Ask Dr. Garcia - The Archives

• I had lipo three months ago, still lumpy in stomach area. Question- Would Velasmooth work to eliminate this?

  Answer:  it might help, worth a try. JG 8.19.08

• Dr. Garcia. I read some many of the questions regarding liposuction and there was that I had a further question about. I am looking to have lazer liposuction and was given your name to research, because you will soon be working at the office I was looking to have the procedure done. My concern however, is that you responded to someone`s question by telling them that you are not a fan of lazer liposuction, yet soon you will be doing it. Why are you going to perform a procedure you are not a fan of?

  Answer:  well, I have a friend that might be working in a new clinic but I am not moving out of my present office or working elsewhere. I am sorry to say that I am still not a fan of laser lipsuction. The procedure was apparently done in the clininc by a family practice physician that worked there but I am not sure of the new physician will be doing the procedure. I will not be doing laser liposuction at any new or old clinic, sorry for the confusion. JG 8.18.08

• Hi Dr. Garcia, is Velasmooth a permanant thing?

  Answer:  no, it is not. JG 8.14.08

• hi Dr. Can velasmooth even out my uneven texture of my calves which I had a bad procedure done 5 years ago? Can it actually move the fat around to smooth it out?

  Answer:  maybe, but only temporarily. It cannot move fat around. JG 8.13.08

• I asked a question a week ago about circumferential lipo of the thighs with a TT at the same time. The PS that are recommending the TT and the thigh lipo at the same time are not using the term circumferential but rather state that they feather into the post and ant thigh area. I was asking tons of questions that day and didn`t walk away with a full understanding of the impact and results of feathering - - is this a term you are aware of and, if so, can you explain?

  Answer:  yes, it is how the treatment is transitioned from one area to another so there is a gradual blending rather than a sharp cut off point. JG 8.13.08

• Wow, you are fast! Are there any special considerations or questions for me to ask my PS about the turning over process while under general anesthesia for the lipo and TT?

  Answer:  no, we do it all the time, I am sure they are well versed on doing it. JG 8.13.08

• Dr. Garcia - When having a TT and liposuction of the flanks, hips, innner/outer thighs, is it standard to assume that the patient will be turned over during the surgery? I will certainly ask my PS, as well, before August 25th surgery - but it was one question I didn`t think to ask during all my consults.

  Answer:  yes, it is assumed. JG 8.13.08

• thank you for your quick response. Two final questions about the pain in the inner thighs post lipo when stretching. What is passive and active stretching that you recommended? Could their be permanent damage and when can I expect to get my full flexibility back thank you soooo much for your time and knowledge

  Answer:  I have never seen permanent damage. As to active stretching, that is stretching you do with your own muscle power, passive stretching is stretching someone does by pushing or pulling things for you, like a physical therapist or massage person. JG 8.13.08

• Hi Dr Garcia, I looked through most of the lipo questions before sending you my question to see if someone has already asked you but I don`t see that my question has been asked. I e-mailed you a few minutes ago about my flexibility after lipo. Just wanted to let you know that my surgery was two months ago in case that is pertinent information for you. Thanks again

  Answer:  not uncommon on the inner thoiughs, that area has only layer of fat versus the two in most treated areas, also the muscle are right there and can get swollen and stiff, warm packs, massage and the active/passive stretching will make it better. JG 8.12.08

• Hi Dr Garcia, Thank g-d for you. Heres my question. I had lipo on my inner and outer thighs. I am a very small girl (not overweight at all) but had a small amount of fat that I could not get rid of. I am a dance teacher and since the surgery I have lost all of my flexibility in my inner thighs. It is extremely painful to stretch and feels like my ligaments are being torn. Could something have gone wrong? I have been stretching daily but the pain doesn`t get any better and my flexibilty is not improving. Could my muscle been jabbed during surgery? Thank you so much for your time

  Answer:  muscle can be scraped from the surgery but in time, with slow passive and active stretching, things will get better, but slowly. JG 8.12.08

• I had a full tt over a year ago. My scar on one side of my tummy did not heal well. The scar tissue attached itself, and caused a ledge. My doctor went back in, and loosened the scar tissue, and did a little lipo to reduce the ledge. My question is that it`s been 3 weeks, and I`ve been doing massage to the area, and now I feel 2 small bumps on each side of my bb (about 2 from the bb on each side.) What could this be? Could it be scar tissue or a swollen lymph node? I just noticed them yesterday. thanks dawn

  Answer:  likely swelling at this point a little too early for scar tissue, continue with the massages and give it some time. JG 8.10.08

• I am slim but I have bingo wings. Do you feel that laser lipolysis would be good for this? does laser lipolysis work?x

  Answer:  I am not a believer in laser liposuction. JG 8.10.08

• Hi Doc. What do you recommend or you feel is better for cellulite? Endermologie or VelaSmooth?

  Answer:  I think VelaSmooth is better. JG 8.10.08

• what is the differences between a tummy tuck and lipo in the stomach area.

  Answer:  the liposuction removes fat only where the tummy tuck removes fat and skin and can allow the muscles to be tightened if needed. JG 8.10.08

• Dr Garcia. THANK YOU FOR ALL YOUR TIME...One question though. I am planning to lose my excess weight through diet and exercise, in fact I am losing that weight now....will this be better than going for a conservative fat removal(liposuction) as you suggested? in other words, what will I achieve different if I lose weight by diet and exercise than from lipo? I am going to have more tight skin in my inner thighs if I do the conservative fat removal because it promotes to tighten skin giving it a lift? or it will be the same as losing the fat by diet and exercise...I am confused. I know I can lose weight by diet and exercise and also by doing a conservative fat removal but what I want to accomplish is a lift/tight inner thighs. Thank you

  Answer:  yes, weight loss first is always best. Since the connections between the skin and underlyng tissues are not damaged through diet but are with any liposuction technique, if you can lose the weight on your own it will lead to a better result with better skin tightening than any machine could give you. JG 8.6.08.

• Hi Dr, what do you think of liposculpture and the SmartLipo skin tightening laser that you can add extra( for some more money) to the liposculpture for more tightening. I am thinking about doing the inner thighs and the skin needs to be tight there...will this be a less invasive option for inner thigh lift?...please advice. Thank you so much

  Answer:  liposculpture is an attempt by a doctor to suggest that what they do with small cannula liposuction is diffeent and better than what others doctors do, it is a false statement and is merely a marketing term. As to SmartLip, I personally think it is a lot of hype with no evidence in any medical literature that it acheives the promises made. The invasiveness depends on how much is removed, not how you remove it, that area is notorious for loose skin so be carefull what you do JG 8.6.08

• Another question doctor. I am having a breast reduction with liposuction to neck, upper stomach area, knees and thighs. Do you think it would be too much if I did my ankles also at the same time? And is liposuction to the ankles more dangerous? Thanks again.

  Answer:  not dangerous, it is alot of surgery but if you are healthy it is likely OK, but the ankles will stay swollen for a long time. JG 8.5.08

• Hi Dr. Garcia, I had liposuction on my saddlebags and inner thighs 18 months ago. After the surgery my doctor did not have a garment in my size so I had to wait 3 days. My results do not seem so great. Do you think that this is the result of not having the garment? Thank you.

  Answer:  I think the garment will slow the swelling and speed the recovery but will not make a surgery less effective than it would have been without it. Not the garment`s fault. JG 8.5.08

• Dr. Garcia: I am planning to have a full TT and liposuction of the thighs. circumferential liposuction of the my thighs (taking about 5 Liters out) and did not recommend doing the TT at the same time. He advised 2 separate procedures with the 2nd at least 6-8 months after the first. My first 2 PS consults did not use the term circumferential and did not advise separating out the TT and the thigh liposuction. Any thoughts?

  Answer:  I think if it truly is circumferential I would space them out, at least 3-6 months. JG 8.4.08

• Good morning doc!!! what do you think of this belly fat burner? thank you!!! http://www.fireyourfat.com/

  Answer:  save your money. JG 8.4.08

• Hello sir, I had saddlebag liposuction 6 days ago and all ok. My question is, can I take the white foam pads out that were placed inside my garment. They are so uncomfortable now. I don`t see my doctor for three days and it`s the weekend so I was hoping to hear from you. thank you

  Answer:  I think it is likely OK to remove them now, I actually do not use them if the garment fits well. JG 8.3.08

• Is it not possible to perform liposuction without the ultrasonic dissolution IF you have local injections instead of put to sleep?

  Answer:  some doctors will do that, I will do it only for small touch up areas. JG 8.2.08

• Hi Dr. Again, Thank you for your time and devotion to this site, it is so very helpful. I understand you are not a fan of smartlipo, what kind of lipo do you recommend for a very fit woman with a small area of fat to rid on upper inner thighs? Also, can fat be stored and later injected into the face? Thank you

  Answer:  ultrasonic assisted liposuction is my preferance. The fat can be injected but then has to be removed without the ultrasonic dissolution to attempt to maintain its viability, but it is still not a reliable result in terms of the survivability of the fat. JG 8.1.08

• Hi Dr. Garcia, i had liposuction 7 months ago, and i would like to know, if there is ever a time, when the skin can get permanetlly brusied? The reason i ask is because on the right and left sides of my stomach right underneath my bra line, there is little dots of bruising. And i am afraid it will never go away. Please advise, thank you so much.

  Answer:  well, if the blood that accumalates under the skin after the procedure is allowed to be exposed to the sun, it can stain the skin on a long term and sometimes permanent basis due to the iron that has oxidized staining the skin. Not common but can happen. Avoiding the sun is important to help it see if it will all go away. JG 7.25.08

• I had liposuction performed on my abdomen about three years ago. I had continued pain and there are noticeable irregularities. How successful is fat transfer to the abdomen. Will this help deminish the pain and assist with the irregularities. The surgeon was clearly overzealous.

  Answer:  will possibly help the irregularities but not the pain, that is due to scar tissue wrapped arond the small nerves and will not be helped by injecting fat. JG 7.18.08

• I want to have liposuction and a tummy tuck. I went a Dr and he told me he prefers the traditonal liposuction. Do you feel the traditon is better than ultrasonic? I know you don`t like smart lipo. Is it true of you have liposuction on your tummy that if you later need a tummy tuck it will be harder to pull due to scar tissue. This one DR said NO LIPO and just a tummy tuck. Maybe lipo to the thighs and hips, but it would be traditional lipo not ultrasonic. It got me alittle nervous.. Thank you for being here for us

  Answer:  I feel that I can remove more fat with less blood loss with ultrasonic but besdes that, the differences are small.In most cases, you cannot do much liposuction under the skin at the same time as a tummy tuck as it can injure the blood vessels so in people with a large amount of abdominal fat, I suggest a two staged procdure with liposuction first. I think a liposuction first followed by a tummy tuck later does encounter scar tissue but it will give a better result than a tummy tuck alone as the liposuction first will thin the skin and give a better contour. JG 7.17.08

• What do you mean by small area`s when describing fat locations? Thank you. Bill

  Answer:  it is an amount more than a size. It also will depend on the quality of the ksin as to how the skin will shrink. JG 7.17.08

• Thank you...and you say the procedure itself won`t tighten up the skin...after the Ultrasonic lipo, how would I tighten up...will exercise be enough? Thank you in advance!

