Question:
Answer:

You would need to establish a doctor-patient relationship, have a physical exam and bloodwork before anything can be decided

Question:

PRP

Answer:

If the injury is within a few days I do use PRP, but if it is longer than a few days I add cytokines and growth factors to the PRP to enhance the healing. It also depends on what the severity of the injury was. I do not do prolotherapy.

Question:

My friend had her lip lift done by you and it looks amazing, so natural and I want my upper lip to look just like hers. I currently have a lip implant in both upper and lower. Lower looks great, but upper is needs improvement as my lip is still very thin. Is it possible to get a lip lift if I currently have a lip implant?

Answer:

Having implants or filler in your lips does not stop a lift lip from giving a whole different dimension to you lips. I would be happy to talk to you in person and discuss how we do it

Question:
Answer:

I have emailed you directly so that you can get me the phone number so I can take care of it for you

Question:

I am a 50 year old woman who's had Botox or Dysport approximately twice a year for ten years.  Recently, I saw a nurse practitioner who injected Dysport beneath my eyes.  I didn't see a problem there, but she said "You have crepey undereyes, this will help.." I trusted she knew what she was doing.  I've never had bags under my eyes and now I do.  Worse yet, my eyes don't seem to close properly now.  I realize that Dysport (like Botox) wears off, but will the laxity likely remain (after the Dysport wears off)?  Thank you for your time, Dr. Garcia.

Answer:

Once the product's effect wears off, the strength of the muscle will return and laxity will go away. In my opinion I think you need a new more injector, sounds like she works on a commission basis.

Question:

Why does it seem like the richest people, celebrities for example, get the worst plastic surgery? 

Answer:

I think it is more of a scenario where the patient requests something, possibly not what the surgeon wanted to do, and the surgeon feels they should provide it as they like to keep celebrity patients happy. It is a poor decision on the doctor's part. At times there is the case of the doctor not doing certain things, like face lifts, so they push what they do perform, fillers, and the appearance of the patient is not the best because the patient needed surgery and not more fillers.

Question:

Hi, Dr. Garcia. I hope you enjoyed a lovely Thanksgiving with your family...and I hope you weren't working! Just checking: Might the holiday be the reason that several questions on your website (from November 21 onward) appear as "unanswered"? Or is your website malfunctioning? You deserve to take some time away from all your screens, but I just want to be sure that you know that the public view of your website features about a week of unanswered questions. Thank you for all you do for all of us!

Answer:

thanks for the heads up, I will look into it

Question:

 say 10-20 mg LSD microdose on monday, wednesday, friday and 100-200mg modafinil on tuesday and thursday. I'd say they benefit in an opposite way and could complement each other. Neither can/should be done daily. Has anybody tried this?

Answer:

I could not endorse that regimen, what is the intent of the microdose LSD?

Question:

Hey it's crooked radix guy, I saw below someone having problems with your email. I sent one regarding my issue but it is not appearing in my outbox for some reason. Just confirming you received it? Thanks.

Answer:

I believe I answered all the questions you posted here, if not , please repost it as I have gotten this question

Question:

From the radix area. Will it be easier to remove early on or is it better to wait?

Answer:

There is no advantage to waiting, but you can if it is not a convinient time for you

Question:

I am not a very big woman and never have been but I do have a bit of a belly. I only weigh 130 and I am 5 ft 6. It jiggles and I hate it, so wondering if I lose it by walking and exercising if it will be more jiggly because of the fat being gone or if it might tighten up.

Answer:

The older one is the greater the likely hood of loose skin, but if you lose the weight by diet and exercise it should tighten up pretty well

Question:
Answer:

I might suggest trying a ThermiTight session. It uses radio-frequency to that the skin and causes it to shrink. Done in the office under local anesthesia

Question:

Do micro current machines work for sagging skin? The professional devices probably work faster, but I bought a Nuface home device. I have been using it for 3 days so far.
This might just be a coincidence or I can't recall if it happened before I started using this device. My body extremities have been feeling weak like I am going to fall over almost like I have MS. I do not know if the device affecting muscles has anything to do with this? Also, the nasolabial fold on one side of my face is much deeper than the other meaning there is more sagging on that side of the face (this is more I started using the device and currently). Is this common or could there be something ore going on.
 

Answer:

In my opinion I think that you might get some transitory swelling of the skin but no long term effects from micro-current therapy for sagging skin. The device if turned up to a high setting can cause the muscles to twitch, but that also will not have any lasting long term positive effects. It is very common for one nasolabial fold to be deeper as the face does not sag evenly. It varies depending on bone and fat loss with time.

