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. All responses are done personally by Julio Garcia.

• What is the healing phase of incision scars,1 month, 3 month 6 month and 12 months? When are they red until and when do they go white and unnoticeable? Also do dissolvable sutures result in a less sightly scar?

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• I have a sweat gland or hair follicle gland near my bikini region that will not go away, its small but fills up like a pimple and has to be extracted periodically, it is becoming scarred. how can I get rid of it, would IPL help?

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• Does botox injected to correct gummy smile, drop lip down slightly at rest and when talking, or only when smiling?

  Answer:  Both at rest and when smiling. JG 5.21.13

• I am having a lower facelift in two weeks. Is it possible in that procedure to plicate the pre-auricular tissue and the tissue over the posterior mandible to add volume? If so, how long does that volume typically last? I`ve grown gaunt in those areas. Sculptra helps some but not enough. Thank you so much for your time and help, Dr. Garcia.

  Answer:  it is possible an should last a few years, but everyone ages at a different speed I am afraid. I think the effect will be relatively small though, so do not expect much more than you see from Sculptra. JG 5.20.13

• I have been using latisse on my lashes but it is so expensive. Do you think the generic careprost would work just as well?

  Answer:  it`s the same product. JG 5.20.13

• Luvitra and Mabel Plus lipo duo? at only $149 for 1 treatment (I want it on my belly) sound like a good deal??? I exercise daily, but still can`t get rid of the pocket of belly fat. Thank You for your time

  Answer:  Sorry, the only thing smaller will be your wallet. JG 5.19.13

• You didn`t tell us what you think of carboxytherapy for stretch marks (and for cellulite). Worthwhile? Hype? The photos seem impressive. If you think this treatment is effective, how long do the results last? Thank you, Dr. Garcia.

  Answer:  I think it is a scam, I have seen severe infections, permanent scarring, I would never do it. JG 5.19.13

• How long does it typically take for a pneumothorax to resolve on its own without any intervention?

  Answer:  It can take a couple if weeks but symptoms are usually better in a few days. JG 5.19.13

• What is your opinion of the Murad Resurgence line of products? It claims to treat the dermatological symptoms of hormonal aging. Is it as effective as, more efective than or less effective than using bio-identical OTC estriol and progesterone creams? It claims to be safe for women who have or who have had cancer, so I`m assuming that its ingredients are significantly milder than OTC hormone replacement creams I`m using. Is that right? Have you had patients who have used these products? Thank you.

  Answer:  The bioidentical creams are more effective, l do not think Murad is any better than the others out there, just marketing. JG 5.19.13

• I am having Smart Lipo Tripex and started Arnica two weeks ago and my surgery is June 11.. Is it safe to continue with these pellets until that time and do I continue with them after. Thank you.

  Answer:  Safe to continue and also for 7-10 days after. JG 5.19.13

• I know it is important to have a lower eyelid bleph expert do surgery on your lower eyelid so your lid will not end up droopy, but what about upper lid bleph? Can nay plastic surgeon do that surgery or does it really require an expert so no droopy occurs? Is lid droopiness also a risk with upper lid bleph? I was thinking of having it done by a doctor who has a plastic surgery spa since I do not want to be sedated. Although upper lid bleph can be done in the office, many doctors still do it at a surgery center or hospital.

  Answer:  I think an experienced surgeon can do both. Upper eyelid droop can happen but is rare in experienced hands. I do mine with general anesthesia ir sedation, NEVER under local anesthesia alone. JG 5.19.13

• Dr. Garcia...I wanted to add something to my previous question (cg 5.18.13)regarding fat grafting to upper eyelids and ectropion repair using a spacer. My doctor has suggested using TarSys (made from pork) as the spacer. I have read on-line where one lady developed an allergic reaction to this material. Are you familiar with this material being used to repair ectropion?

