Plastic Surgery & Cosmetic Surgery in Dallas

Frequently asked questions (FAQs) are intended to answer a lot of the most commonly asked questions that you may have about a specific procedure. By dividing the sections into procedural categories, you may be able to find the answer to the question you are seeking more easily. Please remember that what you read in this section is only intended to provide you with a general answer to a question and should not be considered in any way a substitute for a personal consultation with Dr. Lam.

How does Dr. Lam rejuvenate the area around the eyes?

The area around the eyes is perhaps one of the most important areas to rejuvenate. During a conversation and in normal social encounters, about 99% of the time is concentrated at looking at the other's eyes. Traditional surgery has been only based upon cutting away tissue. Dr. Lam rarely performs removal of skin or fat alone. Using your old photographs, he can evaluate exactly what you used to look like so that his surgical strategy can match your identity and thereby preserve and enhance your identity rather than alter your appearance so that you no longer recognize yourself.

Accordingly, Dr. Lam uses a combination approach to rejuvenate the periorbital area (the region around the eyes). For the upper eyelid that is hanging, he may remove a little extra skin if the eyelid appears to be drooping over the eyelid. Occasionally, he may perform a browlift if your old photographs show that your brow was higher than today. For the lower eyelid, he almost never makes an incision. There have been too many problems with the eyelid actually pulling downward in an unnatural way. Instead, he uses a technique known as "transconjunctival" in which he makes no skin incision to remove any excess "fat bag" that may be protruding. This technique preserves the shape of the lower eyelid and facilitates both a safe and a rapid recovery.

Part of the process of aging is also hollowing around the eyelids, where the bony rim around the eyes becomes more apparent. Dr. Lam believes that visibility of the bony rim around the eyes leads to a more aged look and camouflage of this area is a vital component to his overall strategy in periorbital rejuvenation. Grafting one's fat around the eyes can at times truly provide the most natural and remarkable rejuvenation, especially when combined with traditional skin and fat removal techniques.

After a detailed consultation with Dr. Lam, he will be able to evaluate which method or methods would be appropriate in your situation.

Yes, browlifting and excessive removal of skin from the upper eyelid in most men can alter their appearance in an unfavorable way and even feminize the face unnaturally. He rarely will perform a browlift in a male and will only be very conservative with skin removal from the upper eyelids in men. If you look at the celebrities out there that have a very strong, masculine face, you will notice that almost all of them have a very low brow and a very full and draping upper eyelid contour. For example, Tom Cruise has very narrow eyes but he still appears both youthful and masculine, even in his forties. It is particularly important to review old photographs for men to determine which strategy would be ideal in a particular case. Bringing your old photographs in to Dr. Lam will be very helpful both for you to understand the aging process and for Dr. Lam to help guide you in the best options available for you.

Browlifting can help with the tired expression of one's eyes. However, Dr. Lam performs far fewer browlifts than he did many years ago. We are all programmed by the media and by other plastic surgeons to take two fingers and to lift our brows up to show how much better we can appear. However, careful review of one's old photographs can reveal that your brow may never have been that high. Besides reviewing old photographs, you should review the paragons of youthful feminine beauty exemplified in such periodicals as Glamour, Allure, and Vogue. Many times, one will begin to understand that oftentimes young women who are deemed attractive have relatively low but full brows. The aesthetic over the past decade in particular has moved away from an exposed and elevated brow to a more natural configuration. Evaluating the role of browlifting for you will require a consultation with Dr. Lam.

After discussion with you, if Dr. Lam should elect to perform a browlift his technique does not require any long incisions. He uses only tiny incisions behind the hairline (a total of five) that heal very quickly. He does not remove any hair or skin during the procedure. This technique is known as an "endoscopic browlift."

Traditional eyelid procedures require generally very little recovery time. It is recommended that you take off from work for a week in order to permit sufficient time for most of the swelling to dissipate. Bruising usually takes 1 to 2 weeks to completely resolve. Dr. Lam can use his laser to lessen bruising significantly at the end of the first week should you experience some bruising. With lower eyelid procedures, as no skin incision is undertaken, there will not be a need to remove any sutures. For the upper eyelid, sutures are removed at the end of the first week. During that week, you will have to clean the incision with peroxide and dress the incision with an antibiotic ointment, all of which Dr. Lam supplies you on the day of the procedure.

