Question:

I wonder if you might be able to speculate on why Julia Louis Dreyfus looks utterly amazing. We are the same age, and she looks easily 25 years younger than I. Of course, diet, exercise, genes, make-up, and money go a long way to improving a person's appearance, but what is your professional estimate about what she does cosmetically to look as young and beautiful as she does -- for as long as she has?

Answer:

Celebrities that make large sums of money typically, as long as the avoid the premature aging items like smoking, sun, excessive alcohol and eating properly  do better than the average person as they can use good skin care product, enjoy frequent visits to the aesthetician, and have minimally invasive things done to keep their appearance looking better than most. Genetics and an individual's genetics are the largest influence. They also frequntly enjoy professional make up artists to enhance their appearance. In addition, magazines commonly will photoshop the images to make the celebrity look better. As to Julia, to be honest, I am not a fan so it is hard for me to be enamored by her appearance, I think the last time I saw her on screen was during the original Jerry Seinfeld series. I am sure she remains and attractive though.

Question:

Supra-pubic lift

Answer:

There are a couple of things that can be done. Fat grafting can fill in depressed or flattened areas and excess or stretched out skin can be surgically reduced.

Question:

HydraFacial Vs. Microdermabrasion, Microneedling, Chemical Peels, or IPL Photofacial. 

Answer:

Hydrafacials and Microdermabrasion are pretty close. After that I would say chemical peels, followed by IPL. Last would be microneedling.

Question:

Dr. Garcia, I am 50 years old. I have never done any antiaging procedure.  What can I start doing to look a bit younger! I am white and red hair! Thank you!

Answer:

Without speaking to you and getting a full history, this is a very general set of things you can do. The first things are staying hydrated, using sunblock whenever you go outside, eliminate smoking, use a good facial cleanser, use either a retinol or glycolic acid product at night, have microdermabrasions to eliminate waxy skin. Those are just the beginners list.

Question:

What do you think is best for skin tightening? Exilis or ultherapy?

Answer:

I am not a fan of either, I think the results are short lived, but the Ultherapy hurts more so between those 2, I would tell you to use the Exilis

Question:

How to treat crapey skin on the hips and buttocks.

Answer:

I wish I had a good solution for crepey skin in those areas, but I do not have anything that is effective and worth the money. Sorry. 

Question:

Would these Ingredients work synergistically with your peptide cream?  apple fruit cultured cell extract, grape fruit cell extract, isomalt, squalane, bilberry leaf extract   Do they even do ANYTHING beneficial?  It’s a mineral face powder. It has SPF 50! Thank You for your time

Answer:

those products will not hurt the peptide cream's effectiveness, I think the best way to use them if you desire, is to apply te peptide first and then wait 10-15 minutes before applying the other product on top. They do have some beneficial effects on skin.

Question:
Answer:

I have found Olay Regenerist to be quite good at a fraction of the cost. 

Question:

What exactly is Ferulic Acid? I was told it was a super anti-oxidant! Yeah, sure!! That it also “protects the skin from the sun’s harmful rays, and helps reverse some of the damage your skin has already suffered due to the sun. Promotes collagen production, and skin is smoother and softer as well as younger looking”. Really? Is this true? Or Hype? I appreciate your time and input. You are very honest, Thank You

 

 

 

 

Answer:

Most of the activities as shown by FA can be attributed to its potent antioxidant capacity. It alone will not grow hair or lashes, the other compounds you mentioned previously have been used for years in extending hair and lashes and many patients swear by it. I will say that it should help, but of course the success rate cannot be guaranteed as giving positive results for all patients.

Question:
Answer:

We carry one that I have formulated that you can order and we can ship to you.. Otherwise Retin-A 0.05% applied at night will also help. As to OTC, I like Olay Regenerist Intensive Repair

Question:
Answer:

For the hollows, a hyaluronic acid filler like Restylane is what I use. As to the small wrinkles of the eyelid itself, because the skin is so thin, fillers there are fraught with problems like lumps, so fillers are not done in that area.

Question:
Answer:

Hyaluronic acid fillers like Restylane work well for the hollows of the lower lids but there are no fillers that will yield a smooth result for the lower lid wrinkles as the skin is too thin, sorry.

Question:

Does snail mucin really do anything? It sure is hyped, but I can;t find any evidence it does anything!!! I see no clinicicals on it??? Thank You

Answer:

Any potential benefit it might have would be from the small amount of glycolic acid that the mucin contains, but most other products with glycolic acid have likely much higher concentrations of glycolic acid. Save your money.

