NOTICE: Ask Dr. Garcia is intended for educational and discussion purposes only. It does not constitute a formal medical evaluation nor consultation. No doctor-patient relationship has been formalized by this communication. If you desire such, please feel free to call and schedule an appointment. Otherwise, please be advised that all information that has been given here should be cleared with your primary care physician before changing or instituting any therapy. Explanation of off-label use of substances may be discussed here in but does not reflect an endorsement nor promotion of such off-label use.

Jump to Page: | 1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 | 9 | 10 | 11 | 12 | 13 | 14 | 15 | 16 | 17 | 18 | 19 | 20 | 21 | 22 | 23 | 24 | 25 | 26 | 27 | 28 | 29 | 30 | 31 | 32 | 33 | 34 | 35 | 36 | 37 | 38 | 39 | 40 | 41 | 42 | 43 | 44 | 45 | 46 | 47 | 48 | 49 

• IS it possible to lift loose skin under the chin and turkey waddle with a liquid facelift? Thanks.

  Answer:  most likely not as the amount of filling of the face to achieve that results would make your face look bloated, it sounds like surgery is the only option, sorry. JG 2.2.12

• I had Ultherapy done in June. I am 59 years old. The doctor also injected two vials of Sculptra in my temples and side of my face. I still have the turkey waddle,and there is no lifting or tightening. When will the cosmetic industry stop hyping treatments that are a waste of money?? Also, I assume my age is the reason this was not successful, however I was not told this would be a problem. Besides a facelift what can I do now? My skin is not heavily wrinkled.

  Answer:  well, it is not the entire industry, it is the particular company and then individual doctors. I have not been a supporter of Ulthera.I routinely use Sculptra on patients much older than you though and get good results with it. Recommendations are difficult without at least seeing photos of you, but it might be a facelift, yes. Sorry to hear things did not work for you, but next time, all I can suggest is do a little more research before spending your hard earned money. JG 1.31.12

• I read on an earlier post that you can peform a procedure for a down turned mouth. What is it? How is it done? Thanks!

  Answer:  In some people a corner lift is done by removing skin right above the corner of the mouth. There will be a permanent scar and the lift amount depends on the distance between the lip and the nasolabial fold. JG 1.28.12

• Dear Dr. Garcia, I have been very pleased with your work in the past. I have been reading about the `bull horn` lip lift and think it is just what I need. Do you do this procedure? Thanks, Donna

  Answer:  Yes, we perform it. Please feel free to come in for a consultation and we can discuss what it might do for you. See you soon. JG 1.23.12

• Hi Dr. Garcia 5 months ago I had a facelift and upper and lower eye lids done.My face is still holding much water and I have severe dry eyes..Will this water retention EVER go away? My eye lids close but more of my eyes are exposed and everyday is a battle. On Resasis and going to get stem cell drops made next Surgeon wants to put a stich in eyes to give the eyes a rest...Can you give me your oppinion? Thanks

  Answer:  not sure why there is fluid retention this far out, tissues softening up can take time but swelling should be mostly gone by now. If the eye lids close, especially when sleeping, then the eyelid surgery did not cause the problem. If your eyelids do not close when sleeping though, then possibly too much skin was removed and a skin graft to replace some of the skin removed might help. I think you need to continue the drops as suggested in the meantime too. All the best. JG 1.18.12

• D.Garcia,do you know Dr. Sam Rizk from New York, and his signature face-neck lift technique? What do you think? Thank you for your answer.

  Answer:  I do not know him personally but the claims he makes on his website about his technique are a little inflated in my opinion, and he claims to lift the muscles of the face that have fallen, I am unaware of any published medical articles that state the the muscles detach from the bones of the face and sag during the aging process. Also a subperiosteal lifting causes more swelling of the face, not less.He might do great work, I have never seen it, I have never heard of him though. JG 1.16.12

• Dr. Garcia, I had a consultation with ps about a necklift. I have some sagging skin under the chin and not perfect jowls. I am 50 years old. My face not fat and I don,t have a lot of far under the chin, just loose skin. My cheeks are good, but ps said that I need to have incisions under the chin, around the ears, inside the ears and up to the hair line near the temple. I don`t understand why so high? What do you think, dear doctor? Thank you.

