• Is it possible to have canthopexy sutures removed a year after they were placed? I can still feel mine, and you can see where they were placed. Will my eyes go bac to the way they were before the surgery? If I ask the dr to remove the scar tissue that has developed around the eye, should I be concerned about the eyes drooping?

  Answer:  yes, but some scar tissue will have formed and that may need to be removed too if the tissues are really tight.If the scar tissue is removed you might go back to the way you looked like before. JG 8.29.06

• Dr. G, I have a serious plastic surgery question. I am 51. At age 15, I had my nose fixed. It did not look good, so I had it redone twice after that by the same surgeon. I finally had it done a year ago by another surgeon who said too much cartlege was removed. He used cartledge from my ear. After the surgery, the cartledge grew and made a large bumpy area on top of my nose and sides. Three weeks ago, he used a rasp to grind it down. I thought everything was OK until my swelling went down. I have a large bump on the side (I guess from the cartledge). What can I do? I am so tired of this? Is it dangerous to do the rasp again? Do you know of a really good rhinoplasty doctor? I am desperate to get this fixed for good. Thank you so much for your help.

  Answer:  it sounds like all that can be done is to rasp it out a little more, I am not sure where you live so it is hard for me to tell you where to go, but usually I am hesitant to suggest surgeons because the ones I do not suggest get jealous. All the best. JG 7.25.06

• I asked the previous question about Levulan phototherapy for eyelid surgery scars. Leaving Levulan aside, what treatments are safe and proven effective? cm 7/25/06

  Answer:  I think a YAG laser might help fade the scars a bit. JG 7.25.06

• I had a glob of fat hanging under my chin after fl in the fall. I just had a revision. Part was a skin pull (still under steri strips) and the other lipo. That steri strip came off and I was horrified: it looked awful, worse i think than before but it is very hard, a ridge almost and there is a dent to one side. I am very upset-- what can be done to this hard ridge. The place that was a blob still is there, but its part of the ridge. With a mirror below, it looks horrible. I am very upset-- do you think something can be done? I was told this was a simple revision. I was under a local. It was t

  Answer:  I think there may be more that can be done but you need to give it time to heal and soften as it is always best to operate on the tissues when they are the softest. JG 7.25.06

• I had a revision on a neck lift a ten days ago. I now have the steri bandages on but can see it looks bad: one part was skin pulled and that looks ok. the part that was hanging down had lipo and it looks like it is not changed but that there is a dent where in the middle of my under my chin area. I am very very upset. this was supposed to help this blob of fat or skin hanging down and he did the s

  Answer:  It is still a little early but discussing your concerns with your surgeon at this time is a reasonable thing to do, all the best. JG 7.25.06

• Dr. G, thanks for your response to my taking Arnica after restalyne injection. I read on Internet that SinEcch was the only Arnica that was strong enough for bruising. Is this true, or are they just trying to sell their brand? I need to know what dosage to take. Thanks so much.

  Answer:  no, not true, Arnica from the health food store made by Boiron is good, there are many good ones. 4 lozenges under the tongue, four times per day. JG 7.22.06

• am i too old, my age being 74 to have a facelift

  Answer:  as long as you are healthy it is OK to proceed. JG 7.19.06

• thank you Dr. G for answering my post about the marionete line and the radiance ihad injected. THE line is very deep looking right now< and wondering if this is due to all the pouching (inflammation)>>>? IT looks worse than it ever was> i had the injection 4 days ago.. thank you!! T.f. 7/19/06

  Answer:  it could be, give it a little more time and you may want to see the person who injected you to see what could be going on. All the best. JG 7.18.06

• I am 56 years old with fair and thin skin. I had .04cc Restaylane injected into frown lines 2 months ago. I can still feel small bumps and tenderness. Is it normal to have tenderness after this leng

  Answer:  tenderness this far out is unusual but the lumps can last a long time. May want to go back and see the doctor to check it out. JG 7.19.06

• Is it normal to have dimpling bilat after canthopexy? I am 3 weeks post op, had upper eyes and canthopexy with CFR. How long will this last? ML 7/16

  Answer:  it is not uncommon and usually goes away in a few more weeks, if not it will need to be revised. JG 7.16.06

• One more question about the removal of my stitches -- I have been taking arnica for the past couple of days. Is there anything else that I should take/not take to avoid bruising/swelling? Are the chances of swelling and/or bruising likely given the small size of the incision? Thanks.

