LAM FACIAL PLASTICS

Dr Lam-
I have been having a conversation with Marcie at your office about my nose. She mentioned that you are a specialist in the Asian face as well as the Caucasian face which I find comforting. We talked about the different options for Asian rhinoplasty. She mentioned that sometimes different techniques can be used in addition to rhinoplasty to shape the nose, which I am interested in, too. Also, she mentioned that you are capable in doing Asian blephoraplasty and that you have much experience with them. Can you please tell me how you make a decision on which surgery to choose for the eyes and nose?

Let me first begin by saying that I take a lot of pride in what I do. What I really enjoy is enhancing the beauty of the Asian face without erasing ethnic identity and making someone appear unnatural, overdone, if not plain weird. In fact, I will be taping a segment on Montel Williams in New York City on November 15th on exactly that philosophy and subject.

Let's talk about the nose first since that was your first and perhaps primary concern. I would recommend you try to review this website which is close to 1400 pages long, especially the learning module under "resources" that focuses on asian face along with the extensive before and after gallery that i have and related virtual consultations on the subject. oh, and video and written testimonials.

The major problem that most Asians have (but not all) is a nose that appears too flat and a tip that appears to round and big with flared, wide nostrils: you may have one or several of these problems. My principal method to create a natural nose is a combination of Gore-Tex (which is soft, opaque, and light and tends not to shrink wrap unlike silicone) and cartilage tip grafts. The two things that I do principally to preserve ethnicity, your identity, and naturalness is to maintain a nasal bridge height that is appropriate and to make a tip not overly pointy. For the bridge I generally go to about the midpupil when looking from a profile view. I think the traditional Caucasian "ideal" at the top of the eyelid crease is most times WAY too high and can make an Asian individual appear unaesthetic and also fake. For the tip, I use cartilage from the inside of your nose or if need be ear to create a more defined but not overly defined nasal tip. The exact method is explained more precisely in the learning module section. For even further detail, it would be too confusing here to try to elaborate further. For the reduction of one's nostrils, I don't always do this for two reasons. First, it may not be needed and could actually worsen the full appearing central tip depending on the relative sizes between these two structures. Second, prolonged scarring can be visible if done on the outer part of the nose. If I can avoid it, I try to not cut on the outside of the nostril but to only make incisions inside the nostril by doing what is called a nasal sill reduction which reduces the nostril width but not the flare.

As far as eyelid surgery is considered, I really try to maintain a natural result and achieve permanence. I do not believe in removing a lot of fat from the upper eyelid or removing a lot of skin and raising the crease very high. If you want this, you should choose another surgeon. I can tell you that most plastic surgeons will do anything you want. I don't. I want you to look your best based on my aesthetic judgment (and your agreeing obviously). Also, don't freak out about not taking a lot or any fat. The reason your eyelid may look puffy is not due to the amount of fat in your eyelid but that that lack of fixation between the eyelid skin and the muscle let's the fat slide down lower to make the eyelid opening narrower and the contour puffier.

If you are an older patient then you should watch my video lecture on how I manage the aging Asian eyelid through a combination of methods. It is very detailed and confusing to present in this blog. Suffice it to say that I categorize patients into aging Asian eyelids without a natural crease, with a natural crease, and with a previously surgically made crease. There are so many pitfalls that stand in the way of a surgeon performing work on an aging Asian eyelid that I think a surgeon, no matter how well qualified, should abstain from performing Asian eyelid surgery of almost any kind unless he has technical experience as well as cultural sensitivity and an artistic eye that fits a person's personal identity and race.

best,
sml