  Answer:  hard to say whether the length of the incisions told to you are needed without seeing you. The length of the incision is more related to the amount of skin removed and not on what is performed below the skin. In some cases, the incisions you describe are required, but if there is minimal loose skin, then they might be able to be shorter. They might just be telling you what would be the worst case scenario in terms of the length of the scar so you would not be surprised. JG 1.16.12

• The Plastic Surgeon did remove a scalp suture in my bridge lift, but this has left me with a lot of pain in my neck and chin area. I have trouble opening and closing my mouth where I also have a chin implant One ps said to go to a pain clinic, another to a neurologist and to physical therapy. I am getting confused on which direction to take and feel that no one really knows what to do or wants to get involved. I have written to you before about the chin implant problem and my mouth, and think it may be involved with my neck lift. It seems that everyone I see is telling me to see someone else. Any other thoughts on the matter?

  Answer:  I would undo as much of the surgeries as you can and then see a pain specialist to see if they can start you on some physical therapy and pain management techniques to help you out. I wish you the best. JG 1.16.12

• My plastic surgeon did a bridge neck lift by using a separate suture from the left temple underneath the scalp to the right side and behind the right ear into the neck area. I never heard of anyone doing this sort of procedure and it has caused me several problems: dizziness, neck pain and chin implant problems. Is this an acceptable procedure and is there anyway to get relief from the pulling and pain?

  Answer:  one of these minimal invasive suspension techniques, only will help in a small percentage of patients, hopefully he is willing to go back and cut the sutures to hopefully reverse the problems. JG 1.15.12

• My plastic surgeon did a bridge neck lift by using a separate suture from the left temple underneath the scalp to the right side and behind the right ear into the neck area. I never heard of anyone doing this sort of procedure and it has caused me several problems: dizziness, neck pain and chin implant problems. Is this an acceptable procedure and is there anyway to get relief from the pulling and pain?

  Answer:  hopefully if he goes back in and cuts the suspension sutures, the problems will resolve. All the best. JG 1.15.121

• What is and what do YOU think about a short scar facelift (my jaw line and neck are my problem) and what do you think about drs using `platelet gel` to help bruising? Thanks!

  Answer:  I have used platelet gel for my facelifts for about 5 -6 years now and I find that it helps speed up the healing. As to a short scar facelift, it is only a marketing term. The length of the scar depends on how much skin has to be removed. After access is gained to the tissue below the skin, and whatever is needed is performed, like tightening muscle or removing fat, then the skin is redraped and the excess skin is removed. People that can get away with shorter scars are people that have minimal loose skin and more issues with the tissues below the skin. If someone needed more skin removed and opts for a short scar facelift, the appearance might not be what is desired. Better to have a longer but good quality scar and the desired results rather than less scar and less improvement. JG 1.11.2

• Dr. Garcia, Is there an age cut off time where a mid face lift or neck lift is ineffective? I think I read somewhere that after 65 years old nor=thing will be too effective and ps is a waste of money. What are your thoughts? I am 62 with very good skin but kneed something done with my jowls. I am saving up. I hope you had a wonderful Christmas. Be blessed in 2012.

  Answer:  There is no age cut off as all patients age differently and need different things. You might still be a candidate. JG 12.27.11

• Hi Dr. G, Happy Holidays to you and your family. Thanks for helping all of us with our questions. Mine is regarding under my chin and neck area. As I age it gets less defined and more of an issue. I HATE pictures of myself now. It is becoming an issue as I don`t like my face as much anymore. I work out all the time (size 6) and it seems unless I do surgery I am stuck with excess fat under my chin and a wrinkled neck. What do you suggest and about how much will it cost? Are you available to do the surgery if needed? What is the down time? Are the results pretty dramatic? I really want to see my jaw bone defined again. Warm regards, LLQ

  Answer:  we do perform the surgery that you appear to desire. In your case it would involve removing some of the excess fat in the neck region, possibly tightening the neck muscles and then removing excess skin. How dramatic the changes will be depends on how much needs to be done or can be done. Surgical fees vary depending on time so I would prefer to see you in person to estimate that. A range is about $6200, all inclusive except for your medications for after the surgery. All the best. JG 12.27.11

• Do you know the name of dr in l.a. that invented temporal mid face cheek lift or any other oculoplastics surgeons who do many of these temporal approach mid facelifts? Thanks

  Answer:  There are many but I believe you are thinking of Norm Schorr at UCLA. JG 12.25.11

• Hi, Dr. Garcia! I have had 3 facial surgeries, so I have scar tissue along the sides of my face, AND, unfortunately, also in a horizontal line under my cheekbones! Would this scar tissue make a fat transfer difficult -- or impossible? I have just learned that the cannula has to tunnel through the tissue, and this leads me to wonder if SCAR TISSUE could be an OBSTACLE to this process. Thank you!

