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Answer: sounds like the skin was pulled over aggressively and caused some plication or folding of the upper cheek skin, that should not happen under normal circumstances. JG 7.27.10
Answer: neither should affect the facelift. OK to proceed. JG 7.27.10
Answer: commonly done, yes. Best of luck with the facelift too. JG 7.26.10
Answer: I think what you hear from patients on the internet is usually the results that are not doing well, the vast majority of patients do well and they unfortuantely do not go on the internet to talk about their good experiences. Slow healing and pain can occur but in most cases a facelift is not an unusually painful procedure and most patients are out in public with a little make up in a couple of weeks. Best of luck. JG 7.25.10
Answer: most likely will need more surgery after this amount of time to allow the skin to lay down in a direction with more normal tension lines. It is impossible to predict if the tissue will come down and equalize with the midface. My guess is likely not as the upper tissue might fall, but the lower tissue will also fall, so there will likely be a gap between them unless they are reapproximated. In view that you have had these issues, certainly another cheeklift wil be needed, one can call that a mid facelift if desired. A MACS lift is not what was once called a mid facelift years ago, that is where the tissue were detached from the bones and lifted but that has its own set of risks and I do nto think it would help your secenario, sorry. JG 7.22.10
Answer: scar tissue never leaves 100%, the only thing that can hold the tissue in position are sutures that have not dissolved or residual scar tissue.JG 7.22.10
Answer: not for more than a few hours. JG 7.22.10
Answer: it can in many cases, but not all if there is scar tissue holding it or there is excessive tension in a certain direction from the skin being laid back down in a slightly angled direction. The fat pads are normally left attached to the tissues lifted and are seperated from the skin. JG 7.22.10
Answer: HGH does help in cases of wasting, yes. JG 7.22.10
Answer: usually that sensation is from the tissue that were tightened below the skin that are being held by scar tissue now. JG 7.22.10
Answer: it can be used, but just because it is form a suttborn area to lose fat from does not make it survive any better after it is used as an injectable filler. JG 7.22.10
Answer: Some of the tissue originally held in the MACS suture might have torn free and allowed it to fall. JG 7.22.10
Answer: I think in cases of adult-onset human gorwth hormone deficiency, the treatment with injections is FDA approved and worthwhile. I have never found an oral secretogogue that works past the I feel it working phase. Blood tests do not reliabley show oral secretogogues to produce measurable results by themselves. JG 7.22.10
Answer: I cannot say but many times the surgeon will do something small like that at no charge, it sounds like there is some bulky appearance there from the tissues below the skin that was lifted, debulking them surgically is likely the best option, it can be swelling but unlikely due to the amount of time that has passed. All the best. JG 7.22.10
Answer: well you can tighten by making incisions at the ear region, but no way to tighten the muslces reliably without incisions, there are string methods but I think they are very unpredictable and the sutures break with muslcular action. JG 7.19.10
Answer: well a pure necklift will not fix the jowl region as it only pulls horizontally but a mini facelift might be able to tigthen the neck enough and lift the jowl region superiorly into a better position to give you the desired improvement. As to the eyes, if you have both of those issues it might be a lower lid blepharoplasty with skin excision and fat removal or repositioning. Best of luck. JG 7.18.10
Answer: I do not think it is dangerous in experienced surgeon`s hands. I find that patients are very comfortable when they wake up and take few pain pills after the surgery. My patients are usually able to go out in public after 10-12 days. JG 7.13.10
Answer: I always use a post tragus incision to hide the scar, even in males. JG 7.8.10
Answer: they will say that in their experience they work well, but I think the cannot show that their results are consistent from patient to patient when asked, so I guess they do it as a marketing thing, maybe they charge more for the than regular off the shelf fillers too. JG 7.8.10
Answer: there is a $50 consultation fee that is applied towards your surgery if you proceed. I woudl welcome you to call us and schedule consultation so we can disclose your personal issues. Looking forward to see you whenever you have time. JG 7.7.10
Answer: as to why they use them, I am not sure, it seems like they feel the patient is already asleep for something else so its not a big additional thing. JG 7.7.10
Answer: I like to do the fillers after myself, in order to see exactly where it needs to be placed when there is no swelling, you can use Restylane for all of those areas is you wish. JG 7.7.10
Answer: the fat transplanted will behave like the fat does from where it was taken, so it can, if it survives, grow more than the normal facial fat, and you do not have fat in the lips normally either. All the best. JG 7.7.10
Answer: it is out, but what attaches the sling to the tissues up higher can break and allow it to loosen once again, also, usually the aging neck is looser muscles and skin and if the skin is not treated, the results are not good. All the best and thanks for the kind words. JG 7.7.10
Answer: no, it will not alter anything that is planned. Best of luck. JG 6.30.10
Answer: lifting procedures, no matter which one, will recreate the lost facial fat, they will just lift the tissues that exist into a higher position is all. Best of luck. JG 6.27.10
Answer: that is my first choice for that area, fat would be my second choice, but causes more swelling I feel, and does not last any longer. Best of luck. JG 6.27.10
Answer: minifacelift will do nothing for the temple hollows. If there is fat atropy in the upper face and temple, the only thing that will help is fillers, pulling the skin tighter will not give a more natural appearance in that scenario, if anything, it will accentuate the hollowness by pulling the skin over the boney prominences tighter. JG 6.25.10
Answer: sorry, but the effect is not very effective, migth help fat injections survive better and does decrease swelling and speeds heaing during open surgery, that is how I use products like that, but just injecting parts of blood taken from one`s body in the hope of long term wrinkle reduction is hype and fallacy.JG 6.23.10
Answer: correct, nothing above the jawline will improve with an isolated necklift. Best of luck. JG 6.23.10
Answer: I think it is a scam as Botox or other neurotoxins cannot tighten muscles as the purpose of the toxin is to weakedn or partially parlayze the muslce, I would not perfrom or nor recommend it. JG 6.21.10
Answer: all the best to you. JG 6.10.10
Answer: I do not use Sculptra in the nasolabial fold itself, I use it only to fill in areas where fat has dissolved and that is not what causes a nasolabial fold to become visible. I have on a small number of cases injected Restyalne into the fold and Sculptra into the cheek at the same time to give some effacement of the fold while waiting for the fullnes of the Sculptra to kick in.The only product I use in the tear trough is Restylane. And how did you know I like Rock Music?! Best of luck. JG 6.10.10
Answer: thanks for the kind words. As to clarification, I typically use Restylane for the nasolabial fold itself and I use Sculptra to reinflate the cheeks from fat loss. If the nasolabial fold is due to the skin falling from fat being lost, then filling the cheek can improve the nasolabial fold. If the cause of the nasolabial fold is not loss of cheek volume, then filling the cheek will not is not fix the nasolabial fold area. All the best. JG 6.10.10
Answer: I know the company says it increases collagen production but after years of injecting it personally into hundreds of patients, I think the amount of collagen produced in not visible clinically. As to Sculptra, since it depends on the body creating new collagen and the ability to produce collagen is better in younger rather than older patients, I think the answer is the reverse of what you have read, it works better the younger you are. Filling in the cheeks can make the folds appear deeper in certain lighting. All the best. JG 6.9.10
Answer: well, if the skin was too stiff from the previous insults, it might not have been elastic enough to pull tight, or the surgeon pulled as tight as they felt was possible and not too much in order to avoid increased tension at the incision that could lead to poor healing. I think those two are likely the most common causes.At times when there is alot of scar tissue after previous surgery the tissues are difficult to separate from the muscles and that can limit the degree of improvemnet in some cases. Sorry to hear about the problems and I wish you the best. JG 6.9.10
Answer: just answered it, sorry. JG 6.8.10
Answer: I think the scar from the excision can heal well, and at other times can be seen easily, at your age, not something I would recommend. As to the Surgiwire, it still needs a filler to be interposed to avoid the tissues from reattaching. I think it is a short term fix in most cases. At your age I cannot imagine that the skin is in excess so cutting skin out with a minilift would leave you looking pulled. I do think Sculptra, to try to refill the fullness or rounded appearance of the cheeks is a good option. The younger one is the more robust the creation of your own collagen is with Sculptra. Just remember the Sculptra takes 4 to 6 months to show its final effects and you might need more than one vial and then a touch up down the road, so be patient. Sculptra is likely what I would suggest to you. All the best and thanks for the kind words. JG 6.8.10
Answer: you are very welcome. JG 6.2.10
Answer: The facelift will help the acne scars for a while as as to the red veins, either a YAG or VBeam laser. Botox will lift the lateral eyebrow, it may take 10-20 units per side in most cases. JG 6.2.10
Answer: well, I think the red spots can wait until after as transiently the red spots will get worse from the facelift. As to the acne scars, there will be some improvement of the scars from the facelift, so no need to do anything for them before. JG 6.2.10
Answer: no, it would not have a negative effect. JG 6.1.10
Answer: sorry , but no. JG 6.1.10
Answer: I do not think that is nearly enough to give a good long lasting effect. If you are doing the horizontal lines of the forehead along with the glabella and crows feet I usually inject a total of 100 units. If injecting the glabella and the crows feet I like to inject 70 units but I will at times compromise and only inject 50 as the bottles come in 50 or 100 untis doses and bottles are strictly prohibited from being shared between patients, if the docotr is doing that it is not legal and potentially dangerous for hepatitis transmission. JG 5.26.10
Answer: in most cases it can be done that way, yes. JG 5.26.10
Answer: not much. JG 5.24.10
Answer: there are lots of names out there, very misleading as they are more marketing terms than descriptions. I think it best to choose a couple of surgeons and see them in person and tell them what you are looking for. JG 5.24.10
Answer: there are no true similarities, the faclift takes away excess quantity of skin and the laser imporves skin quality, they are not interchangeable. JG 5.24.10
Answer: less invasive might be possible, as long as it is able to correct the problem, having said that, small incisions do not mean less invasiveness underneath the skin, so small incisions can cary with them longer healing times in some cases. I am always of the belief that if you can get away with something smaller, it is always best. JG 5.24.10
Answer: I think it can vary from fillers, to implants to a mini lift, no way to tell without seeing you as all people have different issues. Sorry. JG 5.24.10
Answer: in 10-14 days you should look pretty presentabel. As to singing, due to the activity the nck muscle I would say 4 weeks, maybe a little more. Best of luck. JG 5.24.10
Answer: OK to perform it with the twitching problem. The twitching will likely not be affected, good or bad, that is from a nerve irritation. JG 5.23.10
Answer: It can be done but the scars from that will typically widen and it could make the scars form the breast lift more visible I am afraid. JG 5.21.10
Answer: only works in a small subset of patients that have minimal to no skin excess. Overmarketed I feel. JG 5.16.10
Answer: well the green thing is old blood that is being broken down and slowly absorbed, might be able to be sucked out by the surgeon, the stitches poking out can happen and they should be cut or trimmed, as to the pucker, it is from an incision being not made longer and the skin is puckered. Many times the puckering gets better with time and massage, otherwise it might need a little scar revision in the future. All the best. JG 5.16.10
Answer: I would suggest you give it at least 6 months and then proceed to have them cut out, all the other stuff will consume your money, make you swollen and not let things heal and settle down. Patience is the best thing right now, sorry to hear about the problems. JG 5.16.10
Answer: usually there is enough scar tissue that will develop that it will stop, there are also pills, anti-sialogogues they can give you to slow the parotid fluid output too. Best of luck. JG 5.13.10
Answer: I htink massage and a little tiem to see how much it softens and settles down is in order, after about 6 months the evaluation of what, if anything, can be done will be more accurate. Sorry ot hear about the problems. Jumping in too soon to try to correct things is not a wise idea. JG 5.13.10
Answer: not commonly accomplished with a facelift.Depending on the casue, it might not be able to be corrected. I cannot say whether it can be done in the office without seeing what the proble is that is causing the droop, sorry. JG 5.9.10
Answer: not sure what part of the mouth you are referring to as the lips are never lifted during a facelift, if it is the nasolabial fold, they might look better with a little more skin being removed. I would give it at least 6 months for the swelling to go down and the scar tissue to soften to allow better ability to lift the tissues. A delayed lifting should not affect the longevity of the total lift done togetehr, should be similar. All the best. JG 5.8.10
Answer: sounds like what might be happening is that an aggressive tightening of the neck muscles is what is causing the senasation, that should loosen up with time though. The platysma muscle which is tightened in some facelifts can cause a very srong pull on the mouth, just like a very stronng grimace. I would try stretching and massaging the neck and see you doctor in follow up to make sure that is what it is. Best of luck. JG 5.8.10
Answer: not really much I can offer, not all patients can have all areas corrected with fillers, sorry. JG 5.5.10
Answer: it can help that scenario in many cases,yes. I think that is the best way to treat it, fillers might be able to evert the lip if injected properly in a small percentage of cases. JG 5.5.10
Answer: yes, its OK. JG 5.4.10
Answer: well, if it bothers you it is likely worth correcting with an isolated neck lift. Your face will continue to age though and in time the cheeks might need to be done. It is certainly reasonable to do it piecemeal though, no need to operate on an area that does not have a significant amount of sagging yet. JG 5.4.10
Answer: it is a little fat and a little loose skin too. Surgically lifting the cheek can improve them and at times fillers around the area can make them less obvious, but the fillers do not always work for that as it makes the areas fuller or rounder. All the best. JG 4.16.10
Answer: if the fat stays, it is a good option, but the fat transplanted will behave like the fat from the area it was taeken, so if it is taken from your stomach and you gain weight in your stomach areas easily, then whatever fat survives, the transplantation, will grow like belly fat. I think the results are not as reliable as regular surgery or implants though, lots of variables as to how well the fat survives. JG 4.14.10
Answer: it is a good policy but very infrequently needed, thank God. JG 4.7.10
Answer: I have not seen any procedure that shows consistent and reproducable resutls. All the best to you also. JG 3.31.10
Answer: depends how deeply they go. JG 3.31.10
Answer: I know of no medical evidence published in a peer reviewed medical journal anywhere that it would do that, sorry. JG 3.22.10
Answer: believe the negatives. JG 3.22.10
Answer: it might be more of a question of fillers such as Sculptra to get that appearance rather than more surgery. JG 3.15.10
Answer: I feel it is better to use Botox. JG 3.15.10
Answer: the threads break in a relatively short amount of time and I think it is playing to hype and hope. JG 3.14.10
Answer: yes, but slowly, might take a few months. Products like Revitalash would help them grow faster. All the best. JG 3.13.10
Answer: well, fillers such as Sculptra to reinflate the cheeks could be done, otherwise it is a facelift to reposition the skin and tissues into a higher position. Sounds like you need a lot of skin removed and MACS lifts try to lift the tissues more than remove skin, that is its marketing ploy since people want shorter scars. Your issues sounds like the skin is sagging due to loss of the fat and the macs lift would not correct that problme as the macs lift elevates the sagging tissue mainly but you do not have much tissue to lift any longer. I think the macs lift was the wrong choice and you need a more traditional facelift with significat skin resection. I wish you the best. JG 3.13.10
Answer: the greaer the asymmetry, the stranger it might look, almost no one has totally even eyebrows. JG 3.13.10
Answer: I think they will have to undo the sutures from the Acculift to allow the tension being placed on the underlying tissue to relax and stop the bulging of the fat pad of Bichat at the corners of your mouth. I am not sure why he did the Acculift if all looked good. All the best. JG 3.9.10
Answer: if it is due to scar tissue, and if the scar tissue can be released, it might ge better in terms of the distortion on animation. It can be difficult to remove the scar tisue and leave no residual though. As to the eyebrow, if it is swept up, there was likely too much skin removed and that will be quite difficult to improve and not leave new scars that are visible. JG 3.6.10
Answer: as long as they are willing to accept the limtitions, in many cases but not in all cases I would, but if it is going to make them look strange in some way, I might decline. JG 3.3.10
Answer: it happens at times as the blood pressure is usually a little higher, especially if the local anesthesia has not worked in all the areas. JG 3.2.10
Answer: in most cases, tightening the SMAS is agood idea to allow the tissues to hold up longer. The Y-lift is just an attempt to do a smaller procedure and make it sound new, but actually it is nothing new. It will likley lift the jawline but not the jowls as much, hard to say. JG 2.28.10
Answer: well, I think you need to find out what exactly he is going to do, there are many doctors out there that like to use fancy terms for the surgeries to make them sound unique, but they are essentially the same that others are doing.Best of luck. JG 2.28.10
Answer: a chin lift usually refers to a neck lift, the chin pad can be lifted too by placing stitches into the pad and attaching it to a higher position on the bone. A chin implant really does not create a lift. JG 2.24.10
Answer: see above. JG 2.24.10
Answer: the chin pad can be lifted and attached to the bone in a higher location in cases where it has dropped. I have never seen the skin, and the skin alone, of the chin pad sag though. If it is just the skin, the procedure I mention is likely overkill. All the best. JG 2.24.10
Answer: removing the fat only removes fat, it will not make the face any tigther and will make it even more thin in my estimation. JG 2.21.10
Answer: unfortunatley, no, I do not, it depends more on the person`s speed of aging, not all 40 year old have aged at the same speed due to genetics and lifestyle habits. Scarring should be minimal and recovery is 10-14 days before looking good enough to be seen in public and 4-5 weeks before full activity. JG 2.21.10
Answer: age and skin thickness does not affect the hematoma or nerve injury risk. Males have a higher risk of hematomas and taking certain blood thinning medications also contribute as does elevated blood pressure. The risk of a hematoma is between 1-2%, most are able to be treated without furhter surgery. JG 2.21.10
Answer: no need to wait for that to be dissolved or worn out prior to the surgery.JG 2.20.10
Answer: I think photos are helpful, over time though, the number of photos being shown has decreased because patients see a result and then think they are guaranteed the same result, and that is not always possible. I do think a number of patient photos is a reasonable request though. I think you are also right, at times, peopel with a reputation can be snobby in some small number of cases. I personally feel some degree of being anxious is normal, but if I feel it is too much, I will postpone things until the patient is sure you want to proceed. Some patients are anxious because of the risk, but others are anxious because they are afraid what their friends and family will say and think, or maybe they are stretching their finances. Apprehension about the risk is normal and can be explained by the staff and those fears allayed, the others might not be able to be talked away I am afraid. All the best. JG 2.20.10