Yes and no. Dr. Lam does not believe that wrinkles should be "cut away". Wrinkles under and around the eyes are creases in the skin that should be managed with a skin treatment. Botox can help prevent these wrinkles from getting worse by reducing their root cause, i.e., wrinkles that appear when you smile, frown, and raise your forehead. With a consistent regimen of Botox, lines and wrinkles that are not too deep can soften if not entirely disappear over time. For deeper wrinkles, a skin resurfacing treatment is necessary, e.g., plasma resurfacing, PIXEL treatments, etc. (See "Skin Rejuvenation FAQs" for more details.) The reason that Dr. Lam believes that the skin around the eyes should not be removed to take care of wrinkles is two-fold. First, it can be unsafe in that skin removal in the delicate lower eyelid area can result in the eyelid moving downward in an unnatural way, as explained above as to why Dr. Lam does not perform an incision in the lower eyelid area. Second, wrinkles around the eyes really are not significantly improved with removing skin even though it may appear that way to you when you take two fingers and pull back on the skin. That maneuver has very little bearing on the way that surgery helps one's wrinkles.

Because the Asian eyelid can be characterized by the presence or absence of a fold on the upper eyelid, there are very important variations in how Dr. Lam approaches the aging Asian eyelid. In addition, the height of the crease is very important in maintaining a natural look for the Asian face. For details of his method, please review the last 3 questions in the Asian Blepharoplasty FAQs section. Also, watch his video lectures on the aging Asian eyelid for a better understanding.

There are two principal ways to rejuvenate the cheek area, lift it or fill it. In Dr. Lam's first textbook, Comprehensive Facial Rejuvenation, he explained his strategy for cheek rejuvenation using what is termed a "midface lift". However, in the evolution of his strategy, he has found that filling the cheek can provide the most remarkable and natural rejuvenation. He considers the cheek as an extension of the "frame of the eye" where the cheek actually supports and enhances the look of one's eyes. In order to simulate the look of how filling the cheek can accentuate the beauty of one's eyes, all you have to do is to take your thumb and lift the cheek up gently and look into a mirror at your eyes, then let go of the cheek. You will immediately see the impact that a slight amount of volume can make. Fat grafting can be the most natural way to achieve this result. Unfortunately, a cheek implant is a poor choice in overall facial rejuvenation of the cheek area for a number of reasons. First, the cheek implant is partially exposed, i.e., can be seen through the skin in an older person, as the soft tissue volume of the face begins to go away. Further, what makes a face look young is the smooth transitions between the lower eyelids and the cheek and the lower face. Fat grafting permits a seamless result in which the hollow lower eyelids are gently blended with the cheek area. A cheek implant, on the other hand, actually worsens the way the lower eyelids look since it renders the hollow under the eyes even more apparent.

Facelifting is an important component in Dr. Lam's overall strategy for facial rejuvenation. Facelifting is a term that truly describes lifting of the jawline and neck only. As mentioned, Dr. Lam rarely believes that the cheek and the brow need to be elevated in most cases. The technique that Dr. Lam uses requires only a limited incision that does not extend into the hair-bearing area. Most traditional facelift procedures require an incision that extends up into the sideburn and up through the temple. Besides adding unnecessary recovery time, the problem with this incision is significant hair loss, especially in the person that undergoes another facelift in the future. In fact, Dr. Lam has performed numerous hair transplantations in women who have undergone this style of facelift. His incision also does not pass low on the back of the ear where your incision would be exposed should you wear your hair short or in a ponytail. Instead, his incision hugs the ear and the hairline so that it becomes virtually undetectable and again does not require any removal of hair.

Dr. Lam's results simply do not look pulled. He lifts and repositions the deeper tissue called the SMAS to achieve your desired rejuvenation without ever tugging or pulling on your skin. He does so in a VERTICAL orientation to match how tissues fall. Instead of pulling back, which can lead to a pulled look, the tissues are repositioned vertically upward so that you 1) have a better neck contour and 2) do not have a pulled look. Also, more invasive facelift procedures that release all the facial ligaments can impart a pulled or windswept look, which Dr. Lam also does not prefer.

