Las Vegas Face Lift - Ask Dr. Garcia Library - Page 1

NOTICE: Las Vegas Face Lift: 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 regarding Las Vegas Face Lift are done personally by Julio Garcia.

• Oh, NO inconvenience at all, Dr. Garcia! You are the one who is inconvenienced by all our endless questions! Here is what I posted: I had a corset platysmaplasty 12 years ago and it fabulous. Over the years of course the skin has loosened . Is it possible that the muscle might need to be slightly retightened too? I went to the surgeon who did it the first time but he doesn`t revise his work because he says it`s always perfect the first time. He also told me he`s one of the only surgeons in the world who does isolated neck lifts in which the incisions are only behind the ears and under the chin. This is what I want because I don`t want scars ins front of my ears. Is he right or is he suffering from an inflated ego? Do other board certified plastic surgeons perform this operation? Is it something you yourself do? By the way, I don`t need a lower face lift. Thank you.

  Answer:  not all patients are candidates for a limited post-auricular incision alone. The reason is some people have excess skin of the neck only in the horizontal vector, which makes them a good candidate for the behind the ear only incision. This is common in younger patients. As they get older and the amount of skin ages in both horizontal and vertical directions, then skin needs to be removed in front of the ear too. You can usually tell by pulling on your skin of the neck and seeing what direction the makes neck looks best. If there is any vertical pulling required and you see a small pleat of skin in front of your ears when you pull with your fingers, you would need the incision in front also. From what you are describing, it appears that your surgeon`s ego is likely as big as his prices. I am sure he thinks the first time was perfect, but alas perfection is fleeting, but if his claim to be one of the few that only does the incision behind the ear, that explains why he will not do the revision, because doing that isolated incision may not be enough in your case now and he does not want to make his claims untrue. Most plastic surgeons do neck lifts and where the incisions are needed is determined by the patients needs and not the surgeons desires. I wish you the best. JG 3.7.13

• Hi Dr, Just a question on behalf of a friend of mine who is 3 weeks post from a SMAS lift and neck lift. She is suffering from headaches that originate from the back of the neck and move forward to the crown. Is this normal due to muscle tension and swelling from the face lift and does this get easier with time? Also, realistically when do the results start to show? Many thanks

  Answer:  the muscles treated during her facelift should not affect the muscles back there.It might be because of the position she is sleeping in, or even lack of sleep. You should see the improvements start to show after about a month or so. I wish her the best. JG 3.6.13

• Question in re: to my 67 yr old mother. She had a full facelift 5 yrs ago, and her PS said it is now time for a mini face lift and wondering if 7500 dollars is an out of a line price for a mini lift? thank you

  Answer:  Prices vary from arwa to area, it is usually about 60-70% of the original fee in most cases. JG 3.5.13

• Hi Dr Garcia !! My PS is having a $50.00 off for Dysport through April. Is this Botox? I have never had it. I am wondering if it would help with the inside corners of the upper lids ( the turtle look). My forehead is smooth and I had a forehead lift/face lift using endotines 8 years ago. I also had a upper bleph in 94` that had a bad outcome. My own stupidity, I let a dermatoligist perform the upper bleph. What do you normally charge for Botox? Is it safe to get botox for the upper lids/forehead and sculptra to the cheeks at the same time? As always, you are sooooo appreciated. My first `go to` man. I always follow your advice. Thank you so very much

  Answer:  Not sure the Botox will help what ails you. The only way to offer Botox or Dysport legally is to use the whole bottle, if you look at the bottle carefully, it clearly states it is meant for one patient only, the doctors that share the bottle between patients are not doing it right. We sell the 50 unit bottle of Botox for $600 and the 300 unit of Dysport for $850.No problem doing Botox and Sculptra at the same time, as long as it is not the same area. I wish you the best! JG 1.28.12

• What do the micro current face lift machines do for the face?I mean do they do any lifting or decrease wrinkles at all. If so,would the results be long lasting? Thank You

  Answer:  Sorry, waste of money in my humble opinion. JG 1.20.13

• Several months after a face lift 3 1/2 years ago, I was prescribed Obagi (retin-A and a bleaching cream)by the surgeon and then started to develop thread-like spider veins on my face. I learned from your site that retin-A can contribute to these forming in some people. I`ve had Candela V-Beam and IPL treatments to lessen their appearance. I am now considering a chemical peel for melasma/sun spots on my face and wonder if it would have an impact on my tendancy for these spider veins to develop. I am now 67, if age has any bearing. Thank you, Dr. Garcia.

