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

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• Prior to having tumescent lipo down on my thighs I did not have any cellulite on my legs. The lipo was done over 2 years ago. Anyhow, the front of my legs are bumpy and pitted and appear as though I have cellulite. Is there anyway to fix this? Thank you.

  Answer:  the fist thing I would try is fat injections if they are dents from uneven fat removal. JG 1.31.12

• One last question about the liposuction under my eye. You say a small canula will be used. Will the suction be done only manually or will the canula need to be attached to a vacuum compressor? I ask because I fear too much may be removed if it`s done mechanically rather than manually. I don`t want to be left with a big depression where I know have a speedbump on my face! Thank you again and sorry for so many questions!

  Answer:  in most cases it is by hand pressure only. All the best. JG 1.30.12

• Thank you for the quick answer to the question about micro-liposuction of the face. What gauge needle would typically be used for that procedure? I`m trying to estimate the amount of visible trauma the procedure willcreate--and so, the amount of time off I`ll need from work.Thank you again and have a great weekend!

  Answer:  they are actually called cannulas and they are about an 18 gauge needle size. They are blunt in order to minimize bleeding. Figure about 5-7 days of swelling and bruising in that area though. JG 1.27.12

• I had fat grafted to my face 5 years ago. I was left with a raised deposit of fat at the lid-cheek junction (at the bottom of the tear trough) about 4-5 mm long x 3 mm wide. It`s not a distinct or hard lump, just a bit too much fat. Though it`s small, it causes quite a deformity; in fact, it has created the appearance of a deep bag beneath that eye, since the bottom of the lid is raised above the upper part of the lid. I don`t want the fat injected with a steroid because I`m afraid it will migrate and I`ll end up with tissue atrophyin the mid-face. So my PS is recommending micro liposuction. I`ve never heard of that being done to the face. Is it safe? Is it effective? Is it likely to cause more of a problem than it resolves? He can`t remove it transconjunctivally because it`s too low on the lid. Thank you for your opinion. Wow -- you seem to help out a LOT of people!

  Answer:  I think small needle liposuction is what I would suggest. Risks are small and is the best option for overgrafting in that area. All the best and thank you for the kind words. JG 1.27.12

• Dr. Garcia, In regards to question last week about The lipo I had on my calves... : 1) Even if 350ccs were removed from each calf, about how much inch loss should I expect to see from that? 2) How long does swelling really take to resolve? 3) Will running exacerbate the slow healing? 4) What can I do for the bruising (was using arnica, but was told it only works immediately after!) 5) Would an at-home ultrasound machine help at all? THANKS SO MUCH FOR YOUR HELP! I REALLY APPRECIATE IT DURING THIS FRUSTRATING TIME!

  Answer:  hard to say without knowing how much was fat and how much was the infiltrated fluid, but I would say less than an inch. The swelling on the calf can take 6-12 to show the final results. Anything you do where the legs are in the dependent position will make it slower for the fluid to be reabsorbed.You can still try the arnica and I do not think the at home ultrasound machines are strong enough to help I am afraid, just got to give it time. Sorry. JG 1.26.12

• Dear Dr. G. Since Cool Sculpting can`t do the upper arms right now, is it worth it to try Zenora just on the arms? If so, usually how many treatments are needed for this area? Thank you.

  Answer:  it is my understanding that the heads required to treat the arms are being worked on but not widely available at the present time. I personally think Zerona is a waste of money, money that can be used for something else. JG 1.24.12

• Hi Dr G. I have an opportunity to try Zenora at a hugely discounted rate. Still, like a pair of nice shoes, if they don`t fit, it wouldn`t be the money saved but money lost so I`m wondering (1) how it compares to Cool Sculpting and (2) whether Zenora carries the same risk of skin laxity as liposuction, etc. Thank you!

  Answer:  CoolSculpting is much better than Zerona, and there will be likely no skin laxity with Zerona as it will likely do very little to the fat. JG 1.23.12

• I`m following up on the tumescent lipo. Is it as effective as the Cool Sculpting, with the same risks of laxity (ie, depending on how much fat is removed, age, etc.) and dimpling? Or does Cool Sculpting do less but has less potential adversed effects? All things being equal, which one would you recommend, especially if the tumescent lipo is cheaper? Thank you!

