Las Vegas Cosmetic Surgery - Dr. Julio L. Garcia - Las Vegas Plastic Surgery

Ask Dr. Garcia

NOTICE: Ask Dr. Garcia is intended for educational and discussion purposes only. It does not constitute a formal medical evaluation nor consultation. No doctor-patient relationship has been formalized by this communication. If you desire such, please feel free to call and schedule an appointment. Otherwise, please be advised that all information that has been given here should be cleared with your primary care physician before changing or instituting any therapy. Explanation of off-label use of substances may be discussed here in but does not reflect an endorsement nor promotion of such off-label use.

I`m 37(fair/olive skin) on 5/12 I had botox(between eyebrow)restaylne injections(lower,upper eyes) and tca 35% peel under eyes and upper cheeks. My question is, it is day 3 and I have not yet peeled, just have dark brown skin in peel area,very dry,wrinkled and swollen. Is that normal? I`ve been putting ice packs on my eyes and seems to be helping a little. My doctor said to put moistuizer on only when starting to peel.He recommended vasaline or Aquaphor. I`ve never heardto wait before. Is that right? Also I`m concerned that I will have a line on my cheek where he stopped peel. Have you seen that before? Thank you for your time. Andrea(San Diego)
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Which type of breast implant is less likely to show ripples on skin= textured or nontextured. I think I got the kind which was less likely to show ripples.
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Iam quite relieved that it is not necrosis because the colour is not black. Just to mention that I am the one with post op nostril widening. I hear some pop in my nose and the the nostrils get wider. It has happened about ten times within this 11 months. Could this have caused the damage? And what doctor should I see, a dermatologist maybe? Thank you.
Answer: I do not think there is any damage, might just be some scar tissue loosening up. All I can suggest is seeing the doctor who did the surgery, they would know the best as they have seen your nose before. JG 5.14.08
As far as vitamin D pill safety, I forgot the pills come in IU. So how many IU is 10 mcg?
Answer: 400i.u. JG 5.14.08
dr garcia, i have dry , red , flaky skin on my forehead which I think is sebborheic dermatitis. I also suffer from rosacea on my cheeks and forehead. How do I remove flakes from my forehead. I have started applying selsun blue shampoo on my hair, cleansing with water on my forehead and applying clotrimazole cream once a day.If it is SD, is this the right thing and how soon should I see any improvements?Thanks
Answer: I think you need to see a dermatologist to make that is what it is and likely they will treat you with topical steroids. JG 5.14.08
Dr Garcia. I am 11 months post op rhinoplasty.I think I have skin necrosis. I visited two doctors, a plastic surgeon and an ent surgeon and they didn`t find anything. The skin around my nostrils becomes a yellow crust and falls, resulting in more nostril show. Is there any case that they didn`t find out because it is very rare?
Answer: I am not sure what is causing it, I do not think there is any necrosis as that would be deep blue or black. Not sure what is going on in your case, sorry. JG 5.14.08
I just had some eyelid surgery to remove some fat in my lower lids under general anaesthesia. Would it be safe to have some liposuction of the waist under another general anaesthetic in 5 weeks? I am a healthy guy in my late 20s.
Answer: should be OK to do if you are healthy to begin with. JG 5.14.08
Is it safe to take daily vitamin D supplements? Is so, there a mg amount you should stay under? Thanks.
Answer: OK to take about 10mcg per day. JG 5.14.08
Is 300 or 320 cc considered a large textured implant? Also, I was wondering how many years you keep patients records? I do not know if my doctor would still have the information after 15 years since I have not been in his office since? Would Mentor have the information on my implants if I gave them my name (and would they know the amoutn of CCs of saline)?
Answer: the definition of large is not the number, but how it compares to the breast tissue and anatomy you have, a 300 could be small on a large framed person and too large for a small frame, no way to tell without seeing you in person. The docotr might have the information, and Mentor might also. JG 5.14.08
Hi Dr. Garcia, Thanks for your response regarding the start of a capsule at 8 wks post. You suggested taking 3000 units for a month and then decreasing down to a 1/3. How long would you recommend continuing on the 1000 units thereafter?
Answer: 2 months, if it is no better by then you can stop the extra Vitamin E. JG 5.14.08
Now that I think I am not sure if I chose nontextured or textured implant. i think I chose whichever one had less chance of breakage. Which one would that be? If I had textured implants inserted, would that cause triangular shape?
Answer: if it is a textured anatomical shaped implant, then changing it to a smooth round implant might alleviate the issue because anatomical textured implants can look triangular in some women when the implant chosen is large. JG 5.14.08
DR..I am looking vit-c serum and good eye cream . Can you recommened me OTC,Because I am leaving for abroad tomorrow and can not order online..PLZ tell me OTC product which you think is good one??THANK YOU FOR HELP.
Answer: SkinCeuticals is good. JG 5.14.08
I had a lower eyelid bleph six months ago. One of my eyes turned out fine, the other still has a visible, puffy piece of fat. The doctor did incisions inside my eyelid on the first surgery. To correct my problem, he has offered to do an incision on my lower lash line. I am concerned that my eyes make look different because of the two different types of incisions. Do I have anything to worry about. Thanks a million for your time and expertise!
Answer: I think it is OK to proceed with the outside incision, they should not affect the healing as long as no skin is removed from the one eye during the touch up.Best of luck. JG 5.14.08
An answer states that MRI can show leaking breast implant. I have saline, not silicone. However, I thought if your implant leaked it would deflate within a week? My implants seem smaller and I don`t know if it is due to tissue loss over leaking (I am only in my 30s). I had an MRI of spine= would leakign show up if the spine was the focus of MRI?
Answer: in cases of saline it can take a little longer than a week in cases where the hole is very small. Usually by one month if there is a saline leak it will be flat, and it will feel different, like it is folding beneath the tissues of your chest. The MRI would not show the implant to any great degree. JG 5.14.08
In regards to question below about traingular shape to breasts, I had a mentor implant put in. The surgeon only gave e tow choice textured or nontextured, which I chose nontextured. What kind of implant should I ask for?
Answer: well, if you have a non-textured implant, then the triangular shape is not due to the implant, it is either some degree of capsular contracture or inadequate pocket dissection. You will need more surgery but changing the implant will not affect it. JG 5.14.08
Hi dr garcia I asked you this question previously but I didn`t make it specific enough. I had a pimple on my face (cheek area). It began as a small bump. Then it got bigger. Then after awhile it became bright red and fragile. I am assuming it filled up w/ blood or something. Anyways, I took care of it by not breaking the skin or agitating it. The pimple or whatever it was ran it`s course. It deflated somewhat and went from being above the skin to level with it. Now, as it is in the present, it is quite strange looking. The edges of the injury are sunken inward. The body of it is somewhat raised and solid in texture. It is maroonish/dark red in color and soft to touch. It definitely does not match my normal skin color. I did not tamper with the injury prior to its present state so im not sure what`s going on. It`been this way for about 2-3 months. Before that it was inflated and fragile. Before that it was just looking like a pimple/small bump. Any ideas as to what this may be? And also, is what I am seeing now, since it`s been so long, a scar or part of the healing process? Again, I did not do anything to this, and I just let it run its course. Thanks!
Answer: there has been tissue loss from the inflammation and the body will try to replace it over time, it can take up to one year, and in some cases the body wil not be able to rebuild it to an even extent, the discoloration is from the skin becoming thinner and the blood vessels below the skin being more visible, that will get better in time but there is no guarantee it will regain its normal color once done healing, if you had tampered with it the whole sceanrio would likely be even worse. I would suggest letting it run its course and not doing anyhing for one year after the episode. JG 5.14.08
If you had breast implants but they look more triangular shaped than circle shaped, is there a tye of implant you can get to make them look more round?
Answer: it depends on what type of implant you had placed that gave you that appearance. JG 5.14.08
If you wanted a little ear cartlidge added between the nostril holes below the tip (the cartlidge which separates the nostrils), could it be done with local injections instead of sedation since it is small area which the nose tip does not need to be cut into? Would the price of a small procedure like this be much less than regular nose surgery?
Answer: it might be able to but injecting local anesthesia into that area can hurt quite a bit. The price will depend on the surgeon performing it, quite awide range I am afraid. JG 5.14.08
Do you think patients would be more satisfied with botox or having the muscle above the brow removed (if the muscle sticks out above eyebrows)? Is botox needed (for forehead wrinkles) if the muscle is removed?
Answer: I think removing the muscle is more effective and when done the patient usually will not need Botox any longer. JG 5.14.08
I am skinny and have no hips. Is this common among females who are skinny? I am afraid to wear tight fitting clothes because people will see that I have no hips (or might think I am a guy). Guys seem to look at me when I wear tight fitting clothes and I don`t know if they are thinking I look nice or like a man.
Answer: yes, quite common. I am not sure what the men are thinking when they look at you though. JG 5.14.08
You have recommended that a person cease using a retinoid over the summer months. Does that advice still apply if a person uses a BHA product as well? I use both a retinoid and BHA due to my oily skin and clogged pores.
Answer: I think the BHA are OK to use as they are not as strong. JG 5.14.08
I have read that after a breast augmentation with silicon implants you need to have regular mri`s to make sure it has not leaked? Is this true and is it better to have a breast ultrasound than a mammogram due to the risk of them rupturing with a mammogram? Thank you!
Answer: it is true, mammograms are not adequate to detect leaking in silicone implants, ultrasounds are not as good at picking up small tumors as a mammogram is. JG 5.14.08
Dr. Garcia: I don`t know if this is the proper forum to address this question, but I know you`re a cosmetic surgeon. A few years ago, I sustained a fall on the sidewalk and tried to buffer it by extending my arm outward (big mistake, I know :) My wrist was sore for about four or five days, and I didn`t bother to have it x-rayed. My question is: if the bone did break, would it have healed/set on its own eventually? There wasn`t any excruciating pain; just soreness that went away in a few days, and I had flexibility in my wrist as well. If I were to have it x-rayed today, could a doctor tell if it was broken and never healed properly? Would they break it and re-set the bone in this case? Thank you for your assistance.
Answer: it can heal on its own and if indeed there was a fracture long ago it usually can be seen on X-Rays now. If it did not heal properly then it could be rebroken and reset if needed. JG 5.14.08
I am 52 yrs. old, in good health, 95 lbs. 5`0. Is it too late to have a breast augmentation? I want to have a cup full C.
Answer: I do not think it is too late but I cannot say what size you could be, it depends on your anatomy. JG 5.14.08
Dr Garcia.I have heard if we use galvanic current over the serums and ampules its penetrates deeper.I use some serums and have NUSKIN galavanic tool.Do you think its really help to penetrates the products and I should use that...thanks.
Answer: sorry, not true, it might actually destroy the serum. JG 5.14.08
Dr how long your eye booster and Dame cream last??
Answer: if used as directed, about 2-3 months. JG 5.14.08
DR GARCIA...I am traveing abroad and want to take your Eye-booster.I found out its comes in syringe.I can not hand carry that due to security purpose.My flight is 23-hours with 2-stop overs.Do you think if I keep in my baggage it can be leaked or destroy?Can I move that in a container with tight lid to make safer?? PLEASE tell me how I can take that with me? Is that worth to take and use for my undr eye ines?? Also why you don`t recommened BAGI vit-c serum??as you carry this in your ffice?PLZ reply in some details.THANKS.
