Las Vegas Cosmetic Surgery - Dr. Julio L. Garcia - Las Vegas Plastic Surgery

Ask Dr. Garcia - The Archives

Lasers and Peels - Ask Dr. Garcia Archives

Questions and Answers

Hello Dr. Garcia, I am very impressed with your compassion paired with your knowledge. I am 43 years old and had a laproscopy gall bladder surgery last year April. My two side insisions have healed nicely with very minor keloid scars (small). I have one 1 inch scar above my bb that is keloid and diamond shaped with some pleat or puckering. (I am not sure if that is due to the fact I put on weight after the surgery or not. I would like to know your advice regarding what type of treatment to use to lesson the scar: laser, injections, topical, or revision. I have been told that revision is not a good idea as it would result in another keloid, however, perhaps the scar could be revised to be hidden in the middle of the bb? I thought of getting a bb ring to hide the scar but I have been turned away due the thickness of the scar and it would just be pushed out. Please advise. Thanks.
Answer: I think the best and most reliable is to surgically revise them, the keloids can form after laparoscopy due to pressure at the port site and repeat incision and closure typically helps the scars look much better in those cases. All the best. JG 8.19.08
Hi Dr. Garcia. Can IPL under the eyes cause crepey skin to become crepier? If yes, is that permanent or temporary and how long would it last? Thanks!
Answer: maybe for a short period of time if it irritated and dried it out but not on a permanent basis I feel. As to when it gets beter, it depends on the patient age and moisturizers used. JG 8.18.08
i had laser treatments for sunspots but the laser left white spots on some areas.. will my skin tone come back eventually?
Answer: it should in the vast majority of cases. JG 8.16.08
Hi Dr. Garcia- hope you are enjoying your weekend! Thanks for all you do to help! I had my 1st IPL treatment for brown spots & redness on my chest 2 weeks ago...wow what difference!!! How long should I wait for 2nd treatment or length of time between treatments? Thank you again!
Answer: 3-4 weeks, so glad all is going well. JG 8.17.08
Hello and thanks in advance for the advice. I have had a peel on my under-eye areas to treat damaged skin. I really want it to heal great so here`s the question: I am currently maintaining a mask-like layer of Biafine on this small area. I`m concerned about letting skin form a hard dry crust considering that the skin around the eyes is very elastic, flexible and in constant movement. Can I keep applying a thick layer of moisturizing Biafine or is that a major problem for the healing process? Is moisturizing a crust in excess problematic for post-peel healing? What are the consequences of preventing the crust from forming by excessive moisturization? Just to be clear, I am not talking about removing crusts once they already exist. Thank you.
Answer: I am not familiar with Biafine, I suggest a copper peptide cream usually but you should really follow the doctor`s instructions as I am not sure what type of peel or to what depth you had and their instructions would be more specific. If they did not give you any instructions, then the peel is so light that the topical application will not influence it much. JG 8.14.08
Hello Dr. Garcia, sorry to bother you again but I previously queried if hair removed during IPL skin treatment (Lumenis Quantum SR) would regrow and you confirmed it should given time. However, it is now almost 3 months with no change, would it typically take this long? Thank you again.
Answer: hard to say, might take 6 months or more in some cases, especially in darker hair. JG 8.14.08
what is your opinion od the CO2 laser-active FX?
Answer: I am not impressed. JG 8.13.08
Hello Again. I had a vein thrapy with a cutera laser on my face by my nose and nasial lines. I had quite a few so Im not sure if the Dr used to high a setting or did not ice me enough??? or is it normal to have welts also scabs & pus bubbles? I called otday and they were not sure but said to keep it moist to prevent scarring. PLease tell me what you recommend as I can see little chunks of my skin missing in the areas where it has) was this normal? & B) how can i prevent scars? Thanks you very signed panicky
Answer: welts and scabs, happen, pus pockets should not. I suggest you have them see you in person to make sure nothing more than moist applications are needed. That is important in order to avoid the scarring. JG 8.13.08
Hi Doc. I`ve had approximately 6 -7 Photofacials over the past 2 years with not ill effects. However, the last time, about 5 weeks ago with the Palomar laser (the others were probably the same machine though I can`t say for sure) my hair fell out of my beard (yes, I`m a guy) 2 weeks after the procedure. It hasn`t grown back. I`ve seen mixed information on the net, the practitioners website, and your archives on whether this is permanent or not. I would appreciated your input and if you don`t believe it is permanent what do you think the time frame is that I can expect to see hair growth in the areas of my cheeks, chin, and neck. Many thanks
Answer: I have never seen it be permanent and the light source is not strong enough to get to the follicle, but the hair that was there has been injured and has fallen out, it should come back in time, slowly. JG 8.13.08
Hello Doctor :) I read and heard that IPL can be used too for the treatment of spider veins/telangiectasia. Is it really effective for it (in the thigh/leg area, I mean) or is old sclerotherapy better for them? (assuming there are not underlying problems linked to varicose veins).
Answer: I think sclerotherapy is more effective and longer lasting compared to IPL on the leg. JG 8.13.08
is there any medication that you can think of which I can apply to that paler/lighter spot where the vbeam was zapped which can theoretically help the redness come back, I read somewhere that some estrogens and prednisone speeds up blood vesselregrowth. what d you think of micropigmentastion for this problem.
Answer: sorry, but none,and I do not thik the micropigmention will ever match. JG 8.11.08
Hi. I am 40 yrs old, 5`2 and about 108lbs. I have had 2 children ( 3 yrs and 8 months old) and am having a breast lift w/aug. I also have some sagging in my arms and dr said Thermage would be great for that after reading your website I am not so sure. Do you still feel it does not do anything?
Answer: still feel the same, yes. JG 8.10.08
but doesnt niacin induce flushing and redness? wouldnt this cause blood vessel revascularization? please explain what niacin exacly does and if there are any serious side effects. Do you think relume can have any lasting effects? like will it cause blood vessels to regrow faster and leave the skin pink without maintenance treatments.
Answer: it will make the area red for a few minutes if at all. Niacin is a vitamin and does cause flushing of the body in sensitive people when taken orally but not in all.I do not think Relume has lasting effects. JG 8.10.08
Hi Dr. Garcia, I`m the guy with the circular footprint left by the vbeam laser on my forehead which is lighter than the surrounding skin and does not flush with the rest of the skin. It never becomes red anymore on its own, only if I squeeze the skin on that spot but then it returns to being pale. You said that the vbeam probably coagulated all of the blood vessels in that spot. Will applying topical Niacin induce the redness/bloodvessels/flushing to return to that spot. All I want is for the lighter spot to match the surounding skin color on my forehead, its been almost 3 years and the redness has not returned on its own like you said it eventually will. I dont know what to do anymore, the options previous docs have said are relume laser which can return pigment to the spot and increase ther rate of blood vessel growth, is this accurate? micrpigmentation, what do you think of these and Niacin because Ive heard Niacin can cause flushing and redness for people in places they havent had it before.
Answer: I do not think the Niacin will help and I think the Relume might help but needs continued application. JG 8.10.08
what are the risks of using the relume or excimer xtrac laser to repigment hypopigmented skin or scars? does this cause skin cancer eventually after prolonged number of treatments?
Answer: never heard of it causing cancer but they have not been out long enough to evaluate that issue since sin cancer can take many years to manifest itself. JG 8.8.08
will repeated exposure to sunlight help speed up revascularization, I heard that the sun causes blood vessel formation
Answer: it can, yes, but wear sunscreen on the normal skin so that it does not get darker at the same time. JG 8.5.08
I had a spot vbeamed on my forehead. That spot is a littlelighter than my surrounding skin. this spot no longer flushes, it never becomes red unless a squeeze the skin on that spot, but then it gets red for 15 seconds and becomes pale again. Even when I exercise it never flushes anymore with my surrounding skin. I assumed this was hypopigmentation, but when I get a sunburn, my whole face gets red but this spot still stays pale. It doesnt even sunburn. However if I go in the sun long enough and frequently enough it tans a little bit but no sign of a pink tinge. What does this mean and how can it be corrected, please help. Its been 3 years since the v-beam treatment Answer: all of that is temporary and in time will get better, the issue is there because the blood vessels have been reduced on a temporary basis and that caused the effects you are seeing, as the blood vessels are re-established, it will return to normal in almost all cases. JG 6.30.08 is there anything I can do to speed up this process of the blood vessels returning and flushing returning. Its been almost 3 years now and it still doesnt flush and that spot is lighter than the rest of skin, please help me there must be something I can do.
Answer: I am sorry but there is nothing that will speed up the re-vascularization of the trested spot. JG 8.5.08
hi dr.garcia,i have very little cellulite on my thighs.it just started to appear, what is the best solution and how long does it last? thank you
Answer: VelaSmooth or Endermologie, it lasts a few weeks at most. JG 8.5.08
Dear Dr Garcia - is there a laser treatment that actually tightens skin and is there one that stimulates collagen. i am almost 50 with great skin- no lines at all- but my age is starting to show in a breakdown of the collagen under the skin as well as slight looseness at neck area - I would like to address it but think surgery is a bit drastic at this point. Thank you as always for your generosity with your time and knowledge
Answer: ablative lasers do that, but it takes a fairly deep treatment, and that means downtime, the older one is the deeper you have to go because the ability of the skin to make new collagen and tighten are less strong in older individuals. Best of luck. JG 8.2.08
Hi! I know you have probably addressed this Q many times already but I can`t seem to find it in the archive. Can you explain why IPL/Foto-facial help lighten dark spots and yet could also create new ones? How does this laser work in lightening? Is it good for Asian skin? Thank you. You are wonderful and so generous!!
Answer: it is a fine line of irritation causing the body to digest the pigement versus too much energy and heat causing a spot to form, that is the frustration, that you need to go slow and low. I is more risky in Asian skin than in caucasians. Thanks also for the kind words too. JG 8.1.08
Hi, Can you tell me what RF laser does,as opposed to infrared? Is it true that RF laser causes fat loss or does it depend on the level used? Is there a book you can recommend that will provide information on all the various options out there? For instance, I am confused about IPL vs. Fotofacial and all the various manufacturers, etc.
