LAM FACIAL PLASTICS

Hi Dr. Lam,

I am only 27 but it appears the volume in my cheeks is decreasing (and quickly recently) and is causing a droopy look. The funny thing is I have a fairly slender face and thin bone structure. So the droopiness of my cheeks is causing a hollow look. Is it normal for a person's face to be changing shape as they get older? Would cheek implants be better opposed to any type of graft or filler? I just feel like my cheeks always looked too heavy for my thin face. So maybe I needed more support for them so they wouldn't have that hollow look.

I also have some premature wrinkles under my eye lids but my right eyelid has noticeably more prominent ones. Is that something that can be taken care of easily with a filler? I lived with my parents for 23 years and they are indoor chain smokers, any way this could have hurt my collagen production or could be contributing to all of these problems? Thanks in advance.

Cason

hi,
in general i hate implants because thin face with bone protrusion looks bonier with a bony looking implant to put it simply. fat maybe a bit premature for your age just because i want it to age well. i would probably recommend fillers that after a few rounds typically last a long time and after a few rounds can even last years. fillers do not fix wrinkles just hollowness. botox fixes wrinkles. consistent botox over a period of a year or two will probably virtually eliminate or truly soften those wrinkles so you don't need as frequently given how healthy your collagen should be at your age. yes, the smoking could have contributed but who really knows for certain.
best,
sml

Thanks for your reply,

I also noticed that my problems look better or worse in certain lighting conditions. But ultimately I think I need something to restore volume in my cheeks. It's weird because I notice some problems in certain lighting conditions that I have never seen and then some that exist in in all lighting conditions. Do you look at your patients in different lighting scenarios to determine the best approach for procedures?

If think my best bet is to get thermage along with a filler. Have you seen good results with thermage as a way of helping tighten sagging cheeks or tired eyes? I most definitely want to be in your hands for these procedures.
I

1. i don't use different lighting per se because i need it to look good in normal overhead lighting. if i try to push out areas in bad lighting then you can look overfilled in normal lighting. all of us will look bad in certain lighting. that is normal.
2. i really would not do thermage at your age. i think it could actually lead to more volume loss. really would not do it. i have an accent xl alternative but still would not recommend it for you.
best,
sml