PHD | Bạt Nhún Làm Từ 1000M Băng Dính | Trampoline Made From 1000 Meters Of Adhesive Tape



Views:5735896|Rating:4.71|View Time:10:1Minutes|Likes:82163|Dislikes:5132
🔰 Facebook chính của Tôi:
🔰 Fanpage :
🔰 Liên Hệ Quảng Cáo : [email protected]

———————————————–
CÁC KÊNH CỦA KHÁC CỦA #PHD nhé,
🔰 PHD Vlogs :
🔰 PHD GAME :

———————————————–

MẠNG XÃ HỘI CỦA #PhươngHữuDưỡng nhé,
🔰 FACEBOOOK:
🔰 INSTAGRAM :
🔰 TWITTER :
🔰 BLOGGER :
🔰 GOOGLE+ :
———————————————–
🔰 Nguồn Nhạc của #PHDTroll
🔰 Music provided by NoCopyrightSounds

🔰 Music provided by TheFatRat

PHD | Nhà Thuyền Được Làm Bằng 1000 Chai Nhựa | Boat Houses Are Made Of 1000 Plastic Bottles



Views:|Rating:|View Time:Minutes|Likes:[vid_likes]|Dislikes:[vid_dislikes]
PHD giới thiệu NoxSecurity giúp bạn thân giữ bí mật 24/24h, không lo bị người yêu đọc trộm tin nhắn. Tải ngay: ______…

PHD | Thử Làm Quả Tạ Bằng Đất Sét | Dumbbell Made Of Clay



Views:2006186|Rating:4.67|View Time:17:Minutes|Likes:24147|Dislikes:1694
🔰 Trải nghiệm 8 trò của Puzzle Joy chơi giải trí thú vị cùng phd ạ:
———————————–
🔰 Facebook chính của Tôi:
🔰 Fanpage :
🔰 Liên Hệ Quảng Cáo : [email protected]

———————————————–
CÁC KÊNH CỦA KHÁC CỦA #PHD nhé,
🔰 PHD Vlogs :
🔰 PHD GAME :

———————————————–

MẠNG XÃ HỘI CỦA #PhươngHữuDưỡng nhé,
🔰 FACEBOOOK:
🔰 INSTAGRAM :
🔰 TWITTER :
🔰 BLOGGER :
🔰 GOOGLE+ :
———————————————–
🔰 Nguồn Nhạc của #PHDTroll
🔰 Music provided by NoCopyrightSounds

🔰 Music provided by TheFatRat

Dr. Sam Lam Lectures on His Fat Grafting Philosophy & Technique



Views:406|Rating:5.00|View Time:22:11Minutes|Likes:3|Dislikes:0

Dallas Fat Transfer expert, lecture, and author, Dr. Sam Lam, lectures on his philosophy and technique with Fat Grafting.

key words: fat transfer, fat grafting, dallas, plastic surgery, plano, texas, dr. sam lam