Answer: they, RF and infrared. both do the same thing, waste your money. RF has bene reported to cause fat loss, yes. IPL and Fotofacial are essentially the same thing, just a marketing term coined by a doctor is all. JG 7.30.08
Good morning, I am SO confused. I am Asian, have slight skin laxity and struggling with hyperpigmentation. Portrait is out for Asian skin at the higher level. Hydroquinone and Retin A (combined via doctor`s prescription) is not doing much. Photo-facial, you said, may help if the hyperpigmentation is new (but how to tell when the spots come and go in different places). It seems like every potential treatment for hyperpigmentation creates new problem. So what is out there? And what will work for slight laxity other than a face lift, which is out of the question for me?
Answer: I really do not have anything else for the pigment and I feel the surgery will be youe safest option for the lax skin, sorry. JG 7.30.08
Hi Dr, My Dr. told me that Radiesse is better than Restylane and the other newer fillers because it lasts longer - a year. Is that true and what are the risks for filling the lower face (naso labial folds and by the mouth? Thank you!
Answer: well, it does last longer in most cases, but whether it is better depends on your definition. Lasting longer does not always make things better. JG 7.30.08
Hi Dr. G., I had a skin tightening (radio frequency) session over the weekend, followed by fotofacial for hyperpigmentation. The doctor who performed this said that over the years, she has learned that this combination works better (and cheaper) than Thermage. She recommended 6; I`ve had 1 and was pleased but now I`m seeing in this forum that radio frequency in laser isn`t good. Can you provide guidance? Thank you!
Answer: I would save our money and skip all the treatments she has suggested, your improvement right now is only from swelling and will all go away in a short period of time, but the IPL will help with some pigment problems, especially if they are relativley recent. JG 7.30.08
Hi Dr. Garcia. I have been struggling with issues with my skin since receiving IPL treatments in Feb and March. My skin has been red, inflamed, blotchy and itchy since the IPLs (I did not have this problem before). In particular, my nose is extremely oily and oozes sebum at all times. Needless to say, I am now getting enlarged pores, which I`m afraid won`t go away. I have seen many derms, the last of whom put me on antibiotics, which I couldn`t continue to take due to side effects. I`d like to try accutane, but I`m wondering if there is a period that you should wait after laser before going on accutane. I had a vbeam treatment 5 weeks ago, trying to calm some of the redness I was experiencing (previous diagnoses were rosacea). Do I need to wait before accutane treatment, or is 5 weeks after vbeam safe to start on it? Thanks Alyssa
Answer: I think the lasers you have had done are mild enough that you can start the Accutane now, best of luck. JG 7.27.08
I have had a peel 30% TCA. My dr advises not to use any oinment or moisterizers until the peel is done. Why is this. Everything online says to keep it moist. The nurse suggested that using anything oily would be couterproductive to all the work the peel has done. I am miserable and want to put some Aquaphor (sp) on - but don`t want to reverse or reduce the results of the peel. Why would she say to not put anything oily on my skin once it starts peeling? Will it hinder the results
Answer: I typically will allow some Aquaphor in a TCA peel that is done that deep, it will in no way reduce or harm anything. JG 7.27.08
Hello doc, thanks for you answer about my morphea. You told that the YAG laser could help me, have you already experienced it on morphea patient ? Thank you very much :)
Answer: we have not but I have read about it being used. JG 7.25.08
in regards to the medlite C questions, is genesis better?
Answer: nope, will need something much more aggressive with some downtime to get an appreciable effect. JG 7.25.08
HI Dr. Garcia, my derm suggested Medlite C laser treatments for collagen building and a more youthful skin glow, as well as skin tightening and discoloration under the eyes. what are your thoughts?
Answer: will work for brown discoloration, will give your skin a healthy glow, will not tighten skin, will not reduce fine lines to any appreciable extent. JG 7.25.08
What do you think the risks might be for an Asian with some hyperpigmentation to undergo Portrait at the highest level (vs. the much lower 1 joule over 3 visits) that is normally recommended for the most effect?
Answer: significant risk I feel. JG 7.24.08
Hi Dr. Garcia, What do you think of all the infrared wraps that are suddenly popping up everywhere? Are they as effective as they claim, ie they help with weight loss, inch loss and even cellulite reduction. Frankly, I wouldn`t mind having an alternative to Velasmooth as, even though it works for me, I don`t like seeing more spider veins after my treatments! Thank you as always.
Answer: lots of hype for very little to no result. JG 7.24.08
Hi Dr.Garcia. I was wondering if you have heard anything about the Pearl Laser? I was looking into Fraxel, and came across the Pearl and was hoping you could enlighten me as to how effective either of them may or may not be for hyperpigmentaion. I have some slight melasma on my forhead and cheeks and across my upper lip. I noticed that it really became prevelant after I did some IPL treatments about 2 years ago. I did a series of 6 treatments and then started to have the brown patches.not sure if that was coincidence or not, but either way I am hoping to be able to get rid of the discolorations. That being said, do you offer any such treatments in your practice? Thank you so much for your time.
Answer: I think if it is relatively superfical and or recent hyperpigmentation, it will likely help some with a series of treatments. I do not think it is strong enough to do anything for the melasma and in some cases can make it darker since it is an ablative laser. Any light therpay can worsen the pigmentation, especially if precautions are not taken like using hydroquinone. I do not offer the Pearl laser, but we do use a YAG lser for isolated brown spots and find it to be effective, it will not totally correct melasma but typically will lighten it to make it easier to cover with make up. JG 7.24.08
Does hair eventually grow back with electrolysis, or is it just laser hair removal it grows back?
Answer: it can grow back if the follicle is not damaged. JG 7.23.08
Why don`t think laser hair removal is effective? Does hair eventually grow back?
Answer: well I think that because I have never seen it be permanent and the FDA has never seen it be permanent, if they had, they would have allowed the marketing materials to say that and they do not, doctor break the rules on what should be said all the time though. The hair will eventually grow back, at times slower and lighter but it will grow back. JG 7.23.08
hi is diathermy a good option for capillaries? and how does it work? is it true you only need about 3 treatments and last for about 2-3 years?
Answer: it does help in many cases. It basically burns the blood vessels closed. As to needing more than one treatment,that is true, as to lasting 2-3 years, no way to say whether that is true, likely not though. JG 7.22.08
hi doctor this is really embarrassing but im a female with hair growing on my chest and breast. I want to remove the hairs but too embarrassed to see a doctor for it. What will be a good laser to remove this problem? would Electrolysis be a good option? Please help, give me good advice........... thakyou
Answer: electrolysis is good as well as Alexandrite lasers. Best of luck. JG 7.23.08
hiiii you said hair removal is not permanent but ps tell me it is with some lasers.. obviously you have your reasons, I was excited now im upset. then after hair removal laser treatment does one need to get a treatment for the rest of there life to leave hair off? and how often do you then need to get the treatment done . thanks
Answer: I am afraid so, the hair growth will slow down and the hair might become more light, but it is not permanent. If you look at the FDA website, theree is not a single laser that is approved for permanent hair removal. It does remove the hair at the time of treatment because the shaft of the hair is burnt, but if the follcile is not damaged, the hair will eventually grow back. What your doctor is saying is completely false and is likely based on laser company hype and his lack of understnading of how the technology works or does not work. As to how often you need it for maintaining the lesser hair, that varies from person to person and also on area of the body treated, cold be weeks to months. JG 7.23.08
I have facial hair and cappilaries. Can IPL laser be used at the same time to treat these two problems? say if the laser is being used for the hair will it also help the capillaries? and is IPL the correct laser for it?
Answer: IPL will help the capillaries but will not help the facial hair, sorry. That will require a different laser, like an alexandrite laser, and the hair reduction is not permanent. JG 7.22.08
hey doc its me with the IPL question again. you said after the treatment you need to get it done every 4-6 weeks to keep up with the effects. is that one session every 4-6 weeks or another few sessions starting all over again? and is it expensive? i thought you just get it done every once a week. wow.
Answer: one every 4-6 weeks to maintain the results once you are to the degree of improvment that has stabilized. JG 7.22.08
dr Garcia when having IPL done you said few sessions will be needed to have the desired effect but after that how often will it be needed to have IPL repeated again? every one month? 6months? a year later? THANKS, YOUR THE BEST)
Answer: it usually is repeated every 4-6 weeks for maintainence. JG 7.22.08
I was thinking of getting a Pixel treatment for fine lines, pores and tightening. What`s your opinion of this laser. Am 52 but not facelift ready yet - had juvederm (naso.-marionette) and botox...Going broke fast...thanks dr.
Answer: very temporary fix if at all, if money is tight, save it for something better in the future when you are ready. JG 7.22.08
Hello again Dr. Garcia, further to my earlier question regarding treatment for seborrheic dermatitis, I am also considering UVB light treatment. However, I understand that this can be aging and potentially cancerous to the skin if used long term and would appreciate your opinion. Thank you so much again.
Answer: I would skip the UVB if possible for the reasosns you site and its minimal effect in most cases. JG 7.22.08
Hello Dr. Garcia, I have mild seborrheic dermatitis in the oily skin area of my nose and cheeks and have tried various topical and steriod creams with no success. Could you please advise any treatment that may help? - It has been suggested to me that pulse dye or IPL may improve the pink/redness, at least temporarily. Thank you.
Answer: I think the IPL is a good idea, might take a series of sessions and then once a month for control. JG 7.22.08
hello doctor, what kind of laser will treat capillaries, fine lines, pores and make skin more tight? if seperate laser needed can you please name them for me?
Answer: IPL for the pores and capillaries and a Rhytec Portrait Plasma for the fine lines, do the Rhytec first and the IPL will require a series and will not be permanent in its effects. JG 7.22.08
Hi Dr. Garcia.....You suggested the possibility of Accutante therapy for helping to reduce pore size & eliminate milia since I have tried many other expensive options that have basically wasted my money. I am 50 years old & do not have acne, but do have very oily skin - when I rise in the morning, especially the t-zone & throughout the day as well. Is the goal of Accutane to reduce the amount & thickness of oil production to prevent it from clogging the pores? Would a low dose therapy (even 10 mg.) be effective to achieve my goal? Also, do you have an opinion on use of daily flaxseed oil to thin the sebum produced b my body? Finally, would the Lam probe be an effective instrument for my milia? Thanks so much for the time & patient education you provide on this forum. If the above fails, I am considering having the Rhytec Portrait with you, but am avoiding this avenue unless absolutetly necessary.
Answer: yes, that is how Accutane works. As to what would be the effective dose, it varies from patient to patient. I do not think flax oil will affect the sebum production to any degree that would make a difference. The LAM probe would help with the milia, yes. JG 7.20.08
What do you think about the genesis laser for the face?