  Answer:  well, it will be up to the skin itself to tighten it, the more fat that is removed and the older one is the less it shrinks, exercise will not tighten it, the only thing if it remains loose is to have it cut out. JG 7.17.08

• Hello Doctor, Thank you for these pages...I read your lipo information area and I realized you`re not a fan of the coollipo neither the smart lipo. I`m an Athlete in my best shape, however I have always had love handles. When I lose weight,I lose my butt and breasts but my love handles are there and then I`m too skinny and muscular except..., when I `m in a confortable weight but still fit with six packs, my love handles get worse. I`m wondering if it may be a health issue but anyway, I feel that traditional liposuccion may be too much but maybe not... and I`m confused by all these different names out...Vaser, cool lipo,smartlipo, and blah blah...any advice? Thank you so much!

  Answer:  I think ultrasonic liposuction is your best bet, either Lysonix or Vaser. JG 7.17.08

• Is there a big difference between ultrasonic and smartlipo. Does one work better? Is one faster recovery time? Does smartlip make the skin tight than ultrasonic?

  Answer:  not a big difference, a HUGE difference. Ultrasonic is much more efficient. Neither one tightens the skin by its technology, lots of hype with that though. JG 7.15.08

• Dr. Garcia, two weeks ago I had Smart Lipo done on my stomach area. I see minimal results. The doctor is telling me results will be seen in about 4-6 weeks. Is that normal, or should I be seeing some sort of results by now? In addition, I have a black and blue above the incision that hasn`t even faded a little bit. I am worried about it because the incision is about 2 inches below it. Do you think it could be permanent damage to the skin? Concerned, Kelly

  Answer:  well by two weeks you should see something, having said that, I am not a fan of SmartLipo. I think it is alot of hype for little result, and if you do push it to get a result, the promises of skin shrinkage and minimal downtime go away. The bruising at this point is not uncommon and can take up to one month to get better. JG 7.15.08

• I had lipo a month ago. I have a hard place above the belly botton that is long and pretruds a little out, The dr recommened injecting the site with something he did not say what, but said it would dissolve the tissue and make soft. Question: Have you heard of this? and does it work ? Thanks

  Answer:  he might be suggesting some steroid or kenalog injections to soften it up, firmness in the belly button areait is not an uncommon thing to happen after lipsuction as there are more blood vessels there than in other areas. I think warm packs and massage would help and the kenalog injections are OK to od as long as it is not too frequently or too high a dose. JG 7.11.08

• Hi Dr. Garcia. I had lipo on backs of thighs a couple years ago, have since had a butt lift, and a small banana roll of skin caused by the lipo under one butt cheek is really bothering me now. Am thinking of having it fixed. PS who did it says its just skin and would have to be cut out and stitched. Any ideas? does this sound right? I am thinking it would heal like a BA crease incision(well) since there is no tension there. It is only about a half inch thick but about 4-5 inches long, looks like butt cheek crease but is unnaturally lower.

  Answer:  I think direct excsions of a banana roll leave unsightly scar that are very difficult to hide, actually there is a large amount iof tension on that area everytime you sit or take a step forward. It will also flatten the crease and I do not recommend it. Liposuction of the banana roll also will make it look worse. The best way to correct it is through a buttocks lift which you have already had and might just need a more aggressive lift on that side. JG 7.9.08

• Hi Dr. Garcia - I plan on having smart lipo to remove fat grafting lumps from my face. I have silicon cheek and chin implants. This may sound crazy but would the implants be at all impacted by the heat or in any other way by the laser or anything related to the smart lipo procedure? I have visions of them catching on fire and my face exploding. Thanks!

  Answer:  the silicone implants will not be affected in any way as they are solid and much deeper. Best of luck. JG 7.8.08

• Hello. I live in San Francisco and I am considering lipo for my thighs. Unlike most women it seems, my distribution is too much, but all the way around. So lipo would be circumferential, which I gather is a much bigger deal than just inner or outer thighs. I`d like to find a doc who has done this procedure *a lot* and who`s local. Where do you suggest I start? Should call my cosmetic derm and other docs to ask who they refer to? Do you refer? Everyone`s got a spiffy website and credentials. But not everyone is the best choice, obviously. Ideas?

  Answer:  Circumferential liposuction of the thighs is a bigger deal but can still be done with good results if the skin is in good shape. Due to potential legal issues, and some doctors wanting to know why I referred a patient to someone else and not them, I think you are best to go to this website and look for a plastic surgeon in the area you desire. I wish you all the best. JG 7.7.08 www.surgery.org/public/findasurgeon.

• Hi Dr. G., I have always had fat arms but normal weight everywhere else. I had liposuction there in Oct `93 but my arms remain fat, most likely because I have gained over 10 pounds after 2 kids. Over the years, I keep thinking that I would like to go back for another round of liposuction but I am wondering if I should now be worried about dimpling and skin laxity, now that I`m in my late 40s. If I do decide to go for liposuction, is any of the smart , laser liposuction any better, as far as dimpling and laxity? Lately, I have heard Velashape may be able to help me get more proportioned arms by burning the fat off. Is this true? If so, it would seem to offer a viable alternative with much less risks. Or is this just another way to lose money while holding on to my fat/bat arms? As always, thank you. You are just wonderful!

  Answer:  I think the greater the amount of fat removed, the greater the risk of loose skin, and to make that look better would necessitate ann incision from the armpit to the elbow which would be visible in most shorter sleeved outfits. I do not think that any of the smart lipo or laser liposuction techniques will do much for you I am afraid. I also think that Velashape will yield small improvements and there is no way to tell how long they would last. I think if you can live with the arm scars, that would be the most reliable and predictable improvement, sorry. JG 7.7.08

• Hi Dr. Garcia, i had a question, i had liposuction 7 months ago, and it looks like the surgeon just made one incision through my lower back area, right in the center ,and targeted my bra line love handles that i had. Now i have brusing on both my right and left sides of my stomach, and it looks like pigmantation , little spots of bruising, i am afraid it will never go away? Will it go away with more time? Please advise, Thank you so much.

  Answer:  it should be pretty much gone by now, I think you should see the surgeon to determene what has occurred, best of luck. JG 7.7.08

• Hello Dr. Garcia, I would like to schedule an appt with you to get an opinion on how to correct the lipo that was performed on the front of the lower thighs and above the knees. It has left the lower portion of the thigh very lumpy and disfiguring. And then there is a roll of loose skin that seems to hang above and over the kneecap. I have undergone one corrective procedure by the doctor who did it in which he tried to smooth out the underneatch fat with a probe after filling the leg up with solution. That helped a bit on lumpiness. Now, it is recommended to do a fat transfer. However, now I am left paying for the corrective fat transfer. I would like a second opinion but I would like to know if I would meet with you personally or only get to see someone from your staff? Many years ago a friend of mine had lipo and recommended I ask your opinion. Thank you in advance.

  Answer:  fat injections might improve it some and might help fill in the area so the skin is not as loose, but I will be honest, it will be improved but likely not totally corrected. JG 7.7.08

• I had liposuction 4wks ago in the stomach area. It is all still hard but mainly around the belly hole and right above it, it is like a roll that is hard and pretrudes out, The dr.is useing a maching called velia smooth( smooths with heat)( have used now 4xs) Question: How long will it take for the hardness to go away ? especaly the roll that pretrudes out? Thanks

  Answer:  it make take a few weeks to get better, and for it to to all go away it might take a few months. JG 7.6.08

• Hello Dr. Garcia: I was thinking about getting a very small tattoo on my right hip area... would this effect me getting abdominal lipo at a later date. Thanks for your time.

  Answer:  no, it should not. JG 7.5.08

• Hi Dr. Garcia, I`m 5`2 and 135lbs. I am trying to decide between laser lipo and mesotherapy (lipodisolve) for those stubborn areas on my thighs that resist exercise. Which would you recommend? I`m weary of regular liposuction because of the pockets and loose skin I hear it can leave. Thanks in advance for your help.

  Answer:  I am sorry but I cannot in good conscience recommend either one. If either one of those techniques did work, and if it removed the same amount of fat that could be removed with traditional liposuction, you would have the same risks. JG 7.2.08

• Hi! Thanks for your time in assisting others. Will smartlipo get rid of fat lipomas on my lower face that I developed 10 years ago after fat grafting? I want to regain more prominent cheeks in my midface and the FG has flattened my face. I`m hoping smartlipo can provide a more sculpted appearance. Any referrals in South Florida? Thanks!

  Answer:  well, it might be it might also dissolve the normal fat around the area I am afraid. I do not have any referrals in Florida for that, sorry. JG 6.29.08

• Hello Doctor Garcia,This is Y I wanted to know what harm can happen if I start exercising before my 30 days are up After Liposuction. I have been doing a little. Riding a bike, jogging,lifting a little. I feel good. I even order another griddle from the company you get yours for more support while I exercise.

  Answer:  it might prolong the swelling and bruising is the most common issue. JG 6.25.08

• HellO Dr.Gracia, Well it has been 2and a half weeks. So far so good I guess...I forgot know How long I have to wear my gearment. It`s better on any way plus I wear a mid-griddle to for my stomach. Is this ok? And sometimes an excercise thigh&stomach suit. For a tighter fit. I`m use to running and doing Kick boxing when do you think I should start back? This is Y , I got the lipo on stomach, inner thigh, back and flanks. Uppper back and flanks don`t look real good to me though. But maybe it`s still swollen. Thanks for listening you opion means a lot.

  Answer:  I think for one month is good if you can tolerate the girdle. I think your exercise program can begin one month after the surgery, slowly. JG 6.10.08

• HeDr.Garcia, I have had my lipo done since saturday, and actually I feel greaT! I thought I would be sore but I dont feeel to day. I hope enough fat was removed. Im briused up preety good though. I`m concerned about my inner thighs and upper back. Kinda look the same.

