LAM FACIAL PLASTICS

Hi, Dr Lam

First thank you for spending your valuable time to answer all these questions asked on this forum. I think we all appreciate it a lot!!!

I have some acne scars on my cheeks and I'm really interested in your silicone injections approach. However, I'm a bit concerned about its safety issue after doing some research on internet. For example, one article in New York Times make it sound pretty scary(just google "Injecting Silicone, and Risk").

In your practice, have you ever seen or heard any similar stories? What's your take on that?

Thanks,

Sam

Richardson, TX

I fix a silicone mishap almost every single week. They fly in for my corrections. The recent press with Priscella Presley does not help matters. Using industrial grade silicone is terrible. What is worse is shoving it in the face in buckets. I have done it shy of 5 years and have tremendous experience with it performing several every single day without problems. I have trained with physicians who have done it for close to 45 years so I feel very comfortable with the product if two criteria are met:
1. an experienced injector is performing it.
2. only pure medical-grade product is used.
best,
sml[/img]

Hi, Dr Lam

Do you mean that as long as the two criteria are met, the issues such as MIGRATION and SILICONOMAS, will not likely to occur, even years later? In your industry, do you know what's the percentage of the patients had bad complications after the injection w/o any Doctor's fault?

The nice thing about silicone injection is that it's permanent. However, it's also the thing that worries me. I just want to be extra cautious while making my decision and i know you can help me!

have a great weekend!!! (looks like it will rain though)

Thanks,
Sam

my honest belief is that migration if it is done right is virtually impossible. i think that siliconomas reflect poor silicone product and poor technique. speaking with experienced surgeons who have done this for 45 years have explained to me that in their experience it is nil. however, my consent forms are out the butt detailed that anything can happen, as you know what kind of climate we live in.
best,
sml

Dr Lam

Thanks for your reply. Now I feel much more comfortable about the silicone injection idea.

Is there any downtime associated with it? If i do it on Friday, will i be able to go back to work on Monday with my "normal" look? How much do you charge for each session? Is it a fixed price or based on how much injections needed?

Thanks,

Sam

In general there is minimal to no downtime following silicone. Most people go back to work the next day. However, there is ALWAYS a risk of bruising that could last a week or longer. I cannot promise anything regarding that. The cost is $700 per session. If you are doing lips and only do one lip the cost is $350. In general, $700 is the flat rate. If you do acne scars and lips or lips and smile lines, i.e., 2 major areas, the cost for the second area is $300 so the total charge is $1000 per session.
best,
sml

HI DR LAM

WHAT DO YOU THINK ABOUT RADIESSE FOR ACNE SCAR? I HEARD IT'S SUPPOSED TO LAST 1-2 YEARS AND IS PERFECTLY SAFE. DO YOU OFFER IT AS AN ACNE SCAR TREATMENT? IF YES, WHAT'S THE COST?

I KNOW SILICONE IS GREAT, BUT I JUST DON'T WANT TO TAKE ANY CHANCE. I'M VERY CHICKEN PLUS, I FEEL LIKE TO TRY A LESS-PERMANENT FILLER FIRST TO SEE HOW IT LOOKS, THEN MOVE ON WITH A PERMANENT FILLER SUCH AS SILICONE LATER ON. PLEASE DON'T LAUGH AT ME.

THANKS A LOT!!!! YOU ARE D-MAN!

J

radiesse is good. i have done it for acne scars. it does last about that time. radiesse costs 800 a syringe. i have seen a few cases where they burned through it after 3 months but that is uncommon. you may need one or two. sometimes more. that is the problem with these products for acne scars is the cost. hopefully, i could get away with just one.
best,
sml

Dr Lam

Is fat transfer as effective as silicone injection for rolling type acne scars? What are the pros & cons ?

Thanks,

Sam

fat grafting is definitely not as successful. i usually use it for acne scars of that kind only when there is a rejuvenative component that is also there, i.e., loss of volume too. I then wait 2 to 3 months before I start silicone for the actual scars because after the overall volume is plumped out I then have probably 50% of the rolling volume loss corrected but not the actual discrete depressions. If you are just looking for rolling acne scar corrections, FORGET fat grafting.
best,
sml

Dr. Lam

are all these filler injections done by you or by your assistants?

Thanks,

Sam

me.

Dr Lam

I happened to see this information on a website in UK. Is this true?

**********************
Is Silicone permanent?

Yes and no- Silicone does give a permanent result. Small injections of steroids can however be used to reverse the effects within the first few months following treatment.

***********************

Thanks!

Joe

never heard such a thing. to me that sounds ludicrous. also, silicone can atrophy the surrounding tissue. i rarely inject steroids.

Dr. Lam

1) Do you normally do subcision prior to inject fillers to avoid possible "dough nut effect"?

2) Is there any temp or semi-permanent filler that works as well as or even better than silicone for acne scars disregarding how long they last?

Regards,

Sam