  Answer:  no aspirin, or Advil or Motrin, nothing that can thin your blood. JG 6.28.06

• Dr. Garcia, I am scheduled to have my stitches released from a canthopexy procedure performed about 3 months ago. I have been have tension in my eyes when I blink, as the stitches are uncomfortable, and I have also been very displeased with the shape. My eyes used to be rounder and more relaxed looking, but not too loose. I am very nervous about having the procedure. My doctor says that he will make a 2-5mm incision in eye eye and snip the suture. What can I expect from the procedure in terms of results? Will my eyes take the shape that they were before? Is it possible that there might be too much looseness? Thanks in advance.

  Answer:  well in most cases it goes back but if enough scar tissue has formed ,the tissue may not loosen unless that is removed too which would involve more down time. JG 6.28.06

• THE TWITCHING OF THE TIGHTER EYELIS STILL THERE AFTER THREE MONTHS AND TWO DOCTORS TOLD ME I NEED TO GO BACK TO THE PERSON WHO DID IT.DOES NOT FEEL SWOLLEN AT ALL TO ME AND NO PAIN EITHER ONLY UNNATURAL TIGHTNESS. HK

  Answer:  not unusual after a canthopexy, it is the muscles trying to get used to their new position. JG 6.27.06

• HI DR GARCIA. HOPE YOU HAD A GOOD VACATION. I AM THE PERSON WHO HAD CANTHOPEXY IN NEW YORK. I MET WITH THE DOCTOR AND NOW HE WANTS TO DO A REVISION NINE MONTHS FROM NOW. HE NEEDED TO PUT MY LEFT EYE UP WHICH WAS LAX WHICH ISONLY MARGINALLY TIGHTER AND THE LEFT EYE WHICH WAS NOT LAX MUCH TIGHTER AND WAY UP HIGH THAN THE OTHER. HE IS NOT WILLING TO TAKE MY RIGHT EYE DOWN WHICH MAKES MY FACE LOOK ASYMETRICAL AND THE LEFT EYE IS SO CLOSE TO WHAT THE RIGH EYE USED TO BE. HK

  Answer:  welll, maybe see if you can talk him into doing it sooner is about all I can suggest. Maybe have him take some pictures of you so you guys can look at them together to so you can point out what you see. JG 6.27.06

• IF HE DOES NOT AGREE TO TAKE THE SUTURES OUT WHAT DAMAGE COULD THE DULL PAIN AND SENSITIVITY I AM FEELING LIKE A TOOTH THAT IS SENSITIVE TO HOT AND COLD ALONG WITH SOME VISION PROBLEM LIKE STRAIN AND PAIN WILL DO TO THE EYE?

  Answer:  should not affect your eyesight. JG 6.9.06

• IF THE DOCTOR AGREES TO TAKE THE THREAD OUT WHAT SHOULD I EXPECT. WHAT THINGS COULD GO WRONG FOR MY EYE AT THAT POINT.

  Answer:  just that the eye may look the way it used to, or if enough scar tissue has formed it might still look the same unless the scar tissue is removed too. JG 6.9.06

• HI DR GARCIA, THIS IS THE SAME PERSON WHO IS HAVING PROBLEMS WITH ONE EYE BECAUSE OF CANTHOPEXY DONE IN NEW YORK. WHEN I LOOK UP AT THE CEILING ONE LOWER EYELID MUSCLE TWITCHES AND EYE OBVIOUSLY LOOKS DEFECTIVE AND THE SAME HAPPENS WHEN I LOOK TO EXTREME RIGHT. WHAT COULD BE THE REASONS FOR THAT. TOO TIGHTLY LIFTED MUSCLE OR MORE POSSIBLY THE UNEVEN SKIN TRIM IN THE UPPER EYELID.COULD IT BE NERVE DAMAGE?

  Answer:  most likely the muscle is too tight. JG 6.9.06

• Dr. Garcia, thanks so much for all of your useful information on removal of stitches from a canthoplexy. One additional question -- how long would you say is the average downtime after removing stitches? Would you say that a long weekend (4-5 days)?

  Answer:  yes, about that. JG 6.9.06

• Is there a guide out there somewhere that gives approximate ranges that various plastic surgery and laser procedures should cost? I've gotten a great deal of difference in quotese from consultations that I've had. Just wondering if there is something I can compare them to accurately.

