Las Vegas Forehead - Ask Dr. Garcia Library - Page 13

NOTICE: Las Vegas Forehead: 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 Forehead are done personally by Julio Garcia.

• THAnk you doctor for your answers and valuable time...so for your answers it is my understanding: 1) that radiesse is okay to do for a quick fix so I be ready in 2 weeks for a party...AND 2)it is NOT necessary to stop the RETIN A for the appointment I have on 05/27 for the radiesse. my last questions will be if I decide to do botox for the forehead...can radiesse and botox be done at the same time? and can botox be use while on RETIN A TOO?...So any filler can be use while on RETIN A? Thank you again

  Answer:  correct, OK to proceed with the Radiesse within that time frame and no need to stop the Retin-A. The Botox can be all done at the same time, yes. The only time you need to stop the Retin-A is when something is going to peel your skin layers off. JG 5.22.08

• Hi, I am 27 yrs old now. When I was 12, a dog jumped on a glass door that I was trying to open and the door smacked my forehead, I immediately had a bump on my forehead. I was so embarrassed I just ran home -I didn`t ice it or anything. The bump never went away and it is still on my forehead, it feels like bone, immovable. It bothers me when I see it in pictures and am self-conscious about it. Is there anyway to remove it?? Thanks for your time! K

  Answer:  could try making an incision over the lump and cutting it out, if it is bone, it will need to be burred down though. JG 5.22.08

• hiiiii .. I had botox done for the first time in my life... when does it start to work? and when does it start to lose its effect? and when will i need it again next? and if i keep using it for long time will i still need to keep using it as often? botoxed the eyebrow tail.. forehead and between eyebrows... new botox me)

  Answer:  it might take 7-10 days or so to work and see an effect. It can last 3-6 months depending on how much was injected and how active your muscles are. Some people with long term use find the muscles do weaken and the need for repeat injections gets spread out wider. One more thing about Botox. It has come out that the education that injectors were given since the beginning of Botox release was incorrect. The bottle is to be used for a single patient. That means that a bottle should not be shared between multiple patients. The company that makes Botox has known about this but has never issued an alert to doctors or patients. The risk is that of the bottle becoming contaminated and passing a communicable disease like HIV or hepatitis from one patient to another. There are no known reports of disease transmission in the use of Botox, but it has not been looked at yet in order to determine that issue. For that reason I strongly urge you to demand that a new bottle be used when you are treated and then observe the injector destroy the remainder of the bottle. If that is not done I urge you to contact the local board of health for the violation. Ask to look at the box it comes in and you will see the single patient, single use wording. JG 5.21.08

• Well, I`m 17 and I hate my big forehead. it sticks out and its long and my face looks wierd because it. I look really ugly. When I get old enough I want to make my forehead smaller and flatter. How would you do that? I see forehead lift but my forehead doesn`t sag its just large. Do I need hair transplants or can you pull my hairline down? I`m just confused and I really want this done.

  Answer:  hard for me to say without seeing you, at times hair transplants can decrease the appearance of height of the forehead, subtle small cahnges can be done to the bone in a subset of patients too. JG 5.14.08

• dr garcia, i have dry , red , flaky skin on my forehead which I think is sebborheic dermatitis. I also suffer from rosacea on my cheeks and forehead. How do I remove flakes from my forehead. I have started applying selsun blue shampoo on my hair, cleansing with water on my forehead and applying clotrimazole cream once a day.If it is SD, is this the right thing and how soon should I see any improvements?Thanks

  Answer:  I think you need to see a dermatologist to make that is what it is and likely they will treat you with topical steroids. JG 5.14.08

• Do you think patients would be more satisfied with botox or having the muscle above the brow removed (if the muscle sticks out above eyebrows)? Is botox needed (for forehead wrinkles) if the muscle is removed?

  Answer:  I think removing the muscle is more effective and when done the patient usually will not need Botox any longer. JG 5.14.08

• Dr. Garcia, Its been two weeks now since my endo browlift and facelift. I cannot move my left eyebrow and my forehead and scalp, more on my right side is still completly numb. My PS office girl said the numbness is completly normal and my left eyebrow nerve could have been niked but will improve over time.Is this true?

  Answer:  in most cases it takes time for the function to come back as the muscles need to get re-attached to the bone, give it some time. JG 5.13.08

• Hi Dr.Garcia..I find your website extremely informative!..I have 2 questions..(1) what are your thoughts on Teamine cream for dark circles?.. and (2) I just recieved botox(forehead) and juvederm(marionete lines)..should I use or stay away from facial masques as I feel they pull the skin?...Thanks!

