This is the Latin motto that was used by my high school, Cistercian Preparatory School, that simply means “to be enkindled and to enlighten”. I like this two part saying because the first part talks about oneself and the second is the effect of the first part on those around you. Let me clarify: “to be enkindled” literally means “to burn” so I interpret that to mean you are set ablaze with passion for what you do and that burnished passion rubs off on other people around you in an infectious way. Further, it just means that you are burning and on fire for life and whatever you are doing.

The second part “lucere” means “to be enlightened” so that you can also be in a learning capacity but I also see it as its literal meaning “to shine” meaning your burning “ardere” serves as a light and a beacon for others around you. As I have mentioned in previous posts, my mentor, Ed Williams, taught me, “You can inspire but you can’t motivate”, i.e., you can shine a radiating light that will fall on the shoulders of those who can see your passion and make it their own but you can’t force someone to do something that he or she has not motivation to do to begin with.

I think we all should be burning with desire and with that burnished energy impart that to others as a shining light so that they can be touched to burn themselves and then to light others forward. Ardere et lucere.

Today I turn the tender age of 40! I celebrated with friends and family this past weekend (see photo), with my sister and my brother-in-law flying in to offer me their best wishes from New York as well as some “over the hill” balloons and a cake that read “Oh No The Big 40″ for fun.

Of course, at this juncture I pause reflectively on my life’s journey thus far. I was on a date last week and was asked, “Do you have any regrets?” I said, “No. I never have regrets.” I think the past is something we can’t change but helps guide us for a better future. I would say that I have had a lot of learning during the 40 years I have graced this planet and hope that I can become a better person every day forward.

Too often we become the sum of our accomplishments or a sum total of our past. I can look at the writings and surgeries that I have accomplished and all the patients I have been so fortunate to touch their lives and feel deep satisfaction. Yes, that is fantastic and quite an honor for me. But, more importantly, I look forward to the future and what is in store for me during life’s journey. If we look at life like a journey (as mentioned in yesterday’s blog), we can savor the ride and look forward to the next road stop coming up.

My spa director, Linda, said to me “Dr. Lam, you are 99.9% right about things.” I said, “No, perhaps in life I am only 70% right but the 30% of the time that I make a mistake, I don’t make that mistake twice or try terribly hard not to repeat that error.” I am in a constant battle to be more self aware, which I think is the most critical thing that we can do. We need to be a better person tomorrow than who we were yesterday. As I mentioned in this blog, my organization EO (Entrepreneur’s Organization), also affectionately known as “AA for Business Owners”, helps me focus on my personal and professional growth.

I am very grateful for where I am today and look forward to where I can become in coming years! I would like to thank the love of my family, the love of my staff, the love of my friends, and the love of my patients who have buoyed me all these years and will do so I hope for many years to come. I leave you with this birthday card wish I received: “My birthday wish for you is that you always have people to laugh with and be close to, things to dream about and work hard for, places you can go to rest and reflect on all that is good in the world and especially in you…and may you always know how much you are thought of and loved.”

This is my second favorite latin quote, “festina lente”, meaning hurry slowly. In short, it means be deliberate and consistent in your application but don’t trip over yourself to try to get to the end result. I really love this saying. Sometimes we get so wrapped up in what we do that we become impatient to get to the end result. That can lead to producing an inferior product that we would not be proud of. As an example, the hospitality kit that I know is shortly forthcoming in this week or in a few days has been something that I have worked on with my staff and webmaster for several months now. It will only be released when it is mature and ready to go with only a few bugs and kinks left after going live. I could have released an inferior version months ago but that would not have been right.

Also, life is a journey. Sometimes, we get so obsessed with the destination we forget to savor the journey to get there. We need to “make haste or hurry”, that is, not waste time going in 50 directions but move forward slowly, deliberately and with open eyes and and with an open mind. This fundamental component informs how I treat my surgical patients. I do ONE surgical case a day. Instead of trying to cram in 3 to 5 surgeries a day, I savor each procedure and want to be as fresh as possible for the case, as my patients deserve. Never heard of such a thing? You’re right. I haven’t either in all my surgical training. That is how I set up my practice, and I love it.

I think “festina lente” is a companion to “per aspera ad astra” (monday’s blog) since through hard work we can attain the stars (the latter saying) by steady and forward-minded application of our talent and efforts. Whenever I feel stressed or want to push too quickly for the end result, I think “festina lente.”