Besides the incisions around the ear area, a tiny incision is performed underneath the chin along the skin's natural crease in order to perform liposuction of the neck as needed and to reunite the hanging bands that develop as the platysma muscle separates, commonly referred to as the "turkey gobbler" deformity or "waddle." After the muscles are brought back into lignment, the incisions are made around each ear and the deep tissues are elevated so that the neck is lifted up like a corset. For more information about the recovery involved, please see below.

In most cases, Dr. Lam does not perform a Contour threadlift. He believes that a Contour threadlift only provides about 25% of the result, at most, that a facelift can supply. However, in the individual with realistic expectations and who is younger, a threadlift may be a viable option. Also, for the person who simply is adversely disposed toward any incision or a facelift, Dr. Lam may consider a threadlift instead of a facelift for you

A threadlift is a specialized incisionless technique that uses permanent clear sutures that have tiny, laser-etched barbs, to hold the tissues in a suspended position. As the collagen surrounds each tiny barb, the thread is held durably in position. The sutures are placed through a tiny 1 mm incision behind the ear to help elevate the jawline and neck. Although this procedure has been touted as a "weekend facelift", it is neither a "weekend" recovery nor a "facelift". As mentioned, the skin only (not the deeper tissues) are held upward but not to the same degree as when the deeper tissues are resuspended in a standard facelift. Longevity of this procedure has yet to be definitively established. Although you will not need any bandages afterward, the overlying skin can look bunchy even up to 3 weeks after the procedure. If you have longer hair, you may be able to cover this bunching but it is important that you recognize this possibility following your procedure. The bunching and slightly overlifted appearance gradually settles down over a period of a few weeks. Generally speaking, there is very little accompanying swelling with this procedure, as there are no true incisions made. Bruising still may occur, most of which can be lasered down at the conclusion of your first week at no additional charge. When you clean your face afterwards, you will have to use only upstrokes not circular or downstrokes for the first 3 weeks as the collagen ingrows into the barbs otherwise you risk dislodging or breaking the barbs and thereby losing some of your result. After a detailed consultation with Dr. Lam, you can decide as to the benefit and limitations of a threadlift in your case.

Although liposuction seems to be an appealing option to tighten the neck tissues, it is not a wise solution in someone 40 years or older. Generally speaking, liposuction of the neck is reserved for someone younger than 40 years old for the following reasons. First, liposuction of the neck in an individual older than 40 years old may produce a worsening in outcome without a concurrent facelift in that the muscle bands ("turkey gobbler") may be more exposed after a procedure without the benefit of lifting them with a facelift. Since the skin elasticity diminishes after 40 years of age, the tissues may not tighten back without the aid of a simultaneous facelift with your liposuctioning. However, for someone with only mild fullness in the neck younger or older than 40 years, mesotherapy combined with Lipovanish and infrared skin tightening may be non-invasive options to help modify this problem without surgery. Discussion with our team at the Luminaire Laser Center (luminairelaser.com and 972-312-8189) may provide answers to your questions about these methods.

There are many ways to undertake neck liposuction. The two basic methods are known as "open lipectomy" and "neck liposuction". Dr. Lam uses both techinques. Open lipectomy involves precisely removing the fat piece by piece in the neck visualizing the area through the tiny incision under the chin. In select cases Dr. Lam also uses what is termed neck liposuction as it uses a machine to suction the fat away. Dr. Lam first releases the tissues adherent to the fat with gentle dissection then suctions the fat out evenly throughout the neck. Dr. Lam believes that some people have significant amount of fat under the platysma muscle, which must be removed to improve neck contour, especially in what many plastic surgeons term a "difficult or heavy neck". With Dr. Lam's technique, none of these necks are really difficult at all. By evenly removing fat across the entire expanse (from jawline to jawline) Dr. Lam is able to achieve more uniform results and at the same time promote good scarring that helps the entire neck maintain an elevated position thereafter.

The recovery following a facelift is limited to a week or two after the procedure. Generally speaking, it is advisable to take one week off of work to have the procedure done and to recover from it. Although there will be some swelling in the first 1 to 2 weeks, the recovery is not significantly deforming, as may be witnessed in other plastic surgery offices. You may have a few areas around the ears that appear slightly lumpy and swollen and you may look slightly pulled for the first 1 to 2 weeks. Thereafter, almost all of those issues will be entirely resolved. If you have bruising, Dr. Lam can laser down most of all your bruising at the end of the first week.

