LAM FACIAL PLASTICS

Hi dr.Lam,
Thank you for your reply, I have still a few questions,
I have one side that is more hollow then the the other side, mistake of the PS with the facelift.
Is that possible to correct with fat transfer.
At leat optical.
With fat transfer is there also fat placed in the region from nose to mouth, to create a balanced look?
Are the eyes done with fat too ? If hollowed and crepery eyes is a bleph also needed first ?
Thanks for reply once again.
Martine.

I have one side that is more hollow then the the other side, mistake of the PS with the facelift.
Is that possible to correct with fat transfer.
At leat optical. TWO THINGS: ONE, WHEN WE FRAME IT AS A "MISTAKE OF THE PS" THEN WE WILL ALMOST ALWAYS SEE IT NO MATTER WHAT I DO TO CORRECT IT. WE NEED TO REFRAME HOW WE SEE OUR FACE. SECOND, SYMMETRY IN GENERAL IS AN IMPOSSIBLE GOAL AND ONE NOT WORTH PURSUING. IT DOES NOT AFFECT BEAUTY AS MUCH AS BALANCE. WATCH THIS VIDEO:

http://lamfacialplastics.com/gallery2/v ... 7.flv.html

THIRD, FAT SHOULD NOT BE PLACED GROSSLY ASYMMETRICALLY BECAUSE I WOULD LIKE IT TO "GROW IN" BALANCED. SLIGHT ASYMMETRIES MAYBE BUT NOT GROSS ONES.

With fat transfer is there also fat placed in the region from nose to mouth, to create a balanced look?
YES AND NO. I ALWAYS PUT FAT AROUND THE MOUTH. THE TAKE THERE IS SLIGHTLY LESS THAN ELSEWHERE. IF YOU ARE TALKING BETWEEN THE BOTTOM OF THE NOSE AND TO THE TOP OF THE UPPER LIP, THAT IN GENERAL IS A VERY BAD PLACE TO PUT IT. OUR WHITE LIP ALREADY LENGTHENS AS WE GET OLDER. MORE VOLUME THERE IN GENERAL WOULD NOT LOOK GOOD.

Are the eyes done with fat too ? If hollowed and crepery eyes is a bleph also needed first ?
ABSOLUTELY, CREPEY UPPER EYELIDS CAN BE PARTLY IMPROVED WITH BLEPH IF IT IS AT THE EDGE. IF IT IS THE WHOLE EYELID, THEN THAT IS UNSAFE TO REMOVE ALL THAT SKIN. I DO NOT REMOVE ANY SKIN FROM THE LOWER EYELIDS ALMOST NEVER. WAY TOO RISKY. BOTOX AND SKIN RESURFACING ARE FARE SAFER.

Thanks for reply once again. YOU ARE WELCOME. PLEASE WATCH ALL VIDEOS THAT I HAVE SUGGESTED SO FAR TO REALLY UNDERSTAND MY PHILOSOPHY AND WHAT I CAN DO BEFORE CONTEMPLATING COMING.

Hi again dr. Lam,
Sorry for all these questions, I have a few more.
As last year i did a sculptra treatment, do I have to wait before doing fat grafting.
I hed three sessions of 1 vial i think and the last one was last year in june.
How long does it take to have the sculptra out of the face.

What is bothering me the most in my face is the hollowness different on te two sides and this is resulting in a mouth bag , sweep i think it is which is more pronounced on the left side.
Is it possible to correct this with surgery before doing the graft.

From where is the fat taken out of the body ? Is a small amount enough as i dont have too much fat, Is it possible to take it from the waist at the sides ?

What is the cost of the fat grafting including eyes and how much time in advance i need too book ?

Thanks again, you are very kind to reply to all my questions.

Martine

As last year i did a sculptra treatment, do I have to wait before doing fat grafting.
I hed three sessions of 1 vial i think and the last one was last year in june.
How long does it take to have the sculptra out of the face.
HMMM, THIS REALLY MAKES THINGS HARD. SCULPTRA LINGERS FOR YEARS. I WANT YOU TO KNOW THAT I HAVE NO CLEAR ANSWER. MAYBE WAIT A TOTAL OF 2 YEARS BUT TO BE HONEST I HAVE SEEN IT LINGER FOR YEARS. NOW, THERE IS NO GUARANTEE THAT THE FAT WILL LAST ONLY BECAUSE IT IS NOT A QUESTION OF THE FAT LASTING BUT THE SCULPTRA SLOWLY GOING AWAY. YOU MUST UNDERSTAND THAT IS SOMETHING VERY HARD FOR ME TO MAKE A PROMISE TO YOU NOW BECAUSE OF THE SCULPTRA.