Answer: OK to put it in your luggage. I carry the Obagi in my office as some people have used it for a long time and like it but I prefer my mixture better. JG 5.14.08
DR.Do you recommened me OBAGI vit-c 15%.I mean is that a good effective product??
Answer: good product, yes. JG 5.13.08
what happens if an endoscopic m/f and browlift surgery with skin removal was done..and the patient is unhappy and wants it reversed..is it possible once u remove the skin?..can it be released at all if anything? Is it normal to have a crooked smile, uneven nose..unable to purse lips evenly?left cheek lower than right? 4 weeks post op? not much swelling left. Thanks
Answer: if done soon after the procedure, the sutures or fixation device might be able to be removed and the tissue pushed back down. A crooked smile and inability to purse your lips is from a nerve stretch or injury and can take at times 6 weeks to get better. JG 5.13.08
I just finished my 2nd tube of Retin A-- I look dried up, more wrinkled , thin skinned with some broken capillaries--Ouch! I`m horrified. When are the supposed benefits of RETIN A supposed to kick in --like new collegan & thickened lower epidermis? How long will it take for my skin to recover (if ever) and what do your recommend to speed the process?
Answer: most people see a change after 2-3 months. If you stop it your skin should get back to the way it was in a few weeks, depending on your age, the older one is the longer it takes to get back. I think copper peptide creams will help and avoiding any other irritants like retinols or glycolic acids. JG 5.13.08
DR GARCIA....I am traveling abroad and FLYING 23 HOURS WITH 2-STOP OVERS,I want to take your eye booster with me.First of all plz tell me its worth to purchased.How long it last and how soon you can see results? Also its in syrige so I can not take as a hand carry and if I keep in my luggage ,do you think it might be leaked?Or do i need to put the cream any other container to aviod wastage.I have not seen the packing,and need your advice how to carry it safely.PLZ respond in details.
Answer: I think it is a very good product, should last 8-12 weeks, and most people see a difference in 4-8 weeks. It should not leak, keep the cap on and in a plastic bag if it is going in your luggage. It does not have a needle so if you want it can be carried on. JG 5.13.08
Hi Dr. Garcia. The bones of my nose feel hot. I had a rhinoplasty before 10 months. What it may be?
Answer: hard to say, I do not think it is related to the previous surgery unless an implant was placed and has gotten infected. JG 5.13.08
Hi Dr. Garcia, I am scheduled for a TT this Friday. I had a cold that started last week which I am just getting over. Is it safe for me to still go through with the surgery?
Answer: I think it is likely OK to proceed, best of luck. JG 5.13.08
DR...I am 5o and have lines very vidsible under my eyes.Is that your eye booster worth to purchased??How long your eye booster last and how soon can be seen visible fference.THANKS
Answer: it will help some, and it will help slow the progression of new ones coming but it will never remove all of the lines. Most people see a difference in 4-8 weeks or so. JG 5.13.08
Dr .....I contacted your office to purchased the eye booster.They told me its in a syringe.I am traveling abroad and flying 23-hours with 2-stop over.I am not sure if it wouldn`t leak if i put in my luggage.I can not take in hand carry.plz dr advice me,what to do??
Answer: it is small enough that it passes the three ounce rule so you can carry it on. JG 5.13.08
I have two questions. You just answered a question for someone about Restylane building collagen and not having to get as many injections by saying that you don`t believe this could happen because of the aging process. Do you feel the same way about Radiesse in that regard? Also, my other question is about the small bump that I can press, it goes down and then pops back up. You mentioned he could possibly nick it and get the filler (Radiesse) out? I didn`t realize it could be done that way that easily, but had to be surgically removed. I appreciate all your answers to what probably seems to you as silly questions!
Answer: yes, the same way. As to making the nick to get it out, it is not always possible to squeeze it and if it does not push out, then a longer incision and surgical removal is needed, but it is worth trying the small nick first. JG 5.13.08
do you believe that scleral show (after surgery) can be treated with treatment of lower eyelid retraction: expansion and reinforcement of the lower eyelid with hyaluronic acid gel . last question of the day...thank you soo much.
Answer: short term, maybe in some small number of selected caes, long term, no. JG 5.13.08
Dear Doctor Garcia, i have started the lower eye lid massage and it seems to give me some hope.....it is only the right eye where i have the scleral show so that is the only one I am massaging....I guess this happens because there was too much skin removed under this eye, will it grow over time, or...how can it be fixed if it persists after 2-3 month? Regards, Renee
Answer: the skin will likely not grow back enough but if the scleral show is due to stiff tissue the massage will help. If in fact it is only due to too much skin being removed, a skin graft is sometimes required, or a procedure called a canthopexy. JG 5.13.08
Docter, Is this a sign of a RED FLAG? My PS NEVER EVER measured my Breast Tissue when I went for my counselatation. He just looked to see what he had to work with. THen had me try on sizers with his office maanger. I said 350 cc. Which he said fine and implanted them. WELL lets just say these are NOT to my liking..TOOOOOOOOOO small for my frame. Anyways is it possible for him to NOW BEING IMPLANTED to detect what size I CAN BE ALLOWED accordingly or am i screwed? Also WHY DIDNT he measure me. He doesnt seem to study the chest very well! Its like whatever you want...why is this?
Answer: well, some doctors do it that way, and they might guess right most of the time, but I prefer to measure and be sure. You can be measured now and see what you can have implanted safely, yes. JG 5.13.08
Last question of the day (my dear Doctor, you are so patient with your patients!): does Restylane regular injections, even if in low quantities really improve, slightly, the own`s body increased collagen or hyaluronic acid production? That is, after having restylane injected regularly in an area, could that area have filled up a bit on its own or can it improve, after the effect of the restylane on itself has gone ? Ok, I leave you alone and won`t bother you anymore. :)
Answer: there is one report that claimed that Restylane injections cause the body to produce its own new collagen, if in fact it did, then patients receiving Restylane injections would show a decrease in their frequency of injections. I have not seen that happen, the aging process will destroy hyaluronic acid faster than Restylane could build it up I am afraid. JG 5.13.08
Hello again Doctor. I followed your advice of the other day and didn`t even ask to have IPL in the undereye area, as you thought it was not recommendable. My questions are: a) does IPL anyway improve the area, even if moderately only, if applied in the cheeks? Does the beam of IPL (if that is the word for that) only targets right where it was applied or does its effect go beyond the specific point where the wand was held against the skin? b) I was suggested to have another session in 30 days. Does IPL cause enough (I don`t expect miracles, but something useful) collagen production stimulation to be worth having it again? Does it really help with lines and skin texture? Because I rather hear (more often) about it being used for pigmentation problems, rosacea, etc., which are not my specific problem (mine is skin texture and a few lines). Thanks.
Answer: It will help with pigmenation only, not much tightening with it. The effect only is where it is placed, not much diffusion. Skin texture might improve but not much tightening of lines. I think in terms of visible collagen prodcution effects it will disappoint you. JG 5.13.08
Dear Doctor, I`ve been offered (presents) a set of products from Roc, both in serum and non comedogenic creams: what is your opinion regarding the quality of the DMEA in them, of the retinol, the copper gluconate, the zinc gluconate, the hyaluronate, etc.? are they good products, are those ingredients there really useful or should I skip them and not use them? Thank you in advance for your answer :)
Answer: good products, nothing in them at too high of a dose though, but overall good products. JG 5.13.08
I have puffy areas at the corners of my mouth. Is there anything that can be done to reduce that?
Answer: without seeing you in person to determine what is the cause I cannot say. JG 5.13.08
I received Radiesse injections in my nose. It didn`t turn out well, although in the past it did (don`t know what happened this time). I have a small bump that is very soft and I can actually press on it to make it go down (it goes completely flat) and stays that way for a few seconds, but gradually pops back up. Does this sound like overfill or that the filler just didn`t go where it was supposed to or what? Also, will it make it worse to keep pressing it (I`m hoping that will make it go away faster!) Thanks!
Answer: no problem with pressing on it. As to why it happened, no way for me to tell, might have been trapped by some scar tissue it could be removed possibly by the docotr making a small nick in the skin and pushing it out at times. JG 5.13.08
Dr. Garcia, Its been two weeks now since my endo browlift and facelift. I cannot move my left eyebrow and my forehead and scalp, more on my right side is still completly numb. My PS office girl said the numbness is completly normal and my left eyebrow nerve could have been niked but will improve over time.Is this true?
Answer: in most cases it takes time for the function to come back as the muscles need to get re-attached to the bone, give it some time. JG 5.13.08
Hi Dr. Garcia, I had my 2nd revision and 3rd third surgery (breast augmentation under the muscle) within a year. I am 2 months post my last revision and have noticed that my right breast is feeling tight. I`ve had slight capsules before. The first time was on my left and the last time was on my right. My PS doesn`t think that either was a true case of a capsule but a combination of things, ie. the pockets not being large enough. Can you tell me if it is the start of a capsule could it begin 8 weeks post surgery? Also would you recommend taking vitamin e and at what amount?
Answer: at 8 weeks a capsuln can start, yes. If you are going to take Vitamin E, I usually start at 3000 units per day in three divided doses for one month and then decrease by 1/3, it will thin your blood though. JG 5.13.08
Doc, I want some second opinions from other docters before even contimplating on a redo for my very unsatisfactory outcome. I just dont know If I want my docter to redo them since I have been unhappy with his work. How does a patient go about calling around when scheduling a counselatation. Does she tell the office the reason is for a second opinion or what do they say to sound more appropriate than I want a new docter?
Answer: I think it is the best thing to tell them what you want to see them for otherwise they will think you have not been honest. JG 5.13.08
Hi Dr. Garcia I have a linear hypertrophic scar on my face - left side cheek near my side burns. It is maybe 1/4 or less of a cm. I have brown skin - of indian descent. Is it possible to treat this scar w/ an excision? As in removing the scar tissue and bringing the normal skin together? With how small the scar is, would it be possible for this to be done w/ little or no new scarring?
Answer: you can but there is a high likelihood of it coming back the same or longer. JG 5.13.08
Docter Garcia. I recieved my very firt implants 1 year ago. 300 saline under. Now before we ever implanted me the docter said i had a nice full lower bottom with loads of tissue not so much upper. He also said my left breast on top was flatter and my right had a beautiful inner countour so there both different. Ever since DAY 3 of my implants the right one (Natural inner countour) was and is completly round like a circle where the naturally flatter tissued one looks natural like REAL! WHY IS THIS? is it CC in my right? It does pinch at times. It just looks like TWO TOTALLY DIFFERENT BREAST. ITs ALWAYS BEEN THAT way since my banages came off! Also the left one that looks better seemed to have been perfect in the pocket and the righty always higher where the nipple is lower...
Answer: if it occurrs that soon after the surgey it is not capsular contracture but likely either implant size choice or size of pocket dissection causing the issue. JG 5.13.08
Docter Garcia. Iam very athletic. My shoulders are very broad my hips are very tiny.....SO im built like a swimmer. I recieved small implants 300cc. Well there like 11.2 in width. They just dont go well with my broad upper body. I know the docter said i can fit up to 13.5 in width. But heres the thing is the rule of thumb broader shoulder woman need smaller or wider implants for body ratio?
