Facial Rejuvenation in Dallas

 

Volume Loss

Facial Fat Grafting
We all lose volume from birth to death, mainly fat loss with some minor bone loss. In fact, if you ask most women, they don’t like how full their faces were in their teens and twenties, so the goal is not a rotund, cherubic face, especially not the overinflated faces today that you see. The goal is to delicately restore lost volume, particularly around the eyes, mouth, and outer face with facial fat grafting. Fat grafting is a technique that in Dr. Lam’s hands is safe, effective, and long lasting, essentially permanent. It can also be combined with blepharoplasty and facelifting, as desired and as needed. A consultation with Dr. Lam will help determine your candidacy for this procedure. For more information, please review Dr. Lam’s page on fat grafting.

Hand Fat Grafting
Another area where we have visible signs of aging is fat loss to the hands. Dr. Lam likes to say that the only two areas that give away aging and are exposed in a fully clothed individual are the face/neck and hands. Do not forget how important rejuvenating hands can be as part of a global strategy of rejuvenation. The hands may be less important to rejuvenate than the face and neck, but hand fat grafting offers a complete solution to exposed sun-damaged areas in a clothed individual.

Gravity

Blepharoplasty (Upper and Lower)
Blepharoplasty simply means to change the shape of aging eyes toward a more rejuvenated appearance and that can include fat grafting, browlifting, removal of extra skin from the upper eyelid, removal of excessive fat bags from the lower eyelids, and even laser treatments around the eyes. However, this section will only briefly discuss how Dr. Lam may remove extra skin from your upper eyelids or some extra fat pockets from your lower eyelids. In most cases, he will perform a fat transfer with a blepharoplasty; and, in some cases, he will perform a browlift with a blepharoplasty. For more information on blepharoplasty, please visit his blepharoplasty page or visit his before and after images on blepharoplasty.

The sagging upper eyelid can be thought of as a balloon that deflates. That is why, even though it is a bit counterintuitive, fat grafting can help plump out a sagging upper eyelid. However, sometimes the skin is simply sagging and requires some removal of extra skin, which he can perform as an office procedure if you are only having that performed, or in combination with a fat graft and/or browlift in the operating room.

For the lower eyelid, he believes that there are usually three problems that should be addressed: excessive fat (so-called “eyebags”), hollowness (visible along the orbital rim bone), and crepey and loose skin around the eyes. He will perform a lower-eyelid blepharoplasty, that is, removal of the eyebags, using what is known as a transconjunctival approach, meaning no external incision, not only to avoid a scar but to ensure that the eyelid shape is preserved and so is its function. He will, in most cases, also add fat around the lower eyelid along the hollow orbital rim and perform a fractionated laser to further help tighten loose and crepey skin.

Browlift
Dr. Lam does not always perform a browlift but when the outer segment of the upper eyelid hangs or hoods over the eyelid, then a blepharoplasty and/or fat grafting may be insufficient to improve the aging around the eyes. He will combine a browlift with a blepharoplasty as needed to improve the appearance of sagging brows but avoid elevating the center of the brows that can lead to a startled appearance. He likes the saying that “Brows do not sag as much as plastic surgeons want to lift them.” For more information, visit his browlift page.

Deep-Plane Facelift
The cornerstone to improve aging of the mid face (cheek area), lower face (jawline), and neck areas is Dr. Lam’s signature deep-plane facelift intended to lift the sagging tissues of aging that can even be evident in younger individuals with early signs of aging. Oftentimes, a facelift is associated with pain, scarring, long recoveries, and should be assigned to “older people” like in their 70s plus. However, Dr. Lam’s facelift technique provides rejuvenation for individuals of all ages even with early signs of aging, with what should be undetectable incisions, very little to no discomfort, and relatively fast recovery periods. Visit his facelift page for more details or visit his facelift before and after images.

Deep Neck Lift
When a neck becomes fuller than desired with aging (or even when it was always full in youth), Dr. Lam performs a specialized technique called the Deep Neck Lift. We oftentimes think that a neck that is too full is caused by fat under the skin that can be liposuctioned, and this is simply not the case. Most fullness in the neck is caused by excessive tissues inside the platysmal muscle (the vertical bands that show up as we age) such as the sub-plastysmal fat, digastrics, and submandibular glands. Dr. Lam performs a very safe and effective reduction of these tissues to improve the contour of the neck more ideally than can ever be achieved with simple liposuction. This procedure can be done in isolation for a younger individual but is most effectively combined with a deep-plane facelift for optimal results and rejuvenation. However, not everyone needs a deep neck lift, and Dr. Lam will discuss with you whether just a deep-plane facelift would be sufficient to achieve your appropriate level of rejuvenation. Watch this video where Dr. Lam explains more in detail what a deep neck lift involves and why it is safe in his hands.

Skin Aging

Botox
Botox is oftentimes thought to have several negatives including a frozen face, an unnatural appearance, or that it is only short lived. In Dr. Lam’s opinion, all of these are false ideas. Dr. Lam performs what he calls “balanced Botox” where you should not have unnatural peaking of the brows or too stiff a result. He also believes that even though wrinkles can slowly return after a few months, the collagen regeneration to the skin that is caused by a few rounds of Botox can reverse years of skin damage in profound ways. If you do stop Botox after 4 to 5 rounds at 3-month intervals, you may still look substantially better for years thereafter if not even longer than that. Dr. Lam performs all of his own Botox because he believes quality Botox is integral to your success in global facial rejuvenation. For more information on Dr. Lam’s philosophy and strategy with Botox, please visit his Botox page.

MesoTox
What happens when you perform Botox for the upper third of the face but leave the lower two-thirds of the face without skin treatments? You do not look balanced or fully rejuvenated. However, if you use concentrated doses of Botox in the lower face, you will be unnaturally frozen. Instead, Dr. Lam has perfected dosing of MesoTox, or MesoBotox, that allows for profound, permanent (yes, permanent) results in texture, pore, tone, scarring, and sun damage with long lasting results in discolorations and acne. The amazing thing about this office-based treatment is that it leads to truly remarkable skin rejuvenation with no risk to any skin type from white to black skin. This treatment can be safely performed in all sun-exposed areas like the neck, chest, and hands, and even work to improve body scars, stretch marks, and acne scars anywhere on the body with no risk of toxicity. Learn more about MesoTox on Dr. Lam’s dedicated page. Or visit his page of before and after examples of MesoTox.

Dynamic/Static Fillers
What about wrinkles that go down your face when you smile? Botox can’t fix these, nor can lasers do an effective job. Dr. Lam has developed a technique using dilute, micro-dosed fillers that immediately improve these types of difficult to treat dynamic lines, that is, lines that show up when you smile. He also uses this same technique – that was originally pioneered by a Dutch physician and that Dr. Lam has since refined – also to treat static lines, that is, lines of sagging around the mouth that a facelift, laser, fat grafting simply cannot manage.

Summary

Only through an in-person or virtual consultation with Dr. Lam can he work with you to establish the best techniques that fit your desires, budget, recovery time, and also his recommendations based on those points. He hopes that you find this website a good way to be introduced to Dr. Lam’s philosophy and results but only through talking with Dr. Lam will you be able to establish the best way to achieve what would be ideal for you. You can also use these pages as a way to reinforce what you may have learned during a consultation with Dr. Lam.