Fillers & Botox Are Not Temporary
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All of us especially in the past year during the Covid crisis has really focused on the investment side of what we want to spend our hard earned Dollar on and I’ve seen actually a trend toward more surgical therapies, rhinoplasty, facelift, fat grafting, eyelid surgeries over just doing fillers as a surgeon. I love doing surgeries. It’s just something really fun for me to make a larger impact. For example, if you’ve got a really sagging neck fillers are just not going to fix it. Even though some people talk about, you know, you can do like a liquid facelift where you’re going to inject something and somehow some other areas are going to magically lift upwards. I totally disagree as I do not believe that actually can occur. I don’t believe that actually works. So there’s this question then of you know our Botox and fillers or these quote-unquote temporary therapies even worthwhile. I’ve talked a little bit about in a previous podcast why I really disagree with this and that these products really are quite durable. At the same time. I don’t believe that these therapies can be very effective If done just one or two times. However, repeatedly after a few rounds you get ongoing Improvement that really gets very durable where that you could maybe go even years without therapy and you could look better than you did at the beginning. So I talked about this, you know BOTOX, for example, I have this photograph. I used it as a point of illustration. I saw this woman in the New York Times about maybe two three years ago and it just blew my mind because when I looked at her her forehead and her upper face looked about 30 years old and the rest of her face looked about 60 years old and that pattern just doesn’t exist. And that I encourage you to listen to my podcasts about balance or my virtual consultation on balanced. But the concept here is that how did this forehead, you know, which should be the worst if you think about where the wrinkles are typically the worst. It’s in the forehead around the crow’s feet area. Even though you do in advanced cases get wrinkles going down the face when you smile which I call grade 3 wrinkles meaning very significant severe wrinkles that’s usually an end stage of that wrinkle formation, but the very early stages are the crow’s feet the frown lines those areas and so when that area has no wrinkles whatsoever and the lower face has tons of wrinkles. First that pattern doesn’t exist in nature. But second of all what’s happened with just repeated Botox is that the area that should be the absolute worst is the best and I’ve noticed that doing this now close to 20 years is my patients that you know, go for about a year without Botox or two years without Botox sometimes three to four years without Botox. I see them back and they actually still have fewer wrinkles than the day they started. Maybe they could have done it for five years, three years, two years, and skipped after a few years. Now that doesn’t always occur. If some people have a really bad habit of over lifting or frowning that can overcome some of that anti-aging effect of Botox, but there’s this deep collagen therapy that is improved with Botox. That’s incredible and can have an incredibly durable impact. Same with fillers. I’ve seen that fillers that if you Google say 6 to 12 months will be gone. That’s absolutely false after a few rounds of doing this every few months, you know, every four, six, or eight months, I’ve just noticed a patient that doesn’t come back for three to five years all of a sudden they still have an amazing whole now. They’ve aged over a few years. They can’t stop the aging process, but oftentimes those fillers have still way overcome what that aging would have occurred over those three to five years. And so fillers really I’ve seen last as long as 20 years to give you some understanding of how long those fillers can last. I had a lady that had a lump in her lip and she said Dr. Lam. What do you think this is? And I said have you ever had fillers? Not really. I said, not really if you never had fillers Oh I had once you know syringe of Restylane back about seven years ago. And I said that is a filler. So I did dental blocks. We didn’t feel any pain to put a little drop of dissolve. She called my office three hours later and said the lump was gone. That won’t happen with natural lip it’s actually just filler. I had a lady that I, you know, I do a lot of lip surgeries. And I had a lady that was sorry. I do a lot of lip surgeries. I had a lady I was doing a lip surgery on and Restylane came out of the lip and I asked her during the middle of the surgery I said, hey, you know, this is a filler that did you just put it in because I don’t want this to be fading out while I’m trying to you know, do a permanent lip surgery on you. I stopped the surgery. She said Dr. Lam. I’ve never had a lip filler. I said, here’s the thing. I’ve had people tell me that they never had fat grafting. I look in the lip. I can see fat they tell me they never had this or that I know what it is. I said look, I know this is Restylane. It is absolutely Restylane or some Juvederm or some kind of hyaluronic acid product. It squirted out the lip. This is not silicone. This is not bio. I’ll commit or whatever. It may be bioplastic. She said Actually it could have been biocomedic but that’s one of the rare exceptions bioplastic. It could be any of those other things. And she said, oh, yeah and in 1998, I had one syringe of Restylane and Europe before the FDA approved the United States and she still had probably about a third of that syringe left in her lip 20 years later. This is not uncommon. I’ve seen people that look overdone. I mean, I’m sorry ten years out and they still have what they did, you know 10 years before with maybe three syringes. So what my point of this is I’d even talk about the title of this whole present this whole section which is investment. The investment side of these therapies, really what I want to focus on people think yeah. These are just temporary now. I love doing fillers. I love doing surgeries and I believe that there are two sides of the same coin. Oftentimes fillers just won’t cut it if you got really large eye bags, you really need an blepharoplasty to remove it. If you’ve got, you know, really saggy eyelids, you need that. If you have a saggy neck, you need to manage that. You’ve got a huge hump and a wide nose nasal tip fillers are not going to work. But you know for you got a little bit of hollowness here and there and let’s say you did a facelift, you did a fat graft and then a year or two later you have a slight degree of aging are you going to go through another surgery again? No, then fillers are great. What if those wrinkles that weren’t quite manageable than Botox really is a good jog. But the thing that I really want to drive home to use at this really is an investment. I liked it you retained that word in your mind because this is not just an over sell to you. It’s something I’m very passionate about because people don’t think about that but these products really really do last and they really really do hold up well over time and of course you lose a little bit here and it takes a while to build up that durability, but if you can focus on the side that this is an investment not just surgery being investment, I think.
I can give you a better perspective on how I see fillers and Botox.