Answer: shoulder width has no effect on implant choice, or at least should not, it is the width of your breast tissue that will limit the implant choice in order to lessen long term risks, to some degree the width of the ribcage will come into play, but not the shoulder width. JG 5.13.08
SORRY... to ask same question for powder form VIT-C.Dr that is a powerful 100% L-Ascorbic Acid Crystles.They claim its easily absorb in skin hile mix in moist or spf and promote building collagen/Elastin.What do you think...OR suggest somthing OTC.What % is good to use in age of 50`s.
Answer: the powder will likely not be absorbed through the skin, I suggest SkinCeuticals Vitamin C although most companies are comparable, I suggest 10-15% or so. JG 5.13.08
DR.I am looking a good product for my under eyes fine lines.I have seen eye booster on your website and I need to ask if its works very well also tell me how long it will take to see the difference?
Answer: I feel it works very well and most patients see changes in 4-6 weeks, some sooner. JG 5.13.08
Dr Garcia.I have found a VIT-C in powder form which can be used with moisturiser or SPF.Do you recommened powder form and it can work as serums or creams???
Answer: I think absorption will likely be unpredictable, I think it best to use pre-dissolved commercially avaialble products. JG 5.12.08
Dear Doc...Any best topical for fine ines and wrinkles under the eyes.Which one you think really works the Best? PLEASE suggest one...THANKS.
Answer: Retin-A or my eye booster cream on my shopping cart. JG 5.12.08
DOC....Can you plz suggest any OTC good moistrizer and VIT-C for me.Any perticular brand you think works...THANKS
Answer: Oil of Olay is a good fair priced line. JG 5.12.08
Hello dr Garcia. I am 10 months post op rhinoplasty. A very thin fibre has comen off my right nostril. That must be a suture, right?
Answer: it certainly could be, some sutures placed in the tip can take months to totally dissolve, should not have any repercussions from it coming out though. JG 5.12.08
Hi Dr. Garcia: I was wondering why Kenalog-10 must be injected into the nose to be effective, but Kenalog cream, if rubbed into the nose following rhinoplasty, is not effective? Why is Kenalog cream, then, prescribed for swelling, such as hemorrhoids? Thank you, Doctor.
Answer: the medication would be absorbed into the blood stream and not reach the tissue below the skin if applied onto the skin directly. JG 5.12.08
Hi Dr. Garcia: Tomorrow will mark 4 weeks after my secondary face-lift. As you will recall from several of my questions, I have had some difficulties. I think I mentioned earlier that I have about an 1/2 inch cut (where skin has actually separated) under my right eye. I have a Dr.`s appointment Wednesday to consult with about this particular problem. I have stopped using anything topically on it. My question is: what options do I have in regards to fixing this problem? If I were you patient how would you suggest we correct this...put a stitch or two in it, apply some kind of ointment and just wait and see? I just want to have some kind of idea of what to expect and more importantly, know if what he suggests is the RIGHT thing to do. Please answer as soon as possible. Thank you so much. 5/12/08
Answer: if the skin is split, the best thing is to clean the edges and suture them closed to get the best quality scar. Letting it heal on its own with ointment will tend to have a wider scar in most cases unless the edges are in very close proximity. The biggest determinant is the amount of seperation of the edges. Best of luck. JG 5.12.08
Do most women need a tummy tuck after having a baby? Is it common to have your belly look flat the way it was before you had a baby? Or will there always be saggy skin or fat reminaing well after you recover from having a baby?
Answer: it is not uncommon but it all depends on how big they get with the pregnanacy. Anything over 25 lbs and the risks of looseness goes up. JG 5.12.08
I,m confused. Is fine-line restylane available in this country? thank you.
Answer: not in the US yet, but Purelle Silk is and works the same way. JG 5.10.08
hi Dr. Garcia, I am 42 years old and have sun damage to my skin. I have had several spots on my chest, arms, and face removed by freezing it off. They keep coming back! I also have started seeing redness around my nose area. Is there a certain type of chemical peel I should do? With limited time off of work? I`m tired of looking old! Thanks for any advice you can give me!
Answer: IPL might help with minimal downtime but they will all come back with time and sun exposure I am afraid. JG 5.10.08
Dr. Garcia my ps says he can replace my 360MP implants with my origional 330MP implants like it was no proble. Is this pretty ease to do and what has to be done to do this?
Answer: pretty straightforward, just open the incision and the capsule and remove one and replace it with the other. JG 5.10.08
CAN YOU HAVE LASER HAIR REMOVAL WHILE YOU ARE PREGNANT? dO MOST PREGNANT WOMEN DEVELOP HAIRLINE ON ABDOMEN WHEN THEY BECOME PREGANANT?
Answer: I would suggest you wait until after the baby. JG 5.10.08
dr garcia, I had two questions: 1. How do I make sensitive skin less sensitive 2. After multiple IPL, my skin has become thin. What should I do to thicken my olive skin. Thanks. Great Site.
Answer: need to stop all irritants, some exist in facial cleansers. I would suggest DMAE creams for now. Thanks for visiting. JG 5.10.08
Hi, I am 2-3 weeks pregnant and I would like to do the Rhytec on my face. Is it safe while pregnant? Is there a higher risk of hyperpigmentation?
Answer: I think it best to wait until after the baby. I do not think the risk of hyperpigmentation is increased though JG 5.10.08
dr garcia, my beard area after a series of IPL on my cheeks, has become so sensitive that even cleaning with water makes it red. What should I do to decrease this sensitivity. Do you think using a trimmer instead of electric shaving will help. I am lost!.Would be really grateful for advice? Thanks
Answer: might need to stay away from the IPL for awhile and use a trimmer, yes, the electric shaver can cause irritation from the pressure. JG 5.10.08
I thought fat was hard to get rid of or you had to exercise to burn it off. Then why does fat taken from you own body transferred somewhere else eventually dissolve on its own?
Answer: because it never survives, or very littel survives to begin with. JG 5.12.08
Hello ... what exactly is the negative of using Renova in the summer, especially if I only use it at night? Last year I used Roc (retinol) over the summer and had no problem. In fact, my skin looked great at that time but started looking bad in December when the weather got cold and dry. I stopped using Roc in February of this year and started using Renova about a month ago. I would like to continue through the summer, taking a 3-month break during the colder months. If I use sunscreen during the summer and don`t apply the Renova during the day, won`t that be OK? Also, between Retin-A and Renova, do you have a preference? Thanks so much for your opinion and advice, as always.
Answer: Retinol is a much wealker version of Retin-A so one cannot compare the two. As to using it only at night, it certanly will be safer than using it twice per day, but it still does sensitize you to the sun. Using the sunblock does help, but is not as safe as not using it during high sun months, it is a risk you can take but I cannot tell you that it is better than what I have suggested. I personally like Retin-A better but some people find they tolerate the Renova better, but it is not as effective I feel. All the best. JG 5.12.08
I think I read somewhere that fat injections (taken from your own body) into your face last about 3 years. So does that mean if you had fat injected from your own body into buttock area (as substitute for buttock implants) that it would only last 3 years?
Answer: It likey will last less than three years in the buttocks. JG 5.12.08
dr. Garcia, sorry just to add question below, is it laser, IPL, or microdermabrasion? thanks doc,
Answer: microdermabrasion is safest amongst those three. JG 5.12.08
Dr. Garcia, in general, which treatment is more safe in terms of side effect and little down time, laser or IPL?
Answer: IPLl is safer because it is weaker. JG 5.12.08
Jan 29th I had liposuction to my bilateral thighs and inner knees. At about 2 months I started getting a 1.5 -2 inch roll under my left buttock cheeck and under my right cheek a bit farther down from where my cheek meets my thigh a crease. Is this something that should be revised? On my 3 month cheek up he said that a butt lifts would help get rid of that. I am already going in on June 5th for a medial thigh lift. So after this I won`t be able to do anything for quite some time. And when I wear a bathing suit I have this huge bulge right under my left cheek. 1) should it be covered to make it look right and 2) will a medial thigh lift help reduce the look 3) how far down the thigh will a medial thigh lift effect? Thanks, sorry for so many questions..
Answer: well, it can be difficult to revise as it comes from an over aggressive fat removal in most cases, but it is hard to ell without seeing you in person. I do not think the medial thigth lift will correct much of the problem though. The medial thigh lift effect wil depend greatly on the type of thigh lift done and if there is a vertical scar. If there is no vertical thigh scar I would say it will imprpove only the top third of the medial thigh. Best of luck. JG 5.11.08
Hello Dr. Garcia, Have you heard of removing veins from hands? What is your opinion on it? I have a couple puffy veins & my hands really aren`t too thin so I don`t think they need volume... Thank you for your advise!
Answer: some surgoens do it but I strongly advise agaisnt it for fear of developing chronic swelling in the hands that might never be able to be reversed. JG 5.11.08
Hi Dr. Garcia. I was wondering what your thoughts on micro fat grafting to the buttocks is and if you perform that particular operation. Thanks so much.
Answer: I do not perform it and I think buttocks augmentation with fat injections is quite variable, unpredictable and might last two years. JG 5.11.08
Do you know where fat often goes on pregnant women who had liposuction on saddlebags on hip area? Will the fat go around the ex-saddlebag area and look lumpy? Will the fat not be distributed evenly?
Answer: could go to the upper back or arms. The fat may and may not be distributed evenly, no way to tell, it varies from patient to patient. JG 5.11.08
Do many women get injections in their hands? Whatt is best= restalyne or radiesse or something else?
Answer: I like Sculptra for the hands. JG 5.11.08
What is best for age spots= bleaching cream or laser? Also, what is best for discolorations from burn (brown & red marks) bleaching cream of laser? If laser, which laser?
Answer: lasers are the fastest. Bleaching creams will not help the red spots. Laser is a better choice for that. I like the YAG laser for that. JG 5.11.08
Dear Dr. Garcia, I took your advice for a few brown spots on my face and have been using Retina A .05% and Obagi Blender. It worked great but I only used it for a few short months as I saw a vast improvement. The spots faded but the skin never peeled or sloughed off. Now I notice the spots are gone but the skin there feels crusty and rough. Do I need to continue the treatment until the skin peels? The rest of my face is smooth, just the treated spots are rough. Thank you in advance for your mothering when we need it. You are awesime!!Happy Mothers Day and have a great weekend.
Answer: I think using the Retin-A alone should help with that, just be sure to avoid sun exposure. Thanks for the kind wishes too. JG 5.11.08
A follow-up on scleral show after lower blepharo... about the massage, should i massage upwards from nose to temple or closed to the eye? Can I use an ointment? If the problem persists after how long can I say it is permanent? Thank you for your reply.
Answer: start near the nose below the incision and massage it in a curved fashion from the nose to the temple. It can improve for months but if it is not better or getting better by 6-8 weeks it might need something done. JG 5.11.08
I had the lipo touch up to my hips and at my tt scar to even it out and I`ve been wearing a waist cincher as my compression garment. Is my cincher tight enough if I can slide my hand under it? It is comfortable but I`d rather not be wearing it so I`ve assumed it is tight enough. lol Also the areas I had lipo on my hips are about 4 inches in diameter each and at the tt scar it is about 2in x 4in. How long do you think I need to wear the cincher? And I had the touch up on Thursday and began massaging it on Friday, was I supposed to wait a week to massage or do it that soon? It does hurt to do it but I thought i was supposed to start asap. Thank you for your advice. Hope your having a Great weekend and a Happy Mother`s Day! :P
Answer: It should be snug but not so tight it is difficult to breathe. I think those areas are small enough that the garment will likely not matter to much. Best to you too. JG 5.11.08
Hi, im 32 years old and considering upper lid sugery for skin removal only. Will in 10 years from now how will my eyes age? Considering that i take care of my skin and diet and excercise. Will i have to do it again? Or is it best to wait when im 42? Basically how do the eyes age with age. I dont have fat baggy eyes just little extra skin.
