Pillow Faces Can Look Weird and Bad

Recently, I had a lady who at the age of 57 started modeling for the first time in her life thanks in large part to the syringes I have put into her face to make her look better.  Her new boyfriend remarked that she looked better than she had when he saw her 7 years ago and was so attracted that they were now going out together.  However, he admonished her never to get any fillers like the modeling agency owner because that person looked artificial.  Little did he know that she probably had 10 times more fillers than her modeling agency owner friend.  How can so many syringes look absolutely natural and not overfilled whereas a few syringes look dreadful?

The answer lies in the artistic distribution of the product.  Unfortunately, I see too often the two areas where product is placed are the central, anterior cheek and the lips.  These areas are very unforgiving and they look very unnatural especially in a face that is volume depleted elsewhere.  It is so important that temperance be executed when filling these two facial zones.  The trick of filling a face naturally and beautifully is to fill other areas of the face so that the face actually looks good.  Balance and restraint is the key.  However, to make a face that is over 50 years of age to truly look amazing requires enough syringes placed all over the face rather than too much in just one area.

Sam M. Lam, MD, FACS is a board certified plastic surgeon in Dallas, Texas. To schedule a consultation please call (972) 312-8188. To Learn more about Dr Lams’ plastic surgery procedures or to ask Dr Lam a question please visit his plastic surgery forum.

Notched Nostrils Following a Nose Job (Rhinoplasty)

Another problem after a bad rhinoplasty that to me is a telltale sign of bad work is a notched or V-shaped nostril.  The curvature of the nostril rim should form a gentle upside U-shape.  When it has been operated on in the past, it can look like an inverted V shape, which to me is a very obvious sign that a rhinoplasty was performed.  To help correct this problem, you can put a graft to lower the nostril rim or I have had success with putting a permanent filler in there like Artefill or silicone to lower the rim to make it look less notched in appearance.

Sam M. Lam, MD, FACS is a board certified plastic surgeon in Dallas, Texas. To schedule a consultation please call (972) 312-8188. To Learn more about Dr Lams’ plastic surgery procedures or to ask Dr Lam a question please visit his plastic surgery forum.

Getting Past Revision Plastic Surgery

One of the toughest things that I have to deal with is a patient who is dissatisfied either with my work or with another surgeon’s work.  I have many individuals who come to me with a sullen demeanor about what another physician created and what could I do to fix it.  Oftentimes the fix is not physical but mental.  That does not always mean that I cannot see the physical deformity but that the mental deformity typically far exceeds the physical one and makes it so that I cannot hope to improve the physical one until the mental one improves.  This is not always the case, as many people have a very obvious physical issue that warrants correction.

In a related video blog, I talk about forgiveness in facial plastic surgery to help a patient move beyond one’s previous experience.  Typically, an upset patient is 75% upset at himself or herself for undergoing a procedure knocking oneself for not undertaking enough research on the subject before undergoing it and 25% angry at the surgeon for not giving one the desired result.  The problem with addressing a dissatisfied patient is that this lingering resentment (both to oneself and to the prior surgeon) creates a mood that is hard to break.  More precisely, what I find as a problem is that despite an improvement or near total correction the individual still harbors regret and negativity in one’s heart that blocks one from appreciating the improvement.  It is almost a kind of post-traumatic stress disorder of sorts, and PTSD is not easily treatable, especially if only the physical dimension is considered.  This is why I spend so much time up front with the mental issues before ever contemplating a physical endeavor like facial plastic surgery for an individual.

Sam M. Lam, MD, FACS is a board certified plastic surgeon in Dallas, Texas. To schedule a consultation please call (972) 312-8188. To Learn more about Dr Lams’ facial plastic surgery procedures or to ask Dr Lam a question please visit his plastic surgery forum.

Forgiveness in Cosmetic Surgery

Many times I have individuals who come to me who are very depressed about a previous cosmetic surgery procedure that they elected to have done.  I can see that for me to help them with anything new that I would first have to help them overcome their previous relationship with their plastic surgeon and what they perceive as a negative outcome.

What I focus on is the concept of forgiveness.  Many times these patients have a lack of forgiveness toward their previous plastic surgeon due to a perceived bad outcome and/or a bad relationship.  Either way they can’t get over it.  What is also interesting is that the lack of forgiveness needs mainly to be directed at themselves, i.e., many times individuals are simply sad and angry that they did not do sufficient research on the cosmetic surgery procedure or the surgeon to let them be duped resulting in their untoward outcome.  I typically say to the patient that 25% of their forgiveness needs to be directed at their previous plastic surgeon and 75% needs to be directed at themselves.

Without being able to get over a previously bad relationship, there is almost nothing that I can do to “fix it”.  The reason for this is that a patient’s regret almost always clouds his or her judgment to the point that the defect is perceived to be present regardless of whether in fact it is or it is not still there.  Oftentimes a previous problem cannot be entirely corrected but just improved so therefore it is important to emphasize this, because without doing this the patient will never be fully satisfied.  Offering forgiveness to oneself for making a previous mistake and forgiving one’s previous surgeon are the first steps to healing so that a new relationship and new intervention can properly flourish.

Samuel M. Lam, MD, FACS is a board certified plastic surgeon in Dallas, Texas, specializing in facial plastic surgery procedures. For more info, or to schedule a consultation please call (972) 312-8188. If you would like to ask Dr Lam a question please visit our Plastic Surgery Forum.

Kenny Rogers and Bad Blepharoplasty and Browlift Surgery

Obviously, there is quite a bit of brouhaha about Kenny Rogers’ facial work. His alien appearance has clearly become the poster child for bad facial plastic surgery. If you are wondering what I see as far as his bad work is concerned, I can break it down into three obvious problems, each of which compounds the other and together make for a really artificial appearing look. His brows are clearly way higher than they should be. This is why I think brow-lifts fundamentally are flawed procedures, and I do not perform them any more. Second, the eyelids have been over hollowed out, i.e., all the skin and fat have been removed and now his upper eyelid shape appears scalloped out. Finally, his canthus (the area where the upper and lower eyelid meet on the outer side) has been shortened, blunted, and tucked upwards. Out of all these three things, I know that most people see the first two as the real problems. However, the canthal distortion in my opinion is truly what creates the most unsightly change to his face. With all three present, you have a trifecta of unnaturalness.

Kenny Rogers and Bad Plastic Surgery

How would I propose to fix this situation?  There is no easy answer.  However, I would consider adding fat back into the brows in order to correct all three problems.  First, fat would refill a hollowed out eyelid.  Second, by adding fat back into the upper eyelid and lower brow, the stark transition of a very high brow becomes less obvious.  Finally, fat transfer can be used to fill out farther beyond the canthus so that the eye once again looks longer and less rounded.  Although this is an imperfect procedure in a case like Kenny Rogers, it offers the best hope in correcting all three of his cosmetic problems.

Samuel M. Lam, MD, FACS is a board certified plastic surgeon in Dallas, Texas. To learn more about Dr Lam’s facial rejuvenation procedures including blepharoplasty, and brow lifts please call (972) 312-8188 to schedule a consultation. If you would like to ask Dr Lam a question about facial plastic surgery please visit our Plastic Surgery Forum.