  Answer:  The peels should be OK, it is the constant long term irritation with Retin-A that causes the problem. All the best. JG 12.15.12

• Hi Dr..... I just had Juvederm on nasolabial and under the eyes but i have lined up appointment for my Micro current face lift and upper lip laser hair removal in 2 days .My Q is that would that micro current facial Or laser hair removal would destroy or spread the Juederm gel on my nasolabial and under eyes area??PLEASE respond.THANKS

  Answer:  Should not have any negative effects. JG 11.28.12

• Dear Dr. Garcia, I am 1 week post-op after my midface/cheek lift. Although I look reasonably good without much bruising or swelling, I noticed that the depression in one cheek is beginning to show again. Not as bad as it was, but that was the main reason I had a midface lift. I was tired of getting that area injected every other month. From your experience, do these things get better after all the swelling subsides after a few weeks or months? I don`t want to have to have it redone. Thank you.

  Answer:  Will likely not get better in time with the procedure you had done, sorry. JG 11.18.12

• Dr. Garcia, Thank you for taking the time to answer my question regarding the midface lift. Some of the physicians have called it a midface and others a cheek lift. So I take it that it is very different procedure. Now I am concerned about the eye area with the midface lift. I will definitely ask him about that. Thanks so much again!

  Answer:  Yes, the cheeklift is just the cheek portion of a facelift, because the typical facelift involves the cheeks and the neck.Best of luck. JG 10.18.12

• Dr. Garcia, Is it true that hypertropic scarring is unusual from S-lift incisions because of the vascularity around the face? With a cheek lift, isn`t there an incision somewhere near the mouth or in the gumline? Can this be done without these incisions? Is the cheek lift different from a midface lift? Thank you.

  Answer:  no, it is either due to infection, excessive tension and in smaller percentages of cases, genetic predisposition to hypertrophic scarring. There is no incision in the gum line routinely. Some surgeons due a subperiosteal release of the tissue in order to get elevation of the tissues of the cheek, and in those cases an intra-oral incision is made, but that is not done in the usual cheeklift.A cheeklift and a midfacelift are operations on the same area but classically, a midfacelift is performed by releasing the tissues off of the bone in order to get them to move and in a cheeklift they are lifted directly on the tissue itself with no release off of the bone. The risks of prolonged swelling and excess traction pulling down on eyelid structures is much higher in midfacelifts than it is in cheeklifts. I do to perform midfacelifts for that reason and also because the tissues do not become detached from the bone with age so I see no reason to approach them in that manner. I am going to guess that the surgeon you are consulting with is promoting the mid facelift over the cheeklift, telling you that you will not have any visible scars with the mid facelift, and that is true if you are one of the rare patients that does not need any skin removed after the elevation of the tissues, if you do there will need to be a scar.You may want to ask him what the chances of ectropion or lower eyelid malposition after his mid facelift is, in general published reports it can be as high as 17%, not a good thing. JG 10.18.12

• Dr. Garcia, I have gone for several consults for midface lifts. One physician says he can do a midface and S-lift/neck in 2 hours. I had another consult today where the physician says that to do both, it would take at least 5 hours. They are both very prominant surgeons in this area so I don`t know whether I am being mislead that both procedures can be done in only 2 hours. What is your opinion?

  Answer:  Sounds like a lot to do in 2 hours. It woukd take me 3 1/2 or so. JG 10.16.12

• Also, is there quicker recovery under local anesthesia with the mid-face lift?