Answer: glad I help and continued best wishes. JG 2.20.10
Answer: no, age does not mater, that is a matter of how tight the surgeon pulls and lifts, the natural or unnatural look is in his hands, not in yours. What your age does affect is how long it will look. In more aged skin, there might be a need for more skin to be removed, but the natural appearance can still be acheived. I have done facelifts on patients 20 years older than you, as long as they are in good health. JG 2.20.10
Answer: well, we like to keep an IV in until such time that the patient is doing well and taking oral liquids. A blood pressure of 200/80 is quite high, can lead to excessive bleeding and in most cases, if we had an IV still in place, we would have given you a medication to lower the blood pressure and not a pain pill like Vicodan nor an antihistamine like Benadryl, their effects on blood pressure would not be too strong and would take a longer time to take effect. JG 2.18.10
Answer: maybe just a cheeklift is all, hard to say without seeing you, all the best. JG 2.12.10
Answer: nope, Dr Rod Hester in Atlanta. JG 2.10.10
Answer: they both lift tissues of the cheek but the cheeklift does it from on top of the muscles and the midfacelift seperates it off the bone and the suspension is harder to get to hold in a midfacelift.JG 2.10.10
Answer: 18 months. JG 2.10.10
Answer: there is no smas midfacelift, the smas is tightened during a cheeklift or a facelift without seperating the tissues from the bone.JG 2.10.10
Answer: in most cases the issue is the degree of traction placed around the eye and the degree of support needed as in most cases the tissues are lifted off of the bone and require a greater degree of support. Complication risks of a midfacelift in the surgeon`s hands that invented the procedure is up to 17%. Not sure who told you it is safer, but that is not true, easier is relative. JG 2.10.10
Answer: highly unusual for someone your age, if indeed you do have it happening, you likely will need it redone much more frequently than others, yes. The complications should not be any higher or worse. JG 2.10.10
Answer: I think it has more control over causing excess bulking from the purse string suture used in a MACS lift. I perfer the smasectomy the vast majority of the time. JG 2.8.10
Answer: I personally like it better than the MACS lift. The names are complicated but at the end of the day, or I should say, end of the first year after the surgery, the differences are really hard to see between all the techniques, it is more marketing hype than anything. The MACS lift is actually based upon an operation that was described in 1908 by a Russian surgeon with minimal changes! JG 2.8.10
Answer: I do not endorse Latisse due to its potential side efects and no eye lash extender helps 100% of patients, sorry. JG 2.8.10
Answer: pleats are where the skin has folded due to an incision being kept shorter, and the skin bunches up, extending the incision to remove the skin can be done but then the scar is longer and potentially more visible. Think of a pleated pair of trousers for men where there are pleats on the waist in front or a pleated skirt, just folded skin. JG 2.5.10
Answer: swelling and creases should all get better with a bit more time. Not sure why the eyelid is blinking slower though if no eye surgery was done, I suggest seeing your surgeon to ascertain what is the cause for the eyelid discrepency. JG 2.5.10
Answer: well, I do not think it will be a mess, I think he is being careful and preparing you for a potential slow helaing and lots of bruising. I think if you can get off the Plavix for a few days, it would decrease the risk, but there is always a risk of a hematoma, even without the Plavix. In cases like yours I think a minimal undermining of the skin will be less risky,the proposed amount of skin can many times be pre-marked and then no further lifting of the skin past that is done to limit the potential severity or size of the hematoma. It might decrease the degree of improvement but there will be a comensurate decrease in the risk. Will likely have to compromise a little is all, I wish you the best and glad the ticker is stil ticking well. JG 2.3.10
Answer: for the right candidate, someone who does not have alot of loose skin, it is a good option, but it is not for everyone. JG 1.29.10
Answer: it is possible in some cases where the degree of deformity is minimal. Minimal deformities can benefit from minimal procedures, but, if you have more than a minimal problem and you have a minimal procedure, then it might not fix it as much as you need. JG 1.24.10
Answer: yes, in a small percentage of patients, that is all that is required. I doubt it would fix a turkey neck though, it would only fix the bands one can see upon muscle contraction is all, once the turkey is there the skin usually needs to be cut out. JG 1.21.10
Answer: well, terminiology sometimes is confusing and some surgeons like it that way. A platysmaplasty is a procedure where the main intent is to tighten the loose muscles of the neck and in many cases there is also some skin removed. A cevicoplasty is a procedure intended to improve the neck in general, that can include removoing fat and or skin along with tightening neck muscles if required. So, a cervicoplasty can at times include a platysmaplasty, but not the other way around. As to the MACS lift, that is more the for cheek pad elevation, so although the incisions are similar, what is done under the skin is quite different. All the best. JG 1.21.10
Answer: it all depends on what has changed, in many cases it is a smaller procedure than the first, but in some people, a repeat full facelift is needed, no way to tell without seeing you and feeling the tissues. A full facelift should not look unnatural if proper tension and positioning is employed. JG 1.19.10
Answer: it would likely be a midfacelift or a cheek lift. JG 1.19.10
Answer: if there is a pleat of skin in front of your ear as you do that, you will need the incision in front also. JG 1.15.10
Answer: difficult as it most likely would leave a pleat of skin in front of the ear that would look funnny. The pulled appearance on the lip is all a matter of how hard and in what direction you pull, that should not persist past a couple of days as the swelling goes down. The jowl needs a vertical lift more than a straight back lift anyway. JG 1.15.10
Answer: it might, all depends on if it develops scar tissue, no way to tell except to wait it out. JG 1.15.10
Answer: it should not do that if properly done. JG 1.11.10
Answer: well, certaily there are negatives, since he has taken care of more patients, there are likely more issues, the less experienced one has not treated as many people so the numbers are smaller, but if you are concerned, the younger might be fine, there is no way to tell l00%. I will say taht a younger doctor likely has a different subset of patients, maybe more that are willing to post things in readable places. We were all younge surgeons once, hopefully we will all also be older experienced surgeons too. JG 1.11.10
Answer: well, experience does help I believe. JG 1.11.10
Answer: the Smartlift is just a mini facelift, so it is a smaller procedure than a regular facelift, healing is shorter, as less is done. In many cases, if one has had a facelift before, they only need a mini facelift the next time. I think the only smart thing is what he is charging you, as it is much smaller than a facelift and the price difference is not larger. JG 1.11.10
Answer: well, it can be done, the twitching will likely not change, no better nor worse. JG 1.10.10
Answer: fat loss that involves loss of facial fat will make the sagging worse as the cheeks become deflated, like letting the air out of a balloon. I think you should get to the weight you desire and then I would be happy to see you in consultation. Depending on what has happened, it might be surgery but it might be a filler such as Sculptra to regain the fullness, all depends. I am not a fan of ribbon lifts as if the ribbon cracks, one side will sag differently than the other. Best of luck with the weight loss. JG 1.5.10
Answer: might be reasonable if it is a mild issue. JG 1.2.10
Answer: do not know about any of them, sorry. Happy New Year. JG 12.30.09
Answer: I do mine in that location for the reason you describe, the incisions there can be incised in a manner to make them look very good. In the tragus, I do it post tragus also to avoid a visible scar there as the skin is then and the color of the scar can show. All the best for the New Year. JG 12.28.09
Answer: A weekend facelift is a made up name for a mini facilft or cheek lift and some neck liposuction, it is a much smaller procedure than a regular facelift and will not last as long. Prices vary from surgeon to surgeon so no way for me to tell. JG 12.28.09
Answer: well, if it is just a percutaneous suture technique it is worse, if it is part of the traditional neck lift, it migth last a little longer. Thre is no evidence that human growth hormone injections enhance fat transfer survival. Stem cells with fat injection do not replace a facelift, they do different things, the facelift lifts the tissue that are there and the injection enlarge the fullness and only by secondary effect lift the skin. There are new machines sold that claim to have stem cells in the supernatant but although it is used in other countries around the globe, it is legally not able to be claimed here in the US. The survival should be better if there are truly stem cells present though, but that is a big if as it depends on the tehcnology used to harvest and process the fat. Merry Christmas and a Prosperous New Year. JG 12.22.09
Answer: hard to say as it depends on how much loss of fat you have in the cheeks but in most cases for someone who has lost tissue it will be 3-5 syringes.Merry Christmas, Happy Channukah and Happy New Year. JG 12.17.09
Answer: it is always proper to express your desires and to be honest, the amount injected is OK for the tear trough but it would not be anywhere near enough to fill a cheek area for roundedness. I think assuming that there is good communication is never good, take an eyeliner pencil and draw the area of yor cheek you want filled when you go in. Best of luck. Merry Christmas, Happy Channukah and Happy New Year. JG 12.17.09
Answer: sorry, but I did not see the question, if it is still numb after one year the loss of sensation might be permanent, there are always small nerves cut during surgery and spots of numbness are not unusual, but they usually shrink over time in size. At this point in time there is likely little that can be done to correct the issue I am afraid. JG 12.7.09
Answer: well, not normal and although numbness can happen, the eyelid closing problem is not normal, sounds like there was some type of muscular nerve damage or too much skin being removed. The purpose of injecting the areas with Botox before the surgery is to get the muscle to be weaker so it tends to stay where you put it after lifting and the muscle do not work to pull the brow back down until it has healed. I do not routinely do it, but some surgeons feel it is a good idea. The drooping of the eyelid after Botox can happen and will wear off though, although if the eyelid sagging is due to the surgery or skin removal, that will not wear off and might need something totally different. JG 12.7.09
Answer: it can be,especailly if they get a chin implant placed to enhace their jawline more. Thanks for the kind words too. JG 12.5.09
Answer: save your money. JG 12.3.09
Answer: not uncommon, but most of the time they are temporary. All facelifts can have lumps. JG 11.23.09
Answer: after 4-6 weeks should be OK. All the best. JG 11.22.09
Answer: that might be hard, I doubt the sutures placed to hold the tissues in a higher location are still there so they cannot be cut and the tension released. It is likely now held by scar tissue and that is risky to cut out in that area due to the nerves. JG 11.22.09
Answer: I think although it is rough, there is no damage being done to your skin with that examination, best of luck. JG 11.22.09
Answer: very reasonable and I would have said the same. JG 11.17.09
Answer: it can be done on its own if indicated. I will say though that in many cases the amount of skin in the neck region cannot be draped in a soley horizontal direction, thereby requiring a vertical lift which then needs to employ scars onto the cheek. In theses cases the surgeon will just go ahead and do something on the cheeks to complete the facelift as a facelift is a cheek lift and a necklift together. JG 11.15.09
Answer: firstly, the short scar is dependent on how much skin is removed, not on the lifting technique. On occasion, depending on how the SMAS is suspended, there can be short term bumps with that one too. JG 11.13.09
Answer: in time as the swelling goes down, the scars will usually shift into a better hidden place and they will also fade in terms of color, but that will take weeks to months, got to give it some more time. You could use ScarGuard or Mederma on the scars at this point. JG 11.12.09
Answer: yes because it is not the sutures that cause the bump, it is the tissue that has been tightened like the top of a purse with a pursestring. JG 11.11.09
Answer: yes, you can get three different bumps where the tissue is pursestrung together because it bunches the tissue up. JG 11.11.09
Answer: they both lift and tighten the SMAS, but the MACS lift is where rather than multiple points of suturing, a purse string approach is used where the SMAS is gathered together in 1-3 places to lift and reposition. The limitation is that there can be a bump where it all comes together and that you lose the ability to lift in various directions. It is not less invasive if the elevation of the skin is similar, but it has been marketed that way though to make it sound less invasive and less scary to the patient. JG 11.9.09
Answer: A MACS lift cannot reliably correct neck banding. I think if that is your main concern, have a traditional platysmaplasty, like that which has bene done for many years. Joel Feldma MD has popularized it many years ago and it stands the test of time. I think when doing facelifts there is a move away from large neck incions but not when it comes to a primary neck problem. JG 11.9.09
Answer: well, imbricating the SMAS instead of seperately lifting it is safer. JG 11.6.09
Answer: nerve damage occurs in less than 1% or even less. Nerve damage is always a risk but the risk is higher or lower depending on the technique used, there are good ways to perform the lift and avoid the areas where the nerves can be injured as still yield a very good result. Long term studies have never shown a superior result long term in the types of surgeries where the risks are higher. Total complication rate, including minor and major problems with a facelift is about 2%. Best of luck. JG 11.3.09
Answer: OK and might be the way to go if not much skin is in excess. JG 11.3.09
Answer: no, they are not as we do not want to injure the underlying muscles. JG 11.1.09
Answer: inadequate lifting of sagging tissues below the skin, not enough tissue to lift under the skin, too tight of a skin pull. JG 11.1.09
Answer: The TENS unit does not help the nerve regenerate, what its intent is is to maintain the muscle size and not allow it to atrophy while the nerve regenrates on its own.The degree of return of function will depend greatly on the type of injury to the nerve. If someone has come back, then the nerve was not cut entirely through which is a good sign but it can take months in some cases for the final return, or degree of return, to be determined. Hang in there and best of luck. JG 10.31.09
Answer: I always use drians, but I never perform deep plane lifts. JG 10.30.09
Answer: I always use drains, but I do not perform a deep plane lift. JG 10.30.09
Answer: right at the edge of the tragus, right at the juncture of the earlobe and the cheek and then in the sulcus between the posterior hairline and the back of the ear cartilage. JG 10.30.09
Answer: personally I think most surgeosn are adopting it so they can say they are doing the latest version of a facelift, it is not dramatically better than other techniques that have been around for many years but have lost their advertising sizzle. JG 10.30.09
Answer: I think you can proceed with the facial procedure without waiting for the fillers to totally dissolve, they will not hinder the performance or outcome. Best of luck. JG 10.30.09
Answer: a facelift is a combination of a neck lift and a cheek lift. Necks generally loosen up faster than the cheeks though. JG 10.25.09
Answer: well, although alot can be done under local in the office, typically when done in the office rather than at a surgicenter, it is a less aggressive lifting, so the results are not as dramatic and therefore last less time. These terms like lunchtime faclift or weekend facelifts are attempts to get people to overcome their fears and get the impression that they will get the same result as a regular facelift with less downtime and quicker healing. That is not always the case I am afraid. I am sure he is a fine surgeon, but there are limtis at times. Muscles are not so much re-attached as they are lifted along with their overlying fat in order to acheive a more youthful shape to the face. The less is because there is less seperation of the tissues from the underlying fat and muscle, less points of fixation and elevation of the tisues, less incisions, hopefully less recovery, but most of the time less improvement and less length of time of the improvement seen. As to the Active Fx, I personally do not see it being worth it, all of the pictures shown for afterwards are too soon after the treatments to determine whether it is worth it, and the reason they show them is because the improvements do not hold up for very long. All the best to you. JG 10.23.09
Answer: well, I will be honest, although you never had a full face, with aging, some facial fat is always lost, so your face is likely less full now than 10 years ago, so a skin only facelift would likely make you look thinner because it would unmask the lost fat. I think some type of bulk producing product will need to be added to make the face look more youthful. This might be injectable fillers like Sculptra, or fat, or in some cases cheek implants, hard to say what would be best without seeing you in person. Best of luck! JG 10.22.09
Answer: I think if you have the procedue in early to Mid August, that would be optimal, we are booked about 6-8 weeks in advance for surgeries at present so a consultation about June would be a good idea. All the best. JG 10.21.09
Answer: that is where I put my incisions on a facelift. JG 10.20.09
Answer: well, the MACS is just a way to suspend the tissues, most people think that shorter scars are mini-lifts, but lots can be done below a short scar. Ultimately, if you need a good amount of neck skin removed, then it will require a longer incision to remove it, no matter whether a MAC suspension was employed. An experienced surgeon should be able to predict the length of the scars required. All the best. JG 10.18.09
Answer: I have to say that you will likely need to get over your fears because it will probably take surgery to correct. JG 10.18.09
Answer: yes, the sutures will break and then the lift will fail and you will look lopsided until the other side breaks. JG 10.16.09
Answer: I would not endorse it. JG 10.16.09
Answer: I would not endorse it, sorry. JG 10.16.09
Answer: well placed scars so that they are not easily seen is possible, but the limiting factor will be how much skin needs to be removed, the greater the amount of skin that needs to be removed the greater the chance the scars will not be hidden as well, so there is a trade off. JG 10.15.09
Answer: most people are out in public in two weeks with a little make up. The scars will fade in time but in some people that can be harder to hide. JG 10.15.09
Answer: I would say that is not the norm but it depends greatly on many variables, to include the type of lifting procedure performed, the condition of the skin, smoking history, so it sounds like it might need a little touch up. My preference is to wait a full 12 months if possible to allow the tissues to loosen and soften in order to yield the best results for the revision. Typically the fillers, if needed, should not be in the picture for 6 months, but as I said, there are many variables. JG 10.12.09
Answer: yes, they should also be improved. JG 10.11.09
Answer: I like a year but 18 months might be better if you can wait. JG 10.11.09
Answer: I know of no topical creams that help broken facial capillaries, I suggest a YAG laser or an IPL treatment as a series, and no matter what is done, they will come back in time. JG 10.10.09
Answer: well, it is always nice to have skilled and experienced people take care of you if possible and if the price is reasonable, a family member or friend can do it but they will not sleep much that first night while taking care of you. JG 10.9.09
Answer: quite a difference, some doctors operate just as well but slower, and some doctors do less as part of a facelift, might want to get a third or fourth opinion until you get consistent answers. JG 10.8.09
