LAM FACIAL PLASTICS

Dr. Lam,
I know you use sillicone as one of your modalities but what about artefill? Any comments on that for facial volume or scars?

Thanks

i use a ton of artefill. i prefer artefill for folds or touchups after fat grafting. with all permanent fillers used more for volume or folds, i am always wary of using it in very young patients like someone in their 20s or early 30s. when i start to reach late 30s i am still conservative. by 40s slightly more agressive. by 50s more liberal. by 60s, very agressive. just want something to age well. i prefer silicone for acne scars and lips and small nasal corrections. i prefer artefill for deep folds and lower facial issues (nothing fills like artefill for that). hope that helps. judgement is always the key with everything.
best,
sml

HI Dr Lam!!!!

I totally understand why and how you use artefill. I remember you saying that for nasolabial folds and other areas, fat graft does not work as well as artefill...

My one question is... since artefill has PMMA beads, that are left there when the collagen dissolves, what happens if one wants either a fat graft or surgery in the area?

I am asking because just as of yesterday, some article in a magazine (but can't know how much I can trust that info), and that was clearly rhynoplasty and plastic surgery (hence my doubts, I could see a bias) said you can not later have rhynoplasty or surgery (and fat grafts?) in areas that had PMMA beads injected. They said it "changed" the tissues and surgeons can not work with that, especially in the nose.

Is that true? to what point? or not true?

Hugssssssssssssssssssssssssssssssssssssssss, HAPPY HOLIDAYS!!!

the nose is a different animal. this is why you see repeatedly in the rhinoplasty section that it is not ideal to inject product (any product) before a rhinoplasty because it can change the blood supply and also make surgical dissection very difficult. this is not as much the case with fat grafting but products particularly radiesse can cause a cement like change under the skin that makes passage of a cannula more difficult. that is why in general i almost always prefer a fat graft as a foundation then fillers afterward rather than the other way around. it is much better that way. also for many other reasons enumerated in the following video:
http://www.youtube.com/watch?v=cTfVutz-hSQ
best,
sml

Thanks for the answer ! just a tiny doubt about the meaning of something...
Just one question: the "cement" problem is one that happens or sometimes happens? more common with Radiesse than with Artefill?

Thanks and hugs!!!!

very common with radiesse. i have been doing artefill now for 1 year and have not done a lot of fat grafts after artefill so we will have to see that one.
best,
sml