  Answer:  I think they are both effective but the liposuction will be more predictable in the amount of reduction as you will visibly and immediately be removing the fat cells. If the tumescent liposuction is cheaper, in your case I would go with the liposuction. JG 1.20.12

• Dear Dr. G. What do you think of Tumescent Liposuction? Is it at least comparable to Cool Sculpting? I don`t need a lot of fat removed so if I go with this option, what are the possible side effects? I worry about dimpling, skin laxity, etc. Thank you!

  Answer:  tumescent liposuction is just regular liposuction done under large volume local anesthesia, so still invasive. A surgeon can remove a large amount of fat with tumescent technique as easily as removing a large volume. The great the amount of fat removed, the greater the chance for loose skin and possibly dimpling. JG 1.19.12

• Dr. Garcia, I sent you this question & received your response but have a follow up question: ORIGINAL QUESTION: I had Vaser Lipo on my calves June 16th, 2011. At this time, I don`t remember the exact amount of CC`s removed- but it was in the area of 700-800cc`s PER calf! However, I still have some black & blues & I am not seeing such a significant difference for such a large amount of fat removal. Does this larger fat removal mean it will take way longer to heal? What else can I do to speed this up? It has me really disheartened right now! :( ORIGINAL Answer: I will say that the recovery and end result always takes longer in the calves due to their dependent position, so swelling takes a long time to resolve. I think the amount they quoted you likely counts the tumescent fluid that was also removed so likely the amount if fat was much less than that, perhaps 50% or so. Massage and keeping the legs elevated when possible and possibly wearing some compression hose might help. I wish you the best. JG 12.2.11 NEW QUESTION: 1) Even if 350ccs were removed from each calf, about how much inch loss should I expect to see from that? 2) How long does swelling really take to resolve? 3) Will running exacerbate the slow healing? 4) What can I do for the bruising (was using arnica, but was told it only works immediately after!) 5) Would an at-home ultrasound machine help at all? THANKS SO MUCH FOR YOUR HELP! I REALLY APPRECIATE IT DURING THIS FRUSTRATING TIME!

  Answer:  the larger the amount removed, the longer it takes to get to the final result, yes. I am afraid there is not much that can be done, besides what I previously said, to speed it up as the calves are dependent for so much of the time. It is a matter of time. Best of luck. JG 1.18.12

• Hi Doc I had artecoll injected about 14 years ago in a one inch scar on my cheek that had depressed. Results were great until recently it has become puffy and I can feel the scar tissue has increased under area. the injection area has become raised. I wonder if you feel that micro lipo would level it out and be better that trying to open it up and remove scar tissue underneath. Thanks, Joe

  Answer:  Low risk, certainy worth a try. JG 1.7.12

• Hi Dr., Each doctor performing the various liposuctions touts its advantages. Understable I suppose since they wouldn`t have gone with the technology/manufacturer if they didn`t - unless the option was not available at the time. In any event, I would like to know what you believe the advantages (if any) SmartLipo v. VaserLipo v. SLIMlipo may be. Seems to me the SLIMLipo does not leave large holes on the skin, which takes months to disappear - but any other factors? Thank you!

  Answer:  I think laser or ultrasound, when of high enough energy, can break the fat up and make it easier to remove. I think the disadvantage to SmartLipo and Slim Lipo is that the cannulas are all very small, so large amounts of fat removal will take a long period of time to perform. It is ultimately the amount of fat removed from one area that affects how well the skin shrinks, little fat removal allows better skin shrinkage, large removal makes it harder for the skin to shrink. I think the evidence for associated skin tightening with all three machines is slim to none, more hype and hope than truth. Of those three, I would use the Vaser over the other two. Vaser can also be done with very small cannulas, I certainly used them when I was using the Vaser technology, so when one compares apples to apples, the skin incisions are equal. Hope that help you. JG 1.6.12

• Oh, I had conservative liposuction to my arms two years ago but wasn`t fully satisfied with the results, so I had Cool Sculpting and Ulthera this year because I was afraid a second round of lipo would have left some sagging skin. I`m 54 and while I work out, I don`t have the skin elasticity I used to have. The combination has left my arms looking better than they ever have. Sorry not to have been clearer about that for your readers!