  Answer:  www.plasticsurgery.org under public education. JG 6.9.06

• What's a better plan: to do Rhytec first, and then a face/neck lift, or to do a face/neck lift and then Rhytec? Thanks

  Answer:  cutting surgery first, follwed by the Rhytec. JG 6.9.06

• dr garcia, is it true that having your first face lift in your early forties is more beneficial to keep your skin firm than waiting till your in your early fifties? Can you still get great results from a second face lift? or are you proned to get the wind tunnel look? how many face lifts can your skin take? By the way you have a great site.

  Answer:  a skilled surgeon can repeat the surgery a second time and leave natural results. Thanks for the kind words too. JG 6.8.06

• will the eyes pretty much go back to the way they were after having sutures released from a canthoplexy, if removed within 6 months after surgery?

  Answer:  they should but it depends on how much scar tissue has developed as the scar tissue can keep the eye in the same position so at times that needs to be released too. JG 6.8.06

• what is your experience with the threadlift procedure ? do you perform it? what about restylane or sculptra? which is the best to start out with? thanks!

  Answer:  I no longer perform the Threadlift perocedure due to the sutures breaking. I think Restylane and Sculptra are good products though. JG 6.8.06

• what is a composite face lift? at what age is that best to do, and what does it correct. thanks!

  Answer:  it is a faceift with eyelids and forehead lift done at a deeper level to try to get everything looking more balanced, purports to lessen some of the visible signs of a facelift but has more healing time. As to what age, it depends on how much aging the patient has. JG 6.7.06

• when removing the stitch from a canthoplexy, do Drs usually use a shot of local anesthesia to the area?

  Answer:  yes. JG 6.6.06

• Have you heard of the tumescent ultrasound and the new lipo stabil body contouring?

  Answer:  heard of them both, I use tumescent ultrasound liposuction and I do not recommend Lipostabil. JG 6.6.06

• midface descent problem. Do you think that a facelift would help a little with the facial sagging.

  Answer:  yes it should. JG 6.6.06

• how long should one wait before the initial surgery before going in to get the less tightened up lower eyelid tightened again.

  Answer:  6 months or so. JG 6.5.06

• if in the canthopexy procedure one eye is slightly less tightened up than the other how will the doctor pull that stitch up. is that another surgery involving anesthesia with new thread looped in or can it be done using the existing thread already in there with just a shot to numb the area and cut in the incision to get to the thread. thanx

  Answer:  another surgery is needed to place a new suture. JG 6.5.06

• Dr. Garcia, I too am having issues with a canthoplexy procedure that I had approximately 2 months ago. I hate the shape that my eyes have taken and my stitches feel way too tight. I would like to have the stitches removed, but am concerned about possible complications. Is this a relatively simple procedure? It sounds as though only part of the initial incision is made and the stitches just snipped. Should I be concerned about any complications? Is there a greater risk of scarring since it is a re-opening of the initial incision? Thank you.

  Answer:  pretty simple to do, and it can be totally taken down or cut and re-done less tightly if the reason it was done for still exists. No big risk of additional scarring though. JG 6.5.06

• CAN YOU SUGGEST SOMETHING I CAN TAKE TO CALM MYSELF BEFORE I SEE THIS DOCTOR LEST I START SCREAMING AT HIM . I AM SO SORRY FOR FOR THIS BUT YOU HAVE ALWAYS BEEN SO KIND IN ANSWERING MY QUESTIONS I FELT I COULD WRIT THIS TO YOU

  Answer:  well, assuming no pescription medications are available to you like Valium or Xanax, maye some Kava Kava or Valerian Root extract, both available in health food stores. And remember, screaming will not help your condition and you may get him/her angry and you stil need them to help you. JG 6.4.06

• I THOUGHT IF HILLARY CLINTON CAN TRUST THIS GUY HE HAS TO BE GOOD. HE AND HIS WIFE DONT EVEN COME ON THE PHONE NOW TO LISTEN TO WHAT I HAVE TO SAY.THEY TOLD ME CANTHOPEXY POSED LEAST RISKS AND THIS LOOKS TOO HARD FOR ME TO HANDLE.I AM GOING ON THE 16 TH OF THIS MONTH TO SEE HIM. HOW DO I PROCEED.I AM SO MAD AND HAVE BEEN CRYING FOR A WEEK NOW. CAN YOU SUGGEST SOMETHING THAT I CAN TAKE BEFORE I SEE

