"Slowing the hands of time"
Call for your Consultation and Facility Tour.
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.
Answer:
Answer: I might use Perlane for those, I think options such as Radiesse and Artefill are risky there as it is so close to the lips that lumps can occur. All the best. JG 7.28.10
Answer: yes, a little moist heat and a little massage along with time will allow it to go away. Best of luck. JG 7.28.10
Answer: the Retin-A will be stronger, but it will exfoliate the scar, will make it red and will never remove the scar, neither of the creams would remove it. As to fading it, if it is brown in color, then the Retin-A is a stronger and better choice, if it is red though I suggest doing neither one as they will both cause irritation and keep it red longer rather than shorter. JG 7.28.10
Answer: I do perform the procedure if I examine the patient and find an adequate amount of fat in the pocket to make a visual difference, typically the amount of fat is relatively small, about 3cc per side. If one has a very round face I do not think you will look emaciated afterwards, but the difference might not be as dramatic as you are hoping for. The procedure is not covered under health insurance and the fee is about $4000. JG 7.28.10
Answer: I do not think either one will remove any wrinkles once the swelling is gone. JG 7.27.10
Answer: sounds like the skin was pulled over aggressively and caused some plication or folding of the upper cheek skin, that should not happen under normal circumstances. JG 7.27.10
Answer: it does help there, should see some improvement in 4 weeks or so and continue from there, the older one is the better to apply it twice daly. All the best. JG 7.27.10
Answer: you are using enough, no need for anything more. JG 7.27.10
Answer: the younger they are the more satisfaction there is with Sculptra as when one is older the Sculptra is not able to create as much collagen due to the advanced age and loss of reparative process. We have a process where surgery is canceled that is different from his. I understand the loss of time and the inablility to put another patient in your place but as long as you eventually have the procedure, I think most surgeons will not charge you a fee like that. As to the hands, I really do not ahve a good filler, lots of peopel use Scultpra but I have not been impressed with the results of any filler in the hands. Thanks for the kind words and I wish you the best. JG 7.27.10
Answer: neither should affect the facelift. OK to proceed. JG 7.27.10
Answer: 0.25ml. JG 7.27.10
Answer: no, I agree with him, suturing it up has a very high chance of infection, those wounds heal well without it and I do think the liquid diet is nto a bad way to go to add to the safety part of it. Best of luck. JG 7.26.10
Answer: I suggest waiting at least 48 hours and try not to elevate your blood pressure and minimize the head down position as much as you can until it starts to get better. JG 7.26.10
Answer: ice to minimize the bruising and then alternate warm and cold starting in 24 hours. JG 7.26.10
Answer: commonly done, yes. Best of luck with the facelift too. JG 7.26.10
Answer: Artefill can be used but more likely the better option would be injecting your own fat, it might take more than one session but as the dents are probably from fat loss, your own fat in that area would be a better option. All the best and thanks for the kind words. JG 7.26.10
Answer: yes. it is possible to do that.Icing will help a very small amount I am afraid. Best of luck. JG 7.26.10
Answer: we usually suggest the moist warm packs to be used 3-4 times per day for a few minutes each time is all, no need for prolonged periods of application. If the sutures were placed in the skin I think it best to resuture them to get the best scar, if they are inside of your mouth, as long as the deeper tissues are intact, I would allow it to heal on its own. I think if the sutures broke you should see him as soon as you can to get checked out. All the best. JG 7.25.10
Answer: 3-4 weeks. JG 7.25.10
Answer: I do not think you should be doing your own injections and I do not know where or why you have come up with the dose of 2.5mg/ml. It is a straight mathematical division problem though. 1.8cc approximately. JG 7.25.10
Answer: I think what you hear from patients on the internet is usually the results that are not doing well, the vast majority of patients do well and they unfortuantely do not go on the internet to talk about their good experiences. Slow healing and pain can occur but in most cases a facelift is not an unusually painful procedure and most patients are out in public with a little make up in a couple of weeks. Best of luck. JG 7.25.10
Answer: yes, OK to do. JG 7.24.10
Answer: the swelling the next day is more due to the amount of fluid that the Scultprsa is dissolved in and not the maount of Sculptra itself, so you might just have had less fluid injected. JG 7.24.10
Answer: The dissolving of fillers varies from patient to patient and I have many patients that have fillers like Restylane injected and it lasts much longer, especially in areas where there is not alot of motion such as the areas you had treated.Not a bad thing. JG 7.24.10
Answer: hard to say without seeing you, but maybe about $12,500. JG 7.24.10
Answer: you can try it, there is no way to guarantee that it will not make the Retin-A more irritating though. JG 7.23.10
Answer: it might absorb better and but it also might cause mroe irritation than without it. All the best.JG 7.23.10
Answer: you can proceed now at your leisure, best of luck. JG 7.23.10
Answer: it will loosen up but it might never resume the normal shape you had before as the skin will likely not relax in that exact way. I wish you the best. JG 7.22.10
Answer: most likely will need more surgery after this amount of time to allow the skin to lay down in a direction with more normal tension lines. It is impossible to predict if the tissue will come down and equalize with the midface. My guess is likely not as the upper tissue might fall, but the lower tissue will also fall, so there will likely be a gap between them unless they are reapproximated. In view that you have had these issues, certainly another cheeklift wil be needed, one can call that a mid facelift if desired. A MACS lift is not what was once called a mid facelift years ago, that is where the tissue were detached from the bones and lifted but that has its own set of risks and I do nto think it would help your secenario, sorry. JG 7.22.10
Answer: scar tissue never leaves 100%, the only thing that can hold the tissue in position are sutures that have not dissolved or residual scar tissue.JG 7.22.10
Answer: not for more than a few hours. JG 7.22.10
Answer: it can in many cases, but not all if there is scar tissue holding it or there is excessive tension in a certain direction from the skin being laid back down in a slightly angled direction. The fat pads are normally left attached to the tissues lifted and are seperated from the skin. JG 7.22.10
Answer: HGH does help in cases of wasting, yes. JG 7.22.10
Answer: usually that sensation is from the tissue that were tightened below the skin that are being held by scar tissue now. JG 7.22.10
Answer: it can be used, but just because it is form a suttborn area to lose fat from does not make it survive any better after it is used as an injectable filler. JG 7.22.10
Answer: Some of the tissue originally held in the MACS suture might have torn free and allowed it to fall. JG 7.22.10
Answer: I think in cases of adult-onset human gorwth hormone deficiency, the treatment with injections is FDA approved and worthwhile. I have never found an oral secretogogue that works past the I feel it working phase. Blood tests do not reliabley show oral secretogogues to produce measurable results by themselves. JG 7.22.10
Answer: yes, fluctuations ae the normal way things go, especially after an open procedure. I would not call it a set back in terms of healing, it just teased you with what you are going to look like in about one year, but then it took it away for awhile is all.Hang in there. JG 7.22.10
Answer: I would stay with the technique you are using. JG 7.22.10
Answer: hyfercation or a YAG lser, but nothing keeps them away forever. JG 7.22.10
Answer: I cannot say but many times the surgeon will do something small like that at no charge, it sounds like there is some bulky appearance there from the tissues below the skin that was lifted, debulking them surgically is likely the best option, it can be swelling but unlikely due to the amount of time that has passed. All the best. JG 7.22.10
Answer: yes, they will go down but it will take time I am afraid, maybe a few more weeks. Go to hang in there for a bit, thanks for the kind words and all the best. JG 7.22.10
Answer: will do nothing for jowling, might actually make it worse as the muscle mass of the masseter will be less and therefore support the jowl skin less. JG 7.22.10
Answer: well, although you may not see many differences between your bone structure and hers, as you are related, most people perceive beauty by way of facial proportions, and those are controlled by boney structure and fat distribution. It is true that attractive people age better or at least look better as they age, and it is mostly becaue of better tissue support and bone structure. The subtle differences between your bone structure and hers is likely the cause I am afraid. JG 7.22.10
Answer: I would have thought the Juvederm should have dissolved away on its own by now, and if thehyaluronidase did not work, it might be because the fullness you now have is due to scar tissue and not any residual filler. JG 7.22.10
Answer: could be either, I suggest using some Cortaid 10 which is a steroid first for about 5 days, twice per day, and if not better, then I suggest seeing a dermatologist. Best of luck. JG 7.21.10
Answer: recovery is about the same as for the face, I suggest starting with about a 20% TCA and you could go stronger as time goes on if needed. once session will likely not take care of all of it though. JG 7.21.10
Answer: just wait until the next day is all. JG 7.21.10
Answer: can be used as an IPL is not a true laser, just intense light and not as dangerous. Thank you for the kind words and all the best. JG 7.21.10
Answer: yes, works well for Rosacea, but it needs a series and then continued sessions to control it. JG 7.20.10
Answer: returning patients are offered a discount yes. I cannto say what it would cost as time is the greatest issue with the fees, so I suggest calling the office, telling them you are a prior patient and then we can meet and discuss what options would best suit you. Congratulations on the twins too! JG 7.20.10
Answer: help red spots and helps to shrink pores short term. Fotofacial, Photofacial and IPL are all the same. Different companies make the similar machines and use different names, they are all intense pulsed light, thereby the name IPL. JG 7.20.10
Answer: depending on how large you are, you might need a revision in 3-7 years. JG 7.19.20
Answer: I am afraid your information is incorrect, there is no way to grow a new nose or ear, there are experiments going on trying to use experimental materials in a mold to try to do that in animals. I am saying that they cannto grow cartilage somewhere else on your body in order to use it as a graft in your nose, correct. JG 7.19.20
Answer: no, there is not, but the older one is the less time it will likely last. JG 7.19.10
Answer: cartilage is made partly of collagen but you cannto grow new collagen like the way you describe, sorry. There are no newly grown ears or noses on humans. JG 7.19.10
Answer: lasers such as that or chemical peels will give you maybe a few months at best, no much else though out there as it is the quality of the skin that has deteriorated and the treatments on the neck cannot be done as strongly as on the face to get improvements. JG 7.19.10
Answer: well you can tighten by making incisions at the ear region, but no way to tighten the muslces reliably without incisions, there are string methods but I think they are very unpredictable and the sutures break with muslcular action. JG 7.19.10
Answer: I think in time they likely will wear out, but no way to tell over what period of time or over how many washings. I would guees a year to two or so. JG 7.19.10
Answer: I feel it is on your skin for such a short period of time it likely does not make a large difference. JG 7.19.10
Answer: I would use them for three months, then switch to maintaining it for a month and then try again on a daily basis. Unfortunately, not everyone gets the same resutls, the results on the ads are not able to be acheived by all. JG 7.19.10
Answer: well a pure necklift will not fix the jowl region as it only pulls horizontally but a mini facelift might be able to tigthen the neck enough and lift the jowl region superiorly into a better position to give you the desired improvement. As to the eyes, if you have both of those issues it might be a lower lid blepharoplasty with skin excision and fat removal or repositioning. Best of luck. JG 7.18.10
Answer: it is made of lactic acid, similar to lactose, but everyone makes lactic acid during exercise so I doubt it would be a problem. There are sutures that are made of lactic acid and they have no problems in patients with lactose intolerance. JG 7.18.10
Answer: if done too aggressivley or too often, it might, but once the tissues have healed and readhered it should not occur. The massage is essentially compression with motion upward as there is no stiff hard spot to massage against. We have our patients massage three times per day for 1-23 minutes for 6 weeks after surgery. JG 7.18.10
Answer: because you will not be able to grow new collagen as you have been led to believe.JG 7.18.10
Answer: Ice at this point will likely not do much, sorry. JG 7.17.10
Answer: just soften sacr tissue. Oral prednisone will have as many bad side effects as good so I would not suggest using it. JG 7.17.10
Answer: sorry, that will not work. JG 7.17.10
Answer: pretty close to the same. JG 7.17.10
Answer: I think the only thing at this time that can be done involves more surgery, sorry. JG 7.17.10
Answer: do not think there was an unequal fill so more likely is a difference in the breast tissue as you mentioned. JG 7.17.10
Answer: I normally use the Nd: YAG but both are good. JG 7.17.10
Answer: I rountinely use 5FU injections in regular scar tissue and it works well but has to be done every 2-3 weeks until better. I do not typically use it on the nose I almost never inject anything into the nose to help with swelling. The injections will soften scar tissue but not remove it. JG 7.16.10
Answer: yes to both, you can also weaken the Retin-A by mixing it with a moisturizer in equal amounts and as your skin gets acclimated, then use less moisturizer each time to allow the Retin-A to get to a higher concentration too. JG 7.16.10
Answer: doubt it is the spiro, it is more likely that you are picking at skin that has been scarred from before and the healing is impaired due to the scar tissue, the most important thing you can do is stop picking at the scars as you are creating a larger problem for yourself. I suggest seeing a dematologist too so they can determine what else cna be used to control your breakouts. JG 7.16.10
Answer: you can try potassium and magnesium, maybe 1000mg of the magnesium per day and potassium 99mg as potassium gluconate per day. JG 7.16.10
Answer: can be done, not as robust of a filler as it is on the face though. JG 7.16.10
Answer: I do recommend them, start at least 48 hours before and avoid all blood thinning products like aspirin, Motrin, Ibuprofen, Alleve for ten days before. I think icing before the injection helps with the discomfort but not with the bruise prevention. All the best. JG 7.16.10
Answer: might work to some degree. JG 7.16.10
Answer: maybe some Retin-A or my cell matrix cream, you can also have some IPL treatments for brown spots and microdermabrasions to keep pores closed, otherwise, I think the other lasers will give you a small amount and cost a large amount. Skip the ulrasound and infrared. Use your sunblock, avoid smoky environments and don`t go crazy spending money before you need to. Best of luck. JG 7.16.10
Answer: just about any plastic surgeon that does liposuction on the face and neck should have a cannula that can do that for you. There are surgeons that do revision surgeries and enjoy it, I have done them for many years but I no longer do revision surgery on patients that had surgery elsewhere. I am fortunate that I am busy enough with new patients that I no longer do revision surgery. It is fine to have regular liposuction done after SmartLipo, the fat removal technique is the same, the difference would be in the alledged dissolving of the fat created with the laser only, the fat removal is the same. Where the other surgeon that does not do SmartLipo has the advantage that I do not is in seeing you in person, there are many cases where the potential negatives outweigh the advantages and things should be left alone though. At times, a surgeon may feel the risk is worth it and other times no. As to many sites claiming that SmartLipo is better than traditional lipo is becasue of marketing. There are many senarios where it has been discoverd that many blogs contain false postings written by people that work for docotrs and have never had the surgery at all, they are all lies. I am not saying that is the truth with the sites you have read, but the most famous case was in the state of New York where a 10 million dollar fine was imposed on the LifeStyle Lift for doing such things. Best of luck. JG 7.15.10
Answer: it is true with the CO2 also but the deeper the laser, the longer the improvements will last.When I say remember, that relates to the pigmentation and not the wrinkles. As to the wrinkles reforming, there is nothing that can stop that because nothing will halt the aging process. New collagen can be formed but the aging process causes loss of collagen so the skin will age. Along with that, there will be small amounts of swelling for a while after any laser, and swelling will make wrinkles look better when in reality they are the same, just swollen and not able to be seen as easily. The laser does remove skin, but the amount of new collgaen that can be recreated will never be as much as what was there once, and the older you are the less robust the collgan creation can be, no matter what technique. All the best. JG 7.15.10
Answer: with the bullhorn lift there is nothing that needs to be done to the cupids bow, but a suture can be placed to cause some rounding and lift at the same time, when you are doing the vermillion roll lift, there is not much that can be done for the cupids bow in my opinion. I am not aware of who is doing the Portrait in the Washington DC area, sorry. JG 7.14.10
Answer: I would do a bullhorn lift over the vermillion lift, I feel the scar is easier to hide and the vermillion lift can leave the vermillion roll flat and unnatural in appearance many times, if needed, a corner of the mouth lift can be done at the same time as either one. JG 7.14.10
Answer: Retin-A is much stronger than retinol. JG 7.14.10
Answer: to be honset, they have not convinced me yet, if it was so good before, why did they have to improve it, even slightly. As to reversing it, all that you need done is to have the sutures cut, but they usually break on their own with time and muscle action of the face. JG 7.14.10
Answer: YAG lasers or Mederma cream is what I would do at this point. They usually fade to a lighter color on their own in time though. All the best. JG 7.13.10
Answer: OK to leave it alone, but it can usually only be repaired with more surgery unless treated with suspension very very soon after surgery. JG 7.13.10
Answer: I do agree that waiting 6-12 months for a revision is best, but as to regular liposuction not being able to remove that small amount of fat, whoever told you that is obviously poorly educated. There have been small cannulas of the size used in SmartLipo for almsot 20 years, sounds like they are trying to sell you on something they spent money to buy. The changes after 6 months are subtle, and as to smoothing out the fullness versus the dents, once you make the layer of skin smooth, then it will look better. JG 7.13.10
Answer: can try Retin-A, or have them hyfercated by a dermatologist, in some mild cases a chemical peel will help, but in most cses they likely will come back and or you will get more in the future. JG 7.13.10
Answer: I would suggest a light CO2 laser for the first question, as to the lotions, either Retin-A for the entire face and neck or my cell matrix peptide. JG 7.13.10
Answer: it is short enough of a time period that there is no need to wean off. Best of luck. JG 7.13.10
Answer: I do not think it is dangerous in experienced surgeon`s hands. I find that patients are very comfortable when they wake up and take few pain pills after the surgery. My patients are usually able to go out in public after 10-12 days. JG 7.13.10
Answer: yes, it is big surgery with significant downtime after the surgery and the results are fair, and many times it has to be done more than once. If you can live with it, it does not cause any health problems. JG 7.13.10
Answer: well, if the surgery was just a week or so ago, the bra, being worn all of the time, might cause enough scar tissue to form to hold it in place. If it is much longer than that, I am afraid it likely will not work and more surgery will be required, such as you described of placing sutures to elevate the capsule into a better position. All the best. JG 7.12.10
Answer: once the wound has healed and there is skin or scar over the incision, it would be OK to apply the Mederma. It will help some, but it will not make it look as good as it could if the incision had not been left open to close by secondary intent. If they were restitched and then the sutures were remvoed as advised, then it should heal as it would had bene expected if it had not been ripped open. JG 7.12.10
Answer: I think it will take a laser or chemical peel to improve, sorry. JG 7.12.10
Answer: it helps if you are replacing olive oil for other saturated fats in your diet, but not just by taking it on top of all other bad fats that can have negative effects on your skin. Saturated fats are bad for you skin, just as they are bad for your heart. JG 7.12.10
Answer: hope it helps. JG 7.11.10