series of really impressive presentations and we're continuing with sam lam who's been a long long term colleague and recently good friend of mine Sam's got a great reputation several areas including my air this dear to me and hair but he also is a great reputation for being expert fat reptans and be talking about practices technique it may be allies left join background but thanks yeah thanks you can make sure I get all my things here or your role alright well thanks for all you guys staying late to hear the last second last talk or last talk book disclosure we have to start understanding before we execute and so this talk will be on thinking seeing and also doing and all those components and if you look at sharon stone over a period of 20 years it looks very much like there's gravitational component that's very heavily based here but if you look at the brows they really haven't fallen much maybe not even at all and if you take a look at the dramatical asus or eyelid skin that's come down on this side if you look at the other side it's actually we tracked it up a little bit so there's a large component where we look at gravity being the principal mechanism of aging when I think that it's actually potentially a much smaller potential out there so in the effort to communicate with patients I think simple models are important and if you heard my talk yesterday at twelve-fifteen I was really gearing the talk more toward ability to communicate with a patient because with good communication you stave off problems down the road but you also help communicate and deliver an understanding of why to do something so I like to say that when you're young you are great when you become older you become a raisin or dehydrated and why should you stretch and pull that raise it into a P because it doesn't look the same instead maybe we should rien fait it to a great now clearly an oversimplified analogy but one that least maybe helps patients understand when they go back and look at their old photos I think the big problem today as you see is that when the past we used to have way over lifted faces and now we're seeing this way over filled faces called pillow faces that are certainly unaesthetic so the caveat here is always go less you can't take the fat out go conservative before you start becoming aggressive get some feedback on to what's beautiful for you you can always add fillers you can always go back and add fat but you have a hard pressed I'm taking it out the idea here is using the analogy of the glass of water i like to use this often times with my patients in the preoperative setting they understand that i'm not here to make them to when and and when they understand that they have the sigh of relief I think the most important thing is to say look I know what you see out there with the celebrities I'm not going to do that for you if you if they hear that there's a sigh of relief usually and that's they're not so worried that you under fill them they're worried that you're going to overfill them and that's unfortunately something that's been a real problem in the last few years so this this little idea and when you ask patients when they like themselves the most you've heard me say this particularly for women it's around 30 ish or so because really often times when they're much younger there's a lot of baby fat there's roundness so with the constraint of keeping the weight the same over your lifetime there's this ongoing depletion of the face and so volume ization to an adequate level is helpful using the old photographs to me are not helpful for me to guide my surgery but it's helpful for the patient to understand that I'm on the same page with them so that sometimes what I usually do so shape instantaneously we look at someone and we can tell their age we can tell their age even 20 feet away and it's due to two things it's the way that light and shadows fall on the face and natural lighting which will won't be talking about too much in this talk but also the visual shape of the face and so when we're young we have this very full round face it becomes sort of a hybrid triangle and in the 30s and then it continues to progress toward a triangle and then that becomes more lower dominant maybe some weight gain or ongoing volume volume loss so I like to take that 30 year old idea and make it more of an oval so this is the idea here is that oval ization is really what i like to do so designing faces I like to create ovals and how do we do that well let's take some examples and go through that here's a lady that I did a rhinoplasty and also I did a fat transfer for and if you look she's got a relatively heavy lower outer face so you don't want to help the buckle air you want to de-emphasize it and so another analogy I help people understand is thinking of a glass of water on a television screen if I ask you how big is this glass of water you would say I have no reference points I don't know if you compare it to a shot glass it looks large if you put a picture of water next to it looks small so it's all relative size issues so this is what if you put volume into the anterior chin into the cheek area it looks like the buckle area is small and that's the number of ccs i put be very frank with you it doesn't really matter the number of si si si I'm putting its you're going to have different take and different results with the volume I just want you to understand sir the artistic component of how I design a face here's a lady here that is a half asian and she's relatively fuller in the buckle but not too much there's this little bit of loss there so I just put a little bit inside there and a little bit less aggressive in terms of total volume around the face and a little less aggressive on the outer cheek is I don't want to widen her face too much since she has asian qualities there's a lady here if you look at her she's relatively flattered and hollower and there's some buckle loss but not terrible and so you put a little bit more in there you create a little bit more harmony start seeing the oval ization I use turn as an example where I touched her up with fillers this is just a raw fat result but what I started to do is I add a little bit more volume here and that what I like