LAM FACIAL PLASTICS

Hello Dr. Lam, I'm very interested in having "something" done, but I'm not sure yet - what you would advise. I am in a VERY public position and I can only take about 10 = 12 days off - total. I am 34 years old and I have had several treatements to help the gaunt appearance of my face. I also have premature aging around my eyes. I had sculptra done about a year ago (just one treatment) and it helped, but the surgeon used it under my eyes and it got WAY too filled. I went from gaunt to looking as if I had excess skin/bags. It has now receded some. It also helped reduce the fine lines around my eyes -- but I am still not happy. I just want to look my age. I have large pores - some acne scarring and all this premature aging. As you can probably tell, I'm really unhappy with the current status of my face. I had 1 treatement of Rhytec around my eyes about 2 years ago. I really thought it helped! But, now I understand Rhytec is out of business.

So, right now, I have botox and received perlane in my cheeks and lips about 3 months ago. It's almost all gone. I look gaunt again.....I want to lose the 5 pounds I gained over the winter for bikini season, but EVERY POUND comes off my face. I have seen - in depth - your fat transfer procedure/testimonials. I have been VERY impressed. I know you are THE best. That's why I would like to travel to Dallas to have you do *whatever* you think is best for me. I say *whatever* because I probably have no idea what I really need - as YOU have the artistic eye, I'm just dealing with the annoyance of my current drawn face.

I am thin, my weight flucuates about 5 -8 pounds, but I'm a size 2 - 4 - so I think that I would be a good candidate (weight wise) for your fat injections. But, I've had surgeons tell me that a chemical peel would be best -- then others say the "Pearle" laser. I just don't know what to do, but I realize that I can't take more than 2 weeks off of work and I can't come back looking drastically different. I just want to start looking my age! Everyone thinks I am 40. It gets depressing, given my line of work AND the fact that I am already spending so much money to look the way I do RIGHT NOW.

Could I send you a picture or video and get an idea of what YOU would advise? I am so appreciative of your time. You are the best -- and I know many patients who have said the exact same thing! Thanks!

thanks. your comments touch my heart. i am always so moved by nice comments from nice people. obviously, fat grafting is the gold standard in most cases. however, you have had different fillers and you sound younger. also, i understand the limitations of recovery. i never try to say that at 2 weeks things are perfect. however, fillers simply can't accomplish what i can with fat grafting. the 5% rule i talk about is only achievable with fat grafting, in other words the small amounts i place everywhere to rebalance the face. however, i use fillers to hit major target zones to keep costs under control until i can do the FT. send a private message (PM) to me and let me give you an initial impression.
best,
sml

Thank you so much for replying! I am grateful. I am going to send you 2 photos so you can see what I'm talking about... I will also send you a NORMAL picture so you can get a look at my overall appearance.

Thank you! I am soooo excited to have you improve my appearance!

i understand your situation now. FT is still the best option but i probably should see you in person to make sure that i can accurately access your situation. because you are younger, you would need less fat but you could still require more downtime considering your downtime issues. unfortunately, i am booked until august for consult times but i have a cancellation waiting list. it would be better to see you in person to discuss. just trying to be safe. i know you are from out of town but it would be a better way to go in your case.
best,
sml

Thank you so much for your time. I appreciate your insight. I sent you 3 additional photos that are probably better. I was wondering how long you would say is really safe for downtime....3 weeks? I also wondered the fate of rhytec? Could you possibly do a chemical peel or suggest another laser at the same time?

Thanks again!

3 weeks is beyond generous in MOST cases but i can't make that promise 100%. given your skin, you really need botox. to understand skin from my perspective, please take 30 minutes and watch this video lecture:
http://www.lamfacialplastics.com/plasti ... eo_id,521/
best,
sml

I watched it, and it was useful. I learned stuff I didn't know.

fantastic. now you see for someone young like you the two biggies for skin (besides sun avoidance, good health, diet and exercise) are botox and volume, not necessarily lasers.
namaste,
sml

Dr. Lam, thank you for providing that link, I learned a lot. I actually have watched your lectures on youtube -- and that is how I knew to ask the dermatologist to inject into my cheeks instead of the lines.... I definitely felt it made a big difference. I guess I would like to ask you a few questions (I am going to get on your cancellation list) whether you like sculptra? Can you get a big difference with injectables --even if it is only temporary? I have seen your impressive before/after photos on your website -- but I was wondering how they might impact MY face. For example, can you put an injectable in the jaw line to widen out my face?

I currently have botox -- I suppose I don't have enough or in the right places if you suggest more. All in all -- I am wondering if you believe you could take a lot of age off of my face with injectables and botox? Do you think I might need another type of surgery to improve my appearance? Rhytec? blepharoplasty?

I guess I just want to start bracing for what I might need and whether I can plan on doing all of these procedures together with one recovery time?

Thanks again -- you are very kind. Happy Memorial day.

you need consistent and well delivered botox. you most likely do not need plasma based on the photos. you do not need a blepharoplasty just fat into the brow based on the photos. i simply put do not like sculptra at all for many reasons:
1. lumpy around the eyes.
2. lumpy around the mouth.
3. unpredictable.
4. painful during injection.
5. expensive.
6. requires multiple treatment.
7. too much guesswork.
8. must wait too long to see results.
i stopped using it a couple of years ago.
bottom line: if you can afford it fat transfer and botox. that's it. if not, perlane until we can do FT.
best,
sml

Thank you! I can't wait to visit -- and have you help me. I will fly in -- at your first cancellation! Thanks again. I am grateful!

have a peaceful rest of the weekend. if you are on facebook, i would appreciate your joining my peace and love group, then inviting all your friends. it is just dedicated to spreading positive energy to all around us:
http://www.facebook.com/group.php?gid=7 ... 453&ref=mf
namaste,
sml