LAM FACIAL PLASTICS

Hi Dr Lam
I know this may sound weird but it's true. My face is starting to feel loose and not enough volume /fat to make my face look youthful and the skin under my eyes are dark and i have fine lines. I hope fat grafting / botox will be able to help me. I know everyone start his/her aging at some point in life, early or late, but eventually. For me i think it's a bit early. But i think because of my habits that causes this aging to start so early. Well i like to stay up at night a lot....and i usually sleep in the morning and i had bad acne problem since i was 19, so i used a lot of harsh cleanser, skin care stuffs for the acne..and much of these products required massaging...and i think this is what makes my skin loose.

I learned in your videos that fat grafting will add volume and refine your facial shape. My main concerns are my cheeks, lower eyelid. So i think adding fats to these area will definitely help me.

Also, can having botox in the jaw area to slim down the jaw be done at the same time as fat grafting? Can these two procedure be done in an office setting (not in an operation room). How many botox injection do you usually give to a patient for the first time?

Also, when i was a kid i fell off of bed and hit my forehead on a metal bar and i think that caused a hollow space on my forehead (kinda feel like the bone is not balance in that area and when i look at myself at an angle in the mirror..with the light i kinda see that area not contouring properly....will using fat grafting to fill in that area help?

Please reply. Thanks Dr Lam. I love your website and all the videos you made on your site and Youtube. They are so helpful. By the way, i think you are already a 100% + surgeon out there. But if you are still looking for improvement (regarding your contest), i think you should do something that no other surgeron will do:
For example: rather than asking your patient to come to Dallas to have surgery, why not coming to other countries like canada, china, etc etc...for one month of the year and perform surgeries in a hospital hear and there.
Since many patients are flying into Dallas, so why not have some hotel room upstair of your office or somewhere near owned by you for patients to stay in Dallas a few nights after surgeries or patients flying in for consultation or for patients' family/friends who fly in with the patients...and remember to charge them rent.
Please note: i probably will submit a better and detail copy for the contest...this is just some thoughts.

Thanks Dr Lam
have a good day.

Hi,
I am not here to judge aging as I have definitely seen people who are in their twenties who look as if they are in their thirties, and thirty somethings that look as if they are 50 plus. Usually, the real cause of this aging is either excessive sun exposure in youth that just kills your skin and aging or some kind of other external stressor like drug use, etc. If you see some of those magazine articles where they have photos of a 25 year meth-addicted person who looks like a haggard 50 plus year old, you will understand why I should not pass judgment on someone simply because of his or her age.

Despite these exceptional circumstances, I would say that fat grafting is excessive in most individuals in their twenties. Interestingly, I just performed fat grafting 2 days ago for a 25 year old from the West Coast but I did so because she was liposuctioned to the point by another PS that she looked much older than her age. I therefore performed a careful and selective fat transfer to replace what she was missing.

The main concern that I have expressed about fat transfer in someone who is in their 20s especially female is that individual may gain weight with aging that can show up in the face after fat transfer. Plus, if one has not gotten pregnant before and there is weight gain during that time, the face can look distorted during the interval of excess weight gain.

Botox in the jawline can be very helpful in contouring a wide jawline but the results last somewhere between 6 months to a year. Botox is an office procedure. Fat transfer requires a bit of sedation and cannot be done at the same time. I can do Botox the day before the procedure for people from out of town.

Fat grafting does not work in the forehead or in a scar. It can look lumpy and it is dangerous.

I appreciate the thoughts but I can't travel to do surgery for two reasons. First, I don't need to. I am booked out 3 months for surgery and if I go to Russia for example, I may be doing one case there. Plus, all of my other patients won't be getting my services (Botox, fillers, etc.) because I am away so long. Also, I have no medical license to do so. With the number of people flying into see me every single day, the only way to maintain an efficient practice is for those patients to make the journey to see me. Believe it or not, I have people flying in almost every day just for Botox and/or Restylane!

As far as a hotel, I am not in the business of running a hotel. I have no square footage left in my building to do that. Plus, I signed a waiver that I would NOT run a hotel based on Plano city codes. Plus, there is a luxury hotel opening across the street from me in a year or so and in the mean time I have a million hotels already a stone's throw away from my office that offer tremendous discounts to my patients. Yes, 30% of my patients fly in for my services but I can't staff or provide more help in doing something that would not be my forte, which is to run a hotel.

Thank you for your queries.
best,
sml

Hi Dr Lam.
Well one of my main concerns is my kinda flat cheeks. In other words, it makes my face look bigger and wider that it really is...cause i have no volume / cheeks to balance out. When i smile it is ok, but when i dont smile, it appears that my cheeks / face is saggy. I perfer not to have a cheeks implants, as it is unnatural. I watched in one of your videos that u dont perfer that yourself. Well the only other option is injections, but i am looking for something that will last me longer and perfer to be permanent, as i live in canada. And yes, weight gain probably will kill me and i am gaining weight a lot comparing to the previous years.

Will it be possible just to put some fats under the eyes area to make the eye more awake (straighten out the fine lines). I am sorry if i make no sense here.

Can fats be injected onto chin area (just a little) to make my chin a little out.

In a way, you can say i am not very open to injections, implants or anything that is not natural and i try to avoid all of them. So i am sorry if i make no sense here or use the 'fat grafting' in a wrong way/ idea/ etc.

Can dimples creation be done at the same time as botox jaw injection? in an office setting?

Well i guess it really make not that much sense here as if you see me in person you can make more judgement, etc.

When i am ready i will book a consulation with you. Thanks Dr Lam.

HI,
TO MAKE IT EASIER, MY RESPONSES FOLLOW YOUR QUESTIONS IN ALL CAPS.
Well one of my main concerns is my kinda flat cheeks. In other words, it makes my face look bigger and wider that it really is...cause i have no volume / cheeks to balance out. When i smile it is ok, but when i dont smile, it appears that my cheeks / face is saggy. I perfer not to have a cheeks implants, as it is unnatural. I watched in one of your videos that u dont perfer that yourself. Well the only other option is injections, but i am looking for something that will last me longer and perfer to be permanent, as i live in canada. And yes, weight gain probably will kill me and i am gaining weight a lot comparing to the previous years.

AS FAR AS WEIGHT AND AGE, WE NEED A PHONE CONSULTATION TO ESTABLISH SAFETY LIMITS AND PROVIDE DISCLOSURE, INFORMATION, AND THE SUITABILITY FOR YOU AS A CANDIDATE TO HAVE FAT TRANSFER.

Will it be possible just to put some fats under the eyes area to make the eye more awake (straighten out the fine lines). I am sorry if i make no sense here.

YES, FAT TRANSFER CAN BE PERFORMED TO HELP A TIRED LOOK BUT IT WON'T HELP FINE LINES.

Can fats be injected onto chin area (just a little) to make my chin a little out.

YES, I DO THAT ALL THE TIME.

In a way, you can say i am not very open to injections, implants or anything that is not natural and i try to avoid all of them. So i am sorry if i make no sense here or use the 'fat grafting' in a wrong way/ idea/ etc.

NO, YOU ARE DOING FINE.

Can dimples creation be done at the same time as botox jaw injection? in an office setting?

YES, EASILY.

Well i guess it really make not that much sense here as if you see me in person you can make more judgement, etc.

IDEALLY, AN IN-PERSON CONSULTATION WILL HELP ESTABLISH WHETHER I CAN DO THIS SAFELY FOR YOU AND TO LIVE UP TO YOUR EXPECTATIONS. CALL ME WHEN YOU ARE READY.

When i am ready i will book a consulation with you. Thanks Dr Lam.