Answer: In time most likely the skin will continue to sag but it will require much less to be done than the first time. JG 5.11.08
Hello Dr. Garcia, My husband bought me a Beautiful Image Facial Sculpting machine for Mothers Day... It says it is consistently shown that Microcurrent causes the following: *500% increase in ATP (Adenosine Triphosphate, the chemical fuel of energy), *35% increase in blood circulation, *40% increase in Gluconeogenesis (production of new glucose), *45% increase in the number of elastin fibers in the dermis, *50% increase in the length of the elastin fibers, *10% increase in collagen thickness in the connective tissue, *35% increase in the number of blood vessels, *28% increase lymphatic drainage I was wondering what your thoughts are on this machine???... It was a very thoughtful gift (as he knows I`m ALWAYS concerned about aging) LOL Thanks so much! All of these combinations are key factors in the effectiveness of Microcurrent Facial Sculpting
Answer: I am sorry but it is a waste of money. JG 5.11.08
Dr. Garcia, the suggestion i heard a lot is that we can increase retin a dose to twice per day or go to higher strength, once our skin has tolerated retin a. My question : 1. how can we tell when our skin is ready to move to higher dose or twice per day, do you mean after the peeling is done or anything else? 2. It is always being said that retin a increased sun sensitivity. How exactly to indicate that our skin is more sun sensitive than before, is it after long term using retin a that our skin get sun sensitive or is it right away while using retin a does our skin become sun sensitive, and what is the indication for sun sensitive skin?
Answer: once it is not red or flaking all the time you can advance the dose. The sun sensitivity is over once you stop the Retin-A, when using it you tend to burn in the sun easier. JG 5.11.08
Thank you Dr. Garcia for your time and knowledge. After a full facelift, is it possible to use a laser to remove the scars behind the ears and into the hair line, which would allow me to wear my hair up. If so, what type of laser would be used?
Answer: the laser can fade the redness but will never eliminate the scars totally. JG 5.11.08
Does high cholesterol cause cellulite? Or is how fat one is?
Answer: cholesterol does not influence cellulite and even skinny people can get it, its a skin problem, not a fat problem. JG 5.11.08
If a woman had liposuction, the she gets pregnant will new fat cells grow where she had liposuction? If not, will new fat cells grow in wrong areas since they are unable to grow in waist, hip or thigh areas?
Answer: far gain in any area once liposuction is performed, it will accumulate in other areas. Once the fat cells are removed, the only thing that can happen is that the ones that remain will grow, but new ones will not form. JG 5.11.08
suicide hotline? is there anywhere else she can go to get it fixed to solve her problems? SHe is telling me it can`t be fixed//Her doctor made her face worse than it was before the surgery and she is only 30 years old, was suffering from some severe hormonal issue
Answer: I am sorry but this is not the correct forum for this question. JG 5.10.08
Hey Dr Garcia Jennifer here again. Thank you so much for you answers about the blood work and iron. I am happy to say that I got surgery clearance. My bloodwork was good enough for my dr to schedule a surgery date. Basically my RBC and hemoglobin is normal and my iron went from 37 to 160 count. Only thing a point off was the hemacrit which was 33.8 and 35 is normal. My had my primary dr give me a clearance for surgery and show along with the bloodwork the iron pills im taking and about the b12 weekly. Since my dr. has been so busy booking surgeries i will prob get put it for surgery on May 22nd, or something sooner hopfully. My questions for you today Dr Garcia are firstly how could you tell if your skin might be starting to sag after circumfrental lipo? Do they feel heavy? hurt when you walk? My legs only feel good when im wearing my garment, but when i take it off it feel like my legs are heavier. Also it looks like I have a hood over my knees. I dont know if thats because im still swollen or its sagging, I dont know what sagging is supposed to look like. Maybe the garment I have been wearing isnt tight enough anymore because a lot of my swelling went away. Where do your patients get their garments from? How tight should they be? I had my surgry April 3rd so I figured by now it was ok to take my garment off here and there. Also I notice that my cellulite appears somewhat worse than the way it did before my surgery. I dont know if thats because I havent worked out in so long or what. THey have this new cellulite technique called accent thats out. Its about $450 per treatment. Do you recommend this or have you heard of it. In you professional opinon do you think I should bother wasting more money on cellulite treatments, or should I should hope exercise and diet clears this up better? Do you recommend anything for your patients who have cellulite? One last thing Dr Garcia, for patients that do have sagging skin from circumfrental lipo of the legs, what is the next step for them? Is there a surgery to fix this? cutting the skin off or something like that? Please let me know when you have a chance. Thanks again.
Answer: the skin sagging is more one of appearance than feeling, you can see it but it will take time for that to be seen due to the swelling, and the skin will not sag to its maximum until the swelling goes down. What you are feeling is just due to the swelling making your legs feel heavy. We get our garments from Design Veronique and we provide them for our patients. They should be snug but not so thght they cut off circulation. It is common for cellulite to look worse as the skin gets looser and I think you can skip the Accent, I am not impressed with its results. We occasionally suggest endermologie for the cellulite and if the skin sags, the only thing that can be done is to cut it off, yes. JG 5.10.08
Is Rhytec safe on dark skinned people? I know lazers are not safe for dark skin.
Answer: it can be used at the lower settings yes. JG 5.10.08
I have a followup question if you would. Cheek lift through old canthopexy inc. How much swelling and bruising should I expect and how much change in contour of face. Surgeon said lifting the top of cheek pad for the outer corner of lower scleral show and asymmetry. Any other suggestions for the very minimal surgery required for this result? Thank You for your opinion.
Answer: the swelling will be considerable due to the tissue being released from the bones of the cheek. I think in some cases a canthopexy with or without skin grafts or flaps can correct the issue without lifting the cheek, but it is hard for me to tell without seeing you in person. I wil say that minimal surgey might not be possible to fix the problem. JG 5.10.08
Hi Dr. Garcia, I am just curious as to how long it takes scar tissue to form. Is it possible to determine if scar tissue if forming vs. normal post-op swelling? Can anything help prevent excessive scar tissue formation? Thank you for all your help.
Answer: it starts after one day but for it to be true formed scar tissue it will take at least 6 weeks to consolidate. Once the injury has occured, avoiding excessive bleeding is about the only thing that can be done in terms of prevention. JG 5.10.08
How long before a scar from a butt lift(Brazillian thong incision) to flatten out, especially the part that dips down to the crack? what do you think about the adhesive silicone strips to treat scars? also, Scar Guard, the brush on silicone treatment, does it work? it is recommended by PS s. I usually scar well, no keloids, but this one is prety aised in spots, i am 10 days post op. thanks for your time.
Answer: it can take months and in some case it might never flatten out. I do not think the adhesive strips do much but I do think Mederma is a good product but to reduce the redness only. JG 5.10.08
I have a slightly droopy lid on one side which had been corrected sufgically before and I now have a big improvement. I have graves disease. Could I have botox to one side of the glabella where the lid is not droopy bu the medial brow and is lower?? Thanks
Answer: yes, should be OK to do. JG 5.10.08
I had a BA done almost seven weeks ago. I had 68MP 330, the left filled to 350 and the right filled to 370, placed under the muscle. I started out with very little breast tissue. On the second day after surgery, the left implant popped up to around my collar bone. The PS had to grab it and yank it back down into place. From there, I wore a strap for three weeks. My right breast has turned out beautifully. The left, however, after that trauma, is still fairly red in color. The skin tone to the breast and the nipple have not gone back to normal. It is not bright red, though, just discolored somewhat. As time goes on, and the discoloration gets better, I am beginning to see areas of some type of bruising that look like hickies. The implant is sitting higher than the normal side by a little bit. The nipple is sitting lower, which I assume is because the implant is riding higher. On that same traumatized side, I have a dent on the cleavage side. It almost feels like there is no muscle attached in that little 1/2-inch spot, which is causing the dent. My sternum is very sore right there. First, what would cause the implant to have popped up like it did? Second, could my muscle have been cut by the middle of the sternum while creating the pocket, allowing this dent? If so, can that be fixed? Thirdly, how long will discoloration and healing generally take after trauma like having to yank the implant back down into place? Thank you so much for your time.
Answer: sounds like with all that you are describing you had a hematoma develop from probably a partial tear of the pectoralis muscle off of the breastbone and that has caused all of what is going on. If there is a hematoma the best thing is to drain it so that will let the implant settle into place and also help reduce the risk of capsular contracture down the road. The strap and massaging might help but it can literally take months to settle down in some cases. JG 5.10.08
Hi Dr.Garcia..I find your website extremely informative!..I have 2 questions..(1) what are your thoughts on Teamine cream for dark circles?.. and (2) I just recieved botox(forehead) and juvederm(marionete lines)..should I use or stay away from facial masques as I feel they pull the skin?...Thanks!
Answer: honestly, I know they feel they have lots of science behind it, I think it is a good product, but not significantly better than others out there like SkinCeuticalks or Obagi. As to the Botox and Juviderm, I think one week should be plenty, by then all should be pretty much set. Thanks for visiting. JG 5.8.08
Hello dr Garcia. On the first days after my rhinoplasty I wasn t very careful and I had some activities. I am now two months postoperatively and everything is ok with my nose. I am worring if this can cause any problems in the long run. Thank you.
Answer: I do not think there has been any damage if you have not seen it by now. JG 5.8.08
dr garcia, i have a very sensitive dry skin on my forehead. Will cleansing with water alone help remove the flakes and some papules that are persistent.Thanks.I am on doxycycline for rosacea.Thanks
Answer: I do not thionk water alone will help, might need a moisturizer on your skin afer you wash, but it will be a trial and error thing. JG 5.8.08
Hello Dr. Garcia, I was wondering how bleaching creams work as far as, once the skin fades back to normal, will the PIH return as soon as you quit using it? And also, if you can get it faded to desirable results and you want to start laying out again, will the skin treated stay lighter and not tan evenly with the rest of your skin?
Answer: if you avoid sun exposure and flourescent lights, they should stay away without the bleaching creams. I think if you want to lay out in the sun again, I would skip the fading as there is no sense in it. The skin treated for the PIH will likely get darker than the normal tanned areas. JG 5.8.08
Dr Garcia, thank you for your promt reply to my question regarding carboxytherapy for unwanted abdominal fat. I`m very hesitant about traditional liposuction. I`m also someone who is susceptible to malignant hyperthermia, so try to avoid general anesthesia whenever possible. I`ve heard about ultrasonic lipo(?). I realize this question may be difficult to answer without a consultation and exam, but what do you feel would be my best option(s)? Thanks for your time.
