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Ask Dr. Garcia - The Archives
Answer: likley would use injectables at your age. I think the implant has more risks. JG 6.21.09
Answer: then, it might be an option, all the best. JG 7.1.09
Answer: complications are rare, less than 1-2%, the issues might be too much skin being removed and the eyelids not closing well, or an alteration in the shape of the eye. In experienced hands, the risks are low. As to fillers versus lasers, they are both relatively effective, but fillers have less downtime. All the best. JG 6.12.09
Answer: no, YAG is stronger. It will need to be repeated but no way to tell how many times. JG 6.8.09
Answer: no, it is just what has to happen to correct what was done before, it is not a matter of being symmetrical to the otehr side, it is that a canthopexy has to close the aperture for it to support the lower lid. JG 6.5.09
Answer: just ask exactly what you just wrote, I will say that likely the eye with the canthopexy will have a slightly smaller opening. Best of luck. JG 6.5.09
Answer: I would wait 3-4 weeks or so. JG 6.2.09
Answer: It is hard for me to say what would be best without at least seeing pictures. Feel free to send them to drgarcia@lvcosmeticsurgery and I wil get back to you. JG 5.24.09
Answer: might get some improvement from a laser, likely no more surgery can be done. JG 5.23.09
Answer: the fat injections there can lead to lumps and the fat can be difficult to remove if it is too much. Fat graftiong and fat injections are essentially the same thing. If fat injections were so good and so reliable then the other fillers would not exist. JG 5.21.09
Answer: Well, as it sounds like Botox made it bettr, it appears to be a muscle issue at least partialy. If you do not want to continue the Botox then surgery is likely going to be needed to smooth the muscle out. I think fat injections around the eyes can lead to big trouble so if anything, try something shorter term. I do not think lasers will yield long term resutls, so it might come down to more surgery. I am sure the surgeons you have seen are being cautious though for fear of taking something and performing surgery and ending up with something worse. Best of luck. JG 5.20.09
Answer: it is in the crows feet and a little under the lashes, the length will vary, maybe a 1/4 inch, at times a little more. JG 5.15.09
Answer: well, understand that removing skin with surgery will remove excess skin but not inprove the quality of the skin so there will likely still be fine lines. I think a canthopexy at minimum would be required in order to avoid worsening of the ectropion you already have too,and that can be done during the blepharoplasty. Best of luck. JG 4.30.09
Answer: sorry, but not possible. JG 4.24.09
Answer: Retin-A woudl be good for the hyperpigmentation and either one for the fine wriknkles, although the improvement will be small. Our DMAE is 5%. If you need something stronger, then it on to lasers. JG 4.23.09
Answer: the creams will help the fine line, the small ones, it will not tighten skin like a laser or surgery will. The DMAE face cream has ingredients in it that can irritate the eye skin so I suggest the peptide cream for the face and the eye booser for the eye region. JG 4.16.09
Answer: there is nothing that will restore the color, if there is enough skin, a very conservative scar excision and reclosure is likely your best bet. JG 4.14.09
Answer: nothing new besides the old ways. JG 4.8.09
Answer: YAG laser. JG 4.6.09
Answer: I prefer HA fillers like Restylane as I feel they last as long as the fat does and have less chance of lumpiness. JG 3.30.09
Answer: can try a YAG laser to fade thm. Fiilers might help, yes. JG 3.31.09
Answer: if all of that has been undone then it might not be able to go back, sorry. JG 3.3.09
Answer: the canthopexy might be able to be released and then it might return to the previous appearance but if the canthopexy was done, it was likely needed to correct a problem and the smaller eye aperture from a canthopexy is a required thing then. JG 3.2.09
Answer: I have no need to use an eyelash thickening agent personally, so no, I have not used RevitaLash, but many of my patients have and like it. It is considered a cosmetic so it does not need FDA approval where Latisse is a drug and therefore needs FDA approval. As to what I sell in my office, I could sell either one. I feel the RevitaLash is a good product and I prefer it so I have chosen to sell that and not Latisse, but I could have chosen to sell either. As to chossing a drug over a non-drug, I make my choices as to effectiveness and potential down sides, so I do not always use a drug, that requires FDA approval, over an OTC that does not require FDA approval if I feel thy are essentially the same. A drug is not necessarilly superior to an OTC product in many cases. As to the claims that Latisse makes, I have heard from patients that have used it that it does not do all if those thing in most patients and we have had a number of patients that have used Latisse than have switched over to RevitaLash. Not every patient will resoond the same way to any product though. I am glad you have had good results and I hope you continue to do so. JG 3.2.09
Answer: I think if you are concerned I would not use it. JG 3.1.09
Answer: well the scar is healed at this point and I have never heard of the scar being black, hard for me to advise without seeing you, might need surgery to cut the scar out and start over again. JG 2.24.09
Answer: I feel it will not do what they say it will. I think lasers can be used to tighen only the skin, and we do perform that. JG 2.23.09
Answer: no, all it measn is a laser is used to perform the cutting. The eye bags can be hidden by injecting around the bags with a filler in some but not all cases. I browlift will elevate your eyebrows where fat removal from your upper lids can take the puffiness away, mostly in the inner upper eyelid. Hard for me to say what would benefit you the most but it sounds liek surgery. JG 2.23.09
Answer: agree with the pinch tecnique and I think there will be some bruising and downtime, about 7-10 days or so, best of luck. JG 2.22.09
Answer: well, generally it is safe, but am not sure as to blaming fat removal during the ptosis repair, if the fat was not in excess, that did not have to be done. I do think the filler might make it look more even for awhile though. JG 2.19.09
Answer: well, it is challening to get even nad the greater the difference, the more difficult it is, but there are not many other choices. If one knew that is was only from too much skin being removed, then a small skin graft would be the way to go to replace it, but I cannot tell that without examining you in person. Recovery is longer than the original surgery and you will be bruised for about one week and swollen for a little longer than that. All the best. JG 2.19.09
Answer: well, it really is not revision surgery as a lower blepharoplasty alone will never fix a festoon, in most cases the festoon can be seen before the eyelid surgery and then the patient counseled about its options. I think excising the festoon is the most predictable, it leaves a small scar, but that is easier to hide than the festoon itself. I think that can be performed at any time since the eyelid incision will not be invovled. Attemtpting to fix a festoon through an eyelid incision I have found to be not possible. IPL stands ofr Intense Pulsed Light, a baby laser so to speak. JG 2.19.09
Answer: I am afraid the non-surgical optiosn will not work, especially chemical peels. JG 2.19.09
Answer: skip the Aluma, especially in that area, but the Restylane or Juvederm might be a good idea. Stay warm! JG 2.19.09
Answer: I am sorry but I have no good options and fillers in the area you mention are very difficult to get right and leave no lumps. JG 2.19.09
Answer: I have never heard of eyelid surgery or steroids causing that, you might have a festoon though that would never be helped with the eyelid surgery or the steroid cream, it might require surgery to remove it if it is a festoon. JG 2.16.09
Answer: usually keloids and thicker scars cannot start to form until about 6 weeks because there is not enough collagen until then, it might flatten out in time though as thicker scars do mature with time. JG 2.14.09
Answer: they normally look at both eyes to compare how tight to make it while doing the surgery. The recovery is worse because the lymphatics that drain swelling are normally kinked off for awhile and that produces more swelling. JG 2.12.09
Answer: healing will be a little more than the original and there will be some more swelling and some discomfort that will be more than the first time. It does normally involve an external incision and the opening of your eye will appear smaller when done. You will look a little oriental for a week or so. Best of luck. JG 2.12.09
Answer: swewllig due to dryness can make the astigmatism a little worse but does not cases it outright. JG 2.10.09
Answer: not uncommon, but if it persists after another 2 weeks I think seeing an eye doctor is a good idea. JG 2.9.09
Answer: very common actually. Might take 8 weeks to get feeling looser. Best of luck. JG 2.9.09
Answer: it does not contain cortisone, it is just gel silicone applied to scars, it is a popular product though. I think for the dark issues the ScarGuard is better. JG 2.9.09
Answer: similar. JG 2.9.08
Answer: could be nerves, but more likely is just scar tissue, I would give it time, massage the area and see how it does, more surgery too soon might just make it worse. JG 2.8.09
Answer: you are looking at about a $600-$700 differnce between the lids being done together, being cheaper. Costs are about $3000 alone and about $5300 together. That is all inclusive. JG 2.8.09
Answer: can try the lasers there, it is a litle ncomfortable but will work. JG 2.8.09
Answer: not common, but not unusual either. Might want to see the surgeon to see if they can give you some steroid drops to see if it is going to help. JG 2.4.09
Answer: well, I guess a better choice of words would be a canthopexy and not a canthoplasty. The pexy involves no cutting of the ligament itself, only a tightening of the existing ligaments of the lower lid, where the canthoplasty involves cutting it in its entirety and then re-attaching it at a higher position. All sutures are internal. It cannot be done from the inside though. JG 2.4.09
Answer: I have never seen a laser or other surface treatment that will help them on a reliable basis. At times if it is due to swelling, then diuretics might help. In severe cases about all that can be done is to cut them out and leave a scar. I think the claims for Aluma are likely not going to hold up. I would save your money. JG 1.28.09
Answer: might need a tacking up of the muslce to a higher point to lift the lid into better position, it would essentially be an incomplete canthopexy but should help. JG 1.26.09
Answer: well, as long as the problem that exists can be corrected with a surgery, it is OK to repeat. JG 1.24.09
Answer: well ectropion can be due to too much skin being removed, nerve injury to the lower lid muscles are from scarring. As to the upper lid, it can be from a seperation of the muscles that lift the lid from the cartilage at the edge of the eyelid. Both issues can usually be repaired with some surgery though. JG 1.24.09
Answer: it has to change because the lateral aspect of the opening of the eye is being purposefully repositioned. In so doing there is some pulling on the upper lid too in some cases. I think the scarring is what is holding it in position and releasing the scar tissue might help if it does not get better with time. JG 1.24.09
Answer: light CO2 laser or a Rhytec Portrait Plasma. JG 1.24.09
Answer: a light CO2 laser or a Rhytec Portrait Plasma. JG 1.24.09
Answer: It wil likley get better with time and not worse, might stay the same though. Reversal of the canthopexy can be done in most cases. I cannot predict how it will look after the relase but it should go back pretty close to the way it was if no skin was removed. JG 1.24.09
Answer: I am not sure how he can say that unless you had the owl look before the surgery.The twitching us usually due to muscle or nerve irritation and there is no guarnatee that releasing the canthopexy will alleviate that. Botox might help, yes. Best of luck. JG 1.24.09
Answer: well, it can happen, not to all, but it can happen, and in time I think it will get better, but slowly. I think you should keep doing what you have been doing, don`t stop. JG 1.22.09
Answer: yes on the bromelain and as to the exfoderm, I would wait at least a couple of weeks or more. Best of luck. JG 1.22.09
Answer: hard for me to say without seeing you in person in order to feel the tissues I am afraid. JG 1.20.09
Answer: light laser peel. JG 1.20.09
Answer: that is about all you can do for now, and then in 6 weeks see the eye doctor again to make sure all is healing well. I would also report it to the state agency. JG 1.19.09
Answer: hard to say becasue it depends where the fat was placed, if it is above the muscle it will be more difficult to remove than if placed below the muscle. JG 1.19.09
Answer: a lower bleph will not correct festoons I am afraid, they might need to be cut out with a resultant scar. JG 1.18.09
Answer: yes, for now, and also some light massage pushing the skin up and out, starting at the nasal area and going up and out toward the temple. JG 1.18.09
Answer: it depends but I would say 5-10 years or so. JG 1.18.09
Answer: it has not been approved for that, it would be off label for it and I think if you are going to risk it you should check with your eye specialist first. JG 1.16.09
Answer: should look markedly better in another 2-3 weeks, and then subtle changes will continue for 3-6 months or so. I do not believe Paralube is a prsecription. I think that eye drop or using Bausch and Lomb wetting solution for hard contacts at night works well too. Best of luck. JG 1.15.09
Answer: no, it does not work right away, it takes weeks and most of the time multiple injections to see an improvement. The material is absorbed by the body over time. JG 1.14.09
Answer: I would avoid the pressure on the globe and massage from the nose outward, with gentle pressure to get the swelling to improve. I am glad the other areas are getting better too, hang in there. JG 1.7.09
Answer: well, I suggest seeing another surgeon in person for a second opinion, I also see no reason why one has to wait 6 months to have a canthopexy suture removed if it is causing problems. An overly tight canthopexy can cause ectropion and scleral show. Steroid shots help only if the culprit is scar tissue. As tp the pain, releasing the canthopexy might help, but it also might not help, some of that might be long lasting I am afraid, all depends on what is causing it. All the best. JG 1.6.09
Answer: massage and mayeb ScarGuard or Mederma for now is about all. JG 1.5.09
Answer: Hang in there.JG 1.5.09
Answer: sounds like an overly tight canthopexy and the bump is likely the knot from the suture used to make the canthopexy, might be a good idea to have the suture cut to allow the tissues to relax. JG 1.6.09
Answer: I am afraid surgery is likely the best, although in a small percentage of cases some Botox might help a bit. JG 1.4.09
Answer: nothing I would put on the scars rigth now, yo can look for Panatol eyedrops or use Bausch and Lomb wetting solution for hard contacts. Best of luck. JG 12.31.08
Answer: way too early to be worrying about all of that, have to give it time, all of what you are seeing and feeling will likely go away and is all within the normal post-operative healing. The hollow eyes and dry eye would not likely start to show up as problems for 6 weeks. Got to be patient. Merry Christmas and Happy New Year. JG 12.27.08
Answer: I think you should let the surgeon do it, without a doubt do not try it yourself. Best of luck. JG 12.22.08
Answer: could be a link,hard ot say though, seriously doubt there will be anything permanent. Best of the Holiday Season to you too. JG 12.22.08
Answer: well, take a few days off on the massage and see how it looks a few days from now, best of luck. JG 12.22.08
Answer: no I have not but we do not allow our patients to use those types of products for one month, I think in time it will get better though, just make sure you get the make up off every night. Best of luck. JG 12.22.08
Answer: It is normal, eveyone is different, just give it time. JG 12.20.08
Answer: well, I will say that the steroid injection medication itself, if caught superficially in the skin, will almost look like pus, actually more like yellow sebum, like in a pimple, and sometimes it is hard granules. It might dissolve on its own in time, but not always. It might need to have a small needle hole made and the material pushed out. Best of luck. JG 12.18.08
Answer: thanks for all the good wishes and I wish the same to you, glad I was able to help at least a little. JG 12.18.08
Answer: I think it will go away in time, yes. Massage and warm moist heat will likely help too. You can also use ScarGuard but do not get it into the eye. Best of luck and glad I could help even if just a little. JG 12.16.08
Answer: personally I do not think it will even last that long and I do not suggest it being done. Maybe they should reposition the fat instead of removing it. JG 12.16.08
Answer: I have not heard of that either, maybe in cases of a droopy eyelid would be the only time, but even then, not sure why that was done. Sorry.JG 12.11.08
