LAM FACIAL PLASTICS

Dr. Lam,
I saw your video about asian rhino with goretex. you sounded very convincing but i want to ask a few questions please

how long has goretex been used as an implant for rhinoplasty?
is it long enough to determine if there will not be post-op complications/outcomes down the years.
(lasik has been out for roughly ~10yrs or so but there seems to be a lot of complaints from 'once happy' patients now about outcomes recently.)

with silicone a lot of patients seem to have skin thinning, transparency. will that happen with goretex as well? (i read in another forum that with goretex as you get older you'll see white under your skin)

and if you had silicone for several years with skin thinning and get it replaced with goretex, will the skin still be as thin? and does goretex has irregularities that can be seen thru the skin?

another doc said that the goretex sits very close to the bone so that it will over time press on it and shrink the bone. is this like a michael jackson effect?

ANSWERS BELOW:
how long has goretex been used as an implant for rhinoplasty?
is it long enough to determine if there will not be post-op complications/outcomes down the years.
(lasik has been out for roughly ~10yrs or so but there seems to be a lot of complaints from 'once happy' patients now about outcomes recently.)
AS A IMPLANT IN THE HUMAN BODY SINCE 1971. AS A NASAL IMPLANT, MOST LIKELY SINCE 1980S.
with silicone a lot of patients seem to have skin thinning, transparency. will that happen with goretex as well? (i read in another forum that with goretex as you get older you'll see white under your skin)
THAT IS ALWAYS A POSSIBILITY. I DON'T THINK THAT RISK IS HIGH. WORST CASE SCENARIO, YOU TAKE IT OUT. I JUST CAN'T MAKE A PROMISE THAT YOU WILL NEVER SEE ANY WHITE. AS FAR AS SKIN THINNING, I WOULD SAY MUCH LESS THAN SILICONE BECAUSE IT IS SOFTER THAN SILICONE BY A HUGE MARGIN.

and if you had silicone for several years with skin thinning and get it replaced with goretex, will the skin still be as thin? and does goretex has irregularities that can be seen thru the skin?
YES, THE SKIN WILL JUST BE AS THIN UNFORTUNATELY. GORE-TEX SHOULD NOT HAVE IRREGULARITIES. IT CAN THOUGH AND IN THAT SITUATION WOULD HAVE TO BE REMOVED.

another doc said that the goretex sits very close to the bone so that it will over time press on it and shrink the bone. is this like a michael jackson effect?
I REALLY DON'T THINK THAT SHOULD BE A FACTOR. IF ANYTHING SILICONE HAS MUCH MORE OF AN ISSUE ON SURROUNDING PRESSURE DAMAGE TO THE NOSE. OBVIOUSLY, GORE-TEX BLOCKS RATHER THAN SOFT SHEETS AND AGGRESSSIVE AUGMENTATION THAT INCLUDES THE TIP HAVE MUCH HIGHER LIKELIHOOD OF CAUSING THOSE PROBLEMS. I ONLY USE THIN SHEETS THAT ARE USED ONLY IN THE BRIDGE SO I THINK THAT REALLY SHOULD NOT BE AN ISSUE. HOWEVER, I MAKE NO GUARANTEES.

My first rhino w/gortex , like an L shape shifted and demaged the tip of my nose, it was so depressing...Dr . Lam is there anyway to fix an indentation on the tip?? The previous surgeon w/2nd rhino, at first he thought he could iron it out w/cartilage grafting, but when he got in there said there was no blood supply, so he could not put any grafting there...so I am stuck with this deformity... It'll be a miracle if my nose ever look normal again ..

yes, silicone micro droplets is most likely the answer. i do that all the time. i hope that can fix it for you.
sml

Can you get a prominent profile from gortex??Had the gortex placed, wanted a higher profile , is there a way to fix it , w/o replacing the implant??[/list]

for very minor adjustments, i use silicone micro liquid (1 to 2 mm more). i can stack that on top of the gore-tex. i'll be lecturing about that next week in vegas.
best,
sml

Is there a video on this ??

not really. i just use silicone to fill those holes. in most cases, it works very well.

Is there any pain , after numbing cream??

yes, you will still feel a slight sting. the whole thing takes less than 1 minute though.