Answer: well, the only laser dissolving of fat is done with a SmartLipo and there is Cool Lipo also, but the claims they make are, I feel, exagerated. The ultrasound technology generates a good amount of heat so it is hard to do it under local anesthesia but there are machines awaiting approval in the US that are external ultrasound that show great promise, likely at least one year away. JG 5.8.08
Sorry, I have another question: I had the touch up lipo yesterday and the PS said come back in 6 weeks for a check up. Apparently he left 2 drain holes open for draining and they are covered with gauze. My questions are, when do I remove these and when can I shower? I still have a good bit of blood coming through the gauze. Thank you for your help. :)
Answer: I would remove them in 24-48 hours and shower only, no baths or swimming pool until the holes have closed totally. JG 5.8.08
Dr. Garcia what is the best regeneration for 65yr thin skin I am worried that after a year or so. my skin could get thiner, and sagie. I have seen before and after of active fx. co2 on older people on emabracemedspa.com looks alittle to good to be true. I heard that if you go to deep one can lose fat and I need all the fat in my face if I even have any. thank you Linda
Answer: well, honestly, the degree of improvement in older skin is not as much and not as long lasting, while you are swollen all looks good but the older one is the less collagen is made from these procedures, so I cannot tell you that it is a good long term option. JG 5.8.08
hello Dr Garcia what do you think about Active FX CO2. deep fx .compared with portrait?
Answer: I think Portrait is more predictable and works better. JG 5.8.08
I`ve been exploring your archives, as I`m considering having cheek implants (malar). However, I can`t help but be concerned over the number of patients having them removed. Is this prevalent. I don`t want to go through the hassle & expense, only to be deformed in any way. I realize one can`t predict exact results, but why so many removals? Thank you.
Answer: no, it is not, it is just that when people get on message boards, they usually do not if all went well, so you can get a slanted view of things. JG 5.8.08
Hi Dr. Garcia, I have several questions/concerns regarding recent (8wks ago) open rhinoplasty. I had a septal tip graft to fill a dent on the left side and a bump rasped off on the right side and septoplasty. My breathing is much improved. However, my nose is more swollen now than at two weeks post-op. My PS injected dilute kenalog into the supratip area which has decreased the swelling in that area quite a bit. Now, the very tip of my nose appears even larger and from the side it looks like the tip is sloping upward more. Would it help to inject kenalog into the tip to help bring that down? When would it be safe to get another kenalog injection? How long does it take for kenalog to begin working? Thank you so much!
Answer: I think it best to let nature take its course so that the kenalog will not affect the graft that was placed. Kenalog typically takes a few weeks to start to work and continues for weeks after. JG 5.8.08
2 quick ?s. Skinbiology...is it any good? Also, when u take MSM do u need to take C with it? i`m taking it for hair rejuviation. thanks Doc
Answer: no experience using SkinBiology, as to the Vitamin C with the MSM, it might help some. JG 5.8.08
My right breast seems to be harder then my soft left. It sometimes has a sting/pinch dull titening pinch! Nothing major it just feels like a knotted muscle. Can this be the scar tissue closing in. This breast also has a firm feel with a lil ripple. My left ne is perfect with no visula or felt problems. Mind you the problem right one has alwaus been the faker looking one from day one. iam 11 month post op. now!
Answer: it might be scar tissue, yes. I suggest seeing your surgeon for a check up. JG 5.8.08
Dr. Garcia. Why or how come saline ripples dont show up at all then after like 10 months it can show? For instance my left breast which is smaller than my right has absolutly no ripples but my larger breast on the inside you can see the ripple on the edge. Mind you they both are the same fill 360 max. NO under or or fill! And do you sincerly beleive silicone wont have this problem?
Answer: it is due to the swelling going down and also something called a piston effect where the implant bounces and puts strain or traction on the skin to make it slightly thinner thereby allowing the ripples to be more easily seen. The smaller breast can also have some element of capsular contracture that may hide some of the ripples. Silicone lessens but never eliminates the ripples, at least with the silicone implants sold now in the US. JG 5.8.08
Can facial resistance exerizes performed fifteen minutes a day with tugging and pulling on skin cause surface skin damage? thanks! also what is the latest on the syneron fotofacial and fotofirm (rf)? thanks!
Answer: the only thing tthe facial exercises will do is create more wrinkles in the skin. As to the latest on the Syneron fotofacil with RF, I am still not a fan. JG 5.8.08
Dr Garcia, It has now been 12 days since my face and browlift. I still has a lot of brusing and swelling and pretty severe pain in my left ear. I had one good day and the pain is back! I am not taking anything for pain because I broke out in hives from either the antibiotic or pain meds PS prescibed a mendrol pak on day 5 of the pak hives not as bright red but still there.I talked to my PS about the ear pain and he said to use warm compresses he does not seem concerned about it, says it is normal(after 12 days?). This was never mention to me as a complication not even on the ABPS website. Do you think this be nerve damage? Is this normal to have busing this long? Does it take a while for the hives to go away?Thanks again for your time.
Answer: ear pain is not common and nerve damage of the facial nerves should not cause that, it could be some old clotted blood stuck in the ear canal too. The hives do take a few days to get better though. JG 5.8.08
I thought people gained fat when they got older instead of lose fat?
Answer: it is not distributed evenly over the body. JG 5.8.08
Is it okay to use electric massagers for the lipo`d areas? Any certain kind to look for if so? Thank you and have a great Friday! :)
Answer: no special brands, but they can be used, yes, use a broad head for the massager though. JG 5.9.08
Is there a hip implant surgery? Or do some women have wider buttock implants to increase their hip size?
Answer: there are no hip implants. Sorry. JG 5.9.08
I had ear surgery which some stitches here and there are still inside my skin on the back of my ear. I feel a little bump where the stitch is. It has been there for years. I thought these were dissolvable stitches but maybe not. Would dissolvable stitches remain inside your skin? I know they are stiches because one bump was sore and itchy so I went to doctor thinking it was some kind of growth when he removed it and found out it was a stitch left inside my skin.
Answer: in most cases, the stitches placed to pin ears back are permanent sutures, but if they have been there for years, they can be cut out now with little bad effect as the scar tissue that has formed should keep everyting in position. JG 5.9.08
My Dr. told me that the over the counter micro dermabrasion weekly treatments are bad because they break down the collagen, is this true? She also suggested a laser treatment every 6 weeks to help prevent my adult acne, reduce pore size and rosacea, will this work? What is the name of the laser that would be used for this treatment?
Answer: well, I just think they are not well constructed and it is something that you can over do and scar the skin instead of improve it, that is something best left to someone else who can see more clearly what they are doing than yorusef in the mirror. I think light lasers done every so often can in many cases control pore size and skin texture, yes. Usually the one used for what you need is an IPL laser. JG 5.9.08
Do most women lose breast tissue as they age or just some women? Do most women also lose buttock tissue as they age?
Answer: almost all do. They also lose buttock mass, but some of that is muscle with some fat. JG 5.9.08
2 weeks ago I had juverderm injected under my eyes. The result: a long lump under each eye. I went back to my doctor a week later and he injected the enzyme to dissolve the lumps. (This was 2 days ago). The lumps have diminished somewhat, but are still bothersome. How long does it take for the enzyme to work? SHould it not have worked by now? Mil gracias.
Answer: the hyaluronidase will do what it is going to do in one day, so if there is still material there you wanted dissolved, it needs to be repeated. Not unusual that it needs to be done more than once, but we try to use the least amount possible to avoid bruising from the needle sticks. Best of luck. JG 5.9.08
Hello, I just ordered your two DMAE products and wondered if you could help me establish a skin care program? Should I use both products morning and night? Will they provide enough moisture for dry skin? Also, I do have some wrinkles and sun damage - do you recommend incorporating Retin A in my skin care program? If so, which product do you recommend putting on the skin first? Is there any other products your recommend other than sunblock? I currently use SPF 55 on my face daily. Thank you very much.
Answer: it is most effective if they are used twice daily, yes. In most cases an additional moisturizer is not needed. Retin-A can be incorporated if desired although the DMAE will help with that too. If you start the Retin-A, apply it first and then wait abot 10 minutes before applying the DMAE cream. I think the sunblock would be the only other thing needed, all the best. JG 5.9.08
Hi Dr Garcia, Yesterday I had touch up lipo to the tops of my hips and above my tummy tuck scar from 2 years ago to help it look smoother. My PS didn`t mention massaging the areas but I see you recommend it. So, do I massage over the girdle, how agrressive do I massage it, when should I start massages and how often? I have lots of brusing today and it`s not exactly in the area I wanted the touch up, does this mean he missed the area? The brusing is just past the area not higher or lower. He also injected some of the fat removed into an area at my tail bone where there was an indented boney area. He said he overfilled it and I haven`t seen it yet but what do you think the chances are that the fat will stay there? Also does it matter if I`m sitting on that area? Sorry for so many questions but thank you for your advise. :)
Answer: you massage with the girdle off, small circular strokes in all directions over the areas treated. We usualy start as soon as you can tolerate the massages. Done twice per day for the first month. The bruising can move to areas adjacent to the areas treated so it does not mean the areas were missed. Sitting wil not put pressure on the boney areas that were injected and I am not a big believer in fat injections lasting too long. Best of luck. JG 5.9.08
Hi Dr. Garcia, i had a tummy tuck 5 months ago, and i recently went to follow up with my PS, because of swelling. I only have swelling on my left side, and it is very hard. Is that normal? How should swelling feel? And long could it take for it to completely go down? Please advise, Thank you .
Answer: not normal, but it can happen, usually is is scar tissue from fluid that was slow to absorb. It might take a full year for all to soften up. In some cases if there is still fluid, it cna be removed with a needle to flatten the area too. JG 5.9.08
Hey Dr. Garcia Jennifer again, .I just wrote to you bout 5 minutes ago. My other question for you Dr is that I have been getting my blood taken a lot. I had it taken 4/26, 4/29 and then again today 5/8. This is because im trying to get normal blood results to get my liposuction date scheduled. Do you think that I am doing it too much? How long should I wait to get it drawn again? The one I took today was a point or 2 off from being normal for redblood cells and iron. I am taking the iron pills Repliva, b12 shots once a week and eating an iron rich diet. Should I wait a week to take it or can I do it Monday or Tuesday? Thanks Dr. Garcia again for your help on all my questions. I appreciate it.
Answer: I would not repeat the blod work so soon, it wil take at least three weeks to see a difference. JG 5.8.08
Dr. Garcia...first let me say thank you for kindly answering all my questions regarding my recent facelift. Today is 23 days post-op and my bruising is fading but now I see a place under my left eye that looks like a cut. Could this have been an old scar from my prior laser resurfacing where the skin has just been pulled away due to swelling? I am putting Vitamin K and C cream on this area. Is there anything I should or can do? I don`t see my Dr. until May 23. Thank you so much. 5/8/08.
