LAM FACIAL PLASTICS

Hello Dr,

Let me just say that I really like your philosophy and dedication, I don't know that many doctors who believe they've been put on earth just to help others...I'd like to ask you two questions:

1- What do you think is a the best option for someone seeking an overall improvement of a skin that is a bit damaged ? I had acne when I was younger, it didn't cause scarring but left me with some red marks and redness of the chin ( this area of my face is just permanently pink) and kind of a blotchy complexion. I used retin- a for a year but I feel my skin is just too sensitive for it. I'd like the redness and uneven complexion to be gone. I'm a 26 years old male and I just don't feel good in my skin. I was thinking of trying some laser procedures.

2 - Can you perform fat grafting on a patient who had cancer (lymphoma) ?

Best Regards,

del

hi,
thanks so much for the kind words.
1- my KTP laser is great for that. either KTP or Pulsed Dye laser is the best. also IPLs that target red can be excellent too. those are the best things for redness. what has truly helped my skin is a change in diet. organic foods, no processed foods, no sodas, no fried foods, and little meat.
2. in short, yes, lymphoma is not an issue. however, if it is for you, 26 is a bit on the young side for me to do fat grafting. i always want to make sure my fat ages well. if it is for your mother or father, then yes.

Hello Dr,

Many thanks for your answer.
What is frustrating with my skin is that it doesn't look bad, it's just that I wish it looked better and I just need some subtle enhancements. I also have a slight depression in my right cheek that bothers me even though it's not really noticeable at first sight (it depends on the light) but I guess it could be corrected.
Regarding fat grafting, I know I'm too young for this procedure - and I don't particularly need it - but I like to do my homework...

Anyway, I really like your approach, I don't live in the US but will spend a few months here next year (In DC),I think I'll book a consultation.

ok, look forward to take care of you. might want to investigate just good skin care products. if you have enough damage to merit it consider obagi or other products. check out my skin website: www.skinwb.com.
best,
sml

I must say that I've contemplated going to a plastic surgeon for quite some time now but I always second guess myself thinking that I'm being ridiculous - and to some extent that's true because there's nothing really noticeably wrong with me and also because I'm a man. I would just like to correct things that are very subtle... but that bother me. I guess I'll have to send a picture of me in different lightings because it's hard to explain only with words.

I've seen some of your videos and I like the fact that you see the face as a whole while patients are often focused on one single flaw... Speaking of your videos, I have a question. You explained that botox should be started early on so as to prevent wrinkles from forming and allowing the skin to rest. What age do you think people (who can afford it) should start botox ?
I also heard that restylane shouldn't be injected in the forehead but why exactly ?
Oh, and last question what is the sex ratio among your patients ?

Best Regards,

Del

1. in fair skinned irish or nordic patients with some sun damage, infrequent (like 1 to 2 x a year) could even be started in the late twenties. for people with bad habits and extensive sun damage even earlier. for those with olive skin and very little sun damage, one could start in the 40s or 50s and still be fine. it all depends. my mom is 71 and does not even need it. however, i did do a fat transfer for her.
2. restylane in the forehead does not work for two reasons. the forehead skin is too thin and does not tolerate a filler. a filler in the forehead does not make sense anyway since the forehead wrinkles are the product of motion. if you try to fill in a fine line, it will either be lumpy or be gone in a second. it is always better to treat the cause (movement that causes a wrinkle) rather than the effect, i.e., break the habit, slow down the movement, that is the trick. for between the eyes, fillers can be quite dangerous in terms of injecting areas of sensitive blood supply. again it is also a cause and effect issue as mentioned above. accordingly, for the area between the eyes, if i do a filler (which is rare), i only use restylane which is reversible in case a 1:10,000 chance of a blood supply issue arises and you and i cannot leave town the night after injection to minimize that risk. unfortunately, most doctors are unaware of safety with fillers and do not carry equipment to handle a problem should it arise.
3. if you include my hair transplant patients, my ratio is 50:50. if you take them out of the equation it is about 85:15 women to men. don't worry about stigma. the fact that you worry about stigma is actually a good sign. to me it means that you will not go overboard. that is a good thing.
best,
sml

Hello Dr,

Many thanks for your detailed answers. It shouldn't be allowed to be so passionate about work !

I've seen your video about overhead lighting (devil's work really) which prompted my message because it's a topic I'm very self-conscious about - even though I shouldn't care bla bla bla...
Anyway, do you think it's wrong to begin fillers between 25 and 30 just to plump things up and add a little fullness ? I look very easily tired...
I wondered if I could send you a picture of me in very harsh lighting to explain more adequately what I'm talking about and what I would like to address.

Best Regards,

yes, temporary products in your age group make the most sense. you can send photos to me as a PM here if you like.
best,
sml

Thankyou so much for sharing this. I was finding same from long last time. You have come with lots of help. Thanks a lot... Good job! Keep posting....

most welcome!

Hi doctor Lam,
You seem to be providing some useful information on the forum so i decide to ask my question.
Awhile back i started experiencing redness on my face and i decide to visit my doctor and he told me thay i might be diagnosed with rosacea which i understand has no cures. he priscribed some pills which should help me but they did not. i was wondering what advise you have for my situation. i came across creams and articles such as this one on how to get rid of redness on face but i am unsure on what i should do. kindly spear a few minutes to give me some advise.

thanks

sorry, i had to delete the link since i do not allow that on here. redness is such a vague thing that there is no easy answer. also, although my laser works well for vascular redness it is not a cure. also, i am not a dermatologist. dermatologists are truly more adept at answering this question than a surgeon is. i don't have a perfect answer for you because you really need to see a derm, which i know you have done but sometimes redness is really hard to manage.
best,
sml