  Answer:  thanks for the additional information.

• Oh, I had conservative liposuction to my arms two years ago but wasn`t fully satisfied with the results, so I had Cool Sculpting and Ulthera this year because I was afraid a second round of lipo would have left some sagging skin. I`m 54 and while I work out, I don`t have the skin elasticity I used to have. The combination has left my arms looking better than they ever have. Sorry not to have been clearer about that for your readers!

  Answer:  thank you. JG 1.6.12

• Dr. G., Hi. When does Cool Sculpting expect to have the head for the arms? Sounds like you offer Cool Sculpting at your office. Are your patients - and also just as important, you - happy with the results? Thank you!

  Answer:  No word on the smaller head. I do not own a machine, but my associate who is not a plastic/cosmetic surgeon does. We work in the same office, but I make no miney from the CoolSculpting. I see the changes and I feel it works well on patients that are good candidates. JG 1.5.12

• Wow. For such a busy surgeon, your response time is truly impressive. Way better than my own medical doctor ... and we are not talking about elective/cosmetic matters. Please thank your wife for us ... not only are you generous, she is also generous for sharing you with us. Time with us is time away from her. So thank you both! My follow up questions are: Does Cool Sculpting reduce fat AND tighten skin? Are the upper arms, bra, back areas that would benefit from Cool Sculpting? And would you happen to know price range?

  Answer:  Thank you for the kind words. As to the areas, the upper back bra area can be done but there is not a head for the arms yet, we are waiting. As to skin shrinking, it will shrink the same amount as with weight loss, no more. As to cost, it varies from clinic to clinic but its about $1500. My wife says you`re welcome . All the best. JG 1.4.12

• Dear Dr., What are your thoughts on the effectiveness of Cool Sculpting as an FDA approved, non-invasive alternative to traditional liposuction? Thank you and god bless!

  Answer:  not everyone is a candidate, you can expect about a 24% reduction in skin fold, results take about 6-8 weeks, not for everyone, but it does work. Does not replace liposuction but is an option for those with small areas.JG 1.4.12

• Hello Dr. What are your thoughts on Mesotherapy? I have read that in some ways it may be preferable to liposuction, ie, that after liposuction, fat may apperar elsewhere in the body that has not had lipo performed on. The upside for me is no downtime. But does it work?

  Answer:  I think at the present time, since there is no standardized formula or treatment protocol, that the results are variable. Some patients do very well, some see no difference, and others have complications such as dents or skin loss. As to being better than liposuction, no, that is not the case. As to fat showing up in other parts of the body after liposuction, yes that occurs if and only if the person continues to overeat. The reason for that is that the fat cells removed with liposuction are permanently gone, so if one over eats and gains weight, that fat has to show up somewhere else. If the mesotherapy did work, the same thing can happen. No one knows what the long term effects on the fat cells is with mesotherapy. All the best. JG 1.4.12

• Happy New Year to you and your loved ones, Dr. G. Thank you for your generosity with your time and knowledge! Is there a cutoff age for when lipo may leave lax skin, thus basically trading one problem with another. I am Asian, and am seriously thinking about lipo since you don`t believe EndyMed and all other non-surgical options work. Can you give me a range of what the upper arms, upper back and bra areas would cost. My doctor recommends doing all as she believes just doing the arms would not leave a pleasing result. Also, what is the range for tummy, waist and flank? I went in for consultation for the arms and came out with recommendations for all of the above. Is there any difference between Vaser Lipo, Smart Lipo and traditional lipo? Thank you!

  Answer:  there is no age cut off as every patient is different. In general the older you are, the less likely for the skin to shrink well, but there are other factors that over-ride that. If you have stretch marks on the skin in that area, the skin has lost its elasticity and will not shrink well. Also, the larger the amount of fat removed from that area, the less likely the skin will shrink well due to the degree of shrinkage needed. There is no set amount of fat in an area that can predict good skin shrinkage though. The approximate cost for arms and upper back would be about $6,500, depending on the time I would need to complete it. It is hard to give an accurate fee quote as the time will influence it to a great degree, especially when doing multiple areas. I think it best to see the surgeon you choose in person to get an accurate quote. I am not a fan of SmartLipo and I think the differences between Vaser Lipo and traditional are small, but with Vaser, the fat comes out easier, no difference in skin shrinkage though. I wish you the best. JG 1.4.12