  Answer:  time will tell. JG 6.4.08

• There is a new procedure for Lipo that selectively reduces fat called Ab etching. This procedure uses a special cannula to contour/shape abdominal fat around a patient`s natural muscle contours to create a more athletic physique. I was drawing the marks on my abs to which would likely be suctioned off(strange, I know)--but when I twist, turn, or move similarly, the original marks stay adhered to my SKIN vs the actual muscular definition underlying. Would this provide a problem after undergoing actual surgery? Please advise...Thank you!!

  Answer:  sorry to tell you, but it is not new, also, the only way it works is by thinning the layer of fat below the skin over the area where the insertions of the abdominals are, and then you hope the skin sticks down where you want it to, you cannot etch fat, and you do not need a different cannula than has existed for many years. You need to have a thin layer of fat and also continue to work and exercise your abdominals from then on, merely doing the liposuction and not working your abs will never yield the desired result, sorry, no to easy way out. JG 6.2.08

• Hi Dr Garcia, I am a very fit 60 year old woman and would like to know how effective smart lipo is for smoothing out an inner thigh problem after liposuction and for love handles above the waistline.

  Answer:  it is not any better than any other method of liposuction, the claims are inflated, sorry to say. JG 6.2.08

• Dr,Garcia, Thank you for answering the question, I was givien some instruction sheets, My sister missed placed them and I was still kinda of sleepy when they were speacking to me, That I thought would just ask you. But I got it together now.Sorry to bother you.

  Answer:  please understand, it is not a bother, I am just concerned because so much of what we have talked about is something that your doctor or his nurse should have told you and been able to answer for you. I get patients of my own who have all of their information in a booklet along with being told and they still call me in the middle of the night or weekends.I just get concerned when patients are not getting the proper information frm their doctor or more worrisome when doctors perform surgery and then are not available afterwards by phone after hours to take care of those concerns. Best of luck. JG 6.2.08

• Hi Dr, Garcia, I got my lipsuction done yesterday, on my inner outer thighs, stomach ,flanks,sides, back. Today I feel pretty good.I`m walking around and everything. I can`t remember what I am suppose to now when can I take s shower, because i have a lot of drainaage.What do you advise me to do. Or should I just back and rest?

  Answer:  we allow our patients to shower the next day. I do not mind answering your questions but I have to say, almost all of the questions you have asked me are questions and things that your doctor or one of his nurses should have discussed with you or given you an instruction manual before all of your multiple surgeries. I am a little concerned that they have not done that for you. Or that they are not available for you to call them and ask a question. JG 6.1.08

• can i remove bio-alcamid from my lips ? and how ?

  Answer:  need to be cut out with surgery. JG 6.1.08

• Dr.Garcia, How do you avoid getting the creases that people write about? And what casues them? And thank you for having this site,and all your answers you have helped us with.- Y

  Answer:  it is a matter of geetting the skin to rest in a natural direction. Pulling too tight will usually make that happen. Thank you for the kind words too. JG 5.29.08

• Oh one more thing does the Arnica you recommend suppose to be a chewable?

  Answer:  dissolve it under your tongue 4 times per day. JG 5.29.08

• Dr.Garcia, I`m having my surgery done Saturday. How do I know if the garment is to small? I read a lot of women with question with it be to tight, and dents in there surgery. What is a proper fit?

  Answer:  it should be snug but not so tight it cuts off your circulation. JG 5.29.08

• Dr. G Are the scars bad after liposuction? How noticable are they, and how can you treat them?- Thank you for telling me about the herbs. Thank You Y

  Answer:  they are small and in most cases fade and look quite good. If they are noticeable they can be revised with a scar revision. JG 5.29.08

• Hello Dr. Garcia, This Y , You advised me that Bromelain and arica were used used for bruising and swellening.From Lipo surgery. When I went to purchase the Bromelain it stated it was use for digestion of protein Am I purchaseing the right one?

  Answer:  that is the right one. JG 5.29.08

• If my GYN recommends femal surgery to remove a cyst on my uterus, can you also scrub in and do lipo while I`m under anesthesia and (obviously) paying for the OR? Need it in my tummy and under my chin. Please advise.

  Answer:  I would not recommend that being done together. JG 5.27.08

• oh and let me add also that he left me with a depression linig on my stomach area that now my vagina looks more swollen than ever. When i`m wearing a pair of jeans, it indents soo deep in that lining, how will i ever be able to fix that? i had a doctor tell me that he would have to add fat to that area and remove fat from my vagina. this is so horibble for me. I`m looking for a doctor that has recontructive surgery experience, i know i alot of doctors won`t even touch me but i met one in NY but the charge is $12,000. Do you do reconstructive surgery?

  Answer:  I am sorry but at the present timne, due to my schedule, I am not accepting revisionary patients. JG 5.26.08

• i`ve had lipo in dominican republic back in 2002, and it was the best experience. i lost 20 pounds and looked fabulous. in 2005, i started having hormonal problems, due to medications and such i gained weight. I then proceded to go to colombia to have a 2nd surgery and needless to say, it was horrible. It was completely different than my first. i did have scar tissue but he said everything would be great. i did not see much of a difference and now my stomach is so hard, no softness but not flat. I`m thinking fo going to see a doctor for reconstructive surgery b/c i still have loose fat, do you think i would get results after a 3rd lipo?i`m 5`7 175, its just i have small pockets of fat on my hips and back and inner thighs, he did take lipo from my upper arms and now i have a crease there and it very noticeable. what can i do?

  Answer:  hard for me to say what can be done without seeing you in person. I will say that after liposuction is done, weight gain afterwards usually accumulates in new areas and some cannot be treated with liposuction. If there is residual fat, that might be able to be removed, but scar tissue will not be removed. Improvements, maybe, full correction, doubtful. Sorry. JG 5.26.08

• Dear Dr. Garcia, I had lipo on my arms a few days ago. I`m slim but had accumulated fat behind my arms. The doc took 100ccs from each arm and advised I wear an ace bandage over a cut up tube sock. I would like the best outcome, so are both garments needed, or is the tight sock enough for the amount of fat taken? He did a really good job, I can tell, and I`m afriad no matter how well I wrap with the ace bandage, it might cause creases. Thanks. And thanks for your post about putting foam in the butt garment. I had 40ccs taken out of each butt cheek (the heart-shaped center, which was the only place i had fat.) It bulged a little, so now it looks much cuter and lifted, but the small garments were too constricting and the mediums too large. You always give the best advice!

  Answer:  well, we usually make liposuction garments that are much easier and realiable to apply for that, I think you should at least do what your doctor has told you though. I think the ace wrap is more important than the sock. Best of luck. JG 5.26.08

• Hi again Dr.G; thank you for answering my question about SmartLipo vs traditional lipo. one last question; the PS in my area told me that tumescent lipo would be overkill for very small amount in abominal area. is there any other method of lipo you suggest for a thin, fit person, that is storing some fat in that area? I haven`t been able to get a clear idea of what type of lipo would work, if SmartLipo is not that good?? thanks much for your time! DG

  Answer:  Tumescent lipo is just a method of fluid injection to either help remove the fat cells and in some cases also provide anesthesia. I do not know of many cases where tumescent fluid is not injected at the time of liposuction. It certainly is done with SmartLIpo. If you have small areas you can just have them do it with a smaller cannula if you wish and your choice of anesthesia. JG 5.23.08

• Hey Dr. Garcia, Jennifer here again. Another question I had for you was could you let me know where you have your patients order their medical garments from? I heard that its better to wear a medical garment then to just by a compression non medical garment from Macys like SPANX. Do you think a medical compression garment is better to wear for full recovery? Let me know what where you have your patients order their garments. Do you recommend a certain kind for the procedure I had done? I had lipo done of my full abdomen, flank, hips and back. Thanks Dr. Garcia.

  Answer:  I do think the medical garments are better. We use Design Veronique. JG 5.22.08

• Hey Dr. Garcia. Jennifer here again, regarding my liposuction surgery I just had this past Saturday the 17th, of my full abdomen, flank, back and hips. Dr. Garcia I went yesterday to get my foam and stiches removed and when I had the foam taken off I had a few bad blisters on me. One of them ripped off with the foam and the cut looks very fresh and is still bleeding. The other blisters the assistant popped and covered with gauze. I think the wrap they put on your stomach is very irritating. So Dr. My question to you is is it alright that I am not wearing a compression garment right now for a couple of days? I am trying to heal my wounds first because of house tender they are and i dont want to cause problems. The soreness definetly hurts and I feel it more now that I am not wearing a garment. I ordered a new garment and am waiting on its delivery but as of right now im wearing nothing but the bandages on my cuts. Is that alright? Am I doing damage to my stomach by not wearing anythign right now? Please let me know if its ok. Thank you Dr. Garcia.

  Answer:  yes, let the wounds heal first and then get back into it, the swelling will persist for a little while longer this way but you need to do that to let the skin heal. JG 5.22.08

• Hi Dr. garcia, i have been keeping an eye on your responses to Smart Lipo questions. last summer you had strong feelings that smartlipo and traditional lipo were basically the same results. have you seen anything to change your mind since then? I am a thin person, age 48,very fit, with a very small amount of belly fat around navel area. I have been told that tumescent lipo is overkill for such a small amount to be removed, so i am still waiting to see what your opinion of Smartlipo is now that it`s been out for awhile. i highly value your opinion and am interesting in your thoughts for my little area that I want to get rid of? also, do u still feel smartlipo does not tighten the skin once healed? thanks much, DG

  Answer:  no, actually my feeelings have solidified, and frm hearing presentations at national plastic surgery meetings, they are stronger than ever. As to the skin tightening, it depends greatly on the amount removed and quality of the skin. JG 5.22.08

• What massages do should be done after liposuction on upper, lower stomach, back, flanks, inner thigh? I read that some go get massages, is there a certain kind to ask for? Thank you - Y

  Answer:  just basically a light Swedish massage. JG 5.22.08

• Hi Dr.Garcia, Thank you for answering my question about the Bromelain and Arnica. So is this something I should purchase after I get Lipsuction? Where do I buy it, and how much do I take?

  Answer:  available at any good health food store, dosage is the standard dose on the bottle, I suggest starting it 1-2 days before the procedure if possible. JG 5.21.08

• Dr.Gracia,This is Y , How are you? Can you tell me what Bromelain and Arnica is used for? I read it a few time with people having or getting Liposuction done.