Answer: in most cases a local physical therapy office cna help you get one,they are used to avoid atrophy in larger muscles but all you do is turn down the strength on the face, they work well and are easy to use for even the unexperienced. They can be rented at some clinics or they run about $250. I have seen and heard of the nerve taking 12 months in some cases although they typically see partial and slow return way before that. It is hard to tell about a full recovery, it can still happen, they could do an EMG of the facial muscles to check for nerve integrity but it can be pretty uncomfortable. I wish you the best, and there are no strangers here, just people I have not met yet! JG 10.7.09
Answer: the effects of Rogaine are not immediate as it only affects the hair that are going into the growth phase, so normal hair loss will continue for awhile after starting before any positive effects are seen. If the hair loss was due to DHT and you continue to use the Rogaine it might help, if you had some unusual allergic reaction to the Rogaine, it should grow back if you stop, but that allergy is quite rare. JG 10.6.09
Answer: yes, the fat and muscles in most cases. JG 10.5.09
Answer: I would do the SMAS lift, the reported advantages of a deep plane lift, when results are shown side to side at national plastic surgery meetings show no difference at one year or 5 years but the healing takes much longer, and these are procedures being compared by world authorities. Maybe the newer surgeons were too new to be at those national meetings. JG 10.1.09 JG 10.1.09
Answer: yes, you could do a necklift which is just the bottom half of a facelift. JG 10.1.09
Answer: I would start with some Retin-A and see what happens. JG 9.28.09
Answer: yes it can be lifted again if needed. Best of luck. JG 9.27.09
Answer: I feel chemical peels are good for spots but not for wrinkles unless you use phenol, and that is rarely used anymore. JG 9.28.09
Answer: we use arnica in our office, both orally and topically, best of luck. JG 9.22.09
Answer: yes, it might. JG 9.21.09
Answer: Lifestyle Lift`s dirty little secret Sep 10, 2009 ALBANY, N.Y. — New York State Attorney General Andrew Cuomo has settled a complaint against a cosmetic surgery company that admits it used its employees to pose as satisfied customers in online ads, reports news source InjuryBoard.com. According to InjuryBoard.com, the company ordered employees to write positive reviews of its facelift procedure Lifestyle Lift on Web sites. Lifestyle Lift also created its own sites of facelift reviews to appear as unsolicited testimonials. In an email, the company instructed employees to “devote the day to doing more postings on the Web as a satisfied client.” Cuomo’s office says in so doing, Lifestyle Lift violated consumer protection laws. Cuomo announced the $300,000 settlement with the plastic surgery firm that created the Lifestyle Lift procedure, which is performed in doctors’ offices in New York and 21 other states. It is believed his office is the first to address these “Astroturf marketing” techniques, so named because they are aimed at creating bogus grassroots buzz about a product. In addition to the cash settlement, Lifestyle Lift has agreed to stop publishing anonymous online reviews and to identify fake reviews posted by employees. I will comment on the Lifestyle Lift but will do so carefully as I have received threatening letters from the company for some comments I have posted here previously, so lets’ look at what everyone can see and read. Let’s look at what the site says. This relates to what was on the site on 1/25/07, so they may have changed it. They claim 60,000 clients, that sounds great, but is like saying there were over 300,000 liposuction clients in the US alone last year. You want the surgeon to have the experience, not the procedure itself. Procedures do not have experience themselves, it is the people performing the procedure that glean experience. It is a procedure done maybe that many times in its existence but not by a single surgeon. I see no documentation that a single surgeon has done that many it appears, and the results of any surgical procedure will vary from surgeon to surgeon. The pictures shown reveal the before pictures with the patient in many pictures pulling their chins back which makes their skin more loose and then in the after pictures they are showing pushing their chins forward which makes the skin look tighter. Also when a patient is smiling, like in the after pictures, that lifts the tissue and skin higher and when you do not smile, like in the before pictures, the skin and tissue look looser. This lends itself to making the results look more dramatic than they are in real life. The pictures also do not say how long after the procedure they were taken so we have no idea as to how long the results last for. Local anesthetic, OK, can be true, but what happens when you feel pain and they have already used the maximum safe amount of local anesthetic. The statement that some people do not look like yourself for months or years has nothing to do with the anesthetic but with how tight your surgeon pulls the skin, not on the individual procedure done, it’s more on how the surgeon performs the procedure. All medical offices also have to abide by OSHA so that is nothing unique to them. There are national organizations that certify and accredit office operating rooms but OSHA is not one of them. The non-use of sedation or general anesthesia also allows other issues, for example in some states if you have a complication from a surgical procedure performed under sedation or general anesthesia you have to report it to the state medical board, but if the complication happens when done under local anesthesia it does not to be reported. Also, at times doctors perform procedures in their offices under local because in some cases they are not granted privileges to perform the same procedure in the hospital or surgicenter due to their lack of training or background. Sure, doing it in the office is less expensive for the patient, and it is also less expensive for the surgeon too. Awake and relaxed, maybe for some but what about the people who are nervous and fidget or move when the feel something that hurts, all while the surgeon is cutting tissues. Immediate results, well any plastic surgery procedure has immediate results but you are not presentable immediately in terms of what you look like because of swelling and bruising. There is no documented advantage to local anesthesia over general anesthesia in terms of how fast you look presentable. Certainly the less surgery you do in terms of lifting and supporting tissues leads to less swelling and bruising, but it also leads to less effect and less long lasting improvements. Overall, I think you will need to make you own decision but I cannot endorse or recommend the procedure as being anything different than what has been out there for a long time, just not referred to by a catchy marketing term. Caveat Emptor. JG 9.19.09
Answer: same way. JG 9.16.09
Answer: in patients that need that yes, but no way to tell without actually examining you I am afraid. JG 9.15.09
Answer: yes, the cheek procedure, whichever you choose should correct the marionettee lines, all the best. JG 9.15.09
Answer: should not affect it in any negative way, OK to proceed. JG 9.13.09
Answer: likely an inclusion cyst and you should have a dermatologist take care of it for you. JG 9.11.09
Answer: just temporary swelling, and yes, it might happen again. JG 9.09.09
Answer: small little soft spikes of hair, yes. It usually works in the first 3 months if it is going to work. JG 9.10.09
Answer: there is no conversion like that, and Sculptra does not come in cc`s, it is vials. JG 9.6.09
Answer: it is just an attempt to make something that has been around for many years sound new and unique to that doctor, beware of operations that make claims that appear to be too good to be true, it usually is. JG 9.3.09
Answer: I think it best to have the tissues as soft as possible to allow the manipulation of the tissues to be the best. JG 9.3.09
Answer: I do all of my facelifts under general anesthesia, and hairloss can happen after a facelift, depends greatly on the type of facelift done and where the incisions are. The only way to prevent it if it was due to the surgery is to limit tension on the skin flaps so the blood supply stays as robust as possible. JG 9.2.09
Answer: the chances of the capsular contracture coming back after it forms and you have a surgery to remove it is at least 50%. The procedure is called a capsulectomy, it is where the entire capsule is removed. The companies quote a rate of up to 24% incidence past 5 years, not sure why the doctors are saying what they have to you.JG 9.2.09
Answer: well for a day or two it is likely the sodium, but if it is just a one time junk food night, it should not lasts weeks. JG 9.1.09
Answer: not a problem having that done while waiting, best of luck. JG 9.1.09
Answer: cheek lift should help them. JG 8.26.09
Answer: yes, complications can happen even in the most skilled hands, also, there is no guarantee that the fat will survive or how long it will last. You can send the photos to drgarcia@lvcosmeticsurgery.com if you wish. JG 8.26.09
Answer: confidence is always important, as to the fat transfers, if he is so confident, ask him if he will redo them at no charge for as many times as you need to achieve the desired improvement for you if they do not work. JG 8.26.09
Answer: it is most likley what is called a MACS lift which is a good option for many younger patients. It should not give you a wind-blown effect. Best of luck. JG 8.16.09
Answer: that should be enough for the two area. JG 8.6.09
Answer: Yes, Rogaine should help there. JG 8.2.09
Answer: all normal from the exfoliation, use a little moisturizer, or skip a day and it shoudl get better, one`s skin gets accustomed to it after about 6 weeks and that all stops. JG 8.1.09
Answer: you can apply it on a dry scalp, no need to wash yoru hair before application. JG 8.1.09
Answer: I figured. JG 7.31.09
Answer: you can cut back nc eit is under controal and just use it a few times per week. It can always be increased if and when the dandruff returns. JG 7.31.09
Answer: no, you would need to stop for a longer time, week or more. JG 7.30.09
Answer: no, you can transition with no problem. JG 7.30.09
Answer: I feel ScalpMed is better as it is less irritating to the scalp. JG 7.30.09
Answer: basically a red wine extract and for it to have any sufficient effect, it can be somewhat costly as most tablets have very small amounts. It has anti-oxidant effects. JG 7.30.09
Answer: Rogaine will potentially slow hair loss and might get some small hairs that stopped growing to restart but it will not necessarilly make a thin hair thicker. It should not have any negative effect though, besides the rare ones listed on the box. JG 7.30.09
Answer: I normally do at least a skin lift and then if the tissues are saggy below the skin, those are tightened too. Some doctors like to give a cheeklift a fancy name or a full facelift a fancy name, but in essence it is either a full facelift, a cheeklift or in some cases a neck lift. JG 7.29.09
Answer: there is a slight difference, there are small cones every so often on the thred in an attempt to serve as an anchor that is stronger than the nothced thread as before, but all of the anchors are connected by the same thread, so if the thread breaks, all the anchors fall. The chain is only as strong as its weakest link. I understand a patient wanting less invasive surgery and I can also understand a surgeon trying to offer something that sounds new and innovative, especially during harsh economic times when cosmetic surgery procedures are reportedly down about 40% across the nation, but it is like the old adage, if it sounds too good to be true, it usually is. Think about it, medical information to doctors goes around quickly, if indeed the procedure did work, why would only a very small number of surgeons be performing it? JG 7.29.09
Answer: I would not perform one, no matter what surgeon vowed they are wonderful, the threads break, can be difficult to remove, and if one side breaks and the other does not then you look like you had a stroke, and since it does not remove skin, it would only be indicated to help a small percentage of patients for a short period of time, sorry. JG 7.29.09
Answer: there is no one correct answer, I suggest doing the area that bothers you the most first. JG 7.28.09
Answer: I think you should see the surgeon to make sure there is no hematoma that needs to be drained, best of luck. JG 7.28.09
Answer: IPL , microdermabrasions and Retin-A. JG 7.28.09
Answer: OK to do, no problem. JG 7.27.09
Answer: stay the same. JG 7.27.09
Answer: sorry, no. JG 7.27.09
Answer: I have not heard of that happening to be honest with you and the septum is further back in your nose, the flimsy part you are likely touching has no cartilage in it and is distal to the end of the septum. JG 7.26.09
Answer: the most common problem is not enough change and that can be fixed by more surgery, touch ups or revisions occur about 5-7% of the cases. JG 7.26.09
Answer: it should not do either one. JG 7.25.09
Answer: well, I beg to differ, although the lateral canthus is not changing, since the canthal ligament in your case is being brought up vetrically, in so doing there will be a small amount of horizontal shortening too although nowhere near as much as the vertical shortening, having said that I think the horizontal width will be closer to normal, in your case the horizontal width is excessive and he will normalize it so it will shorten a small amount, but only to approach the normal width. JG 7.24.09
Answer: well, the entire opening of the eyelid will be smaller, both vertically and horizontally, so the shape of the opening between the upper and lower eyelid will be smaller, narrower. JG 7.24.09
Answer: sounds like it is all normal, all the best. JG 7.24.09
Answer: well, it all depends on what you are referring to, in almost all cases with a tarsal strip, you need to be aware that the apeture of the eye will need to be made smaller. All the best. JG 7.24.09
Answer: well now I am blushing and thanks for the positive story posting. JG 7.24.09
Answer: I guess it is pretty typcial and there is no special technique used but if your skin is thick, as is the case in most mediterranean noses, there are limits to how refined the nose cna be made. It is called a regular rhinoplasty and it does not have to be made any shorter. Best of luck. JG 7.24.09
Answer: impossible to tell, too many variables, it might never be permanent. JG 7.24.09
Answer: yes, it is possible. she is incorrect. JG 7.24.09
Answer: no, there are different fees in most cases. JG 7.24.09
Answer: could look pretty good after 6 weeks, but final result might take on year. JG 7.24.09
Answer: alexandrrite lasers will treat the area faster but might need multiple treatments, neither is a fast scenario for long term hair removal. JG 7.22.09
Answer: Restylane SubQ, not sold here in the US yet, or Sculptra. Best of luck. JG 7.21.09
Answer: risks are lumps, over-correction, non-survival of the fat grafts, prolonged swelling and bruising. In thin areas like the temples the lumps can be seen more easily, and that goes for any filler. JG 7.21.09
Answer: yes it is the way that most surgeons have performed fat injections for years, nothing new. In some percentage of cases it is permanent, in most it is not. What you have after 6 months will likely stay but if you gain weight it will get larger. JG 7.21.09
Answer: can be done, works so-so. JG 7.22.09
Answer: it should work the same way. I cannot comment on effectiveness without knowing the concentrations of all the ingredients. JG 7.20.09
Answer: if you are speaking about OTC creams, likely no bad effect. JG 7.20.09
Answer: I feel they are about the same. JG 7.18.09
Answer: it can allow some minimal spreading of the skin between the brows but injections in that area are the ones that can lead to a droopy lid, although it is quite rare in experienced hands. JG 7.14.09
Answer: I agree, it might look worse due to swelling, give it another 4 weeks and see what happens. JG 7.13.09
Answer: certainly, you can send them to drgarcia@lvcosmeticsurgery.com JG 7.11.09
Answer: I guess the worst thing that can happen is it leaves your eyelid droopy due to the weight and you waste your money. It helps if injected right under the brow to plump the area but injecting the upper lid skin itself is very difficult to get right. JG 7.11.09
Answer: not seen one from a facelift. JG 7.10.09
Answer: it can be much more difficult in protruding eyes for that to be effective. Might not be worth it. JG 7.10.09
Answer: not really any easier, but the end results will take more time to see as the tip can stay swollen for months after the surgery. Nostril size should not change but the shape can change from oval to round at times. JG 7.10.09
Answer: it is a glucocorticoid steroid used for allergies and to try to soften scars. JG 7.10.09
Answer: done properly there should not be any negative effects with time. JG 7.10.09
Answer: a temporal lift is only the lateral part of a brow lift. It is a smaller procedure. The temporal lift might require a slightly longer scalp incision than a plain midfacelift. JG 7.10.09
Answer: do not walk, run away from the doctor! JG 7.9.09
Answer: not a problem, it happens if it got warm but will not affect it, keep it in a cool place though. JG 7.7.09
Answer: Retin-A is stronger. The retinol does not cause the skin to dry up becasue it is weaker and less effective. JG 7.7.09
Answer: all I can say is that you will need to try it, I suggest stopping the Retin-A for a few days before and after the IPL. JG 7.6.09
Answer: same thing. JG 7.8.09
Answer: it can still be maintained, yes. JG 7.6.09
Answer: in some indiduals it can be, yes, but not all, depends on the patient. Happy Independence Day! JG 7.3.09
Answer: well the nerve stimualtion while the nerve is coming back will help prevent the muscle from atrophing and I think it is worthwhile, we use home units the patient can use a few times every day to make it more convenient. The casues of the scars widening are myriad and silicone sheeting migth help some at this point. The redness should improve over 6-8 weeks though. I will say that not seeing the surgeon for one month after the procedure is unusual, usually I see the patient the next day, at one week and then 2-3 other times during the first month and the pateitns are having ultrasound massage in the office twice a week during that time so if there is a concern I can see them more frequently. I think it will all get better but it will not be overnight, hang in there. JG 6.29.09
Answer: the ID is used just for access to prevent bots from entering, I never see the patietn`s name. I am glad I could help out, continued best of luck. JG 6.25.09
Answer: your previous question was in regards to the jowling I believe and in that case, a traditional facelift will do two things, lift sagging tissues and then redistribute the skin in a natural appearance, the limitation of a limited access procedure like a MACS is that while it works well in younger patietns with minimal to no skin excess and just sagging tissue, in an older individual, it can at times leave the skin redraped in an unnatural fashion leaving the stigmata of a facelift procedure. JG 6.25.09
Answer: let the vinegar wash dry completely then apply the peptide cream. JG 6.25.09
Answer: it is just a lesser procedure with less actally perforemed,less draamtic efect as less is needed. We do it when patients only need a small improvement. Yes, we perform it although in most cases patients think they need something small when in reality, in order to make it look natura, something much larger is typically required. JG 6.24.09
Answer: between those two,a traditional facelift most likely, but hard to say without seeing you in person. JG 6.23.09
Answer: hard to say without seeing you in person, there might be something that can be done to improve things, I suggest seeing an occuloplastic surgeon for an evaluation. JG 6.21.09
Answer: hard to say the cause, migth suggest some microdermabrasions or IPL sessions and see how it goes. JG 6.21.09
Answer: could be cutaneous porphyria or a type of hemachromoatosis, you need to see a blood specialist. JG 6.12.09
Answer: just me, sorry there is a confusion, maybe you can post your question and how I might have caused the confusion. Please remember, when I answer the questions here, I do not see the person`s identifying name so it can abe hard for me to continue to flow of a particular posting. JG 6.12.09
Answer: pretty similar for sun spots, for wrinkles, equally ineffective. JG 6.11.09
Answer: well, although I am not a fan, maybe an erbium laser. JG 6.10.09
Answer: it is a peel performed by doctors, it should never be done on one`s self. JG 6.10.09
Answer: if you eliminate phenol, then I woudl say croton oil. JG 6.9.09
Answer: I avoid doing surgery on them if I think the tissues are not soft enougth to get the desired result. JG 6.9.09
Answer: 6-12 months or so I would say. Once the tissues have softened, then it is OK to proceed, doing surgery when the tissues are stiff can lead to less than good results. JG 6.9.09
Answer: about the same, not much difference, but the TCA peel can be done strongly and then there is more downtime. JG 6.8.09
Answer: few months, depending on how deep they perform it to.