You will have a bandage that wraps around your neck and head for the first night, which is then removed the following morning in Dr. Lam's office. You will not need to be hospitalized, as the facelift is a relatively short procedure (about 2.5 hours) done either under light twilight sedation or general anesthesia in Dr. Lam's on-site surgery center. You will then wear a supportive neck bandage (an ACE wrap that will be supplied by Dr. Lam) for the entire week 24 hours a day as tolerated. After the first week, you can wear this light bandage at night for the following 4 to 6 weeks to minimize swelling and to achieve optimal results in your neck. You will clean your suture lines with peroxide and dress them with an antibiotic ointment, which Dr. Lam will supply to you, for the week following the procedure, which you will then stop thereafter. The sutures around the ears are removed by Dr. Lam at 7 days following the procedure, and the sutures under your chin will remain for 10 days. Generally speaking, you should be socially acceptable within one to two weeks. Most of Dr. Lam's patients take one week to 10 days off from their work.

Yes, the standard incision around the ears must be modified for the male patient in most cases. If you have a scant beard that does not extend to the ear, then the standard female incision that curves inside the ear can be designed for you. For most men, however, an incision in front of the ear where it dimples a bit is the ideal location. The one limitation is that in the morning, you will be shaving a bit closer to the ear, which requires more attention and perhaps time. An incision can be made where the normal beard distribution ends, but this incision line can be more visible in those that do not wear a beard. If you wear a beard normally, then this incision line is preferable since the beard distribution does not become moved back slightly toward the ear.

After the procedure, the same rules apply for you as they do for women. However, you will not be allowed to shave for the first two weeks and thereafter you must use an electric razor for an additional two weeks. Although it may sound unappealing not to shave for the first two weeks, oftentimes the light beard that you grow almost entirely hides bruising and swelling. Dr. Lam has remarked that most men already look good several days after the procedure because of this fact. Also, the richer blood supply to the lower face that men possess owing to their beards can help make the recovery even faster than in women.

A facelift result is permanent minus the natural aging that continues to occur over time. You will always look better than if you never had anything done. Another facelift may be beneficial in the future after several years to maintain a result but you will certainly not look worse in a few years compared to someone who never had a facelift to begin with. You will always look better than if you never had anything done. The best way that Dr. Lam explains the permanence of his result is with a simple imaginary analogy. If you had a sibling who is your identical twin and both of you are subjected to the same external factors (sun, smoking, diet, exercise, stress, etc.), after your facelift (and/or other procedures), you will always look much younger than your twin sibling even though both of you will continue to age.

Dr. Lam does not believe that any of these remedies work to help a scar mature well. In fact, rigorous scientific studies that have involved blinded, prospective, randomized, split scar analysis (in other words, good and controlled scientific research) have indicated that these treatments provide no improvement at all in an incision or scar. In fact, Vitamin E oil has been shown actually to worsen wound healing in some cases. In the past, Dr. Lam used Vitamin E oil to help with wound healing. However, with recent evidence to the contrary, he no longer believes that any of these topical ointments do any good to help with scar healing.

Facial fat grafting has become the cornerstone in Dr. Lam's strategy for management of the aging face. Although the initial mention of putting fat in one's face may sound unappealing, understanding its benefits requires an education process that can be quite enlightening. Fat grafting is intended to address one component of the aging face that is oftentimes overlooked, the loss of volume and the hollowing that occurs in the face, particularly around the eyes, the cheeks, and the front of the jawline. Dr. Lam believes that too many facelifts and blepharoplasty (cosmetic eyelid surgery) are performed in people who really may benefit more ideally from fat grafting, especially in the younger individual in his or her thirties and forties who may be too early for a facelift or other such procedure.

During the mid-thirties and beyond, the area around the eyes and at times the front of the jawline become hollower and deflated. What may appear to be extra skin that develops around the eyes and some loosening of the jawline really may be better interpreted as mild to moderate degree of emptying or hollowing in this area. Selective fat grafting in these areas can provide improved balance and harmony of the face and thereby rejuvenate the face more naturally.

The best way to understand the importance of facial fat grafting is to review one's own old photographs in his or her twenties, thirties, and beyond. This self-education process can help every individual truly understand this very important part of the aging process. Bringing your old photographs in to Dr. Lam can also help establish improved dialogue about when you thought your face appeared to be the best.

