LAM FACIAL PLASTICS

Hi Dr. Lam,

I've had I-shaped silicone implant 2 years ago in Korea. My real problem was my flat bridge but my tip was fine. I should have known I'd be moving to Dallas from California so I could have consulted you. In the first year, it looked great. Now, I agree, no matter how great looking it was, the skin around my bridge gets thinner and it starts to look fake. If this will remain like this at 2.5 year mark, I could live with this I guess. 1) DO YOU THINK IT WILL SHRINK-WRAP MORE TO THE POINT THAT I WOULD HAVE A REVISION? 2) DOES THIS HAPPEN TO ALL SILICONE-IMPLANTED ASIANS? 3) DO GORE-TEX CAUSE SHRINK-WRAPPING LIKE THIS? 4) WHAT CAUSES SHRINK-WRAPPING WITH SILICONE? 5) COULD I MINIMIZE OR PREVENT THIS USING ANY COSMETIC CREAMS, ETC? 6)LASTLY, I STILL LIKE THE SHAPE OF MY BRIDGE, IT'S JUST THAT THE EDGES ARE STARTING TO SHOW, ANY WORKAROUND WITH THIS? LIKE A FILLER OR SOMETHING WITHOUT GETTING A REVISION?

THANK YOU SO MUCH DR. LAM!

I HEARD YOU'RE ONE OF THE BEST ASIAN RHINOPLASTIC SURGEONS IN THE UNITED STATES. I WAS IN CALIFORNIA BEFORE AND BEVERLY HILLS DRS ARE TOO EXPENSIVE SO I HAD TO FLY TO ASIA.

1) DO YOU THINK IT WILL SHRINK-WRAP MORE TO THE POINT THAT I WOULD HAVE A REVISION? hard to say. sometimes it stops. sometimes it continues. 2) DOES THIS HAPPEN TO ALL SILICONE-IMPLANTED ASIANS? no, sometimes it does not shrink wrap at all. 3) DO GORE-TEX CAUSE SHRINK-WRAPPING LIKE THIS? typically no but if your gore-tex is too big it can create a similar problem. 4) WHAT CAUSES SHRINK-WRAPPING WITH SILICONE? encapsulation of the implant with scar tissue. 5) COULD I MINIMIZE OR PREVENT THIS USING ANY COSMETIC CREAMS, ETC? no, that is useless. 6)LASTLY, I STILL LIKE THE SHAPE OF MY BRIDGE, IT'S JUST THAT THE EDGES ARE STARTING TO SHOW, ANY WORKAROUND WITH THIS? LIKE A FILLER OR SOMETHING WITHOUT GETTING A REVISION? yes fillers can oftentimes work. there is a tiny chance you can infect the implant when injecting around it but that is rare. still something you should know. thanks for the compliment.

wow! thank you very much for the quick and sensible response Dr. Lam.

Based on your response, since I don't want any surgery, I might opt for filler on the "depressed" area due to shrink-wrapping so it softens the bridge area.

However, would the filler caused shrink-wrapping too over the filler material? Would it thin the skin as well? Would the filler cause scar formation as well leaving a nose more funky looking? How long would it last? How much would the cost be in your clinic if you don't mind my asking(range is fine)? Thanks again. - Yeye

No, fillers will not cause shrink wrapping as far as I have seen. It should not thin the skin either. The cost can vary from a few hundred dollars to 1000 depending on if you want a temporary or permanent filler. If you're going with a permanent filler like Artefill the product does require a skin test a few weeks in advance of the treatment.

Yay! thanks Dr. Lam. You gave me hope and I'm sure there are many out there who might have the same issues who'd benefit from this info knowing how silicone implant behaves like this by and large. I'll probably arrange to get an appointment with you for this. I will try temporary fillers first and test how it would look. Thanks much!

sorry, one more qq: how long does the temporary filler last? months? thanks!

It is variable. Anywhere from a few months or even a few years.