Get Out and Vote

Need I say more? I will not disclose my political affiliations as this blog is meant to be free of both religious and political overtones (no fights, right?). I will say that I am not a very “political” person and hate engaging in political debate. However, I think we all should get out there (in the U.S.) and do our civic duty to make our voice heard and to participate in our glorious democracy.

Coming from another country and being naturalized as a United States Citizen during my teenage years makes my citizenship more acutely aware for me than for many who were born here and take that right for granted. My parents moved from Hong Kong back to the United States when I was 3 years old specifically so that I could enjoy the freedoms that the U.S. would offer me. Obviously, there are many great countries out there, but my parents chose this one for my upbringing.

Last week on Thursday I cast my ballot during early voting in Texas. Let me tell you a little of the saga I went through to actually vote. First, I went to a township called Addison which based on my computer was where I was registered and only 15 minutes away from my office. After a 30-minute wait in line I got to the front of the line where the lady asked, “Do you still live at the address where you registered?” I said, “No.” That led to me talking to the judge, who denied me (and the lady in front of me) the right to vote in Dallas county. I was informed that I would have to go to Denton, my current place of residence. I plugged in the address on my GPS and headed northward. The GPS indicated that my travel time would be 30 minutes, leaving at 5:50 pm during traffic to make my arrival at 6:20 pm (assuming no traffic) with polls closing at 7 pm. I had to go to that location because I had to vote what was called Limited Ballot, meaning I could not vote for officials in Denton County, which was fine with me. Fortunately, there was not heavy traffic but by 6:40 pm, I realized my GPS had taken me into a blind cul-de-sac, and I was afraid that I would not make it. I called the Denton location moderately panicked and then plugged in the nearest cross street into my GPS that the lady gave me and my GPS read arrival time 6:50 pm. I made it there with a combined GPS and verbal navigation at 6:55 pm to vote, 5 minutes before the polls closed. With an accident in front of me and closed lanes coming back southbound, I faced an hour and a half traffic making my voting experience a 3 and a half hour journey that did not even involve extensive lines!

I hope all of you will have a more pleasant experience than I and get out there and vote!

Olympian Michael Phelps

After 4 years of Catholic high school and 4 years of Latin instruction, some of that knowledge will linger in my soul regardless if I want it to or not. I also taught Latin over the summers and still can remember my declensions and some conjugations (frightening huh?). I was thinking that some Latin maxims have really stuck with me over the years, and I thought I would share with you the 3 maxims that have the most meaning to me personally in today’s blog, Wednesday’s, and Friday’s. I have other blogs prepared for Tuesday and Thursday and you will see why on those days.

My absolute favorite Latin saying is “Per Aspera Ad Astra”. It simply means through hard work to the stars. I truly believe that with application of a rigorous work ethic that I have applied since childhood, you can succeed beyond your wildest dreams. If I want something, I don’t take no for an answer but plunge forward to get what I want. I think the work ethic in America has been steadily declining and we suffer from that lack of discipline. Interestingly, the next 2 maxims will touch upon this idea but from a different angle.

It is interesting that I have pursued my career with singular focus based on a deep-rooted passion. I work tirelessly in large part because I love what I do. I think there are two things that we should be careful with when we focus on “per aspera”, i.e., the hard work part. If we do not know where we are going, then hard work is for naught. We need to know what our short and long-range goals are for that hard work to have any merit. Put it another way, if we do not know where we are going, we do not know which direction we should travel in the first place.

Second, I had a leader of mine who came to me and said, “Sam, I have worked really hard. I have spent 10 hours doing this and 10 hours doing that.” I responded, “What was your result?” There was silence. When I talk to my staff, I am more interested in the “ad astra” and less in the “per aspera”. If it takes you 5 minutes to envision and execute a vision, that’s great. If it takes you 10 hours to try to do something but you consistently attain no results, then I am unimpressed. I am completely results oriented. That is where judgement and talent come into play. I really admire raw talent combined with a forceful work ethic. Work should not be just for work sake.

All that being said, I think when we want something badly and our goals are driven through a deep-seated passion and unbending vision then we can achieve it through tireless hard work: per aspera ad astra!