  Answer:  it is used to reduce swelling and bruising. JG 5.21.08

• Hey Dr. Garcia. Jennifer here again. Just wanted to let you know I had my 2nd lipo surgery on May 17th. It was for lipo of the full abdomen, hips, flank and back. I am in some pain of course, much difference than when I had circumfrental of the thighs and knees done. But still sore. I have a couple of questions for you today Dr. Garcia if you dont mind. One, I notice that my private area down there is very purple and swollen, is this normal? How long before the bruising and swelling goes down in that area? I also my surgeron touched up a bit behind my thighs from the last surgery so my legs are somewhat swollen again. I have foam and a white wrap around my stomach but should I still be wearing a compression garment for my legs again since they are swollen again? My dr. did not mention anything to me and when I woke up in recovery I wasnt wearing anything on my legs. I put on a compression thing just now and it feels extra tight around my stomach area, is that good or bad? Is it good to keep your stomach very compressed while healing for this? Does stomach swelling and bruising go down faster than legs? I remember you saying upper body healing is a little better than lower body healing. Hopefully now that I am on Iron pills and I get weekly b12 shots this could help speed up the process. Also once I am done taking my steriods and anitbiotics I was going to start taking Bromalin and Arnica again with massages. Do you think all of this will help? Do you recommend anything extra for the stomach, back flank and hip area? Thank you Dr. Garcia

  Answer:  the private parts being swollen and discolored is all normal and expected,yes. It might take a week or more to get better. I suggest wearing the garment for the legs if there was more liposuction done there. I like the garmet on as much as possible and I think the swelling on the abdomen does go away faster than on the legs. I think Bromelain and Arnica do help, yes. As to the other areas, just massage them once you can tolerate it and best of luck. JG 5.20.08

• I hear some docs are doing lipo under local (IM). I`m interested in abdominal lipo as I`m not a candidate for abdominoplasty (hx open choles.). I`m looking for a reduction in mass not perfection as I continue fitness regimen. 1. What are your thoughts on lipo under local? 2. Which approach has greater chance of PE? 3. How soon after procedure can one fly? (I`m slated to go to UK mid-July). Thanks.

  Answer:  I think liposuction under local anesthesia not uncommonly ends up in an inablity to remove all of the desired fat due to feeling pain. I only do it for very small areas. The risk of pulmonaruy embolism is due to the inactivity after the liposuction, not essentially during the procedure, so both have that risk if you do not get up and move around afterwards. Typically I allow the patients to fly after 7-10 days, but they need to get up and walk down the aisle every hour or so to avoid getting a blood clot. JG 5.19.08

• HI Dr.Garcia I came to see you and was ready for lipo on my stomach flanks and back. Since our intial visit i weighed in at 195 lbs at 5`4. I have since gotten married and regretfully gained 50 lbs. I know I was wondering if i am still a canidate for the lipo? I also moved to LA Ca and would appreciate a reccomendation of a doctor here you might know. thaks Dr.Garcia

  Answer:  well, you are likley still a candidate but the result will be less than optimal as the skin will likely not shrink well. I think it best to see if you can lose some of the weight first and then be re-evaluated to see what is your best option. JG 5.19.08

• Dr.Garcia, This Y I ask you about the extra skin after lipo, I spoke to the 2 different Docs, well thank you for your answer. So I`m not going to be happy with the results on my stomach right? Since I already can pinch extra skin. I will have a lot of extra skin after the lipo right? That`s not good. The Doc, says that he will give me special exericses to help flatten the extra skin. I have never heard of this. And If I didn`t like the results he will consider doing a mini t.tuck. In your opinion is any of this true? And how long do you have to wait to have sex after lipo?

  Answer:  there are no special exercises in the world that tighten loose skin so the doctor who told you that should be put on your do not ever see again list . I think the fact he told you that to me sounds like he is desperate to do your surgery and will say anything to get you to do the surgery with him. Run, do not walk away from that guy. We suggest 2-4 weeks after liposuction before engaging in sexual relations. Best of luck. JG 5.19.08

• Dr.Garica, This is Y I forgot to ask you..If there anything else I can do with the extra tummy skin after the lipo other then a mini/full tummy tuck, I really dont want the scar.

  Answer:  there is nothing besides cutting it out, losing weight will likely leave you with loose skin too if you can already pinch it. JG 5.19.08

• Hello Dr.Garcia, My is question is I have spoken to 2 different Dr`s about Lipo and T.Tuck. I was told I could get both. Another Dr. who done my breast told me he could do lipo on my inner thighs, upper lower stomach, flanks, back. All at one time. And that I would be a happy with those results. I`m only 5`0 I weight 135lbs. I feel I have a extra skin my tummy. I want a flat tummy. Do you think I will get the results I want with just liposuction.

  Answer:  if you have a little loose skin befoe the liposuction on the abdomen, then you will have more loose skin after the liposuction. Multiple areas of liposcution can be done at the same time, yes, and you could have the liposuction done first and the tummy tuck later, sometimes that gives an even flatter result as it is not possible to agressively liposuction the upper abdomen when doing a tummy tuck. JG 5.18.08

• Dear Dr. Garcia, I am a 32 year old woman who is considering buccal fat removal (not aggressive, a minor improvement). I do not have fat cheeks but I seem to be much heavier on the bottow than the top. Do you have any thoughts about this procedure? I am also concerned* about my skin sagging after removing some fat from my lower cheeks. At my fairly young age, is the chance of sagging fairly low? Thanks for your time!

  Answer:  it will likely prematurely age you over time. JG 5.16.08

• Dear Dr. Garcia, I am a 32 year old woman who is considering buccal fat removal (not aggressive, a minor improvement). I do not have fat cheeks but I seem to be much heavier on the bottow than the top. Do you have any thoughts about this procedure? I am also considered about my skin sagging after removing some fat from my lower cheeks. At my fairly young age, is the chance of sagging fairly low? Thanks for your time!

  Answer:  well, the less removed the less chance of skin being loose but also the lesser the degree of improvement. It might look fine for awhile, but ultimately, you will age faster if the fat is removed. JG 5.16.08

• I have internal dranage from minor lipo which has settled in my inner-upper thigh, is there any chance of this purple discoloring becoming permanent? Would tanning this area cause permanent damage? Also I`m considering having my upper eyelids done by a PS Who only does ps on the face and I have been referred to him by one of his patients. What is the most common problem people have from this procedure? Thank you so much as always. :)

  Answer:  it can last a long time but should not be permanent. The most common thing from upper lid surgery is either not enough skin being removed leaving a fold of skin, or too much skin being removed and then you are unable to close your eyelid when you sleep. Best of luck. JG 5.15.08

• I have internal dranage from minor lipo which has settled in my inner-upper thigh, is there any chance of this purple discoloring becoming permanent? Would tanning this area cause permanent damage? Also I`m considering having my upper eyelids done by a PS Who only does ps on the face and I have been referred to him by one of his patients. What is the most common problem people have from this procedure? Thank you so much as always. :)

  Answer:  I doubt it will be permanent but it can last a long time as that skin is quite thin. The most common issues with upper eyelid surgery is either too little skin being removed and not seeing much of a change, or too much skin being removed and not being able to close your eyes when you sleep, not common problems though. JG 5.16.08

• I had lipsuction on my hips because I have uneven distribution of fat or saddlebags in middle of my hip while the rest of hips had not fat. I am afraid if I get pregnant, fat will only go to area on hip where I did not have saddlebags or liposuction done. Then it will look like saddlebags on those areas of my hips since fat will only accumulate there?

  Answer:  that can happen if you gain too much weight during the pregnancy, but if you only gain the recommended 25 pounds, that should not occur. JG 5.15.08

• I just had some eyelid surgery to remove some fat in my lower lids under general anaesthesia. Would it be safe to have some liposuction of the waist under another general anaesthetic in 5 weeks? I am a healthy guy in my late 20s.

  Answer:  should be OK to do if you are healthy to begin with. JG 5.14.08

• Jan 29th I had liposuction to my bilateral thighs and inner knees. At about 2 months I started getting a 1.5 -2 inch roll under my left buttock cheeck and under my right cheek a bit farther down from where my cheek meets my thigh a crease. Is this something that should be revised? On my 3 month cheek up he said that a butt lifts would help get rid of that. I am already going in on June 5th for a medial thigh lift. So after this I won`t be able to do anything for quite some time. And when I wear a bathing suit I have this huge bulge right under my left cheek. 1) should it be covered to make it look right and 2) will a medial thigh lift help reduce the look 3) how far down the thigh will a medial thigh lift effect? Thanks, sorry for so many questions..

  Answer:  well, it can be difficult to revise as it comes from an over aggressive fat removal in most cases, but it is hard to ell without seeing you in person. I do not think the medial thigth lift will correct much of the problem though. The medial thigh lift effect wil depend greatly on the type of thigh lift done and if there is a vertical scar. If there is no vertical thigh scar I would say it will imprpove only the top third of the medial thigh. Best of luck. JG 5.11.08

• I had the lipo touch up to my hips and at my tt scar to even it out and I`ve been wearing a waist cincher as my compression garment. Is my cincher tight enough if I can slide my hand under it? It is comfortable but I`d rather not be wearing it so I`ve assumed it is tight enough. lol Also the areas I had lipo on my hips are about 4 inches in diameter each and at the tt scar it is about 2in x 4in. How long do you think I need to wear the cincher? And I had the touch up on Thursday and began massaging it on Friday, was I supposed to wait a week to massage or do it that soon? It does hurt to do it but I thought i was supposed to start asap. Thank you for your advice. Hope your having a Great weekend and a Happy Mother`s Day! :P

  Answer:  It should be snug but not so tight it is difficult to breathe. I think those areas are small enough that the garment will likely not matter to much. Best to you too. JG 5.11.08

• Hey Dr Garcia Jennifer here again. Thank you so much for you answers about the blood work and iron. I am happy to say that I got surgery clearance. My bloodwork was good enough for my dr to schedule a surgery date. Basically my RBC and hemoglobin is normal and my iron went from 37 to 160 count. Only thing a point off was the hemacrit which was 33.8 and 35 is normal. My had my primary dr give me a clearance for surgery and show along with the bloodwork the iron pills im taking and about the b12 weekly. Since my dr. has been so busy booking surgeries i will prob get put it for surgery on May 22nd, or something sooner hopfully. My questions for you today Dr Garcia are firstly how could you tell if your skin might be starting to sag after circumfrental lipo? Do they feel heavy? hurt when you walk? My legs only feel good when im wearing my garment, but when i take it off it feel like my legs are heavier. Also it looks like I have a hood over my knees. I dont know if thats because im still swollen or its sagging, I dont know what sagging is supposed to look like. Maybe the garment I have been wearing isnt tight enough anymore because a lot of my swelling went away. Where do your patients get their garments from? How tight should they be? I had my surgry April 3rd so I figured by now it was ok to take my garment off here and there. Also I notice that my cellulite appears somewhat worse than the way it did before my surgery. I dont know if thats because I havent worked out in so long or what. THey have this new cellulite technique called accent thats out. Its about $450 per treatment. Do you recommend this or have you heard of it. In you professional opinon do you think I should bother wasting more money on cellulite treatments, or should I should hope exercise and diet clears this up better? Do you recommend anything for your patients who have cellulite? One last thing Dr Garcia, for patients that do have sagging skin from circumfrental lipo of the legs, what is the next step for them? Is there a surgery to fix this? cutting the skin off or something like that? Please let me know when you have a chance. Thanks again.