  Answer:  I think it is better to use your own from the hard palate. JG 5.19.13

• Hi Dr. Garcia: I am scheduled for surgery in one week (5/24) and am afraid I am undergoing too much surgery at one visit. I am suppose to have fat grafting to upper eyelids (hollow eyes)and ectropion repair to lower lids (repaired with a spacer on one eye). Here are my concerns: (1) Excessive swelling (having so much done to the eyes at once) may cause the fat grafting to fail; and (2) my eyebrows are already too high (due to prior surgery) and I`ve read adding fat to upper lid may elevate brows. I am thinking about postponing the fat grafting for another time. Do you believe my concerns are valid? And, if so, do you think it would be wise to only opt for one or the other at this point? Thank you so much. cg 5-18-13

  Answer:  It can all be done but there wil more swelling than if broken up, might want to split them to make sure yiu still want the uppers done. JG 5.19.13

• hey dr garcia, Can i get laser hair removals after carboxytgerapy for stretch marks? if not how soon do i need to wait brcause i just got a session of carboxy for stretchmarks on hips butt and legs today. also whats your opinion on carboxytherapy for stretch marks?

  Answer:  I would wait 7-10 days. JG 5.19.13

• Sorry! I meant to type garcinia cambrogia.

  Answer:  I thought so.

• What is your opinion of the supplement garcinia cambrogosia?

  Answer:  Lots of hype, little science. JG 5.19.13

• Dr Garcia, I have juvederm ultra injected in tear troughs under eyes area like a month and half ago. Results are still there and good. None of it has absorbed. But I`m reading that there`s a chance it can make you blind by suffocating artery. Do I need to worry? I`m completely ok with no probs but I`m really paranoid now. Please reply

  Answer:  No worries, if that was going to happen it is an immediate thing, enjoy the results. JG 5.17.13

• Will making an 1/4inch inch incision over an existing 4 week old incision in the temple in the hair result in poor scar, it is being reopened for revision/removal

  Answer:  should not affect it negatively. JG 5.17.13

• I had a midface procedure that has caused some temporary nerve damage to one side, my smile is slightly crooked and lip covers my teeth more when talking on the injured side, would it be my zygomaticus major muscle that would be injected with a few units of botox to regain symmatry while it heals or the levator labii superioris muscle?

  Answer:  your surgeon should know where and what to inject so that both sides are weakened in order to look symmetrical. JG 5.17.13

• About how long after a bullhorn lip lift can the scars be successfully covered with makeup? And about how long before they are completely faded? I have very fair white skin. Also, in reading this site, you often say that brow lifts fall in 12-18 months. So you would say that they are not worth doing? Do you ever perform them yourself? Have a great weekend, Dr. Garcia!

  Answer:  should be OK in 7-10 days or so. They should look much better and nearly gone in 6-12 months. I say that about endoscopic brow lifts, not traditional open technique. I still do many open forehead lifts but no longer perform endoscopic ones. JG 5.17.13

• Good morning, This is a follow up Q on rhinoplasty on Asians. I am curious why decreasing the bulbous nature of the nose is risky. Is it the risk of keloid scarring? I am not looking for a high bridge Caucasian nose, which would not fit the rest of my face, just lessening the bulbous look of the nose. Thank you.

  Answer:  risky in the sense that scultping the cartilage or placing cartilage grafts will not lead to a refined tip due to skin thickness. That usually will require cartilage grafts or synthetic grafts like silicone, both of which can cause problems in the tip with erosion and or infection. The bridge augmentation is easier compared to tip definition. JG 5.16.13

• Hey Dr. I just had botox for the first time a month ago and like it. Thinking about getting Juverderm for my nasal folds, I am 48 and want to look younger for my age. Is this something I will have to continue to do and is there side effects to this injectable? Thanks

  Answer:  minimal side effects, little things like a temporary bruise, but if you like the look you will need to continue it as it does not stop the aging process. JG 5.16.13

• Doctor: How do you feel about TNS recovery by medicus skin care? I have been using obagi for years now.. Let me know if you think it is worth it. thank you

  Answer:  It is a good product, mught be good to change after that much time. JG 5.15.13

• Is it possible to have fat transferred to neck area where lipo was performed and too much fat was taken out? I am left with skin sagging under chin and unevenness. Thanks!

  Answer:  It can be done, survival is unpredictable and it might have to be performed more than once. JG 5.15.13

• I`m having a mini arm lift next month and considering going on vacation the following month is 4-6 weeks time enough for the incisions to heal and use makeup to conceal the scars?

  Answer:  for a min that should be enough, yes. JG 5.15.13