Wall Drawing #146. All two-part combinations of blue arcs from corners and sides and blue straight, not straight and broken lines. September 1972

We are going to define a different type of culture than the last 3 days of blogs: a little more refined culture so to speak (just kidding). As you would surmise, these blogs are about getting to know me, your surgeon, a little bit better and for me to reach out to you, the reader, with my aesthetic sense of what I consider beautiful. Of course, if you do not like modern art, this blog will be devastatingly boring or foolish. My buddy, Mark Wettreich, who owns an incredible European Art Gallery that focuses on “real art”, would look askance at this blog. I doubt Mark reads my blogs. However, if you are, please stop reading here.

Perhaps the best way that I conceive of my art is of its high graphic design quality. In essence, I really appreciate good design. It appeals to me fundamentally at every level. I love beautifully designed clothing, furniture, cars, anything really (and you know by now my obsession with Apple.) I would have loved to have been an industrial designer. Johny Ive move over (he is the Apple brainchild who has revolutionized the world more times than I can remember.)

Okay, now to the core of this blog. I absolutely love Sol LeWitt. He just died last year. He was an amazing American artist whose structure, clean, and graphic sense of the world I absolutely loved. I am going to insert here my paper that I wrote for the Archives of Facial Plastic Surgery in 2003, which never saw the light of day since the editorial board believed (perhaps rightly so) that my monograph on art did not highlight the beauty of the face. Well, besides the editorial board, you will be the first to read this article that never got published:

“Wall-to-Wall Beauty”

Samuel M. Lam, M.D.

Although Sol LeWitt has produced a prodigious amount of art over the past half century – from sumptuous two-dimensional geometric prints to elaborate three-dimensional cubed lattices, his most significant contribution to the art world remains the wall drawing. When asked if the sobriquet “originator of wall drawings” properly applied to him, he replied, “I think the cave men came first.” His cheeky reply aptly evokes his self-dismissive attitude that permeates his entire life and career. He has constantly upheld the primacy of ars gratia artis and subserved his ego to his artistic ambition. He often declines to attend media events in his honor, arriving late or not at all, and has refused to pose for a portrait by his celebrated artist friend, Chuck Close, because he wanted the public to pay attention only to the art rather than the artist. Even the large-scale retrospective of his work that opened at the San Francisco Museum of Modern Art in 2000 required years of coaxing before he could be convinced that he should participate, given his concentration on the future direction of his art rather than the past.

Part of an entrenched anti-commercialism is expressed in the very idea of a wall drawing. Unlike canvassed works that can be bought and sold as a commodity, a wall drawing lacks this vital attribute of market viability. Although LeWitt never explicitly foreswore a commercial intent, he stated, “I never think about selling a work while doing it.” LeWitt had even naively proposed that any artist that desired to replicate his wall drawings could do so to widen the public consumption of his work but has since retreated from this untenable position given the inferior reproductions that were spawned without his oversight. LeWitt’s massive wall projects are often executed by hired hands under his supervision, as he subscribes to the Conceptualism school that embraces the artistic idea more than the mechanical process, so long as the construction effort remains true to the original design. In fact, the colossal wall installations that are delicately fabricated for a specific site are often completely destroyed at the conclusion of the prescribed event.

LeWitt embarked on his first wall creation in 1968 for a group show at the Paula Cooper Gallery in New York. He wanted a medium that could offer him the most two-dimensional representation of his two-dimensional art, in a word, flatness. He wanted his created work to convey its true two-dimensional essence, which could not be accomplished on a canvas that by its very nature was a suspended three-dimensional object. Beyond this consideration, the artist was motivated by early twentieth-century Russian art that celebrated visual art within the context of a defined setting. His architectural sensibility may have also been partly informed from LeWitt’s time spent in I.M. Pei’s studio a decade earlier. His later sculptural monuments would also resonate with architectural vibrancy. This pairing of art and architecture achieved its fullest expression in the German Bauhaus and the Dutch De Stijl movements of the early twentieth century that prefigured LeWitt’s efforts fifty years later.