Answer: you can likely repeat it every 12 months or so. JG 6.9.09
Answer: there is no one treatment that will take care of all of those issues, in fact some therapies that will help some will aggravate others. JG 6.8.09
Answer: sun spots likey good, pores, good but very temporary for fine lines only good while swollen and for capillaries, nothing. JG 6.8.09
Answer: the weakness of te muslces in msot cases is due ot the nerves going ot the muscle being stretched and in 6 weeks in the vast majority of cases goes away. As to the pain that gets worse as they day goes on, it can be due to swelling that increase throughout the day or due to muscle spasms, so a muscle relaxant might help, along with massage or ultrasound therapy. The puckeing in most cases is due to an attempt to keep the scar shorter and trying to sew a longer side to a shorter side, that also in time will smooth out, but that takes months, not weeks. I know you are frustrated but the things I suggest here at this time are what I would do at this point in time if you were in my office. All the best. JG 6.8.09
Answer: they are not the same thing, if you have tissues that have fallen and need to be lifted, then the facelift is the best choice, if you have lost fat in your face and that is what makes the skin sag, then fat injections might be the better choice. Fat injections into a face where there is plenty of tissue but it has sagged will look just like a fatter face. JG 6.7.09
Answer: no, it will not, sorry, if anything it could lift the tissues up and make the readherence less. JG 6.7.09
Answer: while removing it it can be sutured down to the periosteum, or in difficult cases a small screw can be placed into the bone and the tissue sewn to the small screw. If the implant has been in there for more than a coupe of weeks a capsule so scar tissue around the implant that if not taken out, will not allow the tissues to readhere to the bone. JG 6.6.09
Answer: that is too broad a question as there can be many causes, having said that, if you do not have excess skin then there is no need to remove skin. The natural results can be achieved through many different techniques, there is no one that is better than any other. A midfacelift shoudl not interfere with any intra-orbital nerves. JG 6.5.09
Answer: no, what I said was that if your tissues did not reattach on their own or were not reattached by the surgeon at the time of the cheek removal it can cause sagging. I also said that if you needed cheek implants at your age due to tissue loss, then yes your tissues are not good. There are no special diets or supplements besides a normal healthy one that will influence it, in most cases it is a genetic thing that you cannnot change. A cheek lift for what you have told me will not fix the problem as you needed cheek implants due to loss of tissue or due to poor bone structure and neither one of those is improved with a cheeklift. JG 6.5.09
Answer: a split between the muscles of the eyelid and cheek where fluid accumulates to make it look swollen or like a baggy pocket. JG 6.5.09
Answer: thanks. JG 6.5.09
Answer: yes, it hurts. As to the percentage, that depends on the location of the hair and the skill of the technician, no way to tell. JG 6.4.09
Answer: as to the Sculptra and swelling, they might have pierced the skin fewer times with the needle, they might have injected it a little deeper or they migth hav emixed it into less solution so there were fewer shots, lots of variables that can contribute to that. All you need is one puncture into one vein and the swelling increase, same goes for the Juvederm. As to the second question, they need to look at your thyroid and progesterone level both to see if they are deficient. Best of luck. JG 6.3.09
Answer: well, first, the removal of implants can make you look more saggy if they are taken out if the tissues do not readhere to the bones. In your case, although it is hard to say without seeing you in person, and unless you had some boney issue where your facial bones were underdeveloped, I cannot really see where a person your age would require the degree of intervention that you describe. In cases where someone does need that series of interventions to begin with, as in yours, you need to understnad that for whatever reason, your tissues are not good, will age at a significnatly faster rate than other people and you will likely be saddled with a lifetime of short term resutls. People with bad genetics do not get the results from interventions that others do. The resutls from all interventions certainly depends greatly on what and how it is done, but it also depends greatly on who your are performing it on, the same procedure on two different people can yield dramatically different results. JG 6.3.09
Answer: stairmaster, eliptical trainer, swimming are other optiosn where there is little impact to cause the faster decent of facial tissues. As to exercise keeping you young, that refers only to heart and lungs, nothing else. JG 6.3.09
Answer: I think it is difficult to get all of the hair to die off so many treatments will likely need to be done, and even then, occasionally some hair will grow.JG 6.3.09
Answer: I would sugest a plastic surgeon and in most but not all cases, it should be able to be improved. JG 6.3.09
Answer: no laser will do that, it might cause some temporary redness is all. JG 5.31.09
Answer: the only way will be to get sun exposure on your facial skin which will likey replace the color and but then progress with accelerating the aging process of your skin. JG 5.31.09
Answer: if it causes scarring, the scarring can damage nerves in very rare cases. They would be sensory nerves though and not ones that would cause spasms. JG 5.31.09
Answer: not in my opinion. JG 5.31.09
Answer: all normal, yes. As to why the longer scars than anticipated, that is because after elevating the tissues below the skin the skin that was in excess was more than anticipated and if the incisions were made shorter, they would lead to more sever puckering. It is all normal for the procedure you had done, and will get better in time I feel. JG 5.31.09
Answer: likley none, I would suggest Retin-A. JG 5.30.9
Answer: might want to get your thyroid checked out as bulging eyes can be a sign of an overactive thyroid that needs to be controlled. JG 5.27.09
Answer: same issues can occur with the body implants except they cannot rupture as they are solid. JG 5.27.09
Answer: you need to worry about the medical issue first and foremost. If I remember correctly, you said you were in your early 20`s and I cannot see why you would consider a CO2 laser at this point in your life. JG 5.27.09
Answer: I think you should correct the eye issue first and leave an elective procedure off the table for now, medically necessary issues should take precedence over cosmetic procedures. JG 5.27.09
Answer: might need liposuction and possibly skin removal, the scars from the skin removal can be quite long, extending from the armpit to the elbow on the inner part of the arm. JG 5.25.09
Answer: impossible for me to tell without seeing you to detemine what your skin is like and what it would need, sorry. JG 5.25.09
Answer: yes, it can. JG 5.24.09
Answer: I have to say that I find it unlikley that you would need a full CO2 laser. Maybe something lighter. I think it would be best to do it seperately too to avoid the strip surgery being pulled down from the swelling. JG 5.24.09
Answer: yes, it is much more effective than IPL.JG 5.24.09
Answer: a demand letter is usually written by an attorney and is essentially demanding that a refund of money for services rendered is what it contains, wording will vary. Not sure where you would find one to look at. JG 5.23.09
Answer: that is very unsual, the cheek pad would not grow from the implants, All I an surmise is that either scar tissue formed there or you have a fluid collection in the area where the implant was that cannot be absorbed. If they are still big at this point then maybe a conservative cheeklift is what is needed. I do plan on going to Austrailia in the future but not to work, just to play! JG 5.23.09
Answer: no,but they can develop lumps where the silicone goes. JG 5.23.09
Answer: no reliable way to permanently remove the contracture, if it gets to painful it would need to be removed. JG 5.23.09
Answer: not safe, there is not enough loose skin to accomplish what you desire and could make your face look funny in terms of proportion. JG 5.22.09
Answer: sounds like you need at least modification of the pockets to allow them to settle in a more symmetrical location, that means more surgery, at this point that is about all that can be done. As to being too big, that is difficult for me to say without seeing you in person. Best of luck. JG 5.22.09
Answer: if it is silicone it would need to be removed and if it is saline filled your body absorbs the saline as it is the same solution in the IV you got with surgery. I believe the smallest implant non-custom implant is 120cc. JG 5.22.09
Answer: 14 days if possible. JG 5.20.09
Answer: 20-24% that you will need another surgery, sorry. JG 5.20.09
Answer: just a diffferent laser company that makes a laser that tries to injure the fat to make it easier to remove with liposuction, lots of hype with little to no improvement over older tried and true techniques. JG 5.20.09
Answer: you have on average a 20-24% chance or need for a second surgery. JG 5.20.09
Answer: well, it depends on the age of the patient and their level of activity, for example smoking, excess sun, weight fluctuations and running will shorten the length of time it lasts, in general we tell patients 5-10 years before it is worth repeating, but if you have it done you will always look better than if you had never done it at all. JG 5.20.09
Answer: seems that when you smile the tissues that were tightened move closer together and to make the crease less visible, therefore the easier fix woudl be a filler into the crease, otherwise you would need more surgery to pull the tissues smoothly together as they seem to not be in as good approximation as desired. JG 5.20.09
Answer: in that case it might be some atrophy of the fat due to pressure that was not appreciated sooner due to swelling, might consider a filler to smooth the surface out, fat or Sculptra. Does the crease move or flex when you animate the face? JG 5.19.09
Answer: yes, it normally will go down in 3-6 weeks. I usually advise patients to wait 6 weeks before exfoliating creams like Retin-A are re-started. Glad I could be of service and thanks for visiting. JG 5.19.09
Answer: might be either the suspension sutures used or a crease in the tissue from the tension placed on them to lift them, it might all get better in time, no way to tell at this point though and without seeing you in person. JG 5.19.09
Answer: well, if the muscles in that area are lifted or tightened the tic might get worse or might cause a different type of muscle contraction. JG 5.19.09
Answer: maybe to remove some recent sun spots is about all. JG 5.19.09
Answer: this far out, hard for me to say, blood suppply should not be changing anymore. Might suugest seeing a different plastic surgeon for an opinion. JG 5.16.09
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 5.17.09 www.surgery.org/public/findasurgeon
Answer: I would just say that you did not get the degree of improvement and you are going to require more surgery due to the results and see what they say, all the best. JG 5.17.09
Answer: more surgery is the only thing, the skin needs to be redraped and likley some type of canthoplasty on the eyelid too. JG 5.17.09
Answer: 7 days or so. JG 5.16.09
Answer: it depends on what the paeeint needs, in the vast majority of the cases some skin is removed, and the location is usually around the ears. Tightening the muslces alone will only do it in very young patients. The incision in most cases needs to be carried a short distance in front of the ear to avoid a pleating of the skin at the earlobe. JG 5.16.09
Answer: very possible. The Sculptra takes 4 months to build up so the swelling goes down in between the sesssions but not the new tissue that the Sculptra is causing to be formed. JG 5.14.09
Answer: anywhere form 48-55 is the most common age for those procedures. JG 5.13.09
Answer: it is mostly a repositioning of the malar mound. JG 5.12.09
Answer: the commonly called lower facelift is essentially a cheeklift and a neck lift together, that is really what is called a facelifft, t it does not include the forehead lift which in common parlance is not part of a facelift. A cheek lift is commonly less than a facelift, yes. JG 5.10.09
Answer: the ingredients are 5 different pepetides that are proprietary. They will not counteract with sunlight although if you have no intestinal absorption problems it is likey safer to take oral Vitamin D and get it through a supplement. Vitamin D might and might not have food effects for the skin but sunlight will do nothing good for your ski, only bad. JG 5.10.09
Answer: yes, that is OK to do. It should correct the corner of your mouth.All the best. JG 5.10.09
Answer: they will likely need to repeat the whole endoscopic lift on that side to obtain symmetry. I think placing the incisions for the lower facelift at the front of the hairline leaves less stigma of having had a facelift. Best of luck. JG 5.8.09
Answer: should be OK to do, yes. JG 5.7.09
Answer: well, the average plastic surgeon in the counrty does between 25-50 facelifts per year according to the national data. As to their attitude, my personal advice is if they have that attitude, you should go somewhere else. JG 5.7.09
Answer: eventually, yes. I believe if there is a granulona it might need to be cut out, the long term lumps are more common with things like Radiesse or Artefill though. JG 5.7.09
Answer: call the office and ask for the new one,we still have some of the old ones and will sell those at 50% off, but you need to call to get the old ones at half off. JG 5.7.09
Answer: same name. JG 5.6.09
Answer: no, but the purpose of the sutures is to be in place until scar tissue forms to hold the tissues, so likely the sutures are gone and it is the scar tissue causing the tethering. Warm packs now and stretching. All the best. JG 5.4.09
Answer: they dissolve by a low grade inflammatory response in the body. It is about 50% dissolved in 4-6 weeks. Thanks for visiting. JG 5.3.09
Answer: I think she has chosen a good option for what her concerns are, the risks are of loss of sensation and visible scars. As to how long the results last, it is more dependent on the amount of skin removed and the quality of the skin rather than the technique used. Best of luck. JG 4.30.09
Answer: yes, the are absorbed in about 15 minutes or so. JG 4.30.09
Answer: no, that is due to the oil trapped deeper in the pores, Retin-A helps that along with IPL treatments, but all is very temporary. JG 4.29.09
Answer: the peptide cream helps by assisting the body to make new collagen and also stabilize cell walls so degeneration is slower, most people feel a difference within 4 weeks and many see the difference after 4-6 weeks. One washes their face first and then applies it, ideally twice per day but once at night in younger patients is likely OK. There is no need to apply a moisturizer over it but if you skip the peptide in the morning, the use a moisturizer in the AM. JG 4.29.09
Answer: all normal, yes. JG 4.28.09
Answer: the new stronger peptide cream has 7ml and should last at least one month, it is put on very lightly, small spot on forehead and one on each cheek is more than enough, the older peptide was a larger amount but this is stronger and more concentrated and you need much less, it smooths out more easily than the older cream and has a new penetrator that make is absorb faster and better. JG 4.27.09
Answer: some of the smoothness that existed prior to the surgery was likely due to the smooth contours of the tissues beneath the skin at that time. When complications occur, especially with scar tissue and fat loss, the smoothness of the underlying tissue is lost and undulations of the skin can become apparent. I think in many cases small amounts of fat can be injected to regain the prior smoothness, and the abdomen is a good source for that fat. Although some doctors are claiming they are also injecting stem cells with the fat, that is a theory, a stretch, and is not substantiated at present. But the fat injections do help a large percentage of the people, albeit having to be done more than once at times. Fat transfer should not harm the skin in anyway, and in some cases can improve the texture due to increased support and blood flow from the transfered fat. Congrats on turning 60, I am not far behind, best of luck and thanks once more for the mugs, they have been enjoyed many times. JG 4.27.09
Answer: the facelift alone will not accelerate aging but some complications that can occur after a facelift can make a face look older. Facelifts on thin and fair skinned people are done many times and they do not always have a complication, complications can happen for many different reasons. I do think in some patients that fat transfers can help. Sorry to hear about all the issues, I wish you the best. JG 4.26.09
Answer: no, actually, the facelift should do quite well for that. Best of luck. JG 4.26.09
Answer: There is no routine incision that I use as it is taylor made for the patient, some need shorter or longer incisions and where they fall depends greatly on what the patient needs and wants improved. JG 4.24.09
Answer: no difference really, where it is varies from person to person depending on where their ligaments are attached. JG 4.24.09
Answer: well, it is possible, not sure why the therapist would do that. Most stitches are meant to dissolve after a period of time, during which scar tissues should have formed in order to hold the tissues in their new position. Things always feel a little looser as the swelling goes down and the tissues soften, so I suggest giving it time, by that I mean months not weeks and see how it all goes. Hang in there. JG 4.22.09
Answer: well, it varies from patient to patient. The more damaged your skin is the less time it will last, in most cases I tell the patient that smaller procedures will last 5 years or so. JG 4.22.09
Answer: there is nothing topical or oral that will help, that is how your skin is responding to the aging process and ultimately might require surgery, there are no safe laser skin tightening procedures for the arms, sorry. JG 4.22.09
Answer: I am sorry but I do not have a list of products sold in Spain that I can help you with, you will need to search via the internet for that information. JG 4.22.09
Answer: well becasue typicall there are sutures that were placed into the muscle that make it harder to do the myofascial release and also there is scar tissue that makes it more difficult on top of that. I am not sure why you would have surgey to tighten the skin and muscles and then get myofascial release. Now if it was too tight to begin with, massage will help but until the scar tissue softens and the sutures dissolve, it can be difficult to stretch the myofascial unit and you could cause bleeding and cause the muscle you wanted tight to loosen. The sutures that were placed into the muscle to tighten it were into the fascia but also into the muscle fiber, that likely contributes to the problem, along with the hard scar tissue. JG 4.21.09.
