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  • It is currently Thu May 23, 2013 2:48 am

What would you recommend for me?

section of the forum is dedicated to discussions addressing injectable fillers including Restylane, Perlane, Juvederm, Radiesse, Sculptra, Silicone, Artefill, or other office-based injectable filler, except for the management of acne scarring (See Acne/Acne Scarring Forum).
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What would you recommend for me?

Postby monty_lameer » Sat Mar 31, 2012 6:59 am

Hi Dr. Lam :)

I'm a 33 year old woman, and I have always been told I look a lot younger than I am, however since I was about 27 years old, I have noticed quite significant sagging in my lower cheeks / jawline / chin area, and volume loss in my mid cheek area. I never had very prominent upper cheekbones, but now my face looks very flat. I have quite a long / rectangular face as it is, and this accentuates that in a way I am not happy with.

I have been looking at the options of having Botox injected for a lower facelift but am not sure if this is the best thing for me. Perhaps combined with some fillers for the mid face as well.

Also, ever since I was about 14 years old, I have had what appear to be under eye bags. I am not actually sure if they are technically bags or not. They do not vanish no matter how much sleep I have. They also are not discoloured, but just appear slightly puffy under my eye beneath an area slightly higher (between the eye and the bag-area) of more sunkenness. The puffiness causes the skin to look like 2 faint brown lines under my eyes, whereas if I hold the skin taught, the brown colour goes away completely, so I assume it is shadowing of some sort from the puffiness. When I hold the skin taught, I look so much fresher and younger.

In any case, a year ago I had some Restylane injected into that under eye area and it looked better. It was only a very small amount and more as a sort of “sample” of how it would look were I to get more injected later (my doctor had a small amount leftover from my nose and asked if I wanted to put it anywhere in that very small dosage).

At first I could feel it under my fingers and was pleased with the appearance. It seemed to wear off after about a month and I could not longer feel it there. Is this normal for such a small amount injected?

I would be nervous to have more injected in this area, as I did not have any swelling or bruising from the small amount used last time. I have seen some people who have used fillers in this area and they sometimes look very swollen and puffy, and not just for the first week or so.

Overall, I really want more of a soft, youthful heart-shaped facial shape and less tired-looking eyes. I do not want the hard razor-sharp cheekbone look or the puffy, wax-figure look.

I would really appreciate if you could advise what you personally would recommend for me, and thank you very much for your help!
monty_lameer
 
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Joined: Sat Mar 31, 2012 6:39 am
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Re: What would you recommend for me?

Postby dr. lam » Sun Apr 01, 2012 4:24 pm

yes, globally, fat grafting is a great answer if your weight is relatively stable. however, i can also accomplish this with fillers. if you need more lower face volume fillers can get more expensive but if you just need a little around the eyes, then fillers would probably be better because it would be cheaper. i use tiny microcannulas that less than 2% of docs use out there so i rarely overfill someone and the bruising risk is really minimal. you do not need a facelift or botox in the lower face at your age.
Samuel M. Lam, M.D., F.A.C.S.
Diplomate, American Board of Facial Plastic & Reconstructive Surgery
Diplomate, American Board of Otolaryngology Head & Neck Surgery
Diplomate, American Board of Hair Restoration Surgery
dr. lam
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Joined: Wed Oct 03, 2007 10:51 am
Location: Dallas Texas
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