Answer: waste of time. JG 7.17.08
Hi Dr.Garcia, I am currently using differin every night and I also would like to have glycolic peel 30% once a week. But I know that differin should not be used few days before and after the peel. So, let`s say if I stop differin 2-3 days before and after peel, it will take almost a week already. Therefore, does it mean that I cannot do both things at the same time ?
Answer: pretty much, 30% glycolic acids peesl weekly is not a practica thing. JG 7.17.08
Hi Dr. Garcia....I`ve been researching the best possible option for reducing my enlarged pores and eliminating stubborn milia on my face. I have used the Obagi Nuderm line for 2 cycles & continue to used Retin-A, glycolic acid and Nia 24 products, but the enlarged pores & milia are still present. I`ve been considering either the ablative Active Fx laser resurfacing, the Palomar Lux 1540 non-ablative laser resurfacing or the Obagi blue peel to hopefully achieve my goal. My skin looks pretty good right now with the exception of these problems. Since I`ve wasted my money in the past on IPLs, microdermabrasion series & superficial peels with only minor results, which (if any) of these procedures will help me solve these problems? Do you have any additional suggestions for me? Is it possible for the Obagi Blue Peel alone to give me results (since the cost for this is much more reasonable than lasers)? Thanks so much for your reply.
Answer: firstly, anything you do will be temporary in terms of its pore improvements by that I mean a few weeks to a month or more, I do not think any of the new things you have suggested will do the job, and although Accutane is an option, it has significant downside risks. JG 7.17.08
Hi Dr. Garcia. I was wondering if lasers had any effect on aging the skin. i have had about 20 laser hair removal treatments on my face, 5 acne laser treatments, 1 microdermabrasion, and 2 Fractional Laser treatments. i feel like doing all that stuff to my skin and my face must have some type of effect, even in the long run and it`s got me worried. i`m 21 years old. can you please tell me what you think? thanks!
Answer: I think the negative effects on your skin from the treatments you have had performed will not harm you in any way. JG 7.14.08
I know that you think that a face lift is far more effective that any of the lasers. I do not want to go under the knife. I would like to get rid of the sagging I am seeing in the jowl area and lower face (I don`t have a lot). Do you think that any of the procedures such as Thermage, Refirme or Titan are better than the others? If not is there anything else you recommend other than a face life. Thanks for your continued help.
Answer: sorry, all equally poor at helping you with your area of concern. I do not think any skin wrinkle reducing device will lift the skin enough in a reliable way to make you see a difference. I am afraid with the limitations you are imposing, there is nothing that will do the job. JG 7.14.08
Is it safe to have glycolic peel about 2-3 months after accutane ? Thank you very much.
Answer: if the skin has regained its normal moisture it should be OK to use. JG 7.13.08
Hi Dr.Garcia, Is it safe to have a microdermabrasion treatment while having acne ? I heard that MD is good for acne treatment but would not it create a risk for more scarring, in case that it may squeeze the acne during the procedures ? Thank you very much.
Answer: yes, OK to do, it might bring some deeper cysts to the surface and make them come out to make the skin look worse in the short term. Mederma is a good option for healing scars, yes. JG 7.13.08
If the TCA peel and pearl laser only helps while there is swelling, then what is the best procedure to have beautiful skin?
Answer: well, that is a difficult question to answer as it depends entirely on what you feel makes skin look beautiful, if removing brown spots is the main thing, then the TCA peels might get you there, if it is a number of things that are required to have beautiful skin, it will likley take multiple modalitities, and none will be permanent due to nothinng stopping the aging process. JG 7.10.08
Hi Dr.Garcia. Would the pearl laser improve my skin more than thr 35% TCA peels that I have been getting? In other words, is the pearl laser better than the peels?
Answer: both will work for superficial recent pigmentation problems but I find neither one effective for wrinkle reduction, once the swelling goes down it all the improvement goes away. JG 7.9.08
what can help a hypertrophic surgical scar?
Answer: kenalog or 5FU injections, YAG lasers and external beam radiation. JG 7.7.08
Can dermabrasion help a hypertrophic surgical scar?
Answer: I do not feel it can, no. JG 7.7.08
Wow ... you are so amazing. You not only generously share your knowledge and give your time to your legions of audience ... but you respond faster than my own doctor!!! This is a follow up Q. In order to minimize veiny legs, would it make a difference having my legs done at a lower setting so the Velasmooth suction is not as hard? Seems only my front thighs develop more veins, not the back of the thighs. Also, now that the same company offers Velashape, do you think that is better than Velasmooth? Will they remove Velasmooth from the market at some point? Thank you and god bless!!
Answer: well, the problem is that the lesser setting with the VelaSmooth might help make less spider veins but the trade off might be less cellulite reduction or skin smoothing at the same time. I do not think the risks of VelaShape are any less and the fat reduction I feel is unpredictable. All the best. JG 7.7.08
I am Asian, 52, most people think I am in my 30s. My skin is pretty good, some blotching and my jaw line is not as tight as it used to be. What can I expect from Portrait? I understand the risks for Asian skin is potential hyperpigmentation so 1 deep pass is not an option. What do you suggest? Thank you!!
Answer: mild improvements I feel. If you go for a series of three lighter ones the degree of improvement I feel will be less.JG 7.7.08
I have been getting Velasmooth maintenance treatments every 2 months or so. It helps with the dimpling but I am noticing a lot more veins, spider and otherwise, even on areas that have been treated by my vein specialist. So now what? Am I now left with the horrible choice of less dimply legs but veiny or more dimply legs but less veiny? Ugghhhh. Any suggestions? Thank youQ!
Answer: there is a trade off in many pateints I am afraid, you might need to get the veins treated but continuing the VelaSmooth will make the spider veins come back due to the suction. JG 7.7.08
Do you perform laser surgery for excessive sweating (armpits)? If not, any suggestions?
Answer: I am not familiar with any laser that helps reduce armpit swelling, Botox can be used for that, and the results of liposuction are unpredictable with any technique employed. JG 7.3.08
Dr. Garcia, I have brown patches on my forearms that are bothersome. This year they seem to have spread all the way up my arm (now that I am in the sun). My Dermatologist said they look like birthmarks. Could there be a medical condition going on I should be aware of (allergy related) or is this just sun damage? PS.. any new laser treatments out there that would signifigantly help for this problem? I am a 40 yo woman fair to medium skin. The only medication I take is vitamins and omega fish oil. Also, when I apply sunscreen it makes the area look even more dark and dirty so I feel at a loss. Thanks, kgo
Answer: just likely sun worsening the brown spots that were there but were lighter, you need to wear sunblock not sunscreen when outside to help slow the progression. JG 7.3.08
Hi Dr Garcia. Back in February and March, I had 2 IPL treatments for mild flushing rosacea and some redness under my nose. About 3 weeks after the 2nd IPL (30 J double pass), my rosacea got soooo much worse, leaving me with permanent redness on my nose and upper cheeks, as well as worsening redness under my nose and uncomfortable itchy skin. In addition, the sun, heat and exercise turn my face bright red and shiny and it is quite uncomfortable, something that I never experienced before. Also, each morning when I wake up, my nose is swelled up. I am now going through vbeam treatments (subpupuric) at a different laser center in NYC in an attempt to get back to a halfway normal looking complection and a tolerable lifestyle. I think it is getting a bit better, as it no longer itches and the swelling seems to be going down somewhat, but it is hard to tell as it is still very uneven red and blotchy. Also, since this ordeal started, my nose has gotten very oily, which also was never a problem before, and my pores on my nose are becoming quite enlarged. I feel like I`m in some awful face nightmare! I have a few questions. Why would I react to IPL like that, as it sounds like such a safe procedure. Do you think the vbeams are the right course of action? My new laser derm seems quite confident that they will help, but also doesn`t seem to believe that the IPL had anything to do with this, which makes me nervous, as it is so obvious to me that it did. And third, what can I do to stop these enlarged pores, keeping in mind that I have pretty active rosacea on my nose right now? I currently use azelic acid, but it doesn`t seem to be helping. Do you know anything about DERMAdoctor Picture Porefect Pore Minimizing Solution? Sorry I have so many questions. Thanks for your time! Alyssa
Answer: not all people respond well to IPL, although most do well, hard to say why that happened. I am actually surprised the IPL did that and the VBeam did not as it is a stronger laser, might have been a coincidence. I think the VBeam is a good idea, as to the DermaDoctor, sorry but no personal experience. JG 7.2.08
Hi Dr. Garcia, thank you so much for creating this forum and also for your quick response. Would you please tell me which peel is most effective for fine lines, dull skin and a little hyperpigmentation? I am fair skin, light eyes. Thx.
Answer: I, in general, do not feel chemical peels do much for wrinkles, but if you were going to do one, it would be a 35% TCA. JG 6.30.08
its been 3 years since the v-beam treatmnt, the lighter circular spot on my forehead is till there, how long does it take for blood vessels to grow back and for flushing/redness to come back? 10 years?
Answer: no way to tell I am afraid. JG 6.3.008
(the guy with the lighter spot due to vbeam on forehead) is there anything that can accelerate the blood vessel growth into that area? any creams? relume maybe? anything?