  Answer:  can still be done but the survival of the fat will likely be less due to the diminished blood supply form the scar tissue. All the best. JG 12.13.11

• I had a second facelift 1 year ago, which seems to be healing well. I am now contemplating a facial-contouring fat transfer. My doctor has proposed some filling along the sides of my face, on cheeks, below cheek bones, and along jawline. Question: 1) Do you think there will be a good BLOOD SUPPLY for the fat in areas that are still a little, tight and sore, and have scar tissue? 2) Do you think the blood supply will be as good there as it would be in areas not affected by the FL? Thank you!

  Answer:  the face has very robust blood supply , so you should be fine from that standpoint. Best of luck. JG 12.8.11

• I understand some doctors are doing facial contouring -- using fillers or fat to achieve more filling for face reshaping than just working on micro areas. Do you do this? If not, who would you recommend?

  Answer:  I frequently use fillers to replace lost fat and achieve more youthful contours. At times I also do small cannula liposuction or micro liposuction to remove excess fat in other areas. The options all depend on what the patient needs. JG 12.7.11

• Have you heard of blacklisting? The surgeon who did 2 facelifts on me has lied TO me and ABOUT me. I am now having a hard time finding any help in my area. When other doctors learn he was the surgeon, they turn cold. Do you think my name could be on a blacklist? How can I find out and what can I do? Thank you.

  Answer:  A surgeon should not talk to other surgeons and divulge names and medical issues without the patient`s consent. There are times when a patient gives that permission, but not in all. Some of the local surgeons in your area might not want to perform a revision on a colleague`s prior patient. The reasons for that can be many, at times they might feel uncomfortable commenting on a colleagues work, at other times they might not like to take over someone else`s difficult cases. I will say that in cases such as your, you might have to seek consultations elsewhere. There is not much you can do besides that though. Sorry. JG 12.7.11

• Two weeks ago I have upper and lower blepharoplasties and a mid facelift. How long does it take for the suture ridge to soften? Also at the top of my left ear I have two little bumps that look like suture irritations... what is the best thing to do for those. no pus or drainage but red and very sore. How long for the facial swelling to resolve. I feel my face is still tight without much definition. Thanks for your insight. Have a great day. Oh.. my suture line on my eyes has some milia. How long before those will resolve.?

  Answer:  the suture ridge can take 3-6 weeks to soften, but final results will take a few months for fading and softening. Light massage can help a bit. The selling form a mid-facelift can take months if the tissues were separated from the bones. Should start looking better after 4-6 weeks. A little warm moist heat on the suture line will allow the milia to open and drain. JG 12.4.11

• Hi Dr Garcia, Thanks for answering all the question you are asked. If only all PS gave their patients this much time. Which you were closer, you would be my choice. Question, Have you ever heard a neck lift the involves a t or z cut under the chin to remove excess skin?

  Answer:  yes, they did that surgery many years ago, but it has fallen out of use due to the visible scars. It is quicker and easier than a traditional neck lift, but the scars stay pink for a long time and can be hard to hide. The Z works better with greater tightening than the T one. All the best and thanks for the kind words. JG 11.18.11

• Dr Garcia You say I can now use eyeliner but I`m afraid that I am not able to yet as even when I touch my lower eyelids they are painful so to contemplate make up is impossible. How long do you think I`ll have to wait for this to become better. Thanks again

  Answer:  hard to say, maybe another 2-3 weeks or so. Hang in there. JG 11.15.11

• Dr Garcia I am the lady with the problem of lower eyelids - forgot to mention that I also had lower eye pinch. I am six weeks after operation and my lower eyelids still sore. Thanks you

  Answer:  should be OK to use the eyeliner. JG 11.15.11

• Dr Garcia I had a facelift, fat grafting upper and lower eyes 6 weeks ago. My lower eyelids are still very tender and sore to the touch. Is this normal after 6 weeks? When can I start putting my eyeliner on again? THanks