Question:
Answer:

I would suggest using the Daily Restorative Facial Serum as well as the Daily Restorative Eye Serum

Question:
Answer:

For deep facial lines the options are hyaluronic acid fillers,like Restylane or Juvederm. Each company offers a variety of products that are meant for specific indications. Secondly would be a CO2 laser, either totally ablative or fractionated.The third option for more mild wrinkles would be a microneedling in conjunction with the application or injection of cytokines and growth factors.

Question:

I am considering a TCA peel to treat lines and wrinkles on my face. The esthetician wants to do a microdermabrasion the day before the peel, because she says my face will peel more evenly and I'll have better results. What do you think? And do you think an esthetician is okay to do this, or should I find a doctor to do it. Thanks.

Answer:

I do agree that the penetration will be deeper if you have a microdermabrasion the day before,but that is not the problem. TCA peels are good for brown discolorations of the skin. TCA's effects, even if done deeply, on wrinkles is transient at best. Once the swelling goes down, the wrinkle improvement is gone. TCA does not induce any collagen cross-linking nor collagen growth so I suggest you do no expect much wrinkle improvement.

Question:
Answer:

I think in general it is a good product and yes it is pricey, I think the technology behind products from a company called Omni are better though

Question:

There are MANY positive reviews about the Tria Laser on Amazon! But a particular negitive one stood out, she said the laser melts fat! If that's true I would Not want this on my face. I trust your opinion and advice. What do you think of this laser? Thank you for your time

Answer:

It is hard to evaluate the technology as they use some big claims on their website but do not give enough technical information as to what the technology is for me to tell you if it is effective. In general, I have never found a home unit of any technology to be as effective as a laser in a physician's office. I would suggest you have the hair removal done by a trained technician in a doctor's office to be safe. The potential issues with lasers are burns, scarring, and  fat loss and because of that I think it is always a good idea to be safe.

Question:
Answer:

I think monthly  peels can be done but we do not want to over do it. At the beginning treatments such a slight peels or microdermabrasions or a combination of both are good. Once the skin gets healthier, then every 6-8 week should be enough.

Question:
Answer:

Micro needling alone will not provide much help in improving dermal scars from acne. If it is combined with our prescription grade additives available only from a physician, such as extra-cellular matrix cells or concentrated cytokines and growth factors, and if the needling is done deeply enough, then there can be improvements. I think it is safe to do a microneedling a week or two after a 20 micron laser peel.

Question:

How wonderful is Nicotinamide? I’d like to use it but heard one should NEVER use it in conjunction with Vitamin C? Also, would it inhibit your Peptide cream in anyway? Thank You for your time

Answer:

Nicotinamide does work against Vitamin C and should not be applied to the skin at the same time. It can be used with my peptide though. 

Question:

My derm used .4 ml of Botox on me yesterday. Was that 4 units or 40 units? Thank you.

Answer:

I am sorry but I cannot say without knowing with how much liquid they diluted it as well if it is 50 or a 100 unit vial, it may be 40 units, but no way to know without the amount of fluid and bottle size.

Question:

Would purchasing a Home Fractional device help with the top layer of my skin by addressing the fine lines and pores, leading to texture improvements? Will it simultaneously penetrates deeper into my skin to address larger wrinkles and discolored spots? Thank You for your time

Answer:

I am unaware of any effective or safe how fractional units sold for personal use as lasers cannot be sold to the public. The company maybe using certain terminology in a manner to imply equivalence with a laser but is not a fractional laser. I would steer away form such companies.

Question:

Hello Dr. Garcia, I have been using Renova for many years and love the results on my 62 year old skin. Unfortunately, it's become too expensive and actually not available (backordered) at several local pharmacies. I see some other renova products on the internet not made by ortho. Are they safe? Also, can you recommend an OTC retinol that could give me 'almost similar' results? I was using 0.02% . Thanks so much!

Answer:

generic Retin-A is just as good, might need a little moisturizing cream, but is available everywhere. As to OTC, the retinols are not as strong as the prescription strength.

Question:

I am having this done in conjuction with rhinoplasty but I'm kind of grossed out by the pics and cases I've read of people having lumpy healing that takes months to resolve in necklifts and lipo in some cases irregularities caused by bleeding are permanent. This is not a full necklift, just the incision under the chin, but I'm still worried about the healing process. I'm thinking of just doing rhino at this point because I read these lumps are actually expected with most neck work. What do you think?

Answer:

done with proper techniques, proper size cannuals and using local anesthesia with epinephrine even if performed under general anesthesia, decreases the risks which are rare. They seem more common on the internet because people that do not have the problem rarely comment on their procedure online. Neck lifts are more invasive than a liposuction and depending on what is done can leave some surface irregularities but they are usually gone in less than 4 weeks.  I would not say that lumps are expected on a long term basis though.