• Dear Dr. Garcia, I had slim lipo about 2 months ago and I`m very concerned cause I developed fibrosis on the right side of my abdominal area and it makes it look uneven compared to the left side. My doctor told me to give it a couple of months that it`s small and it will resolve on its own, but I don`t see any improvement. He also told me to massage the area for 10 minutes every day. What I want to know is this is common and if it will resolve on its own and what can I do to break it?. Should I keep using a compression garment as well to apply pressure? what can I do? thank you and Merry Christmas

  Answer:  not uncommon, massage and time will help, the compression garment will not at this point.Best of luck and Merry Christmas to you and yours. JG 12.24.11

• Dr. Garcia, I had Vaser Lipo on my calves June 16th, 2011. At this time, I don`t remember the exact amount of CC`s removed- but it was in the area of 700-800cc`s PER calf! That`s about almost the size of 2 of my breast implants per calf! However, I still have some black & blues & I am not seeing such a significant difference for such a large amount of fat removal. Does this larger fat removal mean it will take way longer to heal? What else can I do to speed this up? It has me really disheartened right now! :(

  Answer:  I will say that the recovery and end result always takes longer in the calves due to their dependent position, so swelling takes a long time to resolve. I think the amount they quoted you likely counts the tumescent fluid that was also removed so likely the amount if fat was much less than that, perhaps 50% or so. Massage and keeping the legs elevated when possible and possibly wearing some compression hose might help. I wish you the best. JG 12.2.11

• Just had inner thigh and knee liposuction two days ago. How long will it take for me to know if my inner thighs will still touch and rub together or if there will be a space between them? I`ve always wanted to have that little V between the upper thighs. My Dr performed the surgery on my back with my knees bent. I just read online that you get better results laying on your stomach. Please let me know when you think I will be able to see the final shape and if I have that V opening and no fat pads around inner knee. Thank you in advance. This is a very cool message board.

  Answer:  I would say 4-6 weeks should give you a good idea. I think fat in those areas can be removed through either approach, one is not better than the other. Final results will be about 6 months though. JG 10.16.11

• Dr. Garcia un cordial saludo. Hace un mes y una semana me hice una liposucion laser en papada abdomen brazos y piernas, me preocupa un poco que la piel del cuello y los brazos de ve como con canales o depresiones por las canulas me imagino y con unas bolitas muy pequeñas, el Dr. que me opero me dice que debo tomar Glucophage, potasio y un diuretico para controlar la fibrosis. Quisiera una segunda opinion ya que he tenido que suspender la lactacia de mi bebe de 4 meses por el uso de esta medicina. la verdad el Dr. que me opero antes de la cirugia me dijo que podia segur lactando despues de 10 dias y que no habia problema, pero despues me salio con todos estos medicamentos.. me sento engañada y no se si seguir confiando en este doctor. Estoy a tiempo de empezar algun tratamiento para mejorar el aspecto de la piel o debo esperar a que evolucione mas... Por favor digame su opinion.

  Answer:  no creo qule la Glucophage, el potasio ni el diuretico van a afectar la fibrosis. Lo que vez es comun y con tiempo y masaje se mejora, tienes que darle tiempo. Buena suerte. JG 10.16.11

• Thanks for the answer about the Zeltique-Lipo Double Special! Glad to know you agree with me. Just wondering if you think there might be any physiological reason to assume the fat could be suctioned more easily after Zeltique. Have a great week, Dr. Garcia.

  Answer:  nope, no different, that is because the cells is supposedly dead and will come out the same way as the other fat. JG 10.13.11

• OK, here`s a new question for you! So, I go to my plastic surgeon to arrange lipo to my flanks. It`s booked 10 weeks from now. In the meantime, he is recommending that I do Zeltique to jump-start the fat removal. He`s a good guy, but methinks he`s trying to double dip into my fat pool. Am I right? Why would he freeze some of the fat cells only to suction them (and more of them) in a few months if not only to make more money? And have there even been any studies on this kind of sequential therapy with Zeltique? I can`t find any, since Zeltique is explicity marketed as a much less effective alternative to liposuction. Even I were to accept his advice and do the Zeltique, what complications (if any) do you imagine that might pose to the liposuction in 10 weeks? Would it compromise the efficacy of that procedure in some way? Gosh, as soon as new technologies are developed, folks are eager to figure out new and creative ways to separate us from our money in their use. Thanks as ever for being there for us all, Dr. Garcia, saving our wallets s well as our (plump) hinds!