Answer: the worst case scenario is loss of muscle tone and resultant scleral show or ectropion. Fat removel to an excess can also happen and that would leave hollowness that cannot be repaired too. JG 12.7.08
Answer: it is killed a hypertrophic scar and in many cases will get better in time with nothing done, kenalog injections can help at times too. JG 12.7.08
Answer: I think the amount is so small it likely will not have any long lasting negative effects. JG 12.4.08
Answer: well the canthopexy will likely help the rounded appearance and not much else, the fat injections, if they survive might make the malar pocket look less visible, otherwise it could be directly cut out, but that leave a scar in its place albeit a good quality scar in most cases. All the best. JG 12.4.08
Answer: it is not common and I think seeing your surgeon is a good idea, they might be able to suggest somethng after they see you in person, best of luck. JG 12.3.08
Answer: the skin to the edge of the orbital bone is improved, but the further from the incision at the lash line, the lesser the degree of improvement. I would likely use a light CO2 laser for a Rhytec Portrait for the resurfacing, and thank you for the kind wises, I had a wonderful time. JG 12.1.08
Answer: almost impossible for me to tell without seeing you in person but I will say that in many cases, similar to what you describe, there cannot be anying further done to lessen the swelling. JG 12.1.08
Answer: hard for me to say but hydrocortisone is something you should avoid until the entire surface is closed. I think seeing your surgeon again is a must. Best of luck. JG 11.30.08
Answer: I would say 6 weeks should be a very safe time period. JG 11.24.08
Answer: Might be able to help with fillers such as Restylane in experienced hands. Tough problem though. JG 11.24.08
Answer: it is not normal but it still might get better in time, if it does not then something surgical will need to be done, yes. I think massaging and taping your eyes as closd as you can might help though.JG 11.22.08
Answer: I would not repeat it for 3-6 months and if the eyelids are the only areas, the risk of pigmentation changes with the CO2 is almost unheard of. JG 11.22.08
Answer: the protective lenses at times can cause some irritation but in general it should get better in a couple of days, in my practice, on the rare occasion they are used I am the one who places them and removes them, no way to know in your case without asking them though. JG 11.22.08
Answer: it is better in that it heals faster with less chance of pigment loss but not as effective at wrinkle reduction. It is stronger than a fraxel and less than a CO2, somewhere in-between. I think for the downtime and safety it is a good choice. JG 11.21.08
Answer: if it was on the lid area itself it can happen at times if too much fat was removed but where you describe it it is much more likely due to the facial fat loss. Best of the holidays to you. JG 11.21.08
Answer: I prefer general anesthesia over deep sedation as under general anesthesia your airway is protected and under deep sedation your airway can become obstructed intermittently and cause problems. I perform them under both methods but only use the sedation lightly and only in patients that will not require a large amount of sedation in order to potentially avoid the loss of the airway. JG 11.20.08
Answer: it might with time and massage, but I cannot say 100%. The massage speeds it up but if it is going to happen, the massage is not the deciding factor, so not massaging it in your case will not be the make or break issue. JG 11.20.08
Answer: I would wait a few days at least. JG 11.20.08
Answer: could be a little scar tissue or a suture tha was placed below the skin, they usually go away on their own or the surgeon can pop them out with a needle at times, JG 11.20.08
Answer: it will get better with time and contraction but it is nearly impossible to predict what it will look like long term, sorry. JG 11.19.08
Answer: yes, they typically do well after the revision. All the best. JG 11.19.08
Answer: well it sounds like there is no fat to be removed so if surgery is what has been decided, then it would be a skin removal from the outside. JG 11.14.08
Answer: it is essentially a repeat eyelid surgery, yes, it cannot be done without surgery. I cannot say that Restylane will make your scenario better without seeing you and every surgeon has their own interpretation as to what revisions are warranted and how they are paid for. JG 11.14.08
Answer: I am afraid surgery is the only reliable way, yes. JG 11.12.08
Answer: well, I do agree that taking fat out to an excess will make your eyes look older as time goes on. There is no other way to remove the fat without cutting that is safe, eventually it might involve not removing the fat but repositioning it to push it back in. Best of luck. JG 11.12.08
Answer: very difficult for me to advise as to what has occured without seeing your before and after pictures and knowing what exactly was done during the procedures. JG 11.12.08
Answer: I do not think edema would last that long, more likely a small amount of fat, as to the upper lids, the scar might need to be revised surgically. JG 11.10.08
Answer: good for some people, has a higher complication rate than a facelift though. JG 11.7.08
Answer: I think most likley the scar would have gotten to look that way without the product, it just got there faster is all. There might not be enough skin to re-cut it so I think allowing it to heal for now might be the safest thing. JG 11.3.08
Answer: I do not think a temple lift wil accomplish what you desire I am afraid. I am not sure there is anything that can make it better I am afraid. Might be able to tell more if a saw some pictures, you can send them to drgarcia@lvcosmeticsurgery.com JG 11.2.08
Answer: the scar usually heals quite well and if red it can be faded with a laser at times. A medial canthopexy is a much more risky and difficult operation and I do not suggest it be done for cosmetic reasons. Best of luck. JG 11.2.08
Answer: usually two weeks. JG 10.30.08
Answer: hard to say without seeing you but browlifts do impact the upper lids to a great degree. JG 10.30.08
Answer: well, if you have crepey skin now before the fat is removed it will be worse after the fat is removed unless something is done, the skin has already lost its elasticity, I have never found chemical peels except phenol to make a significant improvement of the skin of the lower lids once the selling has gone away. I think it needs a laser or Rhytec procedure. Best of luck. JG 10.21.08
Answer: I absolutely agree that another in person meeting is required between you two. Time will tell I guess. JG 10.21.08
Answer: Botox could help lift the brow if properly injected and I think most likely the appearance you have now is due to the asymmetry of the brows that was not appreciated pre-operatively to be as much as it is now. Brow lifts can be done on just one side if needed, yes. JG 10.20.08
Answer: I will be brutally honest, the fact that you have asked so many questions about this issue, if you were my patient and had come in to see me about a procedure, I would postpone it. If a patient wants soemthing done and I feel it is a legitimate thing to do and explain the risks and they agree, then I will proceed, but this surgery is elective, it is not needed, it can be postponed indefinitely. The simple fact that you have asked this many times would concern me and I would not do it myself. All plastic surgoens are perfectionists, so that explaination does not cut mustard. Doing something because you are being threatened to do it all at once is as bad as having someone telling you that you need cosmetic surgery when you do not want it, who`s body and appearance is it? I see very little to no reasons for you to have a CO2 laser too. I re-iterate, if you cannot clearly see the reasons to do the eyelid or anthing else, then either you do not need it or the surgeon has not done his job of explaining it to you and you should hold off on having it done.JG 10.20.08
Answer: it is a method used to estimate how much skin is to be removed and can be used on the lower lids. The incision on the inside of the lids is done through the lining and usually does not get sutures placed but is allowed to heal on its own. The location of the incision is usually made upon what is need to be done in each case. Eye shape can be altered the more that is done, especially when an outside incision is done. I will tell you that I never do surgery on a patient unless they are totally sure of the surgery, it can always be done later, if you are not 100% sure, do not do it now, do it later if needed.JG 10.20.08
Answer: I must say that keloids are very rare on the eyelids, it might need a series of injections and I think lasers will likely not help much, in some cases the scar needs to be cut out and sutured closed again. JG 10.19.08
Answer: I would pass on the lower lid at the present time. The lower lid can be done through an incision outside on the skin or one inside, but I think the change would be small and I think you can wait on it. JG 10.19.08
Answer: not sure if the canthopexy is related, I suggest seeing an eye specialist for a full work up. Best of luck. JG 10.18.08
Answer: it sounds like there could be some things done to improve it but perfect symmetry will likely not be able to be acheived, I am afraid that it is not uncommon for other surgeons not wanting to take over when there have been probelms with the previois surgery though. Best of luck. JG 10.9.08
Answer: sounds more like a case of eyelid ptosis, I suggest you go back and see the surgeon for a check up. Best of luck. JG 10.7.08
Answer: unusual, hard for me to say what could have happened without knowing the details of the surgery though. JG 10.4.08
Answer: I am sorry but I cannot venture to guess, if it is a cyst below the skin not connected with the skin through a pore, it might never go away on its own. JG 10.3.08
Answer: yes, I agree, they usualy develop in the first few days. If they put sutures to hold the lower lid fat over the rim it could be a cyst from the sutures there. JG 10.3.08
Answer: likely a cyst where one of the old sutures was, warm packs and time should let it go down as it opens and drains. JG 10.2.08
Answer: I apprecaite it and I am sure Smile Train would be happy to receive anything from you and they are a good organization. You are most kind and thank you. JG 9.27.08
Answer: well, fat does not go away with pressure but swelling does. I think giving it some time is key right now. JG 9.22.08
Answer: chemosis will not cause the lid to lag, that is either a muscle issue or a skin issue. JG 9.22.08
Answer: well, if they are changing in size throughut the day, then it is swelling, can be allergies or the position you slept in or large salt intake. Swelling cannot be treated through surgery, no matter what the cause so I do not think a revision is in the offing. Sounds like your lower lid is too far down, many causes for that and some surgery could be done to correct that, in some cases at least. JG 9.22.08
Answer: it will last no better than the fat injections, in fact it has a higher rate of cyst formation. I am afraid you do not find alot of sites showing remedies because there are no reliable ones, sorry. You can send the photos to drgarcia@lvcosmeticsurgery.com if you wish. 9.20.08
Answer: no, it is just a way to decribe the incison, most doctors don`t name the incisions, some do for marketing reasons to make it sound different. 9.20.08
Answer: at the lash line and corner of the eye with a small downward leg at the corner, they usually fade pretty well with time. 9.20.08
Answer: a repositioning of the ligament on the outer part of the lid to elevate and or tigthen the lower lid when not in its correct position. JG 9.19.08
Answer: I am not sure if Dr Toriumi has done that type of corrective surgery and you can try other fillers such as Restylane but they will likely react like the fat did. Wish I had more to offer. JG 9.18.08
Answer: might be able to be improved with a canthopexy. JG 9.18.08
Answer: no way to predict how noticeable the scars will be, but there are scars, yes. It will change the shape of the eye if too much skin is removed too. JG 9.18.08
Answer: it is just a skin removal technique, transconjunctival blepharoplasties never tighten the skin on their own. JG 9.17.08
Answer: hello. JG 9.16.08
Answer: hello to you too. JG 9.16.08
Answer: I would go see your surgeon as what you are seeing is not common, the fine wrinkles might benefit from some Retin-A though. JG 9.16.08
Answer: it can be normal in some patients, should be getting better slowly though, best of luck. JG 9.17.08
Answer: well, properly done, the surgery should not negatively affect your eyes long term, and waiting more time will likely not make them look closer in appearance. I think a consultation with a dfferent doctor is warranted to allay your fears though. JG 9.15.08
Answer: I think there are less browlifts being done due to the use of Botox. I do not feel that brow lifts will acccelerate the aging process though. As to Fraxel Repair, I am not a fan. JG 9.10.08
Answer: oooh, OK, now I see, the bruising is from the steroid injections, well, that is unusual too, but I have done it on a few occasions. If it helped, then it is swelling and not fat though. To prevent the melasma I suggest sunblock and using hydroquinone 4% topically until gone. All the best. JG 9.9.08
Answer: if it changes throughout the day it is swelling, if not it is likely fat. Bruising this far out is very unsual I must say. Hang in there for a bit more. JG 9.9.08
Answer: I do not think the CO2 will help, sorry. In most cases they are cut out if they are as bad as you say. In cases where a canthopexy was required to improve an ectropion, there is no reliable way to enlarge the aperature again, sorry. JG 9.8.08
Answer: surgery does not improve texture so I suggest 3 moths to let th eswelling go down,I usually use a Rhytec Portrait or a CO2 laser. Best of luck. JG 9.8.08
Answer: well, the technique used is not common but not uncommon, unfortunately though, removing the graft is most likely not going to help, I think most of what was grafted has absorbed and most of what is going on now is scar tissue. I would guess that due to the difficulty in correcting your problem, they are hesitant to get involved with something that might not be able to correct to any significant degree. I would suggest going to a University type opthalmology program and get an evaluation. All the best. JG 9.4.08
Answer: you can have prolonged dryness of the eyes even without that to start with, so if done, it has to be very conservatively performed. JG 9.4.08
Answer: typically a lower blepharoplasty will not correct hollows of the lids themselves, those are usually due to fat loss and is very difficuult to correct. If you are speaking of hollows of the upper cheek, those will also not be improved with a lower blepharoplasty either but can be improved with fillers such as Restylane. JG 9.2.08
Answer: yes, it cna be done as long as the brow is not lifted so much that the upper eyelids will not close while sleeping. Might be reasonable to do it with the facelift next year. JG 8.31.08
Answer: it should, can try using some Retin-A for now and see how it goes. JG 8.31.08
Answer: it might be too early, no way for me to tell without seeing you in person, as to the pockets coming back, the fat is removed permanently but not all of the fat is removed so whatever was left can pooch out as time goes on. I think the bruising can be gone in that amount of time but I think the swelling will be better by then but not 100% gone for 3-6 months, you will be presentable in public in 8 days though. JG 8.29.08
Answer: for brown spots, it works, but that is all. JG 8.28.08
Answer: sure, that is fine and it does not have sunscreen in it., JG 8.25.08
Answer: sounds like you need more surgery to correct the everted lid, in doing that it might require a skin graft and that will remove the dark spots sand the light spots but the trade is off for an area of skin that is not exactly the same color, hard to say more without seeing you in person. JG 8.23.08
Answer: I am not sure what was done or what is going on to casue it, sorry. JG 8.19.08
Answer: Retin-A or my eye booster cream. JG 8.18.08
Answer: I typically use Restylane and it will not change any droopyness. JG 8.14.08
Answer: not use as to what occured, there might have been sutures there initially that broke and fell out while sleeping or became stuck to a pice of gauze, as long as the edges are touching it will heal well though. JG 8.14.08
Answer: it might be a better plan to inject a filler as tighter muscles will likely not change anything. JG 8.13.08
Answer: could be, yes. I think the lateral scars should look better in time too. JG 8.12.08
Answer: the pimple if not responding can be lanced yes, and there are more agressive methods to resolve the chemosis, patching the eye and applying pressure at night wil also help, and at times more aggressive options after that. Using the FML is certainly OK though. Your story is not the common thing though, unless a canthal tightening or canthopexy was done, in that case the swelling and chemosis are more common and you could have expected it. Best of luck. JG 8.12.08
