LAM FACIAL PLASTICS

Dr. Lam

First of all thanks to a great information you provide to the community. We all very much appreciate it.

I have a question re Radiesse. I have been to a PS and he advised me Radiesse to fill-up my cheeks - they are kind of sunken and show me as always tired and there is a distinct fold people can see which is more prominent if I sleep too much or too less. I understand that this is a temporary solution. Can I do Radiesse now and maybe later on (in a year or so) do fat transfer on my cheeks. I wanted to go this route to see how my cheeks will look like (after Radiesse) before I want to do Fat Transfer for a permanent look (hopefully)

is your procedure Fat Grafting similar to Fat Transfer (other PS use the term Fat Transfer)..

Thanks so much !

A few things: First, do NOT do radiesse if you are contemplating fat in the next 2 years or more. Although Radiesse in general holds better than Perlane, it really sticks around way too long like many years. Now, when I mean sticks around I don't mean aesthetically. Even when the aesthetic result is gone, the product is still there.

Although I have done fat transfer (yes, same as fat grafting) in patients who had Radiesse a year prior, I am not a big fan of doing so. It really screws up my fat transfer for the reason enumerated above, plus if your Radiesse is still there and not faded yet, you will pay for a permanent fat grafting on top of a temporary product.

I also know how people respond to volume. Even my own staff member, Darla, told me, "Dr. Lam, I am only 35 years old, I will not need fat grafting until I am 40 so go ahead and put Radiesse in me." As soon as the Radiesse was in, she said, "Oh my God, I want fat grafting." I said sorry, you have to wait at least a year now and still I am not excited to do it for her. The point is even if you think you probably don't need or want fat grafting soon, you probably really do. Try a hyaluronic acid based product like Perlane first.

Perlane is a great option for your cheeks since it should last you 6 months to a year in preparation for your fat transfer. You can have the remainder dissolved before you contemplate having fat grafting.

Also, remember that fat transfer is different in different hands. Not only from an aesthetic perspective but also longevity. I had a lady who had a fat transfer in Dallas by someone else because he was cheaper than I and had to go back already twice to get that restored and it is still gone. My fat grafting holds tremendously well and I know how to shape it so that the face looks balanced and youthful.

Btw, if you wonder if I like using Radiesse. Yes, I love it for the following indications:
1. deep smile lines (fat won't work and Radiesse lasts a long time)
2. someone that is simply not a candidate for fat grafting because they don't have any donor fat.
3. volume to the hands if they simply don't have enough fat volume to transfer to the hands.

Here are the places where Radiesse is God Awful:
1. lips: DON'T DO IT.
2. around the eyes: DON'T DO IT.

best.
sml

Dr. Lam

Thanks for replying. two follow-up questions -

a) I understand the Radiesse might not be the best choice if I want to go for fat transfer later. I was still contemplating Radiesse If I change my mind in futuure (not to do fat transfer for any reasons) and like getting Radiesse at regular intervals (say once a year touch-up). so in the worst scenario - what is the safe time one has to wait after getting Radiesse to opt for Fat Transfer ? are there any complications if Fat Transfer is done even if some radiesse is still in the face..

b) Can you suggest the indicative price of Radiesse and Perlane (per syringe) and also of fat transfer

Thanks and I appreciate your help !

basically, if you should consider fat grafting, don't do radiesse. that is my policy. radiesse sticks around forever, but it seems as if you have already made up your mind (which is fine). i would say in general if i had a choice, i would wait at least a year and half before considering fat grafting. i have done it in someone less than a year but that is not ideal. you can call my office for my pricing if you want to know how much i charge.
best,
sml

Dr. Lam -

Thanks for the reply. I am not biased towards using Radiesse. The reason I am inching towards that is due to the fact that I have heard it stays the longest and it is most cost-effective. Frankly, I can not afford the cost of Fat Grafting at this time - so I am kind of buying some time before I come for fat grafting. the question I have is - is Radiesse the best choice (assume that I can wait for 1.5 years as you suggested for fat grafting) for the area on cheeks.. I am not trying to do it under EYES and thanks for your advice on that ?
I can consider Perlane as well if you suggest it is better than Radiesse (keeping aside the argument that it is easier to do fat grafting after Perlane).. I am going to call your office for getting costs of the fillers..

Thanks again

Radiesse is the best long term option for the cheeks if you do not want to do fat anytime sooner than 1.5 years.
best,
sml