikely that I would gain significative weight in my face (unless something really serious happened to me, hope not!). In such a case, would you still be reluctant to perform fat grafting by fear of some eventual weight gain?
NO, YOU SOUND LIKE A GREAT CANDIDATE. SEE YOU IN A FEW YEARS! BUT SEE YOU EVERY DAY ON THIS SITE!!!!!

Hi Dear Doctor!!

I have so much to catch up on! so many posts in your blog and elsewhere... but it's a nice thing to have to catch up on

Thanks for the thorough answer!!!!

I guess that I will then wait a couple of years and send you a set of pics so you tell me if it's time to consider fat grafting or if I'd rather wait a bit more.
Of course, as I said, I plan to go and meet you and your staff sooner than that! I can't wait! even if I don't get to have anything done, I will at least stop and say hi!!!!