LAM FACIAL PLASTICS

Hi Dr. Lam,
I am interested in cheek fillers like perlane, and radiesse. I have seen some wonderful youtube videos of young women receiving cheek augmentation with radiesse. The results are amazing. Most of the women don't seem to really need cheek augmentation, and already have decent bone structore, but when they receive the radiesse they look so much more refreshed and younger looking. I would love to receive radiesse cheeks, but my nurse injector thinks that it wouldn't look good on me because I already have prominent asian cheekbones. To me the area is a lot more hollow than what I used to have. I am 35 years old, and have a flat cheekbone profile. i don't want to look like Megan Fox, or Heidi Montag who have both aged after cheek augmentation. This look makes their faces look broad and much more masculine. How do you achieve this more feminine rounded youthful apple like cheeks like Sandra Bullock, or Kim Kardashian? Is less better? Like only half a radiesse syringe in each cheek? Can radiesse be placed in the cheek so that the face doesn't look broader , but will look more slim and youthful when the person doesn't have too much atrophy, or skeletal look? I have read and watched a lot of your cheek videos. I respect and value your aesthetic opinion especially regarding cheeks and asian facial structore.

yes, your injector doesn't get it at all. you do not inject over the cheek bone but you inject between the cheek bone and the nose. in fact, your cheek bone will look smaller, which is particularly good to do in many koreans and in some vietnamese but also other asians and non-asians. it is all in the skill of the injector. i typically use a lot less product to get the same results as someone else.

i stopped using radiesse now because i have found over the long run a build up of cement like tissue under the skin with repeated injections. i have done radiesse for about 5 years probably a thousand syringes now i have fully stopped using it. it is not a bad product i just don't prefer it anymore.

it was funny i had a lady who drives 3 hours for me to work on fixing her lips. she typically gets 2 syryinges of radiesse. she said ok you can do my injection since i am due for it. i injected 1/4 of one syringe of perlane and she said, "wow what is the name of this product? it is so much better than radiesse." i said, "it is not the product it is how it is injected." if you know how to inject it you can do it with almost zero pain (cannot feel the needle) with minimal to no swelling and with very little product to get the job done.
best,
sml

Hello Dr. Lam,

I certainly wish I lived closer as what you're describing sounds like exactly what I needed. I do have a very experienced injector but I think she may be following "best practices" as handed down to her. She said that I needed the product on the top of the cheekbones to provide the "lift." (I have sagging in the middle of my face on either side of my nose and right before the cheekbone. The cheekbones themselves are already very high. I am not of Asian decent but I still have quite pronounced cheekbones. I got some product in the apple and some on top of the cheekbone but for me it just looks like a more exaggerated version of my old shape. What I think I really needed was filler in the apples where I lost the volume. Is there a particular name for this type of method?

I'm thinking that now I'll just have to go in and get more but request that none[i]be put on my cheekbone. Hopefully this will fill in the apple (which still looks flat compared to that cheekbone that is still comparatively high.

[/i]
Thanks

hi,
there really is no name for various parts of the cheek as far as i know. however, i personally divide the cheek into anterior cheek (apple i believe that is what you are calling it), lateral cheek (over the bone), central buccal (center below the cheek itself where you suck your cheeks in), lateral buccal (below the bone), and medial buccal hollow (i came up with this term to describe the area right near the teeth. but this typically occurs in older people who lose teeth.)
best,
sml

basically, there are two things you need to find in an injector: experience (how many they have done and for how long with what types of products) and aesthetic eye (look at their photos). to be honest, that is just as important. no matter how experienced the injector is, the person's eye is just as important if not even slightly more so.

Using my newly-learned terminology the problem looks like this: My prominent lateral cheek already appeared quite elevated compared to the rest of my cheek and that is why I had actually stated that I didn't think I needed anything there. Now they seem even more noticeable with the product and the left one has a discernible ridge on it. The drop in elevation from the end of my pointy lateral cheek to the anterior is almost as drastic as before. My nasolabial folds lifted only the tiniest bit. Maybe they didn't lift at all and it's my imagination trying to justify the $. It was this area where I was hoping for the most change.Where it's now more drastic is the change from my lateral cheek to my hollowed central buccal. With the more prominent cheekbone the hollow looks even deeper comparatively. Long story short, I have a bunch of product where I don't need it.

Your point about the aesthetic eye of the injector being most important is well taken. I recognize that I have a downward trajectory created from drooping periorbital sagging, and the vertical anterior cheek depressions that exacerbate the downward nasolabial folds. Having employed visual design in my profession I know the way to interrupt this vertical trajectory is to create a horizontal one. i.e. FILL the anterior cheek so that my cheekbones join with my nose to create a horizontal line. Now I just have expensive downward lines. My fear is also that she is going to suggest that the correction be for me to fill the central buccal and lots more in the anterior. I wouldn't have had to get those places to catch up even more than before had my lateral cheekbone been left alone. (I've always had a very firm and high lateral cheekbone. I don't think it should have been touched.)

I can take a guess at how she should have done it but in the end it does feel pretty disrespectful to make that suggestion as I don't have a medical background. I do however, have the experience of looking at my hollowed anterior cheeks thousands of times and of using my aesthetic sense. My guess is that the technique used by this fellow in the video might have been the way to go. When I used his method to see the best spot for application, the point ended up right where a small line has resulted from the depression.

Thanks so much for your education. In the past I have had connecting flights through Dallas. Should that happen again, I will be sure to try and get in to see you.

hi,
sorry i deleted your link because i do not like external links on here to other sites. however, i did watch the video. where that doctor marked it is correct. however, you do not need fancy lines to make that decision. all you have to do is look at the linear malar depression and put your fat or filler there. it is that simple. an aesthetic eye is everything. i am about to board a plane in an hour so may not have further responses today.
best,
sml

please give me lead time if you are connecting through dallas so that i have the time to see you. when i do your filler i think you will be blown away. you should not be able to feel my needle entry and i put very little product to get very good results. look forward to take care of you in the future. i have a lot of people fly in just for fillers and botox, believe it or not!
best,
sml