LAM FACIAL PLASTICS

Dear Dr. Lam

I got my upper cheek area filled right below the orbital bone trear trough area. I would like my tear troughs done and here is the reason. My tear troughs were a little hollow before I got my upper cheek filled and now they are quite the bit more hollow. The cheeks do great enhancement in giving me more youthful refreshed look, however, my tear troughs could use some work as well to give me the higher cheekbones I desire like my sisters have.
So, I have quite a lot of volume lift in my upper cheeks and I am wondering how they are going to inject at the orbital bone when it is lined with the filler I had injected. I am thinking that may add more volume to my upper cheek when i really just want the area above the rim below my lower eyelids evened out in volume with my upper cheeks.

What this has done to my eyes is given a more deep set eyes look. I would love to have high cheekbones where there is equal amounts of volume from my eyes down to my cheeks like I used to when I was very young.

I know it is not safe to inject the tear trough area very high from the rim, but if the injector injects a filler at the rim, can they angle the needle in my skin to where It would reach the lack of volume below my eyelid. I really just want this natural look but I am not sure it is possible.

as far as i can read your comments, yes, you can fill the hollow underneath the rim of the lower eyelid. i do that every day. it is technically very difficult to get good results so if you don't come to my office go to a doctor who says he/she does this almost every day and can show you extensive before and after photos. as you can see every day, the number of bad injectors around the eyes. this is technically really the most difficult area to get good results with. also, make sure you only use a hyaluronic acid based product (restylane [which i prefer] or juvederm) not radiesse or something else you can't reverse in this difficult area. obviously, eventually fat grafting is ideal for a permanent result (but only again in highly experienced hands.)
best,
sml

Dr. Lam,

where exactly is the rim of the lower eyelid, you are not referring to the orbital rim (bone) are you?

The results I am hoping to acheive are injecting along the orbital bone or rim area that is along side the tear trough and decreasing the hollowness/transition from my eyes to my cheeks. I really want equal amounts of volume from my eyes to my cheeks, with an experienced injector like yourself, could you do something like that for me?

I would like to resolve this problem for one because my eyes used to have little transition when I was younger and I am hoping for that again. I am older now and have aged in my face a little.

bingo that is the area, the orbital rim. yes, the transition can be softened (not eliminated).

Thank you dr. lam,

I think I understand what you are saying, but not sure.

I guess I shouldn't have had my upper cheek area done without doing the tear trough area because I feel it would be heard to do the tear trough area now because my cheek area is so full of volume and I am afraid more volume will go into my cheek and not under my lower eyelids where I want it to correct the hollowness of it.

I really just want hope that this can be fixed because my eyes look like they are now buried in my face because of a long ditch of hollowness under my eye followed by a new transition of volume in my cheek, does that make sense if you picture what I look like.

So, one more time so I understand better because I am an airhead. Can a fine needle be injected along the orbital rim where needed and angled to head north toward my eyelids to correct the ditch?

1. the cheek should not matter.
2. yes, a needle can be used to fill the ditch. i don't prefer that method. i use a cannula which is a long discussion of why (read my other threads). bottom line: smoother and far less bruising if any.
best,
sml