to do is try to take this scalloping this double concavity into a double convexity something I haven't published yet but I'm actually writing it on the plane going back and the idea of a double convexity is really where I'm going toward understanding beauty when you don't see the scalloping of bone right in the central zone and you join the two areas with soft tissue just looks much more elegant so here's a lady here again you can see that she's got a little bit of buccal suppression her lower anterior cheek is relatively full so you want to bring some more attention to the outer upper portion so the face looks more in harmony again creating a nicer oval this lady is much more depleted you can see that in my opinion she needs much more volume especially into the buckle zone especially toward the lateral area where there you see that bony scalloping that's going on and so this is just a nice way to create a little bit more of a harmonious shape this lady is even more depleted you can see a lot of volume loss especially toward the lateral aspect where that scalping is much more dramatic in that bone when you see that zygomatic arch starting to show to me it's one of the most important area to fill so we'll talk in a moment more in detail about breaking down the buckle zone into sub components but this is the medial buckle hollow central buckle and in the lateral aspect by the way I'm not showing you all the volumes I'm just focusing on the area that I think is the most confusing in the area that requires the most artistry and this lady here is central buckle very hollow so this is the zone right here that's important I really filled her up well and that creates a more harmonious shape and this one obviously to me equally if not more so depleted and just really creating harmony but i think the anterior cheek needs a little bit more so there's better blending in this area obviously with some neurotoxins so I like to if you've heard me speak I've used as before and I think it's a way to visualize a face if you take a look at the photo here first of all this is 37 years old this is 42 so about five years after a fat transfer only put about 15 cc's in very very little but held well for despite our aging and if you look at these two this photo of these two ladies this is my patient here at 42 and this is her identical twin sister who's never had anything done and if you look at them there's something insane taneously what Malcolm Gladwell talks about in a blink of an eye she looks younger to you and this one looks older and if you start to use your plastic surgical wit acumen you may think well the nasolabial grooves may be filled the lips could use some enhancement the Browse could be tucked up a little bit the jaw lines a little slack the things that we usually look at but let's take a look that jaw line is a straight as this one this one actually has a lot more volume and the lips are actually painted a little bit fuller than hers these are paper-thin the nasal able grooves are the same depth the brow is a little bit more higher arch maybe way she's lifting it so what I'm saying is that everything we try to blame is not present here it's the the issue is the anterior chin hollow the outer cheek hollow and the brow suppression where it's more boney boney articulated instead of soft tissue and so that's why this face looks younger to you and if you go back to see when shows a professional model at 32 you can really see that the way that you look at this lady here is the way that you emotionally relate to her here and again using your right brain not your left brain that's surgeons we tend to be too technical instead of more artistic and her sister looks like herself at 37 longevity does fat laughs absolutely it lasts and that's why it's great and that's why it's bad and that's why you have to be careful with it and as I started to understand and look at longevity I was setting for my hair boards and I saw it wow this makes sense it's almost like a hair transplant because over a period of time there's going to be these processes that it gets better and so I looked at my results over time and I think that's the part of the problem is people that are doing fat grafts they're not looking at their long-term results or not following them so they they give up at six weeks to give up it you know for months and I always try to cash my patients to tell them look at four weeks when everything's stretched out you've got a little bit of edema things look almost too good so be careful with that so I don't want to say that it just gets better over time it goes through a period of time of artificial improvement then a drop so I talked about this analogy of the dip which as we go through swelling to maybe an ideal we lose it and then the results over time get better now not all the time sometimes you need a touch-up at this point if it's not improving but this is really where I see things going and then obviously there's going to be further aging that glass of water is emptying further something you have to clearly identify to a patient in advance so there's a lady over time this is a week out look swollen some bruising and then at a month I think she actually looks a little bit too full but I think still looks good overall I wouldn't argue against that and then you know three months maybe it's good in some ways and sometimes I see more of a dip sometimes I see less then six months and the idea is that it's not so much that it's a dip or not a dip it's an evolution and I think it's very important to photograph your patients every three months with standardized lighting with standardized photography and try to look at those changes over time and so I think there's this evolution the only other thing I did for her was neurotoxin but you can see that nice change over time donor dominance another idea taken from the world of hair that I've extrapolated into the world of facial plastic surgery what that is is that hair thats move from the back of the head into the front actually behaves genetically like the hair on the back of the head well I find that actually it's quite similar for fat as well because the fat and various parts of her body and our face act differently so the one