Answer: well, I will say that the first 6 weeks after liposuction will go through lots of changes so the first thing is to give it some time. I do agree 100% that you need to see your surgeon and let them see things so they can appreciate the issue at hand. Final results will not be seen for about 6 months after the surgery, so if something needs to be done, I suggest waiting at least that amount of time. What will need to be done at that point in time can be some further liposuction to the surrounding areas, possibly fat injections to fill in small dents.I wish you hte best and hang in there, things will likely get better with some time. JG 7.11.10
Answer: same time. JG 7.10.10
Answer: well, you can use the Oil of Olay line, or add my cell matrix peptide cream to it, or as a stand alone. Need to add a sunblock during daytime. In general, people think they have to spend a lot to get a good product,and that you have to use many products to get the best results out there but the truth is you do not. JG 7.10.10
Answer: well, the first session appears to have been done at a stronger setting, and as the brown spots start coming off and your skin becomes healthier, less energy is needed or used. Settings have to be tailored to the patient, and many times have to be changed from one session to the next, there is no one setting that would be right for all patients with your skin issues. I might suggest telling them how it reacted and that they might go a little stronger in order to achieve the resolution of the spots you desire. Having said that, the longer the spots have been there, the more difficult it will be to remove them, no matter what technique is used.Also, no matter how they are removed, with subsequent sun exposure, they will come back, nothing will permanently remove them. All the best. JG 7.9.10
Answer: possibly, but I woudl suggest placing a filler in the area subcised to slow the possibility/eventuality of the tissue re-adhering.JG 7.9.10
Answer: my personal feeling is that although there are good ingredients in it, the amount of them is the key factor, in general, I feel his products are way too expensive for what you are truly buying. You will likely get about as good of a result with Oil of Olay Regenerist and be able to buy a full year`s supply for the price of one of Perricone`s single units. All the best. JG 7.9.10
Answer: yes, than can be done, there should not be any significant interference, all the best. JG 7.8.10
Answer: yes.JG 7.8.10
Answer: well, for starters, I guess you got some ablation if you have the waffle appearance at this time. I suggest using some hydroquinone 4% mixed with Retin-A 0.1% to help it fade, also total sunblock and seeing the place that performed it for you to get the prescriptions, I do not think it will go away on its own, but if treated, should not be permanent, funny about the IHOP though. JG 7.8.10
Answer: I would nto use them as the results are unpredictable, not uniform in all patients, I feel it is over-hyped. JG 7.8.10
Answer: I do not think the home units will give you much. JG 7.8.10
Answer: although I am not a big fan due to the mild degree of improvement is mild, but a fractional CO2 might be enough for you at this time. JG 7.8.10
Answer: not very helpful for fine lines and nothing for wrinkles, just the discoloration. All the best.JG 7.8.10
Answer: a photofacial might also help srink pores for a short period of time as it can melt the oil in the pores. I do recommend photofacials in some individuals, typically I suggest it be done every 4 weeks or so until the skin is where you desire and then every 2 months or so for maintaining it. JG 7.8.10
Answer: I always use a post tragus incision to hide the scar, even in males. JG 7.8.10
Answer: it makes no medical sense and I would not recommend it. JG 7.8.10
Answer: I would not store it in a diluted fashion, there is also no need to reconstitute it, all the triamcinolone I have used comes already mixed. JG 7.8.10
Answer: they will say that in their experience they work well, but I think the cannot show that their results are consistent from patient to patient when asked, so I guess they do it as a marketing thing, maybe they charge more for the than regular off the shelf fillers too. JG 7.8.10
Answer: that would be the only one I would recommend to a patient. JG 7.8.10
Answer: no, but we do offer financing through an outside company. JG 7.8.10
Answer: will likely not do much for the wrinkles, sorry. JG 7.7.10
Answer: a rhinoplasty should not cause a runny nose, assuming no complications. A runny nose might indicate a sinus problem or allergies, so I am nto sure what it is you will need. I doubt it is due to the surgical procedure, but I think checking to make sure there is no fluid coming from the sinus or other areas from the fracture needs to be ruled out. A very rare issue could be a cerebrospinal fluid leak from an ethmoid fracture. JG 7.7.10
Answer: visually the differences are small, but silicone coems in a greater variety of shapes and sizes, I usually use silicone for that reason, to have a semi-customized option. Removal is relatively similar and placing them is essentially similar. JG 7.7.10
Answer: there is a $50 consultation fee that is applied towards your surgery if you proceed. I woudl welcome you to call us and schedule consultation so we can disclose your personal issues. Looking forward to see you whenever you have time. JG 7.7.10
Answer: as to why they use them, I am not sure, it seems like they feel the patient is already asleep for something else so its not a big additional thing. JG 7.7.10
Answer: I would do about a 30% TCA peel. I think the tightening will be short lived I am afraid with chemical peels though. As to why no one has a fractional laser in your area, to be honest, that is surprising as the sales reps were very aggressive in selling them. JG 7.7.10
Answer: I would do a CO2 laser, preferentially over a chemical peel for what ails you. I think totally ablative lasers are more effective but you could try a fractional CO2 laser to see if that migth be enough at your age. Most dermatologists and some plastic surgeons have them, so ask if they do CO2 laser, fractional or not. I would skip any RF procedures, their scientific backing of claims is essentially none. JG 7.7.10
Answer: a couple of days after the sutures are out is OK. JG 7.7.10
Answer: I like to do the fillers after myself, in order to see exactly where it needs to be placed when there is no swelling, you can use Restylane for all of those areas is you wish. JG 7.7.10
Answer: because I think it will not give you much improvment.If you are looking for skin tone improvement I would suggest something like a light CO2 laser or a deepr chemical peel, I am not a big fan of fractional lasers but if you need very little help, they might do the job. JG 7.7.10
Answer: Restylane or Perlane could be used there also. JG 7.7.10
Answer: I would ask for your money back. JG 7.7.10
Answer: pain pill will help some, yes. JG 7.7.10
Answer: see adjacent response.
Answer: once stitches are out you can use Mederma or ScarGuard, it will take a full year for maximum fading of the scars though, best of luck. JG 7.7.10
Answer: I persoanlly do not know the injection practices of doctors in that area I am afraid. The 5FU injections can be given as soon as you find someone to do them for you, all the best. JG 7.7.10
Answer: the fat transplanted will behave like the fat does from where it was taken, so it can, if it survives, grow more than the normal facial fat, and you do not have fat in the lips normally either. All the best. JG 7.7.10
Answer: it is out, but what attaches the sling to the tissues up higher can break and allow it to loosen once again, also, usually the aging neck is looser muscles and skin and if the skin is not treated, the results are not good. All the best and thanks for the kind words. JG 7.7.10
Answer: good as long as you keep the brush new frequently. JG 7.7.10
Answer: well, a lift alone will leave you more perky for a while but the same cup size, a lift with an implant will make you more perky for less time than a lift alone due to the additional weight and will also make you larger, a reduction will make you more perky for a period of time and smaller, and a reduction with an implant does not make sense to remove what you have naturally and replace it with something that has the chance of rupture or scar tissue. If you are happy with your breast size, just get the lift alone. JG 7.6.10
Answer: not permanent, nothing that should be done to corect it besides waiting, but it will take weeks to look like it used to. I would avoid putting anything on it now for fear of causing more irritation. I do not think that waxing has any negative long term effects on the skin. Best of luck. JG 7.6.10
Answer: they are essentially the same thing in terms of their effects on the skin but the FDA has chosen to classify Tazorac as more restrictive, I cannto speak as to why they made that decision besides potential fetal development questions that were reported or feared possible. I have had patients that were using Retin-A and became pregnant and then stopped using it, showing no adverse effects. It is more of an issue of development of the fetus rather than damage to the eggs before fertilization from what I have read. JG 7.6.10
Answer: that short of a term of filling should not leave any negative effects if you have it dissolved now. The hyaluronidase used to dissolve the injection material should not have any negative long term efects on your normal tissues. Best of luck. JG 7.6.10
Answer: all normal at this point, most of the swelling will take 4-6 weeks to look better and final results might take up tp 6 months. Hang in there. JG 7.5.10
Answer: I am sorry but I do nto have anything I can offer you, Botox or Dysport have been used for excess sweating in armpits and plams but injecting your whole face is impractical and could weaken facial muscles that you do not want weakened. JG 7.5.10
Answer: as for skin tightening, no, I do not find them effective and potentially can lose fat on the face on an irregualr basis. As to using it for melting fat, I think it is highly unpredictable and would not recommend it be used. JG 7.5.10
Answer: dissolving might help, the allergic raction is very very rare and would include, a surrounding rash, itching, diffuse swellin past the are of injection and if it is sever enough there will be itching and swelling far away form the injection site. JG 7.4.10
Answer: none have been tested, sorry. JG 7.4.10
Answer: can be done as you say. JG 7.4.10
Answer: well, another surgery will not affect swelling and that is what it sounds that it is, swelling goes up and down whereas structutal changes that would be made better with surgery to do not go up and down. Low dose steroids can be tried. All the best. JG 7.3.10
Answer: it more likely affects the egg after fertilization as it develops rather than causing egg damage. JG 7.3.10
Answer: it will lift the outer part of the eye brow in most patients, the amount of lift varies though. The lift between the eyebrows is less but will work too. Best of luck. JG 7.3.10
Answer: there is no age at which it stops as wounds will always heal, there are also the variables of amount of sun damage of the skin that can lower the ability to create collagen, and also the effect of genetics. Those treatments will likely slow the progression down but not halt it or reverse it to any great degree. All the best. JG 7.2.10
Answer: the skin will not look anywhere near normal as the skin graft would leave a depressed scar with no subcutaneous tissue, just scarred skin and muscle. I haver never agreed to do that for that specific reason, in a small number of cases, where the tattoo is very small, I have cut them out and closed the wound, leaving a longer wider scar, but I have never skin grafted one, sorry. JG 7.2.10
Answer: an allergic reaction is uncommon to get better and worse like that from day to day, and a cyst would nto go up on down. It is an unusual thing to say the least. Might want to try avoid sleeping on that side of your face to begin with, and I would certainly tak ethe pills prescribed just in case. Without a discrete mass in one single area that does not go up and down I do not think intralesional steroids or hyaluronidase will work. You might want to contact the company that makes Teosyl and they might have something else to offer. All the best. JG 7.2.10
Answer: yes, as long as you do not have to lay face down on the MRI, and that is rare. JG 7.2.10
Answer: they can be mixed together. JG 7.2.10
Answer: it can cause some bunching of the skin as there is no skin removed and once the suture breaks, and it will, then all goes back to where it was. Best of luck. JG 7.1.10
Answer: if they are brown, maybe. JG 7.1.10
Answer: I feel Potrait is better as it treats all of the skin rather than leaving numerous skip spots untreated but the Portrait company went out of business and there are only a few of us that still have the tips to treat patients. It should be done after the cheeklift and neither one will replace a cheek lift, as to how many treatments wil be needed, it depends on how badly damaged the skin is. Best of luck. JG 7.1.10
Answer: no, it will not alter anything that is planned. Best of luck. JG 6.30.10
Answer: yes, but a CAT scan is a little more accurate. Just need to get a good lateral view is all. JG 6.30.10
Answer: there will be a scar where the incision is made, it is no different than removing a cyst or other mass below the surface of the skin, he likely does not want to get involved with something that went bad. The scar should be relatively small, no longer than the size of the lump. Best of luck. JG 6.30.10
Answer: they also have glycolic acids in them, or at least most of them. Exfoliation is by definition harsh though, less harsh, less exfoliation, and in weathered skin, it is more difficult to exfoliate initially due to the thicker keratin layer. I am afraid if it is too harsh for you then you might need to use microdermabrasions or IPL treatments to exfoliate as they are not done daily and you migth be able to tolerate them better, at least by the next day. JG 6.30.10
Answer: the Fraxel works by irritating the skin and causes new collagen to form, that takes about 4-6 weeks, and then the collagen crossfibers tighten, that takes the 4-6 months. I think you are far out enough that the Retin-A could be used on the neck, start every other night and increase as tolerated. Peels can be done on the neck but the wrinkle reduction is small to none. If all else fails, surgery stil remains an option. All the best. JG 6.30.10
Answer: if it is going to work you will start to see that within 6 weeks and that is the point a repeat injection could be done, in terms of negative effects like soft tissue atrophy or loss,and dilated skin blood vessels and skin thinning, that can continue for up to 6 months. JG 6.30.10
Answer: they usually do go away on their own in time, yes JG. 6.30.10
Answer: you either need to go to a stronger TCA, 35% or higher or to a YAG laser. JG 6.29.10
Answer: they will not come back immediately unless you go out in the sun without protection, no matter what treatment you have used. Lasers do help, but there is no way to guarantee the laser will entirely remove the spot. JG 6.29.10
Answer: same, no difference, they are essentially the same thing. JG 6.29.10
Answer: yes. JG 6.29.10
Answer: I think it best to stop it until the baby is born and you are done breast feeding, although the amount absorbed is likely small, but no need to take chances. I do think it is early enough that the risk of damage to the baby is extremely small. Congrats on the baby and all the best. JG 6.29.10
Answer: 3-4 weeks. JG 6.29.10
Answer: any hydroxy acid peel should help. JG 6.29.10
Answer: I do not think they are vastly superior but they are good, minimal risk and minimal to no downtime, might be worth having them every so often as a way to slow the progression. JG 6.29.10
Answer: it will nto last as long as the other fillers out there, sorry. JG 6.28.10
Answer: most celebrities, because they can afford to hide out for awhile and not have to work, do lesser procedures more often than those of us that work for a living in normal jobs. That can make the subtle changes be seen less as they get it done over and over again, no way to tell how many, but likely many. JG 6.28.10
Answer: my educated guess is way too many. I know she is a fan of plastic surgery, but her skin, albeit smooth, likely does not look as good without her makeup and does not move that way normal healthy skin should move. Things that look good from afar are sometimes far from good. JG 6.28.10
Answer: if it was Juvederm, it shoudl all dissolve in about one year on its own in that area, you can always have more dissolved though with the hyaluronidase too. Best of luck. JG 6.28.10
Answer: the skin tone is not affected by the liposuction, if you had good tone before, then it will remain good. Good skin before liposuction yields a better result after the lipo than in someone that has poor skin tone. But the most important factor is amount of fat removed. Peopel with good skin tone that have large volumes of fat removed from one area can still be left with loose skin I am afraid. Final skin tightening will take up to 6 months as the skin cannot fully tighten until all the swelling is gone. All the best. JG 6.28.10
Answer: yes, could be a small cyst, might need to be drained with a needle by the doctor, all the best. JG 6.28.10
Answer: I let patients return to full activity the next day. I have them avoid putting their head down and most importantly not lay face down for 4 hours. Best of luck. JG 6.28.10
Answer: I would need to know what filler was injected in order to help you. JG 6.28.10
Answer: best thing is to call and ask them if they do revision rhinoplasties, there is no place to look that for that information. Best of lcuk. JG 6.27.10
Answer: it wil not change nostril size,it will usually need top be done to the corners so that they do not droop and the lip volume will not be larger, although more red lip will be seen. JG 6.27.10
Answer: TSH, reverse T3, free T3 and free T4. JG 6.27.10
Answer: well the CO2 might help the crepey skin and the only surgery that might help would be to place fat underneath the dark circle to fill it in and help the light reflect better. Best of luck. JG 6.27.10
Answer: sure, moist tea bags work well too. Lymphatic drainage likewise will help. I have not seen any muscle flaps work for the bag I am afraid. All the best. JG 6.27.10
Answer: you have lost about 80% of the amount injected and now your body is helping to create some collagen around the longer term material in the Radiesse. It is hard to convert amount of filler injected to an implant,because their location is different, with the filler being more superficial and a smaler amount giving a larger degree of improvement. Best of luck. JG 6.27.10
Answer: after 4-6 weeks we use Retin-A and hydroquinone until healed to avoid hyperpigmentation and then we go the usual moisturizers and sunblock. JG 6.27.10
Answer: lifting procedures, no matter which one, will recreate the lost facial fat, they will just lift the tissues that exist into a higher position is all. Best of luck. JG 6.27.10
Answer: will likely not help. JG 6.27.10
Answer: sorry, it is injections or surgery. JG 6.27.10
Answer: I normally use Sculptra. JG 6.27.10
Answer: it should not, no. JG 6.27.10
Answer: if you are eating well like that you can skip the Vitamin C, yes. JG 6.27.10
Answer: I think the tanner is best on top, OK to use the Vitamin C before the tanner though. JG 6.27.10
Answer: it is due the the capability of the skin on that area to heal from that type of injury. JG 6.27.10
Answer: maybe 6 weeks but effects can last 6 months. If it is going to work you should see something in 6 weeks. JG 6.27.10
Answer: that is my first choice for that area, fat would be my second choice, but causes more swelling I feel, and does not last any longer. Best of luck. JG 6.27.10
Answer: eventually, no matter what you, with sunlight and florescent light exposure, they will come back, nothing is permanent as the skin cells have memory. JG 6.25.10
Answer: should not affect your heart. The issues you describe from the previous injections are due to location of the injection, and not the medication per se. The feeling tired occurs from the brows dropping in some cases and the one brow arching more is because as the motor end plates that were affected by the Botox are slowly replaced the replacement rates are not always even side to side. Usually it is a subtle difference but in some people, if the effect from the Botox was more profound, it can be more evident as it wears off. Best of luck. JG 6.25.10
Answer: no, Mederma helps the wounds mature, heal and fade and once they have done that, they do not return to the way they were. As to returning to the same after Retin-A, that only occurs because once you stop using the Retin-A, since it did nothing to halt the aging process, your skin will age once again. JG 6.25.10
Answer: minifacelift will do nothing for the temple hollows. If there is fat atropy in the upper face and temple, the only thing that will help is fillers, pulling the skin tighter will not give a more natural appearance in that scenario, if anything, it will accentuate the hollowness by pulling the skin over the boney prominences tighter. JG 6.25.10
Answer: if the saline does not work they can dissolve on their own in some cases, but if a true granuloma has formed, then they might need to be cut out, yes. Waiting a few days for the saline injections is oK but the sooner they are injected the greater the chance of them dissolving with the saline. JG 6.25.10
Answer: sorry, but no, they will not. JG 6.25.10
Answer: no lasers work on lighter spots I feel, as for the darker ones we use a YAG laser. JG 6.25.10
Answer: shoul be Ok ot do the laser 3 days after the injection, minimal to no effect on the filler. JG 6.25.10
Answer: pretty similar, not much difference I think. JG 6.24.10
Answer: I think if it is still there your only option is to try to dissolve it once more, all the best. JG 6.24.10
Answer: hard to really say, if there are stretch marks in the area I doubt it, that location just does not have great elasticity, even in younger patients, and there is no chart that says this amount of fat removal is safe and more is not safe, sorry, wish I had a more concrete answer for you. JG 6.24.10
