LAM FACIAL PLASTICS

Hi dr lam

About two years ago I had a round flat mole removed next to my nose (in a position very similar to a client named stacey from your videos, who was a patient of yours) which was a bit smaller than 0.5cm in diameter, the surgeon removed the mole in a circular manner rather than a fusiform excision. As a result I was left with a round scar which looked worse. A year later I went to another surgeon who performed a fusiform excision and left we with a better looking straight line which is approximately 1.5 cm in length and quite thin (however he did not perform any aftercare appointments) . This straight line has scar tissue and looks very bad in certain type of lighting. I have seen your patients and am very impressed by the level of care you give your patients. I live in egland but next year i will be visting dallas from england every month in order to help my father start a buisness there. Will you be able to perform surgery on this, and would it be possible to give me a schedule for aftercare, i know it varies according to the patient but approximately. I know you only provide surgery on people who reside in the dallas area but i feel you are one of the best surgeons and am only able to trust someone with your expertise if i am to reexcise the tissue.

Thank you

James

J

the scar is about 1.2cm to be precise when i measured it currently.

James

hi,
i would consider helping you considering your frequent return visits but please also understand that whenever you have already had something done multiple times the tissues become progressively less healthy for revision. that is particularly true when it comes to scars and moles. i just want to undersell you what i can do. i would do a geometric broken line repair most likely to irregularize the straight line and that should help.
best,
sml

Thank you Dr Lam for your quick response

The scar is pretty thin and short. It is not the shape that bothers me but the shiny and weird texture it has. Personally i would not mind if it is reexised as fusiform and made into another straight line as it is only 1cm in length and i feel a geometric broken line may complicate things. Sorry for trying to tell you how to do things doctor(lol). Do you think it would be possible to make it into another straight line like stacey in one of your videos or would this be wrong? ill ring your office so they are able to give me a consultation date. Just because ive had the tissue excised already would that make my outcome less pleasing than other patients.

Once again doctor thank you for any help

ricky james

Sorry doctor

But a quick question. Would you use a multi layered closure for this and what type of sutures would you use?

Thanks

Ricky james

yes, multilayer but i don't know if i can change the texture. that sounds a bit more confusing to me. i may not be able to do what you want. send me a photo to samlammd@yahoo.com just to take a look.
best,
sml

Hi dr Lam

for mole removal you use something called microscope loupe magnification. would you also use this method of closure for a small scar that i currently have as a result of mole removal. Also how long do you leave outside stitches in for.

Thanks

yes, always with magnification. it is simply more precise when working on small areas. the outer sutures stay in for 7 days.

Hi dr lam

I am coming to have a scar revision done by you in early december.

Was Just wondering what will the aftercare involve. I read on your website that in the first week it is very important to keep the wound moist and you would not apply any sort of band aid or steri strips on this. when i go out in the first week after the surgery would I not be able to apply some band aid on the wound so it does no feel so bare. Also after the first week how long before the dissolvable stitches dissolve or are difficult to see. As i go back to university about 6 weeks after the surgery and want the dissolvable stitches to have pretty much dissapeared. Do you think this is possible.

hi,
1. yes, you can put a bandaid over my sutures so long as there is ointment underneath it.
2. dissolvable sutures are under the skin. you cannot see them. they last about 3 to 6 months to help minimize risk of spread back.
look forward to take care of you.
s.

Dear Dr lam

After the stitches are removed, would i need to apply tape on the wound, or would i just leave the wound bare with nothing on it. Also what are the chances of a succesful scar revision. Having seen photos of me do you think there is a strong chance for improvement. I also would like to ask you how long would it take before i see improvement in scar. After a month will the scar look reasonable.

Sorry for all the questions Dr, it is just that i am pretty nervous about this procedure.

Thanks Dr Lam

See you soon

1. no need for tape. wound bare is fine.
2. i think you have a good chance for improvement.
3. it will take probably at least 6 months before you begin to be happy with it. at a month, the scar should be better but there is a chance that it could still look worse due to redness or other visibility.
being nervous is understandable. i look forward to take care of you.
s.

Hi doctor lam

Sorry to bother you again. But was just reading a article on the internet about the vertical matress suture technique and it says it has a high likelyhood of leaving prominent stitch marks (railroad marks). Another article says running subcuticular sutures are best for delicate areas on face and have very little chance of leaving stitch marks. I was just wondering what technique do you use.

Once again im sorry for all the questions.

See you soon

Ricky

i use a running horizontal now that really minimizes railroad tracking.

Dear Dr Lam

I had a wonderful experience at your clinic on monday and am really grateful for your honesty in regards to not having the surgery, i believe i have some emotional attachment that surgery will not correct. In regards to the silikone, there is some sort of swelling that is slowly settling down, and a bit of redness around the injection sites, is this normal. And how lond do you think before i may need another shot of silikone. Also i was just wondering in general as you have seen my face now is there any other treatments you would reccomend for maybe dealing with some acne scars i have such as microdermabrasion.

You are a great doctor, one of a kind.

Kind Regards

Ricky