LAM FACIAL PLASTICS

First I would like to thank you for this forum and giving your time to answer questions.

I am a 30 year old male who has somewhat of "bug eye" look. I had malar agugmentation last year and although my overall appearance improved, it didnt improve what I wanted. Due to the placement I can't get Tear Trough silicone implants. I also outright refuse to have porex orbital rims put in because I've read they are very very difficult to remove (finding a dr. willing to do it is half the battle).
I consulted a very well known and respected surgeon who recomended fat to my tear trough/orbital rim area. I'm terrified of this. I've always heard fat should not be placed in this area. it will only turn out lumpy/uneven and the lumps might even turn to cysts. I've also heard fat graph or lump removal from this area is near impossible or atleast as hard as removing porex.

Is this true? I have read that you dont recomend fat there for anyone under 40 but I do not want fillers. I want something more permanent.

Thank you

hi,
first, fat grafting does not get lumpy if done by someone who knows what he is doing. in general, i prefer to do fat grafting in someone with unstable weight or someone who is just focused on a tiny area like the tear trough. The reason for the latter restriction is that fat is a graft and it may only have 70 some percent take. That is great if you have to fill 30 to 50 cc across the face but may not be worth it in one small area. If you want a permanent solution for a limited area like the tear trough I would recommend Artefill to do the job. I am extremely good with this but you need a skin test first a few weeks before the treatment.
best,
s.