thing you have to be very careful with is it the fat taken from the belly and thighs or have a wonderful tenacious hold but there's also this tendency toward weight accumulation so if someone gains 20 or 30 pounds you have to really be careful and that's why I think in someone in an adolescent phase when you're using it to either rebuild a mandible that's missing or something like that to be extremely careful not to use it as a bio inert substance because it's actually highly bioactive in some respects great you heard about a dip a site derives themselves fantastic as you know fat in the abdomen the thighs is about twenty one percent stem cells but one cautionary thing is not to oversell and over promised people I don't talk about stem cells as a stem cell facelift I think it's an over cell because the results are variable I'm not concentrating the stem cells so I think you got to be careful with putting down your advertising or trying to tell patients that you're going to create such a remarkable change and the other thing that's important is you know there are a lot of modalities out there to improve fat take we hear about that over multiple lectures the one thing I'm always saying is that you know a result that's a little bit underwhelming is ok but a result that's overwhelming it's not and there's a lady that I would say you know what if I had put in something to make her take better I think she would be way too full and so this is one of those things that in majority of my cases I'm pretty close to being on target of where we want to be and sometimes I'm mildly disappointed so I always tell my patients that you're shooting for an eighty eighty-five percent result and I'm going to probably need some fillers to micro touch-up little areas and that communication on the front end is so critical strategy so let's break it down now we're going to talk more about execution so cheek the cheek i divided into the anterior cheek which is the area where you see the mailer depression anterior to the mailer eminence and then the area that resides over the mailer eminence and then the buckle area which will further subdivide in a moment and then the area we I call the upside down you which is not so much the mental sulcus but just sort of the depression the appearance of depression across this area so we have to stop looking at folds and other landmarks but just sort of bony depressions things that you can see less soft tissue the more soft tissue coverage you see the better and the more bone exposure you see the worse so this is more just sort of understanding from that perspective and the goal is to oval eyes the face and so this is just an example to show you so let's break down the buckle further so this is something I think have contribute to the literature is understand the buckle in a more nuanced approach so I divided into the central buckle the backfill zone where you're seeing that zygomatic scalloping and then the media buckle hollow which I think today is not so critical with proper dentition they're not a lot of people that have significant loss in the front when you put fat in here you got to be careful because sometimes it does exacerbate some of the the lines and folds here when the weight is there so I think some things you hear on the media about filling to lift up areas that's my pet peeve because I truly think by filling something you can actually exacerbate areas rather than prove them you can't fill a cheek in the whole of sin you got a facelift result I think this is absolutely absurd so that that's something that I try to dissuade my patients whenever I hear them saying well if you fill this won't this whole thing go up not necessarily so be careful in the medial expanse of the buckle zone so this is just example again just understanding the the fill the buckle area and this one being very careful not to do that so that you don't get a wider face and this is again no buckle filling so that you don't get a widening you can get an illusion of actually narrowing let's talk about the I I think the I is the most important area to frame and understand that because this is the opposite of a black damier removal it's actually adding back do i do blepharoplasty out and show you some ideas where i do and don't so here's a lady that i did a very conservative upper blepharoplasty how do I decide to do that when I see that the edge of skin is at the ciliary margin and where it looks crepey I'll take a little bit of skin away only a few millimeters the rest is done with inflation so this is when I decided this is just done with resurfacing and fat they would end obviously neurotoxins but nothing in terms of skin removal or fat removal here's a lady that if you look at her she has maybe what we call negative vector which I call in a very formal way of bug I and this is something that you can imagine if i took morse tissues away from her she's going to be way overexposed the eye is going to be over over exaggerated so this is nothing removed but just adding it back in this one is a combination of a a trans con plasticity conservative upper blepharoplasty resurfacing neurotoxin and fat and i think when you do all those little things so you know it's i don't always just put fat in but i almost always do just always do start with that because i think almost everyone needs that even when you have some exuberance in the lower eyelid of a shtetl efron oh sorry went too fast this lady here has had previous work done you can see that a lot of removal of tissues and so all i've done is i've just lowered this soft tissue complex back down so conservative change but i think that's all she really needed so the iframe let's break it down let's be really strategic about this and if you look at this we're going to first talk about the medial aspect why do I divide it's just easier for me to fill it the same as the lateral aspect I usually put about 1.5 see season to each and then the nasal Dougal groove about half a CC or so and then you want to be careful these numbers i don't really very very too much i don't go up really high numbers with us at all over here is just that little lateral canthal areas really important to come in from the sem from separate entry to fill the