There are two major objectives when undertaking facial fat grafting: "framing the eye" and creating a more youthful "volume and shape". "Framing the eye" means supporting the hollowing and deflating eye and cheek that occurs with aging. As mentioned, Dr. Lam performs selective blepharoplasty in combination with fat grafting as needed to achieve the ideal results based on an individualized and tailored approach. The aging process tends to deflate and hollow the eyes, which can oftentimes be exacerbated with the principle of strictly removing tissue undertaken in traditional blepharoplasty (or cosmetic eyelid procedure). Adding a lost frame around the eye can be a critical component to achieving a natural rejuvenation in which your identity is preserved and enhanced rather than removed or unfavorably changed.

The second very important concept is understanding the importance of overall facial "volume and shape". In youth, the face can have more of a heart-shaped or triangular shape, especially in the female, which over time begins to dissipate in one's thirties. Interestingly, some women believe that their faces are too full in their twenties owing to the presence of "baby fat". Accordingly, using your old photographs to show Dr. Lam where you thought your face was the best can help establish mutually aligned aesthetic objectives.

Many times, women in particular evaluate their face under the close scrutiny of a mirror magnified to 8x or 10x and bright illumination, as that is the way that they apply make up. Instead, what Dr. Lam tries to have you do to understand the impact that his procedure can provide is for you to step back 5 feet away and evaluate your face with normal overhead lights, as this distance most closely resembles social encounters and how others perceive your youth and attractiveness. At this distance, what takes precedence is the overall volume and shape of your face.

As we get older, our face changes from a more youthful and vibrant triangle into a square, as the cheeks and chin deflate and the jowls become more prominent. A younger individual (in his/her 30's or 40's) may only need to volume enhance his or her cheeks and chin, whereas an older person may require both volume enhancement and a lifting procedure to return the face to an overall more youthful shape. Again, the reason that volume and shape of the face play such a critical role in achieving a youthful face is that is the first and enduring impression that you make to an observer at any social distance of 2 feet, 3 feet, 7 feet, and even 20 feet. Retraining one's eyes away from just filling smile lines (which Dr. Lam can do) is the first start in understanding the power of what volume contouring can deliver.

Absolutely, Dr. Lam performs a very customized plan of fat grafting in every case. In men, the anterior cheek should not be overly enhanced otherwise the face can be feminized. Conversely, the lateral cheek can be a more masculine feature to be subtly enhanced. The lateral (outer) jawline can also be a region to enhance to arrive at a more masculine or youthful jawline. Dr. Lam tailors his approach for every patient. Generally, Dr. Lam is more conservative with volumes in the male face depending on one's age. Again, using old photographs can be the definitive guide in communicating what facial shape is the most desirable.

Yes, Dr. Lam believes that fat is not an ideal filler for lips and facial lines. The fat tends not to persist in the lips very well and can also make the recovery time quite long and deforming, which is unacceptable to him. He has many alternative strategies for lip enhancement, both temporary and permanent, that do not require any incisions and are discussed in the Lip Enhancement and Dermal Fillers FAQ sections. Dr. Lam does place fat along deeper facial lines like the smile lines and the so-called "puppet" or marionette lines that extend just below on either side of the lips. However, he believes that you will most likely be disappointed in your result with fat grafting in this area. Fat grafting to fill a line simply has not yielded consistently excellent results. The reason that Dr. Lam still places some fat into these facial lines during fat grafting is that he wants to ensure a softer transition between augmented cheeks and the unaugmented upper lip. If this explanation is confusing to you, he can explain these principles more clearly during a personalized consultation. Please be sure to bring questions with you to your consultation.

Yes and no. Dr. Lam almost always places some fat along the anterior jawline and chin area, since we lose some dimension in this area as we become older. However, if you have a very weak chin (see Facial Enhancement with Chin Implants FAQ section), you may still benefit more from a chin implant instead or in combination with fat grafting. A chin implant provides more assured projection (i.e., how far the chin sticks out) than fat grafting can. Nevertheless, in most circumstances, fat grafting alone can provide wonderful and consistent results in the chin area. Conversely, if you have only subtle loss of volume in the chin area from aging and only require a little enhancement in this area, a chin implant can make you look different and is simply unnecessary in most cases. A consultation with Dr. Lam will help establish which method would be ideal for you.