Answer: very difficult for me to say wihtout seeing you in person but I will say that if there have been so many surgeries already, it might be difficult. JG 8.10.08
Answer: it depends on how deep you have the laser done, in some cases the area around the eyes can be done without leaving a line of demarcation. JG 8.10.08
Answer: I think there is no surgery or laser that will help, I think most likely it wil get better as the burned tissue heals, might want to try some copper peptide creams and avoid using anything with glycolic or alpha hydroxy acids or retinols in the creams, best of luck. JG 8.4.08
Answer: yes, should be OK to do as long as it is a few days before. I think waiting a couple of weeks for the swelling to go down will be enough to wait for the Botox. 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 bee 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 8.2.08
Answer: it depends on why the canthopexy is being done for, but that is not commonly done. As to ectropion, there can be many casues for that I am afraid, no way to tell in your case without an in-person exam. JG 7.31.08
Answer: I would do a very light CO2 laser or preferably a medium depth Rhytec Portrait Plasma. JG 7.31.08
Answer: not a normal occurence but cna certainly happen, I think a light laser might help those issues as I think cutting and re-suturing them will likely not correct it all.JG 7.30.08
Answer: I think the pain is due to the tisseus being tightened and not from any nerves that were cut, if nerves were cut it would more likely be numb. In most cases, with time, the pain gets better as the tissues relax a bit. It is not uncommon for patients to complain of that afetr the procedure. Best of luck and give it some time.JG 7.30.08
Answer: I think acute swelling might be helped with ketoprofen topically but in your case it is too far out I feel. I cannot say whether a canthopexy will help your condition without seeing you in person, sorry. JG 7.29.08
Answer: once sutures are out there is no need for neosporin, as to the ScarGuard, up to one year. JG 7.27.08
Answer: not common, but if there was a large amount of hooding on the eyelid and one was not getting a forehed lift to correct that part, it could be a longer scar. JG 7.27.08
Answer: I think it will not affect the surgery and you are safe to proceed. JG 7.26.08
Answer: they can be a little raised at the begiing but typically flatten out in time with light massage. JG 7.26.08
Answer: once the sutures are out, wait another day or two and then you can apply the ScarGuard. JG 7.26.08
Answer: well, I think fat or other fillers like Restylane for the arcus are options, I do think the arcus marginalis needs to be released before fat grafting where the off the shelf fillers do not, as to the laser for the pigment, if it brown is will work, if not, it will likely not do much. I think you should wait on all of it until you are done breast feeding, although the laser is likely OK to do now. JG 7.22.08
Answer: the veins can be imporved with some IPL treatments or a YAG laser series of treatments. I think 2-3 months after the infection has subsided would be enough time to wait. JG 7.19.08
Answer: it should not change unlesss that is needed or desired. If the fat is dissolving on the lower lids, then pulling the skin will not make it look any better I am afraid, fillers there are fraught with problems too. JG 7.18.08
Answer: yes, the fee is $50. It would be applied towards the surgical procedure if scheduled within 6 months. JG 7.17.08
Answer: it is likley a cyst form where the sutures were and at times, lancing will be enough, in some cases the cyst wall needs to be cut out and that means a suture or two, can be done under local anesthesia. JG 7.16.08
Answer: in most cases it will go away but it can take months in severe trauma cases, there is no surgery required in those cases. JG 7.15.08
Answer: there might be a small improvement on the scar itself. I think the SkinBiology is OK to use. JG 7.10.08
Answer: just normal wound edge swelling as it lays down new collagen, will flatten out over the next few weeks. Warm is good and light massage is OK in a few days. JG 7.8.08
Answer: more likey you have something called festoons, or a pocket of swelling over the malar fat pad, it can happen when fluid is trapped in a small area where he muscles do not cover it. In most cases it does go away in time. At times some of the heat based treatments can help shrink it, along with massage. I have seen it take months to get better though in some people. At times in cases of low thyroid it is worse too. Best of luck. JG 7.2.08
Answer: I think the science behind Prevage is weak, they are assuming their benefit is the same as that from topical CoQ. I think it is quite over-priced for what you get. They originally released it for sale only in doctor`s offices and when that failed they licensed it to a cosmetic manufacturer to try to salvage all the money they had spent on it. The only treatment for dynamic lower lid wrinkles is to thicken the skin, with things like Retin-A and lasers, or other creams, but understand there is an endpoint past where improvement will not go, so you will ultimately get to a point where nothing more can be done to reverse it, and only to control or slow it. JG 6.30.08
Answer: that is all normal, it takes time for things to balance out, give it some time. JG 6.29.08
Answer: the hard palate graft is needed at times if there is a shrinkage of the internal lining of the eyelid, it is not always required, just in severe cases where the tissues, once released, are not adequate to close the the wounds. I think the fat injections only help in a very small number of cases and I do not think it is worth trying it. JG 6.27.08
Answer: well you will likely need more surgeyr, it might be able to be done conservativley in order to avoid the cat eye look but it will certainly look like that for a period of time though. JG 6.26.08
Answer: it reaches about its max at 6 months or so. As to the sewlling, it varies, depending on what was done, give it some time. I agree with the time for the final results too. JG 6.25.08
Answer: the length of time in the skin for sutures should not have any significant degree of influence on the scarring internally. I leave mine in for 7 days aand I see no advantage to taking them out after 5 days and there is the chance of the incision opening up when taken out too soon. JG 6.24.08
Answer: not in my experience. I do not think Aluma is worth the money. Festoons at times need to be directly cut out leaving a scar right over that area. JG 6.11.08
Answer: I think that is all normal swelling that has migrated downward due to gravity and will get better soon. JG 6.10.08
Answer: no, sorry, it is not possible. JG 6.5.08
Answer: eye wrinkles are due to poor skin quality, and the canthopexy will not correct that, if the topical remedies have not helped, you might need to go to a more aggressive laser like a light CO2 laser or a Rhytec Portrait. All the best. JG 6.3.08
Answer: warm moist heat. JG 6.1.08
Answer: might be infected stitches. The redness and soreness can get worse if the antibiotic does not cover the organism that has caused the infection. I think you need to see a doctor in person, even if not the one who did your surgery. JG 6.1.08
Answer: sorry but it will not help the scars. JG 6.1.08
Answer: fine lines are never helped by a blepharoplasty, that is quality of skin and surgery only fixes excess quantity of skin, might need a laser or at least some Retin-A for the texture. JG 5.31.08
Answer: hard to say what caused it and I am not familiar with the antibiotics available in your location so you will need to discuss that with your doctor, if an abcess forms then lancing the abcess might be needed, let`s hope it does not get to that. JG 5.30.08
Answer: not normal, might need a different stronger antibiotic. JG 5.29.08
Answer: very difficult if not impossible to do I am afraid. JG 5.27.08
Answer: safe, yes, neeed, that is another question. Drooping should not be a problem if properly done. As one ages, if too much fat had bene removed, there can be a worse appearance. JG 5.27.08
Answer: I think that is due to the eye not closing and the cornea getting dried out, might need some eye drops for a while unitl it gets better. JG 5.27.08
Answer: I think at this point it is all within normal for what you had done. I do not think you have an infection but seeing your surgeon is the safest thing to do. JG 5.26.08
Answer: I do it under general anesthesia or local with intravenous sedation, never under straight local anesthesia, fees are about $2700. JG 5.25.08
Answer: well, every doctor is different, in most cases if the uneveness did not exist before, one can expect that if both sides are injected with the same amount, that they should be even, so I think it should be covered with the previuous fee in most cases, if for no other reason than good will. JG 5.21.08
Answer: I think ultrasound might help, and I also think a small nick with a blade and trying to push the oil out might help to smooth it out some. I think the setting should start low and increase as tolerated until it is at the maximum, best of luck. JG 5.20.08
Answer: I think you get a jaded view on the internet and people that are happy are not on here talking about the success. I think overall the complication rate is 1-2% in most cases. I will say that I do not see how the insurance is going to cover your lower eyelid surgery though for vision loss as that cannot happen, only with the uppers. JG 5.20.08
Answer: it is possible since there was so much done around the eye, yes. It usually gets better in 6 weeks, might want to use eyedrops and try to tape your eye closed at night to avoid injuring the cornea by exposing it to the dry air. JG 5.17.08
Answer: Botox before the surgery, the IPL will not matter as you will need many treatments so starting before is fine. JG 5.16.08
Answer: I think it is OK to proceed with the outside incision, they should not affect the healing as long as no skin is removed from the one eye during the touch up.Best of luck. JG 5.14.08
Answer: short term, maybe in some small number of selected caes, long term, no. JG 5.13.08
Answer: the skin will likely not grow back enough but if the scleral show is due to stiff tissue the massage will help. If in fact it is only due to too much skin being removed, a skin graft is sometimes required, or a procedure called a canthopexy. JG 5.13.08
Answer: start near the nose below the incision and massage it in a curved fashion from the nose to the temple. It can improve for months but if it is not better or getting better by 6-8 weeks it might need something done. JG 5.11.08
Answer: In time most likely the skin will continue to sag but it will require much less to be done than the first time. JG 5.11.08
Answer: the swelling will be considerable due to the tissue being released from the bones of the cheek. I think in some cases a canthopexy with or without skin grafts or flaps can correct the issue without lifting the cheek, but it is hard for me to tell without seeing you in person. I wil say that minimal surgey might not be possible to fix the problem. JG 5.10.08
Answer: aggreessive massage starting at the skin near the nose and push up and out toward the temples, might want to tape it up and out at night by placing tape on the outer part of the lid, and use eye drops at night too. JG 5.8.08
Answer: hard to say whether that is what you need without seeing you in person but if there is a need for more skin, the cheeklift can help with that and the incision will likely need to be made a little longer to gain access and repeat the canthopexy in such a way to avoid the scleral show. Might be the only way to go, but I cannto say without a physical examination. JG 5.7.08
Answer: in most cases 35 is too young. JG 5.6.08
Answer: all normal from the surgery and should get better, but slowly. JG 5.6.08
Answer: they will go away on their own, I do not think the ScarGuard will take the bumps away. Warm moist heat will help though. JG 5.5.08
Answer: might have been the dose injected, or the level at where it was injected, or both, glad all is better. JG 5.4.08
Answer: I do not think blepharoplasty will help, sorry. Thanks for visiting. JG 5.3.08
Answer: well, that is a generic dsecription of an end result, it is not a procedure in and of itself, there can be many things that could be done to open your eye more, it depends on what it used to look like and how it looks now, if it is just because the fat graft made the lid too heavy and the lid is lower, then removing the fat graft should help. JG 5.1.08
Answer: low or high thyroid can affect the bulging of eyes and also the amount of tears you make. JG 4.29.08
Answer: well, you can certainly try the Alloderm, I do not think it will last, but I think the mechanism of the defect is loss of fat from the old trauma, I would likely go with something else, but it wil be hard to replace what has been lost, no matter what you choose to use. JG 4.28.08
Answer: most likey they are cysts where the sutures were and the small holes now have a little plug in them, warm moist heat many times gets them to go away, otherwise they can be opened by your doctor with a small needle. The scarring should not be any more extensive than after the first one in most cases. Best of luck. JG 4.28.08
Answer: I think a deep Rhytec Portrait should help those, or a light CO2 laser. JG 4.28.08
Answer: the usual way to initially correct an orbitla blow out fracture is to place a silicone sheet in the floor of the orbiit to support the fat and the eyeball. Once time has passed it might not be as effective, I cannot see how alloderm will help as for it to last it needs a well vascularized area and that does nto exist next to bone.I really don`t have much more to offer. JG 4.27.08
Answer: I think using a silastic sheet to buld up the orbital floor and elevate the remaining fat is a good option. JG 4.26.08
Answer: thnaks for the suggestion and glad things are better, all the best. JG 4.26.08
Answer: I think blephs are safe procedure but I see no reason to do that for someone your age. I think he is being too aggressive. JG 4.26.08
Answer: I think he is likely trying to support the lid with the strip of muscle so the end result will not pull down on the lid and expose your eye too much. I will say that it is rare for a person youe age to get a significant improvement from a properly done blepharoplasty. In most cases the amount that can be safely removed will likely not yield much difference and what look you are trying to acheive might not be the result you get. JG 4.25.08
Answer: whether that will correct the problem will depend on what is the cause, if it was too much skin being removed at the original surgery that will not correct the problem, as to it being caused by scar tissue, there might need to be a graft placed to stretch the scar tisuse out. JG 4.25.08
Answer: yes, remove the old and reapply. Try soaking a moist wwrm towel on the area first. JG 4.22.08
Answer: I think placing cheek implants will likely make the scenario much worse. I think a repeat canthopexy is also likely not going to work as that has been tried and already failed. I think option two with possibly some grafting is likely what you will need, it might be skin graft or mucosal grafting, can`t say without seeing what layer of the eylid is causing the problem, could be both though. I will also say that whatever is done, the apeture of your eye will likely be left smaller on that side. Best of luck. JG 4.21.08
Answer: the bags can only be removed with surgery and at that time the Aquamid might be able to be at least partially removed too, best of luck. JG 4.19.08
Answer: a few days after the sutures are out is OK to start, so you can begin whenever you wish. It is very common for one eyelid to be more swollen than the other. Best of luck. JG 4.19.08
Answer: I think at this time the concern is drying out of the cornea and you might need intervention, a canthopexy or skin graft, to avoid damage to the cornea at this point. It might narrow your eye but it might be needed to save your corneas and eyesight. Nothing internal that can be done I am afraid. JG 4.15.08
Answer: not common, but it does happen. I think the PS should try to make it better, yes, unless he told you before that it was going to happen and you decided to proceed even with that warning. JG 4.15.08
Answer: likely different amounts of fat removed, the swelling should be about gone by now. JG 4.15.08
Answer: it all varies, depending on how much skin there was to remove, the skin removal is what likely rounded the eye out. JG 4.15.08
Answer: the eye shape issue might need surgery to repair but I would wait one full year, as to the dark line, when the fat was removed it likely made it more visible and fillers might be the only way to improve it. JG 4.15.08
Answer: the musces can be accessed through that incision but with the previous surgey, it might be difficult to see what needs to be done, I suggest a regular open forehead lift. That will also fix the sagging of the lateral brow at the same time. JG 4.15.08
Answer: ice is good and I do not think it is anythng to worry about long term. Best of luck. JG 4.14.08
Answer: should be better by now, I think you need to see your surgeon. JG 4.13.08
Answer: canthopexy can make the eye look less round but the opening will end up being smaller too. JG 4.6.08
Answer: hard for me to say without seeing you, could be to much skin was removed, I think you need to see your surgoen to see what can and should be done. JG 4.2.08