  Answer:  it can be normal, especially in cases where fat was injected as that creates more swelling due to the numerous passes with the injection cannula. As long as the incisions are healed, which they should be by now, it is OK to use the eye liner. JG 11.15.11

• I had a lower facelift and neck lift done 8 months ago and had more swelling and comfort issues with the left side of my face right after surgery. The surgeon said to wait and all would resolve...I had lymphatic massage and, again the left side did not respond as well as the right side. Most of the issues have resolved and my face looks good except that the left side has a line that goes along the lower cheek and I can feel a knot from the permanent suture at the start of this line starting approximately 1 in front of ear lobe on cheek and ending 1 1/2 from corner of mouth. The line disappears when I talk or smile but it is there when my face is still and I can see it as a shadow when I see my reflection in a mirror. The surgeon said he can remove the suture but he will have to cut through my cheek and, of course, that will leave a scar. I am not really afraid of getting a small scar if it would take this line away and would not cause my whole face on the left side to drop down. Should I just be happy that I like most of my lift or do you think the lift will hold if I have this permanent suture removed?

  Answer:  well, he would know if it could be removed with a small scar, if that is the case, it might be better to have it removed. Otherwise, you could use a little filler to hide it and it might get better over time. If it has gotten better, albeit slowly, the conservative approach might be better. JG 11.14.11

• Dear, Dr. Garcia, what will give more natural look and stay longer on a face - the fat transfer or steam cell lift? Thanks.

  Answer:  stem cell lift is over hype, they are benefits of using the autologous fat injections but the level of stem cells in it are likely insignificant, so they are using the buzz word for marketing advantages. So in short, they are likely to give equal longevity. JG 11.10.11

• Dr. Garcia, using a tissue glue during the face and neck lift will speed the healing process or prevent from infection? Thank you.

  Answer:  quicker healing possibly, less swelling possibly, I use it many times. JG 11.10.11

• Dr. Garcia, do you do corner of mouth lift procedure? What would the approximate cost be?

  Answer:  yes we do, in the office, under local anesthesia, the cost is $1700. JG 11.10.11

• Dear Dr Garcia Thanks for the help you have already given me. I have a few more questions if you would be so kind. 1. How long does it take for lower eye bleph scar to heal? I am one month out and the scar in one eye is taking longer than the other and is still very visible. 2. My cheeks and sides of face are still hard and swollen (I also had fat grafting) - how long do you think this will last? Thank you Yvonne

  Answer:  the eyelid incisions should look pretty good in 2- 4 weeks, but will continue to improve for 4-6 months. The speed of healing is always different from one side to another. The swelling from the fat injections typically will last at least 6 weeks, and depending on how much was injected, the more injected, the longer the swelling will take to resolve. All the best. JG 11.4.11

• Dear Dr Garcia You have helped me recently in replying to my question - I have another and hope you don`t mind me asking. I am the person who had the Xmacs, fat grafting cheeks and eyes. It has now been one month since the operation and I still have a depression/dent below my left cheek which is causing me a bit of worry. Can this improve even after one month or not? Thanking you again - you are so kind

  Answer:  It can improve after the first month, yes. If you want you can fill it in with a filler like Restylane for the short term until it all smooths out. At least that way it will be easier for you to hide it while it settles down. There would be no down side to suing the filler.Best of luck. JG 11.2.11

• Hi, Dr. Garcia! I hope things are going well for you. I had 2 facelifts, specifically asking for the mouth area to be lifted after damage, and my mouth area looks worse (lower) than ever. 1) My lower face looks tight & narrow now and 1 dr. said a lot of fillers & fat may lift the mouth area. 2) Another dr. does a Vertical type of facelift, which he said could lift the area under the mouth (which appears it would be helpful, and 3) another dr. was concerned about vascularity and suggested endoscopy. QUESTION: Off the top of your head, do any of these possible options sound possibly helpful or likely not very helpful? Thanks!