Answer: the peptide cream should work, but I thik if you are truly concerned about your skin and the effects of aging, you should not be tanning at all. JG 4.20.09
Answer: the truth is often discouraging, but the truth is the truth. JG 4.19.09
Answer: correct, the aging is reveresed with the surgery but aging will start immediately after the surgery so return of the jowls is a matter of time, no matter good the correction is initially. Since there is no wya to stop the aging process, the correction acheived will not be permanent, how long it will last will vary from patient to patient. JG 4.19.09
Answer: not sure what you mean by losing its effect. The first 12 months is where the result of the Retin-A will happen, after that, there will be a slowing down but not a vibile reversal of damage that you saw before. No cream will indefinitley reverse the damage. Changing over to the peptide is a good option, and you could always go back to the Retin-A again at some future time. JG 4.19.09
Answer: they are different, the Retin-A causes irritation and the peptide cream does not, they have very similar effects I feel. I pesonally feel the peptide cream is easier to use and moisturizes while Retin-A does not. JG 4.18.09
Answer: there is no way to predict that as it will depend on how you age, that is a multifactorial issue and there is nottway to predict that. JG 4.18.09
Answer: has been tried for years and the sutures break, it does not last, and if one side breaks and the other side does not you look like you had a stroke. JG 4.18.09
Answer: I personally do not feel erbium offers much, but if you do not need much, it might be of some slight benefit. JG 4.18.09
Answer: if the redness is due to the eye being dried out from inadequate lower lid coverage, then elevating the lower lid should help, yes. JG 4.18.09
Answer: nothing negative will happen to your skin if you use the peptide cream versus the DMAE cream. You will still age, I would expect the signs of skin aging on yoru face would be less. In the future, as no cream will 100% stop the aging, you might need a different cream. New creams are being developed all the time and I am sure in 3-5 years we will have even better products. I am actually work on new mixtures that will likely replace the peptide cream I presently sell, I expect release of that in 12 months or less. In short, if you are concerned about your skin aging the peptide will certainly help, if you are not too worried, then the DMAE might be enough. Nothing negative will happen from the use of a product intended for older more damaged skin on younger patients. JG 4.18.09
Answer: I am sory but the mixture is of five peptides in a liposomal delivery complex and it is a proprietary compound that I cannot divulge, unlike my other creams. JG 4.18.09
Answer: normally 5-7 days. JG 4.18.09
Answer: I think much of the distortion you have at presetn is the swelling in one area and none in the other, it should balance out in a couple of weeks. The jowl, unfortunately, will eventually come back.JG 4.18.09
Answer: lots of different names but all essentially the same. In some small subsection of people, it can be done under local anesthesia. I do not use any fancy terms for my procedure, I just tighten the SMAS and remove the excess skin in front of the cheek for my mini lift. JG 4.17.09
Answer: the peptide cream also helps promote the creation of new collagen, but with no skin irritation, in that sense it does renew skin in a similar way. JG 4.16.09
Answer: can`t imagine how a 30 year old woudl have hollowness there and I do not perform fillers in the upper eyelids due to the high chance of lumps,sorry. JG 4.16.09
Answer: I will be honest, I do not use fillers in that area as the chances of lumps are too high. JG 4.16.09
Answer: stabilizes cell membranes and promotes the skin`s ability to create its own collagen and glycoaminoglycans. The skin normally does that but as we age its capacity decreases and the ingredients help it stay as efficient as possible. JG 4.15.09
Answer: Rhytec Portrait, Retin-A maybe. JG 4.15.09
Answer: it is safe to use on young skin, yes, no negative effects. JG 4.15.09
Answer: the more damaged the skin is the better it is with the peptide cream, there is no negative effect form using the peptide cream on your skin though. JG 4.15.09
Answer: if you are a tolerant person, it could be. JG 4.9.09
Answer: no, that is something that happens when you pull on the skin because there is no way to seperate the tissues around the eyes while doing that maneuver, during a facelift or cheeklift the eyes and their shape is not changed. JG 4.6.09
Answer: sorry, but no, there is not. JG 4.6.09
Answer: I understand what you are describing and I can understand why you are confused and disappointed, I think speaking frankly with your surgeon should be done and go over with him what your desires were and how it has turned out, sounds like it will involve more surgery. JG 4.6.09
Answer: it will loosen and the appearance will change over the next 4-6 weeks. Give it some time. JG 4.5.09
Answer: in many cases a necklift is inadequate to give a good jawline and a full facelift with cheek tissues being lifted and then a horoizontal and a vertical pull on the skin leaving scars in front and behind the ears both. JG 4.5.09
Answer: the platysma muslce is not always tightened in the midline. Actually, if that is doen, it will limit the degree of cheek muscle elevation. The neck can stil be defiend if the cheeks are pulled up and the skin is lifted. In some cases the submandibular glands are saggy and can persist in giving a full neck. Some doctors will remove them, it is potentially dangerous, and trying to lift them is also difficult, so there are limitations in what can be acheived in some people. JG 4.5.09
Answer: the masseters will no be the cause of the chin and jaw pulling down as the masseter pulls the jaw up, it would need to be the neck muscles. JG 4.5.09
Answer: I think it is worth a try, those muscles are smaller and it has not been studied though. JG 4.4.09
Answer: well, possibly, but I would not entertain the idea until the tissues are soft and pliabel as you do not want the tethered tissues of the neck to limit the ability to lift the cheeks up ot correct the problem. The cheek lift has a couple of weeks of downtime and is about half of a facelift.I do not think injectables will lift the tissue enough, sorry. JG 4.2.09
Answer: no, it is true, it does not work as well on all patients as their own body has to respond to the material and create the fullness, older people respond less well. JG 3.16.09
Answer: If the Sculptra was injected too superficially it can leave some lumps, they can at times be improved with saline injections to disperse the material if done relatively soon after the Sculptra injections. JG 3.16.09
Answer: if you do feel it, that typically only lasts a few days. JG 3.16.09
Answer: no, they are lifted seperately from the skin, it is just that the skin elevation is less. I do a modification of the MACS lift, something many of us have been doing for many years, we just did not give it a fancy name. I think recovery is not always faster and swelling can vary also. JG 3.16.09
Answer: not really any negatives as long as she does not get lumps. JG 316.09
Answer: maybe a sparse amount of Sculptra in very thin layers to almost thicken the skin rather than fill in hollows might help, hard to say. JG 3.13.09
Answer: they do totally different things, some people need them both, so it is not an either or scenario. JG 3.13.09
Answer: lumps at this time are not uncommon and might get better with time but Silicone injections do not smooth out the way other fillers do. Steroids soften scar tissue but does nothing to dissolve silicone injections. At 5 weeks I doubt there is any significant scar tissue there yet as the body has not had enough time to have create it yet. I am not sure if you are in the US, but if you are, since silcione injections in many states ar illegal to perform for cosmetic issues, I suggest you seek care by a different surgeon, as one that is willing to break the law is likely not someone that will look out for your best interest. JG 3.10.09
Answer: I thik you will need both the incision under the leck and then also behind and possibly a short one in front of the ear to remnove the skin that will likely be in excess. I prefer not to put mesh in the neck as it can scar in and show.Best of luck. JG 3.9.09
Answer: all the best. JG 3.8.09
Answer: hard to say, if the lower lip can still move then it might be too tight of a series of sutures and the muscle being over tight, if the lip does not move it migth be a nerve injury and that might get better over the next few weeks. All the best. JG 3.8.09
Answer: the more fat you have the more likely you will need skin incisions behind the ears to tighten the skin. JG 3.7.09
Answer: he is a legit plastic surgeon. JG 3.7.09
Answer: some people can tolerate it that way, others cannot, my preference is to do it under general anesthesia but if not, then under IV sedation. I might suggest asking what local hospitals he has priveleges at and also what board certifies him. It should be a board listed under the American Board of Medical Specialists. Best of luck. JG 3.6.09
Answer: I think that will be a minimal to nonexistent issue, the fluid that the material is floated in might go deeper but not the small fragments of the poly lactic acid that will eventually create the fullness. The lump is not do to anything you did, it is more injection related, but I cannot say why he will not do anything about it. In most cases it does get better though, with time, JG 3.6.09
Answer: firstly I doubt the lumps will go away without them being cut out. As to the lower facelift, it might help the jawline some but I seriously doubt it will do much to help the eye region, sorry. JG 3.6.09
Answer: well, lets think about this, Botox weakens muscles, that makes muscles look looser and potentially sag, a platysmaplasty tightens muscles, which is in general the desired effect, so I think if you have loose skin and muscle you need the neck lift, and if you have lots of extra money and want to do something that will not help and likely make you look worse, then use the Botox. JG 3.5.09
Answer: well, the looking done depends on how aggressive it is performed, so a subtle procedure might keep you looking natural yet refreshed so to speak. Best of luck. JG 3.5.09
Answer: well, chronological age is really not something that I go by, it is the amount of sag and damage that needs to be looked at, some people at younger ages can beefit from a facelift and there are some people in their 60`s that still do not need it. JG 3.4.09
Answer: I would keep massaging and might suggest seeing the doctor in person to make sure there is nothing else that can be done. At times it is the way it is injected, but it can happen even in good injectors` hands. The Sculptra typcially builds up for a period of about 4 months and then slowly degrades so the other area that was injected at this point might stay that way for awhile. JG 3.3.09
Answer: although the sutures can be cut, at times scar tissue will still hold it in place. If the scar tissue is aggressively removed in some cases it will help but not in all as new scar tissue will typically form. You might not be able to regain the appearance you had previously in some cases. JG 3.3.09
Answer: as I have said, there are small things like cutting the canthopexy scars that can be done but if the small safe things do not work, she might be stuck. JG 3.3.09
Answer: not uncommon for this to occur in some individuals, we use Robaxin but Valium is also a good choice, might suggest 10mg twice per day and warm packs to help get the swelling down. JG 3.2.09
Answer: the puffyness should have resolved by now but the itching is usually the nerves coming back.JG 3.2.09
Answer: no, the spacer will not fill in the hollow I am afraid. I do not think from what you are describing that the midfacelift and spacer will fix lagopthalmos, that is an upper lid problem. Almost all spacer procedures combined with a midfacelift have an incorporated canthopexy done at the same time too. The scleral show shold be fixed with the procedures proposed. I wish you the best. JG 3.2.09
Answer: scar revision will not do anything for the lines at the side of the mouth, no. Those might take a laser or somethinbg else. JG 3.1.09
Answer: sounds like you are reading about repairing a lower lid problem where there is either scar tissue or excess skin removed and the lower lid needs to be lifted, so they cheek tissues are lifted using the midfacelift and then a spacer is placed with either donor tissue or tissue from your own body to fil in the hole made by the stretching and proper positioning of the lower lid. JG 3.1.09
Answer: no, the canthopexy raises the outer part of the lid and a tarsorrhapy sutures the eylids closed. JG 3.1.09
Answer: should not be any bad side effects down the road and touch ups are needed in about 5-7% of people but not on an ongoing basis. Best of luck. JG 3.1.09
Answer: hard to say without seeing pictures where she is not smiling. I think you will need to be seen by a surgeon in person to determine what would benefit your particular case. JG 3.1.09
Answer: it can take up to one year. Hang in there. JG 2.28.09
Answer: no. JG 2.28.09
Answer: it would lessen the blinking in most cases. If it is injected, there are cases where weeks to months later as it wears off, the muscles can twitch as they start to regain their function, but if that is the cause, it is short lived. There are times where right after the Botox is injected that there is some twitching from the needle causing irritation, but that normally wears off in a few days. JG 2.27.09
Answer: Lagophthalmos is defined as the inability to close the eyelids completely.Blinking covers the eye with a thin layer of tear fluid, thereby promoting a moist environment necessary for the cells of the exterior part of the eye. The tears also flush out foreign bodies and wash them away. This is crucial to maintain lubrication and proper eye health. If this process is impaired, as in lagophthalmos, the eye can suffer abrasions and infections. Lagopthalmos leads to corneal drying and ulceration. JG 2.27.09
Answer: well, it might be where the problem is, but most times the surrounding skin needs to be lifted and re-draped so it does not have an unnatural pull or sweep, even if the tissue below that skin are in good position. What that means is the area improved is small but the scars might be longer than anticipated in order to lay the skin down in a natural orientation and not leave pleats of skin. Fillers will typically lift the normal skin to the level of the sagging skin and in certain lighting will look good, but it will be larger or fuller looking. JG 2.26.09
Answer: essentially the same, the thing with limited procedures is that when small parts are treated, it can leave the surrounding areas un-naturally pulled and leave one looking funny. Imagine trying to make your bed but only smoothing the small part where you slept and not the whole thing, it can look weird and uneven. I am not familiar with any of the surgeons at Monarch Spa though. JG 2.26.09
Answer: it is not typical and I cannot say that losing weight can cause a certain change as where the fat is lost from is unpredictable. JG 2.26.09
Answer: common, keep massaging, it can take a few days for it to smooth out. They should flatten with time and in some cases they can be broken up at the 6 week mark with a small needle and some saline fluid, should not cause long temr issues. JG 2.25.09
Answer: no need to wait, it will not affect anything that needs or could be done. JG 2.24.09
Answer: I have seen it last 2-3 weeks in some cases. All the best. JG 2.23.09
Answer: sorry, not aware who does that in Toronto. JG 2.23.09
Answer: no chemical peel will help, I suggest a YAG lser or a VBeam laser. Lasers that make capillaries worse are ablative lasers, not the ones I just mentioned. JG 2.22.09
Answer: if a laser is done to the cheeks that will pull your lids down still. I think anything you do to your lower eyelids will make the scleral show worse until the lower lid position is corrected, you woudl go from bad to worse. You need a canthopexy, the one you had done obviously did not correc the problem so you need to have done again and more aggressively, maybe by a different doctor. JG 2.22.09
Answer: no, it does nothing for the skin itself. JG 2.22.09
Answer: can be from the suspension of the mid facelift, might suggest getting some Valium for the muslce spasms that are probably casuing the problem. JG 2.22.09
Answer: you know I have answered your questions multiple times over the last few days, please go back and read the answers. JG 2.22.09
Answer: if you have scleral show already, which is the whites of your eyes showing from previous surgery, doing a laser could pull the lid down even more, at least for a period of time. I think you need to get the scleral show corrected before you attempt anything on your eyelids besides creams. JG 2.21.09
Answer: nope.JG 2.21.09
Answer: I believe the Encore is a fractional treatment and I do not use that, I use a complete abaltion, as to LightSheer Diode laser, that is for hear removal and will likley do nothing for skin rejuvenation. JG 2.21.09
Answer: sorry but I am not familiar with that terminology for IPL machines. JG 2.21.09
Answer: I personally do not feel taking the risk of an erbium laser is worth it as the degree of improvement is too small for the risk involved. JG 2.21.09
Answer: I rarely do one single areas like that, usually we do the whole face if we are going deep to get the best effect. We do it at a surgicenter so you go home the same day and I would need you to stay in town for at least 7-10 days. Fees are about $4500, all inclusive. JG 2.21.09
Answer: a nurse can perfrom it but I think she is not being truthful about not needing it anymore after a number of treatments as the issues that cause the problems are never permanently stopped. If she is telling you that I suggest you seee someone else. JG 2.21.09
Answer: I usually suggest that one waits until they see some motion return to the area before injection, but you do not have to wait until it is all back. I will say that the more Botox that is injected, the longer it lasts. I cannot really comment on the eyebrows falling or not without seeing you, sorry. JG 2.20.09
Answer: the thing is that the exfoliating creams that help the pores will possibly aggravate the capillaries, there are not many home remedies that help the capillaries I am afraid. JG 2.20.09
Answer: essentially, yes, all the same thing. At times they might offer other treatments that might work as well for some issues and not as well for others is probabaly what is going on. JG 2.20.09
Answer: it can still work in some cases. JG 2.20.09
Answer: it is smelly, especially that in capsules, might want to buy the oil in a bottle from the internet, it smells much less fishy. JG 2.20.09
Answer: no, it might work faster for the brown spots, will work about equally for the pores and will make the broken capillaries worse or leave them the same.JG 2.20.09
Answer: there is no IPL laser, it is called that in comon discussions since its effects work due to the pulsed light but it is not as strong as a laser and the ony way you change the light emitted is by filters instead of a differnt wavelength emanated as a laser does. JG 2.20.09
Answer: I have never been Down Under but am lookin forward to traveling there in the future. Thank you for the kinds words too. JG 2.20.09
Answer: a nurse can do it but the procedure needs continued use, I think she is trying to sell you something and not being honest about the long term, I suggest you go see someone else. JG 2.23.09
Answer: yes, in time the aging process will allow it to loosen. JG 2.20.09
Answer: I am 51, I use Botox on my glabella, and crows feet, and I use my peptide cream nightly. The only surgeries I have had are orthopedic in nature. But I will not hesitate to have something done when the time comes! Thank you for the kind words. JG 2.19.09
Answer: it does not cause any redness or dry skin, and if your skin was not sensitive before, it will not make it sensitive. But it does not calm sensitive skin that was sensitive to begin with. JG 2.19.09
Answer: most people tolerate the DAME cream under the eye, but if you have sensitive skin, then I suggest the eye booster there and the DMAE on the face. JG 2.19.09
Answer: well, I think showing the injector where you desire it is a good idea and I think the filler he chose to use is not a very long lasting one for that problem so I think in a little while it will all go away. Hang in there. JG 2.19.09
Answer: I would see someone who does those filler injections to see her, like a dermatologist or a palstic surgeon. Best of luck. JG 2.19.09
Answer: the peptide cream is for older more damaged skin, you likely do not need it at your age but certainly can use it if you wish. Red skin after work outs is normal and not much that can be done for that, stay out of the sun too. JG 2.19.09
Answer: In most cases it is safe for sensitive skin, but I would not apply it to an area that is irritated from something. DMAE is a short for dimethylaminoethanol, a naturally occurring substance that facilitates the synthesis of a neurotransmitter acetylcholine. DMAE is a compound found in high levels in anchovies and sardines. Small amounts of it are also naturally produced in the human brain. An intriguing finding in some DMAE studies was that it reduced the accumulation of lipofuscin deposits inside cells. Lipofuscin is a cellular pigment consisting of aggregated chunks of molecular waste. It tends to occur in the cells of older people. It is likely that lipofuscin is not simply a byproduct of aging but also contributes to the aging process. Neurons, heart and skin of older people usually contain particularly large amounts of lipofuscin. It has been demonstrated that DMAE causes some degree of skin tightening. However, despite speculation it remains unclear how DMAE firms the skin -- whether by stabilizing the membranes, boosting acetylcholine, reducing lipofuscin deposits or none of the above. Whatever the mechanism, the effect of DMAE is often noticeable. Besides, even though DMAE can`t fully reverse the existing facial sag, it may reduce its further progression. Some people report a cumulative effect with continued use of DMAE. JG 2.19.09
Answer: derms and plastic surgery offices have it, I think many are also done in a MediSpa whcih is OK as long as they have a physician on staff to make sure it is done properly. JG 2.19.09
Answer: I think you can have the cheeklift as it likely will do nothing for the twitching of the eyelid. Fillers should likewise have no effect on the twitching. JG 2.19.09
Answer: that is not normal, the expected swelling is gone in most cases in 7-10 days. I think there is likely something else going on, either an allergic reaction which should be reported to the FDA or an over-injection of the filler. The lumps might be able to be dissolved using injections of hyaluronidase. JG 2.19.09
Answer: it can work in the cheeks but it should not stretch the skin out. If it survives it can improve the gaunt appearance. JG 2.19.09
Answer: not to any visible amount to make it worth doing it for that. JG 2.19.09
Answer: it is used for reed and brown spots, settings will vary on skin type though. It will not remove the top layer of skin, or at laast it is not intended to. JG 2.19.09
Answer: I think IPL woudl be a good idea, avoiding sun exposure, using a complete sunblock and then consider something like DMAE cream that will not irritate your skin yet help with some of the damage that has occurred. I would stay away from products with any acids in them for fear of aggravating the blood vessels. JG 2.19.09
Answer: I would use a combination of the two and understand the improvements will be short-lived. I do not think IPL is good for the eyelids themselves though. JG 2.19.09
Answer: I think the safest and best option is massage and time, I would not suggest any surgery in an attempt op reverse it. JG 2.19.09
Answer: well, the thing with the skin incision is really not due to the technique as much as it is due to the skin. The extended MACS lift can have limited incisions if the amount of skin is small, as the extended MACS is only a technique to lift the tissue below the skin. In cases where there is small to moderate skin excess, the Tonnard Procedure might do. If the Tonnard procedure is done in patients with a large skin excess, then those incisions will also be long, or more skin would need to be removed at a later date. It is not the lifting technique of the tissues below the skin that dictates the incision, it is the amount of skin that is required to be removed.Hope that helps. JG 2.18.09
Answer: the ones with good results always get posted on websites but the results in general are unreliable and not consistent in their resutls. I thank you for the kind words too, but I am married. All the best. JG 2.18.09
Answer: I think you should seek out a different doctor, what he is saying is a little over the top. JG 2.17.09
Answer: pores are recurring problems so no matter what you do, it is temporary. I think IPL and microdermabrasions are a good place for you to start and maybe some Retin-A or glycolic acid creams. JG 2.17.09
Answer: as to how long it will last it depends greatly on how active your muscles are and how much was injected so it is hard for me to say. In terms of the twitching, I guess that can happen once the nerves start coming back and some muscles are working and others do not, but actually Botox was first developed to treat eye twitches and spasms. Ptosis surgery should not give you an owl look if done properly so I am not sure why that doctor said that. As to fillers around the eyes, they work over the bone but I think the correction of lost eyelid fat is not reliable. The most common fillers used there are Restylane and fat. Hope that helps. JG 2.17.09
Answer: certainly worth contacting him, he is a very reputable surgeon. JG 2.17.09
Answer: not, not much at all, hang in there and all the best. JG 2.17.09
Answer: not permanent, they give you the oral steroids for awhile and then slowly wean you off as your adrenal galnds get back to functioning, it is a slow process. They typically start low and increase it as they need to, they do not want to give you too much, and then once stable they can start slowly bringing it back down as your body adapts. Best of luck. JG 2.17.09
Answer: to be honest, although I think Tonnard is an excellent surgeon and has a great operation, there is really not much difference between them and suggest you stay closer to home. JG 2.17.09
Answer: not always. JG 2.16.9
Answer: real time is about 6-8 weeks for about 50-60% to be down and at times 6 months for all of it to be gone. Tissues around the nose are not normally shifted during that surgery. All the best and hang in there. JG 2.12.09
Answer: surgica time varies but a facelift can at times take 5 hours, no matter what technique is used to elevate the underlying sagging tissues. It seesm a little high on the price, but that varies from location to location and also with the doctor`s experience, certainly in parts of the US, it can cost that much. If you feel he understands your desires and you feel you can communicate with him, then I would go ahead with it. All the best. JG 2.9.08
Answer: in general, I am not a fan of Threadlifts, no matter which one is used. Sorry. JG 2.4.09
Answer: well, there are different opinions on that but somewhere between 2-6 weeks or so. I do not think paper tape will cause or speed the re-adherence. I think that is pressure to a greater degree, limiting the swelling, and in some cases, fixation of the tissues to the bone in a variety of different ways can be done, screws, sutures, etc. JG 2.2.09
Answer: hard for me to tell what the bump is without seeing you in person I am afraid. As to the nerve damage, I do not think it is causing the lump, but as long as it is getting better, that is all good then. JG 2.2.09
Answer: I think fillers can help the brow region but not the eyelid. If you have ptosis, then the upper lid would partially cover the upper part of the colored portion of your eye. Tise can be determined by your surgeon. If it is symmetrical, I doubt it is ptosis. Best of luck. JG 2.2.09
Answer: it likely means that he does a high percentage of his work in that particular area. It is a self-claimed interest, nothing more. JG 2.1.09
Answer: I have not seen it be effective. JG 2.1.09
Answer: not sure what you are trying to acheive with those therapies, they are good for deep tissue massage at times. It will not affect fat loss in any reliable way though. JG 1.31.09
Answer: fees vary from surgeon to surgeon so for that you need to pick a surgeon first. As to down time it is relatively close, maybe 2-4 days different, for the facelift will be about 2 weeks. The necklift alone will not slow down the progress of the falling cheeks. JG 1.30.09
Answer: likley seen due to loss of subcutaneous fat and you did not notice them before as you were loooking at other things. They can be injected with fillers or a laser done but they will come back. I do not think it is swellig from the facial surgery though. JG 1.28.09
Answer: well, if there is anything loose on the cheek or even a little jowling, then the neck lift will not correct it, also at times the excess skin of the neck is in excess both horizontally and vertically and a neck lift will only improve the horizontal excess and not the vertical, so in that case of both horizontal and vertical excess you need the lower facelift. Hope that helps and thanks for the kind words and encouragement, I appreciate it. JG 1.28.09
Answer: there is absolutely no similarity between them, IPL is a pulsed light source used to treat brown and red spots and electrolysis is for hair removal. JG 1.28.09
Answer: I am not sure, you are best to call around and speak to a local electolysis person and they might be able to direct you. JG 1.28.09
Answer: after it has been done for awhile. How often it will need to be redone varies from person to person. It would be much less often than waxing. JG 1.28.09
Answer: there will be nothing effective without downtime. I think for the lines and excess skin around the eyes it might be a completely ablative CO2 with possibly some surgical skin excision in some cases. Restylane can be used in some cases to plump up a deflated lateral brow. A filler there should not cause more or faster skin loosening. JG 1.28.09
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 1.28.09 http://www.surgery.org/public/findasurgeon.php.