Answer: I suggest longer than 6 months, preferably 12 months or longer, all depends on how deep they go. Also, there is a law of diminshing returns, as you get older you will get less from the repeated treatments, no matter fractional or not, it is related to your skin`s ability to create new collagen. As to the limit on the number, the deeper they go, the fewer the number that can be done but there is no set number of treatments one can have as skin thickness varies from patient to patient. All the best. JG 6.24.10
Answer: I think Vitamin A derivatives are just weak Retin-A, can be used, do help, easily found. I think Vitamin C serums are also good at a 10% strength, and I think the Oil of Olay Regenerist line, for the money, is a very good product. As to peels, for maintaining things a light alpha hydroxy acid peel every 6-8 weeks is OK, along with sunblock, no more sunscreen. All the best. JG 6.24.10
Answer: should be OK to use now. JG 6.24.10
Answer: most likley the laser is a better option at this stage as it is likely more a skin quality than a skin quantity issues. Removing skin is only for excess quantity. Glad you are enjoying the peptide and all the best. JG 6.24.10
Answer: I rarely use Retin-A over scars as it can irritate the scars and keep them red longer but if you are set on it, apply the Retin-A first, wait ten minutes and then the Mederma over it. Best of luck and glad I have helped in the past. JG 6.23.10
Answer: my German is rusty but there appears to be not significantly different from most things out there already an dlikey costing less than Byonik, but the packaging is very nice. JG 6.23.10
Answer: personally I would go with the regular CO2 at this point, it was a light treatment, and yes, you had problems, but the skin should be healed enough I feel to proceed. Thinking that the Fractional laser is any safer in terms of time for the original treatment I think is not a real concern. I understand the desire to decrease risk, or at least think you are reducing risk with a fractional laser ( I don`t agree it reduces anything except the result), but I think ultimately you will require the regular CO2 when it is all said and done. All the best. JG 6.23.10
Answer: might take 4-6 weeks for it to totally be gone, warm moist heat will help the blood clot liquify and it cannot be absorbed until the blood actually gets liquid like, that is what makes it take some time. Being able to push it out when the sutures were removed is not common as at that point in time it is rarely liquified enough to be able to be pushed out. Massage, heat and time will make it better. JG 6.23.10
Answer: I do not think laser, fillers, creams or a temporal lift will help, they are caused by fluid seeping out under the skin between the the muscles of the eyelid and cheek where a small dehisence or separation occurs with age and the fluid collects there. They can occur after the surgery you describe but usually get better with time. Head elevation, avoiding salt, and even at times using the light blocker masks that people wear over their eyes at sleep time to avoid the light getting in can apply some slight pressure that will help in some case. I think in time it will get better, but vrry slowly. All the best. JG 6.23.10
Answer: sorry, but the effect is not very effective, migth help fat injections survive better and does decrease swelling and speeds heaing during open surgery, that is how I use products like that, but just injecting parts of blood taken from one`s body in the hope of long term wrinkle reduction is hype and fallacy.JG 6.23.10
Answer: correct, nothing above the jawline will improve with an isolated necklift. Best of luck. JG 6.23.10
Answer: ScarGuard or Mederma are good. JG 6.23.10
Answer: sorry, but no. JG 6.22.10
Answer: it is easier to do it that way. A different doctor can remove it, if they are willing to take over a project half way through, not always easy to find someone that will do that though. JG 6.22.10
Answer: I think Sculptra is much better and unfortunately I have not been able to use the Restylane Sub Q personally yet as it is not legal in the US but would use it if I could. I think seeing a different PS, at last for a second opinion, is a worthwhile thing. I think offering only one type of filler limits you on what could be in the patient`s best interest. Not all fillers are good for all patients. All the best. JG 6.22.10
Answer: Retin-A is a Vitamin A derivative but OTC Vitamin A products are not as strong as Retin-A so I do not think the skin will get crepey. Best of luck. JG 6.22.10
Answer: in general, the effects of vitamins on the skin marketed for anti-aging are nothing special, most multii-vitamins, as long as you add an Omega 3 fish oil, will be plenty. As to celebrity products, they are getting paid to endorse it and they likely had no influence in what went into the product, but they will probably be more expensive than needed in order to pay the celebrity. JG 6.22.10
Answer: if tolerated, it is OK over the Retin-A, as to which is better, they are the same, most people seem to like the gel though. No experience with their glycolic acid product but it is likely OK to use. JG 6.22.10
Answer: it varies, we have been using it there for a few years and in general the results are quite good, but it takes a lot of experience and the learning curve is steep. JG 6.22.10
Answer: no, it is just a bruise that is slowly breaking down and being absorbed, should not be permanent. A deeper injection might leave a less visible bruise, but if it is large enough, you will eventually see it too. The depth the filler is injected depends on what you are injecting and for what you are injecting for. I rarely feel that injecting on the bone is needed or yields a good result. It is best to inject in the same layer as the material you are trying to replace. Best of luck. JG 6.22.10
Answer: I would use a YAG for spot treatments rather than a Fraxel. JG 6.21.10
Answer: in most cases, over time, the grafts do flatten and smooth out, yes, but SLOWLY. No worries about the questions, that is what I do, best of luck. JG 6.21.10
Answer: the hard palate graft is placed under the eyelid muscle, it actually replaces the mucosa and the cartilage tarsal plate of the inner lid, the pink mucosa that lines the inside of the eyelid, and then the other tissue, with or without a tissue advancement or skin graft is placeed over it. It will look like a large bulge as there is significant swelling after the surgery but it might be the only way to get your eyelid back to where it needs to be. I think asking the eye surgeon if they plan on doing a skin grat or lifting your cheek tissues up is a good thing to know so they can describe it more in depth for you. Best of luck. JG 6.21.10
Answer: there is no cloning available for huamn tissue at the present time. JG 6.21.10
Answer: I would only do it under general anesthesia, yes. JG 6.21.10
Answer: it can be a good procedure if the skin of the upper lip has fallen or stretched, but if the distance between the nose and lip is due to an excessive amount off upper jawbone, then the bull horn lift will not help, in that case the bone needs to be reduced, usually done by oral surgeons. If your upper lip used to be higher and has dropped with age, then the bull horn lift is a good option and the scars usually heal quite well. Best of luck. JG 6.21.10
Answer: I think it is a scam as Botox or other neurotoxins cannot tighten muscles as the purpose of the toxin is to weakedn or partially parlayze the muslce, I would not perfrom or nor recommend it. JG 6.21.10
Answer: It is always a good idea to let all the material be gone beofre starting over to have a clean slate to build upon. Having said that, I think the green and purple patches were from bleeding and not the material being injected too superficially.Bleeding is a risk with all fillers, even if injected deeper as the needle still has to go through the skin and can injure a blod vessel and cause it. I fear that injecting Juvederm deepely, where it is not meant to be injected, will last a very short period of time. Best of luck. JG 6.21.10
Answer: yes, I do not feel they are worth the money, sorry. JG 6.21.10
Answer: sorry, waste of time. JG 6.11.10
Answer: all the best to you. JG 6.10.10
Answer: not Retin-A as it will make it worse, but yes for the Mederma. I have heard of Strivectin, have had patients try it and I am not a believer in it, sorry. JG 6.10.10
Answer: I do not use Sculptra in the nasolabial fold itself, I use it only to fill in areas where fat has dissolved and that is not what causes a nasolabial fold to become visible. I have on a small number of cases injected Restyalne into the fold and Sculptra into the cheek at the same time to give some effacement of the fold while waiting for the fullnes of the Sculptra to kick in.The only product I use in the tear trough is Restylane. And how did you know I like Rock Music?! Best of luck. JG 6.10.10
Answer: doubtful there is any relation to the old Dermalive or interaction to the Teosyl, just due to the removal there is more scar tissue there and scar tissue bleeds more easily than normal non-scarred tissue. Hang in there for a bit, it will get better. JG 6.10.10
Answer: might still have the same risk. JG 6.10.10
Answer: could be an infection but more likely it is some blood from the injection that is deep and your body is trying to break it down. I think the antibiotics and anti-inflammatories are fine, along with alternating warm and cold packs too. Best of luck. JG 6.10.10
Answer: save your money, both will not give you much. JG 6.10.10
Answer: well, here is the info. PDT with Levulan is approved for the removal of premalignant skin cells. It is used by many for fine lines, texture and wrinkles, but it has never been FDA approved for that nor do I think it ever will be. The use of PDT and Levulan together is to try to use a machine they already have, the PDT, in other ways to help pay for the cost of the machine. Once you add the Levulan, the safety profile of the PDT is gone and essentially you have nothing better than a chemical peel, which would have cost you lots less money. As to building collagen, yes it does take time, and you might see some improvement with some more time passing, but in my humble personal opinion, with what you are describing, I think you have wasted your moeny. I feel it is marginally effective for fine lines and texture and when you add in the risks of hyperpigmentation, I think it is not worth the money or risk. Sorry. Also, thank you for the kind words. JG 6.10.10
Answer: I cannot say without knowing the amount of units that were injected, typically for the glabella where the lines that form an 11 are, it takes at least 20 units, I use 30 units there. The number of needle sticks is immaterial because it depends on what amount is injected. The end results depend on where it is injected and the dose injected.JG 6.10.10
Answer: warm moist heat, can also apply Arnica gel topically, it is too late for the Vitamin K, that helps the bruise from happening, but it already has. I think you have a bruise and not a Tindall effect. Hang in there. JG 6.10.10
Answer: because Pearlane is meant for a deeper injection and the skin in the tear trough is too thin and Perlane might leave lumps. I agree that Botox can lift he brows but the injection site does not vary, I know thati s what you believe and what you have seen but as a plastic surgeon that has seen the actual muslces that are injected thousands of times during surgery and in view that the Botox migrates after injection as it disperses, there is no need to frown. You are free to believe what you want, but it is not needed. If you understand the function of Botox, you woudl understand that injecting the muslces that depress the brow and leave the muscles that elevate the brow unjected, it is common and expected that the area not injected will rise and will also show wrinkles where the unopposed muscle is continuing to work. Where the Dr focuses depends on what is being attemtpted to be acheived. Whether the injection works depends not only on location but on the dose of medicine injected. If the correct place is injectd with too low of a dose, it will not work and I think that is likely what happened in your case. 6.10.10
Answer: I would save your money. 6.10.10
Answer: thanks for the kind words. As to clarification, I typically use Restylane for the nasolabial fold itself and I use Sculptra to reinflate the cheeks from fat loss. If the nasolabial fold is due to the skin falling from fat being lost, then filling the cheek can improve the nasolabial fold. If the cause of the nasolabial fold is not loss of cheek volume, then filling the cheek will not is not fix the nasolabial fold area. All the best. JG 6.10.10
Answer: I know the company says it increases collagen production but after years of injecting it personally into hundreds of patients, I think the amount of collagen produced in not visible clinically. As to Sculptra, since it depends on the body creating new collagen and the ability to produce collagen is better in younger rather than older patients, I think the answer is the reverse of what you have read, it works better the younger you are. Filling in the cheeks can make the folds appear deeper in certain lighting. All the best. JG 6.9.10
Answer: you are certainly free to hold your opinion but I respectfully disagree as to the Botox and needing to frown. As it is a chemodernervation agent and not a filler, the location of the wrinkle is absolutely inconsequential, as the muscles are in the same place in all patients and the Botox has to diffuse. For fillers I agree it is nice to see the wrinkle to see where you need to inject. As to the tear trough, the only filler I use is Restylane. As to the nasolabil fold I use Restylane and on rare occasiosn Perlane. I would never use Perlane for the tear trough. All the best. JG 6.9.10
Answer: well, if the skin was too stiff from the previous insults, it might not have been elastic enough to pull tight, or the surgeon pulled as tight as they felt was possible and not too much in order to avoid increased tension at the incision that could lead to poor healing. I think those two are likely the most common causes.At times when there is alot of scar tissue after previous surgery the tissues are difficult to separate from the muscles and that can limit the degree of improvemnet in some cases. Sorry to hear about the problems and I wish you the best. JG 6.9.10
Answer: I do not think it is necessary to flex the muscles to know where to inject the Botox. As to what effect the Botox is having in terms of where it was injected, you got exactly what is expected, the inability to raise the eyebrows as the forehead muscles have been weakened. Having said that, not all patients are good candidates for fillers, they do not give everyone the desired look and you might just not be a good candidate for fillers I am afraid. It seems you have tried multiple fillers and multiple doctors to no avail, might need to accept things as they are and await until things get bad enough to warrant surgery. JG 6.9.10
Answer: to some extent yes, but the issues of environmental damage and smoking are not influenced to any great degree,it will certainly help the effects of diminished hormone levels on the skin though. JG 6.9.10
Answer: could try TCA chemical peels or a YAG laser, also need to use hydroquinoe at the same time,sorry to hear about the problems. JG 6.9.10
Answer: Tindall is blue and will not fade whereas the bruise will turn green yellow and fade over time. JG 6.9.10
Answer: might help the penetration a little, yes. JG 6.9.10
Answer: I think so, yes, the implant would not have that risk, but it would have other risks. I know you have read about necrosis and the angular artery but it is almost unheard of when comapred to the many injections with no problems. Bad occurances get magnified because people like to hear and write about disasters, normal outcomes do not get reported on as much. JG 6.9.10
Answer: less of a risk, but I think in general, the risks are small, even in inexperienced hands. When you compare the number of injections performed versus the reported adverse events, the numbers are incredibly small. JG 6.8.10
Answer: I am sorry, btu there is no way to tell because it depends over what size area and vertical height it is injected, you are asking for an answer that is impossible to calcualte. JG 6.8.10
Answer: it can be done in many cases as long as the bone is thick. JG 6.8.10
Answer: correct. JG 6.8.10
Answer: just answered it, sorry. JG 6.8.10
Answer: the two fingers to push the fluid onto the cheeks.JG 6.8.10
Answer: likely, if on the nose alone, about 7-10 days before make up can be applied to hide it, it will be red for a few weeks too. You can send the photos to drgarcia@lvcosmeticsurgery.com, if you would like. JG 6.8.10
Answer: it is hard for me to give very specific answers without seeing you, but a guess woudl be one or two CO2 laser treatments, more if they are a fractional or pixelated CO2 laser. As to the filler, it is an option for indented scars but is not permanent, there are longer lasting fillers but I suggest trying something like Restylane first as if it does nto work well it can be easily dissolved. In some cases the most expeditious option is to accept a scar and have the spot cut out and sutured closed, it is quicker and reliable in most cases, but does leave a permanent scar. JG 6.8.10
Answer: in cases of a burn and only in a burn, the deeper the injury the less it bleeds as the burn has clotted off the blood vessels. JG 6.8.10
Answer: save your money. JG 6.8.10
Answer: the liposuction can be done after the Zerona fails. I do not perform nor believe the hype with Zerona, it is technology that has been around for a long time, has very little to any science to prove its effectiveness and is just preying on patient`s hopes and dreams of avoiding surgery. I personally think it is a scam to try to get patients in to try and then switch them over to liposuction, sorry. Best of luck. JG 6.8.10
Answer: I think the scar from the excision can heal well, and at other times can be seen easily, at your age, not something I would recommend. As to the Surgiwire, it still needs a filler to be interposed to avoid the tissues from reattaching. I think it is a short term fix in most cases. At your age I cannot imagine that the skin is in excess so cutting skin out with a minilift would leave you looking pulled. I do think Sculptra, to try to refill the fullness or rounded appearance of the cheeks is a good option. The younger one is the more robust the creation of your own collagen is with Sculptra. Just remember the Sculptra takes 4 to 6 months to show its final effects and you might need more than one vial and then a touch up down the road, so be patient. Sculptra is likely what I would suggest to you. All the best and thanks for the kind words. JG 6.8.10
Answer: there is no such thing as a safe dose I am afraid, atrophy can happen at any dose, but the risks increases the greater the amount of kenalog injected. If there is going to be Kenalog in it, it should not be done more than every 6 weeks, if it is 5FU alone, it can likely be re-injected every two weeks. JG 6.7.10
Answer: if it bleeds it is less deep, if it does not bleed it is a deeper burn. The deeper it is, the greater the chance for a scar I am afraid. I think seeing a neurologist is a good idea, many nerve issues are not seen on an MRI of the brain, I wish you the best. JG 6.7.10
Answer: the reason I am not a fan of fractional lasers is the expectations, they work in terms of a rlatively mild and short-lived degree of improvement. Most patients that come to see a plastic surgeon expect, to paraphrase Emeril Legasse, BAM! If you are looking for something stealthy that most people will wonder if something was done and accept that it will need to be done every 12 months or so, then the fractional lasers, no matter which company, are fine.I just think they get overhyped and promise things that are not true, the pictures they show are all too close to the last treatment to determine whether it was a wise investment.JG 6.7.10
Answer: I think a CO2 laser would be best if you are going to try a laser. As to fillers, I suggest trying Restylane first. You might need both. All the best. JG 6.7.10
Answer: safe, yes. Legal, yes. Effective, I seriously doubt it.I think stay with the weaker retinols in your case. The Skinceuticals or LaRoche Posay are fine to use. JG 6.7.10
Answer: impossible to tell what smaller procedure you would need until the filler has been injected and we see what effect and where it has made a difference. It might just be a smaller type of facelift with less lifting and less skin excised. Injecting fillers when not needed can make you face look distorted and unnatural, more is not always better though. JG 6.6.10
Answer: personally I would just let them heal on their own and not continue to irritate them. JG 6.6.10
Answer: it is technically possible for it to happen, but the skin stretches quite a bit so it would be hard to get it to happen. I think that is quite a bit to have injected, why not start with 2 cc and then wait a wek or two before getting more. All the best. JG 6.6.10
Answer: should get better but slowly over 4-6 months. Got to hang in there for a bit more. JG 6.6.10
Answer: I suggest not picking them off as they can pull the hair grafts out. Best of luck. JG 6.6.10
Answer: Vitamin B, C E and omega three fish oils. JG 6.6.10
Answer: you might be able to either avoid the facial surgery entirely or opt for a smaller procedure. All the best. JG 6.6.10
Answer: subQ, no problem with the questions. JG 6.6.10
Answer: nope. JG 6.6.10
Answer: lots better out there for less money, Oil of Olay Regenerist for example. JG 6.5.10
Answer: twice per day for a couple of minutes is all you need to do. More than that will not help and can irritate the skin. JG 6.5.10
Answer: I think with all you have been through that using the LaRoche or Skinceuticals is a good place to start, once tolerating them you can get some Retin-A 0.25% and start that by using it twice per week at night, increasing it slowly at night and once tolerating it adding the morning applications as tolerated. Best of luck. JG 6.5.10
Answer: seems that he uses the same picture a number of times and I agree, they are not the greatest. You can consider finding someone else, or at least have him do it in small amounts over a series of treatments. Best of luck. JG 6.5.10