Answer: I would suggest you let nature take its course, ReLume might help but the improvemnt will stop as soon as you stop the treatments. JG 6.30.08
Hi Dr. Garcia, I am a male who just had his first IPL treament for mild facial rosacesa 3 1/2 weks ago..Some areas of my beard hair fell off a week after treatment. How long will it take to grow back? Thanks
Answer: it will likely take about 6 weeks to start growing again. JG 6.30.08
I had a spot vbeamed on my forehead. That spot is a littlelighter than my surrounding skin. this spot no longer flushes, it never becomes red unless a squeeze the skin on that spot, but then it gets red for 15 seconds and becomes pale again. Even when I exercise it never flushes anymore with my surrounding skin. I assumed this was hypopigmentation, but when I get a sunburn, my whole face gets red but this spot still stays pale. It doesnt even sunburn. However if I go in the sun long enough and frequently enough it tans a little bit but no sign of a pink tinge. What does this mean and how can it be corrected, please help. Its been 3 years since the v-beam treatment
Answer: all of that is temporary and in time will get better, the issue is there because the blood vessels have been reduced on a temporary basis and that caused the effects you are seeing, as the blood vessels are re-established, it will return to normal in almost all cases. JG 6.30.08
hello dr. garcia, I want to know what you think of Active FX? Thank you
Answer: sorry but I am not a fan. JG 6.29.08
Dr. Garcia, I am a 38 year old female of Indian origin. I have moderate acne (that seems to be under control right now). My skin is very patchy and has acne scars (shallow, no pits). I also usually have two episodes (1 month each)of cystic acne breakouts a year, but I`m trying to regulate that through a better diet. My problems are uneven tone and very dark patches around my entire eye (not just underneath but on my lid too). I was recommended Fraxel by two dermatologists. I did three treatments which caused hyperpigmentation. I`m pretty much back to normal through using hydroquinone/kojic compound. So laser is not an option for me since I hyperpigment very easily. Tazorac didn`t help with my skin tone. And hydroquinone just lightened the hyperpigment from the laser but didn`t even my face out. I have consulted with several sources who suggested different options for my skin tone issues: 1) Obagi Nuderm 2) Jessner peel 3) silk peel 4) microdermabrasion 5) chemical peel (more concentrated than jessner but I don`t recall what kind). Do you have any thoughts on these options given my skin issues? I did a 1 layer Jessner to start and didn`t have any bad reactions to it. So I am considering slowly ramping up on Jessner and then doing Obagi in the fall/winter time. But I have heard that chemical peels are not recommended by some doctors for Asians. Also my eye darkness is *very* severe. Over the counter treatments have done anything. It is very noticeable as I`ve gotten older. Since this is genetic is it untreatable?
Answer: I think some beta hydroxy acid peels or a Jessner`s peel is a reasonable thing to try with your skin type. JG 6.25.08
Hi Dr. Garcia, What are your thoughts on genesis lasers? I started last summer with good results but my derm recommends a series of 6, they are very expensive and I am hesitant to invest, however I am not ready for a more invasive treatment. Is there any other laser you recommend with little down time or any topical remedy, to brighten and tighten skin?
Answer: sorry but I am not a fan. I think superficial skin peels or microdermabrasions can make your skin shine more but there is ntohing with minimal downtime that will give significant tightening. JG 6.23.08
Hi Doctor, I`ve been searching the Internet for before and after pics of laser treatment of poikiloderma of Civatte and didn`t find that many. But one pic, it looked like the red area just became brown. I would be unhappy with that result, but if that happened to me, could I then use the hydroquinone to fix it? What do you think of lasering POC? Do people usually have good results? Thanks!!
Answer: it can become hyperpigmentated and it can be treated with hydorquinone to help fade it some if it does occur. I do not suggest lasers there as it has a higher risk profile though. JG 6.23.08
How long can I expect the effects of IPL to last? I am going for a series of treatments for mild rosacea. Is this something I should expect to repeat every year, every few years? Thanks!
Answer: 3-6 weeks for Rosacea. You will need it redone every few months. JG 6.4.08
Hi, i had a dermabrasion nearly 2 years ago, and i am very unhappy with the outcome, i have patches of hypopigmentation and i also have patches on my cheeks that have absoloutly no pores, it`s like the pores have been completely obliterated, why is that? Thanks
Answer: the loss of pigment is from the dermabrasion going too deep and losing melanin in the skin, the area with no pores is because it is essentially a scar, and scar does not show pores, sorry. JG 6.4.08
hello dr garcia, How does IPL work? and will you need few sessions normally? and how often do you need to repeat the procedure???? once every 6 monthsss?? or year???? i really want it for the capillaries on my face.... please give me some info about this as i have nooooo information.... thankyou
Answer: it works by damaging the pigment cells in the skin and it always takes a series of treatments, usually at least 6 and then followed by a maintanence program afterwards. The sessions are typically done every three weeks. It is not permanent. JG 6.4.08
Vbeam on surgical scar again...thanks so much for your lightning-fast reply! 2 more questions: would Dermatix C have an effect, positive or negative, on indented scars? And what would you recommend as an eventual treatment, if any exists, to help fill in the indentation? Thanks again. It`s wonderful that you do this for complete strangers!
Answer: no effect, I feel, with the Dermatix C. As to the eventual filling, normally we hope the surgical revision would have relieved that, but if you are seeing a depression after less than one month, then the tissue below the skin that should have been moved underneath the scar has not stayed there, therefore it will require a filler such as Radiesse or Sculptra to fill it in. I would wait about 3 months before doing that. Best of luck stranger! JG 6.3.08
Hi Dr. Garcia, I had Vbeam performed on a red, indented surgical scar on my cheek, 3 weeks ago and 3 weeks after scar revision surgery, as recommended by the laser surgeon (not my plastic surgeon). I`ve seen the laser dr. before and gotten good results; she used the same low setting on the new surgical scar and said it would help with the depth as well as redness. Now it seems the scar is deeper, still red, with a deeper depression in the middle. Have I made a mistake in getting lasered so soon after surgery? Irreparable? Or is it possibly a sign of progress? I`m due for the 2nd of 3 treatments in 2 weeks, but should I cancel and wait for the scar to heal more on its own? Thank you so much.
Answer: Well, not a mistake, I think it will all get back to looking better in time, I think normally I would wait at least 6 weeks for the scar to heal before starting a laser treatment series. A VBeam will establish no significant amount of new collagen, so there will be no filling in from the laser. I do not think you have done anything irreparable. Wy don`t you wait a full month before the next treatment though. JG 6.3.08
Does smoking make the skin sag and cause wrinkles around the eyes? and why? and what can fix it?
Answer: yes, becasue it allows the collagen and the cross links to break and then the skin gets loose, one can laser the skin to try to regain some of the cross links and the lost collagen. JG 6.3.08
Hello. I have a red birthmark on the back of my neck that extends into my hairline Which laser is best to remove this, and how many treatments are necessary?
Answer: YAG or VBeam are good options. No way for me to tell how many treatments though. JG 6.2.08
What laser is best for fine lines under the eye area? Fraxel or Candela Smoothbeam? Thanks.
Answer: neither one is very good. JG 6.2.08
Hello Dr. Garcia, I had a very aggressive vbeam for rosacea that left many bruises all over my face. The purpura took about 3-4 weeks to change to brown marks which took another few weeks to resolve. Unfortunately the bridge of my nose still has a large reddish/brown splotch on it from where the bruise was. It has been over 4 months now. Is this just a slow to heal bruise or has the aggressive treatment induced rosacea on my nose? I didn`t have any problems with my nose before and really only wanted the vbeam for my cheeks. thanks, Ken
Answer: more likely post inflammatory hyrperpigmentation, might need some Retin-A and hydroquinone or some light IPL treatments to help it fade. JG 6.1.08
dr garcia, will rhytec or co2 laser help with the pores?
Answer: for a short period of time. JG 6.1.08
sorry to bother you again. I am the lady who had 1 pulsed dye laser with bruising, then 1 KTP for sudden facial redness. You have said to go with IPL, is it safe to have that after the others? Also as it costs the same in UK as KTP and Pulse dye will it be as effective at evening out the skin tone or should I just try 1 more pulsed dye with bruising or KTP as can probably only afford 1 more treatment. Many, many thanks.
Answer: you can try the KTP if the price is the same I suppose. JG 6.1.08
Suddenly this yearafter temperature virus got continual flushing of the skin. Have been told its either rosacea or sundamage. It is really irritating as burns for lots of the day. However, I do not flush after excercise or alcohol so not sure if rosacea is right diagnosis. Had one treatment with pulsed dye laser which left bright purple bruises for 5 -7 days. Made some nice white patches. Then couldn`t afford the downtime so was recommended by the pulsed dye laser man to his colleaguge for KTP. Now still look patchy I think worse that when I started as always had even skin tone albeit suddenly pink. Should I complete pulsed dye treatment or have more KTP. Do you think I can get even skin tone again. Also after pulse dye laser thought I had some indents and depressions on cheek almost like chicken pox scars although laser surgeon did not think the laser was responsible. I would value your opinion. I am very miserable. Many thanks.
Answer: I would go with a milder option such as an IPL. JG 5.31.08
Dr. Garcia, My question is regarding pigmented demarcation line (PDL) in both my legs/thigs. Is there treatment? Do you offer it? Or I`m a stuck with this forever ): I have read a lot of literature about it, but cannot find information that directs me towards treatment/ Can you help me? Respectfully, MCDJ
Answer: maybe a YAG laser done as a series, we do offer it in our office but without seeing you it is hard to say whether it will be worth your time. JG 5.31.08
dr garcia will rhytec laser help Capillaries on the face?
Answer: no, it will not. JG 5.29.08
hi dr garcia, I just spoke to a ps to get co2 procedure. The ps is telling me that rhytec is much better then co2. Ps told me i wont be getting co2 because rhytec is heaps better. im confused... i thought co2 was better?
Answer: what is better about the Rhytec is that is has less downtime and the risks are less, but it is not as strong or dramatic of an improvement. Depends on how you define better I guess. JG 5.28.08
hello, how long will co2 last? will i need to repeat the laser one or two years after the first to see the same results???
Answer: all deepnds on your age and skin quality, could be 3-5 years in some, less in older people, more in younger people. Repeating it is possible but the degree of improvement will likely not be the same as you will be older and the body`s ability t create new collagen will be less the second time around. JG 5.28.08
Hi Dr. Garcia! I am having IPL for mild rosacea. I also have dark pigment under my eyes which Dr. says is superficial pigmentation and will be helped by IPL. Is that possible?
Answer: I doubt it. JG 5.27.08
hello, can co2 be used for upper eyelids? and how many treatments needed for co2 normally? can it just be one session??? for the whole face.thanks
Answer: yes it can, how many treatments depends on how strong they go. It can be one session yes, just like the face. JG 5.27.08
Hi Dr Garcia. I had 2 IPL sessions for rosacea, the last being a little over 2 months ago. Three weeks and 2 days after the last IPL, I spent a couple of hours in my garden. I did not have sunscreen with me, but put on makeup with 10 sunscreen in it and wore a baseball hat. I thought that 3 weeks was sufficient time with no sun exposure. A couple of days later, my face got very pink, with a perfect line on my nose where the goggles were during my ipl. Five weeks later, and my face is still red with that same line. I had a vbeam treatment a week ago, which seems to have helped somewhat. Is it possible that I permaenently disrupted the pigmentation of my skin. Could it be a deep burn that will fade with time? Have you ever heard of this? Thanks for your help.
Answer: no, nothing permanent has been done, just give it some time. JG 5.26.08
hi doc, for loose skin over the entire face will co2 or rhytec be more suitable and how many sessions will co2 require?