Answer: I have not seen it last permanently but I have seen it last a number of months. You can send the photos to drgarcia@lvcosmeticsurgery.com
Answer: I have never seen that happen, I have seen the swelling cause a festoon to appear for a period of time, but that swelling of the festoon is way below anywhere that fat could herniate out of. Our fee for lower lid fat repositioning is $2650. JG 4.1.08
Answer: puffiness will likely need surgery to reposition or remove the herniated fat. In some cases injecting a filler below the puffiness will mask the degreee of puffiness. JG 4.1.08
Answer: that will be a waste of time and money also. JG 4.1.08
Answer: if he is comfortable doing it I see no reason to go elsewhere. The scar would be the length of the festoon. In some cases make up is required to hide it. I am sorry but due to jealousy reasons I try not to recommend surgeons because others get jealous that I did not refer to them. JG 4.1.08
Answer: it is not that they come back, but what is done is mininmal amounts are removed in order to improve the appearance but not leave one looking hollow. As time goes on, the fat that was left can pooch out and require further surgery. JG 4.1.08
Answer: canthopexy will never fix that, they might need what is called a direct excision, that is where an incision is made right over it and it is cut out, leaving a small scar. It can be done after 3 months or so. JG 3.31.08
Answer: might take up to one year in some patients. JG 3.30.08
Answer: yes, it is just that I would not do the Rhytec over the skin on the eyelid treated with surgery. JG 3.30.08
Answer: well, things do stretch out over a few months, the urgency in repeat surgery would be if there are any problems that could potentially affect your eye itself and from what you have described you are not at that point. If there was too much skin removed you will likely need a skin graft to replace it, and I think 3 months after the original surgery should be more than enough to determine that, best of luck. JG 3.28.08
Answer: unusual for bruising to be there this long, all I can say is that there might be some shadowing from too much fat being removed, wish I could tell more but without seeing you in person it is difficult. JG 3.25.08
Answer: I think they are both related to the fact that during a canthopexy the lymphatics of the lower eyelid are partially kinked and they will not drain as well as it should but it does get better in time. JG 3.23.08
Answer: your mid face, if the SMAS is done properly should be elevated, there is no need for a seperate procedure. It might be because you have lost fat there and there was nothing to lift, maybe some Sculptra injections will reclaim some of the fulness in that area that you have lost over the years. The lower lids might benefit from a laser or a Rhytec Portarit resurfacing. Best of luck. JG 3.23.08
Answer: I think you should move forward, best of luck. JG 3.19.08
Answer: in someone your age there is usually loose skin that needs to be removed so I would do it from the outside since there would need to be an incision there already for the skin removal. If there is no skin excess, then the inside incision is a better choice as it is hidden and there will be no sutures placed. JG 3.19.08
Answer: don`t think lasers will do all of that, maybe a little for the upper lids. JG 3.10.08
Answer: yes, there is some relaxation in some cases though, so some surgeons will overcorrect, expecting a relaxation effect and sometimes it does not relax. JG 3.8.08
Answer: it will lighten for 4-6 weeks or more. I do not think Wydase will prevent PIH or bruising I am afraid. JG 3.8.08
Answer: all of that should get better soon, I might suggest Panatol eye drops. JG 3.8.08
Answer: should be OK, yes. JG 3.6.08
Answer: not likely, but the canthopexy can actually pull on the duct so that it does not function well, don`t know what else it could be. The swelling can be from the canthopexy kinking off the lymphatics at the corner and that can cause prolonged swelling. JG 3.5.08
Answer: might see something in 7-12 days or so, depends on how strong they go. Best of luck. JG 3.5.08
Answer: too early to tell I think, if anything it is more of a too much fat removed rather than not enough in most cases though. I would not do a repeat surgery for at least 6 months. JG 3.3.08
Answer: I will say that swelling from fat injections cna take a long time to go down, but if they are still there now, you might need to consider something to reduce them at this time. JG 3.3.08
Answer: there should be some improvements after a few days with the microderm, as to the fat being removed, I am a little confsed as that is usualy done with the blepaharoplasty. JG 3.2.08
Answer: well, the muscles do lie there and althugh it is not an everyday procedure, it has become increasingly more commonly done due to the interest in Botox, prior to Botox it was not frequently done. Might need a fller to be placed to smooth things out. JG 3.1.08
Answer: it is done with an ultrasound machine, seen at physical therapist`s offices. JG 2.28.08
Answer: a hematoma needs initially to be drained, but after 8 weeks it is too far gone, the difference is in the color, the hematoma will look like a bluish tinge initially and then turn light brown and be deep in the skin whereas post inflammatory pigmentation is superficial and light brown. For the hematoma at this point all I can suggest is warm packs, ultrasound massage and sunblock and bleaching creams to fade the color. JG 2.28.08
Answer: the easiest way is to look at a picture of yourself as a teenager and then a picture of yourself now without actively raising your brows, if the brow position has changed, then a brow lift migth be beneficial. JG 2.25.08
Answer: less than 3 months or so. Office procedure might be possible, yes, an the shape should go back if it is due to the sutures and not anything else. JG 2.25.08
Answer: filler injections. JG 2.24.08
Answer: well cutting some sutures that suspend the tissues might be able to be done under local anesthesia and might be best to do them soon before scar tissue becomes too well formed. Best of luck. JG 2.24.08
Answer: well the alomond shape is done with a canthoopexy by shifting the lateral ligament of the eyelids higher and might appeard wider but will make the aperture smaller actually. It is called Asian eye surgery becasue it can cant the corner of yoru eye up to look more oriental. I will say that what you desire is not always possible. JG 2.24.08
Answer: I think the YAG laser is the best and more specific, the Cosmelean will help but has the risk of reactive hyperpigmentation. JG 2.23.08
Answer: the creams and lasers will not work as it is due to loss of the fat below the skin, it might be helped with fillers such as Juvederm or Restylane short term, but they might not help as much as desired. JG 2.22.08
Answer: lasers do not decrease anything during a blepharoplasty, it does increase the surgoen`s wallet due to promises made from marketing.JG 2.21.08
Answer: it is a surgery done through an eyelid incision to re-attach the muscles of the lid to the cartilage so the eyelid opens more normally. Sutures are usually in place for about one week. JG 2.20.08
Answer: I thik what they have planed is a good course of action for now, it can always be done more aggressively if needed but that should be avoided if possible due to higher risk profiles. The YAG treatments are something that need to be done every 4 weeeks in a series so twice per year is likely not as good or worthwhile. JG 2.20.08
Answer: well, I am a little confused as to the course performed as a TCA peel will never help a bruise and hyaluronidase wil help dissolve a hyaluronic acid filler but will not help a bruise either. I think you might benefit from a laser like a YAG at the 1064 setting, it will likely be a series so I suggest finding a dermatologist or plastic surgeon near you to make it more practical. I am also confused why there was a filler injected and then a eye surgery so close afterwards. Best of luck.JG 2.20.08
Answer: I think fat transposition fails in some cases for different reasons, lets stat by saying that putting sutures in place for a only few days will prevent it from moving is not true, and actually, the more aggressive the pull is, the less likely it is to hold. The fat is not meant to be placed over the rim, and unless it is really bulging quite a bit, any pulling of the fat out to an area where it does not belong, can fail. The reason the line is visible as we age is twofold, one is because the fat might bulge out, and in the past when the fat was agressively removed, down the road, it left a hollow appearance. The other thing that makes the line visible is that there is fat loss over the line and what is being attempted is to move the fat you do not want to remove over the area where it has been lost, the poblem is the tension, if there is tension the sutures fail or the fat moves back and the correction is inadequate.Nature likes to pull things back to where they belong and transposed fat does not belong where they are putting it, it is therefore a compromise. JG 2.17.08
Answer: it is very difficult to replace over-resected fat, but that will not always give you more wrinkles. The milia are easy to take care of, they just need to be opened by your doctor with a small needle. As to the wrinkles though, I suggest a good moisturizer and lets hope it is just the swelling that stretched the skin out and it will snap back. JG 2.14.08
Answer: probably nerve stretching causing the pain. JG 2.14.08
Answer: it is hard for me to say without seeing you in person but it is all unsual I feel, the hot feeling might be nerves that were stretched and they are trying to come back. JG 2.14.08
Answer: tough call, it might hbe better with the fat being removed if it is due to the weight of the fat, possible. Also a likely issue is the needle used to inject the fat could have damaged the muscle of the upper lid and a muse repair might be needed to correct the problem. JG 2.13.08
Answer: the resposne to fat injections or fat transfers to steroids is unpredcitable so it might need more surgery to correct the problem I am afraid if it does not respond in the next couple of shots. The fat cannot be drained and I seriously doubt that there is any localized fluid from the surgery that can be drained either. Best of luck. JG 2.12.08
Answer: fat removal might not correct the darker line of demarcation at the orbital rim and that is why at times a fller is needed. You are correct, I feel that transposition of the fat can at times be unreliable too. It certainly is possible to do the upper and only skin on the lower, might be the safest. JG 2.12.08
Answer: it can be normal at this point due to swelling and should be better in the next few weeks. JG 2.10.08
Answer: sorry but I do not do that and am not sure what they could have done to have that effect. JG 2.9.08
Answer: I think if it is that bad that 6 weeks is likely a reasonable number. Warm packs, light massage and Arnica Montana will help, best of luck. JG 2.8.08
Answer: it wil help what is there get thicker and grow faster but you better hurry becasue it is being taken off the market for patent infringement violations. JG 2.7.08
Answer: could be just from the pulling and swelling frm surgery, in almost all cases they grow back when that happens. JG 2.7.08
Answer: uncommon but still not out of the normal range, some people`s skin is just very sensitive and that can happen, I think swimming is OK at this point though, hang in there. JG 2.7.08
Answer: nothing the eye doctor would likely do for a cosmetic issue, although lasers can reduce the red veins if the doc is willing. JG 2.6.08
Answer: don`t recall the question you are referring to, sorry. JG 2.6.08
Answer: it should not be that way after three months, especially after an upper lid blepharoplasty, hard for me to tell what has happened though, sorry. JG 2.6.08
Answer: it can be the sutures placed for the canthopexy or the tissues scarring in where the canthopexy suture was placed. I think you should go see your surgeon to have them evaluate you. JG 2.6.08
Answer: I think swimming is PK and it will get better in time, some people just talke a little longer is all. Hang in there for a little while longer. JG 2.5.08
Answer: dissolvable sutures will tend to flatten better than permanent sutures, yes. Warm moist heat and time are the best for now. Hnag in there. JG 2.4.08
Answer: I have not seen keloids form on the eyelids in orientals even if they form keloids elsewhere. I am afraid that lasers will not help nor any other surgery. Sorry. JG 2.4.08
Answer: could be the permanent or long term sutures the doctor used to perform the canthopexy, they are underneath the skin and can at times leave small lumps that in most cases get better with time. Hang in there for a bit. JG 2.4.08
Answer: in almost all cases the opening of the eye or eye width does become smaller, yes. It can be undone but cutting the internal suutures to release te tissues but at this point you are likely still quite swollen. JG 2.4.08
Answer: floaters are usually not due to the surgery, might need to see an eye specialist to make sure the pressure in your eyes is OK and you don`t have something going on unrelated to the surgery. JG 2.3.08
Answer: it can be as infections are rare and if they happen they are usually superficial. In time it should look OK, even if there is a small seperation as that area heals well in general. If there is an infection you need to let it heal on its own as putting in a stitch again would get re-infected. JG 1.30.08
Answer: probabaly just the normal swelling. I suggest apllying warm packs and seeing your doctor in a couple of days for follow up. JG 1.30.08
Answer: I would give it at least 6 weeks before undoing it. A skin pinch is a method of doing an eyelid surgery and removing minimal skin excess, it is totally different than a canthopexy. Sounds like you got a canthopexy. I cannot say without examining you whether the filler will be an option for you, sorry. I just think you need to give it some time and then be frank and honest and explain your concerns. I do not know him personally and I am surprised at your age that a canthopexy was required. Best of luck. JG 1.29.08
Answer: yes, they will, to some extent relax. The angle will widen at the outer corner of your eye.The amount of time it takes varies from patient to patient and from type of canthopexy to another, no way to tell I am afraid. That degree of closure will likely not be permanent. JG 1.29.08
Answer: it is true that at this point there is still lots of swelling and things will relax quite a bit in most scenarios. It can be undone by cutting the sutures placed below the skin if it is not to your liking. It might take a couple of months to look significantly better though in some people and final results at times take 6 months or more. JG 1.29.08
Answer: it will loosen and look better in time but part of the canthopexy effects, if it works, is that the eye will look smaller. JG 1.29.08
Answer: it usually snaps back over time. Thanks for visiting. JG 1.26.08
Answer: I think being honest and tell him what it is that bothers you is the first step, if you then feel that he undersands and is willing to proceed, then stay with him. If, on the other hand, he dismisses your complaints and concerns, then go seek care elsewhere. I do not think the scarring will be any worse the second time around. I will say though that waiting 6 months if possible or longer will make the tissues softer and easier for them to be modified during any second surgery. Best of luck. JG 1.26.08
Answer: yes, all normal and it should get better in the next two weeks, gotta hang in there. JG 1.19.08
Answer: sounds like you just need more excision, no sense in putting more tissue into an area where there is already a bulge. JG 1.18.08
Answer: I think the results are, at best, short lived and I feel that the probelms that can arise compared to the success stories make it not a viable option, certainly when off the shelf fillers are easier and have less risk and last about as long. JG 1.14.08
Answer: well if the incisions were made at different levels, they will likely get closer but might not match perfectly. There can be swelling that persists even this far out in some individuals, yes. I think I would give it another month and then voice your concerns to your surgeon. Best of luck and thanks for visiting. JG 1.13.08
Answer: I figured, takes a few weeks to get the change set. JG 1.11.08
Answer: I do not think it will do much for you, sorry. JG 1.10.08
Answer: yes, but it usually heals in a couple of days. JG 1.8.08
Answer: most likely will burn it off or remove it with a small scalpel. JG 1.8.08
Answer: all normal I am afraid and it will take another couple of weeks for it to get better. Ice in the meantime, and a little massage. JG 1.8.07
Answer: I think the surgenn should remove it for you to be safe, can likely be done in the office in a few minutes. JG 1.7.08
Answer: more likely than fat removal causing it, it is likley due to excess skin removed at the corner or scarring at the corner. At 2 months most of the swelling is down and things should look better. You might need a revision of the canthus for the rounded look and maybe a light laser for the crinkles of skin, all the best for the New Year too. JG 1.7.08
Answer: as long as the thyroid problem is balanced there is no reason not to go forward. JG 1.6.08
