LAM FACIAL PLASTICS

Dr. Lam,

I have heard that juvederm is better then restylane because it is softer and thinner and molds better and has less lumps through skin. I had a friend get juvederm and restylane injections in her face and she loved the juvederm better because it resulted in less lumps and more natural look.

I have extremely thin skin and very thin around the eyes. I am considering getting my tear troughs done but a place I am going doesn't have juvederm only restylane. The doctor is highly rec, so that is why I don't want to give it up. I am just torn between the decision of whether my skin can handle restylane under the eyes being extremely thin. Is there a lof of difference between the two products between size of molecules, and do you have juvederm in your office? I just trust juvederm better because I have heard amazing things about it compared to restylane in particular with those with extremely thin skin. Any suggestions helps.

Dr. Lam,

There is something else I would like to mention. I have what a think is a desending outer eyelid. I would like a filler to be placed in the outer eye area maybe along the outer orbital rim and upperwards to give me higher cheekbones. Is this what I am thinking possible. The inner area of my tear trough area has more volume then the outer area. If you were to examine my outer eyelid area you would notice a a hollowness there. Is this just the way my bone structure is? On my right side, my outer eyelid has volume and looks better, but different on the left side. Would you recommend restylane for this area if it is possible to even have volume for my outer eyelid area to balance out the volume in my tear trough area. Does this make sense?

clarification: not descending eyelid but descending volume underneath my outer lower eyelid giving it a hollowness area. Now this is the area that concludes the tear trough area if I am correct underneath the eye, right?

hi wanda,
both juvederm and restylane are excellent products. i have juvederm and restylane in my office. however, i do probably 20 to 1 restylane to juvederm. the reason for this is that experienced injectors across the U.S. from California to New York have had significant problems with Juvederm around the eyes for two reasons. Because Juvederm is so soft, it tends to spread to adjacent areas where it was not injected. I have also heard of prolonged cases of swelling with juvederm in those areas. Now I used to do a ton of juvederm really without significant issues. However, after repeated pleas by TOP injectors (not average joes), I realized I was only perhaps buying time before I would encounter a problem. I think juvederm is good for the lips because it is softer so I keep juvederm around for those who want lips done or insist that they want it in a certain area. I truly believe that it is not the product but the quality of your injector by a huge margin. I can do almost anything with either product but I have extensive experience using the product. I am not worried about restylane under the eyes since i place the product above bone and below muscle so it is quite far away from the skin. in answer to your second point, yes, i can fill the outer tail of the orbital rim that is hollow. i know what you are talking about i believe.

Thank you. My doctor actually recommended sculpra in my eye area today. I am not sure if I want to go for that because I heard something from you before that is causes lumpiness, correct?

I also heard that restylane has smaller molecules then juvederm, that I didn't know either. I was told that restylane is softer then juvederm by the doctor's staff as well, that I also didn't know, I have gotten different sides to both.

Yes, there is a transition from my outer eyelid to my cheek area. I would like to give a softer look by adding volume. I used my had to see what it would look like and it looks much better on me, I just need that extra boost of volume there.

here is my opinion about sculptra under the eyes:
no no no no no no no no no no no no no no no no no no no no no no no no

here is my second opinion about sculptra under the eyes:
no no no no no no no no no no no no no no no no no no no no no no no no

juvederm is softer but restylane in my opinion is better under the eyes. restylane is NOT softer. i think some of its firmness leads to better mid and upper face results. i think juvederm's softness is nice for lips.