LAM FACIAL PLASTICS

Hi Dr Lam

I was reading on another board about a lady who had restylane injected into her face. She said that afterwards lots of spider veins came up in the area that was injected. Do you know why this happened? How do you prevent this?

also same question for fat grafting. how do you prevent veins coming up here too?

honestly, i don't know. my honest opinion is that it is unrelated. here is a possibility. she always had that problem but did not look at her face so closely until after the procedure. now she thinks that it is a new problem. if you think that i am just coming up with a line here, you would be surprised. every day a patient comes to me and says, "Oh, you caused this or that.." and then I show them the before and it is typically 10 x worse but they never looked in the mirror that closely. After a procedure, you get in front of the mirror 2 inches a way 2 bijillion (that is bigger than a billion) times a day under every lighting known to mankind. If you want to watch my video on this subject, watch my video under the postoperative patient companions in the video media center on self perception.

now, honestly, she may have developed more veins. i don't know. i have no idea why she would. i truly believe that people fail to notice problems until AFTER a procedure. that is why rigorous photography before and after that is very standardized is so important.
best,
sml

thanks for your reply. if it WERE to happen, WHY? Would it be because the fat/ restylane was injected too superficially or aggressively? or could you just be prone to them? have you ever experienced this before with fat grafting with any of your clients?

one person said there were more broken capillaries out of a few hundred of my cases. my true feeling is that it probably is unrelated so i just lasered it.
sml

were there many afterwards with this particular lady? sorry to ask, but just trying to get a full picture. Thanks Dr Lam!

as far as i can recall i think i did it twice. obviously, there are no guarantees with anything that is done.
best,
sml

so she had two more spider veins?

also can you explain where you inject the fat? Is it deep, or just below the surface of the skin?

)

no, she thought she had a few more broken capillaries (red not blue) that i had to knock down. i am not convinced of this fact but it could very well have happened.

fat is placed at all levels depending on which part of the face.

thanks dr lam. is it placed deep in the chin? which areas do you place it superficially?

superficially to deep is buccal. chin is medium deep. lower eyelid is deep. upper eyelid brow is medium. temple is medium. anterior cheek deep to superficial. outer cheek is medium. upper nasolabial groove is deep. nasolabial is medium. tear trough is deep to medium deep. prejowl is medium.
best,
sml

thanks dr lam. do you have to go superficial? can you just go medium to deep?

i don't have to go superficial. i don't see why that makes a difference. if you are thinking that it would cause spider veins, i truly think that is in error. however, if you are freaked out, fine. i'll stay medium to deep. the only reason to go superficial is when i put a decent amount of fat in, i like to spread it along all levels but that is not critical.
best,
sml