  Answer:  honestly, I know they feel they have lots of science behind it, I think it is a good product, but not significantly better than others out there like SkinCeuticalks or Obagi. As to the Botox and Juviderm, I think one week should be plenty, by then all should be pretty much set. Thanks for visiting. JG 5.8.08

• dr garcia, i have a very sensitive dry skin on my forehead. Will cleansing with water alone help remove the flakes and some papules that are persistent.Thanks.I am on doxycycline for rosacea.Thanks

  Answer:  I do not thionk water alone will help, might need a moisturizer on your skin afer you wash, but it will be a trial and error thing. JG 5.8.08

• dr garcia, i have rosacea. my cheeks are red and dry so is my forehead. I use aveene extreme cleanser to moisturize and cleanse my skin. My cheeks do fineand are smooth and non-flaky but forehead becomes red and becomes flaky if i don`t use any cleanser. So my question is am i dealing with sebborheic dermatitis or it is rosacea as well and I need to deal with it somehow?

  Answer:  sounds more like seborrheic dermatitis. JG 5.6.08

• i don`t want to use botox will restalyne or juviderm work in forehead on horizontal lines will the material show?? thanks

  Answer:  it can but it needs to be done carefully as lumps can arise since the wrinkles are superficial. JG 5.6.08

• Hi. I wanted to ask you what is the best way for to lift the outer eyebrows with botox and should the injection just be under the tail of the eyebrow. I had botox 4 months ago in my foehead and brow area and it left my eyelids drooped. Now that it has worn of it seems that my eyelid skin is looser than before. I have pictures of just 4 months ago and I`ve aged 5 years in this area. Is it posible that botox can cause muscles to slacken.

  Answer:  the weakening of the muscles should not cause excess skin over time, and your injector should know where to inejct to get the lift, injecting the forehead with Botox will never lift the eyebrows. JG 5.6.08

• Dr. Garcia thanks for answering my question I am the one with the vertical facelift brow lift extreme swelling on forehead,I will call the ps office in the morning my problem is the I live 400 miles away. If this is a hemotoma can it wait until tuesday? I also feel some bumbs on the top of head. The other thing is I am very yellow all over my face and neck. Thanks again for your time.

  Answer:  as long as it is not getting bigger, it can wait, yes. The bumps on the top of the head could be the incisions or the points of fixation where the doctor attached the scalp to keep it in position. The yellow is frm the blood being broken down and you absorbing it. Best of luck. JG 5.4.08

• Hi, it is five days after having a vertical facelift and endroscopic browlift and I have had a lot of pain, swelling and brusing. My forehead on my right side feels very hard and is protruding and I have deep purple around my eyes neck and jowls. Lots of pain around my ears. In your opinion is this all normal or should a expect a longer than normal recovery? I look like a monster! Thanks for your time

  Answer:  sounds like you might have a hematoma on the forehead where the swelling is and that might prolong the healing and also cause that side to drop sooner, I think you should see your surgeon when the office opens. JG 5.4.08

• DR Garcia....How much we can elevate eye-brows with Botox?and do you recommened any specific place for a reall good elevation??I mean just crows feel and between eyebrows ??My DR is new to botox I dont know how many units he gave me but charged me alot.How many units will give me a open eyes and visible elevation?I know its person person but a rough idea how many units need to be inject and which area....PLEASE dr advice so I can talk my Dr.THANKS and THANKS again.

  Answer:  glabella and crows feet for the location, none on the forehead, and you might get 1-3 millimeters elevation. Dose vaires due to the amount of muscle, but we typically use about 70 units total for that. Where you put it in those areas is important though, your doctor should know that, injecting it in those areas but nto in the right location will lessen the lift. JG 5.1.08

• Hi, Dr. G---I have had botox in the forehead between the brows over the past few years. Yesterday the doc talked me into doing the crows feet. I received three injections on each side. I am always VERY careful not to move my head and even sleep sitting up on the day I get botox. Now I am upset that I had it done. This morning I woke up with a bad headache, very dry eyes and feel very light-headed when I turn my head in either direction. Now I am scared that I will have bad side effects and am afraid of what worse might happen over the next 7 days as the Botox kicks in . Please calm my nerves. Thanks so much for any insight you can give me. B

  Answer:  I do not think your concerns are related to the medication itself, You might have some sensitiviuity from the needles being stuck into that area and are having pain or musle spasms but I have never heard nor read of Botox casuing that problem, besides the injection part, the medicine should not cause that so it should not get worse, Advil and ice packs might help. JG 4.30.08

• Can any plastic surgeon regrow a nose on a patient`s forehead (like the one patient whose nose was lost to frostbite)? What is the speciality called for a plastic surgeon who does things like this?