Question:

I have a home microdermabrasion unit... it is a high quality one and a mini version of the dermatoligist version, say about 50% the strength. Been using it safely for the past year after a class.
 
I started using it in combination with neutrogena retinol rapid repair at night with good results. My skin seems very tolerant to both and I have no side effects. How often, in this case, would be optimal to use the microdermabrasion? Thanks.

Answer:

I might suggest every 2-3 weeks, unless you have oily skin and blackheads, then every week

Question:

This not a recognized board certified specialty. How do I find someone in Massachusetts who isn't hawking the usual round of useless therapies? My PCP prescribed low-dose testosterone which did nothing but give me acne and make me depressed. 50 years old, 10 years post-menopause, and I am EXHAUSTED all the time (for no discernible  medical reason like thyroid dysfunction) -- even sleeping at work 3-4 hours throughout the day in my office for the past 6 years. I'm as interested in sex as a 5 year old, suffering aggressive alopecia and decreasing skin texture quality. I'm miserable all the time despite a wonderful and loving husband, meaningful work, and many friends. I teach meditation, work as a therapist, and exercise daily -- though with MUCH less vigor than I used to because I'm just so exhausted all the time. I've gained 18 pounds after a life time of being thin.  I'm even on anti-depressants now but of course, they're not addressing the hormonal problems. Can you recommend anyone who can help? Thank you!

Answer:

you will have better luck in your case with a gynecologist. Although the board of anti-aging is not recognized by the American Board of Medical Specialist, they do offer good training in the arena of bio-identical hormone replacement. What you describe with low dose testosterone in a post-menopausal female is frequent when no progesterone is given and more so when the testosterone is administered on the skin as the production of DHT, which causes the acne and hair loss is higher. I might suggest seeing an anti-aging physician who is likely more versed in what ails you than a PCP that is handling other medical problems. There are many listed at a website  called worldhealth.org

Question:

Hello,   I am a huge juvederm/restylane user in all areas of my face including under eyes for eye hollowing I was getting . I am 42. never smoked, sleep on my back,  user of obagi products , obagi serum, retina ,tns, alpha hydroxy.. drink tons of water , no more alcohol consumption
 
I have used cold tea bags, ice, and all the above to rid of them... sometimes ive noticed in the past they go away on their own.... this time it seems to be taking longer, I also use eyedrops when I need them..
I stay away from the sun completely and smokers...second hand smoke.. thank you...

Answer:

the hollowing out is  a normal part of aging. It appears you are doing all you can but ultimately your genetics will trump all of your good acts. Fillers and eventually if needed, surgery might be the next step but every individual ages differently so hard to tell what the future will bring.

Question:

Thanks for he response on the progesterone cream. In your opinion which is the most effective 'brand' to use? Thanks !!!!

Answer:

KAL or NOW are good brands, but as long as it says USP, you are OK to use it, Just stay away from the wild yam creams that claim it will convert into progesterone, it only does that in the laboratory and not your skin.

Question:

Thanks for the response on the progesterone cream. In your opinion which is the best, most effective 'brand' to use? Thanks soooooo much

Answer:

luckily, they are all pretty equal as they are essentially all generic. You just need to look to make sure it says USP Progesterone cream, that is the key. KLA or NOW are well-known brands that have USP progesterone. Be careful though as some people try to tell you that Wild Yam will convert to progesterone, but it does not, it only happens in the laboratory. 

Question:
Answer:

I think progesterone cream in addition is a good idea, I do think you should take a break from both for about 1-2 weeks at least 2-3 times per year though. Taking the Estrace alone will lead to estrogen dominance and you want to avoid that as it can have effects on breast tissue and the uterus too.

Question:
Answer:

I think progesterone cream in addition is a good idea, I do think you should take a break from both for about 1-2 weeks at least 2-3 times per year though. Taking the Estrace alone will lead to estrogen dominance and you want to avoid that as it can have effects on breast tissue and the uterus too.

Question:
Answer:

I think progesterone cream in addition is a good idea, I do think you should take a break from both for about 1-2 weeks at least 2-3 times per year though. Taking the Estrace alone will lead to estrogen dominance and you want to avoid that as it can have effects on breast tissue and the uterus too.

Question:
Answer:

I think progesterone cream in addition is a good idea, I do think you should take a break from both for about 1-2 weeks at least 2-3 times per year though. Taking the Estrace alone will lead to estrogen dominance and you want to avoid that as it can have effects on breast tissue and the uterus too.