Val Lambros m.d., f.a.c.s.

cosmetic and reconstructive surgery

Publications

Dr. Lambros has written extensively about various aspects of the face, surgery and filling of the face. Below you can link to some of the published works by Dr. Lambros.

Three-Dimensional Facial Averaging: A Tool for Understanding Facial Aging

Plastic and Reconstructive Surgery

(December, 2016)

To my knowledge this is the first article of its kind. About a hundred young female faces were taken with a 3D camera and the contours of the faces were averaged; the same was done with older women, the groups average 50 years apart. The images were registered and animated, and you can see the results in clickable links within the article, or here on the website.

> Download a pdf

Cheek Volumization and the Nasolabial Fold

Plastic and Reconstructive Surgery

(May, 2018)

It seems intuitive to both doctors and patients that putting fillers into the cheeks should pull the face upwards. It does not happen. This article uses direct imaging to show that fillers have only a local effect and do not elevate the face. There are clickable links in the appendix that open animated images of faces before and after injection, so you can see for yourself.

> Download a pdf

The Cross-Cheek Depression: Surgical Cause and Effect in the Development of the “Joker Line” and Its Treatment

Plastic and Reconstructive Surgery

(November, 2008)

This article explains the formation of the "joker line" in facelift surgery, a common deformity after surgery. Most plastic surgeons think they never get them because they don’t see them in their own patients. It discusses treatment and prevention, which is rather easy.

> Download a pdf

Fat Grafting: A Growing Problem?

Plastic and Reconstructive Surgery

(February, 2018)

Fat grafting has a long history in the face, with huge improvement of results. However, in certain people the injected fat may grow. This editorial discusses the issue.

> Download a pdf

Observations on Periorbital and Midface Aging

Plastic and Reconstructive Surgery

(October, 2007)

This article became an instant classic, quoted in almost all discussion of facial aging. Old patient photographs were painstakingly matched (and it was a pain) to recent photographs I took in my office. These images are shown as gif animations, and one can see 20 to 50 years of aging in a second. The findings are surprising. There is much less motion of the skin in terms of dropping than you would expect. There are links at the end of the article to many of the images discussed so you can see the transitions on your very own computer!

> Download a pdf

Stable Landmarks

Cosmetic Surgery Times

(July, 2009)

Subtitled, "Facial photo study shows periorbital change, but little descent," this short article is a summary of the results found in the periorbital aging article.

> Download a pdf

Volumizing the Brow With Hyaluronic Acid Fillers

Aesthetic Surgery Journal

(May/June, 2009)

This is a widely quoted article on filling of the brow. Why would anyone want to do that? Read it and see the results, which are remarkable. Some results are also in the non-surgical and fillers section of this website.

> Download a pdf

Commentary on: The Role of Gravity in Periorbital and Midfacial Aging

Aesthetic Surgery Journal

(August, 2014)

This is a fun read. It is a discussion of an article that seeks to show that gravity makes the face fall down. In fact, it is probably not a strong force — and looking better when you're lying down is from other reasons.

> Download a pdf

The Use of Hyaluronidase to Reverse the Effects of Hyaluronic Acid Filler

Plastic and Reconstructive Surgery

(July, 2004)

There is natural substance called Hyaluronic Acid that lies between the cells of many species of animals and people. Its chemical structure designates it an acid, but its function is to absorb water and fill the spaces between the cells. This is the same material that HA fillers are made of. Another enzyme, called Hyaluronidase, breaks down naturally occurring hyaluronic acid, and there was some speculation as to whether the same enzyme would dissolve HA fillers. Apparently this wasn't tried clinically, to my knowledge, until 2004, when I reported it in this letter.

> Download a pdf

Hyaluronic Acid Injections for Correction of the Tear Trough Deformity

Plastic and Reconstructive Surgery

(November, 2007)

This is one of the first article on using HA fillers like Restyane in the tear trough, the indentions below the eye.

> Download a pdf

Discussion: The Staged Face Lift: Addressing the Biomechanical Limitations of the Primary Rhytidectomy

Plastic and Reconstructive Surgery

(December, 2012)

It is not uncommon for skin to stretch and loosen up after a facelift. This is not surprising, as skin is stretchy material. This is a discussion of this problem, its inevitability in some patients, and what can be done about it.

> Download a pdf

Fat Injection for Aesthetic Facial Rejuvenation

Aesthetic Surgery Journal

(May/June, 1997)

This is a short article from the late 1990s describing the use of fat injection into the face, when that was a revolutionary practice. Many more people are doing it now. Despite the age of this piece, my feeling on its subject are not changed.

> Download a pdf

Models of Facial Aging and Implications for Treatment

Clinics in Plastic Surgery

(July, 2008)

This article discusses my feeling on how the face ages its implications for facial treatment. Just pulling on the face is a limited treatment which works fine in some faces and not in others. It can make some faces look worse — just look around. There needs to be balance in treatment: a little of this and a little of that.

> Download a pdf

Changes in Eyebrow Position and Shape with Aging

Plastic and Reconstructive Surgery

(October, 2009)

This is a discussion about an article describing normal eyebrow position with aging. It’s not obvious.

> Download a pdf

A Technique for Filling the Temples With Highly Diluted Hyaluronic Acid : The "Dilution Solution"

Aesthetic Surgery Journal

(January, 2011)

There are several ways of injecting and filling temples. In this article, I describe filling the temples with a very diluted hyaluronic acid solution. The advantages of doing so are the extreme smoothness of the result. Other methods lead to irregularities.

> Download a pdf