  Answer:  the skin sagging is more one of appearance than feeling, you can see it but it will take time for that to be seen due to the swelling, and the skin will not sag to its maximum until the swelling goes down. What you are feeling is just due to the swelling making your legs feel heavy. We get our garments from Design Veronique and we provide them for our patients. They should be snug but not so thght they cut off circulation. It is common for cellulite to look worse as the skin gets looser and I think you can skip the Accent, I am not impressed with its results. We occasionally suggest endermologie for the cellulite and if the skin sags, the only thing that can be done is to cut it off, yes. JG 5.10.08

• Dr Garcia, thank you for your promt reply to my question regarding carboxytherapy for unwanted abdominal fat. I`m very hesitant about traditional liposuction. I`m also someone who is susceptible to malignant hyperthermia, so try to avoid general anesthesia whenever possible. I`ve heard about ultrasonic lipo(?). I realize this question may be difficult to answer without a consultation and exam, but what do you feel would be my best option(s)? Thanks for your time.

  Answer:  well, the only laser dissolving of fat is done with a SmartLipo and there is Cool Lipo also, but the claims they make are, I feel, exagerated. The ultrasound technology generates a good amount of heat so it is hard to do it under local anesthesia but there are machines awaiting approval in the US that are external ultrasound that show great promise, likely at least one year away. JG 5.8.08

• Sorry, I have another question: I had the touch up lipo yesterday and the PS said come back in 6 weeks for a check up. Apparently he left 2 drain holes open for draining and they are covered with gauze. My questions are, when do I remove these and when can I shower? I still have a good bit of blood coming through the gauze. Thank you for your help. :)

  Answer:  I would remove them in 24-48 hours and shower only, no baths or swimming pool until the holes have closed totally. JG 5.8.08

• Is it okay to use electric massagers for the lipo`d areas? Any certain kind to look for if so? Thank you and have a great Friday! :)

  Answer:  no special brands, but they can be used, yes, use a broad head for the massager though. JG 5.9.08

• Hi Dr Garcia, Yesterday I had touch up lipo to the tops of my hips and above my tummy tuck scar from 2 years ago to help it look smoother. My PS didn`t mention massaging the areas but I see you recommend it. So, do I massage over the girdle, how agrressive do I massage it, when should I start massages and how often? I have lots of brusing today and it`s not exactly in the area I wanted the touch up, does this mean he missed the area? The brusing is just past the area not higher or lower. He also injected some of the fat removed into an area at my tail bone where there was an indented boney area. He said he overfilled it and I haven`t seen it yet but what do you think the chances are that the fat will stay there? Also does it matter if I`m sitting on that area? Sorry for so many questions but thank you for your advise. :)

  Answer:  you massage with the girdle off, small circular strokes in all directions over the areas treated. We usualy start as soon as you can tolerate the massages. Done twice per day for the first month. The bruising can move to areas adjacent to the areas treated so it does not mean the areas were missed. Sitting wil not put pressure on the boney areas that were injected and I am not a big believer in fat injections lasting too long. Best of luck. JG 5.9.08

• Hey Dr. Garcia Jennifer again, .I just wrote to you bout 5 minutes ago. My other question for you Dr is that I have been getting my blood taken a lot. I had it taken 4/26, 4/29 and then again today 5/8. This is because im trying to get normal blood results to get my liposuction date scheduled. Do you think that I am doing it too much? How long should I wait to get it drawn again? The one I took today was a point or 2 off from being normal for redblood cells and iron. I am taking the iron pills Repliva, b12 shots once a week and eating an iron rich diet. Should I wait a week to take it or can I do it Monday or Tuesday? Thanks Dr. Garcia again for your help on all my questions. I appreciate it.

  Answer:  I would not repeat the blod work so soon, it wil take at least three weeks to see a difference. JG 5.8.08

• Hey Dr. Garcia. Jennifer here again, regarding Liposuction. Dr., I dont know if you remember but im the girl that had the first liposuction done on April 3rd the circumfrental of the thighs and knees, and I was supposed to have my 2nd lipo surgery, full abdomen, flank hips and back on May 2nd. Im writing because my Surgeon cancelled my surgery due to unsatisfactory bloodwork. My first sugery I had perfect blood work, and then i was on a bad diet eating junk and everything under then sun. Now since my last surgery I have beeen dieting eating healthy and I get bad bloodwork? I dont get it. Basically my blood work came back this time with low Red blood cells, low hemoglobin and low iron. Do you think this is from the 1st surgery? I did lose a lot of blood and fluid. He took out 5 liters of fat and I remember I felt very faint and was shaking when I woke up and needed 5 fluids bags before he let me leave. On top of that I changed my eating habits cold turkey so maybe I put my body into shock with everything I did to it in a short time. My question to you is that my blood work were only a few points out of range. My primary care dr said I am borderline anemia right now. My surgeon said he will not rescheudle the surgery until i get treated for this and produce normal bloodwork. Is this what you do with you patients dr. Garcia even if they are a few points out of range? My primary care dr said its only a few points off so he doesnt know why my surgeon wouldnt operate on me. Right now my primary care dr put me on Repliva iron pills once a day, weekly b12 shots, and i am trying to eat a lot of spinach and other iron rich foods. Do you have any extra advice to give me on this for making my blood work better? Or any advice about why my bloodwork might of came up bad? Do you think my surgeon was too aggressive on me?

  Answer:  it is certainly due to the blood loss from the last surgery, no surprise there. It could have been improved by waitng a little more time and also starting you on iron to help with the blood cell production immediately after the first surgery. I think what you are doing is enough, it is basically too aggressive to think the next surgery could have been done so soon. JG 5.8.08

• I work out on a regular basis and watch what I eat. I have a stubborn area of fat on my lower abdomen that I can not get rid of no matter what I do. I have an ab 4-pack, but would like to bring out my 6-pack. Just saw a story on TV about carboxytherapy. Does anyone in Vegas offer this procedure? Would like to try and avoid lipo, if possible. Thanks for your time.

  Answer:  I am not aware of anyone in Las Vegas that offers that procedure, and I will say that I do not endorse nor recommend it either. JG 5.8.08

• Dr. Garcia. I had upper and lower abdomen lipo 3 months ago. Still have some hardness on these both areas. Do you think with time, this will go away or is it a scar tissue that needed to be massage and some ultrasound to break it down? Thank you very much.

  Answer:  ultrasound will speed it up but it should get better for 6 months after the surgery. JG 5.6.08

• Hi Dr. Garcia, Have you heard of Accoustic Wave Therapy for cellulite treatment? What do you think of it, twice weekly for 3 weeks and then 2 monthly, so total 8 treatments for $2000.00 front and back thighs area. Is it worth the money? Thanks for your time and answer

  Answer:  I have heard of it and am not impressed with it. JG 5.6.08

• I had smart lipo done on my upper & lower ab`s. It has been 11 days now since it was done. I feel hardness under the skin. I asked about this & was told it is scar tissue & start massaging it twice daily for 15-20 minutes. Can scar tissure form that fast? Will the hardness go away eventuall & is massage the best treatment for this?

  Answer:  more likely it is blood collected under the skin, 11 days is not enough time to develop scar tissue, but massage will help soften the blood too. In time it should get better, even without the massage.JG 5.4.08

• Dear Dr. Garcia, You recently answered a question I had about having received a significant over-correction in a fat graft to my lower face. My PS agrees that there is definitely too much in one area and that, even with the expected resorption, what remains will likely continue the distorted facial plane with which I am now stuck. You suggested that the graft could be reduced by liposuction, but he claims that this is impossible because the centrifuged fat, once injected, infiltrates the surrounding tissue and can no longer be suctioned out as discrete quantities of fat. Is this true in your experience? If so, I assume that the longer one waits, the harder it would be to do, as the infiltration must take time; the sooner the intervention, the better. Is that so? What other ways aside from liposuction might there be to remove it? If, in your opinion, my surgeon is wrong about the efficacy of liposuction in cases like this, how might you suggest I convince him at least to try it? Something really needs to be done to repair this. Thank you very much for your help, Dr. Garcia.

  Answer:  well, some of the fat was injected into the muscle and will not be able to be liposuctioned out, but I can tell you that likely not all went into the muscles and some fat lies above it. I think the amount of fat you are looking to remove is not all of that which was injected, so even if you can only remove some, it should look better. The infiltration of the fat into the muscle occurs at the time of surgery, the fat cells do not migrate over time into the muscle. I would wait at least 6 months to see if the swelling going down is enough of a change before undertaking more surgery. JG 4.30.08

• Hi Dr Garcia. I had smart lipo on my abs and flanks on 1/8/08. I have discoloration on my flanks which I`m afraid may be Erythema Ab Liporaspiration. Have you ever seen anyone with this condition? Do you think it could possibly be bruising at this point? I will of course talk to my Dr about it when I see him in 3 weeks. Thanks for any info.

  Answer:  it can be bruising in the sense that at times some blood can temporarily stain the skin, need to avoid sun exposure and wait for it to fade. JG 4.30.08

• Hi. Is it true that with smart lipo there are no stiches? Wouldn;t that be an advantage over traditional lipo?

  Answer:  it is a doctor preference, some doctors leave the incision open to drain but that can be messy and increases infection and the scars do not heal as well as those that are sutured closed. There is absolutely no advatage to traditional liposuction, you can leave those incisions open too if you want. JG 4.28.08

• I am going to my consultation appointment this week for smartlipo for my upper and lower abs. I am 51 years old and have had 4 children with 1 being a C-Section. After my C-Section, I was left with the pouch that women typically get after a C-Section. I was told by my doctor that Smartlipo will work to get rid of the pouch. What is your opinion on this problem and what is the recovery time.