Answer: CO2 will be more effective. JG 5.25.08
dr Garcia, if rhytec laser is used with high energy under the eyes for one only treatment will it cause any complications to the area???
Answer: it should not. JG 2.25.08
Hello, Do you think the newer Fraxel Repair is any better/more beneficial than the restore treatment that has been out for years? It sounds like the Repair is supposed to be a more aggressive treatment. Thank you!
Answer: I do not think so, I feel the company has exagerrated their results frm the beginging, so believing them now is going to be hard. JG 5.24.08
hello dr Garcia, you metioned that IPL laser treatment doesnt tighten the skin much and doesnt effect the collegen production, will rhytec portrait plasma resurfacing do the trick though? and how does this treatment work?
Answer: Rhytec will tighten skin better, and remove brown spots but will not fade redness. JG 5.24.08
Hello, sorry to be painful- its me - the retinaldehyde girl! Thanks for answering my questions... I asked if retinaldehyde worked as well as retin a but without the irritation and you said this isnt true. Sorry to be dense, but do you mean it doesnt work as well or it does but will still give irritation? Thank you very much
Answer: I think the irritation might be less, but the effectiveness will be less too, if any efectivenessvat all. JG 5.22.08
what are the risks of ipl treatment?
Answer: post-inflammatory hyperpigmentation and it not working to remove red or brown spots. JG 5.22.08
Hi there, I just posted a question about using retinaldehyde on mild scarring & looseness on the upper cheekbone/under eye area. Would you recommend portrait for this area? Do you think one strong session or a series of mild ones would be best? I`m 33, very healthy, with pretty normal skin (although it is now a little sensitive in that area). Thanks again
Answer: I think Portrait would help the scarring but not the redness, for that I suggest an IPL or YAG laser. If the scarring is minimal then I would suggest a series of lighter treatments to decrease downtime. JG 5.22.08
Hi Dr Garcia, I have been using Retin A on my upper cheekbones to try to get rid of some mild scarring from a retinol peel. I am experiencing broken capillaries from this. It seems to be working as the scarring appears to be `coming` out - looking worse at the moment. I have been told that retinaldehyde works just as well but without such irritation. What do you think? Thanks very much
Answer: sorry, but not true. JG 5.22.08
Hi Dr Garcia, I am a 27 years old woman. A year and a half ago I had rosacea fulminans. I took isotretinoin for about 6 months, and it disappeared. the problem now is that I still have red scars. They had faded quite but not enough. I used some creams for that, but I left them because now my skin is too sensitive to anything. Also i see my skin aged and dry (I use nothing for that either because I get pimples)...contradictorily, I have seborrhea too, but that is under control...I have large pores and some areas are red and sometimes with a ligth flushing...What can I do to improve my skin look? I don`t want to use more irritant creams...I have heard something about IPL, microdermoabrasion, etc, but I am scared...what treatment would you recommend me?...or do you think that if I don�t do anything more, time will stabilize my skin and clear my scars and redness? thanks a lot for your patience!
Answer: I think IPL would be the best option, mild yet effective. JG 5.22.08
Hi Dr. This is one of your old buddies, remember KTVY I was the guest coordinator (Terry) I remember your show with you and Della, You said than I didnt need a face lift.LOL..I surely need one now. But thats not the question. I have a big brown spot and 2 blood moles, my insurance wont cover their removal, they say theyre cosmetics, I say they hurt. But anyway, what woiuld you charge me for the removal, I guess its laser. I would love to see you again and I trust you. Well maybe, anyway nice chatting and awaiting your answer. I have not won the lottery so take that into consideration. Thanks Terry
Answer: feel free to call and make an appointment, we usually charge $50 per lesion, hope all is well with you and thanks for remembering me. JG 5.22.08
Hi Dr. Garcia. I had IPL done about 3 months ago. Now I have an area on my cheek that`s a strange texture. It sometimes looks discolored but when I look close it`s not a different color but is different texture than my other skin. I`ve seen that sometimes you say Copper Peptides to fix the texture. Will this help after all this time? Also, I was taking a break from Retin A. Should I start using it again? Will it help the texture? I`m older (50). Thanks.
Answer: it stil might help it some, not as much as if you had done it sooner, hard to say what caused it too. I think if you have the Retin-A, I would start that back up also. JG 5.21.08
heyy dr Garcia, im 27, female, i wanted to know some laser treatments to treat my undereyes and my whole face.. the result im aming for is to make my skin tight and firm.. is there any laser treatments that does the whole face? and how does it work? and how long will it last? how often will i need to do the treatment?thankss
Answer: at you age, and without seeing you in person, I would suggest using a Rhytec Portrait for the entire face. It can be repeated in 18 months if you need it. JG 5.21.08
Hi doctor, I am African American, I have brown skin to light side. I have little chicken pox scars and large pores, they are not bad but they are extreme bothersome to me, I was told to have punch graft, but I don`t thing this going to benefit me a lot, because I want all over all rejuvenation everywhere, U heard about co2, and I know not all lasers work on dark skin, what do you think I should do, I rally want flawless skin, what laser should I have, what I am looking for regarding in skin color change, I have fading light spots and areas on my skin, I read something before if there trauma to the skin like laser, that might trigger full vitiligo, but I just want to go for it. how long recovery I am looking at, will my skin get so dark and then will go back to my natural color, how can I chose the doctor? if the doctor never had experience on dark skin would that not the doctor for me? what laser should I ask for specifically, sorry for so many q. but I find that treating skin and chosing skin doctors is the hardest of all cosmetic procedures. thanks a lot
Answer: well, the first thing is you need to understand that you will never have flawless skin, no matter what you do, you have scars that are permanent, can be improved, but will never be removed, and the dilated pores will recurr over time due to skin oil plugging the. I would not do a CO2 laser on an African American and any resurfacing will be potentially risky. You might want to reconsider the punch grafts and possily fillers for some of the depressed scars and microdermabrasion for the plugged pores. Best of luck. JG 5.21.08
where and what brand of copper peptide do you recommend?
Answer: ProCyte`s. JG 5.19.08
Dr Garcia i had a tca peel and was pleased with it but still have some red spots under my eye (3# weeks) what can I do to eliminate them? creams? Thank youi so much
Answer: copper peptide cream or IPL treatments cna help. JG 5.18.08
Hi Dr Garcia, is 12 months long enough to wait to have a 2nd wire brush dermabrasion after having my last one. Thank you.
Answer: should be OK, yes. JG 5.18.08
Hi Dr. G., What do you think of Velashape? Does it work? Is it the same or better than Velasmooth? Thank you as always. You are completely unique and wonderful in your generosity.
Answer: it supposedly works better than VelaSMooth as the VelaShape is suppposed to melt fat, I have not seen any patients in person that have had a result. I think the technology they are using has melted fat when employed in other machines but it was by accident and not on purpose. I think I would wait a while before trying it. Thanks for the kind words and for visiting. JG 5.17.08
I`m 37(fair/olive skin) on 5/12 I had botox(between eyebrow)restaylne injections(lower,upper eyes) and tca 35% peel under eyes and upper cheeks. My question is, it is day 3 and I have not yet peeled, just have dark brown skin in peel area,very dry,wrinkled and swollen. Is that normal? I`ve been putting ice packs on my eyes and seems to be helping a little. My doctor said to put moistuizer on only when starting to peel.He recommended vasaline or Aquaphor. I`ve never heardto wait before. Is that right? Also I`m concerned that I will have a line on my cheek where he stopped peel. Have you seen that before? Thank you for your time. Andrea(San Diego)
Answer: normal, yes, but it will peel in a couple more days most likely. We use the ointments right away, but no real harm in waiting. JG 5.14.08
Hello again Doctor. I followed your advice of the other day and didn`t even ask to have IPL in the undereye area, as you thought it was not recommendable. My questions are: a) does IPL anyway improve the area, even if moderately only, if applied in the cheeks? Does the beam of IPL (if that is the word for that) only targets right where it was applied or does its effect go beyond the specific point where the wand was held against the skin? b) I was suggested to have another session in 30 days. Does IPL cause enough (I don`t expect miracles, but something useful) collagen production stimulation to be worth having it again? Does it really help with lines and skin texture? Because I rather hear (more often) about it being used for pigmentation problems, rosacea, etc., which are not my specific problem (mine is skin texture and a few lines). Thanks.
Answer: It will help with pigmenation only, not much tightening with it. The effect only is where it is placed, not much diffusion. Skin texture might improve but not much tightening of lines. I think in terms of visible collagen prodcution effects it will disappoint you. JG 5.13.08
hi Dr. Garcia, I am 42 years old and have sun damage to my skin. I have had several spots on my chest, arms, and face removed by freezing it off. They keep coming back! I also have started seeing redness around my nose area. Is there a certain type of chemical peel I should do? With limited time off of work? I`m tired of looking old! Thanks for any advice you can give me!
Answer: IPL might help with minimal downtime but they will all come back with time and sun exposure I am afraid. JG 5.10.08
Hi, I am 2-3 weeks pregnant and I would like to do the Rhytec on my face. Is it safe while pregnant? Is there a higher risk of hyperpigmentation?
Answer: I think it best to wait until after the baby. I do not think the risk of hyperpigmentation is increased though JG 5.10.08
Can facial resistance exerizes performed fifteen minutes a day with tugging and pulling on skin cause surface skin damage? thanks! also what is the latest on the syneron fotofacial and fotofirm (rf)? thanks!
Answer: the only thing tthe facial exercises will do is create more wrinkles in the skin. As to the latest on the Syneron fotofacil with RF, I am still not a fan. JG 5.8.08
My Dr. told me that the over the counter micro dermabrasion weekly treatments are bad because they break down the collagen, is this true? She also suggested a laser treatment every 6 weeks to help prevent my adult acne, reduce pore size and rosacea, will this work? What is the name of the laser that would be used for this treatment?
Answer: well, I just think they are not well constructed and it is something that you can over do and scar the skin instead of improve it, that is something best left to someone else who can see more clearly what they are doing than yorusef in the mirror. I think light lasers done every so often can in many cases control pore size and skin texture, yes. Usually the one used for what you need is an IPL laser. JG 5.9.08
Does IPL help a bit with undereye lines? (collagen buildup to help with wrinkles) If so, can IPL be applied in the undereye area? Doesn`t it harm the eyeballs or something? (assuming anyway that one has the eyes closed, of course!). Can IPL be applied close to the eyes, in the lids, undereye, tearthrough area, etc.? Any precaution other than covering well the eyes if that was the case??? Thanks in advance for the answer.