Answer: it can if the cannula is used in that area, also as the skin shrinks, it might sag causing some deformities, the older one is and the larger the amount of fat removed the greater the risk of it occuring. JG 6.4.10
Answer: in some cases a small amount of skin can be removed to open the belly button more but it is hard to say without feeling the skin to see if that would work. JG 6.4.10
Answer: it is meant for deeper injections for fat loss, if injected around circular muscles like the mouth, it can cause lumps, you can use it for nasolabial fold lines but it depends on what is causing them, not always a good idea. JG 6.4.10
Answer: reasonable thing as long as the expectations are reasonable. JG 6.4.10
Answer: it should not be used on the lips or around the lips. JG 6.4.10
Answer: again, there is no increase risk of necrosis with Voluma than other fillers, and it likely needs ot be injected into the check to correct fat loss allowing the nasolabial fold to be more visible, and not directly into the nasolabial fold so the risk of necrosis shoudl be essentially nonexistent. Best of luck. JG 6.4.10
Answer: depends on what you are having injected, hard to believe a 28 yo has volume loss though unless you lost a large amount of weight. Unnatural appearance from a filler is likely more due to injection technique than the filler. JG 6.4.10
Answer: any filler, if injected into an artery, which is extremely rare in experienced hands, can cause necrosis by blocking the blood supply to the skin. I likely would not use Voluma in that area as it is meant for much deeper injection where fat has been lost, I would use the regular Restylane or Perlane for the nasolabial folds. All hyaluronic acids fillers are not interchangeable, just because they last longer does nto make them able to be used in the same way and in the same layer of skin just because you want it to last longer. JG 6.3.10
Answer: well, the honest truth I do not think very highly of any of them, lots of hype and little return for the investment. JG 6.3.10
Answer: although there is lots of hyaluronic acid in your joints, the chances of oral intake of that getting into your joints is almost impossible, it woudl be broken down into smaller fragments in your stomach and intestine and would not reconstitute into hyaluronc acid again on its own. Save your money. JG 6.3.10
Answer: in some areas, it might be warranted, but it does not have the versatility that Restylane has and Botox is not a filler, but a neurotoxin so its effects on wrinkles are secondary and not primary. JG 6.3.10
Answer: not, it just might cause some irritation as the Retin-A normally does that. I do not usually tell patients to mix it with Retin-A unless they are really set in their ways. JG 6.3.10
Answer: in most cases it should be gone on 6 weeks, rare for it to last longer than that unless something is causing it to reaccumulate, like a tearing of the tissues. JG 6.3.10
Answer: yes, that is very normal, will slowly decrease but you can occasionally get them even months later. JG 6.3.10
Answer: gentle massage after 8-10 days and more aggressive as the tenderness goes down. JG 6.3.10
Answer: the noise if from fluid around it. Solid materal like collagen or PMMA do not make noises. JG 6.3.10
Answer: well, I think under the foundation might be easier as it might smear the foundation if applied over it. JG 6.3.10
Answer: yes, most commonly it is a hyaluronic acid product. Thank you for the very kind words, and I am glad I have helped. JG 6.3.10
Answer: I think you will likely need both, I am afraid, sorry. JG 6.3.10
Answer: well, you are asking for tow things that are mutually exclusive, nothing good will be possible with the little downtime, you have to choose one or the other. JG 6.3.10
Answer: more likely it is the injector or how the mixed and stored the Dysport, tolerance has been discussed but not seen in clinical practice, especially after three injections. I prefer Dysport. JG 6.3.10
Answer: overpriced as it is a multi-level marketing company so you pay alot more than you need to for a product that is not significantly different than most on the market. JG 6.2.10
Answer: I guess you could, not sure how well it woudl work, as to celebrities, I suggest you hold off on wanting what they have if you have never seen them in person, many times what you think they look like is not like that in person. JG 6.2.10
Answer: YAG or VBeam, essentially one to two days with the YAG, maybe a week with the VBeam but the VBeam is more effective, both will likely need more than one session. All the best. JG 6.2.10
Answer: they leak and they might fill up faster then the skin can tolerate too. JG 6.2.10
Answer: nope, not meant to be injected into thin skin and you could get lumps. JG 6.2.10
Answer: would not use an osmotic tiseue expander, too unreliable and I think you would need at least 200cc if not more. JG 6.2.10
Answer: possibly, yes. Starting hormones now will not reverse what has already started though. I think electrolysis is yoru best bet and is effective too. Best of luck and thank you for the kind words. JG 6.2.10
Answer: you are very welcome. JG 6.2.10
Answer: rectangular or crescent shaped. The injection port is underneath the skin and usually is connected to the expander with tubing. The expander will likely need to be in place at least three months if not longer, all depends on how fast you can stretch the skin and then you need to let it sit for a month or two, removing it too soon leads to the ksin shrinking back and losing the effect of the expander. JG 6.2.10
Answer: placing the expander should not make the scar bumpy, but it is a significant deformity with the expander while it is in place. I think if the scar bothers you and the skin is tight, there is likely no other option though. Typically the pocket or capsule is not removed when the expander is removed in order to not damage the blood supply to the skin. Best of luck. JG 6.2.10
Answer: I think in most cases the bruising is gone in a few days, ice will help. I think if injected deeper, the bumps should be minimal to none. All the best and thanks for the kind words. JG 6.2.10
Answer: can happen and swelling does cause discomfort I am afraid. Ice and keeping your head elevated for now and you might want to drop by your surgeon`s office in a week or so for a quick check to make sure all is OK. Best of luck. JG 6.2.10
Answer: The facelift will help the acne scars for a while as as to the red veins, either a YAG or VBeam laser. Botox will lift the lateral eyebrow, it may take 10-20 units per side in most cases. JG 6.2.10
Answer: I feel Alexandrite is best for hair reduction and in general, in areas where the hair grows the slowest is where you will have tee best results. JG 6.2.10
Answer: well, I think the red spots can wait until after as transiently the red spots will get worse from the facelift. As to the acne scars, there will be some improvement of the scars from the facelift, so no need to do anything for them before. JG 6.2.10
Answer: I would use Sculptra for cheek augmetnation, and I inject deeply with that, at the deep surface of the skin. The Tyndall effect is when it is really superficial, and there is usually enough tissue on the cheek to avoid that. As to the under the eyes, I use Restylane there and I inject under the muscle. Could use Voluma for the cheeks in the UK.All the best. JG 6.2.10
Answer: the hardness is all normal from the swelling, that will also take a long time to resolve. I think you will be surprised at how much it will change over the next few months. Thanks for the kind words too. JG 6.2.10
Answer: it is not a simple thning and if the graft is removed it will likely go back to the way it was. I will say that swelling on the tip takes time to decrease and therefore a less than ideal appearance can take a long time to settle down, especially after a graft. I think that as long as the other things have gotten better I would suggest time and a little massage to help the swelling on the tip decrease, but it is a very slow process. Hang in there. JG 6.2.10
Answer: I think the result of fillers in the brow can lift the brow and therefore make the eyelid look like it has less excess skin, especially in patients that have the skin in excess due to fat atrophy from aging in the periorbital area. I have heard of it, seen it, and performed it. JG 6.1.10
Answer: yes, I do. I have seen it work in many of my patients, especially the ones that use bio-identical hormone replacement. JG 6.1.10
Answer: it can be normal in a small number of patients, bruising is always a risk, especially in that area as there are lots of small blood vessels and not alot of thick tissue to hide the bruise with. I think it might take a few more weeks, massage and warm packs will likely still help, although it is mostly a matter of time. All the best. JG 6.1.10
Answer: for loose skin, it would be surgery, for poor quality skin a laser would help, but not for a long period of time. JG 6.1.10
Answer: I would use Voluma. JG 6.1.10
Answer: no, it would not have a negative effect. JG 6.1.10
Answer: the acute swelling will take about 6 weeks and the rest of it might take up to one year. The tip wil drop soem in 4-6 weeks. Best of luck. JG 6.1.10
Answer: yes, we do, after a CO2 laser I like the patients to stay for about 10 days so I can evaluate healing and making sure there are no infections or viral break outs. I always treat the patients with antiviral and antibiotics and Retin-A cream first, if you are going to have the procedure with us we should do as much before you come out here, otherwise an in person consultation and then the procedure at a differnt time would be best. JG 6.1.10
Answer: well, that is one of the areas on the body with the least acceptable scars I am afraid, the act of sitting and walking places tension on those scars and they are usually not hairline scars, are wider and will many times migrate down below the inguinal crease where they are made to the upper part of the thigh making wearing revealing underwear or bathing suits difficult. I suggest you ask the doctor to see some examples of scars before you undertake the surgery and trade one thing you do not like for a new one you don`t like. All the best. JG 6.1.10
Answer: well, yes, if you never have a reset at a better level, you will look worse, better to get worse from a better point than build further aging on no improvement. The depressed scar in many if not all cases extends to the fat, that is why it is tethered. JG 6.1.10
Answer: more effective if done on spots, to be honest. Your own fat can be used, likely not too different than other fillers. The need for repeat treatments is because as the person ages, the skin gets looser and that makes the visibility of the scars re-appear. It is more for maintainence than progressive improvement as there will be a point at which no further improvement can be achieved. I would be happy to have you come here for a treatment but I think you can likely find someone that can do the treatment much closer and save you the costs of travel and hotel. Thnak you for the kind words too. JG 6.1.10
Answer: sorry , but no. JG 6.1.10
Answer: ia think you are a case for diet, exercise and weight loss and not liposuction. Liposuction should not be done to lose weight. Sorry. JG 6.1.10
Answer: ours is geared for all skin types, if you are going to buy OTC, by stuff for kids as they tend to have less problems with irritation. We have not had any problems with tolerance with our product but it can always happen. Best of luck. JG 5.27.10
Answer: back to light duty typically in two weeks, what the cost would be depends on whether you also have a breast lift at the same time to correct the loose skin, I would need to see you in person to tell you whether that would be needed. JG 5.27.10
Answer: only if you have an ectropion, if your issue is just a smaller and rounded opening of the eye and no ectropion, then the hard palate graft will not help. I cannot say that would be indicated in your case without seeing at least pictures, but an in person exam is better.If a hard palate graft is required, it is taken from the roof of the mouth, yes. It is placed through a transcutaneous incision in most cases. I have performed them. I might suggest sending at least pictures to drgarcia@lvcosmeticsurgery.com and that way I can give you a better idea before coming in. JG 5.27.10
Answer: In most cases I have seen the material dries up and is very hard to inject after it is stored. I am unsure as to the stability after mixing it with local anesthetic and I do not think that has been tested by the company. The Botox shoudl be injected within 4 hours and the bottle should not be shared between patients for fear of transmiting hepatitis, the bottle specifically says single patient use and using the bottle among multiple patients is illegal. If injected with Botox that is older than 4 hours of being mixed is something that might just show less effective length of time, so it just will not last as long. JG 5.26.10
Answer: in cases like yorus, where there is not enough skin to begin with, my fear is that the orbital rim implants will stretch the skin even more and pull the lower lid away from the globe of the eye, I cannot see how that would help you. A hard palate graft will sometimes be needed but that is more for ectropion rather than a rounded canthus. I do nto agree with the plan but it is hard to say 100% without seeing you and touching the tissues to see their pliability. JG 5.26.10
Answer: hard for me to say but in most cases of a rounded canthus, it is due to not enough skin and further tightening usually will not help, it many times will need a skin flap to replace some of the previously excised skin and allow the length of the eyeid to get longer, not shorter. Best of luck and sorry to hear about the problems. JG 5.26.10
Answer: not sure why that woudl happen only on your forehead, are you using some hair products that you leave in your hair? JG 5.26.10
Answer: I do not think that is nearly enough to give a good long lasting effect. If you are doing the horizontal lines of the forehead along with the glabella and crows feet I usually inject a total of 100 units. If injecting the glabella and the crows feet I like to inject 70 units but I will at times compromise and only inject 50 as the bottles come in 50 or 100 untis doses and bottles are strictly prohibited from being shared between patients, if the docotr is doing that it is not legal and potentially dangerous for hepatitis transmission. JG 5.26.10
Answer: the tissue expander surgery option would cost more as there would be two surgeries and the cost of the expander too. There is no cost difference on the expander size, they are all the same price. JG 5.26.10
Answer: in most cases it can be done that way, yes. JG 5.26.10
Answer: I am sorry but I would not prefrom a resurfacing laser on your type skin due to the high risk of complications. The YAG might be OK for the redness if done in a series of sessions but there is no laser that will give you much for the scarring. JG 5.26.10
Answer: insurance should cover that for you, I am pretty sure that after that amount of time they are ruptured, you would be on light duty, no lifting more than 20 pounds for two weeks and full activity in 4-6 weeks. If you do not desire to go through your insurance carrier I would be happy to see you in consultation to give you the fee, hard for me to say without seeing you and determining what time would be involved. JG 5.25.10
Answer: 6-8 weeks. Thank for the kind words too. JG 5.26.10
Answer: I do nok think a single treatment will be effective for both, what helps the red will not help the scars and what helps the scars will make the redness worse, at least short term, sorry. JG 5.25.10
Answer: no fillers that will do that in a scar and as to how long the Radiesse will last will depend entirely on how deep they injected it, my guess is nto too long. Subcision will help some on its own, yes, but only mild. It is done under local anesthesia and should not hurt.The ice pick scars can be cut out and stitched closed. JG 5.25.10
Answer: fillers are hard to get right, maybe a series of microdermabrasions is about the safest thing I can suggest at this point. JG 5.25.10
Answer: actually should be the opposite as there should be less oil, maybe the fewer wrinkles reflect the light more, not sure why you see that. JG 5.25.10
Answer: anything to make it look worse is rare, and should get better in time, I have not seen any cases of fat loss with a 1540 laser and that would be the only thing that could make it worse long term. Should be better in another 2-6 weeks. Not much you can do at this point except sit and wait I am afraid. Congratulations and best of luck with the wedding, hang in there for now. JG 5.25.10
Answer: I honestly cannot say because I would never use a CO2 laser that is fractionated as I think it skips too much area for it to be effective past the time interval of swelling. If I were to use a laser for acne scarring it would be a completely ablative CO2 laser, not pixelated or fractionated. sorry. JG 5.25.10
Answer: you can have a cartilage graft from a donor bank if you do not want the rib used. In most cases the size of the graft from the septum for this is small though. I think fillers have not done the job well for you and I would suggest the surgical option for you rather than silicone injections. Best of luck. JG 5.25.10
Answer: I think in Indian skin with those problems you will get little improvement with either the Fraxel ReStore or the IPL as they cannot be used too strongly. It is best to do the Accutane first to control the acne, wait 6-12 months for the skin to regain its ability to heal and then do the treatment. If you break out after the treatments then there will be new scars that will not have been improved with the treatment. JG 5.25.10
Answer: not common, should see the doctor to make sure it is not some type of bacterial or viral infection that needs treatment. If it is and is not treated it could affect the outcome, best of luck. JG 5.25.10
Answer: I suggest waiting until the skin regains its normal moisture and oilyness to allow it the best chance to heal with no scarring. The pricing for the treatments is set by the doctor so I cannot say why the difference. I would not use bi-polar or uni-polar rf for anything on the skin. It has been around for a long time and has been a resounding failure at living up to the claims. JG 5.25.10
Answer: no, microcapillaries cannot be implanted. Scars can heal as pale lines and at times heal very well and can hardly be seen, all depends on the tension on the closure. The bigger the spot removed, the greater the chance of it being visible. JG 5.25.10
Answer: I was a provider for UHC until the end of this month, unfortunately that was the only insurance we accepted and as of now, we are only doing it on a cash basis. sorry. JG 5.24.10
Answer: I am sorry, I must have misread what you wrote as I thought you said he injected into the deepr dermis, if I was incorrect, I apologize. A deep dermal injection, where the dermis essentially meets the subcutaneous fat is OK, anythimg more superifical than that I would not do, no matter how much experience. Actually collagen is produced in the deep dermis, by the time the skin cells get to the more superficial dermis they have lost their ability to create collagen as they are too far from the basal layer.If that is what he said, then I disagree with his statement. If injected into the subcutaneous tissue it can indeed create collagen, but as the subcutnaeous tissue is quite giving, the new collagen that can be formed does not have much localized shape that can replace lost bulk. I typically inject right at the border between the dermis and subQ, many times penetrating into the deep dermis, but it is practically impossible to inject into the deep dermis and only the deep dermis with a filler using that amount of fluid, the dermis will not stretch enough to take it all in. Injecting Sculptra into the muscle is also inefficient. Hope that clears it up some. JG 5.24.10
Answer: I think subcision needs to be done and then I might suggest Radiesse. I think long term fillers can have long term complications though, so although desirable, not always a good idea. JG 5.24.10
Answer: I do not use silicone as it is illegal here in Nevada and in many other states to use for cosmetic reasons, as to having an IPL after silicone injections, as long as they are deep, the IPL should not cause a problem, but if the silicone is too superficial it could cause a burn. JG 5.24.10
Answer: saline will last a few hours and I feel that since fat needs to be injected with larger needles, that the control and fine detail is gone with that technique. I think the fillers that dissolve need frequent injections but they are what I would suggest you stick with. JG 5.24.10
Answer: I think fat is more unpredictable than fillers, my preference is Sculptra as it creates collagen and therefore works to re-establish more tissue where the other fillers just hide the loss. JG 5.24.10
Answer: not much. JG 5.24.10
Answer: there are lots of names out there, very misleading as they are more marketing terms than descriptions. I think it best to choose a couple of surgeons and see them in person and tell them what you are looking for. JG 5.24.10
Answer: A deep dermal or immediately below the dermis is acceptable. Properly diluted and injected with the proper technique should lead to good results and low risk of lumps. I think you are likely OK to proceed and I wish you the best. JG 5.24.10
Answer: there are no true similarities, the faclift takes away excess quantity of skin and the laser imporves skin quality, they are not interchangeable. JG 5.24.10
Answer: less invasive might be possible, as long as it is able to correct the problem, having said that, small incisions do not mean less invasiveness underneath the skin, so small incisions can cary with them longer healing times in some cases. I am always of the belief that if you can get away with something smaller, it is always best. JG 5.24.10
Answer: well, if you know you need both it might be best to do the CO2 laser second, if you are unsure that you need the surgery, then the CO2 laser first is OK to do. JG 5.24.10
Answer: if there is enough skin left and if there was a canthopexy performed at the time of the original surgery, it might be able to be reversed in some cases.