  Answer:  I think SmartLipo is a poorly proven system that is a lot of hype, not any better than other traditional methods but it makes lots of claims that there is little science to support. JG 4.28.08

• Dr Garcia, I live in Baja Mexico. And I have been in the Plastic Surgery Business for 4 years, and so much still to learn. I`m a nurse. My question is can you explain about the fat in some patients being deeper into the body cavity?? I myself you can`t even pinch a inch on my upper torso, but I am a Thick Girl. My P.S. said I have a large frame and a coke bottle figure. But is it possible to have fat deep inside the body? And if so what can be done about this? Thank You

  Answer:  that fat is called visceral fat, it is below the muslces and is wrapped around the organs and only diet and exercise will remove it. JG 4.27.08

• Thank you for imparting your wisdom & experience. You`re truly an anomaly. My question is about the new COOL LIPO, which happens to be a dual procedure where fat is removed & then the skin is tightened. I`ve read it`s very effective for cellulite.

  Answer:  sorry, but I think it is a lot of hype for little to no improvement for cellulite. JG 4.26.08

• Hi Dr. Garcia, I am a 28 year old woman and I am wondering if a woman my age can undergo neck (under chin) and cheek liposuction without lifting procedures. My skin has fairly good elasticity. I have minor nasolabial folds and a little loose skin under my chin, but virtually no fine lines on my face or neck. I`m thin but I have had a little extra fat- very little- under my chin and on my jowls since I was a teenager. My concern is loose skin under my neck and in my jowl area after such an operation. Any thoughts? Thanks for your time and consideration, Dr. Garcia! I appreciate all of your help.

  Answer:  at your age, as long as the amont of fat is not too large, it should be OK. Best of luck. JG 4.26.08

• Hey Dr. Garcia its Jennifer. Dr. my question today is about healing time for my liposuction. Now my 2nd scheduled Liposuction was supposed to be for May 1st. If you remember My first was April 3rd which is when I had the circumfriental of my legs and knees. I just found out today that my dr. needs to postpone the surgery for 2 weeks. So my new surgery date is May 15th. Im a little upset because summer is around the corner and I wanted to heal asap. My 2nd surgery that I am getting is liposuction on my full abdomen, hips, flank and back. Are the rules for these areas the same as your legs? I remember you said the upper body heals faster than then lower. I have a vacation booked to Miami July 28th. Will I be ok by then to lay out in the sun and will I still be bruised and very swollen on my stomach? July 28th will be 4 months after my leg surgery and only 2 and a lil less than a half months after my stomach and other parts. I just hope im not going to look like a swollen mess. I was wondering if you think I should move my vacation to Late August, or keep it the way it is? How do your patients normally heal with that area. As for brusiing on my legs most of it has gone away already. I have a little left. Im just curious as to what will happen with my abdomen, flank, hips and back. I would greatly appreciate your input on the matter. Thank you so much.

  Answer:  rules are the same, but healing does occur a little faster, by a few days. I think you will be fine for your vacation most likley. JG 4.25.08

• Dr. Garcia. Many thanks in advance for your answers. You`re the best, as always. I had my lipo on Feb 13th on upper lower abdomen, flanks, and anterior thighs. How long will I still feel the NUMBNESS in these areas? I have started lympathic massage as soon as 2 weeks after surgery 3x/week. In the past week I`ve added ultrasound to breakdown the scar tissue. I still have the feeling of pulled in my abdomen and the lumpiness. How long should I continue with the lymphatic massage and ultrasonic breakdown to get rid of the lumpiness? If I QUIT the ultrasound and massage starting next week, will the lumpiness go away eventually with time? Should I keep having ultrasound and massage until it goes away?

  Answer:  the numbness can at times be there for 6 months and in some areas even up to one year. I think the lymphatic massage past 4 weeks is not worth it and the ultrasound maybe for 6 weeks. In most cases the lumps will go away in time with your own light massaging and stretching. JG 4.23.08

• Hi Dr. Garcia, how many liters/gallon of fat is it possible to take out from each leg? All my leg until the knee is overweigh but the rest of my body looks good. What do you advice for me? Thank you, Sincerely, Ornella

  Answer:  that is a very indivualized thing, no way for me to tell without examining you in person. JG 4.23.08

• Dear Dr. Garcia, I am a 28 year old young woman who is considering having liposuction of the neck (under the chin). I am thin and I am in good physical condition. I have dark meditteranean and no fine lines on my face or neck. However, my main concern is skin elasticity in this area. I am starting to get nasolabial folds and frown lines, and I am wondering if this means my elasticity is poor. My doctor told me that I a little bit of loose skin under my chin and a little bit of fat. What I find particulary bothersome is how I can see a little bit of the fat deposit under the left side of my chin from the front view- but only when I speak!!! It`s annoying. As for the side view, it just looks a little saggy and a little fatty under the chin- but it doesn`t look like a double chin. I am wondering at my age and with my fairly elastic skin, do you think I might need a neck lift? Or liposuction? I would like to avoid a neck lift if possible. Please keep in mind that my chin is certainly not weak or receding but my jaw line is on the weak side.

  Answer:  I think I would go with a liposuction at your age if the fat is not too large. JG 4.21.08

• Dr. Garcia, I am 48 with a double chin - would smart lipo. or traditional work better on this area? I hope to tighten a little with this too. Also, I am considering having the procedures of lipo. of the chin and upper eyelids by a surgeon whose basic practice is ears, nose, and throat. I have seen photos of his work and checked for complaints. Do you think it is safe to have him perform these procedures? What other credentials do I need to look for? Thanks, Ramona

  Answer:  at your age any type of liposuction will likely leave loose skin that will require surgery to tighten and remove it. I think those types of surgeons, if they practice that type of surgery, can be capable of performing plastic surgery eventhough they did not complete a full plastic surgery training period. JG 4.20.08

• Hi Dr. Garcia, I had a tummy tuck with liposuction and stitches to tighten the muscles 3 years ago. I was fascinated with the results, though my lower abdomen wasn`t totaly flat, I`d say it was like a little hill like shape. But I`m realistic. I had just lost 60 pounds, used to weight 260, (5`4 height) and the surgery was my reward. Unfortunately, I`ve gained 40 pounds since then, my body has changed tremendously !!! I`m very big from my upper portion such as my shoulders, arms, face, the upper part of my chest, back,around my waist and by lower abdomen hasn`t changed. I hardly recognize myself. I`ve always been overweight but with a feminine small waist figure. Please help.!!! I love being chubby, but need to have my narrow waist back.

  Answer:  the narrow wasit is controlled by the amount of fat inside of the abdomen and that fat cannot be treated with surgery, so I am afraid the only solution is to lose some weight, sorry. JG 4.18.08

• didn`t mean to offend you. was just excited to find a website like yours and thought you answered different types of cosmestic questions and concerns. Thanks for the questions you informatively answer for me. Thanks.

  Answer:  sorry, no offense taken, it is just I should not be giving information that does not relate directly to plastic surgery and since I do not see who is posting the questions by name, and since we have had problems with peopel continuing to do it, we need to attempt to control the non-related questions.Best of luck. JG 4.18.08

• my skin is a tight with hard areas all over (abd,back). Would a swedish massage work or what do you recommend your patients to recieve. how many times a week? 30min or 1hr massage?

  Answer:  I think you need to ask your question elsewhere, this is a plastic surgery site. JG 4.18.08

• do you recommend your patient to use utltra dissolve, or a similar ultrasonic device to help patients after liposuction, smartlipo, to speed up the healing process?

  Answer:  we use regular massage, it is maybe once every 3-4 years that we use external ultrasound for a liposuction case.JG 4.17.08

• I just had neck lipo six days ago.I notice a few lines under my neck. Will this go away, are will I need to do something extra. I`m seeing my doc this week but my sister said you are great and I wanted you to tell me.My sister says it may be ripples. Thank you Terri

  Answer:  in most cases they go away as the skin shrinks and redrapes. If the skin does not tighten it might leave ripples, that depends on the skin and the amount of fat removed. If there are ripples then the skin can, at times, be tightened later. Thanks for visiting. JG 4.16.08

• Hey Dr. Garcia, its jennifer. I had some more questions for you regarding Liposuction if you dont mind. First I am happy to say that I have been feeling a lot better since my surgery 2 weeks ago. The Arnica seems to be helping with the bruising and i am walking better as well. If you dont remember me I had the circumfriental liposuction of the legs and knees. So my questions dr. Garcia is, how much longer do you think i have to wear my compression garment for? How long do you make your paitents wear a garment for this type of surgery. Also, the Arnica is helping with the brusiing, is there anything that I could do extra to bring down the swelling faster? I told you last week that I was going back for my 2nd surgery on May 1st. I am getting liposuction done on my hips, back, flank, upper and lower abdomen. Is the pain from this operation going to be as bad as my legs or worse? And how long do you have to wear a garment for for this surgery? Also Dr. the most important question, do you use Reston foam pads on your liposuction patients? I have heard good and bad things about these pads. My Dr. used them on me. He stuck them right to my skin after the surgery and removed them 5 days later when he took my stiches out. Do you use Reston pads? Also do you recommend Open drainage over stiches? Sorry for all the questions. But would be thankful if you could help me out. As always your replys are greatly appreciated.

  Answer:  we normally use it for 4 weeks, but in cases like yours we sometimes use it for 6 weeks or more. The only other thing I can suggest for the bruising and swelling is to keep your legs elevated as much as possible. I think the new surgery pain level will be pretty close to this one`s. I use Reston foam on the abdomen only. I always stitch the incision closed, I do not leave them open to drain. JG 4.15.08

• dr. garcia, Do you know of any good plastic surgeons in st. louis, mo.

  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 4.15.08 http://www.surgery.org/public/findasurgeon.php.

• now a have a question concerning a friend who had smartlipo. The doctor was not able to complete her entire medsecion upper,lower,flanks, back. etc. the first treatment he put the medication all over but was only able to complete her flankds and back, so the front part of her stomach that was not treated got really hard from the medication, i believe a week later she went for her upper and lower abdomen to be completed. Her stomach was very hard and the doctor had difficulty she believes performing the procedure this time. Her stomach is hard he said it`s inflammation and instructed her to take arnica to help. What do you think of her situation.

  Answer:  I would go see a different doctor. JG 4.15.08

• now a have a question concerning a friend who had smartlipo. The doctor was not able to complete her entire medsecion upper,lower,flanks, back. etc. the first treatment he put the medication all over but was only able to complete her flankds and back, so the front part of her stomach that was not treated got really hard from the medication, i believe a week later she went for her upper and lower abdomen to be completed. Her stomach was very hard and the doctor had difficulty she believes performing the procedure this time. Her stomach is hard he said it`s inflammation and instructed her to take arnica to help. What do you think of her situation.