Answer: I do not believe it does much there. I think you would need protective eyegear to try it but I do not recommend you do it. JG 5.8.08
Hi, I am scheduled to get an aramis laser treatment tomorrow. Is there any chance of being burned by this laser ? Is their any chance of facial fat loss with this laser like their is with thermage? I am geting the aramis for acne and acne scars. Thanks
Answer: low risk, but still possible since the water is being targeted. JG 5.7.08
Dr. Garcia, i have sun damage on my neck and i have received two estimates from two different doctors. one is recommending the pulsed dye laser and the other is recommending the Fraxel. which is best for red damaged skin on the neck and broken blood vessels on the face. also, is there risk of permanent damage with either? last question, what about the Titan laser? will it help either of my problems?
Answer: if it is red the pulsed dye laser, the Fraxel will do nothing for redness. I think the Titan is too weak and the risks, in experienced hands of anything negative on a permanent basis is small with the Pulse Dye laser but the Fraxel has some mild risks. JG 5.6.08
Hi DR Garcia. I am 36 yr old female. Can you please tell me what is the best way to firm the skin in lower face and jowl area. My skin seems to have just recently become slacker in this area. What do you think of botox or IPL for this problem? Thankyou
Answer: might consider a Rhytec Portrait, IPL and Botox will not do it. JG 5.6.08
Hi Dr Garcia. Hong long should one wait after scar excision before using V Beam / YAG to reduce redness? Thanks
Answer: 6 weeks. JG 5.6.08
I have been getting a cafe-au-lait birthmark removed with the YAG/MediLight laser. I was told the sun will make it reappear. It is on my arm, so when I am in the sun, will sunscreen over it be enough? He mentioned a band-aid but won`t the rays go through that? I heard the silicone scar sheets block it better, could I put on of those over it? Thanks!
Answer: sunblock would be better than sunscreen. The silicone sheet will not block it and the bandaid will not be as good as the sunblock either. JG 5.3.08
do tca peels work on lines above lips?
Answer: no. JG 5.3.08
i was told that you can order tca peels on line. do they work on vertical lines on lips?
Answer: it will not work and they can be dangerous. JG 5.3.08
What do you think of th portrait express procedure? Also what do you recommend as a creme for fine lines and texture issues especially aroud the mouth? I do not tolerate retin A or any acids. thanks so much.
Answer: mild, but good, for the fine lines I sugges DMAE creams, on my shopping cart. JG 5.1.08
Mahalo for answering my previous question. I have one more. In your opinion do you feel the Fraxel FDDA treatment makes significant improvements in , including rhytids and pigmentation, as well as skin laxity? Do you use this treatment on your patients?
Answer: I am not a believer or fan of Fraxel. JG 4.30.08
Aloha from Kauai Dr. Garcia can you tell me what you know about the fractional C02 peel? Have you used this method in a peel? How does it compare to a TCA peel?
Answer: I think it is likely similar to the TCA peel, neither one is very strong. JG 4.29.08
I`m 55 yrs old and want to know the best method for tightening the upper arms. I had liposuction several months ago which left them a bit crinkly in places and slightly jiggly. I`ve had consultations for the Accent XL laser, but wondered about the rhytec portrait laser for skin tightening? Also, between Accent and Velashape, which do you think is more effective? Thanks.
Answer: I think all of those will be a waste of time, I think you likely need surgery to cut the loose skin out. JG 4.29.08
I have quite a bit of sun damage and crepeness under my eyes. I had an erbium laser treatment two years ago and a profractional laser treatment done this year. Neither have done much to improve the texture under my eyes - do you feel Rhytec might work for me? If not, what would you suggest? Thank you.
Answer: I think it will be more effective than what you have already done, but a CO2 laser will be even more effective, but more down time. JG 4.29.08
My doctor recommended Candela`s Q-Switched Alexandrite laser for several long-stading age spots on my face. She said this laser would completely and permanently remove the spots, and it sounded like this would happen in just one visit. Do you agree with this assessment? Is there a better treatment/option for this problem? Thanks in advance!
Answer: I disagree, it will likely not remove them in one session and it will not be permanent. I think any treatment will allow the spots to come back in time and with sun exposure, I think a YAG laser is better personally. JG 4.28.08
I thought I should post my last question under the proper category. I know that you do not really believe in Thermage. I have had it and the only thing I really notice is a more open look to my eyes. I am beginning to see a decrease in the open look. I do not need an forhead lift but would like to see that wide eyed look again. Should I consider another Thermage treatment to my forhead only or is there something elso to consider?
Answer: maybe Botox to elevate the eyebrows is another option. JG 4.26.08
Hi Dr Garcia. I wrote you previously about a reaction that I have had to IPL treatment. I have had two IPLs for rosacea and sun damage, and since the second one, which was now 5 weeks ago, my face it red and swollen. I can see where I wore the goggles, as the skin around my eyes is lighter--there is a line where the redness starts. The doctor at the center where I got the treatment done had assured me that we would use a conservative, gentle approach, as I have very sensitive skin. However, he did not perform the treatment, and indeed, a different tech perfromed the 2nd one from the 1st. My second treatment used on a Lumenis IPC Quantum was 30 Joules, Progarm 1, 560 Head, double pass. I am a light skinned caucasion woman with mild rosacea. Does this seem like a reasonable treatment? Also, have you ever heard of prolonged swelling after IPL? What is the cause of this? Will it eventually go away? How long should it take to settle down? Thanks for your help with this. The doctors at the center where I had the procedure done want nothing to do with the situation.
Answer: it sounds like a reasonable option, it is just that your skin is very sensitive, it should not be a permanent thing and should get better in time.It might take a couple of months in severe cases though, hang in there. JG 4.26.08
i am 57 with some wrinkles, but not bad, does micrdermabration help wrinkles in marionette lines if zig zaggy, and will it help mouth wrinkles. what does it do and how long does it last. also can you tell me the cost.
Answer: I think the microdermabrasion for what you have is a waste of time, fees vary from office to office too. JG 4.23.08
Hi doctor, I am scheuled to have Rhytec portrait treatment done on my hands in a few weeks. I have the start of sun spots and crepyness forming. Do you use it on the hands and if so how are the results - generally? Many thanks for your time.
Answer: yes, it works well, but not as dramtic as on the face. JG 4.21.08
Doctor Garcia , do sunscreens have expiration dates .. i`m asking because i noticed that all my sunscreens - there are 5 of them ( Banana Boat Nivea Brands etc. ) don`t have expiration dates indicated on the package / container .. , thanks
Answer: I would not keep them past 1 1/2- 2 years. JG 4.21.08
Doctor Garcia does sunscreens which protect against UVA / UVB prevent a person to tan or its only help would be to prevent free radical damage , thanks
Answer: they should slow the accumulation of the suntan too. JG 4.21.08
Dear Dr. what is your opinion on the Mixto fractional laser? Have you used this laser? It is comparable to a co2I was told about 14 days down time. Thanks.
Answer: I have not personally used it and do not plan on using any fractional laser at the present time because I think the claims made are inflated and the results are not signifianct enough for most patients. I would tell you that it will not be even close to a correctly done CO2 laser. JG 4.20.08
hi, Doctor Garcia .. how soon should one apply copper peptide serum after having a TCA Peel .. should the copper peptide be applied the day or two days after the peel or wait until the crusts form ? any suggestion?
Answer: 24 hours later is likely OK. JG 4.20.08
Hi Dr. Garcia. I have had 2 ipl treatments for sun damage and rosacea---one a month ago and one 3 weeks before that. The first treatment bruised my nose considerably, and while the bruising cleared up within a couple of weeks, the skin where I bruised is still very red. I assume this is postinflammatory hyperpigmentation? Is this likely to fade? Most of the reading I`ve done says it will, but I see in a previous question that you answered that you said that PIH is a permanent change. In addition to this redness, I have had a really bad reaction to the last ipl treatment in general. It has been a month since my last ipl and my whole face is still pink, like a sunburn. If you look close you can actually see where I was wearing the goggles, because the skin is lighter there. Also, I broke out in cystic acne after each treatment, which I had to have injected, also leaving me with red marks. Is there anything I can do to reverse these PIH changes? Can v-beam or any other laser be used to treat them? I had v-beam years ago for a port wine stain and it worked very nicely. Also, have you ever heard of someone having a reaction to ipl in which the entire treated area stays pink for this extended period? The derm at the place where I have been receiving the ipls is recommending that I continue with the ipl to get the redness under control, but with the reaction that I have had thus far, I am very hesitant to do so. One last question--my regular derm prescribed Elidel for the PIH, which I have not yet started. Will this possibly help? I feel as if I have ruined my skin. HELP! thank, alyssa
Answer: redness is just inflammation but the hyperpigmentation part would be brown or bronze in color. The redness you have should fade and applying the treatment for PIH would just irritate you more and keep it red longer, you need to avoid the sun, and some of your topical acne treatments can also keep it red longer. Prolonged redness is very uncommon and a light VBeam would help settle it down. The Elidel is OK but only for a few days. Best of luck. JG 4.19.08
Hi and great thanks for your fast reply. (I posted a question cons. a facial fat loss after rf + ipl) I have just a few more further questions concerning your suggestions to fix it. Should I wait a half a year before getting fat or sculptra injections to see if lost fat comes back. And which one of those you would recommend Sculptra or fat injections? Also you mentioned a steroid injections. Where could I get those and should I try to get them as fast as possible? I am now very scared of all this. Thanks for your will to share all this information. - N
Answer: I would say to wait at least 6-8 weeks and see, if it has leveled and is not getting worse you can try a filler, just be conservative with any filler in case it does grow back. JG 4.17.08
Hi, Thanks for your wonderful site! I have a question concerning a possible fat loss after 1 Ipl combined with radiofrquency treatment(Syneron estyle). In 2-3 weeks my face has become very skinny and gaunt. Do you think it could be due to a fat loss? And how long after the treatment it may continue? And do you have any experience whether this fat loss could be normalized within a time and the skin get back it�s normal amount of fat or is it permanent? I�m 31. Thank�s a lot! -N
Answer: well, assuming there is no other cause for the fat loss like excess dieting, exercise or some illness, I am not sure what else it could be except that. It might continue for a few more weeks in fact. In some cases after steroid injections it can come back and one can hope it will in your case. Whatever is going to come back will come back in 6 months. There is a potential that it can be permanent and you would need something to correct it like fat injections or Sculptra injections. JG 4.17.08
Hi Doc, Does laser resurfacing help undereye wrinkles, if not, what do you recommend? Thanx
Answer: for a while yes, I use either a Rhytec Portrait or a CO2 laser there. JG 4.17.08
Hi Dr. Garcia, I did ask my doctor about doing the rest of a series of low passes. Apparently, I was not firm enough, and he said he can tell more in 3-4 months what needs to be done. He also said he feels he didn`t really do a low treatment on the one side as he went over it twice. So it appears I am out of luck unless I get the energy to fight this more. So I will just see you on 05/21. Do you think there is a danger that I am losing my window of opportunity to even things out by waiting? I can already see there will be a difference, so doing nothing is not acceptable to me. See you soon, and thanks again. If I could, I would just have you do whatever should be done; maybe we can talk about that, too.