canthus because if you don't you're going to have a dip out here I usually just put about a half a CC or so then the lotto brow which is a very important and this area here which is that a frame law sometimes through blepharoplasty sometimes through advanced aging and then just sort of unifying the whole brow itself and then I've done not all the time is a little bit of transition so remember you want as few transition as possible so sometimes I see even lateral to lateral canthus a little bit of a dip that I've got to do so how do I do it let's break it down you may have seen my video I'm going to actually articulate this through still images instead so I can narrate it here so this is a lady that you saw in the video where she's a little bit hollow on the outer aspect and I've done some more volume volume ization across here so these little landmarks I've drawn here are just volume just so that and when she's lying in a supine position I can follow this in track this but I fill around the anterior cheek the outer cheek some of the buckle zones and you can see that I've arches out because she needs some in the zone as well lateral mandible as well I do a three point injection going into that area you've heard me talk about the we're not going to go too much in a harvesting but as you know that you really have to go through a factual plane when you're in this area to be safe in the inner thigh and just really following the technique is all discussed in the books I won't go through that harvesting you've heard me heard that saw the video yesterday I hope and just understand that just requires some basic instrumentation I think there's a lot of rain dancing and voodoo regarding processing that you don't have to worry too much about there's so many ways to do what I've trained with doctors have done it with centrifugation others have done it through straining and showing me great 10-15 year results that are amazing so you just place it into this 10cc syringe after harvesting the johnny lock really helps spare your forearm from exhaustion keeps a negative pressure on it and then you go and take remove remove the harvesting can you put the cap on it take off the backside after flipping it around put the cap on it you want to stare Lee centrifuge it so these are in sterile sleeves 3000rpm three minutes take it out you get the supernatant and the infra natan first thing you want to do is pour off the supernatant if you do the information first the fat will fly out and then you want to drain out the infra natan and then the wicking is not so critical you know I know Sid Coleman actually leaves some oil or something to help glide it in there but I like to take some of the excess out and the key is don't not to cut your gauze because you cut your God's you can have little fibers in there you look off any of the residual fat and then transfer over to 25 cc just helps you more expedite expeditiously transfer obviously you want to disengage some of the the air that's in this area so that you don't have it the fat flying across the room transfer that up into the hub and then just place it over across the way with one CCS for injection these are 1.2 millimeter which is what I typically use for the injections I use a 0.9 I'll show a slide in a second of that this it's always important to have the photo in the room when you have the photo in the room because sometimes when the patient and supine you don't know what you're doing i gauge and plan all my numbers before I actually walk in the room so I've sort of memorized what I need to put in I use use a little bit of feedback during the procedure most of it is already premeditated before I walk through the door and this is a reminder for me oh yeah I need a little bit more in the buckle area much more informative than when they're in supine to demo to state these are the one point two millimeters in the 0.9 when I go through the specific parts of the face i'll tell you when i use what but generally speaking i use the 1.2 s for almost everything by the temple 0.9 is what i use for the temple i just think it just bends too much so the best way to conceptualize Fath is from my book is just too mentally conceptualize it at various levels because it's not people always get too obsessed with what plane on plane your end I think the only plane you really got to be obsessed with is the lower eyelid area where you have to be super periosteal there's a recovery what I usually again communication is so important if you communicate with a patient the things that they're going to commit with you before they communicate with you they'll feel more comfortable so I usually tell my patients on the night of the procedure here are the five things are going to make you feel scared one is you may feel bumps inside your mouth because the buck the mucosa so thin the fat may bulge in there and that will settle out ok so just let you know that the other thing is sometimes you may look like Jay Leno I say that and say they don't freak out because they can bulge in the chin area that's normal so not to panic with that that will settle out your browser can look like Neanderthals I use those words because that usually freaks them out and then they go oh wow I get it that's going to settle out I say your cheeks going to look like Chipmunks they will settle out I'll say that you cannot smile normally because it's so tight you will feel tight when you feel the fat the fat will feel hard and firm and those are the things that will all settle out and so I always try to tell my patients that and I always tell them that you may need a touch-up down the road you may new there's gonna be some evolution and changes over a period this year that are not consistent for every single person and if you articulate all that to the patient before hand again you know what I've heard you've heard me say is that an education is told to the patient before they have the procedure and excuses but wait a second dr. lamb I didn't know that was going to happen to me so I always encourage you you've seen me endless with all my talks to really be artists out there and to really understand the face from artistic level and rather than just being a technician thank you very much you you