Answer: it mightbe a tear of the skin from the swelling,yes. I would pass on the Vitamin C cream as it could irritate it too much. Stick with neosporin for now and use ice to get the swelling down, hang in there.JG 5.8.08
Hey Dr. Garcia. Jennifer here again, regarding Liposuction. Dr., I dont know if you remember but im the girl that had the first liposuction done on April 3rd the circumfrental of the thighs and knees, and I was supposed to have my 2nd lipo surgery, full abdomen, flank hips and back on May 2nd. Im writing because my Surgeon cancelled my surgery due to unsatisfactory bloodwork. My first sugery I had perfect blood work, and then i was on a bad diet eating junk and everything under then sun. Now since my last surgery I have beeen dieting eating healthy and I get bad bloodwork? I dont get it. Basically my blood work came back this time with low Red blood cells, low hemoglobin and low iron. Do you think this is from the 1st surgery? I did lose a lot of blood and fluid. He took out 5 liters of fat and I remember I felt very faint and was shaking when I woke up and needed 5 fluids bags before he let me leave. On top of that I changed my eating habits cold turkey so maybe I put my body into shock with everything I did to it in a short time. My question to you is that my blood work were only a few points out of range. My primary care dr said I am borderline anemia right now. My surgeon said he will not rescheudle the surgery until i get treated for this and produce normal bloodwork. Is this what you do with you patients dr. Garcia even if they are a few points out of range? My primary care dr said its only a few points off so he doesnt know why my surgeon wouldnt operate on me. Right now my primary care dr put me on Repliva iron pills once a day, weekly b12 shots, and i am trying to eat a lot of spinach and other iron rich foods. Do you have any extra advice to give me on this for making my blood work better? Or any advice about why my bloodwork might of came up bad? Do you think my surgeon was too aggressive on me?
Answer: it is certainly due to the blood loss from the last surgery, no surprise there. It could have been improved by waitng a little more time and also starting you on iron to help with the blood cell production immediately after the first surgery. I think what you are doing is enough, it is basically too aggressive to think the next surgery could have been done so soon. JG 5.8.08
Dr. Garcia, I had a baby six months ago and have since stopped breast feeding. I am really surprised by the loss of fullness in my breasts now...I had a breast aug. 12 years ago, saline above the muscle 500cc, and while they are now a full D(go figure) they are not as firm as before the pregnancy. What is the best option for getting the fullness back...I do not want a lift because the scar is too visible. Thank you for your time.
Answer: not much that can be done besides the lift, a larger implant I think would not fix that issue. JG 5.8.08
i really need to know where to go for help is someone is contemplating suicide post-surgery (facelift)
Answer: call a suicide hotline immediately. JG 5.8.08
3 weeks after blepharo I have a 2-3mm scleral show between my iris and lower eye lid specially on the right eye. Can this be corrected by surgery or any other method? My doc is in Brasil and I will only see him in September. I cannot be behing dark glasses that long. Any suggestions? Thank you in advance. renee
Answer: aggreessive massage starting at the skin near the nose and push up and out toward the temples, might want to tape it up and out at night by placing tape on the outer part of the lid, and use eye drops at night too. JG 5.8.08
dr garcia, how do i get rid of flakes on my forhead. I use a mild cleanser and moisturize it with cleandula gel, but the flakes keep coming. Can you please tell me a gentle way of removing flakes?Thanks
Answer: you need to remove any skin irritants that are causing it, need to look in your creams, your facial cleansers, etc and remove any agents that exfoliate skin, like alpha hydroxy acids or retinols. Also need to increase your moisturizer use too. JG 5.8.08
Hi Dr.Garcia, do women get breast augmentation in their 40`s? I had to have my silicone implants removed due to rupture, after 17 years. I`m now 46 and I miss looking good. If so, would you recommend saline or silicone again?
Answer: I think either silicone or saline can be done, the silicone might feel a little more natural, and yes, many women in the 40`s have them placed, even for the first time. JG 5.8.08
Does IPL help a bit with undereye lines? (collagen buildup to help with wrinkles) If so, can IPL be applied in the undereye area? Doesn`t it harm the eyeballs or something? (assuming anyway that one has the eyes closed, of course!). Can IPL be applied close to the eyes, in the lids, undereye, tearthrough area, etc.? Any precaution other than covering well the eyes if that was the case??? Thanks in advance for the answer.
Answer: I do not believe it does much there. I think you would need protective eyegear to try it but I do not recommend you do it. JG 5.8.08
I developed a callous after rhinoplasy. Will this go away on its own or will it have to be removed?
Answer: if still there after one year it will need to be removed. JG 5.8.08
I work out on a regular basis and watch what I eat. I have a stubborn area of fat on my lower abdomen that I can not get rid of no matter what I do. I have an ab 4-pack, but would like to bring out my 6-pack. Just saw a story on TV about carboxytherapy. Does anyone in Vegas offer this procedure? Would like to try and avoid lipo, if possible. Thanks for your time.
Answer: I am not aware of anyone in Las Vegas that offers that procedure, and I will say that I do not endorse nor recommend it either. JG 5.8.08
My daughter hit her cheek very hard from a fall. After the bruising and swelling has gone down, she is left with a dark line(about 1 to 1.5 inches long), something hard on the tissue and it is causing a dent or ridge in her face when she smiles. Is this something that is permanent needing some type of plastice surgery? (she is 3 and her pediatrician said that it is boold that for the most part clotted and turned hard???)
Answer: warm packs and massage for the first year and then re-evaluate it, might benefit from something being done to lift the depresson. JG 5.10.08
My doctor said fine line restylane is still not FDA approved in the US. Is this true? Do you use it? I,d love to address the fine lines above upper lip- (regular restylane was too lumpy and I had juviderm injected along lip line but didn`t do much to the fine lines.) Thanks again for your wonderful service.
Answer: can try using old fashioned collagen, it wil last about the same time. Or could use Prevelle Silk, on the market in the US for the same thing. JG 5.8.08
Dr. Garcia my left breast is slopping out to my armpit and making a crease on the side as it settles and the nipple is off copared to my right breast which lloks perfect. Why is this? And can this be fixed? My PS made a mistake in surgery when he went threw the fold on the right and then relized he was supposed to go threw the areola. Insead of going threw the fold on the left he went ahead and went threw the areola on that one which is the one that does not look right. Nobody told me what had happen then when my husband was aloud to come back and see me he surprised me with the bad news on the mistake. Then from listening to my husband he tells me what the doctor had told him and I was pleasantly surprised to find out he hates going threw the areola he perfures to go threw the fold. Why would`nt a doctor tell you that before you went under the knife with him. Is this just a pocket ajustment I need to correct the problem. And letting him go threw the fold on this would that make a big difference if thats the way he perfures to use?
Answer: it is likely to to the pocket size and when implants are placed under the muscle that can happen from the pressure of the muscle pushing on the implant. It can be attempted to be fixed by closing the pocket, but it is not a guaranteed result as it depends greatly on how the tissues heal. As to why the doctor did not discuss that all with you before, that is really up to him, but it is usually discussed at length prior to surgery. I think the revision surgery can be done through either approach so I suggest letting him use the incision he prefers. Best of luck. JG 5.8.08
I had small D implants put in 17 years ago, but since then have put on a little weight and I am now a DD. Can I have them redone to a size C? I hate them this big! If so, how long do you think I would be out of work? I`m a flight attendant. Thanks.........
Answer: yes, but the degree of size reduction required will need to be discussed with the surgoen and they will likely need to know the size implant originally used to make that determination. JG 5.8.08
I heard of some women having 2 implants in one breast. Like a smaller implant on bottom of breast to make the breast sag more. Do you ever insert more than one breast implant? Or I guess my question is can a owmen bring a picture of a model from a magazine and say I would like my breasts to be shaped like hers? Is that possible?
Answer: Stacking implants is something that should not be done. It is nearly impossible to match your breast to someone elses, model or not, due to underlying anatomical differences. JG 5.8.08
Does bleachign cream permanently get rid of brown spots? What I mean is do you have to apply the bleach daily or you will see brown spots come back? This is if you stay out of sun. I do not know if somethign in the bleach dissolves the brown pigment or if it is just temporary?
Answer: no, with time and sun exposure they will come back. Once they are gone or reduced you stop the cream and do not use it again until they come back. JG 5.8.08
Can a women have breast implants when they are older? If not, why?
Answer: as long as they are in good health, they can have it done. JG 5.8.08
At what ages do women tned to start losing breast tissue? And how much (i.e 1 cup size, etc) and about the same on on both breasts?
Answer: they start losing it at varying ages, there is no set date or time. The amount, speed, and balance are individually determined, in some cases you can lose almost all of the breast tissue. JG 5.8.08
Dear Doctor, I am in the midst of a battle against the undereye area wrinkles. I have many products to apply to help (after extensive reading, reading your website, the derm`s recommendations).. and I ended up with quite a bag of products!! The issue is: I assume I can`t lather one over the other if I want to maximize effects. Can I list you the products and you suggest me which to use in the morning or evening or night before sleeping? Before I list everything, I must clarify that I have been using retin-a for years already and I know it is of the most effective substances, but it still seems not enough. There`s why there is this new battle plan ... with too many weapons that I don`t know how to use! Products that I have: a) Retin-a (perfect tolerance, have used it for years) 2) Kinetin 3) DMAE cream (this time around I don`t have yours available, but RoC`s) 4) Glycolic acid (perfect tolerance too although a bit drying) 5) Olay Regenerist with copper peptides 6) Skinceuticals serum with vitamins C, E, etc. 7) Eucerin`s, Redermic (LaRochePosay) and L`Oreal hyaluronic acid fillers (topical!) Of course I always use sunscreen/sunblock in the mornings. But that`s too many products and I don`t know: 1) What to use together or not and when (what hour and what order, which slather over what) 2) HOW to apply it because sometimes I feel like simply putting on the creams makes me rub the eye area somehow, that can`t be good for firming that area! Thanks and sorry for such a long question/s. All the best :) Let`s the war against my wrinkles begin!! but how ;)!???
Answer: use the Retin-A, twice per day if tolerated, wait ten minutes at least before applying sunblock and make up over it. That is all. JG 5.8.08
Hello Dr.Garcia. Thank you for answering my question about the botox injected into the lower eyelid. You said that this causes loose lower eyelid muscles. Do you think this is reversible or will I have this permanently? Thank you
Answer: it all reverses itself in a few months, once the botox wears off. JG 5.8.08
Hi Dr Garcia, I had Teosyal injected in my upper lip on 04.05.08. My swelled up a lot (my lip felt like it was going to burst) and I have patches of bruising. I asked for only a little Teosyal in my consultation as it was my first time and I wanted to be cautious. Now the swelling has gone down I look like a duck. It is also uneven. On one side I look like the joker and on the other it looks OK but still too big and it all looks odd when I smile. I`m mortified that it has turned out this way. Do you think it could all still be swollen? I`m thinking about complaining at my follow up appointment and asking for hialuronidase which I see mentioned by other ladies on this site. Should I expect to receive this for free because the work is clearly uneven? Thank you very much.
Answer: I think there is likley still lots of swelling there and you need to give it at least 10 days or ore before deciding on dissolving anything. As to receiving it for free, it varies from injector to injector, no way for me to tell. JG 5.8.08
1. For minimize pores, is there a down time after IPL treatment? 2. If i dont want to get IPL treatment, and wnat to seek for laser treatment without pain and down time and can see result for quite instant, what kind of laser treatment should i get?
Answer: pink for about 45 minutes is about all. What you are seeking does not and will likely not exist in the near future. JG 5.8.08
Any opinion on the Baby Quasar? thanks
Answer: skip it. JG 5.10.08
hi dr. which is better to use for brown spots, mela-d or intense line defense skin ceuticals?