Answer: it is not a danger, but it is just that doing the treatment sooner would get you even sooner. Two passes does not preclude doing a series of light treatments. JG 4.15.08
Hello Dr. Garcia, it is me again - the 1/2 low 1/2 high Rhtyec mistake gal. I have a follow up with my doctor; any suggestions on what I should ask about? I don`t think I will mention my 05/21 appointment with you. You are a godsend, by the way. I cannot thank you enough.
Answer: ask him how he treats the low energy patients as a series and ask him to do that for you so you do not have to wait. Best of luck. JG 4.14.08
Doctor You are the best !Thank you so much for your professional advise , I really appeciatte it ,I never expected that you will answer that quick , Is amazing that I visited so many doctors (Derm) and no one could tell me that my problem is hormonal , my husband just told me few days ago that I should check my hormones since it looks that my problem get worst when I get my period . Thanks again ..
Answer: all the best. JG 4.14.08
Dr.a year ago I had 6 sessions of Crystal microdemabrassion, ,large pores got a lot better and skin got smother on cheeks and forehead, but the acne on the chin got worst specially during my menstrual period, I tried so many things until finally got better with aloe vera plant and vitamin A suplement 10,000 iu . I stopped vitamin A since I read that can be toxic if you are trying to become pregnant what is my case and then the acne came back . should I go back with vitamin A suplements since it really proved me that my skin got a lot of better or is not safe ? Now I went to a plastic surgeon office and I am schedule to have every friday a series of 4 or 5 of Diamond Microdemabrassion with Salycilic acid. I got my first one with 20% salycilic acid and look good , I see the acne went away ,so I am very happy to see my face clean next one is in 8 days . This results last long? after I finish all 5 micro how many should i do in order to keep my face clean? Thank you for your profesional advise,
Answer: I think that dose of Vitamin A is not good while trying to get pregnant or being pregnnant. I think it certainly sounds like your acne is hormonal in nature and that needs to be treated in order to best control your acne. The microdermabrasion and salicylic acids peels will help keep things in good balance though. After the initial series it might be once a month or more, depends on how oily your skin is. Might want to ask your gynecologist about a birth control pill and its effect on your acne too, all the best. JG 4.13.08
Dr. Garcia Thank you for your quick and reassuring response. The difference in my face from my question to you to today is amazing. Because my doctor did two passes (Active FX) under my eyes, those areas are re-epithelializing much more slowly and are still very red and crusty. I read that Retin A may speed up the process. Right now I am just using a lot of Cetaphil. Would it be unsafe to use a mild Retin A cream at this point? Thanks again. Great site. You provide a wonderful service.
Answer: Retin-A will help it heal faster if used before the treatment, not after it is done, I would not use it now as it will irritate your skin too much. JG 4.13.08
Dr. Garcia I had Active FX Wednesday evening (the 9th). My face is very dry and splotchy and extremely red under the eyes (there is also a small amount of crusting under the eyes on my cheekbones--is this OK?). My plastic surgeon (a reputable Chicago doc) said downtime would be 3 days (but no Sat office hours, so cannot call). There is no way I can go anywhere looking the way I do right now. I have an event next Friday. What are the chances that my face will not look normal enough by then?
Answer: it is not uncommon for that to happen. The downtime varies with strength at which the laser is doen at, and also the thickness of your skin, so the 3 days is an average. I think by next Friday there will be lots of improvement. Hang in there. JG 4.12.08
I just had my 2nd IPL treatment today for redness and my skin looks very unsmooth, almost like shallow indentations throughout my cheeks and lumpiness. Is this normal for this soon after treatment? They upped the power today. My 1rst treatment left my skin texture very smooth after a couple of weeks, but did not look like this initially. Thanks
Answer: it is common, due to swelling and is temporary. The setting might have bene stronger and it can cause more swelling if it is. JG 4.12.08
Hello Dr. Garcia, I am 48 years old, female, caucasian, pale, hardly tans, female. I am thinking of getting 3 Siton Profractional laser treatments. Each one would be 3 weeks apart. I have some fine lines, wrinkles around lips, some cheek wrinkling when I smile... nothing too serious yet. 1. Does it work? 2. Are there side effects? 3. How long does the redness last? Mostly I`m concerned about making things worse. Thank you very much. cs
Answer: mild improvement possibly around the mouth, the cheeks will only look better while you are swollen. The side effects are that of hyperpigmentation and of it not working. Redness lasts about 3-7 days, all depends on how strong they go. Do not think you will make things, worse on your skin. JG 4.12.08
Dr. Garcia, sorry to not identify myself as you get so many questions. I sent a question and referred to my 05/21 appt. I am the person whose physician accidentally did high Plasma on 1/2 of face and low on other side, then went over low again.
Answer: I figured it out, see you soon. JG 4.11.08
Hello Dr. Garcia, I did make an appointment with your for 05/21. Is there anything I should bring? As I said, my doctor did say he would do another procedure if I saw a difference in 3-4 months. Quite honestly, I cannot see how I would not, given the extreme difference in the treatment given, at least as it appeared on my skin. I am not so concernec about 3 months out, it is more like 6 - 9 - 12 months. I wanted the results of a high treatment, and no way to sugarcoat it; that is not what I got. I don`t quite understand why I should have to wait so long, nor what your opinion of the correct treatment would be (if any.) I have the feeling he may be just hoping I won`t press the issue. This is very depressing; I do not mean to be self absorbed when people have so many real problems, but I cannot help the way I feel. I also have to say I am skeptical whether he would know whether there would be a difference in time or not, as he apparently is not so comfortable or experienced with the Portrait in general.
Answer: if you have the pictures from before the treatments, that might help a little. When I do a series of the ligther treatments in an attempt to get maximum improvements, we do a series of three with 3 weeks in between. See you soon. JG 4.11.08
Sorry Dr, referring to my question below I didnt make myself clear. I meant, the Vbeam laser is not available in Western Australia. There are other types of lasers, just not this one
Answer: Oh, sorry, could try a Nd:YAG laser, there are more of those. JG 4.11.08
Hi Dr. Garcia, Thanks for answering my question regarding removing the purplish vein underneath my eye. I have done some research, and realise this laser is not available in Western Australia where I live. Are there any other lasers that could be of some help, or any other options for me? Thank You!
Answer: I am sorry, but none that I can recommend. JG 4.11.08
Hello Dr. Garcia, I love being tan.I am am developing quite a lot of brown spots and am considering some sort of treatment to get rid of them. I had Photo Facial on my arms, legs and chest and it helped a little , but not much. If I have Levulan done in October, can I tan again by April of the next year?
Answer: I think you are wasting your time and money, once you tan the spots will come back. You need to make a choice, tannned with spots or no spots and spray on tan. JG 4.10.08
I am going to get laser sunspot treatments done as well as tattoo removal done. i went to two different places that use different lasers. which one is a better laser and would see results better the ipl or the medlittle nd yag laser? thank you very much
Answer: I use the Medlite Nd:YAG, an IPL is not a true laser and will not work as well for the tatoo. JG 4.10.08
Hi Dr, Just wondering what the best treatment for my veins would be. Under my eyes, near where my eye starts to hollow out above my cheeks I have some purple veins. They are a tiny bit lumpy and make the area look purple. Also a few tiny red veins under my eyes. What laser would you recommend? Also, I have some redness on my cheeks. Not veins, just blotchy. What laser can you recommend for this? Thanks!
Answer: VBeam would be the most effective but has some downtime. For the cheeks you can do the VBeam or IPL for less downtime. JG 4.10.08
Dear Doctor. I have few but noticeable little depressed scars on nose and a few on the cheek. My skin is super light and completely even, never had problems with peelings or anything causing hyperpigmentation or pigmentation problems of any kind. What do you suggest for those depressed scars? a) localized dermabrasion (to the point of wounding the skin and then wearing something to protect the area or b) punch excision o however you call that. The scars on the nose are rather big , relatively speaking, those in the cheeks small (not sure if punch can be done with them). A) Which procedure do you prefer as in having better results for the scars to get filled up/not noticeable (I don`t mind having a line, I hate having a depression) B) which one is best for the nose versus the cheek? C) what are the downsides and downtime of each procedure? I have my appointment with the derm tomorrow and even though it is a knowledgeable person from all I know, I value immensely more YOUR advice (more than the one of other docs, since you are so interested only in our education and wellbeing, shhh ;)) and I prefer to go there with an opinion of you to make a better informed decision. Hugs.
Answer: possibly fillers for the nose and punch excisions on the cheeks if they are small. Laser might help the nose, dermabrasion could if it is not microdermabrasion,and I do not think lasers or any dermabrasion will help the cheek scars if they are ice pick type scars. Good luck. JG 4.10.08
hello Dr. Garcia, i have v-beam done about 3.5 months ago with some bruising. well there is one small area that still has some bruising. it isnt huge but i dont like it there. will this ever heal or is there something a doctor can do to make it not discolored anymore? thank you
Answer: very unusual. It should be gone by now, might want to go back and see your surgeon and see if they are willing to do anything to help it along. JG 4.8.08
Hi Dr. Garcia - Do you think the results of a light vs. deep rhytec are similiar?