  Answer:  the recovery will not be any faster under local, no matter what is marketed by offices.JG 10.3.12

• Dr. Garcia, Can mid-face lifts be safely done under local anesthetic? Would it be too painful to have it done this way?

  Answer:  I would not perform it that way. JG 10.3.12

• Hi Dr. Garcia, I`m the one who sent you pictures a couple of weeks ago. I`m wondering if I should have the midface lift if it is going to just give me a rested look. From looking at a lot of before and after pictures, some look almost the same or minimal improvement. I guess what I`m looking for is something that would give me a more dramatic change. To spend money just to look rested doesn`t really see worth the money. What is your opinion?

  Answer:  he trade off between looking rested and something dramatic is that in the dramatic choice, you might look different, not like yourself, and it might be obvious that you have had something surgical done to enhance your appearance. You will need to make that decision, on how visible you want it to be, before you decide on what to do. My personal preference is to have the patient look natural, I prefer not to over do a person as I feel, even if they want that look, if others that see that work performed by me will likely scare off potential patients who may think it was my choice.I am not saying that a dramatic change is not a good decision, but I like to get patients back to the way they used to look like when they were younger, if that requires something dramatic due to the changes that have occurred, so be it. If they are looking for an appearance they never had, that becomes a more difficult decision as it might never be dramatic enough of a change in the patient`s eye.JG 10.2.12

• Thank you Dr. Garcia. I am trying to decide whether to have my midface lift done with one surgeon who does it through the mouth versus another who does the S-lift. What is your opinion on the two techniques? Diana

  Answer:  I think the swelling when the midface lift is done through is prolonged and there is no skin removal, so it is not something I suggest to many patients. JG 9.17.12

• Dr. Garcia, I am contemplating whether or not to have a midface lift. I don`t know whether it`s worth the expense of doing this if there is not going to be a significant improvement or perceptive difference. Could I send you my picture so I could have your opinion. I`ve tried Radiesse and it lasts several months for the nasolabial lines, but does not last more than 1 month on the cheek hollows. I have a depression on my cheeks that have developed over the last couple of years. Thank you.

  Answer:  Certainly, please send them to drgarcia@lvcosmeticsurgery.com

• Hi Dr. G., How long after a lower face lift does all swelling go away? Thank you.

  Answer:  the more swollen you get immediately after the surgery, the longer it takes, but in general, most will be gone in 6-8 weeks, but scars or incision might take 8-12 months and the sensation can also take months to resolve. JG 9.6.12

• I had a lower face lift on June 28th. How long does it take for swelling to go down, and for the real results to show. Thank you!

  Answer:  Most of the swlling is gone in 6-8 weeks, scars will fade for 1year. JG 9.3.12

• Hi, Dr. Garcia. I have seen a surgeon who offered an option to help me after 1 damaging necklift and 2 distorting facelifts. He offered a Transtemporal Subperiosteal Mid-face Lift. 1) I can see how this would lift cheeks, but how much can this typically lift the mouth area? (My mouth area is now too low on my face and unusually downturned.) 2) Also, he hesitated to revise the bad facelifts, but I was hoping he could revise that in order to improve the vectors. (He said the vectors were wrong.) Do surgeons ever revise a second facelift to improve the vectors? Thank you for your kind assistance.

  Answer:  it can lift the mouth some as it will be pulling the muscles of the cheek, which are the muscles that move the mouth, into a higher position. I think being conservative at this point is a good idea. Maybe consider revising the skin vectors after the mid facelift has healed, it might then require less revision to the facelift part. I think surgeons often do revise vectors when doing a second facelift, yes. I wish you the best. JG 9.2.12

• Dr. Garcia, Thank you for answering my earlier question regarding local anesthesia verus twilight. I have another question regarding the longevity of facelifts. I do not have jowling, but the fat has fallen to the nasolabial area and I have depressions in my cheeks from loss of fat or migration of fat. Which facelift would best address this problem? Life-style, miniface lift, S-lift, or SMAS? Which one lasts the longest? Thank you.

