LAM FACIAL PLASTICS

Hello Dr. Lam,
I would like your opinion on a few acne scar treatments:

Fat Transfer- I have read other posts that state that you do not feel that this is a good treatment for acne scarring. I saw that you used the words "not safe" and "dangerous". Could you please explain what you mean by that.

Subscision with filler- Do you think that this procedure could work on acne scarring?

CO2 laser- Do you feel that this is ever a good option?

I will be looking forward to your answers!

Fat Transfer- I have read other posts that state that you do not feel that this is a good treatment for acne scarring. I saw that you used the words "not safe" and "dangerous". Could you please explain what you mean by that.
what i mean by this is that 1. fat does not fill in skin etches well. it is a deep soft contouring material that truly makes faces rejuvenated. 2. when fat is done in very young people like 20 something i am always worried about how it will age since it is a live graft. i want to make sure that the person does not gain weight as he or she ages (that can affect the fat). 3. fat should not be placed asymmetrically because the fat can change with weight and it may not look smooth. 4. fat should be placed evenly over the face for the same reason as #3. all that being said, i think fat can help scarring in select circumstances: 1. someone old enough to justify fat like late 30s and beyond with stable weight. that way i can fill the scars somewhat and also blend in the fat into areas of aging. 2. the "stem cell" effect which is variable may help the skin's scarring over time but i want to undersell that since it is not predictable in every case.

Subscision with filler- Do you think that this procedure could work on acne scarring?
in short, no. i have not been impressed with these results.

CO2 laser- Do you feel that this is ever a good option?
pretty much no. for two reasons: it does not work that well and the recovery is tremendous with ongoing loss of skin color over many years and a depigmented line that shows up along the jawline after 5 to 7 years.