Samuel M. Lam, M.D., who wrote the textbook Complementary Fat Grafting (Lippincott), says he has honed the essence of a foundational approach to filling the face.
The Plano, Texas, facial plastic surgeon outlined his simplified approach to fat transfer today during the 2017 Vegas Cosmetic Surgery and Aesthetic Dermatology meeting, in Las Vegas.
Dr. Lam’s approach points aesthetic physicians to acceptable start ranges for fat in prescribed facial areas; then, adds subtle artistic cues for optional cosmetic outcomes.
He says there are three things doctors need to know to get the best outcomes using the technique.
- First, avoid the anterior cheek, which makes people look too artificial.
- Second, fill the lower eyelid perpendicularly and release the orbital septum to avoid complications.
- And, third: Do not overfill but follow the prescription for safe volume.
Things can and do go wrong. But there are ways to avoid fat transfer issues, according to Dr. Lam. Providers, he says, need to know the limitations of fat transfer. And good communication with patients about the nature of fat is critical.
“For example, fat is a bioactive substance that also has variable resorption. If the surgeon does not account for future weight gain, someone may look good now and then worse over time,” he says. “Further, I do not believe in touching up patients because repeated fat can cause an overfill. I use fillers to micro-finesse my fat results. Telling patients they can have some resorption is critical.”
The bottom line, Dr. Lam says, is to: educate better, avoid lumps around the eyes, and don’t overfill.
“Traditional fat grafting — using small droplets of fat — works. It is how you apply this technology that matters. It is who is driving the car and not just the car that matters,” he says.