LeWitt’s contemporaries of the 1960s were also explicitly and subtly exploring the immediate environment in which their art was displayed. Dan Flavin’s fluorescent light sculptures illuminated the entire room in which they were exhibited and cast a luminescent glow and shadow on neighboring walls, floors, and ceilings. In fact, Flavin is credited with introducing to LeWitt the expressive and intellectual nature of serial, permutated forms that would become an integral element in LeWitt’s idiom. Donald Judd’s wall-mounted sculptural pieces were also intimately tied to the wall from which they were suspended. Similarly, Andy Warhol canvassed the Castelli Gallery with Cow Wallpaper, a work that must have resonated with LeWitt; and Eva Hesse’s Accretion that consisted of numerous fiberglass tubes propped along the expanse of a blank wall echoed LeWitt’s aesthetic ethos. Despite all of these varied concurrent artistic endeavors, LeWitt would most fully exploit the architectural interior and transform it with his site-specific wall installations.

Over the past thirty years LeWitt has continued to evolve his style of wall drawings from the intimate to the dramatic. Initially conceived in the 1960s, his drawings represented little more than transference of his paper drawings to the wall without a premeditated link to the environment in which it would be presented. In the early 1970s, he began to develop an artistic idea more specifically for the physical space that it would occupy. In Wall Drawing #51 in Turin, he hired three draftsmen to connect every architectural point on the wall (light fixtures, door knobs, wall corners, etc.) to each other in every conceivable combination using blue chalk. In 1975, his art underwent a transformation yet again: he began to alter the background wall color to suit his artistic needs rather than be satisfied with the typical, preexisting white facade. He relinquished part of his artistic control to his draftsman, ordering only that “White lines from the center of a [black or yellow] wall [be connected] to specified random points” as would be determined by his skilled draftsmen. By the 1980s, LeWitt’s work achieved a strong visual vitality through use of bold geometric shapes and vibrant color schemes. LeWitt himself has commented that the newfound boldness of his work reflected the size and grandeur befitting the architectural space. His wall drawings continued to expand in scale to occupy neighboring walls, adjacent rooms, and even moving out to the outdoor environment. By the 1990s, LeWitt began to use acrylic as his favored medium rather than pencil, crayon, and India ink, which he had relied on in the past. Although LeWitt still refers to his collective works as “wall drawings”, use of acrylic transformed his drawings into paintings. The austerity of his early works gave way to the playful exuberance of his acrylic pieces that exuded bright, saturated, glossy colors with a simplified geometric vocabulary. Despite all of the intellectual rigor that LeWitt has applied to his art through his writings and advocacy of the Conceptual movement, his oversized wall drawings provide an immediate, seductive appeal that remains truly unique in twentieth-century art.

Heart Math

As I alluded to in Tuesday’s blog, a leader is an individual that commands quiet respect without having to ask for it. The person who needs to ask for it most likely does not own it or deserve it. Leaders however are not born in many cases and are not born out of crisis. Instead, they are mentored by someone more senior than they are who have inspired them to be leaders. I have had many mentors. As mentioned before, Ed Williams was my singular hero who taught me my flaws more indelibly and who showed me a path that I needed to see.

Along those lines, when a leader leads because he or she naturally draws people into a followership position, it is important that the leader not drag down his or her staff through negative emotional energy. In fact, a strong leader will draw down everyone’s energy unwittingly in many cases. Oftentimes, anyone within 15 feet of this leader will either be buoyed by his or her presence or demoralized by it without that leader actually opening his or her mouth. In It’s Your Ship (a book given to me by my nurse Beth to read), the author suggests that if you are the leader and you are not having the best day, get out of the way and allow your followers freedom not to be shackled by your emotional slavery, albeit unintentional.

Also as I have mentioned, we are all leaders in many respects and we all draw and give energy to those around us. That is part of the reason that I started the “Tell me about your passions” forum to just have fun with imparting a little happiness and joy through related passions. The California group Heart Math has claimed that the electromagnetic forces of our hearts radiate about 15 feet around us and when our energies are low and negative we impart that out to those who are in our proximity. Accordingly, to buoy those around us rather than to anchor them downward, center your emotional gravity first before you inflict that negative energy on all those who see you. Over time if your energies are sustained negatively, you will either attract those who thrive on negative energy or you will polarize away all those who embrace positivity.

I think that is why in large part my patients are happy ones because I attract those kinds of patients, who are inherently happy individuals. I think as much joy as my patients get from seeing me, I in return attain the same level of joy in seeing my patients. My patients are truly the driving force behind why I wake up every morning and enjoy coming to work. For all of you out there who struggle with negative energy, remember that whatever energy we think we are containing within us actually can affect all of those in near proximity to us even without our knowing it (or at times their knowing it). The stronger an emotional force you are as a human being the more effect you will have on those around you, positively or negatively. I hope you will learn to radiate positive energy around you by being, thinking, and feeling as positively as you can every day.