Answer: I think it can vary from fillers, to implants to a mini lift, no way to tell without seeing you as all people have different issues. Sorry. JG 5.24.10
Answer: I would wait at least 2-4 weeks after the hyaluronidase to let any swelling go down and be better able to evaluate where the new product needs to be injected.I think Voluma is fine, I wish we could use it here in the US. It is injected deep so lumps should be a low risk in experienced injectors. Between Voluma and Ultra, for facial fat loss I suggest Voluma, no question about it. JG 5.24.10
Answer: in 10-14 days you should look pretty presentabel. As to singing, due to the activity the nck muscle I would say 4 weeks, maybe a little more. Best of luck. JG 5.24.10
Answer: I cannot say what can be done without seeing you and knowing fully what was done in the operation, in many cases some of it cna be reveresed though. I ma sorry to hear about your problems. I suggest seeing your surgeon, or someone else in the plastic surgery realm that can see you in person to determine what can be done. All the best. JG 5.24.10
Answer: if the difference was not there right from the begining it is likely some blood collection that most likely will go away with time, massage and moist heat, I think you should see your injector so they can examine you and see what is happening. JG 5.23.10
Answer: If I can help, I will certainly try, but without seeing you first I cannot say what I can do and I most likely cannnot do it during the first consultation either. JG 5.23.10
Answer: OK to perform it with the twitching problem. The twitching will likely not be affected, good or bad, that is from a nerve irritation. JG 5.23.10
Answer: no better than older IPL treatments, the results are mild and the spots will come back in time. JG 5.23.10
Answer: allergy medicine is OK to take and I think after 10 days Afrin can be used. JG 5.23.10
Answer: you can try a YAG laser btu it can be risky in darker skinned people. JG 5.23.10
Answer: we have one on our shopping cart. JG 5.23.10
Answer: it will be more gentle and less effective I am afriad, there will be no good without the bad with retinoids. The IPL can be done but you need to be off the retinoid for a few days before and after. JG 5.23.10
Answer: no, it will stay in place. JG 5.23.10
Answer: I believe you cna get them without a prescription, but I am not sure. JG 5.23.10
Answer: yes, it might, but it could take time if the treatment was not too deep, with time and a litle sun exposure it might come back. JG 5.23.10
Answer: more fluid would be added every two weeks. JG 5.23.10
Answer: should not make the skin saggy. Expander would be in place 3-6 months. JG 5.23.10
Answer: very unusual, if the filler had been injected above the fold to cause that, it should have dissolved by now. I guess you could try the dissolving, little risk, not sure how much it will do as the filler really should be gone by now, if it was real Juvederm. JG 5.23.10
Answer: just a couple of days. JG 5.22.10
Answer: too much hype, too little result long term, too little time of minimal improvement, too much money spent, too much money in the doctor`s pocket. JG 5.21.10
Answer: sounds like you had some type of canthus tightening procedure at the time of the eyelid surgery to avoid the lower lid form pulling down. In time the tisue might loosen but I cannot say 100% how much looser they will get, they might stay smaller always. JG 5.21.10
Answer: no, it cannot as the CO2 works on the skin and not below. The effects of the new collagen will last a few years, the older you are the less time it lasts. JG 5.21.10
Answer: they can only be bought by the doctor, there is no website for lay people to get that info. JG 5.21.10
Answer: no, that can cause more scrring as it can decrease the blood flow. JG 5.21.10
Answer: they should know where to get one. JG 5.21.10
Answer: any eye drop can cause that problem, especially when the drops are wearing off. JG 5.21.10
Answer: It can be done but the scars from that will typically widen and it could make the scars form the breast lift more visible I am afraid. JG 5.21.10
Answer: could be from a too superficial injection, yes, or some slight bruising. Neither one of those fillers are meant to be injected below muscle though, they will not last long time periods if that is done. For cheek augmentation is is placed deeply, right on top of the muscle and I use Sculptra and not Restylane or Perlane for facial fat loss of the cheek. For the rim of bone below the eye I use Restylane and I inject a little below and a little above the muscle of the eyelid. All the best. JG 5.21.10
Answer: nope. JG 5.21.10
Answer: it could be an option but the tissue expander would need to be there for a few months to stretch the skin out adequately. The tissue expanders made will be larger than that I am afraid, about half of an orange size. JG 5.21.10
Answer: no, because it does not work well. JG 5.20.10
Answer: no need to wait for it all to wear off, and as to the upper and lower eyelid price, all inclusive, is $4600. Thnaks for the comment also on our previous patient. JG 5.20.10
Answer: The laser would best be done near you so the follow up visits can be done properly, I suggest a CO2 laser, might want to see a dermatologist if you cannot find a plastic surgeon that has the laser. JG 5.20.10
Answer: at your age,if injected like the Restylane you are using now, it might get lumpy as it needs to be injected much deeper than regular Restylane. JG 5.20.10
Answer: we sell Revitalash. JG 5.20.10
Answer: well, for dry skin you cna try soem creams that contian DMAE or try our cell matrix cream, neither should irritate your dry skin. JG 5.20.10
Answer: just old fashioned 0.05% Retin-A , nothing new by any means, might work safer than a peel. JG 5.19.10
Answer: maybe alight laser. Best of luck. JG 5.19.10
Answer: hard for me to say but the amount of lift one gets with fillers like Sculptra will likely not be to the same degree as you see when pulling on your skin in an upward direction. It sounds like what you need is surgery, if you are willing. JG 5.19.10
Answer: Kenalog can casue atrophy with one shot, I think the saline just disperses the material over a larger area and does not cause it to dissolve, and running has no effect at all. Massaging will help the collagen carrier gel to possibly dissolve or disperse faster. The carrier gel is usually gone in 6-8 weeks so maybe just giving it some more time will allow it to look better. JG 5.19.10
Answer: I do not think the hyaluronidase will cause any internal damage to your pre existing nasal structures or tissues. I would likely use it if needed to dissolve a filler if I thought that was the problem. JG 5.19.10
Answer: If 2 cc`s cannot correct the problem, then you are not a candidate for fillers and need surgery I am afraid. Not all folds can be corrected with fillers. JG 5.19.10
Answer: I am sorry but I cannot commment on the products to make your hair more lustrous but I will say that the fast product is a scam, save your money. JG 5.19.10
Answer: might take 3-7 days until it feels better, a little less before it looks better. JG 5.18.10
Answer: it can be due to deeper burns or you are burning tissues that have been burned before and not do not have the same healing capacity. Once burnt I would suggest at least neosporin or Silvadene, but the latter is a prescription. Apply it until healed.JG 5.18.10
Answer: well, at best it will be a waste of time and money, at worst, you might get hyperpigentation, I would skip it if I were you. JG 5.18.10
Answer: the dents can still happen, I cannot say 100% whether you could eventually get the desired results. JG 5.18.10
Answer: there are many creams sold OTC with it and there are peels done in medispas with it. JG 5.18.10
Answer: 2-3 days before. I have not seen bromelain thin the blood. JG 5.18.10
Answer: I will admit, I have not heard of that happening before, might be some acid that is made in your mouth with the food or vitamin and your saliva, not sure what you can do about it and I have never heard of that happening after a septoplasty either, sorry. JG 5.17.10
Answer: those products will help it get closer to the previous thickness, the older one is with the steroid use the less likely it is they will get back to the prior without intervention. If it was just a short period of time once it should have a minimal effect, if it was more, the effect will be greater. JG 5.17.10
Answer: from what you are describing I think a more realistic time to fade wil be 3-4 weeks I am afriad. He might have gone deeper to get a better effect and that has made it go the way it has. All the best and hang in there. Also, thank you for the kind words of encouragement. JG 5.17.10
Answer: that is unusual, what vitamin are you dissolving? JG 5.17.10
Answer: I see no way how Kenalog will dissolve the Artefill, personally. I agree with you that the negative potential side effects far and above outweigh any positive from the injection. I only inject Kenalog into a scar, and then it is mixed with 5FU too, never Kenalog alone. JG 5.17.10
Answer: copper peptides are OK in the short term and then Retin-A for longer term. Best of luck. JG 5.17.10
Answer: I have not seen dents occur from hyaluronidase injections. JG 5.17.10
Answer: should be functionally 100% if reapplied every two hours. All sunblocks are total blocks, it is sunscreens that allow some sun through. JG 5.17.10
Answer: only works in a small subset of patients that have minimal to no skin excess. Overmarketed I feel. JG 5.16.10
Answer: well the green thing is old blood that is being broken down and slowly absorbed, might be able to be sucked out by the surgeon, the stitches poking out can happen and they should be cut or trimmed, as to the pucker, it is from an incision being not made longer and the skin is puckered. Many times the puckering gets better with time and massage, otherwise it might need a little scar revision in the future. All the best. JG 5.16.10
Answer: the majority of the time what is broken in a nasal injury is cartilage and not bone, but when repairing the cartilage to straighten it out, the nasal dorsum part of the cartilage has to be pushed together and that usually requires the bones to be broken in order to push them together. Hope that explains it a bit more. JG 5.16.10
Answer: use the peptide cream at night and just use teh sunblock and the rest in the am, the one that you really need to wait in between is the peptide cream and a few minutes for the sunblock, the rest cna be done more quickly. JG 5.16.10
Answer: the bottle should last 6-8 weeks if not more, depends on how often you reapply. JG 5.16.10
Answer: in most cases, what was going to repair itself after a laser will do so by 6 months I feel. I am afraid there is not much you can do to help nature along in this scenario. Once all the healing that is going to happen has occured, I feel Sculptra might be a good option for the refilling of the loss of the facial fat. Best of luck. JG 5.16.10
Answer: all should get better in time, hang in there, all normal at this point. JG 5.16.10
Answer: he might not have had the size he needed of that brand the day of surgery, I do not think there is a large difference between them though, nothing I would worry about. JG 5.16.10
Answer: I would suggest you give it at least 6 months and then proceed to have them cut out, all the other stuff will consume your money, make you swollen and not let things heal and settle down. Patience is the best thing right now, sorry to hear about the problems. JG 5.16.10
Answer: we were not selling enough of it to make it cost effective for me to have it made as it would expire before I can sell the mininaml amount I need to have made, sorry. JG 5.16.10
Answer: there are so many out there that I usually tell people to get one of the preset multiple antioxidant pills out there, there is not one that I think alone will do the trick. JG 5.16.10
Answer: I think a little higher dose is a good idea and as to the Omega 3, I suggest 1-3 grams per day in most cases. JG 5.16.10
Answer: I personally do not feel the Retin-A is needed with my cream but soem people insist on using it in conjunction, so I tell them to put the Retin-A on first. You can apply the Diffferein first and then follow with the peptide cream if you desire, no problem with that. JG 5.16.10
Answer: just press a cool wash cloth on your face and peel it off, do not rub.Ice for the first 3-5 days is all that I suggest. JG 5.16.10
Answer: I have had occassion to cut it out, yes. JG 5.17.10
Answer: results are usually about 6-8 weeks. No bad effects from oxygen peel and fading the spots most likely. In most cases the VBeam can be repeated after 6 weeks, but it depends on the strength used. Best of luck. JG 5.15.10
Answer: personally I prefer Dysport when proper dose is used, the amount of saline is important as to the volume the doctor needs to injected, but the dose is the overriding important thing. Not sure why you are getting such a short time of response from either one too, I see 3 to 6 months from those injections, but I inject 20 units of Botox and 60 units of Dysport to each crows feet area. One last thing, the bottles of Botox and Dysport are not supposed to be shared between patients, it is a single patient use vial, splitting bottles between patients is illegal and can cause cross contamination with things like hepatitis, so make sure that you buy the whole bottle and they are not sharing. Best of luck. JG 5.15.10
Answer: typically the incisions are placed in pre-existing wrinkles, usually the deepest one, so if you had a wrinkle that was angled that was more appropriate, that may be why. The more skin that has to be removed, the longer the insision is, and no two eyes are ever the same. Claiming one can remove all of the skin with a certain size incision is disingenuous and might leave residual skin in many cases. The lateral crows feet incision will likely not move up or down, but stay where it is. As to the amount of skin removal at the lash line, it is always easy to say more skin can be removed, but it is always better to go back and take a little more because taking too much out can leave you with scleral show and potential corneal exposure and injury. The aperture of your eye might be smaller now if a canthopexy was required to avoid a postoperative lagging lid. I understand your friends making those comments but I would venture to say that most times they have never looked at your eyes preoperatively as critically close as they are now. Don`t get me wrong, I am not saying that your concerns are not well founded, but it is always easy for another surgeon to crticize someone else`s work. If you have lost confidence in your surgeon, you certainly should not go back for more surgery, but be wary of those that only say what was done wrong, for most likely, they have had similar occasions of less than optimal results that they have not volunteered to tell you about. I wish you the best and ask you to give it a bit more time before having more surgry. JG 5.14.10
Answer: there is no conversion chart of what cc implant will yield a certain end result as the ribcage shape has to be taken into consideration, sorry. JG 5.14.10
Answer: most likely there has been some breast tissue that has been lost and there, unfortunatley, is no conversion chart for what cc implant will give what cup size as the dimensions of the ribcage also come into play. Sorry. JG 5.14.10
Answer: I have not heard that myself but will look into it. JG 5.13.10
Answer: do not think massage will make it worse, no. I think after the first couple of months that massage will not do much to flatten the granules I am afraid. JG 5.13.10
Answer: if you have access to all of those I would suggest Restylane Sub Q and it will be an immediate fill, second choice would be Sculptra but it takes a few months to build up, I personally would not use Radiesse for filling in fat loss in the cheeks. Best of luck. JG 5.13.10
Answer: usually there is enough scar tissue that will develop that it will stop, there are also pills, anti-sialogogues they can give you to slow the parotid fluid output too. Best of luck. JG 5.13.10
Answer: the laser will likely help with the elements left over from the bruising but will not do anything for the lumps. If they are still there they will likely need to be injected with hyaluronidase to remove them. JG 5.13.10
Answer: I htink massage and a little tiem to see how much it softens and settles down is in order, after about 6 months the evaluation of what, if anything, can be done will be more accurate. Sorry ot hear about the problems. Jumping in too soon to try to correct things is not a wise idea. JG 5.13.10
Answer: eventually, with time, yes, they will come back in the same exact spot and you would likely get new ones too. Sunblock will help, but there is nothing that will stop it forever. Bleaching creams do not need to be used once the spot is gone, that is for treatment and less for prevention. JG 5.12.10
Answer: the laser has that temporary effect until the new skin comes to the surface, part of the procedure and expected. When one is trying to stimulate new collagen production you need to go through a destructive process first, for lack of a better word. As to my opposition, it is because the claims made are over inflated and they also market it as essentially risk free and I have seen and heard about too many disasters from non-ablative therapies to agree with that. They are feeding on the patients` fears and desires for a profit. Don`t get me wrong, we need to make a profit,but you should give the patient something significant in return.Some patients are quite happy with the results, but then one needs to ask, were their expectations so low that anything would have made them happy. JG 5.12.10
Answer: it has never been studied on pregnant patients to the best of my knowledge, so I cannot say 100%. The 10% Gly is likely OK though. JG 5.12.10
Answer: in time it usually goes away with hot packs and massage, the shots are usually not needed. Not uncommon with a TUBA. Hang in there and just wait to see him in a couple of weeks. JG 5.11.10
Answer: yes, but wait at least 10 minutes before applying anything over it, including make up and sunblock. JG 5.11.10
Answer: I have them wait 10 days, same for the nasal spray, the skin usuallly shrinks quite well in most cases, especially the higher up on the nose it is. JG 5.11.10
Answer: it can be left in place and the wafer placed on top of the center of the existing implant. The healing times will be essentially the same, not much less. As to the scar I suggest ScarGuard or Mederma. JG 5.11.10
Answer: A wafer could be use, yes.It can be sutured to the other implant if needed, or a small screw placed through bothimplants too. JG 5.11.10
Answer: the scar would be over the lump, should be relatively small, should not leave an indentation. The small granules are not able to be felt until they congeal into a larger lump that is easier to remove. Might suggest Dr Stacy Folk in Denver. Best of luck. JG 5.11.10
Answer: it is the slow damage that occurs with the suntan that is worse, the quick burst from a laser vaporizes the skin and causes no long term damage to the DNA of the skin cells, not a dumb question at all. JG 5.11.10
Answer: it is not the filler, it is how much they inject and where they place it. JG 5.10.10
Answer: I think the Nd:YAG will be more risky and if you try to decrease the risk it will be no more effective than the IPL, also understand that no matter what method you use, they are ALL temporary as the skin has memory and with sunlight or florescent light, the dark spots will come back. JG 5.10.10
Answer: about the only thing I would suggest as to a laser would be a light series of IPL sessions. Don`t forget the sunblock! JG 5.10.10