Answer: not much difference. JG 5.7.08
Hello Dr. Garcia, I had botox injected underneath my eyes for wrinkles in that area. About a week later I woke up to find that I had an extra line under both eyes that extends all the way around the orbital rim. It is now 7 months later and I am still left with this line. It has gotten a little better. I am positive that I did not have this before the botox. What do you suggest I do? Thank you
Answer: might need a laser and also, never use Botox for the lines of the lower lids, it is risky, does not work most of the time and if it does, it can leave loose muscles and bulging fat of the lower lid. JG 5.7.08
dr garcia, is dry skin more suscepotible to flushing/blushing and itching in rosacea, hence the need to moisturize. thanks
Answer: yes, correct. JG 5.7.08
Hi Dr Garcia, I have some deep bumps on my cheek (Mostly on just my right cheek) that are soft and colorless, and they don`t really raise much at all above the skin level, but they sometimes get red and inflamed and turn into pimples. What are these? And is there a treatment? Do you think any sort of light treatment might just get rid of them so they dont get inflamed anymore? I got very, very little sleep over the past few days, maybe 6 hours over 2 days or so, and they got inflamed. Think maybe it`s because of lack of sleep?
Answer: hard for me to tell, it does not sound like intradermal moles as they would not get red so its either a mild form of Rosacea or a seborrheic dermatitis reaction. I think seeing a dermatologist in person is the best thing for you to do. I do not think lack of sleep is the cause. JG 5.7.08
Good day Dr. Garcia I was wondering what I could have done to fill out the area between the bottom of my nose and the top of my lips. I have very fair skin and I don`t have much fat on my face so the two veins, one on each side of that area of my face stands is standing out quite a bit. Now that I`m getting older and there is even less fat in that area, I am beginning to show signs of vertical lines which I would like taken care of. I would like to have something done that is permanent but I don`t know where to begin investigation different products. Thank you for your time
Answer: I would strongly suggest you avoid any permanent products, you can consider a combination of Sculptra for the deeper part and Restylane for the more superficial ones, but they will last only months. JG 5.7.08
Hi, I am scheduled to get an aramis laser treatment tomorrow. Is there any chance of being burned by this laser ? Is their any chance of facial fat loss with this laser like their is with thermage? I am geting the aramis for acne and acne scars. Thanks
Answer: low risk, but still possible since the water is being targeted. JG 5.7.08
can you tell me a little about the skin cream mela-d? will it irritate skin at first, and what is it mainly used for. thanks
Answer: OTC bleaching cream, not as effective as prescription strength hydroquinone. JG 5.7.08
Good evening Dr. Garcia.. Is lemon juice safe to apply under the eye area to lessen the appearance of eye wrinkles or is it too strong? And also will it do any help in the eye area or will it have no effect? Thank you..
Answer: safe, probabaly, effective, well, I would say unreliable, could be too weak or too strong. JG 5.7.08
Hello, Ok, so can Restylane injected in the lines above the lip make you look like a duck? I have some lines that I want filled, but I DO NOT want my lips fuller, as they are full enough. Also, what are your thoughts about Refinity Peels? Good for wrinkles? Thanks, ashtin
Answer: if too much is injected, yes. Might suggest a thinner product like Restylane Fine line. JG 5.7.08
Hello dr Garcia. I`ve posted again about my nostrils` reduction that are getting wider and wider post op. I visited my surgeon yesterday and he said that everything is ok, but I think he is just too optimistic or inattentive. My nostrils are getting wider and pull the whole nose. Can this lead to skin or tissue necrosis because of the exerted force?
Answer: there should not be any necrosis, no. JG 5.7.08
Dear DR.Garcia. I hope you are doing wel. I previously asked questions about good over the counter stuff to buy to help in the aging provess. I really appreciated your answers and went to GNC to purchase the items (some I had already been using). I did get overwhelmed when I noticed the different dosages. I guess I never looked and just bought the products before by grabbing it off the shelf (uh oh). The sales person was no help so I am wondering does it matter your age or weight? How do I know what dosage for a healthy 58 yrs old female for Vitamin C B E Coq10 Calcium with Vit D Fish Oil? Should I take Vitamin D seperately? I asked my PCP and she said middle of the road dosage!!!! GOD bless you for all of your help. Your site is much appreciated.
Answer: they can all be taken together, CoQ is 100mg or more in gel caps, the fish oils are at least 1000mg per day. The B and C I suggest twice the RDA. The E about 400iu daily. I need all the blessings I can get, thanks. JG 5.7.08
Dear Dr. Garcia Thank you for always answering my questions honestly and promptly. I value your opinions. My question is this. Most plastic surgeons provide many services, treatments and surgeries but do have an area of expertise. What is yours? Face, breasts, eyes?? What do you like doing the best? I need some help in several areas and am just wondering? Thanks in advance for your honesty.
Answer: over 50% of my practice is facial cosmetic surgery so that would be where most of my experience is. JG 5.7.08
These are my experience : 1. 10 years ago i use retin a 0.05% for about two months, after the peeling it make my skin more oily and make my pores at apple cheek look enlarged. I stopped it 2. And then 1 year ago i tried again retin a to minimzie my pores. I wash with glycolic acid facial wash and after that put retin a 0.025%. After 3 months doing so, my pores still large and my face become more oily again. So i stopped both the cleanser and retin a. 3. Last month i tried product called picture porefect containing AHA and retinol, to minimize pores. After only twice using it, my face become more oily again. I stopped again. So the question is : what do you think of my skin reaction, and what should i do to shrink the enlarged pores at my apple cheek and nose? I am looking for at home treatment, and now i am using face cleanser pH 5,5 and sunblock every day
Answer: I think IPL is a different approach that you can take, or microdermabrasions. JG 5.7.08
1. Is NDGA (Nordihydraguaiaretic Acid) has ability to shrink enlarged visible pores at face skin? 2. Is it ok to combine product with NDGA with a retinol product?
Answer: no experience using that product, sorry. JG 5.7.08
May I ask you how would a surgeon go about fixing my nipples so they are more centered than all over the place! So much for the Harvard/Yale plastic surgeon of mine!
Answer: well, in most cases it is due to improper pocket location for the implant. JG 5.7.08
Regarding my nipple placement. He suggested the only way to center my nipple on the implant is to remove my nipples and replace them in the center? Ummm...thats like an entirely different surgery PLUS IMPLANTS! Is he nuts? I never heard of this before. I wish i can send you photos. Also....I notcied my left one falls more to the armpit and the right is dead center and not so pliable. You rhink this is CC? I really dont mind having a redo. I just wnat to make sure im not going nuts...
Answer: that is absurd, I think you need to seek out another surgeon. The right side might have some capsular contracture or just a larger pocket, hard to say. I think pictures help some but in your case it would require a physical examination as the implant needs to be moved to see what can be accomplished, sorry. JG 5.7.08
I had a bil lower bleph with canthopexy 16 months ago. I have asymmetry and scleral show. I`ve gone to an oculoplastic surgeon who is suggesting a cheek lift with canthopexy for correction. The incision would be just lateral eye over the old incisions but would extend out a little further. What is your opinion on this? Thank You.
Answer: hard to say whether that is what you need without seeing you in person but if there is a need for more skin, the cheeklift can help with that and the incision will likely need to be made a little longer to gain access and repeat the canthopexy in such a way to avoid the scleral show. Might be the only way to go, but I cannto say without a physical examination. JG 5.7.08
I am 24 years old and since I was a teenager my breasts have been very large (DD - DDD) and very sagging. I know that a breast reduction can take out milk ducts and therefore there is a chance that one can not breast feed. I do not have children but eventually would like to. Can a breast lift take out milk ducts? Also, do you have any weight requirements for a procedure like this?
Answer: A breast lift will take out some ducts, but less than a breast reduction. I have not weight requirements, but I will say that the larger the breast left, the less time the lift will last for. JG 5.7.08
Hello Dr. I had 2 vials of Sculptra injections about 3 weeks ago. I have what I consider severe facial wasting. I see some results and I am wondering if I should go in for more or wait to see if I see more improvements. I don�t mind spending the money if it works.
Answer: if you have severe facial fat loss it might take 5-6 vials and it takes 3-5 months for the injection performed to reach maximum fullness so I would go for the next round. JG 5.7.08
Dr. Garcia. I had upper and lower abdomen lipo 3 months ago. Still have some hardness on these both areas. Do you think with time, this will go away or is it a scar tissue that needed to be massage and some ultrasound to break it down? Thank you very much.
Answer: ultrasound will speed it up but it should get better for 6 months after the surgery. JG 5.6.08
My docter tends to play it safe! He places his implants far apart to be safe! Mine are 360 11.2 diameter and so far apart there is at least a 3.5 inch gap. What can I do to fix this? also being small- low b cup prw ba, my nipples were naturally far apart! Now ones centered and the other is literally under the other and far to my armpit! Its ridiculous n hideous! Can this be helped? Is my docter just not good?
Answer: to be honest, I am not sure how that makes it safe, it might avoid one problem, synmastia, but the issue is the implant needs to be centered behind the nipple evenly, that might require an adjustment on the size though. I think you need another surgery and possibly different implants and a pocket adjustment, sorry. JG 5.6.08
Dr. Garcia, i have sun damage on my neck and i have received two estimates from two different doctors. one is recommending the pulsed dye laser and the other is recommending the Fraxel. which is best for red damaged skin on the neck and broken blood vessels on the face. also, is there risk of permanent damage with either? last question, what about the Titan laser? will it help either of my problems?
Answer: if it is red the pulsed dye laser, the Fraxel will do nothing for redness. I think the Titan is too weak and the risks, in experienced hands of anything negative on a permanent basis is small with the Pulse Dye laser but the Fraxel has some mild risks. JG 5.6.08
If I move my face a lot, the botox will wear off faster?
Answer: to a degree, yes. JG 5.6.08
Hi, Dr. G! What do you think of the Obagi D�colletage System? I`m getting a bit of loose, rough skin on the neck and some wrinkling on the chest, as well as redness and unevenness from acne (but no age spots or mottling). Does this work? If not, what will, without exacerbating the acne? Thanks!
Answer: I do not think it will do much, mild at best. I think it works best for skin discolorations. JG 5.6.08
Dr Garcia, I have between A and B size breasts. I used a Modela breast pump several times a day to produce enough milk to nurse my twins for one year. It`s been eight year since, and my breasts are very stretched out and sagging. The nipples are lengthened and the areolas are stretched as well as the surrounding skin. Would a breast lift remove so much skin that I would be left with very little breast? I would like to do something but prefer not to have implants.
Answer: a breast lift removes no breast tissue, so the size should not change, just be in a better position. JG 5.6.08
Hi Doc, Had botox injected into crows feet and between eyes this a.m. (I`m in Ca.) it is now 4:30 p.m. and I still have lines and furrow between eyes. My question is how long before I see results? Thanx, JoAnn
Answer: 7-10 days before it works. JG 5.6.08
dr garcia, i have rosacea. my cheeks are red and dry so is my forehead. I use aveene extreme cleanser to moisturize and cleanse my skin. My cheeks do fineand are smooth and non-flaky but forehead becomes red and becomes flaky if i don`t use any cleanser. So my question is am i dealing with sebborheic dermatitis or it is rosacea as well and I need to deal with it somehow?