  Answer:  I do not think the Arnica will help much and I am not sure why the stomach feels hard, the local anesthesia should not cause that, I think there may be a diagnosis problem there. Unless the fat was hard to begin with, it should not be like that after injecting the local anesthesia unless tey included something in the mixture that is not the standard. JG 4.15.08

• Boy i wish i would have know about this website before we had this procedure. Thanks for the information about my sister. If fld is in common to collect in the arms, then what would you think it is and should she go see a medical doctor to make sure it`s nothing else. Whatrecommendations do you give for patient if they are arms wrinkle up like my description is there anything to help it, she won`t be able to wear short sleeve shirts and lift her arm above her head without people noticing her skin. Any professinal help for those women with large arm that may have issues like my sister. She has a small frame size 6-8. very active, but has very large arms disproportion from her body. thanks for answering my questions, this website is awesome. Do you have any questions that i should go to my doctor and discuss with him. Anything i should ask him concerning smartlipo. Also what about visceral fat could that be the reason for abd continuing to poke out.

  Answer:  well I think it is fluid, although unusual, there might have been a small vein torn or a lymphatic vessels torn that has contributed to the problem, I do not think anyone except a plastic surgeon will be able to determine what is going on as the others are not familiar with the procedure. If the arms stay wrinkled she will need to have the skin cut off, that will leave a scar of variable length on her arm. I do not have any specific questiosn for your surgeon and I do think there is a possibilty that the reason your stomach pooches is the visceral fat that he migth not have diagnosed properly. Best of luck. JG 4.15.08

• Dr. Garcia: Smartlipo really does not work. Why is that? I wasted $13,000.00. I just wanted an overall sculpting with a minor problem area in my abdomen and flanks from chidbirth. My main concern was those two areas and have had the initial procedure and a followup revision to those two areas. I still have the same fat that was there initially and now I am requesting a refund and they are stating I just need to give myself more healing time for the revision. It has been 17 days. I have no soreness in my abdomen and it does not seem swollen to me, just seems like the same fat is still there and no change otherwise. Can I find documented proof that the procedure does not work properly? If so, could you point me in that direction?

  Answer:  well, it does remove relatively small amounts of fat and if that is all you need, then it is OK, but I feel it is a technique where they have inflated the claims and have little science to back up the claims they make. I think you are the documentation you need. I am not a believer in the technology, the science is little to none. You can likely find some of the science at the website for the company, it shows that in one study the differnce after the SmartLipo was only a 17% decrease in fat. Doesn`t sound like it is worth $13,000 for 17%. JG 4.14.08

• Thanks dr. garcia for answering my questions so quickly. I`m a little nervous now that you say don`t believe in smartlipo. You don`t believe it`s effective at all. I meant to mentin visceral fat could that be the reason for my sisters abdomen to poke out after having to garment off. I`m really nervous about my sister inner arms b/c they have deep hard dimples in them. with your procedure after a person wears the compression garment does that happen to there arms? She also keeps having build up of fluid on her arms that the doctor has to keep removing with a needle. have you heard of what i`m describing to you happening to patients wrinkling of the skin and fluid? We both are new to this all and was sold on the down time from work.

  Answer:  I think it is not as effective as more traditional methods, they use a small cannula and claim the fat is disolved with the laser, it in essence is a smaller incision tecnique but that can lead to lesser results. I think it can remove fat, but it cannot remove large areas and is more tedious and slower to remove the same amount of fat compared to otheer liposuction techniques. If the patiens was not a good candiate to begin with for liposuction, they can have wrinkled skin. It sounds like your sister was likely not a good candidate for liposuction and any method would have given her the same problem, it is just thast with the lure of good skin retraction with SmartLipo, the doctor tried it and now finds out that she was not a candidate for it, from what you are describing. Fluid accumulations can occur with any type of liposuction but I must say that it is not common in the arms. JG 4.14.08

• Hi doctor, should after 4weeks of having smartlipo on my arms, should i be able to get ina shirt that once was too tight around my arms without the compression garment on, b/c at this point i can`t and i`m feeling a little discourage, my doctors keeps telling me inflammation but i don`t think so. how much longer for i can say it`s know longer inflammation he just didn`t take enough out.

  Answer:  by 4 weeks there should be a good amount of decrease is size, yes. with any liposuction technique. JG 4.14.08

• Hello Dr. my sister is 4 weeks out of surgery (smartlipo) and she feels when she out of her garment for hours her stomach pokes back out, she doesn`t feel that her abd. is flat like the doctor assured her. What could be the cause of this not enough fat removed, inflammation, etc. I`m only 2 weeks out and my abd feels jiggly and not as flat, what are your thougts, I hope i`m explaining were you are able to understand. What meds do you give to your patients for sedation and pain when performing smartlipo.

  Answer:  it could be because the diagnosis of subcutaneous fat, which could be treated with any type of liposuction, was incorrect and she had intra-abdominal fat which is treated by no liposcution technique. Yes, she might still have fat from a very mild small fat rmoval too and if that is the case, then more liposuction would be indicated. I am sorry but I do not use SmartLipo as I feel the claims the company and their docotrs make are inflated and meant to lead patients to believe that the machine is better than other older tried and true methods and it is not, it is a lot of hype for little to no improvement over older well-established techniques. JG 4.14.08

• Hi Dr. Garcia, I recently had smartlipo completed, and I have a lot of hard areas over abd/back/flanks. I saw someone recommend lymphatic massages, but when i viewed how they do them, it`s a very soft technique is that beneficial to hard areas that need a little more pressure to areas, I want to know the best massage that will benefit these areas. Second question, my sisters arms are very wringled and hard after her smartlipo procedure. Her skin is like clump together will the skin unwrinkle and return to normal over a period of time, Is this unusual? Our midsections are not wrinkle, but her arms are. She`s concern and what another doctors opinion. Thanks for your time.

  Answer:  I do not think hard areas will appreciabley improve with lypmhatic massage over more traditional, more aggressive methods, the hard spots are likely scar tissue or areas of blood collection that need to soften up with time. As to your sister, the skin might still smooth out with time and massage but as you are finding out, SmartLipo and all of their claims are not what as wonderful as they lead people to believe. She likely would have had loose or wrinkled skin no matter what technique was employed, but the promise of SmartLipo and skin shrinking is tempting to believe. JG 4.14.08

• Dr.Garcia. what are your thoughts on post cirm.liposuction..with lymphatic massage? Is one more prone to clots post op with this, and do you do this with your post lipo pts? thank you so much terry

  Answer:  I think it is a good idea, it will not cause blood clots. We do suggest it for our patients after surgery. JG 4.14.08

• Hey Dr. Garcia. Jennifer here again. Just curious on about your professional opinon on what is the best technique to perform Liposuction? Do you think the Tumescent techique is better or the ultrasound technique? have you ever heard of the ultra sound technique? Ive been hearing about a lot of drs. using it. My dr. did the Tumescent technique. I was just curious to know what you think is best and what you use? Thanks Dr. Garcia.

  Answer:  I start with general anesthesia, we then inject tumescent fluid to disrupt the fat cells, we then use ultrasound, and then evacuate with traditional liposuction. I have been using ultrasound technology for liposuction for over 10 years. JG 4.13.08

• Even when I`m really thin, I have these scary legs that belong on a 300+ lb. woman. When I`ve dieted and exercised to the point where I have no breasts and my ribs show, I still have extremely fat legs. This is not just the thigh area, but hips to heels. Is there a liposuction procedure that can help something like that? If so, approximately how much down time would be involved? I don`t know if you give price info online, but I haven`t priced costmetic surgery in many years, so I don`t have a clue how much it would be. Also, I had a botched lipo in `89 and it left a whole bunch of broken veins. Is that typical? The botched part isn`t so much the veins as the concave/convex new shape it gave to my thighs. I`m assuming if I had lipo top to bottom, that can be corrected.

  Answer:  liposuction can be done there, the swelling persists in the legs much longer and the final result will likely take a full year, especially low on the ankle area Prices vary and you need to decide on your surgeon as that will determine the fees. Broken blood vessels can occur after liposuction in some cases, yes. It is not due to anything being done wrong though. Further liposuction on the areas around the depression might bring the surrounding areas down and make the difference less noticable. JG 4.11.08

• Dr. Garcia its Jennifer again, thank you again for your answers about my liposuction question. Sorry to bother you again but, last night I felt that my garment was so tight I wasnt getting any circumlation and i felt the bottom of my garment was digging into the back of my knees. I took a shower and slept last night without my garment, I also came to work today without wearing it but its in my bag. I ordered a different garment online yesterday and i am having it overnighted so it should be here by today. I think the one i had was too small for me. The zipper area was indenting in my thighs and it wouldnt even pull all the way up to the top so I felt like the top of my thighs were not getting compressed. Is it bad that I slept for a night without the garment? It was just one night and this morning but I am going to put the new one on as soon as it gets here. Also dr. I picked up this medicine at the vitamin store called body mend Its a small bottle of liquid with a dropper. It has Arnica mont in it, Belladonna, other ingreiients and its 20% ethanol. Its supposed to be for the aid in recovery of surgeries. have you ever heard of this before or somethign like this? Is it ok that I am taking it? Also should i stop taking it 2 weeks before my next surgery which is May 1st. Thanks again for helping me with these questions.

  Answer:  being out of the garment like that should not be a problem. I have never used the liquid drops you have bought but althouh I think Arnica will help with the swelling and bruising, the belladona will make you sleepy. If you want to take it I would do so only at night. I would stop it 2 weeks before the next surgery, yes. Best of luck. JG 4.11.08

• Dr Garcia its Jennifer again. Thank you so much for clearing the circumfrential liposuction question up for me. My 2nd surgery is booked May 1st. I am getting my whole stomach, hips, flank and back done. Is one month between surgies safe enough? Also will healing my stomach and hips be faster than healing my legs? I heard legs are the worst to heal from? Also I am still leaking some fluid through my wounds by my knees. The color is an orange color, doesnt smell but is still leaking. Is this normal? Let me know, thanks again.

