LAM FACIAL PLASTICS

Dr, when I will be able to travel to get the fat graft done by you, how long should I think of staying there? I assume there is a follow-up... how long after the day of the procedure?
And for how long do patients have a degree of inflammation that does not allow them to work or pursue their usual activities?
I would like to know to take that into account when thinking of when to make a trip, for how long I would be out of work due to the procedure itself, out of being there in US and/or not being able to go back to work or look "decent" out of the inflammation .

The derm I usually visit thinks that he can only guess, but as to give you some idea, that he thinks you might (MIGHT) work with around 10cc of fat given the shape of my face, degree of thinness, etc.

Hugs!

hi,
typically my patients stay a day or so if they are from the U.S. people that are traveling from abroad may want to rest up for a week just to make traveling easier. the only difference in after care would be possible laser at a week to manage any bruising that sits an inch or more away from the eye area.
http://lamfacialplastics.com/gallery2/v ... t.flv.html
recovery is all dependent on swelling that you experience. typically someone in their 30s to 40s experiences about 10 days of time that does not look good. over that age, up to 2 weeks or slightly more. it is not to say that you will love it at a week or two. most people don't. i say that conservatively one week you won't like it and others won't like it, two weeks you won't like it but others probably will like it. 3 weeks, everyone should like it. but again these are parameters. watch this video to better understand recovery parameters that i establish:

also, as far as number of cc 10 cc is like nothing. most likely about 20 cc if you are young (30 to 40 something). 35 to 45 if you are late 40s to 60s, rarely i someone totally depleted 60 cc. but again everyone is different and also whatever one doctor injects it has no bearing on another doctor's because take is dependent on a particular surgeon and also how that fat is distributed. many docs put 15 cc into the cheeks. i put 1.5 cc then balance that with additional cc's elsewhere. hope that makes sense.
best,
sml

Thanks! super clear!!!
I wonder why is that an injectin of fat causes that much inflammation (for relatively long time / many days) while the injection of fillers does not? or at least causes an inflammation that goes away on one day?

Thanks for all the tips!

that is due to the fact that i use a cannula to inject the fat instead of a needle. plus, i inject microdroplets of fat whereas when i put restylane it is more of a large single volume of product. you can't do that with fat. plus, i put fat all over the face, whereas when i do restylane i just put it in 2 or 3 locations. if i did as much restylane per volume as i put fat in you would go broke. let's consider 15 cc as a conservative amount of fat. 15 cc of restylane would cost you the price of a fat graft. most people inject only 1 to 4 cc at any given time. hope that is clear too.
best,
sml

Yes, very clear!!
At least I think I understand. After all, a cannula versus a syringue means a wider area of "invasion" of the skin to introduce the substance... the wider the area of "aggression" to the skin, the more inflammation will logically ensue. By the same token, many injections produce multi areas of mini inflammation, versus one only area of inflammation. In this case, the skin is not just reacting to the inflammation caused by the introduction of something in the skin in one area (small or large) but to many mini "aggressions" at once. The whole inflammatory response is logically stronger and covers a larger area. Not to mention that, as you say, the ccs injected with injectable fillers are less than those injected during fat graft. There goes more swelling, of course, because the total volume of what is injected is way higher.
Is that correct?

correct!

Another question, this one onset by a friend interested in the procedure... I told her I am not sure she is a candidate or should not talk thoroughly with you about her meds before traveling. She is allergic (not sure to what) and takes regularly corticoids orally. I would assume that taking a corticoid right after the fat injection might cause fat atrophy...? or is oral corticoid not problematic for that? I know that people are given in different procedures (OTHERS) corticoids to diminish the swelling, but I assume neither for swelling nor for other uses corticoids, orally, would be good before, or right after a fat graft.
If you can, and I know you can only guess not knowing first hand her case, let me know if corticoids are usually a contra indication or something she should discuss with her doctor here first before even trying to set an appointment to travel.
Hugssssssssssss

no problem with oral steroids. i give them to all patients after a fat transfer as it is.
sml

Oh, she will happy to read that!

Now, into the "let's learn something today" part (sorry, I always ask so much ), does it mean that localized injections of corticosteroids are the cause of fat atrophy, not the oral intake of them? I remember you mentioned some time (correct me if wrong) that they can lead to fat atrophy, but maybe you were referring to cases where it was needed or used to diminish lumps with that risk involved?

Oral corticosteroids are something you give in order to diminish the inflammation, is that correct?

BTW, to not keep you so much in the dark, I asked my friend what she takes and she said loratadine 10 mg, dexametasone 2 mg. Not all days, some days a lower dose or some other anti allergic, but regularly needs to take that med with that combo.

Hugs and hugs

her meds are fine. also, yes, it is the injectable form that causes fat atrophy. precisely correct.
best,
sml