  Answer:  well, they have some aspect that is reasonable, but I do not think any one will likely do anything dramatic done alone. The fact that three surgeons suggested three different things tells you that there is no one single correct answer to fix the issue in your case.It is hard to say what might be best without seeing at least pictures of you before and after to try to figure out what you had before and what was done during the two facelifts. Please feel free to send any picture, if you wish, to drgarcia@lvcosmeticsurgery.com for my review. JG 11.1.11

• Hi Dr. Garcia I wrote you yesterday re my neck bands showing as a result of a neck lift. Thank you for your prompt response re the likelihood of a corset platysmaplasty not helping the situation. What would you recommend to correct this situation? A redo of the neck lift??? Or......?????? Also, you did not tell me if the corset platysmaplasty will leave a line or fold or other indentation or protrusion down the center of my neck where the bands have been tied together. I am as concerned about that possibility as I am about the visible neck bands. If that would be the case, I would be trading one problem for another and the procedure definitely would not be worth it for me. You provide a very fine service. because of your objectivity. It`s very hard to completely trust a surgeon who is recommending that a procedure be done. It seems highly unlikely they will say it won`t work. The possibility of the appearance of neck bands after neck lift and liposuction of the neck was NEVER mentioned by my surgeon. I have been quite unhappy with the result of the surgery for nineteen months now. It`s time to address the situation but I don`t want to simply make another mistake and be disappointed one more time. Thank you for your prompt response yesterday and I look forward to hearing from you re the above.

  Answer:  well, actually it sounds like you need to put some fat back into the area to soften the appearance of the bands. The facelift did not cause the bands to form,they were already there but just hidden. The liposuction likely unveiled them. I am not saying to put all the fat back, but a layer to hide the muscle edges would be a good option. As to a corset platysmaplasty leaving a line or fold, normally it would not but if your neck has been thinned out where there is little to no fat underneath the skin, it certainly might. I wish you the best. JG 10.27.11

• Nineteen months ago I had a neck lift performed with liposuction of the area under my chin. As a result, neck bands appeared and have not resolved. The surgeon is willing to correct the situation and is recommending a corset platysmaplasty. As I understand it, this involves an incision below the chin through which the neck bands are gathered together and tied in some way. Do you think this is an appropriate procedure to correct my problem? The rest of my neck is smooth and I consider that part of the former neck lift a success. The residual bands are my only problem. Will a corset platysmaplasty leave a ridge or fold of skin or a line of any kind down the center of my neck below my chin where the bands have been gathered together? I have seen several plastic surgeons re how to correct these neck bands. Some say the corset platysmaplasty will leave a line, others say no. So I don`t know what to do. I don`t want to trade one problem for another. I will appreciate your input very much. Thank you very much for your assistance.

  Answer:  It might help, but I think part of the reason you have the visible bands now and not before is because the fat covering the muscle has been removed and now its just skin and then muscle. Tightening the muscle will change the angle of the muscle, but it might not change the visibility of the bands.I do not think it will be any worse, but I am not sure you will much better either. JG 10.27.11

• Dr Garcia Thanks for your answer regarding fat injections 3 weeks out. I have bruising in the nasolabial folds and my eyes. The funny thing is my other bruising has faded a lot but not where the fat was injected. Could this be permanent? Regards Yvonne

  Answer:  The bruising is worse there due to the large needles used and the numerous passes used. Also, you cannot cauterize the bleeding in areas of fat injections like you can in the surgical area. Normal for what you had done. It will not be permanent. JG 10.23.11

• DearDr Garcia I am now three weeks out from a Extended MACS (third suture) plus fat injections upper and lower eyes, cheeks and nasolabial. My cheeks are still very swollen and too high. I also have discoloration on one eye and in the nasolabial areas. Is it normal for my cheeks to still be high and swollen and is the discoloration normal after three weeks. Thanking you in advance for your help Yvonne

  Answer:  fat injections are commonly slow to improve and can take up to 6 weeks, so what you are seeing is normal I am afraid. They should have warned you about it before the surgery. JG 10.23.11

• Dear Dr Garcia I had a facelift plus fat injections to upper and lower eylids and cheeks 6 days ago and stitches out today. My two questions are: 1. I have crusty bits where my stitches were - can I put scar cream (name is scarban) as of today or do I wait till crusts are away? 2. My cheeks seem to be way too high and swollen giving me a deformed look. I know it has only been 6 days but is this normal and how long will it take for the swelling to go down? Thanks a lot Yvonne

  Answer:  You are very swollen and things will look better with time. As to the scars, give them a few more days for all dried blood to fall off before using any scar creams. JG 10.11.11

• cost of facelift

  Answer:  in my practice, all inclusive, they vary from $6,900 to $10,000, depending on what is performed. JG 9.28.11

• Regarding proximal plane, (under the cheeks), I thought it might be harder to dissect in that area to loosen it again? But you think the real problem would be scar tissue? I got the impression that you don`t do 3rd FL revisions. Do you know anyone in the U.S. that does? Thank you.