As part of our series on human relations and leadership, I want to have you think about how you treat EVERYONE around you. Do you treat the rich and privileged with more respect? Do you treat waitstaff with callous disregard? How do you view the strata of humanity as equals or as those who don’t deserve your attention?

Perhaps the greatest role models for this excellence in leadership are two individuals: my mother and my paternal grandfather. Let me discuss with you their singularly remarkable attributes. My mother has instilled in me that every human individual is valuable and should be treated with dignity, respect, and love. In fact, those who are in need and may be deemed at a lower station in life, she goes out of her way to make sure that they are supported emotionally, financially, or in whatever way possible. She helps all those in need around her with a blind eye and with absolute self-abnegation. She is truly a role model for me and continues to be one in my life.

My paternal grandfather with whom I share a birthday (November 6) was a great man in the classic sense. He was honored with the Order of the British Empire (O.B.E.) and met with heads of state like Nixon and LBJ. But what made him great was not his wealth, fortune or title but his character. At the age of 50, he stopped “working” and gave over his life to help those less fortunate for the glory of God by giving away his fortune slowly to those in need. He opened a Baptist College and hospital in Hong Kong and truly spent every waking moment helping all of those around him without desire for recognition. In fact, when he died (I was only a baby at the time), many caddies and their family from the golf club came to my uncles and aunts and said, “What are we going to do? He was paying for all of our education including our college.” He made it a point not to share with my family his altruism as that is the greatest gift he could make was his quiet generosity. My uncles and aunts reassured all the caddies and their families that the pledge my grandfather made would be carried through to fruition by them.

The people that I associate with are those who are dedicated to treat all humanity with love and respect. I simply cannot tolerate individuals who hold themselves above others around them. We are all part of a common race and we are all flawed creatures. Next time you have an individual that you treat with disrespect, think for a moment of why you should consider yourself better than that individual. In my opinion that behavior makes you lower than the person that you are treating badly.

N.B.: As you can see, you now have full capability to post this blog to your facebook account, send it in an email, subscribe, etc. in a single click (see below). Hopefully, that will make this blog more fun and more shareable.

Somehow the past several weeks, I have really enjoyed compartmentalizing my blogs into 3-part series. Perhaps I am trying to get you to come back to read more the next day. Perhaps it is in homage to my good friend in South Korea, Dr. Young-Kyoon Kim, who is both a cosmetic surgeon and an artist and who is fascinated with the number 3. Whatever reason, I enjoy these mini-serial blogs that explore a topic more in depth than a single longwinded blog could accomplish. (This one is longwinded enough.)

I really enjoy my job and one of the most fascinating parts to me is the human relations we have with one another. I am also fascinated by leadership. This blog is about both. Exhibiting a positive force on those individuals around you. Today we are going to talk about controlling one’s temper. I had a leader of mine who came into my office with staff in tow and who was visibly irate. Reportedly, my leader had lost her temper and fired off some less than genteel words toward her followers (I am putting this mildly.) I could clearly see that her followers had lost significant respect for her (and so did I). I realized that her leadership skills were deeply in peril, and I alleviated her of her job almost immediately.

I separated out my staff from her and first talked to my staff and apologized for her behavior and that I considered it unacceptable. I then moved my former leader into a room and said, “If you can’t control yourself, how do you expect to control those around you.” Obviously, I did not mean “control” in a dominating way but control in the sense of having people under you inspired to follow you. Essentially, she had no answer and that compelled me to end her career as a leader in my workplace.

I really look at all my staff as leaders influencing everyone around them. Don’t think you have to be the “boss” to have this blog relate to you. Oftentimes the boss is not the titular boss. If you read Emotional Intelligence you will understand that the real boss is the person who walks into a room and instinctively commands respect and followership. Typically, if no one is following you, there are two reasons for this problem. You didn’t inspire followership or you didn’t hire the right people that can be inspired. Accordingly, I blame the leader not the followers for most things. My leaders are held to a higher accountability.

