LAM FACIAL PLASTICS

Dr. Lam,

I have watched your conferences on youtube where you talked about fat grafting and the most important areas that need volume restoration. I know you have mentioned anterior cheek but I can't remember the technical names for the other areas. I had my tear troughs and a little in my upper cheek, but that doesn't seem to create optimal balance in my face for some reason. I have a artistic eye and I am thinking of the place that you mentioned once where when you pucker your lips the area that sinks in your cheek is one area, correct?

I have gotten my nasolabial folds done in the past, and what a waste. I did not understand volume back then like I do now, thanks to your insights and knowledge.

To all you readers out there, getting your nasolabial folds injected with fillers is a huge waste, don't do it. Too many doctors are doing NL folds for aging faces and they just don't get that correcting those will not make you look more youthfu and rested. Correcting those won't do anything. I did and I regret it. It is not the area that needs the work. The area that needs the work is the cheeks, cheeks, cheeks. Focus on the cheeks and eyes!!! I never knew that until I listed to ongoing conferences and videos from dr. lam and got it done myself. I am amazed at the results in my cheeks making me look more youthful.

If someone is gaunt, the anterior cheek is only part of the story. The buccal area (area that puckers in when you suck your cheeks in) can be the second most important. Actually, if you have good malar (cheek) bone structure and your anterior cheek is relatively in good position AND you are gaunt, the buccal area can be the number one area to fill. If you have good cheek structure and are gaunt, filling the anterior cheek can make you look even more UN-balanced if you don't fill the buccal area. If you have a wide face, the buccal area (pucker area) is the last place to fill. It will make you look heavier. Sometimes, the prejowl (in front of the jowl) can be the number 1 area to fill in the face to make the face look slimmer. Anyway, there are a hundred permutations to a face that need to be considered. That is part of the artistry that a physician should exercise when evaluating a face. That is why going to a doctor who is not only technically good at what he or she does (as you know that volume filling is technically much more difficult than filling the smile lines and lips), but also artistic who should guide you (not the other way around) on what are the areas of critical importance when dealing with your face in particular. Ultimately, using fillers cannot completely balance the face. That takes fat grafting which is like having unlimited paint to contour the brow, upper eyelid, lateral canthus, temple, nasojugal groove, entire tear trough/lower eyelid, anterior cheek, lateral cheek, buccal zone, precanine fossa, nasolabial fold (but as you know fat is not great for this and oftentimes unnecessary), medial buccal hollow, lateral mandible, prejowl sulcus, and anterior chin. Doing that with fillers would be cost prohibitive, especially since it is temporary.

One more thing: not everyone wastes their money with a NLF fill. About 1 in 15 will get a benefit if they have a certain parentheses shape to the fold and the relationship of that fold to the mouth. However, that person would often still get a better improvement by volume filling first. I think I cover more explicitly when to fill a fold in one of my videos. It just should not be a knee jerk reaction to fill a fold in the majority (I mean majority) of cases. If we are done with everything and you have disposable income, that is another story.