Question:
Answer:

The fat loss is related to the amount of energy and heat applied as well as time. Being able to monitor time and internal temperature as well as skin temperature makes having fat loss a choice. By hat I mean if you want to break up some fat it can be set to do that, or it can be set to not do that also. My preference is ThermiTight for that.

Question:

What do you think of UltraShape?

Answer:

I think it is a very effective method using good science to decrease abdominal fat

Question:
Answer:

the best option is for someone who does not have a lot of sun damage is either a laser or a dermabrasion, after that fillers are an option but do not last very long as they have to be thin fillers and the motion there will make it dissolve quickly. The laser and dermabrasion, if done deeply can have some prolonged downtime and can remove sun damage which can leave a line of demarcation in sun-weathered people. ThermiSmooth is a radio-frequency therapy that will help mild lines and does not leave lines of demarcation if the fillers are not an option

Question:

Can bioidentical hormones (for a woman who is deficient) form more collagen in eye hollows? Can they also make chicken neck skin look more smooth?

Answer:

the hollows are more more fat loss than skin issues and the hormones, although it does enhance collagen production and has benefits on the skin, it will not affect the fat or volume loss. The only lines it will help are the small thin superficial ones, the chicken neck would not be improved I am afraid.

Question:

As women age, do they lose bone in the center of their forehead so it appears flat? I don't know if I lost bone or if I was born this way, but it makes my eyebrow bone stand out. I guess I have a prominent eyebrow bone. Do you know what causes a female to have a prominent eye brow bone? Is it too much testosterone? I also have prominent shoulder bones.

Answer:

the more common cause for that is loss of subcutaneous fat and to a smaller degree muscle atrophy. If it was due to your bone you would have always had it. I think in your case it is the fat loss that makes the bones more apparent, something that can be improved with fillers. Same goes for the shoulders, loss of fat and muscle, but fillers there will likely not be cost effective.

Question:

Three plastic surgeons I have consulted have suggested a corner of the lip lift by excising a small amount of skin superior to the lateral edges upper lip and then suturing at the vermillion border. I have decided to do it and have seen the post op photos of this procedure from the surgeon I have chosen. At 3 months post op on the 12 photos of different patients I have seen, I can't detect any signs of scars. Of course, that's my main fear, since the mouth is so visible. I realize that physicians only show photos of their success cases and not their disasters, but in your experience, does this procedure, if well done, leave almost no trace? I have Type I skin and make good scars, but I'm afraid that this may be the one time that I'll have a disaster. What do you think? Thank you.

Answer:

that area typically heals well and the scar usually, if visible, appears like a small wrinkle, but there are some patients that wear make up to cover it a bit more. Without any make up it can occasionally be seen in some patients.

Question:

Hi Dr. Garcia,
I was trying to determine if I have oversized muscle above my eyebrows or if it's prominent bone. You recommended an x-ray to see which one it is. I had past MRIs done of my brain. I still have the films. Would looking at these images sow if I have oversized muscle or prominent bone in eyebrow area if the MRI did not focus on that area?
 

Answer:

They might if they went down low enough, You can ask a radiologist where you are to look at the frontal bone/ sinus area and overlying structures and see what they say.

Question:

Hi Dr. G.,
With your new website, even though the archive is organized by subject (great ... easier to find previous Qs and As) but when I look up previous Qs, I don't see your As, just a bunch of Qs.  
Please bring back the previous site ... it wasn't as organized but easier to find and easier to read.
 
Thank you!

Answer:

I apologize, that is not what is supposed to happen, I will alert my web service and correct it ASAP.

Question:

Can fascia be used to fill in flatness on center of forehead? If so, would the fascia be turned into liquid to inject or would a large piece of fascia be placed over the center of forehead? Is this as easy or complex procedure?
Also, when people age do they often lose fat from the forehead making it look flatter? Or maybe I was born this way.

Answer:

Depending on the degree of flatness, it might be possibly, but fascia is quite thin and not readily available from your own body in large amounts. It cannot be injected, it needs to be placed surgically though. Losing fat from above the eyebrows and temple region is a common problem with aging . Usually Sculptra or one of the hyaluronic acid fillers are used to replace the lost volume.

Question:

I can't afford neck lift but there are txs with radio frequency and more out here. I think I have a spot of puffiness (fat I think) on each jowl which could be taken care of with something like spot ultherapy if I can find someone to do it. What do you think of Radio Frequency treatments / lasters? Any experience?

Answer:

I think the safest one in terms of reproducible results and safety is ThermiTight. It should do well for what you need. The difference is applies the RF internally, bypassing the skin and in that way you have better control and less potential side effects. I use ThermiTight in my office rather than Ultherapy.