  Answer:  they are all trained to do it but not many continue to do it after they finsih training, look for a unversity based reconstuctive surgeon. JG 4.27.08

• For prominent muscle above eyebrow (which stikcs out on a flat forehead), do you think it would look better to surgically remove the muscle or botox. I think with botox the muscle will still show but just not move.

  Answer:  in time with the Botox injections the muscle should shrink some due to atrophy, otherwise it could be surgically removed. JG 4.25.08

• Will restylane or radiesse (spelling?) injections fill in a flat forehead? Would implants work for a flat forehead or would they look too artifical (show outline of implant on forehead)?

  Answer:  I do not think the injectable fillers will be cost effective nor long lasting enough. Implants could be custom made I guess and as long as they are under the muscle should look OK. JG 4.25.08

• what do you think of fillers for forehead wrinkles that are rather superficial . i do not want botox?? what filler and would it looklumpy?? thanks

  Answer:  Restylane would work, or Juvederm. Best of luck. JG 4.25.08

• Hi Dr. Garcia...how long should one expect juvederm to last in the lips? I had it a month ago (love it!) but seems like it may be disappearing already. Also, do you recommend fillers for deep forehead wrinkles? If so, preference for which one? Thanks!

  Answer:  2-4 months, varies from patient to patient. For the forehead we use Restylane. Best of luck. JG 4.23.08

• Dear Dr Garcia, I am 27 years old and the doctor put me injections in my frown lines, crows feet and forehead, he used 85 U in total ...I don´t like the results, it changed my facial expression completely...my questions are: When do you start to get rid at least a little bit of the effects? is it progressive since the injections? or is only after the 3 or 6 months that you start to note an improvement? with that dossage, in how many months do you think the botox will wear off? the location of the injections influences in the duration of the effect?...I mean, in some places it will go faster than in others? thanks a lot Dr Garcia! and sorry for my english...

  Answer:  nothing you can do to make it wear off faster, should be gone in 3-4 months, in areas where there is alot of motion it wears off sooner. JG 4.23.08

• can an endoscopic browlift recede the hairline or make the forehead look bigger or longer? Can they all be reversed or released? I just got one 2 weeks ago and am seeing the lateral ends too high making my eyebrows look diagonal.. Is the release itself another major surgery with the same downtime and swelling, etc? How long would I have to wait? ..asking because my Dr is not in town right now and I was hoping you can help me before I have a nervous breakdown

  Answer:  yes, if the endoscopic lift does indeed rotate the eyebrows up, it has to by definiton do one of two things, either shift the hairline back or cause wrinkles in the forehead, because the skin has to go somewhere. I will say that many surgeons that use that technique say that neither one happens, and in some cases it does not because the amount of lift of the eyebrows is so small that nothing changes, for the good or for the bad. The eyebrows looking angled is due to the direction of the lift and the fixation, hopefully as the swelling goes down that will improve for you. The release is fast and easy and quick healing, if done soon enough after the first it adds almost nothing to the recovery. JG 4.23.08

• I went and to my dermatologist b/c I have a bumpy forehead due to enlarged oil glands. She is recomending laser skin resurfacing. She said a chemical peel would not help.Do you agree? The two options I am thinking about are, the mini Co2 or the erbium. What`s the better option. I cannot afford a lot of down time. Thanks

  Answer:  I agree but also know that the improvement will not be permanent, how long it will last will depend on how much your skin will rebuild the sebaceous glands after healing. I think if downtime is an issue I would suggest the erbium. JG 4.19.08

• Can you remodel all forehead bone ? because I dont understand when you say only at the eybrows (My forehead doesnt have a natural slope but projects outwardly)is any there any other way. I`ve read about ffs forehead recountouring is the surgery similar to this ? , How about shaping goretex or bone cement? I know its hard to determine a method without assessing me but i`m just trying to gather as much information as possible before I proceed. Thank You

  Answer:  no way to do that in a safe manner that would warrant the risks for a cosmetic procedure, I know of no one that would do calvarial remodeling if not for a birth defect that was causing a medical problem. The forehead recontouring you have read about is likey just the bones around the eye socket. Gortex could be placed but it does not feel like bone and could shift if it is a piece of that size. Bone cement would not hold its shape. JG 4.17.08