Answer: sounds more like seborrheic dermatitis. JG 5.6.08
thank you Dr Garcia, have one final question! What is your general opinion of Lumenis One and would the clinician have started with the yag laser module or the IPL head, you obviously know the system and just wanted clarification on the stages of treating this vessel on my nose. Would just like to thank you again, have been very helpful.
Answer: I think most physicians would start with the IPL head as it is less risky, and then move on from there, I will tell you, even if the YAG head is used, it will take a series of treatments. A VBeam laser might get rid of it in one setting or it could be hyfercated to remove it, old fashioned and low tech but effective. JG 5.6.08
Dr Garcia. I forgot to tell you I am 43 years old and the horizontal lines are 2, each one aligns to each corner of my mouth where they start(approx 1/2 inch down my lip). Going in as if each line is going toward the middle of my chin under my mouth. I hope I explained this situation the right way...thank you
Answer: yes, answer is the same. JG 5.6.08
Hello Dr Garcia. I have horizontal lines forming in my chin, between my lower lip and my chin. I am also in maintainance obagi with 0.1 retin A 3 times a week. My question is what are this lines? should I apply the retin A in this lines too? I also noticed that marionette lines are kind like forming too, too early to say but I see them We know retin A kind like makes your skin thinner so I dont know if by applying them in the fold of the marionette lines OR THE HORIZONTAL LINES IN MY CHIN is going to make these 2 LINES WORSE...Please advise me. THank you
Answer: you cna apply the Retin-A there and they are dynamic wrinkle lines from the skin folding over and over again. Retin-A only thins the epidermis, which is good, but it thickens the dermis, which is also good, so Retin-A is not causing all of this, it is the normal aging process. Retin-A will not help the marionete lines. JG 5.6.08
Dr Garcia, when you replied unfortunately it did not really totally answer my concern, the vein was very slightly raised even before treatment and has remained so after the first IPL, can you tell me why that may be. Also would you not expect to see any difference after the first course, they are using Lumenis One which has 3 modules on the machine, one of them I think is the ND yag Laser, is that correct? Would he have started off with this, just concerned I cannot see any difference as yet, next course is not for another 3 weeks. Also I asked you about the indentation at one end, is that normal? Many thanks again for your assistance.
Answer: it will remain raised from the selling and might not go flat until the vein is totally ablated or clotted. I would never expect a difference after one session with the Lumenis One. The indentation is normal and usually fills in with time. JG 5.6.08
Hi Dr. Garcia, Have you heard of Accoustic Wave Therapy for cellulite treatment? What do you think of it, twice weekly for 3 weeks and then 2 monthly, so total 8 treatments for $2000.00 front and back thighs area. Is it worth the money? Thanks for your time and answer
Answer: I have heard of it and am not impressed with it. JG 5.6.08
thanks for all the advice. Have you or have you had a paitent or have ever heard of a revision rhinoplasty that could regain the appearence of a Roman Nose from a previous surgery that left the nose small and upturned.
Answer: it will usually require a graft of some sort but it can be done, yes. JG 5.6.08
Dear Dr. Garcia, I am a 40 year old male caucasian with fair skin, brown hair brown eyes. I have a depressed saucer type of scar on my right cheek. I have had this since I was about 15 and was caused from either acne or a cyst. It is approx. 5mm wide and 10mm high. There is also a hard lump on one side of the depressed area. The scar goes away when I smile. The scar seems to be getting more noticable as I age. Do you recommend excision or subcision/filler? With excision, approx. how big would new scar be and what prevents there still being a depression in the area? What is the best filler if I choose that procedure? Is there anywhere to view before/after pics of each? Thanks for your time.
Answer: I think subcision and fillers should be first, the length of the scar if cut out would be 50% longer than the diameter of it now.Results will vary from patient to patient I am afraid so pictures do not always show a good representation JG 5.6.08
Hi Dr Garcia, I am in my first month after my botox injections, from now the effects will gradually wear off?
Answer: yes, that is correct. JG 5.6.08
Dr Garcia, can botox do permanent damage?
Answer: I have not seen that nor read bout it occuring. JG 5.6.08
Dear Dr. Garcia, My hair loss from this cortisone shot is getting worse. Have you seen hair loss from a cortisone shot and if so, in your experience, when does the loss usually stop?
Answer: I have seen it and it usually stops aftere 3 months and starts to get better in most cases. JG 5.6.08
Dear Doctor, I`m from Hong Kong. I have consulted local surgeon for blepharoplasty and he suggest not to have blepharoplasty because its too early to have this surgery. He said it will look good for few years and your eyes might droop again slightly which will make your lower eye lid droop little. Is is true? Is it save to have blepharoplasty at the age of 35.
Answer: in most cases 35 is too young. JG 5.6.08
Dear Dr. Garcia. Will rubbing fresh pineapple juice or papaya juice in areas w/ crows feet as well as below the eye area for eye wrinkles helps in improving its appearance? Is ist also effective for the whole face? Thank you and God Bless.
Answer: it is a mild alpha hydroxy acid but the creams sold are more effective. JG 5.6.08
Dear Dr Do you think there is a cut off age for getting breast implants. I am 39 years old and think I may have left it too late?
Answer: I think it would be OK for you still. JG 5.6.08
i don`t want to use botox will restalyne or juviderm work in forehead on horizontal lines will the material show?? thanks
Answer: it can but it needs to be done carefully as lumps can arise since the wrinkles are superficial. JG 5.6.08
Hi DR Garcia. I am 36 yr old female. Can you please tell me what is the best way to firm the skin in lower face and jowl area. My skin seems to have just recently become slacker in this area. What do you think of botox or IPL for this problem? Thankyou
Answer: might consider a Rhytec Portrait, IPL and Botox will not do it. JG 5.6.08
Hi. I wanted to ask you what is the best way for to lift the outer eyebrows with botox and should the injection just be under the tail of the eyebrow. I had botox 4 months ago in my foehead and brow area and it left my eyelids drooped. Now that it has worn of it seems that my eyelid skin is looser than before. I have pictures of just 4 months ago and I`ve aged 5 years in this area. Is it posible that botox can cause muscles to slacken.
Answer: the weakening of the muscles should not cause excess skin over time, and your injector should know where to inejct to get the lift, injecting the forehead with Botox will never lift the eyebrows. JG 5.6.08
Dr. Garcia: How long do you advise your patients after a facelift to postpone exercising - which includes weight lifting? Also, I had to stop Hormone Replacement Therapy (HRT) prior to surgery. Tomorrow will be 3 weeks since my surgery. Do you think it would be safe to reinstate the HRT? Thanks so much.5/5/08
Answer: 4 weeks. I think you can start the HRT now. JG 5.6.08
I had juviderm injected today and have that blueish-gray tint about the size of a dime I guess from being injected too superficially. How long does this take to go away? Is there anyway to speed it up? thanks!!
Answer: massage and time, it might take a few weeks to get better. JG 5.6.08
Hi Dr! I have asked you several questions in the past regarding a rev. abd. scar that needs revised as well as a L. breast crease that needs redefined due to the pulling from the rev. abd. I am scheduled to see my ps at the end of the month. He is planning on addressing these issues with another surgery in the fall. If I still have any hesitations afrer my appt. with him. how do I find the names of the best ps that would redo a rev. abd scar, redefine a breast crease etc. What types of ps would be considered the expert in these procedures---breast reconstructive surgeons? (the ones who deal with post-breast cancer pts) or massive weight loss patients (where upper body lifts are performed more commonly? Although I trust my ps, I need to make sure that I have one of the best who is experienced in `clean-ups` of a rev. abd. I have come to learn that a rev. abd is a uncommon procedure. I am guessing that going to another ps in my area may not be effective as they may not be very experienced with the rev. abd procedrue, nor the clean-up needed. At what point do I start making consultations with other ps in the North Carolina area? Is it smarter to stick with the original ps who did the procedure? At what point to I start researching rev. abd experts all over the nation? I really need to have peace of mind. How do I access this info?
Answer: I do not think there is an expert but I think seeing someone who does alot of breast surgery and tummy tucks is important, some surgeons do mostly faces. Surgeons that do reconstruction after massive weight losss would also be good choices. JG 5.6.08
I am a 37-yer old white female. I had juvederm under my eyes last week in an effort to correct dark hollow dark circles. I now have a small lump under each eye, and the hollows and darkness remain unchanged. What is the concept with juvderm? After the injection, was the material suppose to be massaged into the hollows under my eyes? Or is it supposed to go on its own? My surgeon will be dissolving it in a day or two. I am not sure if we should try again. Is it tricky to get right? Do certain skin types fair better or worse? Should I have seen an immediate result? Thanks very much.
Answer: It has to be injected where it needs to go, the lumps can be flattened with massage but it will not be able to be moved into position. It is a tricky place to inject. When placed in the right area, by the time the bruising goes away in 10 days it should look better. JG 5.6.08
hi dr garcia, are are you? can radiesse be injected into the vertical lines above lip? if not ,what is the best filler for that, perlane, restylane, or captique. also will it last longer if a tiny amount of botox is injected along with it?
Answer: I think Restylane is OK but Captique is better, not Radiesse or Perlane. I do not recommend injections of Botox around the lips as it can weaken your mouth and make you look like a stroke patient. JG 5.6.08
Dr. Garcia, I had upper and lower blephaproplasty done 2 weeks ago. I have red broken capularies at the bottom of each eye and on the top lid of one eye. Is this normal and will this fade? My concern is that I have broken capularies on my nose and I have fair and sensitive skin.
Answer: all normal from the surgery and should get better, but slowly. JG 5.6.08
Doctor Garcia, Is there anything to get rid of food allergy`s. I`m not sure if the tigger is something that has to do with food because usually this happened last year I would get non-itchy red bumps on my face that would go on and off and they totally disappeared in the winter. Any thoughts to what it might be or how I can prevent this from happening?
Answer: only thing you can do is avoid that food. JG 5.6.08
Dr. Garcia, I had rhinoplasty done in Sep. 2004. My plastic surgeon has been using Kenalog-10 to try and soften the tip; he claims that even after 4 years the steroid will reduce some of the residual swelling. I`ve been to him for 2 injections spaced 6 weeks apart, but I have noticed no substantial differences, although there may have been a slight reduction. Would using a higher dose of Kenalog be helpful? I asked him about this, and he said atrophy might result. What are my alternatives at this point?
Answer: I think at this point the changes will not occur in most patients. JG 5.6.08
Hello Dr Garcia I have been very interested to read the letters on your website and would really value your advice on a problem I am experiencing with cellulitis. I had a rhynoplasty operation two years ago to correct a childhood accident and had a nasal implant fitted. There were no complications whatsoever with the first operation however although i was happy with the bridge of my nose it accentuated the fact that one nostril was much bigger than the other. I tried to get used to this but after a couple of years I decided to go ahead with a revision septorhynoplasty which took place at the end of Feb 2008. It was a minor operation compared with the first op and on the whole I am happy with the outcome. The surgeon had to shave part of the implant so that the nose became more asympetrical. The week after the op when I went for plasster removed there was an angry red mark on the end of my nose where the implant had been shaved. The surgeon said to keep an eye on this and visit my gp if if it didn`t improve. It did seem to get worse but then after I had applied sudocrem the inflamation went down. Howe