LAM FACIAL PLASTICS

Dear Dr Lam,

I have a mouth and lips situation. Ever since I was in 9th grade I started to have anxiety about my lips. I feel as though they are sticking out and making me look tense and angry, even though that's not how I feel inside. People usually tell me to cheer up, or don't look so scared, or the would treat me unjustly because they think I am a mean guy. Usually when people see me or talking to me, they tend to play with their lips, or put their hand over their mouth. They are just reminding me that my mouth and lips is ugly.

My lips situation has caused me so much anxiety that I had to dropped out of school. I keep on changing from job to job because people at work think I am a jerk because I constantly look tense.

The pointy mouth situation has gotten so bad that now, sometimes, I feel uncomfortable with myself even when I am alone. I can feel my lips sticking out and making me feel serious and causing me extreme anxiety issues. The feeling of my lips sticking out and the feeling of seriousness only intensify when I am out in a social setting, and the anxiety is almost unbearable.

My pointy mouth and lips situation is very important for me to resolve and I come to you today to seek your expert consult. I ask not for your sympathy but rather for your expertise because I have reviewed your website and your patient testimonial. I believe you're a person of good character and I would be glad to take my chances under your care.

I will be able to provide you with some pictures over this weekend. But just in case you should be reading my post before I send you my pictures. I would like to provide some information about me and my history to help you make a better assessment of my situation.

I am a 24 years old Vietnamese male. I had one previous surgery attempt to fix my mouth and lips situation when I was 19. The doctor over in Thailand, did upper lip reduction to improve my smile and they also did some fat tissue removal around the mouth. The result was only 30% satisfactory because of the improved smile. However, as for the fat tissue around my mouth, it actually only made my mouth appear more pointy.

What I hope to achieve with your help is,

1. (definite purpose) I would like to decrease or completely eliminate the sensation and tension I feel on my lips as though they are protruding out because this makes me feel like I am mad or angry when I am not. This causes me lots of anxiety. And even if I can't completely solve my protruding mouth but feel its ok. That would be great too because I rather let other people think I am mean than for me to feel mean inside.

2. I guess this is dreaming but I would like my mouth and lips to look more presentable.

Thats all. I know its very hard for you to make your assessment without pictures, so I will get them to you ASAP via private message.

Thank You very much for providing me with some hope.
Vo,P

i shall await your photos.

Hi,
I have reviewed your photos and would like to respond to you appropriately. Remember that this is not a formal consultation just responding to general comments that you have made and a quick analysis of a two-dimensional image.

You have asked for my expertise, and I shall provide it here ... although perhaps not what you expected. The main expertise that I want to offer you is psychological not plastic surgery. Given the language that you use about how people react to you, it sounds that you have been truly obsessed with your image to the point that it is crippling you socially. As far as your photos, I do not see any obvious deformities. However, when you start to perceive that you are being treated differently because of the way you look (when I do not see any obvious deformity), you are crossing into or have crossed into a syndrome known as body dysmorphic disorder.

There is a book that I recommend you purchase and read called the Broken Mirror by Dr. Katharine Phillips that you can buy from Amazon.com. You need to read this book and hopefully get professional help from a psychiatrist/psychologist. I hope you do not take offense at these comments (especially since they are anonymous), they are only intended to help not to hurt you. Hopefully, this blog will be helping more people out there reading it suffering like you.

You certainly can get more plastic surgery professional opinions but I can promise you one thing: if you ask enough plastic surgeons someone is going to cut on you. Many plastic surgeons do not have the ethical integrity to say no since they have a substantial financial advantage to operate on you. Someone is going to say yes to you. Before you continue your journey to seek more advice from plastic surgeons, you truly need to read the book I recommended and seek a different kind of professional advice.

Now, I do not want you to feel alone in this matter, as all of my patients following any bigger procedure can be tormented by other people, in large part due to their own perception that other people may be seeing changes in them. I have thoroughly addressed this topic in the video series "postop video companions" in the video entitled "other people's perception of you", which I call the most important video for my patients following plastic surgery to watch. Many patients start to act weird at work because they are worried that someone will notice that they had plastic surgery. Do you know that other people start to react weirdly to them. Why? Because simply put, they were acting weirdly first. If you are worried that someone is staring at your lips, do you know why that person is acting weirdly to you? Because you are acting yourself weirdly to the other person. Picture that I come into a room and greet you without eye contact looking downward, I fidget a bit, then stare over your shoulder. Do you think you would not be acting weirdly back to me?

I truly truly truly want the best for you and hope that you read the book I recommended and report back how it affected you. I also truly recommend professional guidance and I do not mean from another plastic surgeon. I hope that this forum entry has helped others other than yourself.
best wishes,
sml

Dear Dr Lam,

First I would like to say Thank You for your opinion. I have heard something similiar before.

But all the things I been through is real.

1. 10th grade: I was in a bus with about 60 vietnamese kids my age, people were playing guessing game, and a kid shouted out " who has chinky eyes, cricket nose, sharp lips, and acne face?"... Everybody turned and looked at me and they all suddenly became quiet! I sat there for 2 hours until the bus ride was over!

2. 10th grade: I walked into plaid pantry, I asked the clerk for a match, the female clerk replied " you want a match between my butt and your face?", I said "no" and she gave me the matchest and I walked home.

3. 9th grade: playing ping poll in cafeteria, a chinese kid yelled " you're ugly to me, in front of everybody".

4. 9th grade: play over my friend house, his sister see me and keep on calling me "ugly".

5. 8th grade: My own mother said I am ugly. My brother said " I am ugly".

6. 10th grade: selling newspaper door to door, a lady open the door with her kid beside her, the kid said to mommy " he look funny mommy". She apologies. I walked away.

7. 6th grade: Waiting for school to open, a kid walked by said " you're ugly".

8. 9th - 11th grade: My friend keep on calling me "fuck face".

9. Age 23: Standing in formation in my class A ( US army). Drill SGT did his inspection, came up to me and said " your face look like you need to take a shet, I don't like it", and he keep on saying more and more....

10. Age 23: US army, solider mate, said " you look like you're going to kill somebody".

These are just 10% of the things I remember on top of my head right now. They are real to me. I only want to look normal so people could leave me alone, so I could live my life however I want to live it!!!

I really wished you would help.

i appreciate your words. i would say that a huge component to the negativity that you have received is due to a certain level of racism layered on top of kids being unkind and also your negative outlook on life. certainly, the U.S. military is not a place for warm fuzzies. it's the military for God's sake.

i think you are trying to blame your mouth to cure your social/professional problems when i don't think it will offer you satisfaction. i would keep my same advice for you now. it does not mean that you would not be a candidate for cosmetic enhancement in the future. however, right now you need someone to help you more on how you think and perceive first. i truly wish you the best from one asian male to another.
best,
sml