Dr. Sam Lam Plastic Surgery Forum

Dear Dr. Lam,

I am considering having some perlane for my upper cheeks and restylane for my under eye area.

Can you please answer one question for me: What happens to the skin once the fillers are absorbed from the body and disappear? For example, in people who lose weight, some sagging is observed. Does the skin stretch during the time we have facial fillers (it seems logical that it does)? What happens once the filler is gone?

My face has always been very thin. I would like to see how I look with a temp filler, but I am worried that once I start this, I will have to keep using fillers so my skin doesn't sag.

that's a good question. here are my thoughts:
1. i can't promise anything since everyone's perception is different. that is you probably will not sag but you might think you sag because you are thinking you will. trust me i know human nature and my patients' perception of things.
2. people that "sag" after weight loss only do so after MASSIVE weight loss not after a few pounds. You can gain and lose a few pounds and the body adapts. Therefore, putting a tiny amount of 4 ml, like a few table spoons should most likely not affect anything. the skin of the face also is much more resilient than body skin that tends not to have the regenerative capacity of the face. also remember you are ALREADY SAGGING. i am just filling the slightly loose balloon that is hollowing so in most cases I probably am not stretching anything.
3. obviously, if you can afford it fat grafting will solve those problems because it is permanent and you will not have to keep getting fillers.
anyway, those are my honest thoughts. not trying to sell you a concept but explain why i think that fillers are safe.
best,
sml

Dr. Lam,
Thank you for your reply!

I don't have sagging or loose skin in my tt area, and this where I'd like to see some plumping up. You are saying, though, that I may see some sagging after that or I may have "problems." Is this correct?

I think fat grafting can be a good option for the future. I would like to see how I'd look with a filler there first, and then consider a more permanent option, especially around the eyes.

No, I am saying quite the opposite. Because this is not 100 pounds of fat being lost on the body, the stretch with fillers on the skin should be negligible. I also stated that the skin retracts very well on the face. Please read my last answer again. When you lose 100 pounds, that is when your body skin sags. 1/2 ml of fat or filler is really very little to stretch anything in my opinion. hope that helps.
best,
sml

I appreciate the clarification! Yes, I understand. I am very new to this, and I am still trying to make sense of the whole process... Thank you for taking the time.

my pleasure.