Fat grafting is an entirely incisionless procedure that requires no cutting, sutures, or bandages. It is performed under light twilight sedation or deeper anesthesia in Dr. Lam's surgery center in about an hour and a half. The process begins with sterile (clean) harvesting of fat from the area where you have the most fat on your body. For some women, it may be the belly and for others the thighs. For most men, the extra fat is only distributed in the truncal area (belly and love handles). Dr. Lam does not use a liposuction machine to harvest the fat. Instead, all the fat is gently harvested with a handheld syringe so that the fat cells are not traumatized or damaged during the harvesting process.

The fat is then centrifuged to remove the unwanted impurities (like blood, lidocaine,and lysed fat cells). The fat is transferred into tiny 1-mL syringes that are used to insert the fat using a 1-mm blunt cannula. A cannula is a device that is blunt and soft at the tip so that the underlying facial tissues are not harmed in any way.

Dr. Lam carefully places about a fifth of a rice granule of fat per pass of the cannula with thousands of little passes to rebuild the entire face. This micro-droplet technique provides the absolutely smoothest results and the best longevity since there is rich blood supply that supplies and surrounds each tiny parcel of fat.

Harvesting of fat from the body only takes very small amounts of fat away and generally will not result in a body contouring benefit except in the very thin individual. If you require liposuction, you will still require this procedure by a plastic surgeon who performs body plastic surgery, as Dr. Lam does not perform any body procedures. Dr. Lam highly recommends you defer having your body liposuctioning until he has completed his facial fat grafting procedure so that he has access to your "best fat", the fat that is hardest for you to lose no matter how much dieting you do. This fat tends to be the most ideal for facial fat grafting.

No! No! No! This is perhaps one of the greatest concerns that patients express early on, as the procedure simply does not make intuitive sense. Dr. Lam only places fat along areas of hollowness like around the eyes, the cheeks, and the anterior chin. Placing fat into the jowls and neck would make you look fatter, which Dr. Lam does not do. Also, if you are slightly heavier in the neck and jowls, fat grafting into the other facial areas can actually make you look slimmer since the augmented areas now make the other heavier areas look proportionately smaller. The best way to understand this principle is to think of a glass of water. If you put a very large glass of water next to it, the original glass of water looks very small. If you put a very tiny glass of water next to the original glass of water, the original glass of water appears large. This is the principle of harmony (to be discussed below) that Dr. Lam exercises when rejuvenating your face.

All of us tend to gain some weight as we age, which is natural and to be expected. Surprisingly, we also lose some volume in our faces at the same time. Generally speaking, gaining and losing approximately 20 pounds or so will not make a difference in your face in most cases. However, patients who are grossly overweight or who have a wildly fluctuating weight may not be ideal candidates for fat grafting. Discussing these concerns with Dr. Lam will help you decide what are your best options.

Placing fat near the jowl can make the jowl appear smaller based on the above principle. Also, the jowl itself if it is prominent enough cannot be entirely addressed with fat grafting but requires a facelift to improve this condition. Dr. Lam will also address the jowl and other areas of the face that appear heavier with a process known as microliposuction to reduce areas of heaviness. As we get older, we not only lose volume in some parts of our face, we also gain volume in areas that we don't desire.

Dr. Lam achieves uniformly smooth results with his fat grafting, as this is his specialty. He has literally written the book on the subject, Complementary Fat Grafting. He has yet to encounter a situation where he has had to remove any of his own grafted fat. With the absolutely precise micro-parcels of fat that he delivers in every case, he achieves the most seamlessly natural results. Also, fat grafting is a permanent solution with a couple of caveats. As you get older, you will lose some fat naturally but less so than if you never had fat grafting to begin with. A simple analogy will be explanatory. If you had a twin who has not only the same genetic makeup as you do but also controlling for all external factors (diet, stress, smoking, sleep, etc.), you will also look substantially younger than your twin. Not only are Dr. Lam's fat grafts permanent, but also his patients often look significantly better at a year than they do at a month following the procedure. This is a very common observation. Fat grafting is a graft so it must have enough blood supply for an optimal outcome. In the majority of individuals between 35 and 60 years of age, fat grafting rarely requires a touch up. In a smoker or someone older than 60 years of age, occasionally, Dr. Lam needs to put some additional fat at 6 months to a year following the procedure. However, Dr. Lam's touch up rate is about 5% overall, and a touch up is extremely easy to perform and requires little less than an hour with a much shorter, sometimes a weekend, recovery time.