Answer: average diameter for an areola is 4 centimeters. JG 1.28.09
Answer: you only need to change them if there is something wrong with them, no need to just change them out. Due to potential known side effects though, about 24% of the time there will be more surgery required later for a variety of different reasons. Risks are slightly higher with larger implants but not$ with shape. The titanium covered implants are not out yet, no one knows if they will be released and no one knows if it will cut down on re-operation rates. JG 1.28.09
Answer: it is a lip lift or vermillion roll. Not all patients are candidates and there are limitations with it. Most plastic surgoesn will do it if it is indicated. Healing time is a few weeks. Risks depend on which technique is used so I think after you meet your plastic surgeon those issues can be addressed.JG 1.28.09
Answer: it is called a tip rhinoplasty. In general it is safe. Usually the nose might get larger with time but it is due to the skin getting thicker and more surgery will not help that. Cost will vary from surgeon to surgeon so you need to choose a surgeon and see. JG 1.28.09
Answer: yes, the cuts are on the inside and it is called a closed rhinoplasty. JG 1.28.09
Answer: Macrolane is not legal in the US. Hormones tablets also do not work and are potentially not safe due to potential issues with breast cancer. Most men that have grown breasts in terms of the transsexuals have had other injections or sugery to enlarge them. Sorry. JG 1.28.09
Answer: months to grow back, not years. It will likely be softer and maybe a little lighter. It is done by specialists in electrolysis that are not doctrors. JG 1.28.09
Answer: well, the truth is there is nothing permanent in hair removal, electrolysis is likely the longest lasting though. It will take many sessions though I am afraid. Best of luck and thank you for the kind words. JG 1.28.09
Answer: In most cases the ptosis repair can be undone if not too much time has passed. Ideally if it has to be revised they can fix it to the desired correction at that time. There usually is no muscle cutting, instead it is suturing of the muscle to the tarsal plate or cartilage of the eyelid. I think if you see an experienced surgeon that you should not be scared to have it fixed. Best of luck. JG 1.27.09
Answer: that is not correct if it is done properly. At first you will likely not be able to close but the lid should be able to close when relaxed afer a few weeks. The risks of ptosis surgery are under or overcorrection, so it is best to have someone do it that does alot of it to make sure the very thin muscles are adequately treated. Both plastic surgeons and eye specialists can do it if they are well trained. JG 1.27.09
Answer: I would wait at least 2-4 weeks to let the fluid from the injections be absorbed. JG 1.27.09
Answer: it will not dissolve it but will disperse it so it would be thinner. I think after that time it will likely not be as effective. I think after 4-6 weeks any saline inejctions will be difficult to use. JG 1.27.09
Answer: well, the surgery is best for skin excess and tissues that have fallen or dropped that are below the surface of the skin, the lasers are to improve the quality of the skin, little fine lines, not to tighten loose or excess skin. Therefore, what you need depends on what you have. The Radiesse lumps might be able to be removed with the surgery. Nothing special you need to tell the surgeon besides that the lumps are there. I might be able to give you more insight as to what I would recommend if I saw pictures of your face. Please feel free to send them to drgarcia@lvcosmeticsurgery.com JG 1.27.09
Answer: well, a cheek lift and neck lift would help, if that is what a lower facelift is to you, then that would do the job, it would just not improve the forehead or eyes is all. I do not think the fillers being in place would make the operation any different. Best of luck and bundle up. JG 1.26.09
Answer: It might, yes. The problem is there is likely some loss of tissue and that will not be repaired with lifting it. JG 1.26.09
Answer: well, if he has proof that it works he should publish it in a medical journal because I see no way that he can claim that. Likely no harm though. JG 1.26.09
Answer: it involves the reattachment of the levator muscle to the tarsal plate of the upper eyelid. I think you might want to get a second opinion from an opthamologist in your town to explain the issue to you better, but it can be don by a plastic surgeon who is trained on how to do it. Best of luck. JG 1.26.09
Answer: no, there is no maintanence for all of them regardless of size. I think both silicone and saline implants are both safe. JG 1.25.09
Answer: it sounds more like you need a ptosis repair of the upper eyelid and not a brow lift. Juvederm will not elevate the lid but might fill in the hollowness. Best of luck. JG 1.24.09
Answer: not approved in the US, it appears to be an option but no word on how long it lasts though. JG 1.24.09
Answer: yes, it does sound like a spasm. I think a low dose of Botox is OK to try. I will also say that stress can make spasms better. JG 1.24.09
Answer: hydrodissection is the process of lifting or seperating tissues with the injection of fluid. The sooner after the injection the better the chance for it to work. JG 1.24.09
Answer: there is a chance that it will dissolve, yes. If the saline is injected soon and right into the lump it can hlep, but it does not work all the time. In most cases a touch up of the Sculptra is needed after one year but not as much as was first injected. Technique and age of patient also determines the result and its length. JG 1.24.09
Answer: hang in there. JG 1.24.09
Answer: all the best,see you soon. JG 1.24.09
Answer: well if it is a clump of the Sculptra powder, in theory it could get large in time, I would sugggest you see your injector for a possible injection of saline into the lump to attempt to break it up to prevent future issues. I think after this amount of time you can stop the massaging as benefits will be very small now. Best of luck. JG 1.23.09
Answer: best of luck. JG 1.22.09
Answer: to some degree yes, not much else you can do. Again, I do not think you have fullness from the Sculptra at this point, it would take 3-4 months for that to build up, you have mostly swelling at this point. JG 1.22.09
Answer: yes stop those too. JG 1.22.09
Answer: follow all of his instructions and apply ice, best of luck. JG 1.22.09
Answer: the skin will not stretch out on a permanent basis from the injections. JG 1.22.09
Answer: I would not make that assumption for another 3-4 weeks, most likely it will all get better.JG 1.22.09
Answer: it is common and almost expected to have a smaller eye aperture after a canthopexy unless it is so mild that it almost was not needed to be performed, it has to happen, it is not a matter of sometimes, it geometrically happens. About all that can be attemtped is to cut the canthopexy sutures and release the scar tissue to hopefully allow the tisseus to go back to where they used to be before. You should not have an owl look unless too much skin was removed at the same time as the canthopexy. Hard for me to say more without seeing the before pictures and understanding why they did the canthopexy to begin with, but it is very rare to do on a person your age I must say. All the best. JG 1.20.09
Answer: I likely would not do it for at least 4-6 weeks as at five days it is usually due to swelling and not uneven Sculptra. The issue with problems can arise anytime it is injected, with any filler for that matter. JG 1.19.09
Answer: I would go see the doctor and see what was injected thre, in either case, massage should help make it smaller or go away in most cases. JG 1.19.09
Answer: could be they did not dilute it as much, could be they injected it deeper. Hard to say. Having it diluted from last week does not make a difference with what you are speaking about though. Best of luck. JG 1.19.09
Answer: the area right in front and behind the ears is usualy the last. I think at 4 weeks there is still lots of swelling that seeing it uneven is normal but will get better with time and some light massaging. All the best. JG 1.18.09
Answer: if you are going to seperate them maybe 3 months or so. As to scar reduction creams, we use ScarGuard, and start it 48 hours after the sutures are out. Best of luck. JG 1.18.09
Answer: at least 6 weeks. JG 1.15.09
Answer: it can but it can also be uncomfortable to get the injections and also uncomfortable if they get to an area during the surgery where you are not nnumb. JG 1.14.09
Answer: does not last, would not do it, if the thereads break you will look lopsided until the other side breaks. JG 1.14.09
Answer: sure, the old fashioned skin only facelift, still done, especially on repeat facelifts. JG 1.14.09
Answer: about 31/2 to 4 hours, it takes longer to do under local anesthesia because if you get to any area where the local anesthesia is not adequate, you need to stop, inject and then wait. JG 1.12
Answer: no, that is not true. The risks of hematoma are not affected by those issues, but the risk of hematoma is there for all surgeries, it is about 1-2% in facelifts, a little higher in males. JG 1.12
Answer: no, sedation does not make it require less local anesthetic but you are more comfortable while it is being done and the injections hurt much less. I have doen facelifts under local with sedation. Also, the end result is up to the surgeon. The LifeStyle lift is a procedure that is marketed as something unique when in reality it is not, it is all marketing, any surgeon can do similar things and just not call it that. Also the name of the procedure is no guarantee as to the result, results vary between surgeons, so just because the results look impressive from the examples they show does not mean the surgeon you are going to use will give you those types of resutls. Best of luck. JG 1.11.09
Answer: the degree of skin tightening is impossible to tell without examining you, if it is just the bands, then the skin might not need to be removed but the looser the skin is to start then the greater the length of the scar required to fix it. I think the vast majority of the time some skin removal will be needed in a few years if not done now. JG 1.11.09
Answer: I will comment on the Lifestyle Lift but I will do so carefully as I have a received threatening letter from the company for some comments I have posted here previously, so lets’ look at what everyone can see and read. Let’s look at what the site says. This relates to what was on the site a few months ago, so they may have changed it. They claim 60,000 clients, that sounds great, but is like saying there were over 300,000 liposuction clients in the US alone last year. You want the surgeon to have the experience, not the procedure itself. Procedures do not have experience themselves, it is the people performing the procedure that glean experience. It is a procedure done maybe that many times in its existence but not by a single surgeon. I see no documentation that a single surgeon has done that many it appears and the results of any surgical procedure will vary from surgeon to surgeon. The pictures shown reveal the before pictures with the patient in many pictures pulling their chins back which makes their skin more loose and then in the after pictures they are showing pushing their chins forward which makes the skin look tighter. Also when a patient is smiling, like in the after pictures, that lifts the tissue and skin higher and when you do not smile, like in the before pictures, the skin and tissue look looser. This lends itself to making the results look more dramatic than they are in real life. The pictures also do not say how long after the procedure they were taken so we have no idea as to how long the results last for. Local anesthetic, OK, can be true, but what happens when you feel pain and they have already used the maximum safe amount of local anesthetic. The statement that some people do not look like yourself for months or years has nothing to do with the anesthetic but with how tight your surgeon pulls the skin, not on the individual procedure performed, it’s more on how the surgeon performs the procedure. All medical offices also have to abide by OSHA so that is nothing unique to them. There are national organizations that certify and accredit office operating rooms but OSHA is not one of them. The non-use of sedation or general anesthesia also allows other issues, for example in some states if you have a complication from a surgical procedure performed under sedation or general anesthesia you have to report it to the state medical board, but if the complication happens when done under local anesthesia it does not have to be reported. Also, at times doctors perform procedures in their offices under local because in some cases they are not granted privileges to perform the same procedure in the hospital or surgicenter due to their lack of training or background. Sure, doing it in the office is less expensive for the patient, and it is also less expensive for the surgeon too. Awake and relaxed, maybe for some but what about the people who are nervous and fidget or move when the feel something that hurts, all while the surgeon is cutting tissues. Immediate results, well any plastic surgery procedure has immediate results but you are not presentable immediately in terms of what you look like because of swelling and bruising. There is no documented advantage to local anesthesia over general anesthesia in terms of how fast you look presentable. Certainly the less surgery you do in terms of lifting and supporting tissues leads to less swelling and bruising, but it also leads to less effect and less long lasting improvements. Overall, I think you will need to make you own decision but I cannot endorse or recommend the procedure as being anything different than what has been out there for a long time, just not referred to by a catchy marketing term. Caveat Emptor. JG 1.11.09
Answer: for a fraction of the people that have minimal sagging, it might work, but I will tell you, it is nothing new, it was first done in 1921 and the guys now are trying to make it sound like it is something revolutionary. I think though, since it is a smaller procedure, not only is the degree of improvment less, but it wil therefore last less time too. Best of luck. JG 1.10.09
Answer: no way to tell becasue pain tolerance is individual, typically the forehead hurts more than the face and neck and both are easily controlled with pain pills. Most patients are back to full activity in 4-6 weeks. During that time there is some swelling and bruising but you look fairly presentable after two weeks. JG 1.8.09
Answer: well, it is a good idea and most people will not do it anyway as they are stiff. JG 1.7.09
Answer: sounds right, eys. I agree with you about the shots, hang in there. JG 1.6.09
Answer: the eye not closing is usually due to the upper lid so that sounds rigth. As to the cortisone improving redness after a laser, sorry, will not help and might actually create new visible red blood vessels from thinning the skin and wil slow the healing. I think the ridge will likely get better, but localized shots of cortisone do not help localized swelling, I fear it is an attempt to just do something to pacify you. Best of luck. JG 1.6.09
Answer: I do feel massage helps, yes. You are probably more critical of yourself than others too. Wait and see your surgeon tomorrow and see what can be done. Best of luck. JG 1.5.09
Answer: they should not hurt, not sure what it will do for swelling though, it works for scar tissue but not for localized swelling. Massage is always up toward the top of the ear, best of luck. JG 1.5.09
Answer: the trampoline platysmaplasty is a made up name, trying to make it sound new and improved. The length of time that the neck lift wll last will depend on your tissues, the degree of improvement will be controlled by the technique used. So it might be a shorter technique but might not last any longer if as much as more traditional techniques. JG 1.4.09
Answer: ask to speak to his patients, ask other doctors in the city to see about what they think, ask to see pictures, those are good ways to find out a little more. JG 1.4.09
Answer: sorry, but no, never. JG 1.2.09
Answer: I think the cream is good to start and the vinegar slution is OK if it is OK with your doctor. The vinegar only helps remove the dead skin though, it will do nothing to fade the pinkness, that only comes with time. I am sorry but it is impossible for me to tell when your eyelid will close completely, it all depends on swelling and the amount of skin removed. Usually once the splint is off we allow the glasses to be worn. Best of luck. JG 1.2.09
Answer: well, typically that area is where the most dramatic changes are seen in most traditional facelifts. JG 12.31.08
Answer: well, I am not sure what you are calling a lower facelift, a jowl is made of cheek tissue that has fallen and hit a watershed ligament that casues a fold and allows the skin to fall onto the jawline. In some cases a cheeklift will fix that, in others it might take a necklift and cheeklift together, which is a traditional facelift.This is most commonly what is needs to be doen to leave a balanced and harmonious result. A traditional facelift does not include the forehead though. Hope that helps. Pictures can help decide, yes. All the best for the New Year to you also. JG 12.31.08
Answer: did not sre the question but those ridges are normal and they will usually flatten out in about 4-6 weeks after the surgery. JG 12.29.08
Answer: 4, maybe 6 weeks of cheek swelling that is visible. I think the risks are actually higher though, cutting skin is low risk, in this case they are lifting all of the tissue off of the bones of your cheek and repositioning them, they will be right by the infra-orbital nerve which is never exposed during the regular procedure, also the lifting and re-securement of the tissues can lead to uneven smiling and lip closure in some patients on a temporary basis. JG 12.29.08
Answer: I stil think the failure potential is there because of the need to use sutures to attach it to the screws. JG 12.29.08
Answer: not sure what you are describing as a lower facelift but if it is a face and neck lift, those incisions are typical, it just does not lift the forehead. Not uncommon for a ridge to be felt where the sutures were placed into the muscle, that goes away in time though. Best of luck. JG 12.31.08
Answer: not sure how they will support it unless a higher incision outside of the mouth is made. Merry Christmas and Happy New Year. JG 12.27.08
Answer: they only thing is that in mild sagging the smaller procedures work well, and in severe sagging they do not, so if the patient is a candidate for the smaller procedure, it should be fine. Merry Christmas and Happy New Year. JG 12.27.08
Answer: I think the helaing is just as long as a facelift as the tissues need to be lifted off of the bone, there is a possibility that it might help the hollows but the chances are slim, I have been unimpressed with the longevity of midfaclifts too. I know some people use screws, but is is not the screws that fail, it is how you attach the tissues to the screws, that is with sutures, and they are what fails. The incisions are typically about 4 inches in your scalp hair. Best of luck, but remember I warned you. Merry Christmas and Happy New Year. JG 12.27.08
Answer: I do not think it will make much of a difference if you are set on having both, might suggest the facelift though because you might find that it has given you enough and you might not want to proceed with the browlift. Merry Christmas and Happy New Year. JG 12.27.08
Answer: sorry, no personal knowledge. JG 12.19.08
Answer: no, it is all done together. JG 12.18.08
Answer: well, that is really a personal decision, but most of the swelling from the forehead lift will be gone in 4-6 weeks, so maybe after that would be OK to proceed. I wish you the best. JG 12.18.08
Answer: no difference, together or alone. JG 12.16.08
Answer: normally the fat that has fallen into the jowl is not removed but repositioned into the cheek where it originally came from. JG 12.15.08
Answer: well, a neck lift only pulls back so in most cases there needs to be a vertical pull which means extension onto the cheek, and a cheek lift and a neck lift together is a facelift. JG 12.15.08
