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. All responses are done personally by Julio Garcia.

• I have always had these ugly fat pockets next to my mouth, can they be safely lipo`ed? And would it make my mouth look saggier if I got rid of it? Here is a pic: http://i.realself.com/full/8e30a659c31b53017073692309ab0da1/533476-515300.png

  Answer:  I think getting a smooth result might be difficult in that area, I am not sure I would try it at your age. JG 6.12.13

• Good evening.just had smart lipo triplex neck and jaw. Am sore and swallowing is rather difficult. Is this normal..I realize my Comfort Wear compression garment must be tight. I am hoping this discomfort is because my surgery is only about 5 hours past. I can swallow it just hurts. Notice also the left side of the compression does not cover all the way to the left ear where the right one does..seems like some shin on left is squished out...Dr Garcia is this all normal. have Antibiotics, and pain, pills...still taking arnica Montana . Thank you so much. Your Canadian admirer.Jg Ottawa

  Answer:  All normal, use a little ice and adjust the compression to make it even. Should be better tomorrow.All the best. JG 6.11.13

• When having abdominal Lipo can a panus be reduced or removed as well? Thank you

  Answer:  as long as the skin where the liposuction is performed is not separated form the underlying tissues it should be OK. Liposuction on an area that is going to be undermined and shifted can lead to poor blood supply and healing problems. JG 6.6.13

• Dr Garcia, does smartlipo in the abdomen more than once cause scar tissue which will or might cause problems for a person who has never been pregnant before and has to go under c section?

  Answer:  Any small amount of scar will not affect the pregnancy. JG 6.2.13

• Luvitra and Mabel Plus lipo duo? at only $149 for 1 treatment (I want it on my belly) sound like a good deal??? I exercise daily, but still can`t get rid of the pocket of belly fat. Thank You for your time

  Answer:  Sorry, the only thing smaller will be your wallet. JG 5.19.13

• Does wearing a compression garment after abdominal liposuction help prevent loose skin afterward? Would spanx work just as well? Thanks

  Answer:  It helps the swelling go fown faster and helps with the discomfort but does not make the skin shrink better, Spanx are not enough. JG 4.30.13

• I am considering Lipo for my abdomen but I have heard that fat can move elsewhere. Does this usually happen and where would it mostly go? Thanks

  Answer:  fat cannot move, but if you gain weight and you have had liposuction in an area, the fat might accumulate in a different area than before. JG 4.22.13

• Well, I seem to have inadvertently given myself a breast augmentation. I had a small amount of fat suctioned from my hips two years ago, but all the fat now has migrated to my breasts. I used to be a 32A and am now a 34C/D! Some women might welcome this but not me. I feel like I`ve suddenly got two extra limbs that need to be managed. My weight has remained stable. Have you ever seen this happen before? Can I have liposuction for my breasts and underarms? Will it cause scar tissue that will interfere with mammagrophy readings? And where would it be best to remove the fat so as not to leave me with sagging breast tissue (which I never had before)? Laterally -- under the arms and by the chest wall? I can`t wear any of my old clothes and, as a runner, now have to bind my chest. Suggestions? Thanks so much for your insights.

  Answer:  liposuction can be done on both areas and any small amount of scar tissue should not interfere with a mammogram to any large extent. Depending on how firm your skin is, the fat removal might leave you small to large amount of sagging, depending on how much fat is removed. It would be best to remove it from the more superficial layers as the supporting ligaments of the breast tissue are attached to the muscle, the skin lends minimal support. Best of luck. JG 4.20.13

• Hello. A close friend of mine is going for a neck liposuction/lift revision for asymmetry. She`s worried that she will be numb for longer than she was when she had the original procedure a year ago. The numbness is greatly diminished, but still present. She goes for the repeat procedure next month. I know there`s no way to predict, but if anyone has the knowledge/experience, it`s you. What do you think?

  Answer:  I doubt it would end up any worse, but it will be more numb for a while, just like the first time. Final return of sensation is by 18 months after the last surgery. JG .1.29.13

• Hi Dr. Garcia, I had Smartlipo on my lower abdominal area to smooth the area out some after a previous Smartlipo procedure,and have been out about a year and a half. I don`t know what went wrong, but i now have a very pronounced line across the lower abdominal area about half way between my navel and pubic area. It look really awful, and there seems to be more fatty area on the lower portion in the upper pubic region than above where the line is, up towards the navel. It looks really odd and am very unhappy with the result, after spending a few thousand dollars. I don`t know if there is anything i can do to fix it that doesn`t involve surgery, and would appreciate any suggestions, TIA. I can`t go back to the original PS that did the procedure because i have since moved overseas.

