LAM FACIAL PLASTICS

Hello Dr. Lam,

I had a dermabrasion done 15 months ago. Shortly thereafter, I went on accutane & finished taking my last dose Jan. 25, 2009.

I have an appointment to come see you concerning my acne scars in May. They are very shallow saucer shaped scars that cover large portions of my cheeks. Which seem to be beginning to hollow, I am 34. Also, I have a loss of pigmentation from the dermabrasion in some areas.



I pulled up the package insert for accutane and it says: Do not have cosmetic procedures to smooth your skin waxing, dermabrasion, laser for up to six months after finishing accutane

I am VERY hesitant to do the silicone microdroplets. I want my options for fixing wrinkles open later when I may want laser. I looove the idea of fat grafting. However, after MUCH reading, I noticed you like to smooth the effects with laser.

Being that you may want to smooth the effects with laser and accutane says don't do anything like that for up to 6 months, atleast. Should I go ahead and come in for the consultation? Or should I wait until August when my six months will be up?

Maybe, I don't know what line of re course you will want to take to help the scars to begin with?

Thank you sooooo much for your help and your answer.


Kimberly

kimberly,
to be honest, i am even more conservative when it comes to accutane. i typically wait a full year to a year and half before doing any dermabrasion, laser, etc. it is simply not worth the risk. fat transfer and silicone i can do even shy of 6 months but no resurfacing. sorry about that. i do not use fat for acne scarring unless there is aging with it then i can use the fat for aging (loss of volume) but not directly for acne scarring with the hope that the scars will improve a bit just from the stem cell changes. i do not believe fat is safe (or effective) to fill saucers. fat is a live graft and can evolve with time so you cannot fill holes with it safely in my opinion. i believe silicone is safe but i am not here to convince you of it. you can make your own decisions about that. i have videos on silicone safety in my video log section but you must make an educated decision.
best,
sml

Dr. Lam,

Thank you for your response. This is sooo important to me, thus, your response meant so much!

Even though I was on accutane up until Jan. 25, 2009, COULD I STILL RECEIVE A TEMPORARY FILLER AS EARLY AS MAY 18th, 2009? Then, if I decide to have the micro silicone later, would I have to wait an enormous amount of time for the temporary filler to wear off?

I do wish to have the fat grafting done for the hard look beginning on my face, if I have temporary fillers done May 18, 2009. Will that set the time back further than the accutane already has for the fat grafting?


Would the mirco silicone droplets, prevent me from being able to have fat grafting or even a laser smoothing of some sort IN THE NEAR FUTURE? For instance, as soon as my year and a 1/2 is up from the accutane? That is my concern with the silicone, that it would knock out options of laser and fat grafting in the future. I have read enough, that I am fine with their safety. I just wish to keep those two options open.

So, sorry for the length of this message. I am so eager to come get some help on these scars. I wish to be ready for anything you may suggest, and I am one that likes to read up before I do something.

Thank you soooo very much!!

By the way, I have spoken with Marcy a few times from your office, she is great! She is really on top of it, and so easy to talk to. (I am on the list for coming in sooner, if there are cancellations)



Thanks again,
Kimberly

Even though I was on accutane up until Jan. 25, 2009, COULD I STILL RECEIVE A TEMPORARY FILLER AS EARLY AS MAY 18th, 2009? YES. Then, if I decide to have the micro silicone later, would I have to wait an enormous amount of time for the temporary filler to wear off? GENERALLY, YES. I LIKE TO DISSOLVE SOME OF THE RESTYLANE BEFORE SILICONE IF THERE IS STILL SOME PRESENT. I GENERALLY PREFER TO MOVE TOWARD SILICONE DIRECTLY BUT SOMETIMES I FILL SILICONE ON TOP OF RESTYLANE IF MOST OF THE RESTYLANE IS GONE.

I do wish to have the fat grafting done for the hard look beginning on my face, if I have temporary fillers done May 18, 2009. Will that set the time back further than the accutane already has for the fat grafting?
NO. THE ACCUTANE DOES NOT AFFECT THE FAT GRAFTING MUCH. IT REALLY ONLY AFFECTS LASERS AND PEELS.


Would the mirco silicone droplets, prevent me from being able to have fat grafting or even a laser smoothing of some sort IN THE NEAR FUTURE? NO, IT HAS NO EFFECT. For instance, as soon as my year and a 1/2 is up from the accutane? That is my concern with the silicone, that it would knock out options of laser and fat grafting in the future. I have read enough, that I am fine with their safety. I just wish to keep those two options open. NO PROBLEM.

So, sorry for the length of this message. I am so eager to come get some help on these scars. I wish to be ready for anything you may suggest, and I am one that likes to read up before I do something. NO PROBLEM.