Answer: I think the deep has better results. JG 4.8.08
Dear Dr, I have rosacea (more than 20 years) and for the past 3 mths have been recently taking isotretinoin capsules on low dosage (10mg every second day). It has been quite effective in reducing red , itchy outbreaks on my face. I have periodic laser treatment to reduce/control telangiectasias, however I`ve read where it can be dangerous to do so while taking accutane. My doctor told me it was OK - if I stopped using the accutane a week prior to laser treatment. Having read your informative web site, I`m not convinced of this assertion as it seems there`s a chance of damage to the skin pigmentation and delayed healing. Could you please tell me if it is in fact safe to do, as my doctor suggested, or should I be waiting until I`ve completed 6 motnhs on the accutane - and if so how long to wait until safe? I don`t want to cause adverse damage to my facial skin. Thank you very much in advance.
Answer: well, I think if the setting on the laser is low and since you are not removing too many layers of skin because they are concentrating on the red only, it is likely OK to do it. JG 4.8.08
Dr. Garcia, Thank you for taking the time to answer all our questions. Here is my problem. I have an approximately 1 inch scar on my nose- right on the flat part so it is painfully obvious. It is 8 months old and has improved somewhat, but not nearly what I would hope. Some areas have linear depressions, others are simply wide and depressed. There seems to be a linear border (slightly raised)which surrounds the entire blemish. I am not prone to scarring, but am to hyperpigmentation. Is it possible to excise a scar on the nose with not a lot of extra skin? What would be the best course of action? Thank you so much. Gigi
Answer: hard to revise the scar without loose skin, a laser resurfacing might smooth it out but can be risky, with your skin if you tend to have hyperpigmentation. Fillers are not always possible to smooth out a scar, I think I would give it some more time and see what happens. JG 4.8.08
Thank you very much for your quick response to my post of the Rhytec procedure 9 weeks ago! In your response you said that it should be evaluated and treated - have you found something that should be used to help prevent or minimize scarring that I could propose to my PS? Thank you again!
Answer: might need shots of steroids or 5FU to soften the scars or a laser to fade the redness. JG 4.8.08
I had the Rhytec Portrait procedure 9 weeks ago at level 3 around my eyes (upper lids, side of eyes, and under down to cheekbones) by a plastic surgeon. I still have significant red areas under my eyes, my eyelids, and on my left temple. My surgeon is baffled as to why this has happened - she says that this has never happened to any of her patients. I am very fair, blue-eyed, with very sensitive skin (which was very nice other than some wrinkles). I am worried that these are permanent scars - they look like burns. Is there something that I can be using to help these areas heal? I plan on going to see a dermatologist but after reading your answers, it sounds like this is very unusual and likely a user error. Thanks for any advice.
Answer: very unusual I must say at that setting, assuming only one pass was done. If more then one pass was done, then it is not uncommon. Can prolonged redness be a sign of scarring, potentialy yes, it needs to be treated to make sure it does not go that way. Best of luck. JG 4.7.08
Dear Dr. Garcia, Having lived in Vegas for about 3 years, I have been getting sunspots on my face and they are getting really dark now (even can`t hide with makeup). I am very interested in Pearl laser or IPL, or any kind of treatments that can make my sunspots go away. Can you please tell me what would the most efficient and the cost of it? Thank you!
Answer: I think for low cost and low risk and yet still effective, the IPL is where I would start since they are recent, best of luck. JG 4.7.08
Dr. Garcia, one more question. I have to go to Las Vegas end of May for business; would there be any chance of having you take a look at my face and give me your thoughts? I did take pictures on day 3. If that would even be possible, do you think it would make sense?
Answer: please call the office and tell them you would like an appointment and that we have been communicating on the web. See you soon! JG 4.5.08
Hi Dr., Is Velasmooth at a lower level just as effective as the highest level, or is it the higher level you go, the better result? Does Velashape work, in your opinion? You are so amazing. There is no other expert in any area who provides such quick response to so many Qs. You are one of a kind. Thank you so much.
Answer: typically, the higher the level the more effective. Thanks to you for the kind words. JG 4.5.08
Hi Dr. G., I am confused about the Velashape. What is the difference between it and Velasmooth? Does Velasmooth have cumulative tightening of the skin with regular (every 6 weeks) treatment, in addition to helping with cellulite? Does having it at the highest level cause spider veins? I seem to be having more visible veins since I started treatment. As always, I am so grateful for your generosity in sharing your valuable time and knowledge. Blessings!
Answer: not much difference between the two, just more energy being put out to try to damage the fat to a greater extent. I do not think VelaSmooth has cumulative effects, no. High settings can cause spider veins in some peoeple, yes. All the best to you. JG 4.5.08
Dear dr.garcia, do you know if Dr Val Lambros can do botox,and treat noticable viens on legs and face freckles? thank you
Answer: not sure,you would need to call him. JG 4.4.08
Thanks, Dr. Garcia. I saw the doctor yesterday. He said he honestly feels I will see no difference in the two sides, and that he cannot do anything for 3-4 months, but if I see a discernable difference, he will do another procedure using less strength on the side he did the high power on and a bit more on the side he did on low power. I guess I will just have to wait and see, but it is stressful. Thanks again.
Answer: keep me posted. JG 4.4.08
Dr. Garcia, are you aware of any creams or lasers that can help with stretch marks...some pink and some white on breast and hips? What about the same areas with old scars (not sure Mederma would help after a long time)? Thank you for all of your past quick and informative answers. Bless you.
Answer: none that really work, no. Mederma and lasers will only help if the scars are red and the red is the only thing they help. Take care. JG 4.4.08
Hola DR. Garcia. About 2 weeks ago I was adviced to spend 400 dollars on a lazer treatment called Q alex to take out the sunspots on my shoulders. I am latino and my skin has a yellow tone and loves color! So after 2 weeks the spots are happy to stay on my shoulders...should have spent the money on a new coat or something. WHAT WILL WORK on sunspots on the shoulder area on a Latino woman? I had a Blift on my face and it took care of scars and spots beautifully...left a trace of color on the face though. Should I do this on my shoulders? I just want even skin in this area. Thanks doc!
Answer: a Q switched YAG laser will help, but it will never be done in one sessions, it will take a series, but no way to tell how many. A chemcial peel on the shoulders is riskier than the laser. JG 4.3.08
Hi Dr., G., I have been using a prescription hydroquinone and Retin-A cream; instead of a solid patch of brown hyperpigmentation, I now have dispersed, blotchy brown and lighter areas. Is this normal? That is, is the hyperpigmentation being broken up and eventually improving/fading? If this is not normal, should I stop using the cream? In addition to the cream, what other options are available that are actually effective for Asian skin? Will the Portrait help? Thank you!
Answer: yes, with time it evens out, some areas just respond faster than others. Portrait would help too though. JG 4.3.08
Hi Dr. Garcia, ThermaTip CL apparently drastically reduces cellulite/and results are long lasting. Does it? As well, if you have additional info, please share. Thank you
Answer: I have not seen a single patient in that it worked. I sold my Thermage machine long ago due to my and my pateints` disappointments. JG 4.3.08
Yes, I totally agree about going elsewhere. Thanks again; I will ask about the extra low pass. Take care.
Answer: all the best. JG 4.3.08
Thank you so much for the answer. Yes, I don`t know what joules were used; I am assuming 1.2 for the two low passes and 3.0 for the high, but I don`t know. What would you think about doing another low pass on the one side in about 3 weeks or so? I see the doc today and may ask him about that. You are so kind, and obviously knowledgeable. I wish I lived closer!
Answer: 2 times 1.2 will not be exactly equal to a 3 joule pass. I think doing another pass of the 1.2 after three weeks is reasonable. Might want to consider going somewhere else in the future, I know accidents happen, but this is a big one because although the results wil not be bad, the doctor should immediately see a difference after one hit of the low energy spot compared to the high energy, if they do not see a difference, I think that is not good. JG 4.3.08
What is the difference fractionated UltraPulse Encore CO2 laser (activeFX), which is suppose to be a single treatment) and fraxel?
Answer: the only difference is marketing hype. JG 4.3.08
Hello, I hope you can help me. I just had Plasma skin resurfacing on my face and neck. The doctor did 1/2 my face at high power, went to my neck on low power, then did the other side of my face on low power by accident. Because of that, he then went over that same side again with low power. He said he does not know if two low passes would equal one high pass; we will just have to wait and see. Is there anything we could do now? I am not comfortable just waiting 3- 4 months to see, and I am just so upset (not mad, just very upset.) Any suggestions on what I might talk to him about doing now? I can sure see a difference in the healing between the two sides. Also, the reason I started this is due to abnormal skin cells on my nose; not sure what level was used on my nose. Thank you so much.
Answer: well, it should be close, hard to say without knowing the exact joules used, but in most cases it will look pretty close, got to hang in there. JG 4.2.08
I am a woman in my mid-forties and my concerns are fine lines (getting deeper every day) around my eyes, enlarged pores, crepiness, and sagging starting in the jowel areas. What do you recommend a fraxel CO2 laser or a plasma portrait laser? Thank you for all your help!
Answer: I think the PLasma Portrait is a better option for the eye region but likley neither one will lift the jowls to any significant extent. JG 4.2.08
DR Garcia, You mentioned below the risks of the VBeam Laser. What are they? Can a person have two of them, and if so, how far apart in time should they be? Thank you.
Answer: the biggest risk is hyperpigmentation, in rare cases some people have become pale from the redness fading, for awhile. Teye can be done in a series if needed and I suggest 4-6 weeks inbetween. JG 4.1.08
I read about the micro laser peel and the softlight laser peel, correct me if I`m wrong, but I`ve found that the former has the same downtime as the later, but the former goes deeper than the softlight as it ablates the outer most layer of skin...up to 50 microns. How deep does the softlight laser peel go in microns?
Answer: it depends on the energy setting the doctor uses, no way for me to tell. JG 4.1.08
Where do you suggest going for mole removal on the face?
Answer: could try your dermatologist. JG 3.31.08
In terms of exfoliation after a single treatment, which would you suggest for better results considering all pros and cons of each,the softlight laser peel or one microdermabrasion? How does microdermabrasion affect a face with fine hairs?
Answer: the microdermabrasion will not affect hair and if the brown spots are the problem, then the micro laser peel is the way to go, if it is skin texture, then they are about the same. JG 3.31.08
thanks a lot Doctor Garcia for the answers on the TCA :) more power to you and God Bless
Answer: all the best. JG 3.31.08
What do you suggest for brown spot removal on your face? And what is the cost for this? Also, do you remove moles from side and tip of nose and will there be scarring? Should you do these procedures during the time of year when the sun is less strong?
Answer: we use a YAG laser, done in a series, $100 per session, we no longer remove moles and we suggest not using the laser during summer months, JG 3.31.08