Answer: I would not do it at the same time as the heat might accelerate the dissolving of the filler. I also see no reason of doing fillers on the nasolabial fold as normally the fold is lifted during teh facelift, unless they are trying to do a lesser facelift procedure procedure. I would wait 4-6 weeks for the filler. JG 12.14.08
Answer: no, I am sorry, I am not a believer, I used to have a machine and got rid of it as I and most of the patients were disappointed with the results. Save your money. JG 12.14.08
Answer: all normal, with time and masage it will all loosen up, but it can take weeks to release itself from the underlying tissues. It is adherent because the initial scar connects all the tissues from which the lipoma was removed, as the scar tisue matures it releases into seperate layers and all should return with time and patience. JG 12.14.08
Answer: OK, lets try again. There are two ways to treat the SMAS, it can be lifted seperately and sutured, or it can be imbricated. Either technique can be done when doing a regular facelift or a mini facelift. When I said that an imbrication is similar to a traditional facelift, I was referring to the SMAS seperation versus an imbrication. A mini facelift with treatment of the SMAS will last longer than a mini facelift with no treatment of the SMAS, but a mini lift with SMAS treatment will not improve as much or last as long as a regular full facelift with a SMAS treatment. JG 12.14.08
Answer: Retin-a and laser might help, but I would never had expected a mid facelift and lower eyelid surgery to fix any crows feet issues. Not usre about the lymph nodes though. JG 12.14.08
Answer: I think it is unrelated to the surgery due to time. JG 12.13.08
Answer: minilift will help the cheeks but not the neck, so you might be able to get away with just a minilift if the neck is in good shape. JG 12.13.08
Answer: well, a minilift will not give you the same result as a full facelift, your PSP at the time of a minilift will last longer than a skin only minilift though, but do not expect full facelift results with a minilift using the psp. Whether you are ready for a full facelift or just a minilift is the question I guess, no way for me to tell without seeing you in person I am afraid. JG 12.13.08
Answer: well, I get the SMAS plication from the sp, but what does he mean by the first p? If no skin is being lifted or removed and the first p stands for percutaneous, I would recommend you find a different surgeon. Any treatment of the SMAS will last longer than a procedure with no treatment of the SMAS, but the skin removal is key and I am not sure what he has planmned. I will say that the term psp in not a common term used in our profession of plastic surgery so he might be trying to use it to make it sound like soemthing unique. The only psp I know of is made by Sony Play Station! JG 12.13.08
Answer: yes, the aging process is not halted and in people with poor tissue quality, since the jowl is the furthest away from where the tissues are lifted or removed, it is the earliest to come back, the older one is the faster it comes back. Also the lesser invasive the technique used, the faster it will come back. Younger people with a correct technique will get 5-10 years before a repeat procedure is warranted. JG 12.13.08
Answer: well, at our national meetings we have a panel every few years of patients done by the world authorities on the various techniques and although the deep plane lift takes longer to heal, at one year the differences compared to the other techniques is not visible. I guess I need a clarification as to what your surgeon is referring to when he says psp. JG 12.12.08
Answer: I think I need to have you describe what you aee calling a traditional facelift for me to answer your question effectively. In many facelifts, the SMAS layer is treated,but not in all, it can be lifted seperately and tightened or it can be just imbricated or folded over. If the facial fat has been lost then imbrication is better, and typically imbrication is safer than lifting the SMAS as a seperate layer. SMAS treatment can be done during a a regular facelift or a mini facelift. A mini faclift with SMAS treamtent does not equal a full facelift with SMAS treatment though. JG 12.12.08
Answer: correct, but that is assuming the traditional facelift lifted the SMAS, in other words, the different techniques of tightening the SMAS lead to little difference. If it was a skin only facelift, then any treatment of the SMAS will give a longer lasting result than a skin only facelift. Hope I made myself mroe clear this time. JG 12.12.08
Answer: it is away of supporting the tissue beloe the skin, lots has bene written about it but when compared to other more traditional facelift techniques, at one year the differences are small and at 5 years they look the same. It is less risky than a SMAS elevation though. JG 12.12.08
Answer: well as long as it is not a fractional CO2, it is OK, otherwise it will not be stong enough. As to the lower eyes and the TCA,I do not feel the wrinkles will go away, it will look better while swollen is all. I think a light CO2 would be better, yes. The time element seems about right. Not anything to be worried about as long as you are healthy, best of luck. JG 12.3.08
Answer: that is correct, not everyone will get them. If they are tightened they usually do not hurt after that, they are tightened by sutures being placed. JG 12.3.08
Answer: if they are visble, then tigthening them is a good idea and should be part of a neck lift if required. They will not show in all patients though. JG 12.2.08
Answer: the incision is likely only for the liposuction, if they were going to tighten the muscles of the neck in the center the incision would be longer, but it is possible to do that. JG 12.2.08
Answer: well it has the weakest concentration of Retin-A sold by prescription, I do use such mixtures for my patients but at higher concentrations of the ingredients. JG 11.25.08
Answer: I am sorry but there is no surgery I can recommend to you for your conerns, none of the things you mention will help in my estimation, sorry. JG 11.25.08
Answer: lots of prayers is about all I can suggest.I think if soemthing goes wrong, what can be done will depend greatly on what exactly went wrong, some things cannot be undone. JG 11.25.08
Answer: I persoanlly do not have a license to practice in Australia, I only know a small number of surgeons there, if you email me at drgarcia@lvcosmeticsurgery.com with your concerns I might be able to help you. JG 11.25.08
Answer: will not do it, save your money. JG 11.25.08
Answer: well to be honest, I know lots of celebrities and in person their skin is no different than most other people, it is alot of make up and computer enhanced photos. No magic potions. JG 11.25.08
Answer: I ma laughing out loud, thanks. JG 11.25.08
Answer: I would not use Gortex nor Aquamid, I usually use Restylane for the lips, and I do not recommend fat injections either. I would not suggest anything permanent be attempted for fear of long term problems. JG 11.25.08
Answer: either an open or a closed technique can be used with success. JG 11.25.08
Answer: in general, the larger the implants the greater the risks. JG 11.25.08
Answer: I would not recommend any type of thread for lifting without a full facelift being done at the same time. JG 11.25.08
Answer: stop the Retn-A and use a god moisturizer, it should all get better with time and should not be permanent. JG 12.1.08
Answer: the filler cna be done after the lift, no difference. JG 11.25.08
Answer: I am sorry but I know of no safe permanent fillers for the lips. JG 11.24.08
Answer: yes, they can. JG 11.22.08
Answer: the lower cheek wrinkles will be improved some, but fine lines are a skin quality issue not a skin quantity issue and surgery improves more quantity than quality. JG 11.22.08
Answer: the microlaser will not improve the peelies and I think one should wait at least 6 weeks after the surgery to have it done. I think MLP will not diminsh many wrinkles, its effects are very mild. JG 11.22.08
Answer: well, nothing is totally safe, the lighter you go, the safer, but the less improvement, maybe you should just consider some Retin-A for now. JG 11.21.08
Answer: well I am truly impressed if he personally has done thousands of them, but I guess that is a remote possibility. I will say that if he has done that many, either he has seen your problem numerous times before and coudl have predicted it happening or he is not being truthful. I would go see see another surgoen. His claims do not ring true to me. JG 11.20.08
Answer: I feel it is safe, yes. The speed with which it works can be a couple of weeks or more for the flashes and emotional issues. JG 11.19.08
Answer: all the sutures will break eventually, but if they break months later once the tissues have healed in their new location, that will not cause it to fall, it will fall due to aging. If the sutures fail early on then in that case the tissues will fall much sooner and faster, but that is in the first few weeks or so only. Hope that explains it a bit more clearly. JG 11.18.08
Answer: results will vary from patient to patient, due to the amount of strength of the pull, the amount of tissue that is lifted, and how long the elevation lasts in place. I might suggest seeing someone else for a different opinion. 11.18.08
Answer: it is usually a series of treatments, no way to tell how many it will take, the worse they are the more tmes it will take and in time they all come back, the sclerotherapy is the injection of an irritating solution in an attempt to cause the blood inside of the vein to clot and close off the vein fr a period of time. 11.18.08
Answer: eventually gravity wins and the tissues fall back down, yes. After a few months, once the tissue have re-adhered, the future descent should be pretty even. All the best. 11.18.08
Answer: I would stay away from oral bios of estrogen or testosterone, yes. By bio-identical I mean what the end result is, an exact replica of nature, they are manufactured from different sources, but as long as the end result is biologically indentical, that is the thing. Most patients feel beter in 2-4 weeks, but they continue to improve for longer than that. The only reported increases in blood clots have been with synthetic estrogens delivered by oral methods. JG 11.17.08
Answer: well if you can stay off the oral methods and use what they call bio-identical, that would be the best with the least risk in my opinion. All work about the smae speed and the worse you are feeling to start off, in general, the faster you start feeling better, best of luck with everything. JG 11.17.08
Answer: as long as the infections are resolving, if they are getting worse or not improving I would postpone it. JG 11.16.08
Answer: I think some rearrangement of the facial skin is required to avoid pleating in front of the ears. I think age is certainly one consideration in surgery, but it is really more to the physical deformity. I do not think there is anythig non-invasive that will yield a worthwhile attempt. JG 11.16.08
Answer: no, no negative effect at all. JG 11.14.08
Answer: personally we do not use any headgear for that. JG 11.13.08
Answer: when I mention CO2 laser it is the completely ablative,non-fractional laser, if I ever comment on a CO2 laser that is fractionated I will say it is a fractional laser. Hope that clears it up. JG 11.13.08
Answer: well, it might be able to be done short term, but you at times can pull the scar downwards and in time it will rise back up to where it was, hard for me to tell without seeing you in person. JG 11.12.08
Answer: it is a good product. JG 11.10.08
Answer: the leg issues sound like some early varicose veins, might improve with some sclerotherapy, as to the hands, it can be due to loss of fat in the hands that maeks the veins look more prominent, can consider Sculptra to make your hands look more plump. JG 11.10.08
Answer: well, since I am one of the few that is a memeber of both, I can honestly say that one is no better than the other for facial issues. JG 11.10.08
Answer: we use ultrasound massages to help swelling and it might be something you cna look into to soften the area faster. Best of luck. JG 11.10.08
Answer: I do not think the temporary screws work any better than other methods of fixation and was abandoned years ago except for a small number of physicians. The removal of the screws adds little to nothing to more swelling though. In my experience and with what I have seen in major plastic surgery meetings that type of fixation is no better and as to longevity, it might last ten years in some and it might last less than a year in others. Best of luck. JG 11.10.08
Answer: it is a plasma Portrait procedure by Rhytec, it is a skin ablative treatment, not a true facelift. JG 11.7.08
Answer: because supporting the tissues after they are elevated off of the bone can lead to the sutures not holding and the tissues pulling down, even the guy who invented the operation claims a 15% complication rate. The most common complication is the lower eyelid to be malpositioned. JG 11.7.08
Answer: it will likely last a few weeks, it is a scam and that is why the threads were taken off the market for percutaneous use. Complications are no result, one of the sutures breaking and not the other so you are uneven, and also that of the sutures poking out through the skin or leaving a visible line in the cheek. JG 11.6.08
Answer: actually there is very little skin removal and more of a repositioning of the deeper tissues. Midfacelifts in general do have longer swelling due to the fact that the tissues are elevated off of the bone in order to perform the midfacelift and causes more swelling for a longer period of time than a regular facelift or mini facelift. JG 11.5.08
Answer: save your money. JG 11.4.08
Answer: limit the motion for about one month. It does feel tight but it is a short term thing, I think limiting motion lets the incisions heal better. JG 11.3.08
Answer: yes, it is OK to do that. It should not cause anything bad. JG 11.2.08
Answer: no, a facelift will help the cheek and neck areas only. It would require either eyelid surgery or a foreheadlift. JG 11.2.08
Answer: well, it is alot of surgery, yes, but could all be done at the same time if you are healthy. Likely the most uncomfortable thing will be the laser around the mouth. JG 11.1.08
Answer: usually in the crease of the ear, but understand that when draping the skiin, if there is enough skin that is tightened to create a pleat at the earlobe, there will need to be a scar in front of the ear too. The neck lift scar can at times be seen when wearing a ponytail, yes. The liposuction incision is about 1/8 of an inch. Best of luck. 11.1.08
Answer: the time involved varies from surgeon to surgeon, no way for me to tell, sorry. Sutures are usually left in place for one week. I would not use Ibuprofen for two weeks after the surgery. We allow light walking in two weeks, normal exercise in one month. There is no less invasive procedure that will remove loose skin of the neck. I think I would wait until after the procedure to do the filler so it can be placed in the correct position after the skin is redraped. JG 10.31.08
Answer: would avoid the injections if at all possible to avoid any permanent tissue loss, I think time and massage is all I would do. JG 10.31.08
Answer: gingko has been reported to cause excess bleeding so it should be stopped two weeks before and after surgery, also need to avoid Vitamin E over 400iu daily. JG 10.30.08
Answer: well, that might be his opinion, most surgoens say one month. JG 10.23.08
Answer: not really, Renova has a moisturizer in it is about all. JG 10.22.08
Answer: well, the scars directly in front of the hair will eventually fade and it avoids an unnatural displacement of the hair, as to the nerve damage, that is not true. As to the scars now, if they are red I might suggest some YAG laser sessiosn to help fade the redness is about all I can suggest, best of luck and give it some time. JG 10.20.08
Answer: they are capitlizing on people`s hopes and desires. Profits at times drive practices. JG 10.19.08
Answer: the length of time it will last varies, but I usually tell my patients 5-10 years if there is minimal weigth fluctuation. I think if all else looks good and it bothers you, it is certianly OK to proceed and enjoy the advantages while you can. I am a firm believer in only operating on what is broken and if the rest of it looks fine, then leave it alone. Botox can help to some degree when utilized by an experienced injector but the length of time and degree of correction is relatively mild and might need a filler in addition and will do nothing for the neck. Downtime for the necklift is about 14 days of light activity and full activity after one month, best of luck. JG 10.19.08
Answer: a common way to perfrom a facelift. It should age normally so that it will not look abnormal as time passes. JG 10.19.08
Answer: that is correct, the balloon fits in the back of your throat, I have done many lases around the mouth with it in place. JG 10.19.08
Answer: 5-10 years most of the time. JG 10.18.08
Answer: no, a laryngeal mask is used and that protects the airway without requiring a tube in your windpipe. It kooks like a mask but fits inside of your mouth, it should not be anything like the original surgery you describe. JG 10.17.08
Answer: correct. I think in time the tissue might sag, no way to tell though right now. The aging from now on should look harmonious as you age too. JG 10.17.08
Answer: it can be avoided if one wishes, yes. JG 10.16.08
Answer: a couple of days after the sutures are out. JG 10.15.08
Answer: B and C vitamins are OK, the Omega 3 fish oils and Vitamin E need to be stopped two weeks before as they increase bleeding, also avoid any OTC products that thin the blood like aspirin, Motrin, etc. Best of luck. JG 10.15.08
Answer: cheek pad repositioning should not affect the lower lid at all as long as they do not access the cheek through the eyelid incision. JG 10.15.08
Answer: well some swelling is normal, by this time the bruising should be gone, the bruising is a sign of maybe more bleeding post-operatively and that can contribute to a longer period of swelling. As to not looking better, I suggest giving it 3-6 months to settle in and then speak with your surgeon, all the best. JG 10.15.08
Answer: hard to say wihtout seeing your before and after photos but it might need more surgery to rebalance things out. JG 10.11.08
Answer: a necklift will not include the jowl, that typically needs tightening of the cheeks and a cheeklift and necklift together is called a facelift, the forehead is not part of a facelift, it is either called a forehead or a brow lift. The length of the incision is controlled by the amount of skin that needs to be removed, the more skin, the longer the incision. JG 10.11.08
Answer: they will not hurt, will not work as well as the physical therapy units, but worth trying. Best of luck. JG 10.11.08
Answer: I have heard of it but I do not think it would make much difference, ultrasound would as it tends to generate heat and dissolve some of the clotted blood, but the TENS units are mostly for pain control and muslce issues which are not the case with a hematoma. Hematomas commonly look worse with time because it can take quite a while for the blood to seep to the more superficial layers to be seen. Give it some time. JG 10.10.08
Answer: I think 10-14 days is enough to wait. JG 10.6.08
Answer: it will not affect the surgery in any way. The marionette lines will likely improve more after the facelift than the nasolabial folds will. JG 10.3.08
Answer: I think minilifts are fine, but I think having a quicklift, where it is claimed to have been done thousands of times as a proocedure but the pictures shown are not of the doctor you will be having perform the porcedure is unethical marketing, the AMA frowns on patented surgical procedure. The company refuses to publish any article in legitimate medical journals explaining what the quicklift does that is so superior. In short, if you want a minilift, go see a plastic surgeon and skip the hype of the Quicklift. JG 9.29.08
Answer: I am sorry but I do not perform the Quicklift nor do I recommned it. JG 9.28.08
Answer: it is a release of the skin from the underlying muscles in that area, usually a filler is placed into the space that is created to slow the re-attachment of the skin to the muscle, it might cause the filler and improvement to last a bit longer, but nothing dramatic. JG 9.26.08