Answer: it will likely get better but I will say that lower lid issues as you describe are very very slow in terms of speed of improvement, just a little light massage, pushing the lid up and out in the meantime helps. JG 1.5.08
Answer: sounds like either PDS or Monocryl, so at msot it should be 3-6 months, I think the best thing is to massage it and go back when you can to se the doctor and let them see if any suture needs to be removed. All the best. JG 1.1.08
Answer: yes, it will settle down, if the suture was totally removed. All the best. JG 12.31.07
Answer: I think a browlift done through an incision in hair is possible and a upper lid blepaharoplasty at times is also helpful at the same time. All depends on the severity of the muscle weakness. I think a direct lift with a scar right above the eyebrow is easy but also will leave a visible scar. JG 12.29.07
Answer: the differences after an eyelid surgery, since that area is affected so easily with minimal amounts of swelling, will get better but it might take 3 months or more for a final result. The little bumps are usually due to the sutures and with time they open up and flatten out on their own. You can try applying warm moist heat packs and that helps many times. As to the incision, ideally it is placed in the crease so it should heal in the same place where it was before JG 12.29.07
Answer: all normal, warm moist heat will speed their going away and the itching is part of the healing process and will get better in time also. JG 12.29.07
Answer: the likelihood is much less, correct. I think repositioning fat is a good procedure if it stays but it can be unreliable at times. JG 12.28.07
Answer: all normal and will get better slowly with time, nothing to worry about though. JG 12.28.07
Answer: syringomas have to be treated with hyfercation or a laser to burn them, but they grow back. I do not think Retin-A or a chemical peel will help them. Surgery should not make them any worse though. Sorry. JG 12.26.07
Answer: well, assuming you did not have any laser to the lower eyelids, it is unusual, yes. The acute swelling from cutting surgery can make wrinkles look a little worse for a few weeks but that usually gets better after about one month. At times if absorbable sutures are used for the lower lids, they can leave milia where the sutures were and they need to be opened with a small needle to let the oil out, warm compresses might also help that too. Hard for me to say much more without seeing before and after pictures and more details about what was done, sorry. JG 12.26.07
Answer: I do not think the hollows are due to too much fat removal, likely just becasue the forehead is still slightly swollen It will take 3-6 months to settle in. The wrinkles on the lowers is from the temporary swelling and that will get better. JG 12.26.07
Answer: I think it will correct itself, not uncommon for that to look that way in the healing phase. JG 12.24.07
Answer: normal, due to swelling at this point. JG 12.24.07
Answer: all normal, due to swelling, give it some time. Merry Christmas. JG 12.24.07
Answer: we ue Mederma or ScarGuard for our patients. JG 12.23.07
Answer: sorry, waste of time for that and for most areas. JG 12.23.07
Answer: could have the doctor inject hyaluronidase to dissolve the Juvederm. JG 12.20.07
Answer: the redness will take 6-8 weeks or more and the final result will be at least 6 months. Best of the season. JG 12.18.07
Answer: if too much fat is removed, yes, it might look sunken in the future. JG 12.14.07
Answer: I think tranconjunctival fat and a skin pinch is certainly safe. That is what I usually do in that scenario, all the best. JG 12.14.07
Answer: if it does not go back to he normal shape the only way to get it there is to remove the canthopexy suture, and that is not dangerous to do. Scarring and retraction of the lid, if they are going to happen usually are seen within the first 6 months after surgery. There are patients that have to have the suture removed if it is pulled too tight at the time of surgery. JG 12.13.07
Answer: the problems is the fat needs to be placed between the surface of the skin and the muscle and fat injections there can be lumpy and do not survive well so it is not a good option. Best of luck. JG 12.12.07
Answer: due it the skin being thin and the blood vessels in the skin being seen as there is no fat to reflect the light off. No surigical, laser or cream solution, sorry. JG 12.12.07
Answer: hang in there. JG 12.12.07
Answer: in 4-6 wees syou get about half the swelling down and the remainder takes another 3-4 months, so hang in there. JG 12.11.07
Answer: well short term the upper lid surgery can cause both of those but neither should be there long term if they were not there before. The upper lid surgery should not create new long term wrinkles. JG 12.10.07
Answer: yes, that will help some, but it is more a matter of time. JG 12.10.07
Answer: the swellling form the uppr lids does move down onto the cheeks due to gravity, yes, and the tightness in the corners is not unusal when the muscles are tightened or the lid itelf is supported with a canthopexy suture. All of that gets better in time. In most cases after 6-8 weeks things are better. It might take 3-6 months though to get to the final result. JG 12.10.07
Answer: all normal at this point and will likely take another 6-8 weeks to have a substantial change, just hang in there for a bit. JG 12.11.07
Answer: give it some time, it will get better, I have had that happen but it will improve in time. JG 12.10.07
Answer: I think they will heal well in time and you will likely not need any surgery to correct it. JG 12.11.07
Answer: the hard lumps are where the sutures were placed and that will all get better in time. I think the looser skin will also look better in time too. A little too early to worry yet. JG 12.9.07
Answer: scar is scar, no way to remove it. When doing eyelid revison it is very common to do a canthopexy to avoid ectropion, correct. JG 12.9.07
Answer: I think enough time has passed that a revision is OK to attmept but I really cannot speak to what it would take to correect the problem without seeing you in person and evaluating the tissues. The scars will be permanent but should fade in time. I cannot judge without seeing you whether it would be worth it. JG 12.8.07
Answer: from what you are describing I do not think further surgery will help. If you did have scarred muscle it would not get better as the day goes on, and the crepey skin comes from the swelling going down and then the skin looking the way it normally does, it is just that the swelling hides it in the morning. I will say that morning swelling from the position youy sleep in or allergies or a number of other causes will never be helped by surgery. As to the line of demarcation, that migth be helped with injections of a filler like Restylane of Juvederm.Fixing the crepey skin is difficult, can be done with laser, but lasts only a few years. Best of luck. JG 12.8.07
Answer: possibly. JG 12.7.07
Answer: yes,for all of that, and as to the CO2 laser causing a pulled look, if it is done deeply it can result in that and will for sure look like that while swollen. JG 12.6.07
Answer: I think revising it with a little surgery might be better than with the CO2 laser. JG 12.6.07
Answer: I think that is OK to start using but I would not wait too long to see the surgoen in case you need oral antibiotics too. JG 12.4.07
Answer: I do suggest waiting at least 6 months from the original surgery before a revision and actually prefer one year if possibel to let the tissues soften. The touch up will likely be very similar to the first surgery, most of it will need to be done again. I think the end result will be in the surgeon`s hands and also how you take care of it after surgery so make sure you follow all instrcutions. JG 12.4.07
Answer: there is such a procedure, there are actually many variations of the procedure and many of them work well. The side with the stitch might need to have it removed and at times the surgery might need a small revision to even it out. I would cut the stitch out to lessen the chances of scarring. JG 12.3.07
Answer: it wil help burns or abrasions but I do not think it will fade the scars anymore than just time would. Between the two choices you are giving me I suggest the Aloe Vera as a moisturizer, the Vitamin E can plug pores at times. JG 12.3.07
Answer: you are correct, multiple surgeries, especially in thin skinned areas like the eyelids, can result in scar tissue that allows more swelling to form and also for slower resolution of the swelling as the scar tissue impedes the absorption. I would give it time and let it go away on its own, the human body has an amazing capacity to heal itself, give it a chance. JG 12.2.07
Answer: the eyelid surgery in terms of excess skin usually would last 5-10 years and in some cases more. The fat pads removed are not totally removed and as you age and the muscle weaken, more fat might need to be removed, better to take more out later than to take too much out as it will look hollow and it is hard to correct. The CO2 laser effects might last a few years, 2-3 and not much more I am afraid. The irritation of the eyelids could be from the Jan Marini eyelash product, or a dermatitis. All the best. JG 12.2.07
Answer: I think experience is important and I do think the lower lids are more complicated than an upper lid surgery. I will say that the amount of skin to be removced is that skin in excess in the relaxed position, if you remove the skin in excess when squinting the removal will be too agressive and have problems. Skin removal is not the answer for thin poor quality skin, it is for skin quantity. JG 11.28.07
Answer: it is a touch up to lessen the rounded appearance and the move the lid up so the white does not show excessively. JG 11.28.07
Answer: the redness is likely due to the lid being pulled down and the eyeball gets dried out. I do not think the rounded appearance will change much in the future from what you are describing, sounds like you will need a touch up possibly. JG 11.28.07
Answer: might need a YAG laser or some bleaching cream to fade the brown spot, that occurs from the blood underenath the skin being exposed to sunlight and oxidizing and staining the skin brown. JG 11.25.07
Answer: the long suture is used below the top layer of the skin to keep everything well approximated and then it can be pulled out and removed after it is no longer needed usually one week. It is a personal preference of the surgeon, not any better than other methods. JG 11.25.07
Answer: sorry but nothing will likely help, nothing reliable. JG 11.23.07
Answer: most likey, just give it some time. JG 11.21.07
Answer: that would be about $13,000, all inclusive with a one night stay at the hospital and all other charges. JG 11.21.07
Answer: well, I have to say that I have not heard of palepbral narrowing being a necessary part of a subperiosteal lift, it is due to the amount or aggressiveness of the lift, and initially it can be due to swelling but you are way past the swelling stage. Hard for me to say what can be done to correct it without examining you. JG 11.17.07
Answer: at this point in time it is likely due to swelling and some temporary weakness of the muscle and I feel that it will likely regain its normal position in time. JG 11.14.07
Answer: the damage will continue to worsen, faster if you are in the sun, but even without the sun they will get worse. Nothing will permanently remove or prevent them. I would consider either a light CO2 laser or a Rhytec Portrait. JG 11.13.07
Answer: might consider a small nick in the skin and then try to push the pearls out. I think more grafting might make it look worse. JG 11.13.07
Answer: well, more grafting might leave more problems, might want to consider a small nick in the skin over the pearl and have the fat pushed out. JG 11.13.07
Answer: I think it would be more efective and likely last 1-3 years. JG 11.13.07
Answer: well the endotine is for a brow lift,not for an eyelid lift or a blpeharoplasty so they are different things, I think the endotine brow lift done through the eyelid incision might last 3-7 years or so. JG 11.13.07
Answer: must be a speed demon. JG 11.10.07
Answer: it heals pretty close to the same color if taken from the other lid, and it will take a number of weeks before it looks OK, it will be visible for at least 4-6 weeks if not more. JG 11.8.07
Answer: it can be muscle and I agree you need to give it time to let it all settle down and then a proper evaluation can be made. JG 11.8.07
Answer: if you have pictures of your before and present appearance,please send them to me at drgarcia@lvcosmeticsurgery.com so I can see what can be suggested as options. JG 11.10.07
Answer: I think advancing the higher crease down is a better idea and should not be more complicated than the first one. JG 11.7.07
Answer: I think if the lateral brow is what has sagged it is a good option, I do it when needed. Best of luck. JG 11.5.07
Answer: I think it is best to do then seperately. I have my facelift patients stay here for about 10 days usually. JG 11.4.07
Answer: absolutely, brows first. JG 11.3.07
Answer: a canthopexy should help with the scleral show but it might also need skin graafting if the cause is lack of skin. I do not think an eyelid procedure of any kind will help a festoon. JG 11.2.07
Answer: likely from the swelling, give it some time and it should improve. JG 11.1.07
Answer: no, it will get better, just too new of a scar, give it a few months. JG 10.31.07
Answer: I think it is very low, it will not survive but it will cause swelling for awhile and that will make it look better while swollen. I think Juvederm and Restylane also are difficult to get to correct over-resection of fat. The rim responds well but only the rim and it can last 8-12 months in most people. JG 10.30.07
Answer: maybe just an upper lid blepharoplasty. JG 10.29.07
Answer: I usually use Restylane or Juvederm at present. JG 10.26.07
Answer: I feel that injections on the lower rim will offer something but it will not correct a deep socket shadowing I am afraid. JG 10.26.07
Answer: I think most likely the lid should retain its shape. New scar tissue will actually form rather than the old one stretching. Cutting the old scars out will cause some new tighness, yes. In general, if there is enough skin, the revision should do fine. In general the eyes should look pretty similar, yes. Best of luck and hang in there.JG 10.25.07
Answer: could cut the scar and a little more of the festoon out and reclose it. JG 10.25.07
Answer: might want to se an opthamologist to have them taken care of, I do not think a blepahroplasty is indicated. JG 10.25.07
Answer: hard for me to tell without actually seeing you to determine what the cause is, sorry, wish I could tell you more. It is still normal to be a little light sensitive at this time. JG 10.23.07
Answer: the shape of the excision is actually tailored to each patietn, some peopel need different skin excisons because of their anatomy. A skin removal will not change the shape of the eye like a canthopexy can though. From what I see the blepaharoplsy is what I would do to deepen the upper lid if that is what you desire. JG 10.23.07
Answer: not that I have seen or heard. JG 10.23.07
Answer: hang in there, it will get better. JG 10.23.07
Answer: it is called chemosis and will get better but it will take time, a couple of weeks at times. JG 10.22.07
Answer: sounds like a better option with the canthopexy. JG 10.22.07
Answer: they can be uncomfortable, yes. JG 10.22.07
Answer: where are located? JG 10.21.07
Answer: see you then! JG 10.21.07
Answer: most likely massage and injections will not do much at this point out form the surgery. Surgery is likely the only thing. JG 10.21.07
Answer: I agree, before is better. Best of luck. JG 10.20.07
Answer: I only use peels for discolorations and not wrinkles so probably none. I use lasers or Rhytec Portrait for that area. JG 10.20.07
Answer: could be a small hematoma, or some granualtion tissue or some fat that is begining to dissolve, all will get better, the steroid eyerops might help a little. JG 10.16.07
Answer: I think lasers are vastly superior to chemical peels for that, I feel most of the improvement after the chemical peel goes away after the swelling goes down. JG 10.16.07
Answer: it is possible that the insertion of the levator muscles was stretched. An unusual occurance, yes. JG 10.15.07
Answer: it is determined by where the lateral lid is and also the laxity of the lower lid. A transconjunctival incision is from the inside and it will only treat the fat, no canthopexy or skin removal can be performed throuh that incision. JG 10.13.07
Answer: I do nto think anything topical will aggravate or improve the puffyness I feel. I do not think cortisone is a wise option. I do agree with your sugeon that you need to give it some time though. JG 10.13.07
Answer: might be able to be improved with a canthopexy. JG 10.13.07
Answer: still can be from the surgery, yes, will get better on its own in time though. JG 10.11.07
Answer: about 4-7 days more for a facelift I would say. I think if they are all needed, best to do them together. It is more expensive doing them seperate, maybe more than a $1000 difference. JG 10.10.07
Answer: it is a type of midfacelift. I think the complication rate from attempting to lift the cheek fat through a lower lid incision is very high and I do not recommend it. You assesment is correct. JG 10.9.07