  Answer:  you know, lots of famous people go see certain surgeons, and although there are many good famous surgoens, not all famous surgeons are good, and not all good surgeons are famous. Also, complications can stil happen, even to the leaders in the field, they are at times protected from bad press by their reputations though. I also have seen lots of bad surgery on famous patients, just because they are famous does not mean they chooose well all the time. I know you are upset, just hang in there and lets see where it goes. I will tell you I will be out of town though June 16-25 so I may not get back to you right away after your visit. JG 6.4.06

• I THOUGHT IF HILLARY CLINTON CAN TRUST THIS GUY HE HAS TO BE GOOD. HE AND HIS WIFE DONT EVEN COME ON THE PHONE NOW TO LISTEN TO WHAT I HAVE TO SAY.THEY TOLD ME CANTHOPEXY POSED LEAST RISKS AND THIS LOOKS TOO HARD FOR ME TO HANDLE.I AM GOING ON THE 16 TH OF THIS MONTH TO SEE HIM. HOW DO I PROCEED.I AM SO MAD AND HAVE BEEN CRYING FOR A WEEK NOW. CAN YOU SUGGEST SOMETHING THAT I CAN TAKE BEFORE I SEE

  Answer:  you know, lots of famous people go see certain surgeons, and although there are many good famous surgeons, not all famous surgeons are good, and not all good surgeons are famous. Also, complications c

• HTIS OPHTHALMIC PLASTIC SURGEON HAS WRITTEN BOOKS AND IS BASED IN NEW YORK FIFTH AVENUE. ONE WOULD THINK HE WOULD BE ABLE TO PERFORM THIS SIMPLE SURGERY WITH MORE CARE. HOW SERIOUS IS THE SURGERY HE PERFORMED BECAUSE MY EYE WAS SWOLLEN FOR MORE THAN A MONTH AND THE LEFT EYE WHICH WAS MORE LAX WAS FINE AND RECOVEREDE WITHIN a week.

  Answer:  eyes will always heal differently as there are many variables. I think you need to hang in there and have him work with you to help you with your problem. JG 6.4.06

• DR GARCIA , THE DOCTOR TOLD ME LATER HE FOUND A LOT OF SCAR TISSUE THAT THE REMOVED FROM THE EYE WHICH I AM SURE HE HAS TIGHTENED MORE THAN REQUIRED. I FEEL TERRIBLE THAT HE DID IT. WHAT IMPLICATIONS DO THAT NOW POSE FOR THAT EYE.

  Answer:  really hard for me to say without more information that is probably difficult to get, it really depends on how that scar tissue was removed and what it was doing. Sorry. JG 6.4.06

• HOW SOON CAN THE DOCTOR PULL OUT THE THREAD THAT HAS BEEN TIEDTO THE BROW AFTER THE SURGERY AND HOW IS IT DONE?

  Answer:  I imagine it can be done at any time, it just needs the skin to be opened and the suture clipped. JG 6.4.06

• Dr garcia , if in the canthopaxy procedure there is more tension or pull felt after two months of surgery in one eye only and the same eye feels tightly pulled upis there a possibility that it is pulled up more than necessary?

  Answer:  it could, yes. JG 6.4.06

• If stitches are released 6 months or more from a canthoplexy procedure, will the eyes still relax and appear rounder?

  Answer:  it should unless the scar tissue holds it up. JG 6.4.06

• Hello Dr Garcia.I have had saline implants for about 6 years and recently discovered that I may have a capsular contraction. The nipples are assymetrical with one nipple up higher than the other and one feels firmer than the other. I have been massaging them but I am wonderong what I can do to fix the problem. I did some research online and discovered that there is an antibiotic that can be taken that is said to help also the capsule can be squeezed but that is not recommended. Let me know what you think. Thanks

  Answer:  I have not found any of the oral medications effective and massage may help keep it where it is but it will not loosen the capsule, it might need surgery. JG 6.4.06

• I am a relatively thin person, 6 ft 170, age 49 but have double chins happening. I am not sure if this is loose skin or fat deposits or what. This is really my only problem area except my stomach and it is very unsightly. My question is are there any methods for reducing the loose, flabby rolls under the chin through exercise devices, etc? What would be the best method of reduction? Thanks.

