LAM FACIAL PLASTICS

Hi Dr. Lam,

I've come across your forum and had a few questions I wonder if you can answer, as I'm unable to fly to Texas at the moment.

1) Is your KTP laser (or any pulsed-dye laser) safe and effective in eliminating redness from scarring for Fitzpatrick skin type IV? (Middle-eastern descent, olive skin tone, although lighter than many of the Hispanic patients in your photos)

2) Can the above lasers be used to eliminate hyper-pigmentation caused by a TCA Cross? (i.e. One week following the treatment, can these lasers be used?) Do you prepare patients with creams before/after TCA Cross?

3) Correct me if I'm wrong, but I've read that KTP laser may cause bruising, and if so, you can help improve the bruising if we are still in town. What treatment do you use to help the bruising?

4) Are some scars too SHALLOW to treat? (Scars, not pores)

5) I came across one picture in your before/after collection of a darker skinned gentleman (here: http://www.lamfacialplastics.com/galler ... lNumber=16), and was amazed to see that while some non-ice pick scarring is noticeable, his ice pick scarring (similar to what I have) is pretty much all gone. How many TCA Cross treatments did he require if you don't mind me asking?

6) Finally, in a non-skin related question, generally speaking, are procedures such as fillers and blepharoplasty advisable to anyone 25 years of age? (Namely, to improve the perma-tired/angry look or to add volume to the cheeks)

I appreciate any input you can provide, as I have mentioned, it's nearly impossible for me to fly to Texas at the moment (completing grad school). I have more specific questions, but don't have any pictures uploaded yet. I can follow up once you've responded.

Thanks.

1) Is your KTP laser (or any pulsed-dye laser) safe and effective in eliminating redness from scarring for Fitzpatrick skin type IV? (Middle-eastern descent, olive skin tone, although lighter than many of the Hispanic patients in your photos)
YES. BUT LIKE MOST THINGS OF THE SKIN, IT CAN BE TEMPORARY SINCE THE SKIN REPLENISHES ITSELF. IT CAN LAST A FEW WEEKS, MONTHS, OR AT TIMES YEARS.

2) Can the above lasers be used to eliminate hyper-pigmentation caused by a TCA Cross? (i.e. One week following the treatment, can these lasers be used?) Do you prepare patients with creams before/after TCA Cross?
YES, BUT BLEACHING CREAMS ARE EASIER, CHEAPER AND MORE EFFECTIVE. I DO NOT PREPARE THEM BECAUSE TINA ALSTER PUBLISHED A PAPER MANY YEARS AGO AND SHOWED NO BENEFIT IN THE PRE-TREATMENT WITH BLEACHING PRODUCTS.
3) Correct me if I'm wrong, but I've read that KTP laser may cause bruising, and if so, you can help improve the bruising if we are still in town. What treatment do you use to help the bruising?
NO, KTP DOES NOT. PDL CAN. KTP IS USED TO TREAT BRUISING NOT CAUSE IT.
4) Are some scars too SHALLOW to treat? (Scars, not pores)
YES, POSSIBLY. BUT IF IT IS VISIBLE ENOUGH TO MY EYE THEN IT IS OFTENTIMES TREATABLE.
5) I came across one picture in your before/after collection of a darker skinned gentleman (here: http://www.lamfacialplastics.com/galler ... lNumber=16), and was amazed to see that while some non-ice pick scarring is noticeable, his ice pick scarring (similar to what I have) is pretty much all gone. How many TCA Cross treatments did he require if you don't mind me asking? 3 TO 5. CANNOT RECALL EXACT NUMBERS BUT THAT IS ABOUT THE AVERAGE.
6) Finally, in a non-skin related question, generally speaking, are procedures such as fillers and blepharoplasty advisable to anyone 25 years of age? (Namely, to improve the perma-tired/angry look or to add volume to the cheeks)
GENERALLY, NO BUT THERE ARE ALWAYS EXCEPTIONS. I HAVE DONE FILLERS IN 25 YEAR OLDS WITH GREAT SUCCESS. TYPICALLY THESE ARE INDIVIDUALS WITH EARLY AGING FROM SUN DAMAGE OR FACIAL FEATURES THEY WERE BORN WITH THAT THEY JUST DID NOT LIKE.
I appreciate any input you can provide, as I have mentioned, it's nearly impossible for me to fly to Texas at the moment (completing grad school). I have more specific questions, but don't have any pictures uploaded yet. I can follow up once you've responded.
NO PROBLEM. BEST WISHES.

Thanks! I'm about to PM you a follow-up with pictures.

as you see in my PM back to you, i do not think you really need any CROSS treatment and it will probably not help. fillers could help but i think you look ok a bit gaunt in the face. you really have ptosis and need a different type of surgeon to help you not me.
best,
sml