  Answer:  I am sorry, but you are correct, at this time in my professional career, I no longer do revisions on surgery performed elsewhere unless it is due to aging. There is no surgeon I know that specializes in revision facelift. JG 9.27.11

• Do you think Gutek`s tightening in a more proximal plane is the most problematic part of a 3rd facelift? Even more so than the usual scar tissue around the ear? Would waiting longer than a year help, to give the scar tissue more time to soften? Is there more danger under the cheeks -- of disturbing the nerves? Is it possible he just pulled harder from the ears, but did not dissect under the cheek, so it would be easier? Sorry to have 5 questions, but they`re all so closely related. You are a gem. Thank you.

  Answer:  I think the proximal plane might be one of the contributors to the issues but likely not the entire cause. The looser the tissues become, the better it will be for a revision. At one year the tissues usually have softened as much as they are going to. Anytime there is surgery done in a a previous surgical area, the risks of nerve damage are higher as the nerves are harder to see due to the scar tissue that forms. I do not think it was an effect of pulling in one area and not pulling in another that has caused your issues though. All the best. JG 9.27.11

• My doctor tightened under my cheek in a second facelift in a misguided attempt to lift my mouth. He says, the tightening of the SMAS was again done secondarily in a much more proximal plane with interrupted sutures of 4-0 PDS. Even though these have dissolved, it is still very tight there. If I were to have a revision facelift (3rd), could that area be safely undone so it could be lifted properly? Or do you think undoing would be a big extra problem (besides the usual scar tissue around the ears)? Thank you!

  Answer:  whether it can be done and positioned into a better location will depend greatly on the degree of scar tissue and whether the SMAS is able to be safely released without causing an injury to nearby nerves.Best of luck. JG 9.26.11

• I am the person who had 2 facelifts by Gutek, the 1st, in which my face was anchored downward, then in the 2nd, lifted, but not enough, particularly vertically. So, my lower face looks LOW on my face, narrow, and hollow. He has also tightened under the cheeks too much. I can`t find anyone in the Kansas City area who will revise it. They say they are afraid of the scar tissue and possible nerve damage in a 3rd facelift. Do you think it`s necessary to have to travel elsewhere to get a revision? Is this unusual? Have you done any 3rd revision facelifts, and if so, how many? Do you know anyone else who has? Thank you!

  Answer:  well, at times, the surgeons in a location do not want to undertake surgeries for a myriad of reasons. They might be concerned abut risks of intraoperative injury and possibly of the inability of getting a significant improvement due to what has been done before. I have done facelift revisions after multiple surgeries on some people, but luckily the numbers are less than 25 as it is not required often. It might serve you well to have at least another opinion from someone in a nearby town that can give you their impression.All the best.JG 9.26.11

• I`m talking with a doctor who says that an incision inside the hairline taken a few inches up above the ear can provide a lot more vertical lift than if the incision stops at the top of the ear. I`ve only heard about this recently. Is this true? More vertical lift is what I`ve needed the most because of a doctor pulling the skin downward on my face in an imitation necklift. Thank you very kindly.

  Answer:  well, the higher the incision goes, potentially the more vertical the lift can be, as far as the skin is involved, but you also need to take into consideration that if the incision is within the haie, as that skin is pulled more vertically, it will likely displace the temple/sideburn hair higher, potentially into an unnatural position, leaving a place on your face that should have hair not having any and making it look abnormal. All the best. JG 9.21.11

• My doctor tightened under my cheek in a second facelift in a misguided attempt to lift my mouth. He says, the tightening of the SMAS was again done secondarily in a much more proximal plane with interrupted sutures of 4-0 PDS. Will these types of sutures dissolve? If so, how long should they take to dissolve? My face look horribly hollow under my cheeks and am hoping this will improve somewhat. Thank you!