  Answer:  surgery is the only effective thing I am afraid. JG 6.4.06

• How many procedures can be combined in one surgery session, if procedures wanted are breast reduction, tummy tuck, lower body lift (including thighs, butt, backside), face/neck lifts? If all can't be combined in one session, how far apart should I wait between surgery sessions? Thanks.

  Answer:  I think that is to much at one time and I would suggest 3-6 months between large sessions. I would limit it to about 5-6 hours per session and how to break them up depends on the time needed in your case for each part. JG 5.30.06

• They also told me they cannot touch the eyes for another year if there is something wrong. what solution is there to a problem lke this?

  Answer:  I think 6 months may be enough of a wait. JG 5.29.06

• hi dr garcia.it has been a month and a half since the doctor lifted my lax lower eyelid muscle thru the incision in the upper eyelid and some skin trim in the upper eyelid.I have noticed that I feel a slight pull on the corner of one eye only and also the same eye has a tiny bit more slant to it than the other eye.also the amount of skin trim is less in the same eye which seems like has been left out to compensate for the difference in the shape.sometimes the same eye looks smaller than the other. is this normal at this point.I call the doctor and they told me they are still settling down and it is the final look that matters. I am not so sure.PLEASE HELP ME WITH SOME INFORMATION ON THIS. I AM CONFUSED.

  Answer:  all normal for this soon after the surgery. The muscles will continue to relax and balance out in time. JG 5.29.06

• How best to judge if you really need an eyelift? are results usually satisfactory?

  Answer:  usually satisfactory and a surgeon is the best to tell you the answer to if you need it. JG 5.29.06

• How soon after Rhytec or other lasers is it safe to have a face/neck lift? And vice versa?

  Answer:  I would wait 6 weeks.JG 5.29.06

• Are there any real options to having a Blepharoplasty performed? I had a consultation with with a Cosmetic surgeon and he said although he could do laser, Restylane, and Botox to me, he would not recommend it. I'm a little confused about it all. Help! MG

  Answer:  there is nothing out there that will replace the surgical procedure. JG 5.16.06

• Do you do Alloderm lip inplants? Do you know the average cost of them and how long it lasts?

  Answer:  I no longer do them as I was disappointed with how long they lasted, about one year. JG 5.25.06

• How long does it take for the scars to go away from a cantho procedure? Are the scars generally noticeable?

  Answer:  they will fade some in 6 weeks or so. JG 5.22.06

• Hi DR Garcia, Can you tell me what procedure is the best for scar removal under the breast after 2 years of breast augmentation and it is still very red and even purple in places What should I do. Doctor only suggested mederma and it has not helped at all. Thanks so much.

  Answer:  well, if it is a keloid, 5FU injections may help, otherwise, cutting it out again may leave it looking the same. JG 5.22.06

• What is the longevity of Captique (1cc) in the lips? I've heard anywhere from 4 months to one year. I'm looking to get Captique because I've been told it's more natural looking and feeling in the lips.

  Answer:  2-4 months, at times a little less, at times a little more. It is a good filler, similar in applicaton to collagen and easier to use superficially then Restylane for small wrinkles. JG 5.16.06

• Dr. Garcia, one last question about removal of stitches from a canthoplexy. What does this entail in terms of down time? My Dr. said they open the stitch partially with a device using radiofrequency to avoid bruising and bleeding, and would need to stitch the opening closed after removing the stitch from the tendons. In your experience, can most people return to work the next day or shortly thereafter? My Dr. said most people can, but I am interested in others' experiences. Thanks very much.

  Answer:  yes they can return to work soon but there will be some bruising and swelling for a bit. JG 5.14.06

• For building up the cheekbone undereye area, what filler would be best?

  Answer:  for the cheek itself I would say Sculptra. JG 5.11.06

• Dr. Garcia, what are the risks of having stitches removed from a canthoplexy? I only had minor tightening, and my stitches are very uncomfortable. Also, my eyes are very unnatural looking. I am concerned about having the stitches removed, though, and having more droopiness under my eyes. I just had the procedure done 5 weeks ago. Thanks.