What is bothering me the most in my face is the hollowness different on te two sides and this is resulting in a mouth bag , sweep i think it is which is more pronounced on the left side.
Is it possible to correct this with surgery before doing the graft.
THIS IS NOT EASY TO FIX WITH ANY SURGERY. I WOULD NOT BE ABLE TO FIX THAT AS A SURGEON. THAT IS A VERY DIFFICULT THING TO UNDO.

From where is the fat taken out of the body ? Is a small amount enough as i dont have too much fat, Is it possible to take it from the waist at the sides ?
TYPICALLY, BELLY AND THIGHS. IF YOU DON'T HAVE ENOUGH, I GO TO LOWER BACK, BUTTOCKS, OCCASSIONALLY TRICEPS. THE WAIST ON THE SIDES IS NOT A GOOD AREA TYPICALLY. OCCASIONALLY I GET FAT THERE BUT ONLY IN SOMEONE THAT IS NOT SUPER THIN. IF THEY ARE, EVEN THOUGH YOU THINK IT IS GOOD FAT IT IS NOT A GOOD SOURCE.

What is the cost of the fat grafting including eyes and how much time in advance i need too book ?
FOR COST, YOU MUST EMAIL MY STAFF CONSTANZE@LAMFACIALPLASTICS.COM. (PLEASE ALLOW A WEEK TO RESPOND. SHE HAS TONS OF EMAILS TO RESPOND TO. SORRY.) I HAVE A STANDARD FULL FACE PRICE THAT INCLUDES THE EYES. I AM BOOKED OUT A COUPLE OF MONTHS. HOWEVER, YOU MUST READ THE ANSWERS TO YOUR QUESTIONS ABOVE. YOU MAY NOT BE A SUITABLE CANDIDATE GIVEN THE LIMITATIONS I EXPRESSED ABOVE.
Thanks again, you are very kind to reply to all my questions.
MY PLEASURE.

Dr. Lam,
I am very sorry to hear that fat grafting is not an option for me now. I did have not many vials of sculptra and i see it gradually leaving my face. The injector said to me that after 1.5 years it would be all out.
I had it once above my eyebrow, just a tiny bit, and it is already all gone.

Would it be an option for you to correct my face with other fillers temporarely untill i could do the fat graft ? What fillers would you use ?

My face became squared after relaxing of the facelift with the jawline under my ear still lifted up oo high.
The eare in the middle of the face , which was not adressed by the facelift is sagging.
As the lift was pulled to much vertically and ALSO horizontally it is very weird now, with heaviness on the underside. Difficult to explain.
Which areas or possible to correct the heaviness, squared assymetrical face ?

Thank you for letting me know, as i am not able to find anyone with a good asthetic eye here in Belgium for doing that. If I suggest the sculptra i have done in the past and in the areas where it was done in the past (when i was living in Spain) they are afraid to do it, they only have the knowlech of making the cheecks a bit fatter or something like that but notting about facial correction.

Thanks for reply,
Martine

here is my thought: if you can definitely tell me that the sculptra is almost all visually gone, then i could consider fat transfer. however, you must accept the risk that if there is residual sculptra going away then fat may need to be replaced over it. generally, fat can do a lot of sculpting that temporary fillers simply cannot do, especially around the eyes. fillers, however, can do things fat cannot do well like folds, creases, lips, and lines. i use them in combination. i look at fat transfer like the box springs and mattresses and fillers like the bed sheets and comforter. They ideally work together. the other problem with temporary fillers is that they make my fat grafting progressively harder to do. as i have no idea what is temporary or not, i really prefer if someone is going to do a fat transfer to do that first (mattress) then come back to do some fillers in the folds, etc. it is the ideal way to go.

fyi: i am keynoting on fat grafting in bruges, belgium in mid-september 15-16.
best,
sml

Hi dr. Lam,
Nice of you to reply that quick.

However i have another question, Since i have the impression that the s-lift does not hold up any more, is it nessesary to reedo a decent facelift with fat grafting to adress the bottom heaviness ? All the fat i have in my face seems to be in the wrong location, to low around the mouth and to high under my eyes due to the skin pullup.
How should you be treat this . Move also fat in the face to the right plave with adding some extra fat ?

Thanks again for reply.

PS. In which clinic or what place are you in belgium in september ?

that is hard to say until i see you. i have to see you to decide really what you are talking about. actually, i do not know which clinic i am presenting at. it is a maxillofacial conference there.

hello dr. Lam,

I still have a few questions about fat grafting.

I feel and know that the skin disected with the macs lift 2.5 years ago, and which was and still is overstreched , i feel on that part, about 2 inches or a bit more skin was disected and pulled , and that part has still a lot of tention.
What happens if you try to put in fat in that area, it probably will explode ?
I think now 2.5 years later a have a tiny bit of skin more in the midface, can the whole face be redraped together with fat grafting , maybe also the diagonal lines created by the facelift will finally go away?