Unfortunately, no. Dr. Lam has seen many patients from other surgeons who have come to him dissatisfied and disillusioned with fat grafting or a facelift because they were promised that either method would correct folds around the mouth. Dr. Lam believes that there is no long-term correction of the folds around the mouth with fat grafting or a facelift. These lines must be addressed through office-based (non-surgical) methods as outlined in the Skin Rejuvenation and Dermal Fillers FAQs sections.

No. Although Dr. Lam performs numerous fat grafts, he believes that fat grafting is not an ideal method to enhance one's lips for three reasons. First, fat in the lips most often simply will not last. With the use of silicone, Dr. Lam can achieve a natural, permanent, soft, and non-surgical enhancement of one's lips. Second, the swelling/deformity with fat grafting in the lips is both protracted and can be quite alarming. For the results that you eventually obtain with fat grafting in the lips, Dr. Lam does not believe that it is worth it. Third, the ability to sculpt natural looking lips with fat grafting is harder than with silicone or Restylane in Dr. Lam's opinion so he will not use fat in the lips.

Although facial fat grafting does not require any incisions or bandages, there still will be some recovery time necessary. Generally speaking, the first week following the procedure you will look swollen to the point that you will most likely not be socially acceptable. The second week following fat grafting will be much better but you will still be moderately too swollen. By the end of the second week, most observers looking at you may actually begin to see more improvement than deformity. It oftentimes takes up to 3 weeks before you begin to like your result. Nevertheless, most people return to work after 7 to 10 days following their procedure and you should allow that much time off from your work schedule. Wearing dark sunglasses for the first couple of weeks can make it much easier to camouflage your swelling, as most of the noticeable swelling occurs around the eyes. If you have been to other fat grafting websites and noticed that the recovery can be much worse and longer, you should not be dismayed. Many other surgeons overfill the face which, in Dr. Lam's opinion, not only makes your recovery time unnecessarily long but also your results can appear unnatural.

Dr. Lam will review with you all the details about what you should and should not do in his instructions that he will give you. However, in summary, it is a good idea to reduce your dietary salt for the week following your fat grafting to minimize swelling. Also, you should refrain from a lot of household busywork or bending over, which can make you more swollen. Periodic icing of the treated areas will also help reduce swelling more quickly. As there are no incisions or bandages, you will not have to clean or take care of any incision lines. There is in fact very little postoperative care.

You will feel surprisingly very good. The areas from which the fat are harvested will feel a bit sore, as if you worked them out the day before. That mild discomfort should last typically only several days. The face will feel somewhat tight and a bit flushed for several days with only very minimal discomfort if any.

Surprisingly, fat grafting oftentimes can make the skin appear much softer and smoother afterwards. However, if this change should occur, it will often take 6 months to a year before it is evident. Dr. Lam has seen even wrinkles soften and uneven color and texture improve. Somehow (which is not all together understood right now), fat grafting affects the skin in an impressive way to help rejuvenate the skin. In some studies, the skin texture and tone looks better 10 years after fat grafting than it does even one year afterward. There is almost a reversal in the aging process.

Although Dr. Lam performs every procedure with the precision of symmetry, he believes that subtle asymmetry is natural and present in almost every person without detracting from overall attractiveness. In fact, it is impossible to make both sides of the body the same through plastic surgery. However, Dr. Lam believes that "harmony" or the proportion between various facial features, like the nose, eyes, cheeks, and chin is really what leads to overall beauty and attractiveness. Accordingly, Dr. Lam always strives to evaluate the entire face as a unit to see how each part of the face can be enhanced to make the overall impact of the face more attractive. Understanding facial balance and proportion requires a keen artistic eye, which Dr. Lam exercises in every case.

All of Dr. Lam's cosmetic procedures are performed on site in the Lam Facial Plastic Surgery Center. All procedures are performed on an outpatient basis, i.e., you will not require hospitalization or an overnight stay. Most of Dr. Lam's procedures are performed under the comfort of twilight sedation but his surgery center is equipped to perform all levels of anesthesia, including general, which he prefers for rhinoplasty or longer cases. Dr. Lam's surgery center and licensed medical staff are equipped to handle all levels of emergency and have a transfer agreement with the Presbyterian Hospital of Plano situated one block away, where Dr. Lam is on staff.