  Answer:  There are no reports in the medical literature regarding the staged procedures but I see no problem in the performance of the liposuction after the Zeltique. You can expect up to a 20-24% reduction in the fat from the Zeltiq per session. I have to agree with you though. To plan ahead of time on doing both makes no physiological sense. The only thing getting jump started is his bank account. All the best. JG 10.13.11

• Dr. Garcia, Thankyou very much for your reply for the smartlipo problem, re the ridge above the navel where you suggested heating pad and excercise to try and break it away from the muscle. I forgot to tell you i had the abdominal SL procedure 2+ yrs. ago, so would what you suggest still be effective, or would i need a different approach to the problem? Thankyou in advance for your reply.

  Answer:  Sorry, thought it was recent. What I had suggested will not work now. You can try sessions of endermologie, but it might come to a surgery to release the attachments and followed with aggressive massage. JG 10.11.11

• Hi Dr. Garcia, Thankyou for your awesome website and the valuable advice that you give. I`m sure it has saved a lot of people from spending money on treatments that don`t really work. I have had Smartlipo done on a few areas, and i guess its ok. for what it is. And seeing as i haven`t spent a fortune on it, the results have been reasonable. But i have a problem with the shape of my abdominal area after having the SL there. I don`t really know how to describe it, i guess its like a very noticeable ridge on the upper part, above the navel, and is noticeable under t-shirts. Below that under the navel my abdomen feels very firm, especially when standing upright. I guess that is scar tissue? What would you recommend to smooth out the very noticeable ridge? Thankyou for your advice.

  Answer:  Hiw long you are aftet the surgery makes a difference, but in general, warm packs, massage and stretching back and rotating can help break up the areas where the skin is tethered down to the muscle. Best of luck. JG 10.11.11

• Hi again Dr. G., do you think lipo can make cellulite worse? For whatever reason, most cosmetic surgeries have not improved me. In fact, I think my cellulite got WORSE after lipo - but of course no one told me that could - or might - happen. But after getting my arms done (even though I work out ALL the time!) I was told I didn`t want the ugly scar from an arm lift so I decided to do lipo and now I can definitely see more cellulute. Thanks.

  Answer:  if fat is removed in certain areas, the cellulite mitth appear worse as the surface of the skin has less pressure upon it, it is a known risk. At best it will stay the same, JG 9.18.11

• Dr. Garcia, how effective is the new Zeltic Cool Sculpting particularly around the stomach area? How many sessions would you recommend to see good results? Would you recommend this new technique over the more invasive liposuction techniques? Who would be the best candidate for Zeltic? Sorry for all the questions, I just want to ensure that it is not just hype with minimal results. Thank you

  Answer:  It does not replace liposuction, it is part of the spectrum available. It reduces the fat by about 22% after each session, it takes about 2 months to see the result, it can be repeated if desired. So, as long as you expect less dramatic results than surgical liposuction, then it iis a good non-surgical option. JG 9.6.11

• Sorry last question, you say to remove the fat pockets by my lips by cutting it out through an incision in my lips, is that more invasive than microliposuction? What are its advantages over microliposuction? I like your no nonsense approach as why I`m interested in having you do it. Here is the pic one more time: http://i.realself.com/scale/311089-122790.bmp

  Answer:  I think the vutting will be more precise and definitive. JG 7.16.11

• Thank you! So does the liposuction have the same pitfalls in the area I showed you as far as dents is concerned? You mentioned if you were to do it you would go through the lip, would that leave a visible scar? Here is the pic for reference: http://i.realself.com/scale/311089-122790.bmp

