LAM FACIAL PLASTICS

Hi Dr. Lam,
I am very glad to have found your website.

I had silikon injections (microdropplet, medical grade) just a month ago! I have several problems. The first is that my lower lip is bigger than I wanted it to be. I could live with this, but it's pulling my face when I talk and it has created very obvious labio-nasal wrinkles!

The second problem is that I have some ridges and lumpy tissue on the inside of the lips. My injector suggested kenalog, but I am scared because I've heard it can distroy healthy tissue.

1. Should I try the kenalog in your experience?

2. Could a very minimal lip correction be performed? I will be looking for a very minimal reduction and I am worried about scars and asymmetries.

3. My lower lip is pulled down right now by the silikon and is showing my lower teeth? Could a slight lip reduction pull it up again?

Thank you so much for considering my situation!

Hmm, sounds as if you had more than microdroplets used. Kenalog in general is not very effective and carries with it some risks. I could perform a modest lip reduction but I would have to see you to make that determination.

Hi Dr. Lam,
Thank you for responding so quickly! I was assured it was the microdroplet method, so I am puzzled, too.

I will try to schedule an appointment (virtual or in person) with you.

I will say this much: technique is everything. When I perform microdroplet technique, I use only 1/100th of a cc per pass done in a perpendicular randomized fashion (rather than linear beading, which means running a needle through the lip and pulsing drops in, which I think can be less controlled). In addition, almost all of my patients are underwhelmed with one session. I cannot recall anyone saying they were overfilled after one treatment. Most likely, the "microdroplets" were bigger than "micro", perhaps 1/10th of a cc or 1/50th of a cc, or even more likely a huge volume of microdroplets were placed during one session. I use only 0.3 to 0.4 cc per lip and wait an entire month before retreating. I do not exceed this limit, ever. With silicone being permanent, I don't compromise my technique, and I have tremendous experience with it. Unfortunately, I also have tremendous experience dealing with other people's silicone and other lip problems (almost every week!) I would say at least twice a month someone flies in for me to correct their lips.