LAM FACIAL PLASTICS

Hi Dr. Lam,

Just wondering what you would suggest for my face. What type of scarring is this and what's the best way to treat the indents in my face?
Thank you for your help

as far as what i can see most likely CROSS TCA but i may recommend silicone injections when i see you depending on how you look in person.
best,
sml

Hi Dr,

Thanks so much for your reply.

I'm in MI and I really can't afford to come there right now, I'm thinking of trying TCA myself.

Is it just basically cleaning the skin and dipping a toothpick in it and the dotting it on the scar/sunken area? It seems like a lot of people have done ok doing it themselves so I'm contemplating trying that.

it is the most dangerous thing you can do. i have a gentleman from LA that has craters on his face from an unlicensed person doing it. it has taken me years to do this perfectly. if you don't come to me, find someone local who has tons of experience. read my posts on this.
best,
sml

Ok, thanks Dr.
I am looking into when I can come out to see you.........what's the pricing like for silicon injections and what is it for tca? I'm sure it depends on how much you use of course but with my pictures you can see I have both cheeks pretty much covered in scarring so that should give you an idea.

Also, I'm thinking of doing subcision first becuase so many people i've talked to have had good luck with it and I can do it here but I wanted to ask you if I were to do subcision and then use a filler can I still then have you do silicon microdroplets? Can you do it if someone has had HA filler put in their scars?

Does tca work on boxcars too? Or do you usually use silicon for that?
Unfortunely, most of my scars are boxcar, I only have a few icepick ones.

Thanks so much for your help

Oh, forgot to ask, how long does the healing take (i.e. scabs gone) for tca? And how long till you see the result?

And is there a healing time at all for silicon? Or is that pretty much an instant result?

P.S. I measure my scars and most are 2-3 mm, a couple are closer to 4 if that helps at all

hi,
1. for pricing you have to call my office 972-312-8188. i don't post that on here. sorry.
2. i really don't like subcision. i don't think it works well and really cannot be combined with silicone or TCA at the same time. won't work and dangerous if you do that. you can subcise an area with HA fillers, no problem. i just don't like subcision.
3. TCA works on icepicks only.
4. TCA takes a few days to heal. in certain circumstances it could take a whole week. if it pigments it could take even a few months for the pigment to settle. that is why it is important to stay away from a lot of sun for the first few weeks after TCA. silicone minus bruising has no real recovery. sometimes things look too perfect at less than a week. this is swelling. so don't get too excited at an early date with the results. the collagen growth for TCA takes 90 days to show up. silicone has a second component of growth which occurs also at 90 days with collagen growth.
best,
sml

Ok, thank you, so after looking at my pictures do you think silicone would do a lot for me?

i believe so for at least the larger holes. for the pinpoint ones, that may be harder.

Hi Dr. Lam,

What do you recommend for hypopigmented acne scars on the neck, chest, and upper back? Is surgery a possibility?

Best,
Frustrated Patient

surgery is most likely a bad idea for risk of worsening. if the pigmentation is the problem, you might consider tattooing by a skilled provider. always consider doing a test area first. there are not a lot of good solutions for hypopigmentation.

Thanks Dr.,

So I'm wondering if you think silicon is the solution to my bigger ones...........what about the one I have HA in?
I had HA filler put in it in September, can you still do silicon there? How does that work?

Thanks

i think silicone is your bigger problem with the reservation that i change my mind when i see you in person. you can put silicone on top of HA, so long as you understand that part of it (the HA part) may go away over time.

What do you mean silicon is my bigger problem?

silicone will probably help with the majority of your issues.