  Answer:  lip scar should heal well and likely not be seen. JG 7.13.11

• Oh I`m sorry, I don`t think I described the right area of my face for fat removal. It`s not fat pad of bichat it`s closer to my mouth. Here is a link to my pic with the problem area circled. What method of fat removal do you suggest? http://i.realself.com/scale/311089-122790.bmp

  Answer:  if you only see it when you smile I would leave it alone because if that were the case and you removed it, you would have a dent when not smiling. If it is there all of the time, even at rest, then I would remove it with a small incision in your lip and surgically cut the fat out rather than liposuction. JG 7.13.11

• Interesting, so from what you have seen are any there indentations, dents from the incision method of fat removal of perioral mounds, or does this generally just happen with lipo? I`ve been reading up on it on the internet today and I notice most doctors favor the micro canula technique as opposed to incisions but nobody seems to give a reason. What are the drawbacks to the incision technique in your opinion? Thanks.

  Answer:  I have not seen it when it is removed form inside the mouth because the superficial layer of the cheek is not touched. The down side of the incision technique is it takes an experienced person to perform it, otherwise very safe, liposuction is easier but not the best for fat pads of Bichat. JG 7.11.11

• Hey I asked about the pouches of fat removed at the corners of my mouth. What bad results have you seen with micro lipo specifically, and what method of removal did you mean when you said an incision could possibly be made inside the mouth?

  Answer:  from the micro liposuction, I have seen the inability to remove the fat pocket, dents depressions and temporary muscle weakness. As to the incision inside the mouth, if what you have is a large fad pad of Bichat, that can be accessed through an incision inside your mouth to remove the fat. JG 7.11.11

• What can I do about the pouches of fat at the corners of my mouth? Most people have them but are very small and unnoticable. Mine are large. I`m only 32 and have always had them but put on a few pounds over the years and now they`re really noticable even though I`m nowhere close to fat. The rest of my face looks good but they ruin my appearance and almost make me look sad all the time. Can I have them liposuctioned?

  Answer:  they can possibly be removed with an incision inside your mouth, I have not seen liposuction work well as they are underneath some muscle and you might damage the muscle trying to remove it with liposuction. JG 7.11.11

• I know you`re not a fan of Zeltique, but I have a small area of fat on each hip (about the size of my palm) that I would like reduced, and I would like to avoid liposuction if possible. I consulted with a dermatologist who said he can`t do it because the area I want to treat is below the top of my hip bone. He claims that Zelqtique can only be used ABOVE the hip bone, for instance on love handles. But then I consulted a plastic surgeon Iwho said he COULD treat these areas with Zeltique! Before I plunk down money with the second guy, is he right? Or is the dermatologist right -- that these pockets of fat on the sides of my hips CANNOT be treated by Zeltique. Gosh, we`re so lucky to have you, Dr. Garcia! Thank you for your honesty and generosity with all of us.

  Answer:  well, although I am not a fan at present, I am always willing to change if I see good evidence that is reproduceable.I think that if one needs a small reduction in fat, it might work, from what I hear, if it works one can expect about a 20% reduction in the area treated, just not sure that is enough for some people to see a difference. The machine works but forcefully sucking the area into rollers and then essentially freezing the fat cells in an attempt to damage the fat cells and let them dissolve slowly over time. It is for that reason that some areas may not be able to be treated due to the need to be able to pull the skin in-between the rollers. maybe ask the plastic surgeon if he is willing to discount the liposuction if it does not work. Best of luck. JG 7.6.11

• I had extensive bruising following a minor lipo procedure to my hips two weeks ago. Will moderate walking help the trapped blood to dissolve more quickly and expedite the healing of the bruises? Thanks so much! Have a great holiday weekend, Dr. Garcia!

  Answer:  it might help some by moving the areas a bit, but it is more a matter of time. All the best. JG 6.30.11

• Which liposuction method would you estimate is the safest for love handles and abdomen? Thanks.

  Answer:  I perform ultrasonic assisted liposuction, in experienced hands all liposuction techniques should be safe. JG 6.22.11

• Dr. Garcia, Is Zerona or Zeftig really effective? Is there a noticeable change or would I be throwing away money on this treatments? Are there any good alternatives to liposuction? Thank you.

  Answer:  of the 2, the Zeftig appears to have a large clinical effect, but I think I would wait to see if the results last. JG 6.6.11

• If I get liposuction on my tummy can I drive myself home after the surgery or do I need someone else to drive me home?