  Answer:  it is just the eyes will relax a bit, be less almond shaped and a little rounder. JG 5.9.06

• I am a youthful 53 yr. old woman. Average weight. I had abdomnioplasty 3 years ago in Brazil. The feeling never retuned in my abdomen.Should I give up waiting? Also why does my belly itch at night and no amount of scratching, rubbing, makes it subside?Any suggestions? Thank you, TC

  Answer:  the itching is due to the nerves being caught in scar tissue and not much you can do for it exept maybe a little benadryl at night. As to the feeling, whatever was going to come back has come back so what you have now is permanent. JG 5.8.06

• How serous is the surgery that needs only about a millimeter of skin trimming on the upper eyelid if necessary? How soon can it be done after the inital surgery?

  Answer:  not very and it can be done whenever the doctor feels the swelling has gone down enough and the skin is pliable enough. JG 5.8.06

• Hi Dr Garcia, I had lax lower eyelid muscle due to blepharopalsty seven years back. I had surgery one month back to get them tightened. The doctor went through the incision he made on the upper eyelid and lifted up the lower eyelids.He also lifted the corners of my upper eyelids and trimmed some skin of upper eyelids. I do see a tiny bit difference in the amount of skin trimmed. I think tiny bit less was trimmed on one side which is evident only when i close my eyes and some discomfort in the same eye.With my eyes open I cannot make out any difference in the size of the eyes.They say I should throw away the mirror and wait for everything to settle down. What are the things that can cause the discomfort in such type of surgeries? Am i getting upset too soon? The corners of upper eyelids are still numb.The doctor is asking me to see him in june? Eyes look beautiful. Just the discomfort in one eye bothering me. Could it be permanent?

  Answer:  give it time, it is way too soon to decide anything. JG 5.8.06

• I had a lower bleph and fat removal from my lower eyes, and have been left with hollowness under both eyes. I can't stand looking at myself. Is there something that can be done to fill the hollowness? Can this area be re-filled?

  Answer:  very difficult for fillerrs to work there. JG 5.6.06

• Dr. Garcia, I previously asked you about releasing the stitches from a canthoplexy. When is it safe to do so? I am displeased with the shape of my eyes, but also had c02 undereye laser at the same time (about one month ago). Will I need to wait a while before I have the stitches removed?

  Answer:  I think it is OK to proceed now. JG 5.6.06

• dr garcia, i had rhinoplasty with you 3 months ago. at times my nose looks wide and others real thin and long. does it have anything to do with how i sleep or eat? i do massage it daily. when will i see final results? my nose has no shape yet/

  Answer:  more with the sleep than with the eating, although really salty foods can aggravate the swelling. It is normal for swelling to wax and wane but slowly in time it will do that less and less. A little massage at night and in the morning will help. Final results may take a year, the more that was done, the longer it takes. It also is influenced by the thickness of the skin, hang in there. JG 5.5.06

• Is there any natural way to treat eyebags? are cucumbers effective?

  Answer:  not much really. JG 5.6.06

• Hi. Dr. Garcia-sorry my question is not going through...I am scheduled for an upper bleph in June and I don't have lots of excess skin, just enough that it bugs me. Having never had any kind of plastic surgery, how can I be assured I will look natural and be happy with the results? FYI-The dr. is very experienced-he specializes in faces only. And, I know he does about 3-4 blephs a week. Thanks.

  Answer:  well, natural all depends on what you desire, there may be a subtle change for sake of being safe and you may not notice enough of an alteration to be happy, so talk to him about it. JG 5.3.06

• Hi Dr Garcia, I am scheduled for an upper bleph at the end of June. I don't have a lot of excess skin, just enough that it bugs me. My biggest fear is that it will change my natural look & I will look

  Answer:  just make sure they do not remove too much skin or fat and you should be OK. JG 5.6.06

• Dr. Garcia, can the stitches from a cathoplexy be removed?

  Answer:  sure. JG 5.1.06

• I'm in my 20s and I already have sagging upper eyelids. What should I do?

  Answer:  hard to imagine that your lids are loose enough to need surgery. I would wait. JG 5.6.06

• I recently had a transconj procedure done on my eyes and do not like the results. I want to have the stitches released/removed. How long after the surgery would I need to wait to do this? Thanks.