Answer: not much that will work I am afraid. JG 10.9.07
Answer: no, I just think it is another brand, we have used it and have been happy but I cannot say it is better than any other brand. If you are not pregnant then the Retin-A Micro is OK, if you get pregnant then stop it. I think some people like the Retin-A Micro, I just have not seen any significant difference and the Micro is more expensive. Just a way to extend a patent. As to the fat removed with your blepharoplasty, that fat will not come back but not all of the fat was removed so as you age some more fat may droop or pooch out. JG 10.6.07
Answer: well, I am not sure how he can say that, understand that when a skin pinch is taken and no muscle work is done that the skin is not truly redraped over the muscle and it takes time, 3-6 months in most cases, for the skin to redrape itself so in most cases that will correct itself on its own. When you put a chemical peel on top, that creates more skin irritation and can slow the process. In the worst case scenario, depending on where the wrinkle is it can probably be improved with a little more skin removal or a light laser, just hang in there for a bit more. JG 9.30.07
Answer: I think you really need to wait at least 6 months for things to settle down to be able to evaluate for the need to do a revision, still too soon. JG 9.30.07
Answer: yes, can start day 3, just rub gently up and out towards the corner of the eye. 2-4 times per day for 2-5 minutes. JG 9.28.07
Answer: I think most of what you are seeing is all the tissues getting back to normal, things will shift and move for another 4-6 weeks, just keep out of the sun, use Mederma or ScarGurad on the scars and give it some time. JG 9.28.07
Answer: I feel it is not as effective and it is harder to control than the lower lids but can be done. JG 9.26.07
Answer: if it is not affecting the motion of the lid you can leave it. JG 9.24.07
Answer: could be too tight, doubt suture irritation this far out. Might need the canthopexy cut and released to make it better. JG 9.24.07
Answer: I think 2 months is OK, but also wear the eyelid shields to be safe. JG 9.23.07
Answer: well the fat removal is all done in a conservative fashion because if too much is taken out it will look hollow, it might still be swelling at this point though, I would give it at least 3-6 months to decide if you need a touch up. JG 9.23.07
Answer: the irritation at the end of the incision is common due to irritation, especially when a chemical peel is done at the same time and will get better in another week or so, as to looking like more wrinkled, that is because the skin is dry and has lost its moisture, normal after a chemical peel and over the first month and some moisture will get better. I do not think the wrinkles are from swelling. JG 9.22.07
Answer: All I can say is gentle massage to help the swelling that is stil there to resolve. JG 9.20.07
Answer: some masseuses do lymphatic massage, for the eye surgery just a gentle wiping from the nose to the side of the cheek. Lymphatic massage is just a technique to push fluid or swelling into the lymphatics to get it to resorb, so the massage is done in certan directions. JG 9.20.07
Answer: the only effect low thyoird has is maybe dry eyes, because less tears are made. In some cases there is also puffiness due to edema or swelling, but that can come and go. JG 9.20.07
Answer: need to do a browlift. It reattaches at a higher level after the tissues are lifted and pulled back. JG 9.20.07
Answer: well when you lift the brow it pulls on the upper lid skin so it can be difficult to gauge the proper amount of skin to remove. I usually perform the browlift first. JG 9.20.07
Answer: unusual if it was just a fat removal of the lower lid through the tranconjunctival approach, if it was something more it could be some torn stitches from the swelling that should subside, but slowly. You should probably go back and see the surgeon just to make sure. Best of luck. JG 9.19.07
Answer: the canthoplasty is more dramatic and more secure, which one you need can only be determined with an examination. JG 9.16.07
Answer: complications are actually not common and might be needed in your case. JG 9.16.07
Answer: just a small suture from below the skin that needs to be removed is all, your surgeon can do that for you. JG 9.16.07
Answer: not normal and not likely due to the surgery, might want to see an eye specialist. JG 9.16.07
Answer: well, it certainly can cause skin dehydration and the continued treatments you have done have likely not allowed it to heal, I think you need to use a good quality moisturizer and leave it alone so it can heal, I think in time it will get back to normal. JG 9.05.07
Answer: it is the depression that starts at the inner part of the lower eye and goes downward on the edge of the orbital bone, it is a problem seen not felt. JG 9.4.07
Answer: 50% in 6 weeks the other 50% in 3-6 months. JG 9.2.07
Answer: it is called a transconjunctival blepharoplasty where the fat is cut out, liposuction is not safe there, fees will vary from one surgeon to another, but it will be about $2500 or more. JG 9.2.07
Answer: Malar festoons will not be helped with the laser not the surgery of the lower lids. Some people have them due to seperation of the muscles that allows the fluid to accumulate there. Conservative fat removal is always the best approach in terms of the puffyness. As to the mole, it would rarely be removed with just the amount of lasering done for wrinkles removel, it would take much more lasering than that, I think if you can see and feel it you should point it out to her. JG 9.1.07
Answer: not uncommon and usually does go away on its own. JG 9.1.07
Answer: although plastic surgery results do come soon, they are not fast and at times, if someone`s skin is less elastic, the ability for it to snap back after swelling can take time. I will say that what you are seeing is not uncommon, and in time along with little things like DMAE cream or Retin-A things do get better. In rare cases if too much fat was removed that will require some skin removal or lasering to hide that, wish I had more to offer but I think you need to hang in there for a little longer. JG 8.31.07
Answer: I think it is too early to tell much and I feel that most likely it will all balance out as the swelling goes down. JG 8.31.07
Answer: it actually lengthens them more than having new ones grow.JG 8.30.07
Answer: incisions are usually made 6-10 mm from the lashes, once the swelling goes down, if there is enough skin the incision can be advanced down to a lower site, but let it heal for a bit and see what is happening. JG 8.30.07
Answer: There is at least a 50-50 chance it will need to be cut out, if it is accessable it might be able to be removed from the inside, yes. JG 8.29.07
Answer: well it is more due to how they heal and blood pressure and mostly things out of their control as long as they follow post operative instructions. Some people have a genetic tendency to form thick scars, but infection and excess tension are also contributing factors to it. No way to predct it totally. Thanks also for the kind words. JG 8.29.07
Answer: well there are two strengths so it if it 10mg/ml that would be an OK dose but not too many times. JG 8.28.07
Answer: well a canthopexy can alter the shape of the eye but it is usually done in those people where an abnormal position of the eyelid exists to begin with and we are just trying to get it back to the way it was, in those cases it should not alter the eyelid shape to something it should not have been to start with. I do it in some but not all patients as not all need it, but it is a good procedure. JG 8.27.07
Answer: I think it is too soon to tell and most of that will all balance out in time, likely just due to swelling at this point. JG 8.26.07
Answer: you can do that but if it was due to previuos cosmetic surgery insurnace will likely not cover it. JG 8.25.07
Answer: it is quite rare to do it that way for a routine blepharoplasty, I have seen a very small number of surgeons perform it that way because it is easier, in time the scar does heal fairly well but can be seen without makeup. All the best to your friend. JG 8.25.07
Answer: not normal, I would see the surgeon to make sure that all it is is due to swelling. JG 8.23.07
Answer: the darkenss can be from residual blood in the area, warm packs might help, as to the lump I think your surgeon needs to look at it to make sure it does not need to be injected or cut out, there can develop little things called pyogenic granulomas from where the incision is during that procedure. In the meantime hang in there. JG 8.23.07
Answer: it involves taking skin from the surrounding area and making an incision and lifting that skin and moving it over to an adjacent area, so it will create more scars than are present now. JG 8.23.07
Answer: need to pick a surgeon and ask them as prices vary from surgeon to surgeon, usually a surgeon needs at least photos to detemine whether the patient is a good candidate for the surgery too. JG 8.21.07
Answer: well it certainly sounds like a simple fix will not work, you most likely wil need something more aggressive such as at least a skin graft along with the suspension sutures. It might also involve a flap procedure if it is able to be performed on you. Sorry to hear about the problems, JG 8.21.07
Answer: most likely they are small cysts where the sutures were that have filled up with a little oil, warm moist heat should get them to clear up. In some cases the surgeon needs to open them up with a small needle to let them empty. The redness on the corners will get better in time, you can use Mederma or Scargurad to help it fade. JG 8.21.07
Answer: you are most welcome, hope I helped out. JG 8.20.07
Answer: I suggest either Mederma or ScarGuard, best of luck. JG 8.20.07
Answer: not normal and it can take 6 weeks at times to get better, I think you need to go back and see the surgeon and see what else is going on. I think dark glasses will help with the light sensitivity. JG 8.20.07
Answer: the cream is a little too irritating so I am playimg with the ingredients, maybe another month or two, as to the hollows, I am still playing, it takes time as I want to wait 6 months after each surgery to see if it works. JG 8.20.07
Answer: to be honest there is nothing reliable for true hollows, if it is the ridge of the bone fillers like Restylane can be used but nothing at present works well for lost fat from the orbit. JG 8.20.07
Answer: not uncommon when skin is removed form the lower lids, usually from the skin being stretched due to swelling and then needing to contract, it also takes some moisturizer and a little time but they should go away. JG 8.17.07
Answer: wait at least 6 months and the scars are visible for 2-6 months. JG 8.17.07
Answer: it can from the degree of bruising that can happen. The needles that are used for fat injections are larger than those used for regular fillers and can cause more swelling and bruising. JG 8.16.07
Answer: cannot say if it is permanent, could be from the fat injections and the bruising it causes. JG 8.16.07
Answer: it sounds like it could be a pyogenic granuloma and it migth need to be cut out and stitched again. JG 8.15.07
Answer: I do think it is swelling and it wil take time, avoiding salty foods and continued head elevation are about all you can do besides being patient. JG 8.13.07
Answer: I think if there are signs of it dissolving I would wait it out if at all possible, all the best. JG 8.12.07
Answer: no, just some stretching of the nerves and it will all settle down. JG 8.12.07
Answer: it can take 2-4 weeks for it to settle down. Hang in there for a little longer.JG 8.12.07
Answer: should look lots better in 4-6 weeks, at this point there is still lots of swelling, hang in there. JG 8.11.07
Answer: the skin of the eyes is very sensitive and you certainly do not want the cream in the eye but if you can tolerate the creams on the eyelid skin, it is OK to use. JG 8.10.07
Answer: for what are you using it and which cream or gel are you referring to? JG 8.10.07
Answer: it can be the case, yes. I think avoiding sun for at least three months is a good idea. JG 8.10.07
Answer: I think the question is a reasonable one to ask and you can also ask to look at pictures and speak with pateints too. The state medical board keeps a record of complaints on physicians. JG 8.9.07
Answer: I think it is becasue of the number of things done and you are also a little older too. It will get better. JG 8.9.07
Answer: no, at worst they will look like they used to but they might look better because the cheek tissues have been raised and are not pulling on the lower lids. JG 8.8.07
Answer: might want to use aloe vera from a bottle, might be less irritating. JG 8.8.07
Answer: Botox in the crow`s feet is OK but I think most of what you are likely seeing will get better in time. In my experience the fat injections do not last more than a few months to a year in most hands. JG 8.8.07
Answer: at this point in time the swelling can certainly do that, yes. Waxing is OK now. JG 8.8.07
Answer: it will help it fade. JG 8.7.07
Answer: I do not think the ScarGuard will make it worse and is safe to use. JG 8.6.07
Answer: nothing long term, just might need to leave the stitches in a little longer as the skin heals slower when there is kenalog around. JG 8.6.07
Answer: all due to swelling and should get better in a couple of weeks or so. JG 8.6.07
Answer: I think 6 weeks is OK. JG 8.6.07
Answer: it is common and it is temporary. Time and ice and elevating your head along with avoiding the crying and salty foods will help. JG 8.6.07
Answer: I think it is still normal swelling trying to go down, not uncommon. JG 8.5.07
Answer: all normal and will settle down in time, just hang in there for a little. JG 8.4.07
Answer: I am afraid it will do little good. JG 8.3.07
Answer: I am not sure laser will correct the tint to the eyes and certainly will not help the hollowness from too much fat being removed, that actually is very hard to correct in most cases. Wish I had more to offer. JG 8.3.07
Answer: most likley swelling and the eyes trying to readjust after the ptosis repair, give it some time. Herring`s law is where the normal lid rises up to try to match the message from the brain to the ptotic lid. JG 8.3.07
Answer: it does irritate the skin in some people with sensitive skin and you need to be very careful not to get it into the eyes. The wrinkles most likely will get better in time. JG 8.2.07
Answer: boy, I disagree, I think it will look worse. May want to consider a filler for the rim. JG 8.2.07
Answer: the tic will not cause any damage besides just be a nusance, there will be no long term effect on the muscle, actually it keeps the muscle in tone. I will say that at times stress is a trigger for that tic, could try some valerian root or 5HTP from the heath food store and see what happens. If the tooth needs a root canal it could from the swelling in the bone, yes. JG 8.1.07
Answer: the hollow eyes will not be repaired with an eyelid surgery because that does not replace lost fat. JG 8.1.07
Answer: I think just telling him what you are experiencing will not hurt their feelings but those nerves are very unlikely to be damaged through that particular surgery. JG 7.31.07
Answer: yes, there is, it is called a canthopexy and can be done but at times a more extensive procedure with eyebrow lifting is required, varies from patient to patient. I had a good time on my medical convention trip too, thanks for asking. JG 7.31.07
Answer: I do not think it is related to the surgery in any way. JG 7.30.07
Answer: I really cannto say without at least seeing some photos, please send them to DrGarcia@lvcosmeticsurgery.com
Answer: doubtful the surgery was the casue as it would have happened right away, now if the eyelid skin was not allowing the skin to close over the cornea then maybe that could ahcve allowed the corneal infection to start. JG 7.15.07
Answer: with dark glasses maybe. I have never heard of lashes being shaved off on purpose. Best of luck. JG 7.13.07
Answer: it wil go away if the tissue was lifted aggressively and the skin removal of the lower lid was removed conservatively, as to when it will relax, there is no way to tell. JG 7.12.07
Answer: it can be, yes. It can be like that for 6 weeks in some people. JG 7.12.07
Answer: Emu oil has no real effect on scar tissue I feel. The Scarguard is not a good moisturizer so you might need both. JG 7.12.07
Answer: most likely it is muscle and if it is it can be consevatively trimmed, otherwise it could be a little fat, although that is less likely, or just scar tissue. JG 7.10.07
Answer: yes, the fat injections can certainly contribute lots to swelling and bruising. Still OK for the Emu oil. JG 7.10.07
Answer: it is just for moisture, it will not fade the scar the way the other creams will, I think you should put sunblock on if you are going to go outside, just put it over the Emu oil. JG 7.10.07
Answer: I think Emu oil is OK to use, yes. It will help the skin if the skin is dehydrated, no specific brand of oil though. JG 7.9.07
Answer: not usual but not uncommon. The type of fixation does not affect the bruising. JG 7.9.07
Answer: could just be to the lift of the midface causing somw folding of the lower lid skin. JG 7.9.07
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 7.9.07 http://www.surgery.org/public/findasurgeon.php.