  Answer:  should have someone drive you. JG 5.20.11

• Hi Dr. Garcia, have you heard of the aqualipo procedure? If so, what are your thoughts?

  Answer:  no better than the old tried and true method of injecting fluid before aspirating the fat, in fact, it is likely less effective as part of the purpose of injecting and waiting was to reduce blood loss, and with the constant infusion and aspiration, there is no time for the medication that would cut the bleeding down for it to work. The aspirate in the collection bottle might look good, but one has to remember that it is mixed with a large amount of the fluid that was being put in at the same time, giving a false impression of the amount of blood loss and fat removed. JG 5.5.11

• Can metformin be helpful to decrease my appetite?

  Answer:  Metformin is not an appetite suppresant . JG 4.21.11

• Hello Dr Garcia, is it possible to get lipo on my stomach, arms, flanks this year, even though i wanna start having babies by next year(im getting married next yr Jan). I wanna look good for my wedding and my new husband. Im already fit, i just want a more shapely body(coke bottle). Will getting pregnant a year later mess up my results, even if i lose weight after having babies? Thanks.

  Answer:  it can be done yes. Gaining baby weight will not affect the fat removal but might stretch your skin out, that would have happened though with or without the liposuction. JG 4.20.11

• I would like to know if I have lips dissolve or liposuction or anything to get rid of fat around the middle area around my waistling and below my belly button if it will make the skin lose and flabby when they dissolve or suck out or however it is done? I am not a big person at all, actually very thin, but I have some small rolls of fat around my middle. I just don`t want lose skin after the procedure.

  Answer:  the larger the amount of fat, along with the presence of stretch marks or older skin make the possibility of loose skin higher. JG 3.28.11

• Do you have much experience with liposuction on the banana roll? I have a butt below my butt. I consulted with a ps and was told it must be done conservatively as is is a support for the buttocks, is there a way to make this area look better? I can email pics for a better evaluation.

  Answer:  well, yes, I will say that a true banana roll will be easily treated with liposuction but can lead to a buttock that looks even more saggy afterwards. As to a banana roll supporting the buttock, no, that is not the case, but if the transition from buttock to posterior thigh is not smooth, the buttock looks saggy. It is for that reason that you see almost all bathing suit models hike up their buttock when showing their bottoms. Most women have lost the prominence of the upper buttock from dieting and not working the muscles there enough, leading to a flat upper buttock, and that is where the support comes from. If you have it done, it has to be just a small amount. Best of luck. JG 3.2.11

• Dr please tell me which laser is the best to lose inches? Zerona (laser looks like an octopus) or LipoLaser with Lapex 2000 BCS (like `steel` pads)? Thank you very much

  Answer:  None, sorry. JG 2.28.11

• Is Vaser Shape a possible alternative to Ultrashape?

  Answer:  Vaser Shape is new, trying to capitilize on the methods used by UltraShape and I cannot say whether it will be as effective as UltraShape. I would wait for a while and see where it goes, but my initial impression would be that if it is effective at all at dissolving fat, it will not be as effective as UltraShape. JG 1.30.11

• Do you think you will likely add Ultrashape to your practice if/when it gets US approval?

  Answer:  as soon as it is able to be purchased I will have one. JG 1.30.11

• Hi Dr.G There`s a new machine out called EXILIS and it is suppose to be a revolutionary non-invasive device for wrinkle reduction, body contouring and skin tightening. There are about 30 machines in the U.S. as of now. My current ps is offering 4 sessions at $1250 for one area. Before I get suckered in, as usual, I run things by you first. Waste of money or it`s a go for it . What do you think? Thank you as always..Happy Holidays and Happy New Year to you and yours..

  Answer:  skip it. A Happy Holiday and Prosperous New Year to you too. JG 12.22.10

• Thank you, Dr. G., for your patience. What about Slimlipo? It is supposed to be better than smartlipo. Hype as well? Supposed to heal faster than smartlipo, reduces skin laxity post-healing, etc.

  Answer:  same hype, companies and doctors, many not plastic surgeons trying to capitalize on patient fears and desires. Skip it. JG 12.12.10

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