LAM FACIAL PLASTICS

Dr. Lam,

I recently saw you for some temporary fillers restylane and perlane (early July). You filled many areas, under eye some, hollows of my cheeks, lower chin, just to the sides of my nose. Thank you, I love it!

I have a question though, will sleeping on my face at night make the fillers dissolve into my skin faster? I am having great response, but, wanting it to stay around for as long as possible.

Also, I had botox to lessen the wideness of my face. I LOVE THE DIFFERENCE. Nov. will be 6 months on that procedure. Can you tell me, will my face widen back out, is there a way to know or kind of watch, to avoid another round of botox to the jaw line? If there isn't a way to keep the jaw line from coming back, would a second round of botox to the jaw line make my face any more narrow than it is now? I feel like it is in perfect proportion right now, thank you again!!

Is there a way to retrain your facial movements (fore head namely)? Have you actually known any patients that have been able to do this successfully?

Another thing is, I have shallow, rolling acne scars that cover a large area on both sides. You have commented that they are not noticible, well, in better words, I just don't remember them. I had to point them out to you, so?? But, they are there . I asked if silicone would be an option, you said, it wouldn't work well for these.

So, I guess, I am being like the kid who asks twice, just in a different way if they can do such and such. Also, I KNOW YOU ARE NOT ONE TO SELL FALSE HOPES. But, I still have to ask, HAVE YOU EVER had someone have a fat transfer w/ those conditions whose acne scars were improved? Are they in the minority, few and far between.

If after a fat transfer I had ANY acne scars that silicone would work well with, could I do those particular scars? Would it be better to have the fat on the bottom layer, or the silicone filling in the missing skin?


I do have pigment loss from a previous dr's aggressive dermabrasion. If I am not a candidate for plasma resurfacing now, pretty much, does that mean I will never be?

One last question, is it better to have a drooping looking nose fixed BEFORE or AFTER a fat transfer? Just interested in restoring my face to what it looked like when I was younger, not trying to change everything, although it sounds like I am on a roll hugh .

Thanks again for your honesty and answers, I wish everyone could know what a great person and Dr. you truly are!!

Thanks,

HI,
THANKS SO MUCH FOR THE KIND COMMENTS:
I have a question though, will sleeping on my face at night make the fillers dissolve into my skin faster? I am having great response, but, wanting it to stay around for as long as possible.
NO, YOU SHOULD BE FINE.

Also, I had botox to lessen the wideness of my face. I LOVE THE DIFFERENCE. Nov. will be 6 months on that procedure. Can you tell me, will my face widen back out, is there a way to know or kind of watch, to avoid another round of botox to the jaw line? If there isn't a way to keep the jaw line from coming back, would a second round of botox to the jaw line make my face any more narrow than it is now? I feel like it is in perfect proportion right now, thank you again!!
IT IS IDEAL TO REINJECT AT 6 MONTHS IF THERE IS SLIGHT WIDENING. IF IT IS "PERFECT", IT MIGHT NARROW FURTHER. GENERALLY, THE THOUGHT IS THAT IF YOU DO 2 ROUNDS CONSECUTIVELY THAT IT MIGHT LEAD TO MUCH LONGER LASTING IF NOT PERMANENT (FOR ME I DON'T PERSONALLY BELIEVE THAT) RESULTS.
Is there a way to retrain your facial movements (fore head namely)? Have you actually known any patients that have been able to do this successfully?
YES, SOME RARE PEOPLE CAN DO THAT. HOWEVER, BOTOX 2 TO 3 ROUNDS USUALLY BREAKS HABITS FOR A LONG TIME.
Another thing is, I have shallow, rolling acne scars that cover a large area on both sides. You have commented that they are not noticible, well, in better words, I just don't remember them. I had to point them out to you, so?? But, they are there . I asked if silicone would be an option, you said, it wouldn't work well for these.

So, I guess, I am being like the kid who asks twice, just in a different way if they can do such and such. Also, I KNOW YOU ARE NOT ONE TO SELL FALSE HOPES. But, I still have to ask, HAVE YOU EVER had someone have a fat transfer w/ those conditions whose acne scars were improved? Are they in the minority, few and far between.
I WOULD SAY THAT IF I CAN'T SEE THEM WELL THEN MOST LIKELY FAT WON'T HELP. I WOULD RATHER "SELL" FAT TO HELP REJUVENATE THE FACE AND NOT FOCUS ON SCARRING BECAUSE IT IS UNPREDICTABLE. I HAVE SEEN A LOT OF TEXTURE IMPROVEMENTS WITH FAT TRANSFER BUT ACNE SCARRING CORRECTION TO THE POINT OF SATISFACTION IS MUCH LESS COMMON.

If after a fat transfer I had ANY acne scars that silicone would work well with, could I do those particular scars? Would it be better to have the fat on the bottom layer, or the silicone filling in the missing skin?
I HAVE DONE IT BOTH WAYS. IDEALLY, I DO THE FAT TRANSFER AND BUILD THE FOUNDATION WITH IT, THEN AFTER A YEAR OR SO I FINESSE IT WITH SILICONE.

I do have pigment loss from a previous dr's aggressive dermabrasion. If I am not a candidate for plasma resurfacing now, pretty much, does that mean I will never be?
IT IS NOT THAT YOU ARE NOT A CANDIDATE FOR A SAFETY REASON. I HAVE DONE A LOT OF PREVIOUS CO2 AND DERMABRADED PATIENTS. MOST LIKELY THE REASON THAT I DID NOT OFFER IT TO YOU IS THAT YOU PROBABLY WOULD NOT GET AN APPRECIABLE BENEFIT FROM IT.

One last question, is it better to have a drooping looking nose fixed BEFORE or AFTER a fat transfer? Just interested in restoring my face to what it looked like when I was younger, not trying to change everything, although it sounds like I am on a roll hugh .
THAT DOES NOT MATTER. YOU CAN DO IT BEFORE, DURING, OR AFTER.
thanks for the nice comments!
sml