  Answer:  they can be released at any time. JG 4.16.06

• I HAD A MID FACE LIFT ABOUT ONE WEEK AGO. I HAD GONE BACK TO MY P. SURGEON AND SHOWED UP THAT ONE CHECKBONE SEEMS MORE PROMINENT THAN THE OTHER. THERE IS ALSO AN INDENTATION UNDER THE MORE PROMINENT CHEEKBONE. HE SAID IT WAS STILL SWOLLEN AND EVENTUALLY BOTH SIDES WOULD LOOK THE SAME. I AM CONCERNED THE INDENTATION IS NOT GETTING ANY BETTER, 10 DAYS AFTER SURGERY. DO YOU AGREE WITH MY DR? ALSO, IF THIS INDENTATION UNDER MY CHECK DOES NOT GO AWAY, IS THERE A REMEDY? I AM GOING OUT OF MY MIND. THANK YOU.

  Answer:  uneven swelling is the usual thing, and as to the indentations due get better in time. Light massage might help. Hang in there.JG 4.16.06

• I had a lower bleph 10 days ago. My PS tightened the lower tendon below my eyes. Now my eyes look and feel tight; the corners of my eyes have somewhat of a slant. Will my eyes loosen up? I am worried that I will need to have the stitches removed. Will this entail new incisions?

  Answer:  they should loosen in time, but I cannot say how soon. If removing the sutures or releasing them is needed, yes, there will be an opening of the old incision part way.JG 4.14.06

• I noticed the ? regarding Sculptra being used for the ball of the foot and wanted to share my experience. I had it done to one foot four months ago and there is absolutely no improvment. I have Sculptra in my face and it was a breeze with excellant results. The foot was very involved, with multiple, painful injections and ultimately there wasn't one drop of improvment.

  Answer:  thanks much for the insight, I and I am sure all the others appreciate the first hand account. JG 4.14.06

• How much do you charge for work on the under-eye lids? Just fat removal or repositioning.

  Answer:  about $2700. JG 4.13.06

• How much do you charge for buttocks augmentation? Is it a implant or fat? Is it permanent? What is the recovery?

  Answer:  Implants, cost is about $8100, recovery is face down for two weeks, no physical activity for 4 weeks. JG 4.13.06

• I was in for a consultation years ago, but never had a procedure. I'm at the time in my life that I'd like to reconsider plastic surgery and was wondering if two can performed on the same day. I need a Breast Reduction and a Tummy Tuck I think ( I had a C-section that was performed vertically leaving me with what looks like a buttocks on my belly!) There is some overhang which causes a sweaty rash when the weather gets warmer and I'd like to rid myself of that excess skin) Do you know if insurance will cover either of these procedures?

  Answer:  Insurance will not cover the tummy tuck and may or may not cover the breast reduction, depending on how much is taken off. Those two procedures can be done at the same time. JG 4.10.06

• I don't like underneath my eyes. I have fine line and a depressed tear trough with slight bags. Also, my orbital rim is slightly showing. What procedure, or procedures, would you recommend to rejuvenate this area? It seems to be swollen but yet with a loss of fat at the same time? Two separate problems.

  Answer:  sounds like you need a blepharoplasty to correct those issues but the oribital rim may be hard to change without an implant to the area. JG 4.8.06

• hi, your site is awesome. Please could you give your opinion on thread lift and if its worth trying instead of a full face lift. I'm early 40's slim with sagging skin to the lower face, not many wrinkles but in need of rejuvenation. Long thin facial features with not much definition in the cheek area. Thank you.

  Answer:  I think the hype for threadlifts is just that, hype, they do not last anywhere near what a facelift does and the threads can break. If it lasts 12 months it is a great result. I think the threads will be used for other things but as it is being promoted now, I cannot recommned it instead of a facelift. JG 4.8.06

• I had liposuction on my back, hips, waist, chin, and upper arms 9 days ago and haven't been feeling very well since then. I'm not running a fever but am very, very tired, all of the time. I'm not on any pain medication so I'm not sure what's going on. It was tumescent lipo and even though I'm sore, there isn't that much swelling which tells me it was a pretty gentle procedure. I feel like I have the flu. Is this normal?

  Answer:  flu can happen after surgery because your immune system has been temporarily weakend, and also there is blood loss from the surgery that can make you weak but it will get better in time. Best of luck. JG 4.8.06

• hi, i had eye bag surgery 4 years ago when i was just 40, i have noticed that there is a swellin under my right eye in the orbit area, nose side, that has become worse over the last 6 months. its not painful but never goes away, could this be fat returning in this eye so soon? what can be done without more surgery? thank you DT from uk.