Answer: at three weeks there is still alot of swelling, the lower on your nose, the longer it takes for the swlling to go down. It wil take up to one year for the final result, so you need to be patient. JG 5.10.10
Answer: we do not have Voluma here in the US but that would be a good option. I am likewise surprised at how small of an amount they injected, no way that small amount would have helped. I think the Voluma is worth a try first, yes. Best of luck and you are in good hands with Mulholland.All the best. JG 5.10.10
Answer: if it does not flatten on its own, it might need to be cut out, there are no injections that will dissolve the granules. JG 5.9.10
Answer: olive. JG 5.9.10
Answer: the collagn,n the granules will be there for a long period of time I am afraid. There is no injection that will dissolve it I am afraid, if it does not flatten on its own it might need to be surgically cut out. JG 5.9.10
Answer: can`t really say. JG 5.9.10
Answer: the younger one is and the less fat atrophy they have the less Sculptra one will need so it can be possible. As long as they have experience with the filler around the eye it is OK, I do it all the time. JG 5.9.10
Answer: well the filler that carries the long standing granules will dissipate over 6-8 weeks and massage will help that too. Hang in there. JG 5.9.10
Answer: I am afraid there is likely not much that will help as the problem is long standing, I think the degree of improvement with steroid injections at this point is minimal and if any will likely be temporary. The steroid injections can inded cause thinning of the tisseus and also the broken blood vessels. JG 5.9.10
Answer: not commonly accomplished with a facelift.Depending on the casue, it might not be able to be corrected. I cannot say whether it can be done in the office without seeing what the proble is that is causing the droop, sorry. JG 5.9.10
Answer: not sure what part of the mouth you are referring to as the lips are never lifted during a facelift, if it is the nasolabial fold, they might look better with a little more skin being removed. I would give it at least 6 months for the swelling to go down and the scar tissue to soften to allow better ability to lift the tissues. A delayed lifting should not affect the longevity of the total lift done togetehr, should be similar. All the best. JG 5.8.10
Answer: sounds like what might be happening is that an aggressive tightening of the neck muscles is what is causing the senasation, that should loosen up with time though. The platysma muscle which is tightened in some facelifts can cause a very srong pull on the mouth, just like a very stronng grimace. I would try stretching and massaging the neck and see you doctor in follow up to make sure that is what it is. Best of luck. JG 5.8.10
Answer: not much difference. JG 5.7.10
Answer: My choice for fat loss in teh face is Sculptra, that is much longer lasting than the hyaluronic acid fillers I feel. Best of luck and thanks for the kind words. JG 5.7.10
Answer: been around since about the 1920`s, do not think there is much science behind it to back the claims. JG 5.7.10
Answer: not so much, anything that fades the brown spots and controls acne will potentially aggravate the redness, or at least not make it any better. The redness can be made better with some IPL treatments. Best of luck. JG 5.7.10
Answer: 5%. 4% for the Titanium. JG 5.7.10
Answer: I think with your underlying diagnosis, nothing will work well I am afraid. JG 5.7.10
Answer: I personally feel Juvederm is very short lasting as a cheek filler and to believe or suggest, as the doctor did, that the filler will draw the fluid out of the malar bag is ridiculous, absurd and an out an out lie in order to get you to spend money on something that will not work. I strongly suggest you go to a new more ethical place. Best of luck. JG 5.7.10
Answer: tingles in some people, lasts 2-6 hours and is not drying. JG 5.7.10
Answer: a little of both. Hang in there. JG 5.7.10
Answer: yes, if desired. JG 5.7.10
Answer: nope. JG 5.7.10
Answer: I think it is less important when applied topically on the skin than when taken internally, but in general, alhtough they, the Omega 6, are all over the place in skin oils, I would avoid them as they are all pro-inflammatory and we have enough inflammation as it is. JG 5.7.10
Answer: it is infrequent, peopel that have Sculptra and have no problems do not post I am afraid. The Sculptra does not migrate very easily, so as long as it is not injected in that area, it shoudl be fine. JG 5.6.10
Answer: if the skin becomes irritated from the mixture, for a short period of time it can be darker and then should progressively lighten over time, by that I mean months, not days. I would continue it if you are not having any skin irritation. JG 5.6.10
Answer: it works well, for the money, since a generic is available, I think it is very good for the combination of issues you mention. JG 5.6.10
Answer: it is years away from being done commercially.Eventually it will likely replace the techniques presently used, but not for a long time. JG 5.6.10
Answer: sorry, but theer is no way to get it to dissolve only the lump. JG 5.6.10
Answer: the sunblock is titanium dioxide, zinc oxide sunblock, Elefac I-205, tocopherol, tocopheryl acetate, pycnogenol, Vitamin C, beta-carotene, selenium and micronized iron oxide in a moisturizer and the lip plumper is a proprietary compund so I cannot disclose the ingredients, sorry. JG 5.6.10
Answer: as of this month I have rescinded my contract with HPN and no longer accept any insurance cases. I still do perform breast reductions on a cash basis, but if you look at your insurance carrier`s provider list, there should be at least a couple of plastic surgeons there that can put in for it to be a covered benefit on your insurance. All the best and glad I have helped in a small way. JG 5.5.10
Answer: likely the most reliable thing will be to wait a full year after the injury, allowing the scar to contract and then have it electively surgically cut out and reclosed with appropriate plastic surgery techniques in multiple layers, bringing the surrounding tissue in to fill in the depression. All else will be less effective. All the best. JG 5.5.10
Answer: can try squalene oil,tea tree oil,emu oil, ScarGuard or Mederma. As to the SK`s, might want to see a dermatologist and have then burnt off with a hyfercator.
Answer: It is seen on the hip but is more likely a problem with curvature of the spine, that would be a major issue and it might be able to be improved but likely not totally straightened, it would include permanent rods up and down your spine, that is done by orthopedic surgeons. JG 5.5.10
Answer: for prior existing patients there is no consultation fee, looking forward to seeing you whenever convenient. JG 5.5.10
Answer: the Palomar 1540 is pixelated and is abalative in smal spots, not entirely surface abalative though, essentially the same as what you had. Calling the Polamar 1540 non-ablative is a lie, it is used for marketing only because it creates numerous microbeams or holes, read ablative here, that go into the skin with untreated areas around them. JG 5.5.10
Answer: not really much I can offer, not all patients can have all areas corrected with fillers, sorry. JG 5.5.10
Answer: it is essentially the same. As to what happened, if it was done too deeply or at too high a setting it could have burned the skin slightly causing the textural changes too. I would proceed with much apprehension. JG 5.5.10
Answer: well, I have not seen the autopsy report either, the pulmonary embolism can happen due to the position the patient was in, just from her only blood not flowing. This is especially a higher risk in paients on oral contraceptives and those that smoke. Injections into a vein can be missed at times and any filler, PMMA, silicone, or any other filler, if injected in a large enough amount into a vein can migrate to the lungs and have the same exact effect as a pulmonary embolism. Fat injection have also been found to potentially cause embolisms that can result in the same problem. JG 5.5.10
Answer: I have to say that is wishful thinking. I do not think the Fraxel will give you much improvement to speak of once the swelling has gone. The Fraxel also will not softten the scar tissue, that will happen with time even without the laser. JG 5.5.10
Answer: essentially, yes, with a variety of different devices. They will come back in time and the treatment will have to be repeated though, all the best. JG 5.5.10
Answer: I have never seen it last more than one year personally, you could consider having hyaluronidase injections to dissolve it. JG 5.5.10
Answer: not much help I am afraid, and Fraxel and IPL will likely not help and could make it worse, just think about what those machines are marketed for, treatemnt of hyperpigmentation and spots. JG 5.5.10
Answer: it can help that scenario in many cases,yes. I think that is the best way to treat it, fillers might be able to evert the lip if injected properly in a small percentage of cases. JG 5.5.10
Answer: I know of no bad interactions between them. JG 5.5.10
Answer: sorry, but I do not. JG 5.4.10
Answer: well, it will be effective to some degree but never as much as the prescription strength. JG 5.4.10
Answer: yes, its OK. JG 5.4.10
Answer: the blood will, with time, dissolve, it cannot get trapped. JG 5.4.10
Answer: it will spread a little, yes. The fluid itself can cause swellling when injected. JG 5.4.10
Answer: never when sutures are in place, wait a couple of days after the sutures are out to begin using it. JG 5.4.10
Answer: yes, cartilage can be injured without a bone injury. I think most likely it can be repaired without breaking the nasal bones. JG 5.4.10
Answer: I think it is too early to get worked up about things as you are still too close to the surgery date, I suggest giving it some time, at least 6 weeks before re-evaluating things. At this point there is lots of swelling that can cause distortions so I would not make any judgements at this time. Hang in there for a bit more. JG 5.4.10
Answer: could have been some that got into the eye itself, I have not seen that happen very often and have not seen anything more than a transient irritation as you had from it. I am not a fan of the extensions as I have seen many women permanently lose their eyelashes from them. JG 5.4.10
Answer: should be OK. JG 5.4.10
Answer: yes, it works. JG 5.4.10
Answer: I just think that it takes an enormous amount of material to be injected to get a long lasting effect, it is intended for more superficial use and when injected deeper it is not as efffective. Radiesse for nasolabial folds is OK but not for volume loss. Best of luck. JG 5.4.10
Answer: anything you do will not be permanent I am afraid, repeating the peel can be done, but they will come back, sorry. JG 5.4.10
Answer: well, if it bothers you it is likely worth correcting with an isolated neck lift. Your face will continue to age though and in time the cheeks might need to be done. It is certainly reasonable to do it piecemeal though, no need to operate on an area that does not have a significant amount of sagging yet. JG 5.4.10
Answer: yes, they go hand in hand. Results vary from patient to patient and in most cases a breast reduction is covered by insurance and that will save you quite a bit of money. All patients that have a reduction need a lift done at the same time, yes. JG 5.4.10
Answer: there are silicone implants that fit into that area, called the peripiriform area that might help, it is an implant that goes underneath the base of the nose to both sides but it can be trimmed, that will be your best bet. Otherwise using hydroxyappatite mixed with your own blood can help, it is a material used by oral/maxillofacial surgeons. Best of luck.JG 4.24.10
Answer: I would give it at least 6 months if not longer. The scars are the same. It is a personal preference on awake under local or general anesthesia. If there is exess skin it can be removed at the same time, yes. I think if it bothers you then it is worth doing it. If you have lost confidence in him I think it best to see someone else. JG 4.24.10
Answer: an ENT should be able to perform that surgery, it is a common procedure for them. Best of luck. JG 4.24.10
Answer: just a good moisturizer. JG 4.24.10
Answer: there is no such thing as collagen fibroblast injections and the collagen injections last a couple of months, much less than hyaluronic acid fillers. JG 4.24.10
Answer: difficult to say without knowing exactly what he did surgically but the eyes being smaller can be caused by a canthpexy if that was done, if that is the case, as the swelling goes down it wil get somewhat better but not in all cases In small fraction of patients the canthopexy has to be undone. A canthopexy is where the lateral aspect of the lid is shortened or tightened to avoid the skin being pulled down. As the the downward cant of the scars, swelling can at times push scars downward but usually if it is due to swelling, it should have gotten better to some degree by now. If the scar is pointed down, it will fade with time but the direction likely will not reverse itself.Wish I had more to say but witout seeing the befores and after and knowing what was done surgiclaly, I cannot say more. Best of luck. JG 4.24.10
Answer: bovine collagen is no longer sold, only human derived collagen, there are not many choices of that either. JG 4.24.10
Answer: collagen fibroblast injectiosn are hype as the fibroblast has to be your own, you cannot just use a generic fibroblast from somewhere else. JG 4.24.10
Answer: unfortunately, since it will irritate the skin it can cause reactive postinflammatory hyperpigmentation. The more effective the treatment the greater the risk of reactive PIH I am afriad, there is no free lunch. JG 4.24.10
Answer: Artefil will get a little collagen production but most of its effect is by the PMMA it has, that is why it is not approved nor shoudd be used for tissue loss.Best of luck. JG 4.24.10
Answer: or a silicone implant made for that,need to see a surgeon to se what can be done for it besides fillers. As to the other fillers, likely Artefill would be best. All the best to you. JG 4.23.10
Answer: 3-6 for the Restylane and in that area Sculpra does not work as well as it does in the cheek as it needs to be injected into tissue with good blood supply for it to create the new collagen. JG 4.23.10
Answer: probabaly not too effective and if it were would take a few vials on each side, and also when filling in tissue loss, it takes very large amounts of filler, not the usual one or one and a half syringe like when injecting into the folds or lip lines, it takes lots of volume.In severe cases it can takes 3-6 syringes to fill in each cheek on someone with a significant amount of wasting or tissue loss. JG 4.23.10
Answer: ca be done but the muscles need to be reattached to avoid them not being in the proper place. JG 4.23.10
Answer: kenalog might not work, surgery will be more effective. JG 4.23.10
Answer: should be able ot be done, or conversely you can use fillers to smooth the nasal dorsum out. Best of luck. JG 4.23.10
Answer: sorry, but no, it will not, it is meant for improvement in the fine lines that are from poor skin quality, and the lose skin that is starting on your neck is a quantity not a quality issue. JG 4.23.10
Answer: its a concentration thing, look for 10%. JG 4.23.10
Answer: if no improvement is seen after 3 months, you can stop. JG 4.23.10
Answer: if that is the case it might continue until all the Restylane that is in direct contact or communication with the puncture site has all come out. It is a very rare occurrance. Best of luck. JG 4.23.10
Answer: I do dot think you will get any significant skin tightening with the Thermage, nor the IPL but the IPL will work for the brown spots. The longer you have had the brown spots the more treatments will be required, no way to tell how many though. Not all of the spots will go away, the longer standing ones wil be the hardest to lighten, and in time, they will come back. Nothing will permanetly remove the spots. All the best. JG 4.22.10
Answer: Artefil counts on your body encasing the permanent PMMA particles in collagen and the Sculptra works by getting the collagne to form around the dissolvabel L-poly-lactic acid material, there is no way to compare which one creates more. JG 4.22.10
Answer: I do not think it will make it more visible necessarilly, it might lighten the brownsih discloration some as willthe Vitmain C but not sure how much of a difference. JG 4.22.10
Answer: skin grafting would make it worse, the laser can only fade redness, short of a prolonged option of placing a tissue expander to stretch the skin for 6 months and then revising the scar, there is not much that can likely be done, the scars in that area tend to widen due to the activity of the muscles of the arm. The tissue expander is essentially a large balloon that is stretched slowly over months and it stretches the skin but the arm will look pretty weird while undergoing the stretching. JG 4.22.10
Answer: an upper lip reduction can be performed removing a small strip of skin right at the base of the nose to elevate the skin and therefore the lip up. JG 4.22.10
Answer: I think the ability to shape them is exaggerated, they are not as maleable as they promote and there are no safe fillers that have that same ability either. JG 4.21.10
Answer: they do not work so well in that area, I would not suggest you have it done, sorry. JG 4.21.10
Answer: yes, it will come back, even if just from friction on the skin. I guess all you can do is hope. JG 4.21.10
Answer: I am happy that they got better but I would ventrue to say that it will come back in the near future. Not much you can do to prevent it recurring, glad you did not get a burn from the peels too. JG 4.21.10
Answer: fillers will not displace facial fat to any visible degree. Fillers are not that mobile after being injected where you can displace them to any appreciable degree I am afraid, more likely swelling was caused making it look like that. Sounds more like you are losing facial fat, could be genetics, stress, weight loss, aerobic impact activities, lots of variables. JG 4.21.10
Answer: I think that will be fine, as to the ice, we suggest 3-4 times per day after the injections for 5 minutes each time for a couple of days. The ice before is just immediately before for a few minutes while waiting for the injection. Best of luck. JG 4.21.10
Answer: I think at this point ther is an enormous amount of swelling and I think it is very premature to even look at the nose to see how you like it, things will change for up to one year so you need to give it time. JG 4.21.10
Answer: well avoiding OTC blood thinning products like aspirin and Motrin, along with the use of Arnica for 2 days before and a few days after, ice before and after might also help, but there is nothing that will avoid it 100%. JG 4.21.10
Answer: I always have a nurse in the room with me, I am never alone in an examing room with a patient.Being alone saves the doctor money though. JG 4.21.10
Answer: I cannot say that it an absolute, and if it were in fact true, it would not be so in all darker skinned individuals as the issue with thicker scar tissue is due to many factors along with race. I personally feel the potential for lumps is higher with Artefill. JG 4.21.10
Answer: I know of many doctors that store it for up to one year using sterile technique. JG 4.21.10
Answer: have not heard it being very effective. It is likely safe but unsure if it is really effective. JG 4.20.10
Answer: they can try steroids bt uthat will have other untoward side effects, that`s one of the reasons that I shy away from using BioAlcamid for scenarios like yours. I understand the desire for long term or permanent improvements, but there are limitations to that too. JG 4.20.10
Answer: I am not a believer of the claims made for Nia24, sorry. JG 4.20.10