As also i am missing the back lower part of my previously pronounced jawline, (part under the ear) which i always liked, i am born with it, it is not there any more, the skin was lifted so high vertically (and also horizontally).
If you put fat in the face and i need to a bit of a wider face, (it became much thinner and smaller with the facelift) will that make the jawline even higher as the volume will lift all parts of the face?


Or is it possible to create volume and keep the same shape in that area.
I am afraid the facelift messed up my face, maybe it would be possible to lift the midface and then add some lenght again with the graft ?

Let fme know what you think, do you know already where i can meet you in september in belgium, i would like to see you if possible , thnaks, Martine

a few things:
1. a fat transfer will not lift anything. it will only fill.
2. i do not believe anything will "explode". i feel comfortable putting fat in areas where you were lifted.
3. i most likely would plan on targeting filling that outer jawline which is an area i target in many people who have had a facelift. as you know, fat transfer cannot be guaranteed in any one area but overall looks tremendous.
4. a huge part of enjoying my work is by letting go of your anger about your past and letting go about your previous work. until we no longer see a need for a fix, it will be hard for you to like what i do. look at what i do as the ability to make your face look great regardless of your past.
5. fat grafting will not help or hurt redraping. it is just to soften features and rejuvenate the face.
6. i will try to see if i have time in bruges this september. i could most likely meet you for a short time there.
best,
sml

Hi dr Lam,
Thanks for the reply, I really woukd like to see you just a short time in brugge so that you can decide if the fat grafting eventually with a corrective facelift would work for me.
Even if it is 10 minutes, i come to the location where i could meet you. How can I scedule an appointment with you.
If i know something could be done to restore my identity i am happy to travel to your practice.
I am looking for 2 years in finding someone who is confident to do the fat grafting on my face and you seem the only one capable of doing.
The two others i spoke with all said, not enough fat., i think i do have enough fat.
And also they either do fat grafting alone never in combination with an eventually new corrective facelift.
I really hope you can.
I am sitting in my home for already more then 2 years, is soon as i leave the house and meet other people the all look very surprised to me like the hell what has happened with here face. And commenting to other people that or probably i am ill or some bad comestic work is done.
So i prefer to sit inside and try to find a solution to live with at leat for the next 10 years if possible. I am willing to do the fat grafting procedure again after several years if nessasary.
Thansk again, martine

martine,
i would be honored to help you but truly i would like to work on someone who does not feel ashamed and feels compelled to sit at home. we all have struggles in life. it is hard for me to fix something physically when i sense a deep emotional level of burden. i cannot clear that with surgery. we all must see ourselves as beautiful. until then, it is hard for me to fix things. watch this video. i just saw it on my friend's facebook wall 5 minutes ago:

http://www.youtube.com/watch?v=RU7w0Z35XEE

i will let you know when i am in bruges. basically i am keynoting on september 15th. will be there for a couple of days.

God bless you,
sml

Hi again dr. Lam,

I know , you are right, by the time i could see you i think a lot of my problems should be history, and i know first i have to feel fine with myself before undergoing any cosmetical surgery.
Anyway i guess by that time i will be ok to discuss with you my options.
I miss the face I had all my life , the facelift altered my face so much, much more then aging, it is hard to live with that.
Actually the lift aged my face, created wrinkles under my eyes, pushed the corner of my eyes upwards, bunched skin under eyes, ... which i did not have before, etc....
Can hardly use makeup, it is sticking on the skin.
The inventor of the facelift , whome i spoke to some time ago thought that te before picture was 10 years old, can you imagine.
A facelift should make someone refreshed and look younger. The oposite happened.
I asked the suregeon who did the lift how much skin she cut away and lifted on both sides , she did it different on both sides, and she refuses to send me the information, only the technical report was send upon my request.
I asked her a dozen times , no answer. She probably knows she made a big mistake as i came to see her with the complaint of volume loss and a bit of sagging skin and i trusted her as she acted to know everthing. So she pulled the skin so much , opposite result.

I always was very happy with my face, didnt matter if I was fat or thin, i always liked my face, untill the sagging after the volume loss. The facelift made it worse and i was horrified and had panic attacs to know that this was the face i have to spend the rest of my life with. I wake up with it and go to sleep with it. So finally i hope someone can restore a bit of my identity so i can recognise myself again and go on with my life.
I deeply regret that i gave my face in the hands of a such unexpericienced person which i did not know at that time, just recently others are telling me about other mistakes and bad surgery she has done.
A face with our eyes are the reflection of our sole more then anything

Thanks again for your message.
Martine.

sorry again to hear of your plight. ironically, i will be able to offer you freedom only after you have already found it not before.
sml

Hi dr. Lam, I understand what you are telling me.
However due to the fact that you are in belgium in September, i still would like to take the opportunity to see you because if i have to see you later only for consultation in the US for me it is a lot of distance.
I can travel for the procedure itself of caurse but it is better for me to know before if i am a suitable candidate for you.

I would appriciate your response and a little of your time in September.
Thanks ,
Martine