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• Dr. Garcia, is liposuction of the neck ever a good idea, without neck lift surgery? I say this specifically for a male who has lost the definition between chin/jaw line and neck. Not over weight, but many years of doing neck exercise to strengthen the neck muscles during football years I suspect have contributed to this.

  Answer:  it can be done, the older one sis the less likely the skin will shrink though, and that can leave you with looser skin. Sounds like in your case that liposuction alone is not the ticket. JG 11.9.12

• Dr. G., Why does it take up to 6 months before real result can be seen with lipo? I had lipo done on my arms on July 2nd, and I don`t see any change. I am so discouraged. Does this mean I will need another procedure because the doctor didn`t take out enough fat? Thank you for sharing your knowledge.

  Answer:  because the swelling has to go down and the skin needs time to shrink, before that there will likely not be total skin contraction although most of the swelling, 60-70%, will be gone in about 6 weeks. Should be seeing some improvement by now in your case. Might need another session, yes. I wish you the best. JG 10.4.12

• I am a 52yr old female and am not happy at all with the way my body and face look. I am not a fat person and never have been. I am 5ft 6 and weigh 120, but to me it looks like I use to way alot more and have sagging or excess skin on my abdomen area around my middle and my legs are all jiggly and have dimply places in them. My but is also very jiggly and have dents on my butt cheeks also. My arms have loose wrinkly skin too. I have read alot about different procedures like exilis and lipodissolve for the abdomen area and exilis to tighten up the skin and help with the cellulite problems. Are these two procedures of any help and if not, is there anything at all u could suggest to help this problem?

  Answer:  I do not think either one will help, if anything the lipodissolve could make it worse if it works at dissolving fat. It might be surgery time, and the scars from that might not be thin lines that are easy to hide. JG 10.1.12

• I was wondering how long it takes to see the results for Cellulaze. It is supposed to help with cellulite long term. I had work done on the fron and back of legs 2 months ago, as well as a bit of the upper stomach area (around the waistline). Thank you.

  Answer:  It is as good as it is going to get. JG 9.3.12

• Hi Dr. I had liposuction 2 months ago. How long before I can expect the results I will see long term? I hope you`re enjoying the long weekend.

  Answer:  Another 2-4 months for the final result. JG 9.3.12

• Hi Dr. I am almost 4 weeks out from liposuction and I know I won`t see final results for months. But really, how many months before I see anything. I am kind of depressed to not see any improvement, after all the money I spent, the inconvenience, pain and discomfort. It`s not like I have unrealistic expectations. Thank you!

  Answer:  you should see about 50% of the end result by 4-6 weeks or so.I wish you the best. JG 7.25.12

• Thanks for your answer to my question about liposuction of the cheeks. What is your fee for that? And are the incisions visible? Do you place them intraorally? If you place them externally, where would you make them on the face? Thank you very much.

  Answer:  The incisions are made near the hair close to the ear but it will depend on the shape of your face, at times a second decision is required. The fees aré $1,750. JG 6.5.12

• Hi, Dr. Garcia. I had fat grafting to my cheeks 5 years ago, and it was way overdone. It hasn`t gone away with time either. In fact, my cheeks look like small trampolines,,,or like that pre-packaged biscuit dought that pops out a can! If you poke my cheeks, they bounce back up. I believe I`ve read here that you do small canula liposuction to correct such problems -- something my plastic surgeon doesn`t do. He wanted to inject kenalog, but I`m afraid that other soft tissues will be damanged. I had the fat put in in the first place to augment my bony face, so I don`t want to go back to being bony and saggy. Anyway, do you do this procedure? If so, what are your fees? I assume it`s an office procedure and would only require me to be there for one day. Thank you!

  Answer:  I do perform that procedure and it is done in the office under local anesthesia, correct. JG 6.5.12

• Hi, doctor. I had a relatively small amount of fat liposuctioned from my abdomen, outer thighs and hips 2 years ago in a plastic surgeon`s office. (A total of 350 cc`s was removed. Is that considered small or moderate? I know it wasn`t a large volume.) I am 5`3 and 100 pounds, so even a small amount of fat spread over those areas was really noticeable. It`s been great to have it gone. Since then, my weight has continued to remain stable -- just up or down by a half pound or so from day to day -- but my breasts have almost doubled in size, particularly the upper two thirds. While many women might welcome this, I don`t. I`m a runner, so it`s uncomfortable, and many of my clothes don`t fit. I`m 30 and have never been pregnant, so it`s not hormonal. Have I essentially just caused my fat stores to move to my breasts? Is this a known or expected phenomenon following liposuction or does this seem strange? I would have my breasts liposuctioned, but I don`t want to cause scarring that would interfere with mammography readings. Thanks for enlightening me on this matter. Hey, this is a beautiful thing you do. You are wonderful to be so generous with your time!