  Answer:  SMAS will last the longest. JG 8.24.12

• Dr. Garcia, I am trying to decide between two surgeons in my area to perform a facelift(S-lift or mid-face lift). One surgeon does this under local where I will be awake and the other will do it only under twilight. The surgeon who operates under twilight says that an effective lift must be done under this type of anesthesia and the other under local must be just a feather lift. I don`t know which to believe. Also do you know if the Fraxel Restore Dual is effective and safe on Asian skin? Thank you.

  Answer:  I would not use the Fraxel on Asian skin, personally. As to the surgery, if they are both surgical procedures and not just a thread lift, it ultimately is a decision between the surgeon and the patient. Using twilight makes the injections of the local anesthesia much less uncomfortable and will keep you from begining to fidget or move as you will likely need to be in certain positions for long periods of time without moving. I prefer using general anesthesia or twilight. I would also ask what surigenters the doctor has privileges at to the do the same procedure. If he can only perform it in his office, I would seek out a different surgeon as he probably does not the appropriate training to be certified to perform it at a surgicenter. Certification is a must. Best of luck. JG 8.24.12

• Thank you so much for answering my questions. I love your site.I had a face and brow lift almost 4 months ago. How long does it take to see the complete results of a facelift and brow lift? Do you think that a peel should be done on the neck for wrinkles and if so how long after a face lift? If so what type of peel? I have also read on your site that you think Neutrogena UltraSheer Sunblock is a good product. Do you recommend that or the Fallene Total Block. There is a big different in price. Are both just as effective? Thank you

  Answer:  It will take about 10-12 months for final maturation of the results. I think peels can be done on the neck, but not deep enough to get improvements lasting more than a couple of months. Lasers are even riskier there with potential scarring. If you were going to do the peel I think I would use 35% TCA done by a physiican. I prefer Fallene but the Neutrgena is easier to find at stores. I think they are pretty equal, I think the Fallene blends in with a little less skin residue. JG 7.26.12

• Thanks for the answer about the arcus marginalis. I`ve already had a midface lift to correct the sag, but the triangle beneath my eye, lateral to the nose, still sags and is puffy. Can the arcus marginalis itself be reattached (not just the midface tissues)? If so, will it help with the sagginess and puffiness?

  Answer:  the arcus itself is a very narrow thin piece of tissue that acts like a dam, I am not sure that such a structure alone can be repaired. JG 7.18.12

• Hello Dr., I am sorry if this question has been asked before but can you please tell me the difference between a lifestyle lift (and various other names) and a face lift, the cost range of both, and how long the results of each can be expected to last. Thank you for sharing your knowledge.

  Answer:  I cannot give you costs as that varies from surgeon to surgeon in the same city. As to the LifeStyle lift, there is some difficulty in explaining it to you as their surgeons are not allowed to speak about what is done. So I will base my points on what I have seen from the numerous patients that have has a LifeStyle lift and then have come to see me for a facelift just a year later. First thing is that the amount of skin undermined is less, the ability to lift the tissues below the skin is limited in its direction and the work on the neck is minimal. Many of the photos you see in their ads show people that have had additional things that are not included in the straight LifeStyle lift. That is the reason why they are now saying that a LifeStyle lift is any of a number of procedures that can be done in a short time in the office, thereby covering the fact that the patients they show have had multiple things done, rather than the original LifeStyle lift which was essentially a mini facelift.In my opinion, the more things you correct, the longer it lasts and that is why I believe the facelif tis superior. One can expect 7-10 years or more with a facelift. I wish you the best. JG 7.2.12

• Hi, Dr. Garcia! Happy July! I`m wondering about fat loss during facelift surgery. My plastic surgeon says that the dissection for a face lift always damages the fat layer above the fascia, causing even more gauntness -- which is part of what I`m trying to correct with a facelift. Is that true? If so, doing facelifts seems counterproductive. Thank you!

  Answer:  I think the fat loss can be mitigated by dissecting the skin alone, leaving the fat on the fascia where it can draw blood flow to survive. JG 7.1.12