LAM FACIAL PLASTICS

I enjoyed our consult on Friday & have only one concern regarding my procedures. I am concerned that the neck & lower facelift is not going to remove enough excess skin that I have in my mid-face. I realize I'm going to need a little extra to make up for the new fat that will be roosting there, but I'm worried that I will still have too much sagging skin. Can you guide me past this concern? (I'm thoroughly enjoying my Botox benefits; wrinkles disappearing by the minutes.)

hi,
nice meeting you too. do not worry about the extra skin. remember a facelift is there to tighten muscles. skin removal is a byproduct of muscle lifting. we simply think we have too much skin in the midface, when we really do not. rest assured, we all pull and lift our fingers on our face and think, "Boy, I must be loose there." You should not think that after a fat transfer and a facelift because things will look so much better. look forward to take care of you.
best,
sml

Thank you Dr. Lam for your quick response. I spent about 12+ hours watching & reading your website yesterday. (OK, yes I do have a life & I'm not obsessing, just trying to be a well-informed patient.) I am considering waiting on the nose job due to the fact that I watched your video & you referenced how some noses actually haven't gotten bigger, the face just got smaller. I will try to compare this 52 yr. old nose with my younger one & see if there is much difference. Any other suggestions to help me make up my mind? I have a feeling if I don't do the rhinoplasty with the other procedures, I probably won't do it at all. Decisions, decisions...

hi,
yes, your nose has not grown most likely. that being said, you are an excellent rhinoplasty candidate hate to say even better than your husband, as i mentioned. thin skin, more bulbous tip with thick cartilage. you should have a very feminine soft nose when i am done. i would highly encourage you to consider keeping it because it will give you a total facial result that i think you will find eminently pleasing. either way is fine with me. today's assignment 13 hours on the site. lol.

best,
sml

If I decide to do my nose (which I am leaning towards), can we do a digital image of what approximately it will look like afterwards at my pre-op? Also, will my Botox injections affect the timing of my surgery? I was looking at early November so I will be healed by mid-December for our son's college graduation and Christmas festivities (& company). Should I be preparing my skin, such as Retin-A and/or bleaching cream? I read about this on other sites & just thought I'd ask.

(I failed the homework assignment; only spent about an hour. Lol)

in general, digital imaging is much easier to show for profile images. you do not truly have a profile issue. your tip is broader and boxier. i rather show you an idea of tip refinement that would benefit you:
http://www.lamfacialplastics.com/galler ... 5.jpg.html
although your nose does not look exactly like this you can get an idea of how the broader tip with cartilage width has ben subtly but dramatically narrowed.

botox is not an issue. if you do come close to your 3 month visit then i can do another round for you. i would do it a day before but otherwise you can do your surgery based on your easiest convenience.

no, i do not believe in the prep work. i am basing this on a study by tina alster from 2001 2002 ish that looked at no difference between prep and no prep work. if you feel more comfortable to prep the skin, that is fine with me.

1 hour is still pretty substantive. nice work!
best,
sml

Thanks Dr. Lam. I took a pic of my profile & was pleased with my nose profile -- not so much with the wrinkles by my ears that showed up in the picture that I had no idea were there. We'll take care of those little suckers in November. We can come back the first part of Dec. for our botox & hubby's artefill. Thanks for all of your help. Have a great day.

my pleasure!