LAM FACIAL PLASTICS

boy, that sounds bizarre. obviously, i am not excited about taking care of this either to be honest with you. if it is just overproduction of collagen, then 5-FU scar dissolver would be the first line of treatment. O/w it sounds as if you need this stuff cut out if that fails. Make an appointment to see me, and let's take a look.

send me a PM with a link. honestly a photo probably won't help me much because it is hard to see anything with skin issues but it is okay with me.

I got both of your PMs. Your photos are pretty good, actually. However, obviously, I cannot guarantee an accurate assessment without seeing you in person and touching and feeling the affected area. Here are my thoughts:
1. They don't look like granulomas or scar tissue. What they really look like to me is that over time you have lost your own natural soft tissue coverage revealing the PMMA as I see a smooth whiteness there in the very sensitive thin skin. If you look back at your photos two years ago you probably will notice some loss of fat around the eyes.
2. How then to deal with it if we suppose that is the issue? That is actually very tough. I personally do not think 5-FU will do anything given a look at the photos. I also would not add fat to that area as the lumps will actually become more visible when the fat lifts them forward. Perhaps, if I am right in my diagnosis, a few drops of silicone will help blend them in with the surrounding tissue better if you and I think that outright excision of these areas is too risky. I would have to see it. I would probably move against that idea as I do not want to create a further problem.
3. Your second PM asked me about fat grafting. Yes to the entire face but no to the area where the PMMA resides, as mentioned. I would truly have to see you in person for consultation to make some decisions. Since we are corresponding already, bring a couple of photos when you thought you looked the best. I am booked out a few months as it is so you will have time to get your travel plans in order. You can put yourself on the waiting list for an earlier appointment. Try to book your appt. tomorrow since I would like to get you in sooner than later.

All that being said, I may be totally wrong with my diagnosis until I see you. Don't worry I will treat you with respect and try to figure out the best course of action if I can conceivably help you.
best,
sml

I think anything else at this point is conjecture. If they blew up that fast, silicone is not a great idea in putting a permanent filler into a moving target. That may compound things. I don't know what is going on. I don't use PMMA (as you probably know if you watch my video "Why I don't use Artefill/Artecoll" in my video logs section of this website). In all fairness, you had this done with a different brand in a foreign country so I can only guess what you had put in. I had a lady from the Virgin Islands who had "Restylane" placed in her tear trough but it was anything but. The company could not match out the numbers with anything that Medicis (the manufacturers of Restylane) made. Same thing with another lady from South America who had "Restylane" but turned out to be some permanent filler. I had to remove part of her lip to help matters. I think if the area is rapidly evolving without signs of infection (redness, tenderness, drainage, fever, etc.) then perhaps 5FU may still help. Let's hold on further commentary until I see it. If it truly gets worse rapidly, you might want to see a local doctor who can help you more expeditiously.

same here. hope you have a restful remaining memorial day weekend.
best,
sml

possibly. if it is rapidly evolving, the answer is probably no. if it is static, i would consider it.

injections take 2 minutes. you'll be fine.
sml