Cosmetic Facial Enhancement:  A Mechanic vs. an Artist

I had a lady come to my office a few months ago who said that she went somewhere else for a facial fat transfer because it was a couple of thousand dollars less than what I charged.  She then came to me to touch up the work and to improve it.  The areas she wanted done did not make sense to me and I truly believe it would have caused her a problem and both wasted her money and would make her look worse.  She retorted, “Are you serious?  You are not going to take my money and do what I want?”  I replied, “No.”  I was not trying to be offensive but I knew that what she was looking for would be harmful for her or deliver no discernible results.  Do I take a risk in explaining to a prospective patient what I would rather help her with (even though clearly she could decline the offer) rather than mechanically doing what she wants?  Of course.  However, at heart I am an artist and I relish and have a deep passion for designing beautiful faces.  Unfortunately, most surgeons and injectors are mechanics rather than artists, and many patients are used to hiring a mechanic.  I am not a mechanic.  Yes, true, I am technically competent and precise but I just don’t cut and paste.  I create works of art that are both natural and attractive.

I am constantly going to meetings and studying my results so that I can improve my work and create more attractive results for my patients.  They deserve nothing less and to be honest I need to uphold my values of what I do as well.  My job is fun because I am able to guide someone to do the right thing whether it is surgical or non-surgical.  I put procedures into three categories:  green, yellow, and red.  Green means you really should do it because it will be worth your money and you will look amazing.  Yellow means it won’t hurt you but most likely you are not going to see much difference so I’ll do it for you but don’t expect too much improvement.  Red means you will not look good and most likely will look worse if I do it for you so you better find another physician to do it.  Accordingly, I help guide patients to do green procedures, explain that I would do a yellow procedure for them but would advise them to focus on the green ones, and would not do a red procedure under any circumstance.

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 at or to ask Dr Lam a question please visit his plastic surgery forum.