Answer: no, and I do not and do not plan and performing it anytime in the future. JG 9.25.08
Answer: as to being happy, most people do not get on message boards unless there is soemthing they do not like, so getting the impression that most people are not happy is an inaccurate assumption, statistics show that there is likley greater than a 95% satisfaction rate with plastic surgery doen by true plastic surgeosn. I am unaware of the statistics of those being done by non-plastic surgeosn doing palstic surgery as that has not been studied. As to the aging process, it is correct that nothing can be done to stop it, and depending on what is chosen to reverse some of its effects, it could but should not casue side effects that are worse if careful thought and decisions are made. If I did not see an overwhelming number of patients being happy I would not be doing this specialty. I will say though that as time goes on with the public`s misconception of appearance, generated by unrelaistic images in magazines due to computer enhancements and the stress to look better, some patients get some doctors to do things that should never be done, and then it leads to dissatisfaction. In general, the patient expectations today are hugely more unrealistic than they were 20 years ago. I also blame the surgoens for not learning how to say no to patients too though. JG 9.24.08
Answer: the swelling can be causing it, I might suggest some massages to help the swelling resolve. JG 9.20.08
Answer: I think the moisturizer you asked about would be a good choice. JG 9.20.08
Answer: it depends on how hard you pull and in what direction you pull on teh skin also. Thank you for the kind words too. JG 9.16.08
Answer: I personally think it is a waste of time and peels in African American skin have to be very light and that will not help wrinkles. Could try some very light glycolic acid peels is about all. JG 9.13.08
Answer: I think you need to ask your own surgeon, we never use dressings of any sort on our facelifts as I feel they aggravate the swelling and can irritate the skin as you say. JG 9.13.08
Answer: sounds like you need the facelift essentially redone to improve all of those areas. JG 9.11.08
Answer: it is a large operation that lifts all of the tissue of the face at a very deep level, it has associated prolonged swelling and after one year the results are not any better than other types of facelifts where the tissue are lifted in different ways. The natural look comes from how hard you pull on the skin is all, that can be controlled with both techniques. JG 9.10.08
Answer: lots of negative hype from people that do not do facelifts to get people to do the treatments that they do. JG 9.10.08
Answer: I suggest giving it about one year to let all the tissues soften so any further surgery can be as effective as possible. It can be done likely through all of the previous incisions. As to why the sagging is coming back so soon, it can be because your tissues are too weak and do not hold up, or the sutures that were placed to lift the tissues broke, hard to tell without seeing you. Wish I had more. Best of luck with everything. JG 9.9.08
Answer: an S-lift is essentailly a mini facelift, or a cheek lift, the S comes from the apparent appearance of the shape of the incision used, it usually involves some type of suture placed to lift the underlying tissues like a purse-string, it goes by other names such as a short scar facelift, J-lift, cheeklift, and many others. JG 9.7.08
Answer: very difficult, it might be able to be fixed if the nerve connections can be found and then cut, but like I said, not easy. JG 9.7.08
Answer: I think it is an attempt to make somethng sound new when it was originally described in the plastic surgery literature over 75 years ago, so its nothing new. JG 9.7.08
Answer: it should be, yes. JG 9.6.08
Answer: you will always be ahead of the aging curve even if you only have it done once. JG 9.3.08
Answer: the lip lift can be done in a couple of different ways, to lift the upper lift alone or a corner of the mouth lift, I will say that looking grumpy will need at least the corner of the mouth lip that leaves scars from the corner of the mouth to the nasolabial fold but in some caes even that is not enough if the cheek tissues are too saggy. JG 9.1.08
Answer: in most cases in experienced hands when doing the canthopexy during a cheek lift the eyes don`t get smaller as it is only done to support the lower eyelid and avoid a pulled down lid.Best of luck. JG 8.31.08
Answer: it might, as to giving a good result, if you have minimal sagging,it can be. To make the answer short, I do not perform midfacelifts through the temple or the eyelid incision, if you think about that, you can likely guess I suggest you not have one done that way if I am not willing to do it that way. JG 8.29.08
Answer: in the crease in front of the ear, like a facelift. JG 8.27.08
Answer: I lift the cheeks from an incision in the crease of the ear, just like a facelift incision. JG 8.27.08
Answer: mid facelift, yes, I do not perform that procedure from the eyelid access because even the surgeon who invented is has a 15% complication rate with the eyelids being uneven or pulled down. It sounds like a small procedure but actually it is pretty invasive once they get under the skin. JG 8.27.08
Answer: that would be a forehead lift, same thing as a brow lift. JG 8.27.08
Answer: It cna usally be done through the same incision, JG 8.28.08
Answer: maybe 5-10 years, the older the tissues are the less time it will last. JG 8.27.08
Answer: the eyelid incision gives more extensive exposure so it likely would be more of a lift. JG 8.25.08
Answer: most likely they are dissolvable. If they are permanent sutures and continue to give you concern they can be removed, yes. I would say it is not common but not unheard of. Warm packs and massage might help it all dissolve. Best of luck. JG 8.25.08
Answer: the Parotid gland is different from the cheek fat pad. There is nothing safe that can be done to minimize the parotid gland. A cheeklift will not reposition or alter the parotid gland. JG 8.25.08
Answer: there is nothing else that can be subsituted. Just because the lift is only done through the temple does not mean that the canthopexy will be required, it is a matter of the cheek tissues and how they are lifted, not where the incision is. JG 8.25.08
Answer: it can be from tissue being removed, it can be from not enough tissue being removed in the adjacent area, it can be from the pull of the skin, it can be from the skin scarring to the underlying tissues. I think fat injections do work in many people, but without knowing more clearly what is the casue I really cannot tell you much more. If you want to send me a picture to drgarcia@lvcosmeticsurgery.com I might be able to tell you more. JG 8.23.08
Answer: the pexy can be done at the time of the lift, it is a description of attaching the tissue to something immovable in order to attempt to get it to stay in place and not fall down again. In your scenario since too much fat was removed, the pexy might and might not be needed, also pulling the brows higher in cases where the fat is gone can leave your eye socket looking a littel skeletonized or more boney. There are occasions where only the outer part of the brow needs a lift, hard to say without seeing you. JG 8.23.08
Answer: that should be decided before the surgery, not during. I have found that the medical literature reveals that procedure to have a high dissatifaction rate and complication of the lower lid being pulled down. Not sure what he is relating to if the pexy is not a canthopexy which is commonly part and parcel of a cheek lift through an eyelid incision to avoid the pulled down lid. I think using Botox before can be done in order to allow the muscles to be weak so they adhere in the new position but is not used routinely. Not quite sure either as to why the upper lid would need to be done. Hope that helps, and thank you for the kind words. JG 8.23.08
Answer: no, it does not. JG 8.21.08
Answer: I think it does happen, especially the short term hair loss from the stress of surgery. I suggest you stop the hydrocort cream as that will slow the healing. Just continue to keep it clean and apply the neosporin to avoid infection rather than the Aquaphor, I think as you are concerned you should see the doctor as soon as possible, that is what they are there for. JG 8.17.08
Answer: hard to say without seeing you in person to determine whether any less invasive thing is an option, at times it is, at times a lesser procedure can leave stigmata that make it look unnatural and might look worse. JG 8.14.08
Answer: if you have gained the weight and it has stretched the skin it will be loose agian, it will not always go back to the way it looked afterwards. JG 8.13.08
Answer: sorry but no change in my feelings, interestingly enough it has not been presented at a single national plastic surgery meeting, curious I feel if it truly is that ground-breaking. JG 8.6.08
Answer: try the Sculptra first is what I would suggest as a facelift will not fill it in and you might look tighter but still too thin. JG 8.6.08
Answer: I have, it can take a while but in most cases it does get better on its own, give it some time. JG 8.5.08
Answer: It is likley not anything you can take care of on your own, it might need some aspiration of fluid or injection of some material to soften them, will need to wait and see your surgeon, sorry. JG 8.3.08
Answer: the mini facelift will likely not lift the medial cheek much in most patients, but the SMAS full facelift should. JG 8.1.08
Answer: I would suggest waiting about 6 weeks. I do not think doing it at the same time is a good idea. JG 7.29.08
Answer: no, they are not as good as the traditional ones. Ribbons do not change anatomy, lots of hype, little resutls, lots of money for the doc. JG 7.29.08
Answer: there are occasions where the eyes will not close totally when you sleep after a facelift and that can cause irritation of the corneas and short term deterioration of vision that in most cases gets better, but to be sure I suggest seeing your eye specialist when you can to make sure. JG 7.28.08
Answer: 4 weeks usually as long as the incisions are well healed. JG 7.27.08
Answer: I think you can have the mid faclift done and see if it is enough, and then if not, a small amount of skin can be removed later, in that way, if the desired degree of improvement is acheived then there are no visible scars. But be aware that is might not be enough. JG 7.27.08
Answer: no worries.JG 7.27.08
Answer: 0.1%. JG 7.27.08
Answer: 0.1%. JG 7.26.08
Answer: sorry but there are nto enough muscles causing it to pull down that Botox would help. I think the liqid facelift for people that have minimal to no loose skin and have lost facial fat that makes them older is a good option, we perform it here using Sculptra. JG 7.26.08
Answer: no difference, really, just a marketing term to make it sound new and improved, those that have been injectijng fat have been using microdroplets of fat and very small injection cannulaes for many years. The fat transfer is accomplished by harvesting fat through liposuction from one area and then cleaning it of all blood componenets, some doctors will centrifuge it to do that, and then injecting it into the desired location using numerous passes with the cannulae and small droplets at each location of the track of the needle. JG 7.25.08
Answer: I am sorry but I am not familiar with either one. JG 7.25.08
Answer: I perform it through a cheek lift incision, which is the incision in front of the ear that is one half of a facelift incision. The term mid-face lift was coined when surgeons, trying to be coy for marketing reasons and to attempt to seperate themselves form other surgeons give newer approaches to a surgical region a fancy name. The cheek is the mid face but as it was and has been used to signify a procedure done through the lower eyelid and the temple rather than the cheek incision, it allows other surgens to understand the approach differences. As to having skin removed, not all patients need it, but if you pul your cheek or midface up in the direction you desire, and you see a pleat of skin, no matter how large or small, then some skin removal will likely be needed, otherwise, if you do the midfacelift and do not remove the skin when it is needed you will be left with a visible pleat of skin that you will need to hide and that is harder to hide than an incision from it being cut out. Once again, it is all marketing, what normal sane person would want an incison if they are told they can have the result they want with no incison, but as most things in life, things good from afar are usually far frm good. One of the inventors of the procedue, Dr Rod Hester, at our natioanl plastic surgery meetings has stated that even in his hands the complication and re-operation rate in his practice is up to 15%. Best of luck. JG 7.25.08
Answer: yes, in areas where we want long lasting support they are commonly used, they can become infected as they are braided is one issue though, hopefully if it has cleared up now it will stay that way for you. JG 7.24.08
Answer: the attempt on both is to lift the tissues of the cheek. The differences are really minimal as in both cases incision are made in the scalp and at the lower lid, the difference is that in an endoscopic lift there is no skin removed where in the open techniques skin is removed. I do not think there is any significant differences in terms of longevity. Incisions can vary but there are many different ways to get to the tissues. The risk of lower lid problems is with both if the incision is made there and the tissue suported from there. I really am afraid I cannot sort it out for you as I do not perform the endoscopic technique nor the mid facelift through the lower lid incision as the complication rate is too high, about 15% in the hands of experienced surgeons. JG 7.23.08
Answer: yes, it could, you might want to see the doctor to see if they can be removed and allow it all to heal faster, best of luck. JG 7.23.08
Answer: in truth, it is just a method of suspending the tissue one wants to elevate, instead of using sutures. There is no evidence that it works any better than sutures and in some cases the endotine can poke through the skin and or break and crack. JG 7.22.08
Answer: OK to do, should not cause any problems. JG 7.22.08
Answer: a few days to a couple of months duration in some patients, I strongly suggest not doing it. JG 7.22.08
Answer: The weak lower lip comes from stretching on the mental nerve that can come from a facelift or a neck lif. The bulging can be due to a couple of things, it can be fluid below the muscles that has not been drained during the aspirations or it could be fat that was not removed from below the muscles and when the muscles are tightened, then there can be a bulge created. Without knowing what was done surgically and what they saw it is nearly impossible to tell you which one it is. I think what you are doing is the best for now, stay in close contact with the surgeon and maybe he can tell you more the next time you go in, certainly draining the fluid is important to get the tissues to stick back down and the lip should move better in usually 6 weeks or so. All the best. JG 7.20.08
Answer: yes, it releases the skin from the underlying tissues and then the surgeon can either hope the skin does not attach too quickly, some will put a filler in at the same time to slow the re-attachment. The endotine is just a different method of supporting the tissues, it is not different though over the standard mid facelift. JG 7.20.08
Answer: Isolated cheeklift. JG 7.20.08
Answer: no, I would not recommend a threadlift for anything unless the person`s face was paralyzed. JG 7.18.08
Answer: yes, it has to in order to lift the eyebrows. JG 7.16.08
Answer: similar, yes. JG 7.16.08
Answer: I have to tell you that I think without massive weight loss, there is no indication for a facelift in a 28 year old, if you have not had massive weight loss and there are issues that are leading to you looking 20 years older than you really are, I see no need for a facelift, your desires might need to be tempered and I think the surgeon might be looking at dollar signs. Ask him how many 28 year facelifts he has done in the past. Even in an older patient, the naslobial folds are the least improved thing with a facelift. You might not get what you want even with a facelift. JG 7.15.08
Answer: I think you need to see a doctor in person to evaluate your desires and see if there are any reasonable options for you. JG 7.15.08
Answer: I strongly doubt that you need a facelift at your age unless you have lost a tremendous amount of weight. Although there are likely changes that have occurred in the past few years I think other options might be considered, maybe Sculptra to refill in the cheek region to lift the skin up would be a safer option I feel. JG 7.15.08
Answer: a midfacelift will typically no do much to the neck or chin area. If it does anything it will be while you are swollen only. JG 7.15.08
Answer: most mid facelifts that are marketed using that term instead of a cheeklift are all done subperiosteally, throught the lower eyelid and a temple incision. JG 7.15.08
Answer: usually that is due to swelling in the area and in a couple of weeks should get markedly better. At times the muscle tightening can cause indentations, but if that were the case it would only show up when the muscle is moving, not at rest, and they also get better in time. JG 7.11.08
Answer: the cheeklift uses an incision at the crease of the ear and lifts the tissues and removes excess skin, while the mid facelift is done through a lower eyelid incision and a temple incisio and and although it lifts tissues, it does not remove skin. It also has a higher rate of complications since it seperates the tissues from the bone and if they are not supported adequately they can sag and pull on the lower lid causing problems. JG 7.7.08
Answer: well, there are very small risks of nerve injuries, but they are rare and that surgery is done commonly without problems, that will likely be the only way to correct the jowls in your case. I am not a fan of a mid facelift but a regular cheeklift will do what you need with lots less risk than a mid facelift. JG 7.7.08
Answer: 10-14 days. JG 7.7.08
Answer: probably. JG 7.7.08
Answer: I think it is less invasive than a subperiosteal mid facleft, yes. Anytime an incision is made and skin is removed there will be scars. The quality of the scars is dependent on the tension on the wound once closed. JG 7.7.08
Answer: it is true as they skin is thicker and they therefore bleed more. JG 7.6
Answer: I do not think it is needed to lift the tissue off of the bone and can be risky, I think a SMAS procedure of the cheek lift is enough. JG 7.6
Answer: it might be a small hypertrophic scar that needs steroid injection or excision, not likely a suture is still there after that much time. The lump could be excised too, likely under local anesthesia. JG 7.5.08
Answer: we do use Sculptra in our office, yes. JG 6.30.08
Answer: I would not use it there due to the high chance of the muscles causing it to clump and form granules. CO2 laser would be a better choice I feel, and will last longer than most other fillers that can be used there. Spot treatments can be done with CO2 lasers, yes. JG 6.30.08
Answer: the same thing except some doctors when they do a mid facelift make incisions on the temple and inside the mouth to lift the sagging tissiues but then they do not remove any excess cheek skin, but durring a cheek lift the cheek tissues can be lifted at that time too. JG 6.29.08
Answer: correct, a temple lift is sepearate from a cheek lift, but the incision are similar at times. Just tell the surgoen what you are interested in. JG 6.29.08
Answer: I think they and all like it are a waste of time. I would go with the fillers, much more relaible. JG 6.28.08
Answer: yes, a midfaceift although it uses a temple incision, does not routinely lift the brows. JG 6.28.08
Answer: it will lift the eyebrow but not th echeek, the cheek can be lifted at the same time but then it is more than a temple lift. The forehead lift will lift the entire brow, while the temple lift only lifts the lateral aspect of the eyebrow. JG 6.28.08