LAM FACIAL PLASTICS

Hi Dr. Lam,
I'm an asian woman and have natural double eyelid. It has been a few year, only my left eye developed multi folds and the crease set a lot higher than the right side, I think I loss some of volume around the upper eye lid on the left, so this side looks hollow. (even I have never done the eyelid surgery) My right side is normal. What is your suggestion on this, What procedure you will perform to correct it, do I need to do on both eyes to make it look even?

And I also have another problem, my face on the left side looks smaller (on the side where the ear and go down to the jowl, jaw line) than the right side. As the aging process, I loss the fat (no sagging yet, I'm 34 year old) but it shows the bone structure so I can see it clearly my left side hollow and smaller than my right side. Can I do the fat transfer to put into that area to create more symmetrical and how long the fat will stay there? Please advise!

I was thinking to have these problems fixed for a few years but I was scare about the outcome. As I read your web site I think I gain my confidence.

Thanks a lot.

B.

in answer to your questions:
1. if you have a real fold and have multiple folds, they may either be due to the way you were born or fat loss. attached is a 40 some year old Chinese woman who had a little bit of skin removed along with fat transfer. however, if you have multiple folds due to a lack of a fold, then you need a formal double eyelid procedure on BOTH eyes to maintain symmetry. the only way i will truly know that is to see you in person but a photo can help.
2. fat is not great to fix symmetry since it is a live graft and can change a bit with weight. i use fat more symmetrically. in fact, two things about asymmetry: it is almost impossible to fix and also people are way too concerned about their own asymmetry when no one else cares. it does not impact on beauty. balance and proportion do. please go to my blog and do a search on symmetry, then click on the link for "symmetry: refocus your thinking", then read it.
best,
sml

Thanks Dr. Lam.
My left eye looks more like the left eye of the Chinese woman below. It was originally have same crease, no multiple folds same as the right eye, but somehow due to fat loss I think like you said, it is now has higher crease and multiple folds. My right eye is still the same as before (normal) so both eyes don't look even. The procedure that you did to have a lilted bit of skin remove along with fat transfer, could you tell me the fee and will it take longer for recovery compare to the formal double eyelid surgery? And if that is my case, will you do anything with my right eye to maintain symmetry.

I know, if it doesn't look that bad, I'm not concern. But it is just a few years now, it really looks different between the right and the left sides (if my right side is 10, my left side maybe 7, I'm talking about the size, I'm sorry I can't think of any better way to explain it). I know it is impossible to create symmetry so I think I just need an improvement to make it looks better (maybe from 7 to 9, still talking about the size for my face on the left). I'd love to see you in person for consultation but I live far away so maybe I can send you pictures. And please let me know the fee if you think you can do something to improve for my case.
Thanks again Dr. Lam.

B.

Okay, let me take a look at a photo. Because right now everything is conjecture on my part. You can send one to me as a PM. As you can see, attachments are easy.
best,
sml

Okay, I have reviewed both sets of photos. I do see a need for fat grafting around the eyes, a bit into the cheeks and chin. This is particularly evident in the photo without makeup. I think I can get the eyelid position lower and better with the fat transfer but i want to be careful in two respects:
1. symmetry is an almost impossible thing to achieve. i tend to put fat pretty symmetrically because fat is a live graft so i don't like being aggressive in correcting asymmetries. that is, fat will grow and shape so i need to be pretty symmetrical in my placement. however, in your case, i could put a little bit more on the left upper eyelid.
2. fat grafting holds very well but the brow upper eyelid area is hard to estimate how much retention, in other words, it is very hard for me to predict with certainty how successful i will be exactly. that being said 3 things: 1 there really is no other option to improve your situation since you are hollow and a double eyelid is absolutely out of the question. you need to lower the eyelid not raise it any further. second, i typically still get some nice hold there even in the worst case scenario. third, i stand behind my work so in case i need to put more, i wouldn't charge you.
in short, i think you are a good candidate with two further caveats:
1. i assume your weight is pretty stable (typically does not swing 20 pounds or more). you look thin so i am not really worried.
2. have you had kids yet? i am not here to frighten you. just to say that during weight gain of pregnancy, you can theoretically look too full in the face. i have never seen that but i always throw that out.
best,
sml

Hello Dr. Lam,
I have 2 kids and I think I'm done.
So fat grafting for upper eyelid, is that the same fat that uses to put into the face? if not, then what kind of fat is that? And is that take longer for recovery compare to the formal upper eyelid surgery ?
For my face, you said I need fat for cheeks and chin, that mean for both sides? but will put more fat into the left side where I concerned, right?
Could you tell me the fee for the procedure.

Thanks Dr. Lam!!

B.

yes, the fat is the same for the upper eyelid as anywhere else on the face. i take it from the thigh/belly and transfer to the deficient facial regions. for the answer about putting more on one side, usually not. please read my previous answer. i have addressed asymmetry both from a fat safety issue as well as from a psychological issue. it is way overrated. everyone is focused on symmetry. i am focused on beauty, balance and youth. they are not the same thing. the cost including all anesthesia and facility charges is 9k. the recovery is worse with fat transfer (watch my recovery videos called patient video diaires). however, you DO NOT NEED A BLEPHAROPLASTY AND IT WOULD BE TERRIBLE FOR YOU. you need the opposite of a blepharoplasty. your creases are very high in the air and they do not need to be higher. it will make you look unnatural especially because you are Asian. if you are interested, we should probably do a phone consultation at some point. this is all very hard to describe reasonably in a forum discussion. you can call 888-866-3388 to schedule. there is a 100 dollar charge for the consult that is applied to any procedure with me.
best,
sml

Dr. Lam,
Orbital fat grafting is the same term for the procedure for my eyes to correct the hollowness? I know you will make the incision to lower the creases. But to transfer fat to the upper eyelid, do you inject the same way like you do for the face or place the fat thru the incision.
Thanks!!!
B.

no, there are absolutely NO incisions. plus, you've got it all wrong. you can't make any incisions to lower the crease. making incisions will make the creases higher!!!! the fat is use to lower the crease by restoring the volume lost. again, i know these are tough concepts.
sml

Thanks a lot Dr. Lam for your time!!! I'll make an appt for phone consultation since I stil have questions regarding this procedure. Hopefuly I can have one soon.
Could you answer one more please. For fat grafting procedure, in general, do you think how long it lasts. Most of your before and after photos showed upto 2 years, do you know what will be happen after 2 years? do you think the fat may start to wear out at this time ?
Thanks again Dr. Lam.

Bren

No, once the fat has held with blood supply, it holds. it is permanent minus the effects of aging. we can talk about this further. my fat holds very well. not everyone's fat does.