Back on subject, I have experienced so many terrible leaders during my surgical apprenticeship in large part because surgeons have a God mentality and their arrogance obscures their ability to inspire followership. Honestly, I chose not to do my residency at Baylor College of Medicine, my alma mater, in large part because I was going to be exposed to a group of general surgeons who did not exemplify what I strived to be. I intuitively avoided being abused so that I would not perpetuate that abuse forward. My mentor, Ed Williams, with whom I did my fellowship is an exemplar of leadership excellence and humility in the face of adversity. After 18 fellowship interviews, many of which I truly loved, I realized that I needed to be with Ed because he was going to teach me as much as how to be a surgeon as how to be a gentleman. Thanks Ed for your foundation for excellence!

Before we begin, I would like to thank Mike again for quickly accomplishing a request I made. If you notice on the bottom of this blog, you can now subscribe to my blogs so that you don’t have to keep checking back in to see if I have posted my blog. Most often I have my blogs posted in the morning before I go off to surgery. However, I sometimes forget or don’t have it done on time so it comes later in the day. Now, you can receive an email (if you so desire) informing you the exact moment a new blog is posted and can then link you straight to the new blog. It also allows you to send an interesting blog straight to a friend who might be interested in the topic covered. You can also post my blog to various social media outlets as you see fit. Now on to today’s blog:

I just got back last night from Los Angeles where I gave 3 lectures at Cedars-Sinai and had a fabulous time. I also learned a tremendous amount and would like to thank my friend, Babak Azzizadeh, for inviting me to speak there. I was particularly enlightened by Val Lambros’ lecture on understanding the evolution of facial aging in which he used superimposed images of an individual at youth and after aging with morphed animations between the two images controlling for facial position. What was remarkable is how the upper and midface DO NOT FALL but just lose volume and deflate.

I like what he said which was, “The brows do not fall as much as we pick them up.” When he showed images of the brow over time, some came down literally only 1 or 2 mm, others stayed the same height, and still others actually went upward with aging as the skin retracted upward. Therefore, even for the occasional brow that came down 1 to 2 mm, a browlift would oftentimes exaggerate the brow position upward making the eyelid look different and unrejuvenated. He also mentioned that (and he demonstrated this on himself) when he lifted his brow up with his finger his eye actually looked smaller, making him look older. The fuller outer brow contributes to the lengthening of the eye shape further outward, which is similar to the shape in youth.

Let’s discuss eye shape in youth. He mentioned that in most individuals, Caucasian, Asian, or any race, there is a relatively almond-shaped eye that becomes increasingly rounder as the lateral canthus (outer part of the eye) starts to move inward toward the nose. This beadier, smaller, rounder eye is less attractive than the more open, almond eye shape that is more prevalent in youth. As mentioned, by exposing the narrowness of the outer eye by lifting the brow, the eye can look smaller and thereby more aged. That is why a traditional lower-eyelid surgery that involves cutting of the lower eyelid skin and tightening the skin thereafter further constricts the outer eye and can make the eye look even older. By filling the outer brow, you visually extend the outer eye shape to make it appear younger since the eye appears wider. Okay, this is really hard to explain but a simply brilliant thesis predicated on empirical evidence of aging using unequivocal superimposed images from youth to aging. In addition, a fuller framed brow is simply what exists in youth. For all of these reasons (both illusory and real), a browlift can actually age someone further.

He evaluated positions of moles and other static landmarks during the aging process. He found that moles simply do not change direction gravitationally downward. The moles that did migrate with facial aging did so in a radial fashion along muscular pull lines, i.e., almost horizontally that would indicate that the face is radially contracting, i.e., deflating, rather than falling downward. Again, remarkable insight using powerful superimposed young and old photographs of the same individual.

Unfortunately, for the neck and jawline, oftentimes a facelift is still required to accomplish the required rejuvenation. However, what he also showed was that the jawline matched out from youth to aging actually shows the jowl because the surrounding tissues are lost. That is the soft-tissue in front of and behind the jowl begin to disappear to reveal the jowl. At times bringing the jawline down with fat transfer in front of and behind the jowl could actually be better in certain circumstances. I think with a very prominent jowl and neck descent, a facelift is still mandatory to get the desired results. However, I have come to appreciate the power of filling the outer jawline in select patients who would benefit from this fill both for the sake of facial rejuvenation as well as for creating a better-balanced face. All of these ideas represent a remarkable revolution in thinking that justifies volume replacement as the singular technique for upper, midfacial, and parts of or the entirety of lower facial rejuvenation.