  Answer:  That was a small amount of fat to be removed. Once that fat is removed,new fat will tend to go to new places like .it sounds has happened in your case. Liposuction might be an option for you if the amount of fat is small and it should not interfere with good breast screening, certainly no worse than regular surgery to reduce your breast size. Thank you for the kind words and I wish you the best. JG 6.2.12

• I`m a very thin and fit woman (5`6 , 108 pounds). As I`ve aged (now 55), the one place on my body that seems to be collecting fat is the mons pubis. Is this common in aging women? I have no idea if this is to be expected or not. Can I have conservative liposuction? Obviously, I don`t sagging skin to replace the puffiness. Thank you for your time and expertise.

  Answer:  Not uncommon and liposuction works well in that area. JG 6.2.12

• Well, here`s a new and particularly embarrassing low in the endless surprises of aging. I am a very thin and fit woman, but I now have a fat -- and not just pudgy but actually fat and jiggly -- pubis. It`s actually making my clothes not fit. What`s up with THAT? Is this common in aging women? I mean, is this a condition that plastic surgeon regularly see and treat, like saggy breasts, or am i a rare case? I`ve never heard of this lovely side effect of aging before until it has come up for me in the past year. (I`m 54.) Can I have it liposuctioned? Have you done that for any of your own patients, Dr. Garcia? i`m humiliated even to seek out a consultation for this problem because it`s pretty embarrassing and also because I have absolutely no idea if any plastic surgeon will ever have even seen such a thing before. Oh, the indignities of the body in decline! God bless all of you brave and apparently fearless women and men who hover over us in various states of decay and try to slow it all down, even just a little. Thanks for listening and for letting me know your thoughts.

  Answer:  it is not uncommon for that to develop, it is an accumulation of fat that can be removed with liposuction and a plastic surgeon would be the one to do that for you. Best of luck. JG 5.15.12

• Happy Friday, Dr. Garcia. Just curious: I had liposuction to my upper back/bra area last week. My plastic surgeon told me he removed 400 cc`s of fat (200 from each side). Is that considered a small, medium or large amount for that area? Have a great weekend!

  Answer:  that is a medium amount but should yield significant visual difference. All the best. JG 4.27.12

• Do you feel that the new cellulite procedure Cellulaze could help tighten and fix skin bumps, waves, and irregularities left by tumscent liposuction, specifically on the front of the thighs? If so, how much improvement do you think I can anticipate? If not, any suggestions to fix the damage? Thank you!

  Answer:  I cannot say if it will help, it appears that the Cellulaze is supposed to target tissue more superficial than what you are describing. It is not a cheap procedure and is usually done under tumescent anesthesia so you have to weigh the uncertain benefits. The front of the thigh skin is notorious for poor skin contraction so further fat removal would not be a good idea I am afraid.Short of a thigh lift, which is a major surgery with long scars, I really do not have much to offer that is reliable and reproducible. JG 4.25.12

• Hello, I have no fat left due to three fat graft surgeries to fill in the rippling of my breast reconstruction. My surgeon does not do butt implants, but he does do the Brazilian Butt Lift, which, without fat, I am not a candadite for. I am so embarrassed to ask my next question to him for he brings many people into the exam room on my visits, and you are always so kind to answer. My butt is flat, and it looks even MORE so, since the 500 cc implants. CAN the fat FROM my butt be taken out and reinserted to a more firmer,rounder form? I`ve never heard of it, but to me it seems like it would be as simple as leaving the air out of the balloon and blowing it up again. Do you see any problems with this?

  Answer:  it is very difficult to shape fat injections into a particular shape.Sorry. JG 4.24.12

• I had lipo to my anterior axilla 10 days ago. The pressure dressings were removed on Friday, and when the tape was pulled off, many layers of my skin came with it both on my chest and on my back. They bled profusely and scabbed. Frankly, these cuts are far more painful than the lipo; they are even preventing me from wearing any shirts that touch my skin. I`m pretty sure that they will leave big scars, especially in light of their location. It`s upsetting because I`ve spent a lot of money to improve the appearance of my arms and chest, hoping to wear short sleeves this summer; and now I`ll have to cover up my scars. My questions for you are 1) any suggestions for treatment and 2) do you think they are likely to scar badly? Anything I can do to reduce that chance? Thanks very much for any help you can offer.

  Answer:  I would suggest some copper peptide creams and once healed change to squalene oil, hopefully they will heal with minimal problem. I wish you the best. JG 4.3.12