Answer: They both can cause irritation, if it occurs just stop it and retry a few days latrer. OK to use with the Vitamin E. JG 7.8.07
Answer: I do not think the implants will help but removing skin should, the length of the incision required varies, the looser the skin the longer the incision will need to be. JG 7.8.07
Answer: did they do any laser or chemical peel to the skin? JG 7.8.07
Answer: we do not like to remove muscle as it closes the eyelid, if it is close to the rim of the boney socket it is likely not muscle though. Taking fat out should not affect the muscle being seen. Fillers might help camoflauge it, yes. JG 7.8.07
Answer: no worries, just get it taken out this coming week. There can be some little wrinkles from the skin re-attaching and that should all get better. JG 7.8.07
Answer: there is a new product sold by Jan Marini that helps with the eyelashes, we sell it in our office. I do not think the facials will assist in anyway though. JG 7.8.07
Answer: no down time difference to speak of, the bigesst differecne is the traditional blepharoplsty is done with an outside incision so skin can be removed where the transconjunctival bleph is from the inside and therefore no skin can be removed. JG 7.8.07
Answer: no, it is a common thing as the blood leaves the eyes slowly, it is a matter of time. I would not worry about blindness though, just hang in there. JG 7.5.07
Answer: Cortisone will do little good, it sounds like you need more cut out. JG 7.5.07
Answer: Cortisone will not remove the festoon. In terms of cutting it, I mean a cut right directly over the pouch, not a lower eyelid incision far away and then an attempt to pull it up, the scar needs to be placed right over the festoon. JG 7.4.07
Answer: no surgical correction at present. I would stick with the Juvederm for now. JG 7.3.07
Answer: I do not think it will help, it sounds like a festoon and it might need to be cut out directly. Cortisone can cause tissue loss of the normal areas around it. JG 7.3.07
Answer: I think the Dermalogica product is OK, but not totally effective for all patients, might need to try some others, including Dermablend. Mederma will help with the tissue healing but will have little effect on wrinkles I am afraid. It does help with redness though. I think in terms of fat removal, we are always conservative as too aggressive of a removal can be nearly impossible to correct. At this point I think it is still mostly swelling though. If you had periods of swelling that came and went prior to surgery, that will never be improved. Fluid retention is partially genetic but it is also environmental in terms of allergies. I think you can use the Retin-A and hydroquinone on the non-treated hyperpigmented skin but not on the lasered areas until healed. I usually have the patietns mix them on their palms and then apply it to the skin, equal amounts of each. The peeling does mean it is working and it flakes as it breaks the bonds between the superficial epithelial cells causing them to exfoliate to flake off so new skin cells can surface. JG 7.2.07
Answer: you can use Mederma or Scargurad, just to not let it get into your eyes is all. I will say that they will help but you will always have scars, they will fade in time though and be barely visible in most cases. JG 7.1.07
Answer: that is done occassionally if the lower lids are swollen and need a little support to pick the skin up and lift it so it lays against the eyeball and protects the eye from getting dried out, it should not have to be done for very long. Best of luck. JG 6.30.07
Answer: no, just the swelling. JG 6.28.07
Answer: just twice per day is all on both. If the incisions bleed after the sutures just hold a little mild pressure and it will stop, nothing else needed. JG 6.28.07
Answer: I think laser on olive skin is risky and a removal of lower lid fat will make the dark circles worse. There is a small possiblity the skin that is lasered will not tan but a greater risk is that it will get darker. JG 6.28.07
Answer: only from the outside I am afraid. The internal one is more for prevention than treatment. JG 6.27.07
Answer: in time the redness will get better, yes. The only good solution for malar bags is to cut them out, the methods you suggest I feel will not help. As to the redness, it greatly depends on the type of laser used, your skin type, and how deep the treatment was done, so no way to tell without knowing all of that. I would not put bleaching cream on the white spots. I have seen the redness take up to one year but it is usually gone in 3-6 months in most people if it was a CO2 laser, best of luck. JG 6.27.07
Answer: all I can say is good luck and don`t be surprised if they do not go away, but you might get lucky. JG 6.26.07
Answer: I think the blink is OK to use, yes. If it is protective oitment it needs to dissolve on its own I am afraid, no way to get it out. Hang in there. JG 6.25.07
Answer: well the green is normal brusing resolving, as to what is affecting your eyes, it could be a reaction from protective ointment put into the eyes at the time of surgery, it could be due to abnormal tightening around the eyes not allowing the fluid of the eye to drain properly. I would use some eye drops to moisturize and lubricate your eyes and if not better in 2-4 days I think you should see an eye specialist, all the best and thanks for visiting. JG 6.25.07
Answer: I would be concerend, ask him if he will refund your money if they are not gone and see what he says. If they are true malar mounds I think it will require more. JG 6.25.07
Answer: most likely not related to surgery and most likely will go away on its own in time. JG 6.25.07
Answer: I think it will still settle down in time. The bump could be a stitch, may want to show it to the surgoen. If it is it can be taken care of easliy. JG 6.13.07
Answer: the canthopexy will not affect the redness from the laser or increase any risks from the laser. I think both procedures can be done at the same time safely. JG 2.2.8.07
Answer: well, unfortuantley lasers although relatively non-invasive, will yield slight results as the skin of the eyelids is too thin to laser it aggressively, and eyelid surgery might be needed but if the assymmetry is due from the brows falling, that will not be repaired with an eyelid surgery. Teh eyelid surgery might run about $2700. JG 2.2.8.07
Answer: I do not think anything but a true laser will tighten the skin and you have aleady had problems there so I would be cautious. JG 2.27.07
Answer: it is not scar tissue but the swelling that has extended to the cheek to a mild degree and hwen then muscles move, since they are swollen, they pull on the lower lid, he is correct that in time it all gets better. JG 2.24.07
Answer: pretty similar to the first I feel. JG 2.22.07
Answer: rally hard for me to say without seeing you , but I think waiting 6 months, at least, is a good idea. JG 2.20.07
Answer: for crows feet either a CO2 laser or a Rhytec Portrait, no laser wil fix hollows. JG 2.19.07
Answer: sorry but no. JG 2.18.07
Answer: no. JG 2.18.07
Answer: pictures migth help, but a scar revision will require more skin removal so you must be sure there is enough skin to do that and not cause further problems. JG 2.18.07
Answer: well although that is not common it does happen, some people react more strongly to the sutures. It is uncommon for steroid injections to be used afer only two weeks so I begining to think there is something else going on, I think staying in frequent contact with your surgeon is important to make sure there is nothing else going on. JG 2.16.07
Answer: I think in general upper eyelid surgery is a great operation. Best of luck. JG 2.14.07
Answer: well the national rates reported at meetings is about 8% for significant complications. I do noe do any lifting of the midface either through the mouth or eyelid, I only lift the tissues of the cheek or midface through a cheek incision and do not lift the muscles off the bone as that is where the problems start. As to underye puffyness, maybe just a conservative fat removal through an incision inside of the eyelid, called a transconjunctival blepharoplasty. JG 2.14.07
Answer: he is an experienced surgeon. As to the mid-facelift, even in the hands of the surgeons who invented it, there are high complication rates if done through the eyelid incision. I certainly understand that you want to listen to your surgeon, but although he can make suggestions, the ultimate decison on what to have done rests in your hands so if you do not want the mid facelift, do not have it, its your face and you get to decide, if he refuses, go somewhere else. JG 2.14.07
Answer: both, you can go to work but you will not look very good. JG 2.11.07
Answer: common, normal and will get better as the tissues heal, give it a little time. JG 2.10.07
Answer: I suggest Rhtec Portrait or a CO2 laser, fees for the Rhtyec Portrait would be about $1250. JG 2.9.07
Answer: I do not perform it and am unimpressed with its ability. JG 2.8.07
Answer: it can be some of the nerves being caught in scar tissue and irritating the nerves that go to the muscle, not much can be done except massage and time I am afraid. JG 11.30.06
Answer: I seriously doubt it. JG 11.29.30
Answer: I think a truthful survival of the fat is 50% at best, risks are small though. I can`t say how many Dr Seckel has performed though. JG 11.28.06
Answer: releasing the suture can cause some asymmetry, yes, the fee would be $2650. Please sned a photo to drgarcia@lvcosmeticsurgery.com as that would help me tell you more. JG 11.27.06
Answer: I do not recommend the threadlift as it does not last, as to tatoo removals, we do them and it takes a variable amount of sessions to remove them, cost is $100 per 15 minutes. JG 11.27.06
Answer: please see adjacent answer
Answer: price will vary but about $350-500 per side, depends on the size, if done under local anesthesia only, in the office. JG 11.26.06
Answer: the scars can take up to a few months to improve I am afraid and the muscle dysfunction is not uncommon with that incision and approach. I am not sure what type of sutures he uses so I cannot say whether it will dissolve but it should get better slowly. I would suggest going back to see him and make sure all is OK. Best of luck. JG 11.26.06
Answer: well I must say that is highly unusual, especially on the eyelids, I think a visit to your surgeon might be the best and it might require steroid injections but agian, those should be rare occurances. JG 11.26.06
Answer: yes, the scar will soften and lighten but it might take up to one full year for it to fully mature. I think waiting for the scar to soften will allow the greatest amount of motion and make it easier to perform, so I would wait as long as you can. JG 11.26.06
Answer: well although the tissues can be released, if too much skin has been removed, that can only be put back by adding skin, that means skin grafts and they will never look like the original skin. If you have scleral show a canthopexy is almost always a must, the midfacelift tissues will not correct that. JG 11.24.06
Answer: a festoon is a little area of swelling that occurs where the muscles of the lower lid end and the cheek tissue starts. I think that incisions on the lids might affect the draining some, so let`s see what the doctor can do with the injections. JG 11.24.06
Answer: I would see an eye specialist, it might just be swelling in the muscle of the eyes that will get better in time on its own. JG 11.24.06
Answer: the throbbing and twitching do not mean they are loosening, no. As to removing the sutures, what can happen is that the lid will not be in the correct position and might bow downward. JG 11.23.06
Answer: sounds like a good idea, best of luck. JG 11.22.06
Answer: I find the transconjunctival blephs are shorter as there is no skin removed and no sutures, as to liking eyelid surgery, yes, I enjoy it quite a bit, but I am conservative, it is very difficult if not impossible to repair over resected issues on the eyes. Better to do a little more than too much the first time. JG 11.21.06
Answer: I think I would wait it out, I only use cortisone shots, especially on the eyelid in severe cases and it is not very effective if it is residual fat that is there. JG 11.21.06
Answer: well, if the fat is removed, it cannot be repositioned, it is one or the other. There can still be swelling at 6 weeks, yes. JG 11.21.06
Answer: They still make Renova and the gel is more commonly used for acne as it is alcohol based and helps a little more with acne than the cream based. I am sorry to hear about the problems with the erbium, your healing time is highly unusual unless a deep second degree burn occurred. I think for the hyperpigmetnation I suggest mixing the Renova with some 4% hydroquinone to help fade it, and continue the sunblock, not sunscreen. JG 11.20.06
Answer: not unusual, it can be where the sutures were and some warm moist heat should help them open up, not a long term problem. JG 11.20.06
Answer: a homeopathic material used to decrease swelling and bruising. It is not a prescription medicine. JG 11.19.06
Answer: there are many different brands of absorbable sutures and they can at times cause a level of inflammation, I agree that more surgery might be needed. JG 11.19.06
Answer: I think we can do it now, please call the office at 870-0058 for an appointment and we can do it in the next week or so. JG 11.19.06
Answer: please call and make the appointment with my office. I am unsure what may have happened to the email except if you posted it on the agelessforever.net site and it pertains to plastic surgery it got transfered to my plastic surgery site at lvcosmeticsurgery.com. JG 11.19.06
Answer: all normal and should get much better by the end of the first month.I think that amount of time of waiting for the Botox is adequate. JG 11.19.06
Answer: it is not a simple procedure. The incison is the same length as the original. I usually use genral anesthesia. JG 11.19.06
Answer: I would be happy to hyfercate them for you, just call the office and I can see you as soon as you can. JG 11.24.06
Answer: depends on the case and what the patient wants to do, in terms of wanting to avoid a scar, either can help but the injections need to be redone every so often, time interval varies. JG 11.18.06
Answer: I think a canthal procedure might not be needed at all, all you might need is a pinch of kin removed which does not require an involved canthopexy procedure. JG 11.18.06
Answer: it should relax in a few weeks if the scar tissue is released, in some cases you should see it almost right on the operating room table. JG 11.16.06
Answer: a small electrical machine that can burn things off. JG 11.16.06
Answer: it varies, at times we use an incision on the outside and at times on the inside, all varies with what the pateint needs. I could quote you fees but that varies greatly form doctor to doctor. I suggest you get a fee quote from the doctor you are considering perform the procedure. I can only quote fees for people that are going to have me do their surgery. If you desire that fee quote, contact us via email at drgarcia@lvcosmeticsurgery.com rather than the message board. Thank you. JG 11.15.06
Answer: laser will help with the fine lines but not for the bags, that will take surgery. Best of luck. JG 11.14.06
Answer: probably asked on the agelessforever.net site and it was referrred her due to it being a plastic surgery question, please post it again here. JG 11.14.06
