LAM FACIAL PLASTICS

Hi Dr. Lam,

I live abroad and I had fat grafting to my lower eyelids (I'm in my early twenties have always had a hollow deficiency there and didn't need grafts anywhere else) about six weeks ago.

I can't compare my doctor to you but i can say i did lots of research about different doctors and this doctor seemed to follow all the same technical aspects that you promote (cannulas, placing micro droplets instead of clumps or strips, etc.). Therefore i'm hoping you might be able to help me with some questions given some of the (in my perception anyway) similarities between techniques.

In the last couple of days the graft has seemed to go down quite a bit. In the first couple of weeks after i had the graft i did find that it was swinging, going from looking good to looking bad to looking good again from day to day, and lots of changes were taking place. But then it seemed to stabilise, and now in the last couple of days has been going down. My question is: is this a normal event occuring, and can i expect it to perhaps get fuller again as time goes on. I have seen you mention in your vlogs that a dip can occur after some months in your patients; what exactly is this "dip" (is it a loss in volume), and is it possible that i'm going through a dip that has occured early? (sorry thats propably a few questions rolled into one)

and secondly: My doctor says he won't put in fat again until at least six months to a year has passed even if it is looking hollow because he says it can take that long to stabilise and we would be acting prematurely. do you agree with this? I see some doctors on the internet do a series of injections 1 month apart, how does that correlate with my doctor's view?

Thanks Dr.Lam i know that was quite lengthy. Your time is much appreciated

Hi,
First, it is entirely inappropriate for me to comment on another physician's procedure. Even if you believe that what he does is similar to mine, it is not the same and I cannot be certain if it is even similar in terms of amount, distribution, plane of injection, processing methods, etc. All of that being said, I can only safely comment in general about fat grafting:

1. The dip usually occurs a few months out where you start to look as if you lost part of the fat grafting when you have not. The swelling is down but the fat has not grown yet.
2. I would agree with your physician that in about 90% of cases I would not go back in before 6 months to a year because as stated in point 1, it has not "grown" or blended yet.
hope that helps,
sml

Thank you Dr.Lam for your swift response, I hope I didn't come across as generalising your work, I have great respect for what you do, I just wanted to give a context to my question. I just have one follow up question to your response; regarding the dip that occurs, is it possible for this to occur at around six weeks, or not really?

Thanks again

No problem. Yes, it is possible. I have some patients who are disappointed with results at 6 weeks and then start to pick up at 6 months and beyond. A conservative approach toward fat grafting is always recommended. In any case, your physician should make further recommendations regarding your care. I don't like to have unnecessary chefs making the soup.