  Answer:  if your energy level is fine, it is OK. Upper on the body heals faster than legs, yes. Soem leaking is not unusual, the color is ornage because there is a little blood and serum in it. JG 4.10.08

• Hello Dr Garcia. My name is Jennifer I messaged you about a month ago letting you know about my circumfrential of the thighs and knees liposuction surgery. I had the surgery done on April 3rd. I am on quiet a bit of pain and am very swollen and bruised. How much brusing is normal? I feel like the back of my knees and the sides are solid purple. my ankles are very swollen. I feel at times my compression garment might be too tight. My legs also feel warms when I touch them. I finished my antibiotics and my steroids. I just wanted to ask you with your circumfriental of the thighs liposuction paitients, how much brusing and swelling is normal? Do you schedule massages for them? I am scheduled for 1 massage a week at my drs office. How tight should the compression garment be? Is it normal that I am in this much pain after a week of surgery. My bruising is very severe I think I have blue, green, yellow and purple bruises all over. My dr. said thats fine because he was very aggresive on me, They removed 5 liters of fat. Is that safe? I would really appreciate your opinon on this. Thanks Dr. Garcia

  Answer:  the swelling and bruising can be substanial, as can the discomfort too. We start the massages after one week and try to keep the legs elevated as much as possible to help with all of that for the first month. I think what they removed is likely safe and your issues are common. Best of luck. JG 4.10.08

• I asked about removing the fat that hangs over sleeveless shirts and you said lipo but if the skin is not in good shape it would have to be cut out and would leave a scar....Where would the scar be? Could it be hidden? Many thanks.

  Answer:  it would be right over that area, without seeing you I cannot say where the incison would be or if it could be hidden. JG 4.10.08

• Hi Dr. Garcia :) I have the same problem as another poster, looks like you can visually trace the cannula suction lines which appear depressed while the surrounding tissue is raised . On May 8th I am going back in with the same PS for lipo to fix this problem and to improve the square shape of my hips, which should have previously been done. Do you think the PS can really fix the rippled look on my low back from the lipo he did previously? Also he recently injected cortisone into the old tt and bb scars which were still red and inlarged 1.5 yrs after the surgery, would it help to start using the mederma again? Thanks so much for your help. :)

  Answer:  I think there will likely be a considerable improvement, yes. I think the time for Mederma has likely passed though. JG 4.8.08

• Hello Dr.-What type of procedure would you suggest for the fat that hangs over sleeveless tops in front of my arm pit? Thank you.

  Answer:  migth try liposuction if small and the skin is in good shape, or it would need to be cut out and leave a scar. JG 4.6.08

• Thank you for your response to my question about lumpiness on my abdomen 1 year after lipo. You suggest that the lumpiness is due to scar tissue and further surgery may be necessary to fix it. What type of surgery do you recommend and do you suggest I go back to my orginal surgeon? He has all the credentials and I researched him...great reputation. I was just the unlucky one who isn`t happy.

  Answer:  might take a repeat lipo with no fat removal in order to release the skin from the underlying scar tissue so it is smoother. I think speaking with your previous surgeon is a good choice. JG 4.6.08

• Dear Dr. How are you??? I am a 38 yr old woman and I have had excess belly fat for a long long time..I`ve never had kids and i do some walking like twice a week, but i can`t seem to get rid of this belly fat and it bothers me, do u recommend i keep up with my crunches or have some kind of lipo procedure done?? I`m scared of the side effects and after surgery effects..what exactly would you recommend? will I have a flatter belly after the lipo?? please help me..what are your consultation fees??

  Answer:  well, liposuction should not be done for weight loss, but if the fat is above the muscles and below the skin, it might be an option for you. Our consultation fees are $50.JG 4.5.08

• I`m confursed about smart lipo..would you reccomend it? will I see a huge difference in my problem areas? Waht do you recc?traditional lipo or smart lipo for optimal results? thank you!

  Answer:  I am not confused about SmartLipo, it is essentially no different than other forms of liposuction and there is no evidence it can remove fat any better nor cause skin to shrink any better than other more studied techniques. JG 4.3.08

• What are your thoughts on Mesotherapy for treatment on the upper outer thighs. Do you think it is worth the time and money? Possibly two treatments needed. Thank you Dr.Garcia!!

  Answer:  I think it is a waste for all body parts. Sorry. JG 4.3.08

• I wanted to ask what you thought of smart lipo? after having a baby. is it better than traditional lipo and if not what is it for?

  Answer:  I do not think it offers any advantage over other methods of liposuction. JG 4.3.08

• hi, I want to know what is liposculture and how does that work.

  Answer:  it is merely an attempt to make liposuction sound new, they use slightly smaller cannulas or tubes to remove the fat and they claim to be doing smaller amounts to acheive shape, it is what we have been doing for 20 years in different forms. JG 4.1.08

• hi dr garcia....... i got smart lipo 5-6 days ago.. i was told that i would lose 5-6 lbs of fat, but my weight is the same. would this happen at a later datE/ also, what happens to any fluid that doesnt drain? thanks so much

  Answer:  well, it all depends on how much they took off, that is a large amount of weight loss to be achieved by SmartLipo and I think they likely exaggerated their claim. The fluid that does not leak out will be absorbed by your body over a few weeks. JG 3.29.08

• Dr. Garcia, Two days ago I had smartlipo with suction done on my upper and lower abs, my flanks and arms. My waist looks really small which I love but it goes from my upper stomach being flat to my lower stomach sticking out like a balloon. I know that there will be some bloating for awhile but this looks really weird. Will this go away?

  Answer:  in most cases it will go away in time. JG 3.28.08

• hi dr garcia i had smartlipo and vaser yesterday on my saddle bad, hips and lower abdomen. everythings sore, except my stomach is burning like someones sticking a kinife in it. does this sound like normal recovery?

  Answer:  all normal and will get better in time. JG 3.25.08

• Hi doctor i am having lipo on my back stomach and sides what is the difference between cold lipo and untrasound lipo which do you prefer to do and is there something you like better than these two i listed. what is recovery time.thanks

  Answer:  I prefer ultrasound, and am not a fan of the cold lipo. JG 3.24.08

• i was wondering if a doctor who is a member of the acadamy for cosmetic surgery is licensed to do breast implants, and lipo. thanks

  Answer:  the academy of cosmetic srgey is not an organization that grants a license to perform surgeyr, that is granted by each individual state and that stil does not guarnatee the doctor is properly trained. JG 3.24.08

• Dr. Garcia - just thought I would give an update - I originally e-mailed April of 07 after LUA lipo - recovery was complicated by multiple seromas which had to be drained 4-5 times each. Well I am almost a year post-op and have been completely pain free for about 2 months - the pseudobursa that developed under my right rib cage has resolved and the skin actually looks better than pre-op. It was a long recovery that required diligence. I would encourage people to be patient - it is true that final results take up to about a year. Endermologie and massage/myofascial release really helped me, as did DMSO, and an absolute must is stretching - gentle, sustained stretching. Thanks again for your support - at the time I really thought I had taken vanity to a ridiculous extreme - I am not sure I don`t still think that and doing anything else is not on my agenda but my PS was great through it all, as were you.I am extremely athletic and back to a full schedule - Thanks again - hope this helps others out there!

  Answer:  many thanks for the report, I am sure all readers appreciate your openess and follow up. Continued best of luck. JG 3.23.08

• Dr. Garcia, I am a petite (105 lb/5`4 ) 37 year old woman. I have noticed recently that my thigh area is a bit bumpy/cellulite. I do not need lipo, as my thighs are too thin to begin with IMO. What do you think of Velashape? I was told that it might help with the bumpiness. I am concerned however that even if it does smooth my legs, it will it make my thighs thinner, as the same doc mentioned that the Velashape could thin out my friends belly.

  Answer:  I think the VelaShape is a good option and I think the amount of fat loss is very small and would not worry about it. JG 3.22.08

• Doctor Garcia I had a liposculture I am the same person with previous question with the bloating abdomen, I also have my left thigh that is uneven from a compression garnment that was too tight and created a dent on my thigh so I bought one from veronique design which is very comfortable I also have hardening on my love handle and hip area now its only been 3 weeks do you think I still have alot of time before I get my final results because my doc says it will take 3 months for the final outcome and that I have to wear the compression garnment for 3 months. Also how effective do you think the gel sheeting is on the bikini area incision I will be wearing a gel sheeting belt that goes all the way around it has velcro to adjust it.Also my arms got a little lipo they weren`t too big to begin with but it seems like all my skin is dry like alligator skin and saggy the doctor again says it takes 3 months for my skin to bind. In regards to my tummy tuck how long does it take for the abdomen to attach once again to the wall. I am following a low carb diet by the way. What do you recommend for my dry skin , the doctor recommended mederma how effective do you think it is?

  Answer:  the uneveness should get better in time and it does take about three months to get close to the final results. We have the patients wear the garment for one month only. I personally do not use the gel sheeting as I find that it does not make much difference. It can take 3 months for the tissue on the abdomen to reattach, all depends how long there is swelling below the skin. I think Mederma is good for scars but not for dry skin, for that I would use Curel moisturizing lotion. JG 3.22.08

• I just had liposculpture done and a tummy tuck after 7 pregnancies, I am at 3 1/2 weeks recovery,feeling much better however I have this sensation like an object is floating like in a ballon full of water (my abdomen) I am afraid that this is fluid imbalance also my belly button is leaking yellowish clear fluid,my drains were removed 2 days ago. It is very uncomfortable when I push on one side of my abdomen the other side blows up and viceversa from side to side. Is there treatments if it is an imbalance and if so what type of treatments. where the incision took place bikini area is also leaking yellowish fluids although it looks like is growing skin and is beginning to close since there is white like skin growing on it. In addition I have purple track like marks above the incision will these go away? Should I also wait to use a gel sheeting belt until the wound closes completely? Very worried please let me know what you think is going on?

  Answer:  the purple line is just bruising and will go away in time, as to the other, it sounds like you have a fluid acculmulation and it needs to be drained by your surgeon. I think using the gel sheeting while still draining is difficult so I would wait on that. JG 3.22.08

• I would like to ask your opinion fixing the banana roll area. I`m furious... I made the mistake I had Liposculpture on my upper thighs in Europe about 15 months ago... My thighs look worse than before, my perfect bubble butt disappeared and I have banana rolls especially visible one under my right butt cheek. I saw two doctors in Beverly Hills they both said they could fix it with Smartlipo. I`m really nervous about making it worse. What`s your advice? Should I go overseas and try Ultrashape? Are there any other options? Please advise. Thanks a lot.

  Answer:  well, I think neither one is a good option, actually the option to improve it is probabaly re-injecting fat above the banana roll to make it less visible. I think with those methods you will be left with possibly some fat removal but then looser skin which will look worse than what you have now. JG 3.19.08

• Hello Dr. Garcia, I had lipo on my abdomen 1 year ago. I still have lumpiness and general uneveness that I am very self conscious about. At this point I do not think it is water retention or scar tissue from the surgery. I`m worried I got a botched lipo and was wondering if there is anything I can do to smooth the surface of my stomach at this point? I`ve heard endermologie helps. Any suggestions?

  Answer:  I think at this point it is not swelling and is likley small scar tissue below the surface. Might need mroe surgery to correct it at this point. Endermologie does help, worth a try. JG 3.10.08