LAM FACIAL PLASTICS

Dear Dr Lam,

I have watched many of your very informative videos on various cosmetic procedures as well as possible complications, especially regarding fillers. Just a couple of days ago I had a HA filler injected in my nasolabial folds. Now having passed the age of 40 I also really wanted some enhancement / volume restoration in the cheeks but the plastic surgeon ended up using two syringes in my smile lines and we decided to first see how that would work out. Though I can obviously see some difference, it hasn't done much for the overall volume in my face, which was what I really wanted.. I have always been happy with the bone structure of my face but now feel the time has come for some subtle volume restoration in that area. I am now considering having a filler in the upper cheek area but am particularly worried about possible lumps or other complications (the chipmunk look) as I have read some horror stories in blogs and forums. I am well aware of the importance of having a skilled injector, unfortunately I can't see you as I live in Europe (Greece particularly) but was hoping you'd be willing to at least 'guide' me a bit in the right direction.. My question is: would Restylane be suitable for the cheeks as I don't want anything too dramatic, at least not the first time? Restylane being a softer substance than say Radiesse or Sculptra or even Juvederm Ultra, I'd think there are lower risks of possible bumps and lumps? The doctor I saw is a skilled and renowned plastic surgeon here but I feel it really takes a lot of expertise as an injector to get a smooth, natural result as I am sure you'll agree. So for some restoration of volume in the upper cheek area, would Restylane or Restylane Perlane be an option in your view? If not, what filler would be? Lastly but not least importantly, I read about risks (hitting a nerve etc) with the intra-oral method for cheeks. I know you use this method but how substantial are those risks with a less than 'gifted' injector? And should I expect lots of bruising if this method is not applied?

It is a huge pity your practice is so far away, I would not think twice about seeing you if I lived across the ocean!!! Thanks so much for your time and expertise, and who knows one day..!

yes, restylane in my opinion may be the safest product to use for a few reasons. it is thinner than perlane so it is much easier to control for someone just beginning to inject. i prefer perlane in the cheeks because it lasts longer but it is much harder to control. also, restylane is reversible. i have not done the through the mouth technique for years now. it is far too inaccurate. i now go through the skin and target the area. the best way to feel comfortable with a physician is to ask him if he does that area frequently and to show you results. nerve issues are pretty rare in my opinion even for someone inexperienced. do some homework before you find your injector. credentials may be nice but experience counts more. maybe in the future, i can do your fat transfer and you will then be done for a decade or more. just this past week i have had several individuals fly from europe and will have another one this next week. when it is permanent and done once then it is much easier to justify the flight.
best,
sml