Dr. Sam Lam Plastic Surgery Forum

i was wondering what facial feature makes us look older.
is it the face as a whole,or is it certain aspects ie: eyes,wrinkles,sagging cheeks/jowls.
thankyou.

what i always say is that when we look at a face and think that it looks older we see the face as a "whole". our brain makes instantaneous reads of another person's face and within a split second we either say that person looks good, bad, young, old, ugly, beautiful, etc.

however, obviously, our brain must do so by looking at various parts of the face and synthesizing that information. in other words, our brain must have a vocabulary in which these 4 things that i see will make me think this person is young or old, beautiful or unattractive. these are the things that i work on to trick our brain into seeing that other person as attractive.

now what are these things? here are the elements that i believe denote youth in a viewer's eyes, at least the big things: brightness to the face, minimal transitions, i.e., overall there is uniformity to the face where one part of the face blends with another part, convexity rather than deflation. all of those things are treatable with fat transfer. if you look at a 30 year old overweight, they are uniformly round. if you look at a 60 year old person overweight, they have pockets of fullness and still pockets of emptiness with marked transition zones. these are the things that you can still make that judgment almost immediately at 10 feet away.

how about beauty besides youth? the single word that i have is proportion. a nose that is too big for the face, a hairline that is too high, a chin that sticks out too far, a face that is too wide, a mouth that is too small, all detract from one's attractiveness. what i do with fat grafting is to provide balance to the face. what i do with rhinoplasty is to provide the balance where parts of the face look in proportion (or at least improvement). i can't take someone very unattractive and all of a sudden make them beautiful. i can take them one step higher on the beauty chain. usually that's it. for example, if your face is really too wide, i can't put it in a vice to make it smaller. however, i can blend the chin and frontal cheek region to create the illusion of better proportion.

now what do many of my female patients think makes them look older or less attractive? first and foremost, lip lines around the mouth. in most cases completely irrelevant toward making someone attractive. the reason they see this problem is that they are used to seeing themselves too closely in the mirror. in addition, that is the only vocabulary they have about beauty. i always try to help them see that this is irrelevant because no human being can see their lines unless they are within 2 inches of their face. most women micromanage their face by complaining of asymmetry and facial lines. read my blog on why asymmetry is so totally overrated. under the blog section, click on the category on the right, "Dallas Facial Cosmetic Surgery" then slide down 2 entries. For my thoughts on facial folds, watch my video log, "How about those smile lines?".

that is why i use old photos to help someone understand, e.g., that their brow was not 10 inches higher in their face but fuller. no one really gets my philosophy until they sit down with me in consultation. then the light bulb goes on when i show them their old photos. okay, those are my ideas about what one person sees when they judge another person's beauty and youth. obviously, when you judge my photos and decide on me, you pick me because the person in the after photo "just looks better". that is the goal. not to fix every little flaw but to create a composite image where someone else looking at you says "wow" but can't tell what i did.
best,
sml

gosh !
thankyou for such a long and informative reply.

for me ,when i look in the mirror i look ok ish,but its glimpsing myself in shop windows which is the downer the only way i can discribe it,my whole face looks 'heavy' , i,m not overly overweight,about one stone (14 lbs) and i,m now on my healthy eating plan to move these lbs..........i would say most of that weight is around the tummy.

anyways i,m going to get more pics taken to send them on to you ,are there particular angles they should be taken.?

i don't think i need more photos. i have a good idea about your face. i think i can improve it and also hopefully erase your browlift and eyelid procedure, which tend to feminize your upper and midface.
best,
sml

Haha Charlie, I was reading your post and I know EXACTLY what you mean! I think what you're describing in the shop windows is the "shadowing" effect, before I had my liposuction I had these fat pouches in the midface and buccal area which I absolutely hated and they didn't blend in with the rest of the face (mind you, this wasn't again I've had these since I was a child!).

Just be careful when you decide to have your fat transfer, make SURE YOU'RE AT THE WEIGHT YOU WANT AND WILL STAY AT!!!! That part can potentially expand and deflate with weight loss or gain, so if you were to gain or lose you could end up looking worse than if you had nothing put in at all even if you looked alright at the time of the procedure. In my case, my face acts as an odometer for weight gain/loss. You can see a significant difference even with 5lbs and my asian girlfriends can also attest to this. My white girlfriends don't seem to have the same problem, for them its the butt or the hips...lucky them!!!

i agree with cat. i would tell you not to lose all your weight though and look too "ideal" because my fear is that you would gain some back and the fat may not be "ideal".
best,
sml

hmmmm i yo yo between fat ish and not so fat ish.!........but its only ever on the belly.!
apart from that i,m happy with my overall build .
if i could move it from one place to another i would put it on my arms,i always wear long sleeves because my arms are quite thin.
i guess i should be 'working out'but i hate gyms with a passion,saying that i do a lot of manual work and that for me is enough.

just figure a relatively stable weight for you. that is important. if you feel as if you fluctuate at 20 pounds up and down, you can still have fat transfer, there just might be times it looks better and other times not as good.