LAM FACIAL PLASTICS

Hello Dr. Lam,

I really appreciate the wealth of information you offer on your site - thank you!

I am 31 years old, and in the past year have developed deep tear troughs/under eye hollows making me look really worn out. It is a real bummer because everything else looks great. I have been tirelessly researching my options, and I am incredibly frustrated becuase I don't know what to do because dealing with this area is so precarious, and there's a great risk for complications that could permanently ruin my appearance. For fat grafting in particular, I have read so many horror stories about lumps and scar tissue formation, and I'm really scared to embark on this procedure, even though I know it could really help solve my problem.

I am coming to understand that you are an expert in fat grafting, so I have a few questions for you:

1. How many procedures would you say that you've done around the eyes in particular? Have you run into many complications?

2. I am prone to inflammatory responses around my eyes, such as excessive swelling (when crying), and urticaria-like reactions to my own tears and to salt water (when I go swimming in the ocean). These can range from slight redness/swelling/small hives, to full on golfball sized swellings (as is the case whenever I go swimming in the ocean). Given this, I'm even more concerned about potential complications. What's your take? Would this make me a poor candidate for fat grafting in this area?

Thanks in advance for your time Dr. Lam!

1. How many procedures would you say that you've done around the eyes in particular? Have you run into many complications?
LITERALLY HUNDREDS. THIS IS MY SPECIALTY. I DO ONE ALMOST EVERY OTHER DAY. I HAVE NEVER HAD A LUMP UNDER THE EYE. I HAD ONE LADY WHO HAD SCAR TISSUE FROM A PREVIOUS BAD BLEPHAROPLASTY AND MY FAT MADE THE SCAR LOOK WORSE. I STENTED IT WITH RESTYLANE. AFTER A YEAR, THE FAT SMOOTHED OUT THE SCAR AND I DISSOLVED THE RESTLANE. IT WAS AMAZING. I HAVE HAD 2 TO 3 BUMPS IN THE BROW THAT I HAVE MANAGED. HAVE NOT SEEN ONE IN A COUPLE OF YEARS. I REMOVED THE BUMP PRETTY EASILY. I HAVE TAKEN A LUMP FROM UNDER THE EYE BUT IT WAS FROM ANOTHER DOCTOR'S WORK. I HAVE NOT HAD ANY BUMPS ANYWHERE ELSE ON THE FACE THAT I CAN REMEMBER.

THERE ARE THREE "COMPLICATIONS" THAT I WOULD LIKE YOU TO FOCUS ON:
1. IF YOU GAIN WEIGHT (LIKE 20 TO 30 POUNDS) THE FAT CAN LOOK TOO FULL MAYBE BULGY EVEN. HAVE NOT REALLY SEEN THAT SPECIFICALLY UNDER THE EYE. HOWEVER, I HAVE HAD A COUPLE OF PATIENTS WHO HAVE GAINED A LOT OF WEIGHT AND THERE FACE SHOWS IT MAYBE EVEN MORE THAN IF THEY JUST GAINED WEIGHT. IF YOU ARE A WOMAN, REMEMBER PREGNANCY CAN ADD WEIGHT AND CREATE TEMPORARY DISTORTION DURING PREGNANCY. THIS IS THEORETICAL. HAVE NOT SEEN IT.
2. IF YOU HAVE COLOR ISSUES LIKE DARK SKIN, VEINS, ETC., FAT WILL NOT FIX THAT.
3. I ALWAYS UNDERSELL WHAT I CAN DO WITH FAT IN ONE AREA LIKE THE LOWER EYELID. I HAVE HAD PATIENTS LOOK AMAZING BY MY BEING ABLE TO BLEND IN DIFFERENT PARTS OF THE FACE THAT MOST PATIENTS DON'T CARE ABOUT BECAUSE THEY THINK THE LOWER EYELID HOLOW IS ALL THAT MATTERS. TYPICALLY IT DOES NOT. I WOULD HAVE TO DO A LIVE CONSULTATION TO TRULY HAVE YOU UNDERSTAND THIS. BLENDING SMALL AREAS OF THE FACE CREATES A FACE THAT LOOKS MORE VITAL AND ATTRACTIVE BUT NOT TOO FULL. WATCH THIS VIDEO:
http://www.lamfacialplastics.com/galler ... rgery.html

ALSO, WATCH THIS ONE:
http://www.lamfacialplastics.com/galler ... Zones.html

2. I am prone to inflammatory responses around my eyes, such as excessive swelling (when crying), and urticaria-like reactions to my own tears and to salt water (when I go swimming in the ocean). These can range from slight redness/swelling/small hives, to full on golfball sized swellings (as is the case whenever I go swimming in the ocean). Given this, I'm even more concerned about potential complications. What's your take? Would this make me a poor candidate for fat grafting in this area?
YES, THIS COULD POSE A PROBLEM WITH YOUR AFTER CARE. YOU MIGHT HAVE MONTHS OF SWELLING THAT I CANNOT PREDICT. AGAIN, HAVE NEVER SEEN THIS BUT POSSIBLE. PLUS, I WOULD HAVE YOUR ALLERGIST CHECK YOU OUT BEFORE CONSIDERING ANY LOWER EYELID FILLING.
hope that helps!
best,
sml

Thank you so much for your quick and informative response, Dr. Lam.

I actually have an appointment with an allergist in a couple of weeks (it's my first time seeing an allergist). Are there any specific questions I should ask him in relation to having fat grafting or restylane injections around the eyes?

Thanks again!

not really because he/she will not know the answer to it. the best thing is to resolve any allergies BEFORE contemplating fat transfer for two reasons:
1. if any puffiness is causing the hollowness or making it worse, maybe you can avoid an FT.
2. your recovery may be a lot better if we decide to proceed.
best,
sml