Answer: as long as it is stored in a sterile fashion, it can be used for the same patient, many doctors do that. JG 4.20.10
Answer: if it is redness from the skin irritation, that should clear up in a few hours after you stopped the massage, not sure why it would stil lbe red for a long time past that, migth need to see the doctor that injected you to make sure there is not an infection brewing. Best of luck. JG 4.20.10
Answer: hard for me to say without seeing you but if the second surgeon had not seen at least pictures of you, it is hard to say why things were done or not done. It sounds from what you are saying that a canthopexy was done to correct or prevent the lower lid form pulling down, if that is the case that can make the eye look smaller, at least while swollen. I think you need to see your surgeon and speak with him and explain your concerns. Having said that, many times the best thing to do is to give it time as many things correct themselves without intervention and more intervention when it is not needed can lead to new problems. Best of luck. JG 4.20.10
Answer: it seems reasonable but I cannot say 100% without seeing you in person. As to the swelling, it will likely last longer than last time I am afraid. I would start the arnica nad bromelain 2 days before and continue for 2 weeks or so. Best of luck. JG 4.20.10
Answer: should not be a problem, I wish you the best. Julio Garcia MD 4.19.10
Answer: the issues are lumps and not lasting from the Radiesse, and not lasting with the Sculptra. I think it is not the motion as much as there is not enougth tissue there to incite a reaction to create newer collagen and cause the filling in to occur. For the first few weeks, and especially right after, they look great, but it is how they look at 3 months and after that counts and that is when the disappointment is seen. I think Sculptra is the better choice between the two. Best of luck. Julio Garcia MD 4.19.10
Answer: none of them are effective. Julio Garcia MD 4.19.10
Answer: I think when you start injecting large volumes of any product like Artefill or Precise, the risks of lumps goes up. When injected in smalll amoutns over a large area the risks are much less. I would not use Artefill for fat loss myself. Julio Garcia MD 4.19.10
Answer: they might use it, but it only works on sun acquired recent brown spots, it will not fade skin to a lighter tone unless it is removing a suntan. Julio Garcia MD 4.19.10
Answer: no preference on the IPL machine and I think the pixel erbium will give very limited degree of improvement, and short lived too. Julio Garcia MD 4.19.10
Answer: no better than all of the other OTC products out there I am afraid. Julio Garcia MD 4.19.10
Answer: I think the percentage of it not resolving is maybe 5-7%, in most cases with time and massage the callus gets softer and smaller. Julio Garcia MD 4.19.10
Answer: can try Brooke Seckel MD in Boston,best of luck. Julio Garcia MD 4.19.10
Answer: we use Retin-A and hydroquinoe before a CO2 laser to prepare the skin and lessen the risk of hyperpigmentation. Julio Garcia MD 4.19.10
Answer: yes to both and unimpressed with both to be honest. I do not use it there anymore. JG 4.18.10
Answer: might help with the darker brown spots, otherwise not much help. JG 4.18.10
Answer: well, it appears it is swelling as fat does not change from AM to PM. Likely related to the menstrual cycles. JG 4.18.10
Answer: the later the time, the less the effect, I suggest in the first 6 months, after that, the effects will be much less. I would not do it for at least 4 weeks after the surgery is performed. Best of luck. JG 4.18.10
Answer: do not think they will be permament, I would give it time, might need a little more laser to help them fade, not uncommon around the ankles to be honest. Avoid the sun and you can apply warm packs as that might help a little bit. All the best. JG 4.18.10
Answer: the darker your skin is to start with, the riskier it is with PIH, post inflammatory hyperpigmentation. JG 4.18.10
Answer: Try Brooke Seckel MD in Boston. Julio Garcia MD 4.19.10
Answer: both very similar, as to the hyperpigmentation I would use an IPL or a Q Switched YAG laser. JG 4.17.10
Answer: th eeyelash extensions can pull out the lashes in some cases and as to Perirrcione, I think they are good but way too expensive for what you get. JG 4.17.10
Answer: I would just avoid the burn area. It might not heal well there. JG 4.17.10
Answer: 2-3 months at most. JG 4.17.10
Answer: it can work well, around the lips it might last 2-4 monts and about the same in the marionette lines, but it varies from patient to patient. Prices are prety much the same. All the best. JG 4.17.10
Answer: I know of no surgeon that bills themselves as an expert in this area, it is not difficult to perform though, it is just the resultant scars has to be acceptable to the patient. The sutures are out in one week and the swelling is decreased and you are able to go in public after one week but the final results take months. As to the acculift, save your money. JG 4.17.10
Answer: IPL or VBeam laser. JG 4.17.10
Answer: I would not use it myself on a patient. JG 4.16.10
Answer: yes, in time it will come back, the skin cells have memory. Although sunblock and avoiding sun are absolutely needed, in time, there will be some light damage and it will come back, sorry. JG 4.16.10
Answer: lots of unfounded hype, your skin cannot select individual ingredients that are in liposmal carriers, your skin will absorb them all and then use what it can, but there is no skin sensitive selectivity to absorb one product over another. He cleverly never quite says that but allows you to make that assumption from what he writes about it.JG 4.16.10
Answer: DMAE and CoQ 10 are good skin care product ingredients but by no means are they the only ones, I am afraid you are looking for something that willl never exist. A single, non-changing answer to what is best for your skin. There are many things that are good but no one thing is ever best. Rotating products to get a variety of good ingredient can be a good idea as one cannot apply all things that are recognized as helpful and get them all to absorb in adequate amounts. JG 4.16.10
Answer: yes. JG 4.16.10
Answer: yes. JG 4.16.10
Answer: Sacre Bleu, not even close to being worth it.JG 4.16.10
Answer: DMAE and CoQ 10 are good ones for OTC products. Alternatively you can use my cell matrix cream on our shopping cart.JG 4.16.10
Answer: yes, but they are over priced for what he puts in there, oh well, but they are good. JG 4.16.10
Answer: although it can happen, it is not supposed to happen, it all depends on what energy levels were used. That striping in most cases falls off in a few days, but it is not needed for the good effects to be seen. I cannot say whether it bodes ill or good as I am not sure of the settings used, but as long as the skin did not burn and flake off it is likely going to be OK. Best of luck. JG 4.16.10
Answer: correct, Q-swithced YAG laser. All the best and same back to you. JG 4.16.10
Answer: the rhinoplasty can, in a small percentage of patients, alter the appearance of the lip, but that is not common. Fillers are commonly used for the lips and that might be a more predictable intervention for you to consider.Best of luck. JG 4.16.10
Answer: it is a little fat and a little loose skin too. Surgically lifting the cheek can improve them and at times fillers around the area can make them less obvious, but the fillers do not always work for that as it makes the areas fuller or rounder. All the best. JG 4.16.10
Answer: it is likely from the lasr and the controled burn, short of more laser to try to smooth it out I am afraid there is not much to offer, sorry. JG 4.16.10
Answer: no science I am afraid, more likely is when one problem is fixed your eyes gravitate to a new area. JG 4.16.10
Answer: yes, still safe, best of luck. JG 4.16.10
Answer: it can, yes. Treatment with antibiotics is the first step. JG 4.16.10
Answer: laser first, then the hair grafts at leat 6 weeks later, or more. Best of luck. JG 4.15.10
Answer: surgery will help change things that are static, but things that change, like your potential swelling, will not be improved with more surgery I am afriad. It is difficult to say why it is happening, thinsg normally heal and reattach, but some individuals, for some unknown reason, can have intermittent amounts of swelling. It could be allergies or other irritants that can trigger it, or even the position when sleeping, face down will cause more nasal swelling. Wish I had more to offer. JG 4.15.10
Answer: just the Mederma. JG 4.15.10
Answer: on the face, glycolic acids and TCA peels. JG 4.15.10
Answer: you can add Retin-A but for it to work will take months not weeks. No on the lasers. JG 4.15.10
Answer: I think the evidence for increased bleeding is small, but taking a few days off before and after might help and certainly will have no adverse health effects for a short period of time. JG 4.15.10
Answer: I think it is safer than the others out there. It is definitely effective for symptomatic relief. I would change the flax oil to straight Omega 3s to eliminate the pro-inflammatory Omega 6 in flax. All the best. JG 4.15.10
Answer: no, they do not. JG 4.15.10
Answer: Mederma or Scarguard should help. JG 4.15.10
Answer: in the short term, it will work, but since you cannot stay in the sling forever, eventually when you get out of the sling and the skin starts to move, it can widen at that time. There is nothing you can do to prevent it from stretching if it is in a place where there is skin tension, sorry. JG 4.14.10
Answer: can be small nerves caught in the scar tissue. JG 4.14.10
Answer: if the fat stays, it is a good option, but the fat transplanted will behave like the fat from the area it was taeken, so if it is taken from your stomach and you gain weight in your stomach areas easily, then whatever fat survives, the transplantation, will grow like belly fat. I think the results are not as reliable as regular surgery or implants though, lots of variables as to how well the fat survives. JG 4.14.10
Answer: minimal. JG 4.14.10
Answer: I would not use textured implants under the muscle,myslef, as the muscle action makes the implant texturing less likely to adhere the way they are supposed to, aand I also feel textured implants leak more than smooth ones, the differences between capsular contracture on smooth vs. textured is essentially nil. JG 4.14.10
Answer: we do not have those implants here in the US, but as to capsular contracture rates, they are likely the same. You have to wonder why tehy are offering a discount on one of the types though. JG 4.14.10
Answer: is it red or brown? JG 4.14.10
Answer: final result will be 12 months, yes, as the swelling is slow to resolve on the tip, the swelling only goes down when you are flat on your back. Ice helps but will not shorten the time by much. JG 4.13.10
Answer: yes, it is temporary. Massage will not cause hyperpigmentation, I feel, after an injection. Redness is normal as the medication is working, but redness is NOT hyperpigmentation. Hyperpigmentation is brown, not red. JG 4.13.10
Answer: It can take up to one year for things to settle down, it might be swelling and it might be scar tissue, I suggest not jumping the gun and giving it some time. Stay in close contact with your surgeon too. All the best. JG 4.13.10
Answer: not much difference. JG 4.13.10
Answer: good peel, cannot say whether you would need it that often without seeing your skin in person though. JG 4.13.10
Answer: well, there are eye surgeries to improve it but they are not like a cosmetic eye surgery, but the incisions are similar. If the other eye is not involved there is no need to do both. JG 4.13.10
Answer: I think what he has suggested is a good start, as to a facial wash, anything with glycolic acid will be good enough, many are sold OTC. All the best. JG 4.13.10
Answer: Restyalne and Juvederm have a natural hyaluronic acid component where Radiesse has a collagen gel in which are floated small pieces of essentially artificial bone. They should not be used interchangeably, it is not just a matter of using what lasts longer, they should be used in different areas and for differnt problems. Lifting weights has no affect on the fillers but running can do to repeat impact, but people that are aggressive athletes tend to lose facial fat more quickly and their tissues fall more quickly so fillers are needed more often. The downtime is essentially the same for all, a few days of swelling and maybe some bruising. I suggest seeing a plastic surgeon or a dermatologist for your fillers rather than a less experienced injector that will sell you something without taking other issues into account. I wish you the best. JG 4.12.10
Answer: it is likely a scab, still adherent and will not fall off until the tissues underneath it are healing. So do not try to knock it off, let it fall off when it is ready. That can happen frequently when umbilical henrias are repaired multiple times, just got to hang in there. Keep up what you are doing too. JG 4.12.10
Answer: we stopped selling it not because there was anything bad, it was just that when I started offering the cell matrix peptide cream, everyone wanted that one and no one kept buying the DMAE cream. 4% is what the DMAE should be in the cream. JG 4.12.10
Answer: in a small percentage of cases a small procedure in the office can be done, all depends on what is causing the bump. JG 4.12.10
Answer: I prefer to see patients go to a plastic surgeon or dermatologist. All the best. JG 4.12.10
Answer: well, if the larger eye shows white below your iris, it likely needs a canthopexy on that side also. At your age, the only things that can cause the scleral show, which is the white part of the eyeball showing below the iris, is a muscle paralysis, over active thyroid or excessive skin being removed at the original surgery. I am sorry to say that more surgery will likely be needed at some point. All the best. JG 4.12.10
Answer: I think there likely will be some changes that occur over the next few weeks. Trying to go in and do too much too soon can cause more problems, I suggest waiting some more for now. All the best. JG 4.12.10
Answer:
Answer: I do not, the only material that is approved in the US is a dermal tissue sling, it is expensive, and it dissolves after a few months. I rely on the patient`s tissue and proper pocket dissection to acheive the correct pocket size and stability. JG 4.12.10
Answer: I would see if he can get a culture of the infection so we can see what the bacteria is and what the sensitivity to the antibiotics are so we can treat it. At its worse, it migth need an operation to go in there and see if there is anything that can be drained or removed surgically, but that would be the last ditch effort. Best of luck and wish I had more to offer. JG 4.11.10
Answer: if they went deeply, it ca take months as essentially, it is a burn, or frost bite if you will. I think hydroquinone will likely make it worse, as will Retin-A, best to let it heal, you can use some copper peptide cream or aloe if you desire. I think IPL will likely just aggravate it and make it not heal any faster. JG 4.11.10
Answer: it can be, especially the first few months. Usually if I place a tip graft I do not have the patient massage for a couple of months to avoid the graft becoming displaced. JG 4.11.10
Answer: that is what he did and grafts poking through the skin are quite rare. JG 4.11.10
Answer: impossible for me to tell without seeing you in person, sorry. JG 4.11.10
Answer: less than 20 lbs at 2 weeks, no limitations after 4 weeks. JG 4.11.10
Answer: probabaly, for a short period of time, and then he will need to sell you another series of treatments. JG 4.11.10
Answer: we cannot use it here in the US but I think it is likey very expensive for what length of time it will last as it is not permanent. JG 4.11.10
Answer: I do not think that will do much for you I ma afraid. Might need an ablative laser on the skin around the depressed spot to pull the depressed skin up higher. Best of luck. JG 4.11.10
Answer: all normal, the petechia can occur for the first 6 months as the skin is thin and can tear from minimal shearing, even from your pillow case, that will also get better in time as the skin continues to heal. The healing period will take at least 6 months. Best of luck. JG 4.11.10
Answer: As hard as it is, I think the best thing right now is to let the tissues soften and heal. Doing more surgery right now could make all things worse.That skin is quite thin and delicate and being too quick to try to fix or change things could make it even worse. Give it some time and then lets see where it goes. I can understand your regrets but most likely things will improve quite a bit and what might need to be done will be smaller. I wish you the best and hang in there. JG 4.11.10
Answer: I would refrain from any impact training where there is bouncing on a hard surface for one month, non-impact training such as walking on an treadmil or an elliptical trainer could be done after 2 weeks I feel. No special dietarty restrictions and I would avoid sleeping face down for at least one month. Best of luck. JG 4.11.10
Answer: should be like you saw it after the cast came off, yes. All the best. JG 4.11.10
Answer: I would still use the Restylane SubQ, I think the advances in fat injections are over estimated by those claiming they get them. JG 4.11.10
Answer: not reallly, but it can slow the swelling`s resolution. Scar tissue is a stable material. Sounds like swelling in your case that comes and goes for some reason. JG 4.11.10
Answer: at least 6 months, in people with a large amount of fat removed and older patients it might take longer for the skin to shrink back down as much as it will. Skin does not always contract evenly but in most cases it does. JG 4.11.10
Answer: I am sorry but there is nothing you can do except waiting to allow it to wear off. Some improvements should start in a few weeks so it will not look like that for too many months. Ice and keeping your head elevated might help with the swelling in the meantime. As to being recommended by Allergan, all that means is that they purchase the products from them and have atteneded training seminars. The presence on the Allergan website does nto necessarilly mean that she is any better than others. I wish you the best. JG 4.10.10
Answer: am not convinced the elastoplast does much and as to the skin ailment, it all depends what is itching you as to what I would recommend. JG 4.9.10
Answer: it certainly is due to the use of the LipoEx and if you already had that problem, it could happen again. I suggest you do not proceed with an further sessions. JG 4.9.10
Answer: I usually use them in combination, it is more irritating, yes, but more efective also. JG 4.9.10
Answer: yes, it will work, if it was only in the epidermis,which does not happen in PHI, all you would need is a single microdermabrasion and it would be gone. The thin skin will respond to the bleaching creams as well as other areas, but that skin can become more irritated from the cream too. JG 4.9.10
Answer: for crow`s feet I use 20 units per side.JG 4.9.10
Answer: it can be repeated, yes. Tumescent liposuction will only remove fat, if you are lucky enough to have good skin quality, the skin should shrink back down well, but removing fat will not, in and of itself, tighten the skin. If the skin sags, the only solution is to have the skin cut out with the resultant scars. JG 4.9.10
Answer: possibly, yes. Best of luck. JG 4.8.10
Answer: Due to potential legal issues, and some doctors wanting to know why I referred a patient to someone else and not them, I think you are best to go to this website and look for a plastic surgeon in the area you desire. I wish you all the best. JG 4.8.10 http://www.surgery.org/public/findasurgeon.php.
