LAM FACIAL PLASTICS

Hi Dr. Lam,

I'm a 22 year old female and I started IPL fraxel treatments August 2009 and ended April 2011 in the understanding it would heal four deep pitted acne scars I had on my forehead, I had 12 treatments. I had no idea the kind of danger I was getting myself into; the "spa dermatologist" was very friendly, told me insurance covered my pricing, and continued to schedule me for more treatments in 4 week intervals. However, now I have lost complete volume to my face, cheeks, eyes, and forehead in what I believe to be overall fat loss and very unelastic skin; everyone thinks I just lost weight. I am horrified and will never let laser touch my face again. In your experience is there anything medically I can do: are there gels to apply, supplements I can take, can I get fat grafts to restore my face or is it possible at my age that in a couple years the fat pads, collagen and skin will regenerate and grow back?? Please respond ASAP!

don't panic. just wait for now. sometimes things get better over time. i would wait this year out and see how things change. but i can restore volume in many ways. let's cross that bridge when we get to it.
sml

thank you for your respons Dr. Lam! The entire skin has gone flat to my face as if all the underlying tissue has melted, I had nice buccal padding on the side, forehead, cheeks, chin and jaw and now it's just skin and bone! Do you think that could restore itself after a year or so, if not, can your fat grafts restore my eyebrow, forehead, cheek and chin padding permanentely?? Thank you so much, this loss is very disturbing to deal with right now, my facial expressions and everything are distorted, I'm in the hopes it will regenerate!

i think things can get better over time. right now i would wait patiently and hope for the best. yes, fat grafting can help but i am always careful in treating someone very young (if you read this forum) because the #1 issue with fat grafting is significant weight gain (20 to 30 pounds) afterward that can lead to a fatter face, which is obviously what i don't want. at your age, i just want to make sure that it ages well for you.
best,
sml

thank you, what do you think is causing the sudden fat and volume loss in my face, and do you know how long it will last? I am hoping to patiently wait for the process to stop and volume to return but it seems impossibly horrifying. I have a fast metabolism and excersize so gaining 20lbs has never been possible for me, I am considering the fat grafting- does it restore the cheek, forehead, chin, mouth and buccal padding I once had?

no clear idea but at high energy levels it could have damaged the blood supply to the fat. it can restore everywhere but i do not like doing forehead because it can look saggy over time. nevertheless, i think things look very good even without forehead injections.
best,
sml

Thank you for your honest response! So in your experience of plastic surgery and dealing with the skin, is it possible for healing where the blood supply, fat and volume will come back to my face after a couple of years, or could this be permanent damage where once the fat cells are destroyed they can't form back??

honestly, i don't have enough experience with this issue that i can answer that question. i know there are support groups out there that can do a better job answering your question than i can. i use IPLs in my office but i use very low settings because of all this Internet based exchange. i really hope things work out for you and if not i am here to help you in the future.
best,
sml

thank you, I'm glad there are options! With the loss of elasticity to my entire face- forehead, eyebrows, jaw- could I possibly undergo a full facelift with the fat grafting to have my skin tightness back, or am I too young for that where fat grafting will give me the volume, tightness and lift I need?

a facelift will absolutely not help a young face like yours. facelifts do not tighten skin. they are meant for sagging muscles in the aging face. radio frequency treatments like thermage can help but that has been known to lose fat at high levels too so i would not worry too much about the skin looseness. think about volume down the road. that is the key.
best,
sml