LAM FACIAL PLASTICS

Hi dr Lam,
I had a tiny bit of fat injected into my marionette lines about 6 weeks ago, it didn't really do anything to correct the lines, so my surgeon then injected juvaderm ultra plus into them, I don't know which of them is causing a irregular look in that area, but it looks like there is a small bulge of misplaced filler or fat below the line and when I smile it looks lumpy. I have had wydase to dissolve the juvaderm, but am unsure whether it did, I had a strange response to restylane in my lip and border, where it got lumps and with several rounds of wydase is still present. How can I tell if its fat or filler? If it is fat is it likely to reabsorb in this area on its own? It not would 5fu be helpful? and is it better to intervene sooner or wait? Would it require several rounds. Thankyou.

1. if it is doesn't go away and the wydase (hyaluronidase) was properly injected into the area then it is fat not juvederm.
2. 5FU really only works if the fat has fibrosis and not if it is just a soft lump. if it does not go away after a year, then i would excised it (cut it out).
best,
sml

Hi again,
I wanted to let you know the fat or filler feels hard, it was injected 8 weeks ago. Would there be any harm in injecting 5fu at this stage? Is it likely that some of the fat will dissolve in this area on its own?

you should probably check with your doctor. however if it feels hard, it may be more responsive to 5FU. in general if the fat was done by someone inexperienced it will probably go away anyway. if not, then it might stay.

Hi again
Just noticed in certain photos there is a greyish ting where the fat was injected is this fat nerosis? Does that mean the fat will not survive? Will it go away on it's own if it is or need some sort of intervention.

hmmm, i have never seen a grayish tinge so i don't know what you are speaking of. you should really ask your physician that question.
sml