Answer: a photo will help, yes, please send it to drgarcia@lvcosmeticsurgery.com JG 11.14.06
Answer: might need a laser or hyfercator to burn them off. JG 11.14.06
Answer: it wil go away, if it reacts the way you describe it is swelling and in time will flatten. JG 11.14.06
Answer: very unusual, and allergies to sutures can happen but those sutures should have been removed so all that should subside. Kelocote might help but it is hard to avoid getting it into the eye itself, tough problem. I think it will get better in time but it will be weeks I am afraid from what you are describing. JG 11.14.06
Answer: yes it can and it should go away when it dissolves. JG 11.14.06
Answer: it is still a little early for all of the swelling to go down to yield your final result and I do not feel the microdermabrasion will do much. JG 11.14.06
Answer: It might but I would not be too hopeful of the steroid shot helping. It might need more surgery to release the scar tissue and do a canthopexy, but not quite as tight. JG 11.14.06
Answer: just normal swelling. Massage and time will help. JG 11.13.06
Answer: heat helps as does the massage, just push it out to the side gently for a few minutes a few times per day. JG 11.13.06
Answer: all normal as the blood does move down with gravity, just keep it out of the sun to avoid staining. JG 11.13.06
Answer: you might need a canthopexy and a skin graft to the lower lid if the problem was that too much skin was removed. I think the canthopexy will help with the rounded shape. Hang in there. JG 11.12.06
Answer: well a hypertrophic scars is almost the same thing as a keloid, but the difference is the keloid extends past the line where the cut was whereas the hypertrophic scar does not, but they behave and react in the same way.JG 11.12.06
Answer: Thank you for all the kind words and let me know if you have any questions. JG 11.10.06
Answer: I think on option is to have him cut the bump out, it will extend the scar a small amount but should remove it. At the same time a canthopexy can be done to pull the lid up and give it more close opposition against the eyeball. Hypertrophic scarring is rare on eyelid surgery. Hopefully the scar can be placed into a wrinkle to make it less visible. JG 11.9.06
Answer: I do not think Lipodissolve is safe, the material they are using was initially studied in Brazil and subsequently taken off the market there. I would just wait it out a little and let the fat dissolve a bit on its own and it will. JG 11.8.06
Answer: yes all normal and actually all good signs. It can in certain cases take a full year to heal totally. Hang in there a little longer, it seems like things are going well, albeit slowly. JG 11.8.06
Answer: well the eyes might be able to be seen better but their size does not truely change, what procedure would be best in your case would require me to see you or at least some photos. JG 11.8.06
Answer: not uncommon as the sutures placed into the cartilage and muscle are permanent and it can take the tissues a while for them to settle down. I do agree it is already past the usual amount of time so I suggest seeing your surgeon to make sure all is OK. Best of luck. JG 11.7.06
Answer: you would need to inject around the malar mound, not into it directly. JG 11.7.06
Answer: possibly a canthopexy can fix it. JG 11.7.06
Answer: the changes would be to the cornea of your eye, potentially developing a cataract like problem. I am afraid what you are describing will take some invasive option. I think the muscles should be working by now. JG 11.6.06
Answer: What you describe unfortuantely is a common complication of that procedure. If you are having significant eye probelms I think you need to have it revised before you develop some eye issues that can become permanent, best of luck. JG 11.5.06
Answer: very unusual I must say, I doubt any sutures being the problem although some swelling to the eye muscles is more likely the culprit. I think you need to see an opthamologist for an exam so they can test your extra-occular muscles. As the swelling improves I think it should get better. JG 11.5.06
Answer: all that you describe is normal, it will look much better in a couple of weeks, it should look pretty good at one month but might take a few months for the final result. JG 11.5.06
Answer: way way too early, especially in cases where there is lots of swelling, you have to give it time. By one month things look better but final results are often not seen for three to six months. Hang in there, it will all get better in a bit. JG 11.5.06
Answer: most likely a cyst where one of the sutures was, may need to get the cyst opened with a small needle by the docotr. JG 11.4.06
Answer: It is normal and that numbness can take months to totally resolve, just give it some time. JG 11.4.06
Answer: it appears you had some type of ptosis surgery from you describing the stitches on the inside. If the lid has dropped and the surgery involved a raising of the lid it needs to be repaired at the earliest opportunity, no need to wait. JG 11.1.06
Answer: well, it is possible but it will need to be redone every so often. JG 11.16.06
Answer: no, not typical, especially on the eyelids. I am not sure how much the topical steroid will do. The scar tissue might be causing that but it is also a known phenemenon with certain techniques for mid facelifts. Revision of the scars later might be needed along with a canthopexy to support and correct the scleral show. Best of luck and thanks for visiting. JG 11.1.06
Answer: I do not think there is much difference in the numbing between fat repositioning or removal, as to why it gets numb, it is because there are many tiny nerves in the area where the incisions need to be placed but in most cases the vast majority of the sensation returns in time. I think Botox for the fine lines is not a good idea and the laser can usualy be done at the same time, I use a CO2 laser or a Rhytec Portrait. JG 10.31.06
Answer: if there is not enough skin removing the skin could create more tethering or webbing, may need to wait until the skin gets a little looser. Re-excision is very rare in eyelid surgery for scars alone, unless there is too much skin and that is also needed to be done. JG 10.30.06
Answer: it is very effective and easy to do but it will leave a scar so you need skillful closure. JG 10.30.06
Answer: it is called an orbital rim implant, tear trough implant, designed by Dr Ed Terino. JG 10.30.06
Answer: possibly, but the scar will always be there. JG 10.29.06
Answer: majority of the result is seen in 4-6 weeks but it will take three months and at times more for all of the swelling to be gone. Lasik is OK one month later. JG 10.29.06
Answer: no, not the way it should be. JG 10.28.06
Answer: I feel the muscle slings are less bulky and more natural than the PTFE sutures which are permanent threads. I would always wait at least three months, and preferably 6 between the surgeries. If the previous times yo have had surgery and the leavator procedure failed and we have to assume they did it well, then maybe going to the sling is the shorter route. All the best. JG 10.27.06
Answer: I think cut them out and then a laser if needed for some other reason. I am not familiar with many opthamologists in California though, may want to try another plastic surgeon. JG 10.26.06
Answer: although they can be done it is difficult and they do not always grow, need to see someone experienced who does alot of them I feel, not for everyone, and there is lots of swelling too. JG 10.25.06
Answer: yes, and it can be done for the upper with difficulty but is usually done for lower lids only. At your age it might leave some loose skin, yes. Weight loss would not affect those fat pockets I am afraid. JG 10.24.06
Answer: well all I can guess happened is one or both of the sutures placed into the lateral canthus for support have dettached or broken allowing the skin to get loose. Might need some more tightening of the skin along with fat removal, it is not due to the laser. JG 10.24.06
Answer: if you have been seen before we might just want to see you to make sure of what we have planned or what we can do. JG 10.24.06
Answer: I do not think Thermage will help and I think there is no cream that will shrink loose skin, try to get some better sleep is about the best. JG 10.23.06
Answer: it is a litte less as there are no external incisions and you are able to wear make up sooner. The hollow look only happens if too much fat is removed, and that is rare. JG 10.23.06
Answer: well, although I am sure it is not their first desire, they can do it for you. Best of luck. JG 10.23.06
Answer: well if it is fat of the eyelid a little more fat removal might work, but if it is on the cheek itself, making it a festoon, more tightening of the face may not correct it. In severe cases it needs to be directly cut out, leaving a scar there. JG 10.22.06
Answer: please forward the pictures ot drgarcia@lvcosmeticsurgery.com. As to the Hipocratic oath, yes we do swear to it at graduation from medical school, but the reality is she may just want to keep him on good terms with her regardless of any oath. At times doctors do not want to take over the care of another doctor`s for fear of inciting a lawsuit and also to keep the original doctor from saying bad things about the second doctor to avoid the second one getting sued down the line. There is also the belief that many times if a revison is needed the origianl surgeon may know the scenario better and also that of fees because the second surgeon would charge most likely a higher price as the first surgeon commonly will do a discount or perform it for free in some cases. Hang in there. JG 10.21.06
Answer: possibly. JG 10.20.06
Answer: I do not think the ultra sound machines we have in the US will do much either. JG 10.20.06
Answer: I do not think it will work, but it probably won`t hurt to try it. JG 10.20.06
Answer: I will get back to you individually after I review it. JG 10.20.06
Answer: I agree about the cortisone in the eyelid and she may have said all of that in order for you to go back to the original surgeon to avoid hard feelings, but if you have lost confidence in her you should seek out someone else. JG 10.20.06
Answer: probably less swelling than the original placement. JG 10.18.06
Answer: nothing reliable I am afraid. JG 10.17.06
Answer: the rounding comes before the canthopexy, typically from the lower lid being pulled down ,causes are multiple, a canthopexy typically creates a deeper angle of the corner of the eye. As to revisions, they can be performed but are not easy to do. JG 10.17.06
Answer: well, I suggest some kenalog or Mederma, may need a scar revision in a couple of months too. JG 10.17.06
Answer: releasing the canthopexy does involve swelling , but it should be less than the first, as to the rounding, it very likely will return. The rounding might not be able to be fixed without a canthopexy, maye a less aggressive one. JG 10.17.06
Answer: 6 months or so. JG 10.17.06
Answer: it can happen, at times there are sutures placed that are not a formal canthopexy which can do that, or the other side might be a little pulled down and too rounded, either one can happen. May need a little revision work. JG 10.17.06
Answer: certainly, please forward them to drgarcia@lvcosmeticsurgery.com and I will get back to you. JG 10.16.06
Answer: the Alloderm essential froms a lattice work for your own tissues to grow upon, it in and of itself does not survive. As to the graft, usually the Alloderm is placed internally not externally and if the facelift lifts the tissues vertically to the eyelid, it might and it might not give you the tissue in the location or layer you need, I cannot tell without seeing you, may need to ask your surgeon about this. I seriuosly doubt chemosis caused any lid retraction, chemosis is an issue of the eyeball itself and does not influence the lid. JG 10.14.06
Answer: for the scar it can be cut out and revised, for the fullness of the face, maybe Sculptra, but is is not permanent, for the hollows of the eyes, I am afriad there is not much. As to the color difference, you may need to laser the rest of the face to get the color more even, sorry. JG 10.14.06
Answer: most likely you will need the scar tissue removed. JG 10.14.06
Answer: yes, that can be undone. The canthopexy cna also be revised. JG 10.13.06
Answer: well, the success varies, depedning on what is being corrected. Alloderm will help with relatively small problems but if there is a large amount of retraction and loss of support it might not be enough. Really hard to tell without seeing you in person to see how pliable the tissues are. Maybe you should seek a second opinion by someone in your town. JG 10.12.06
Answer: well, the pictures that should have been taken before surgery should tell if it was there before the surgery. As to repairing it, it is difficult for me to say without physically examining you as I would need to feel the tissues to tell what can be done. JG 10.11.06
Answer: I would just wait and do it all together. JG 10.10.06
Answer: I think it might be possible to do both at the same time but removing the fat can be difficult. JG 10.10.06
Answer: a forehead lift can be done, prices unfortunately will vary from doctor to doctor, so you need to see them in person, or you can send me pictures to drgarcia@lvcosmeticsurgery.com so I can estiamte time needed. JG 10.10.06
Answer: it involves cutting the incision open and then cutting any sutures and scar tissue to allow it to drop, all very similar to what you had done already, just reversed. JG 10.10.06
Answer: I think 6 months is reasoanble time to wait, I think reducing the graft size is better than total removal and canthopexy, in order to achieve easier symmetry with the left. All the best. JG 10.6.06
Answer: it can be performed but may or may not correct loose skin, it is meant to support the corner of the eye when it is loose, it is not meant to correct excess skin. Stitches are all internal but the incision made to do the canthopexy will have outside sutures that are removed after 5-7 days. JG 10.5.06
Answer: external ultrasound. JG 10.4.06
Answer: if not relaxed by 6 months it proabably will not relax much more without more surgery. JG 10.4.06
Answer: It can be both that is causing it and it might need a revision at some point in time. I sugest at least 6 months, preferably one year if possible prior to the revision. The palate graft may need revising too. Soundss like you had a mid facelift before. JG 10.4.06
Answer: most likely just swelling from fatigue and poor sleep and should all get better, avoid salty foods and use cool compresses on your eyes. Hang in there. JG 10.4.06
Answer: I think at this point you would need the suture cut and the tissues released, so a bit more then just cutting the sutures as the tissues have healed and need tt be relaxed. JG 10.4.06
Answer: I would wait at least another two months to allow the tissues to soften, preferably even longer than that. JG 10.4.06
Answer: yes, the canthoplasty might be too tight but the graft should be softening by now. The canthopexy can always be revised and loosened if needed. Best of luck. JG 9.30.06
Answer: we always strive for symmetry so if there is enough fat that needs to be removed on both, then both should probably be treated. We run a fine line though as we do not want to remove too much fat as that problem is almost impossible to