  Answer:  yes, they will dissolve in about 3 months. All the best. JG 9.21.11

• Regarding volume in a facelift, my surgeon did plicate at the sides of my face, but I still look tight & narrow. 1) Is plication the same as imbrication? 2)Would a revision surgery necessarily make face look even tighter and narrower, or could that be avoided? 3)In other words, is there a way to make face look wider in a 3rd facelift? Sorry for 3 questions, but they all seem to closely relate. Best and thank you so much.

  Answer:  plication ddn imbrication are similar but not the same, in imbrication, the tissues are pulled in layers to create a folding over and over on itself to look like more volume, In plication, if the location of the sutures is too far apart, it will actually flatten the tissues rather than build them up.The only way a redo would make you look tighter is if the tissues are again pulled too tight and too much skin is removed. Releasing tissues might make the face look wider, but in the short term you could try using Sculptra to avoid surgery and get a volume increase where you need it. All the ebst to you too. JG 9.5.11

• I was the one who said my neck is too tight after a FL, and you thought that perhaps too much fat had been removed. Is removing fat from the neck a standard part of a facelift? If so, is this typical? I had no idea this could or would be done in a FL. I was conscious during the surgery and don`t remember anything like that taking place. (I`ve had lipo in the past, so I`m sort of familiar with how it feels.) Thank you!

  Answer:  The day can be removed by directly with scissors or with liposuction and syringe so there is no noise. Fat removal is done if there is fullness in the neck. JG 9.5.11

• A PS told me that he does a cheek lift on a deeper plane that adds volume. Do you know what that could be? Could the extra tightness caused by a previous facelift (9 mos. ago), esp. under cheeks, cause problems with a revision surgery? Thank you for your help.

  Answer:  With any technique where the tissues are folded upon themselves rather than just pulling them tight will give the appearance of creating more volume, but you do not need to do a deep plane to accomplish that. It is just as easy if not more effective to imbricate the tissues from a superficial plane. In most cases by 9-12 months, things have gotten soft enough that a revision can be attempted. Best of luck. JG 9.4.11

• It appears that my surgeon tightened too much at the base of my neck (in a facelift). My neck looks weird and scrawny, with lots of bands. Previously, it had enough fat in it and did not look old and scrawny. Do you know how/why he would have tightened at the base of my neck? Do you think this could loosen with time? Thank you.

  Answer:  It more likely is due to too much fat being removed rather than too much tightening. Fat injections might help smooth the contour out. I think it will likely improve only a small amount with time. All the best. JG 9.4.11

• My surgeon, Philip Gutek, did extra tightening under my cheeks in a more proximal plane, in a misguided attempt to lift my mouth. It did not lift my mouth, but looks terrible -- too tightly hollow and bony. Do you think this could loosen from a revision facelift, with massage, or with time?

  Answer:  depending on how aggressive you want to be, the sutures can be cut out to loosen things by opening everything up, massage might help some, and time will also allow things to sag, in time and slowly. JG 9.4.11

• Thanks for you answer below about the need for a revision of my facelift to re-suspend the modiolus and adjacent tissues. Approximately how much do you charge for such a procedure? And how long would I need to stay in Las Vegas? Thank you very much for your time and help! Hope to meet you soon!

  Answer:  I would need you here for about ten days, and the fee is about the same as a cheeklift due to the type of dissection required. Fees, all inclusive of everything except your medications, done under general anesthesia in the surgicenter are $6275. All the best.JG 7.22.11

• Hello Dr, At 43, although I do not have excess skin to warrant a face lift, however I find my face is sagging due to my muscles or tissues ageing. What is the name of the procedure which lifts only the underlying muscles and what is the downtime on this procedure? Thank you

  Answer:  Still a facelift, just not much skinin removed, otherwise might look into injectable Sculptra to refill your face. JH 7.19.11

• Re: moist heat on bruising after a face/neck lift...If I use a heating pad with moist heat, how long can I leave it on at a time and how often can I use it? Thanks so much.

  Answer:  Use it for 5 minutes or so.JG 7.10.11

Jump to Page: | 1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 | 9 | 10 | 11 | 12 | 13 | 14 | 15 | 16 | 17 | 18 | 19 | 20 | 21 | 22 | 23 | 24 | 25 | 26 | 27 | 28 | 29 | 30 | 31 | 32 | 33 | 34 | 35 | 36 | 37 | 38 | 39 | 40 | 41 | 42 | 43 | 44 | 45 | 46 | 47 | 48 | 49