Answer: Retin-A I feel, it has the longer time period studying it for its effectiveness. The Retin-A is a daily application where the other is a chemcal peel administered every few months or so as needed and is riskier for developing post-inflammatory hyperpigmentation. JG 4.8.10
Answer: we used to sell their products but no longer do. I cannot really tell you what the differences are, sorry. In general the Obagi product line i good though.JG 4.8.10
Answer: no devices that help, and back when we sold our DMAE cream, we had DMAE and lipoic acid in it, it works if the concentrationa are high enough. JG 4.8.10
Answer: we no longer sell the DMAE cream because when we started selling our peptide cream, the users all wanted to switch over to that and I was not selling enough of the DMAE cream any more so we stopped having it made, no other reason that that. As to the size of implant, there is an upper limit on Silicone implants made in the US when they are not custom made, but saline implants or recontructive implants can be used and can go larger.JG 4.8.10
Answer: it is a good policy but very infrequently needed, thank God. JG 4.7.10
Answer: it is swelling but I have no good solution to correct the problem I am afraid, sorry. JG 4.7.10
Answer: I use the Vicryl Plus Sutures by Ethibond. JG 4.7.10
Answer: I no longer use DMAE creams, so I cannot recommend one, I suggest the peptide cream that we sell on our website. JG 4.7.10
Answer: I do not use them for augmentation, only for breast cancer reconstruction patients. The valve do fail more than normal saline implants. There is no legal limit on what can be placed into a patient though. JG 4.7.10
Answer: Vaniqa. JG 4.7.10
Answer: that happens if the lower lid needs to be tightened with a canthopexy. That is required if the lower lid has lost muscle tone and is hanging down, it should not always happen. If the canthopexy is needed and is not performed, and skin is removed, it can lead to serious problems with corneal exposure. JG 4.7.10
Answer: still OK to do, yes. JG 4.7.10
Answer: it might still improve with more treatments. JG 4.7.10
Answer: need to keep using the product for it to stay gone. JG 4.7.10
Answer: it is a prescription item and not all plastic surgeons have it in their offices. JG 4.7.10
Answer: most likely just swelling, do not think that pushing the cartilage around will do much good though. I suggest leaving the tip alone for now and letting the swelling go down on its own, if anything, just a little ice. All the best. JG 4.7.10
Answer: Recent studies involving a gel formulation containing DMAE have shown that the compound can increase skin firmness, even in younger subjects.Thirty healthy adults between the ages of 36 and 49 were given tests that measured changes in skin tautness after application with the DMAE gel, compared to placebo. Results indicated that the placebo had little or no effect on skin firmness, while the DMAE-treated skin exhibited greater tautness.Researchers offer two possible explanations for these results. First, DMAE may enhance water retention in connective skin tissue, causing the surface of the skin to tighten. The second, and more likely, explanation involves DMAE’s cholinergic feature, which enhances the skin’s ability to transmit acetylcholine. The neurotransmitter’s function in sending signals from nerves to muscles may promote a form of muscle tightening in the skin. It is important to note that although DMAE cannot fully reverse existing facial sagging, it may reduce its further progression. Some people report a cumulative effect with continued use of the compound.Age spots, or “liver spots,” also may respond effectively to DMAE in cream, gel, or tablet form. Studies have shown that DMAE’s membrane-stabilizing properties reduced the accumulation of lipofuscin deposits inside cells. Lipofuscin, a brownish cellular pigment consisting of aggregated chunks of molecular waste formed by the inefficient metabolism of fatty acids, tends to occur in the cells of older people and is primarily responsible for age spots. DMAE has been shown to flush excess lipofuscin from affected skin cells.DMAE is a potent, site-specific free radical scavenger. An in-vitro study found that adding DMAE to myocytes (the heart’s pumping cells) protected individuals from cell damage resulting from ischemia, a lack of oxygen and blood flow to the heart, and from metabolic inhibition. Taken in the proper dosage, DMAE’s antioxidant effects can offer probable benefits of value in the maintenance of overall cellular health.As to the Retin-A, it should help with the lines, yes. JG 4.7.10
Answer: that would involve two surgeries, one to place the tissue expander, and then a second one. The cost for the second one is the $7000 and the first one is about $4500. While the expander is in place you will also need to live with a large swelling on the front part of your scalp that can be quite disfiguring also, so one needs to be prepared for that. JG 4.7.10
Answer: nothing that is reproducaeel and reliable I am afraid. If the electrolysis did not work, the laser will do even less than that, especially for blonde hair. Could try prescription Vaniqa though. JG 4.6.10
Answer: OK.
Answer: neither, buy some generic Retin-A with a prescription for the best option. JG 4.6.10
Answer: I am not hot about it. JG 4.6.10
Answer: the skin might have stretched or you might have lost some of your own breast tissue is the most likely causes. JG 4.6.10
Answer: the only one I thought was worth the money was the one we used to sell, but we now sell a pepetide cell matrix cream instead on our shopping cart. JG 4.6.10
Answer: well,the dilution is what I mentioend earlier, but I personally do not think the crsytals stay intact for very long after injection for the saline injectiosn to work days or weeks after the injection is first done. I guess you can hope they are correct in their assessment, but I have not seen it be effective in practical treatmen terms. One can always hope. JG 4.6.10
Answer: sutures never relieve tension, that is done by loosening the tissues prior to closing the incision.JG 4.6.10
Answer: I think Dexon causes more infections than Vicryl does and I feel the Monocryl is stiff and tends to poke through the skin edges and gets exposed. Scar revisions seem like they would be easy but actually they are difficult as they need to have larger and larger pieces of skin removed and unless one can diminish the tension on the wound when closing, the scabs form from the pressure and then they break open from lack of adequate tension release. It might be allergy, it might be infection and it also could be that there is not enough of a release of the tension to get the wound to heal without complications, sorry. JG 4.5.10
Answer: well, if the saline injection is done in the first day or so it might dilute the kenalog enough and spread it out over a larger area to decrease the effects, but once it has a negative effect, injecting saline will no longer help. As to tretinoin, I seriously doubt it will help as the steroid is much stronger than the tretinoin. The faster the atrophy occcurs the worse the potential long term effects can be I am afraid. JG 4.5.10
Answer: less than the other sizes. Upper pole fullness is actually only natural in a pubescent breast, or a pregnant milk-engorged breast. As time goes on into the twenties, a full upper pole is not natural. That is not to say that women do not wish their breast`s upper poles to be full, therefore push up bras, or the use of overly large implants to acheive that appearance. The truth of the matter is that natural upper pole fullnes is an oxymoron after the age of about 22. Does not mean you cannot have it, just means it is not natural when not wearing a bra. JG 4.5.10
Answer: The latest reoperation rates are about 20-24%, taking into account all reasons why a woman would want or need a second operation. The implants are not truly rejected, as they are not living tissue, they just have negative side effects, like the capsular contracture, a known risk, not relaly a complication. I would say that the implants being smaller do have a lesser chance of reoperation than larger implants, yes, but I cannot say what the break off point would be. JG 4.5.10
Answer: I had a wonderful time with family, thanks. As to the cast, and final shape, not really, it is more of a protection of displacing the bones right after surgery and an attmept to reduce swelling. I think the ultimate end results are not significantly influenced, although you might see the end result slightly sooner is all. All the best. JG 4.5.10
Answer: in general, the smaller the implant the less the complications, I think for your frame and measurements, either one is likely OK though, but when in doubt, I like to go smaller. You are talking less than one ounce difference. Best of luck. JG 4.5.10
Answer: I use both Vicryl and PDS absorbaable sutures. I do not use Monocryl or Dexon. JG 4.5.10
Answer: depends on the kind used, it can take 6 weeks to 6 months, there are a number of different kinds. JG 4.5.10
Answer: a deep one under general anesthesia is $4000. JG 4.5.10
Answer: the dissolvable sutures might have gotten infected or you are allergic to them. Might just use neosporin to help it heal. JG 4.5.10
Answer: I think the dangers of DMAE creams are hyped and not really true,as to the best, it is impossible to tell because none of them tell you the concentration of the DMAE in the cream. JG 4.5.10
Answer: have not used Smart Lash and we do not sell Latisse. JG 4.5.10
Answer: for the rim of the orbit yes, for the eyelid skin itself, no. JG 4.4.10
Answer: not every woman that loses fat loses breast tissue, it depends on what percentage of their breast is made up of fat versus breast gland, the more fat in the breast the more they change with weight loss. Making the chest muscles bigger without weight loss will not affect the size of the breast though. Toning muslces will not tone your breasts, it is an old wive`s tale. JG 4.4.10
Answer: Sorry but none of them work. JG 4.4.10
Answer: might suggest some IPL treatments and also some Retin-A. Micordermabrasions might help with the pores too. Happy Easter to you too. JG 4.4.10
Answer: swelling or maybe the pocket is not large enough for the implant so it is not sitting entireey on the bone. JG 4.4.10
Answer: Carnosine is a small molecule composed of the amino acids histidine and alanine. Carnosine is found in relatively high concentrations in several body tissues—most notably in skeletal muscle, heart muscle, nerve tissue and brain. The exact biological role of carnosine is not well understood, but many studies indicate that carnosine has antioxidant potential. Carnosine may also act as a neurotransmitter (chemical messenger in the nervous system). Carnosine has been called a longevity nutrient since laboratory studies on tissues indicate that it can delay senescence and provoke cellular rejuvenation in cultured human fibroblasts. Carnosine has been called the anti-aging and anti-oxidant dipeptide. The exact role of carnosine supplementation in human health is not clear at this time. L-Carnosine is a dipeptide composed of the covalently bonded amino acids alanine and histidine and is found in the brain, heart, skin, muscles, kidneys and stomach. L-Carnosine is naturally produced in the body by the enzyme carnosine synthetase.L-Carnosine supports healthy aging and cellular rejuvenation by its effects on two mechanisms: Glycosylation and free radical damage. Glycosylation is the oxidation of proteins by glucose resulting in cross-linking of proteins and which is implicated in loss of cell function, genome integrity and accelerated aging. L Carnosine also protects the aging process of the brain by retarding lipid peroxidation and stabilizing cell membranes. There are more studies doen on the L-carnosine and its effects. When you buy Carnisien you get both R and L isomers of the carnosine. The dose I take is L Carnosine (alanylhistidine) - 500 mg each pill. I take 1 carnosine capsule before or with breakfast daily. Happy Easter. JG 4.4.10
Answer: no, a vasovagal attack happens mostly in normal hearts.It is just an overproduction of parasympathetic chemicals. JG 4.4.10
Answer: sounds like it stil is a little swelling, might take a full year. JG 4.4.10
Answer: no scientific proof I am afraid. JG 4.4.10
Answer: there is no risk of thinning skin and I feel it is as effective if not more than kenalog. JG 4.4.10
Answer: need surgery to trim the cartilage down is all. JG 4.4.10
Answer: I think they are not as good as Portrait as there are millions of skip areas, it allows the skin to heal faster, but you are only treating a small percentage of the skin. The bigger drawback with the portrait is the healing time I feel. JG 4.4.10
Answer: Voluma and SubQ are meant for deeper injections not for lines. Although I guess it is possible to have fat loss in a young patient causing the nasolabial fold to be visible, but in younger patients it is usually due ot a skin issue and not a fat loss issue. Look at a newborn babay, they have no fat loss and they have nasolabial folds Using a longer lasting product if the others did not help will not make it work. You likely need to have a different injection technique used for the fold. For a nasolabial fold to be seen secondary to fat loss, then the area that needs injecting is the cheek and not the fold so it cna lift what has fallen. All the best. JG 4.3.10
Answer: I prefer the Restylane family of products. JG 4.3.10
Answer: Although those things happened, I do not think they have caused the polly beak deformity, that is usually due to the cartilage that has been altered. As much as I hate to say it, it might need more surgery to correct if it bothers you that much. The cast falling off will allow more swelling and possibly some widening of the bridge if the nasal bones were broken. The post operative activities are not too far different from what you would have likely been told, so that likely did not influece the issue.Sounds like you need more cartilage and septum work is all. Best of luck. JG 4.2.10
Answer: I have not seen nor read of those reports about minoxidil myself. I am no longer affiliated with ScalpMed but I do not believe they have a foam application. Best of luck. JG 4.2.10
Answer: Run,do nto walk from that place, they do not know what they are doing and could harm you permanently in that area. As to the Rstylane for the tear trough, that is yes, but not at that place. JG 4.2.10
Answer: good stuff. JG 4.2.10
Answer: yes. JG 4.2.10
Answer: if it is brown PIH the Lustra should help, worth a try. Best of luck. JG 4.2.10
Answer: the amount of fill appearance is not from the type of filler, it is the amount of filler injected. JG 4.2.10
Answer: yes, still a fan but mild improveemnts, I think it will be a long time before something really safe is out for olive skin.JG 4.2.10
Answer: there are different types of Restylane and Juvederm that were developed for that, it is nothing new nor something Dr Wexler is the only one doing. JG 4.2.10
Answer: depending on the depth of the CO2,if done ligth or fractional, it could be followed with a TCA spot peel after 6-8 weeks if the skin has healed. JG 4.2.10
Answer: I never use Botox around the mouth and as the to the cheeks, it would have taken a large amount of Botox to have that effect, so not quite sure what has caused that except lots of swelling. You can have some Botox injected into the lateral brow forehead region though and that will drop the lateral elevation of the eyebrow that is giving you the Vulcan appearance. All the best. JG 4.1.10
Answer: yes, it is reasonable. I think using your own intranasal cartilage would also be best. Good luck. JG 4.1.10
Answer: the phenol peel will do much more, numerous lighter peels do not equal one deep one I am afraid, but the risk of hyper and hypo pigmentation are greater the deeper you go. JG 4.1.10
Answer: I have not seen any procedure that shows consistent and reproducable resutls. All the best to you also. JG 3.31.10
Answer: it can be done but if the implant proves too big or small on the chin then it will need to be revised. JG 3.31.10
Answer: there might be some small amount of swelling at this point still. It can take a full year to all heal and settle in, best of luck. JG 3.31.10
Answer: totally ablative CO2 laser.UltraPulse CO2 was the most widely known. JG 3.31.10
Answer: depends how deeply they go. JG 3.31.10
Answer: it is the method used to diminish those lines and a droopy eyelid is possible but rare. JG 3.31.10
Answer: in that case it is likely secured to the front edge of the septum to push everthing down and out more, to gain projection. The graft should just place the tip more forward, not change its shape. Best of luck. JG 3.31.10
Answer: hard to say what that occured, might not be reproducable in the future too, sorry. JG 3.31.10
Answer: Jessner`s peels will not do anyhig for the thick nasal tip, only mild effects for recent brown spots. JG 3.30.10
Answer: it works by actually debulking the thickness of the Rosacea, like a sander. In most cases it is a one time thing, at least for a long time as the Rosacea does not grow quickly. Erbium can do it also but it is going to bleed lots more because it does not cauterize the tissues like a CO2 will. I think the Fractional is a waste of time, especially for this problem. The debulking can also be done with a loop hyfercator, an electrical cautery device. Best of luck. JG 3.30.10
Answer: it can be used on the eyes also, no need for a different cream. I think if you desire you can apply the Retin-A first and then my peptide and skip the Skinceuticals. JG 3.30.10
Answer: correct, what you have after two years is scar tissue, not swelling. I think the kenalog will be of little help in most cases. Cutting the scar tissue out just allows new scar tissue to form, the only time that would not occur is if there had been an infection or excessive bleeding which could potentially be avoided the next go round, but if neither of those two things happened, more surgery will likely not help. Personally, I would leave it. All the best. JG 3.30.10
Answer: for acne, nonn of those, for pigmentation, if it is light and recent they all will help some but the most effective is TCA. JG 3.30.10
Answer: well, the one in a different town might give you a slightly more objective opinion. I will say that in many cases the patient thinks there was not enough fat removed but what remains is the necessary layer of fat to avoid dimples and then a large amount of loose skin that cannot shrink due to age and location. As to the type of anesthesia for the touch up, it depends on how much needs to be removed, no way for me to tell. Sorry and best of luck. JG 3.30.10
Answer: usually 7-10 days.JG 3.30.10
Answer: certainly worth a try or those breathing strips can be worn to see if they help. All the best. JG 3.30.10
Answer: I think the IPL will be as effective for that and also alot cheaper. JG 3.30.10
Answer: yes, it can. DMAE creams and my peptide cream also help. JG 3.30.10
Answer: I would not inject Sculptra around the eye. Not all scenarios can be remedied with fillers and some issues can never be made better no matter what is done I am afraid. I am not a fan of the Titan and without seeing you in person I am afraid I cannot say what it would take to make it look better. JG 3.30.10
Answer: I think that is a little extreme, I think a few days before and 2 weeks after is reasonable. JG 3.30.10
Answer: Botox is not a filler, it is a muscle weakening agent. Botox or Dysport both weaken muslces so if you use a filler, like