LAM FACIAL PLASTICS

hello Dr Lam,
i have a large fold of excess skin underneath and around my eyes and it is more noticible when i smile. im very petitle and muscular but i dont know why there is fat under there. whenever i take picture u cant help but notice the large crease under my eyes which takes the focus off my eyes itself. I was wondering if im an a candidate for a blesparoplasty and if so can it be combine with cheek liposuctuion. when im running i can feel my cheeks bouncing up and down I know that alot of people desire full cheeks but mine looks to babyish. I also was wondering why some thin people have chubby faces. also i dont know if this applies but i was reading that you only remove excess fat from under and around the eyes, but you do not do skin lifts which would slightly pull the skin back making the eyes appear more almond shaped and defined. i would like to achieve this in order to get a more "exotic" look and bring out my eyes. is this possible Dr. Lam?

this is known as an orbicularis roll. it is the muscle under the eye that becomes more pronounced with smiling. here is my thought with it. DON'T TOUCH IT!!!!!!!!!!!!!!!!!! Trying to improve a minor thing that is perfectly natural in a young face has a high likelihood of disaster.

as far as fat in the cheeks, just give it time. as you age, it will start to disappear before you know it, especially after a few children. don't have it sucked out.

bottom line based on the short synopsis of what you told me. don't touch anything.
best,
sml

Hello, Dr lam thanks for the super speedy response!
I do understnd what you saying but i think its alot more noticible in person. i have seen older people who haven' 't had any cosmetics surgery done and under their eyes are smoothe. iam just seeking a more smoothe look under the eyes that would not make me look older. it may not be a huge problem now but as i get older i think it going to get wrose and fill up with more fat. it does look horrible and ignoring it is not an option..do u have any other sugestions that would smoothe out those muscles?

i would not treat the muscle. botox can help but it is not worth it and will probably fail. leave the muscle alone. risk is not worth it. if you proceed, you proceed not with me but with another surgeon. however, i am advising against it. you may wind up with another slew of surgeries to fix something that you didn't need to begin with. you may have some slight hollowness under the eye from what i can tell. i would consider an experienced injector to help with restylane. that might make the muscle appear better.
best,
sml

Hello, thanks again
I'm not young and naive i just don't understand why removing excess skin underneath and around the eyes would lead to further problems. I know plastic surgery comes with many risks and complications but i don't think what i want done is going to lead to disaster. people remove fat and excess skin everyday and everywhere so i just have a hard time understanding what you mean. i know you said its a muscle but what about the fat and excess skin that i don't want there i dont think all of it is mucle. basically my question is What is the worst that could happen generally speaking?

thanks.

the risk is an eyelid that turns downward where you have a problem closing your eyes, dry eyes, and an unnatural look. yes, surgeons remove skin every day from under the eyes but in the majority of those cases IMHO there is either slight to significant changes to the eyelid shape that is irrevocably changed. watch these videos of mine to understand my position better:
http://www.lamfacialplastics.com/galler ... r.flv.html

http://www.lamfacialplastics.com/galler ... 4.flv.html

best,
sml

Thanks Dr. Lam, I will be checking out those videos shortly