  Answer:  it might be because they correctly removed a conservative amount of fat and with time the residual fat is poking out a little. May need a little more taken out through an incision inside of the eyelid. Best of luck. JG 4.5.06

• I'm so sorry to keep bugging you...about the massage after lipo, you had suggested a Swedish massage. Is the massaging something I can do myself after the first week? And do I only massage around the punch wounds or the entire area that was lipoed? Do I massage hard or gently?

  Answer:  yes, you can, but some areas may be hard to get to. You masage the entire area that had the lipo. It should be a gentle massage.JG 4.2.06

• whats lasts longer around the mouth restylane or hydrafill and whats the difference between them 1.4.06 tp

  Answer:  I have not used Hydrafill as it is not approved for use in the US yet but they are both hyaluronic acid fillers. JG 4.1.06

• Just had tumescent liposuction on my arms, flanks, back, waist, and under my chin, . This was done yesterday. I have opted not to do the ultrasound treatments at my follow up appointments because you said massage would be just has good,thank god because this will save me over 200 dollars. When do I start the massaging, how many times a day do I need to do it and for how long?

  Answer:  We start the massages after the fist week, twice per week, over the areas of suction, like a Swedish massage. JG 4.1.06

• Just had tumescent liposuction on my arms, flanks, back, waist, and under my chin, . This was done yesterday. I have opted not to do the ultrasound treatments at my follow up appointments because you

  Answer:  go with the regular massages.JG 4.1.06

• To the question about lipo for jowls...would you recommend lifting over lipo?

  Answer:  yes, lifting is better.JG 4.1.06

• How do you feel about the liposuction on the jowl area. I do have fullness there and don't like the rounded look of my face. Could this be used to enhance cheekbones?

  Answer:  yes but it might accelerate the visble signs of aging in a few months and leave loose skin. JG 3.31.06

• dear dr garcia im a 39 year old female thinking of having a filler in my jowls, the cornors of mouth. what do you think is best hydrafill or restylane as im not sure which is best or lasts longer. many thanks. tp. 31.3.06

  Answer:  I think Restylane is safer. JG 3.31.06

• As to my question below concerning assisted liposuction...it sounds like laser-assisted isn't the way to go. What about the ultrasonic after treatments? They recommended four of them about 3 or 4 days apart starting a couple of days after surgery. They are charging me $50 a treatment. They said it helps with the healing process. Is that worth it or just a waste of money?

  Answer:  I advise massages and the ultrasound will help to some degree, but not much better than regular massages. JG 3.29.06

• How do you feel about the effectiveness of laser-assisted liposuction with the tumescent technique? I'm having my arms, back, waist, hips, and chin done and have already planned on paying for the ultrasonic sessions in my 4 follow-up appointments. Do I need both of these treatments? Which one would be best if I had to pick?

  Answer:  There is no reproducable medical scientific evidence to back up the claims of laser assisted liposuction, no matter what type of fluid is instilled. JG 3.29.06

• I had eyelid surgery in 2001. I've noticed that under my eyes the skin is crepy and hollow. Is there anything that can be done to help?dls

  Answer:  lasers or Retin-A for the crepey skin, not much reliable for the hollows though. JG 3.25.06

• I am 47 and I have deep wrinkles and deep sockets under my eyes with loose, baggy skin. (I believe these are considered lower eyelids) Is there a filler that can be used to fill this area such as Resalyn? If so, which one would be the safest.

  Answer:  All fillers have potential problems with lumps there. Sounds like it needs something like skin being cut out, not fillers. JG 3.23.06

• I am 40 y/o female & considering a forehead lift for horizontal lines & moderate eyelid sagging. My Dr. who gives me botox recommended Therma Cool if I wasn't ready for surgery. Which do you think I

  Answer:  save your money and skip the ThermaCool. JG 3.22.06

• As far as the diet pills and liposuction, what is it about the diet pills that could cause complication directly related to the lipo?

  Answer:  unstable blood pressure during the sedation or anesthesia. JG 3.21.06

• Hi Dr. Garcia, thanks for the answer re blepharoplasty. If patients are not happy with results, is it generally due to unrealistic expectations or too much skin taken off or not enough? My only fear i

  Answer:  The unhappiness can be due to all three of the issues you mention, and also an incomplete explantion of what the surgery can do and more importantly what it cannot do. JG 3.21.06

• I'm on a low dosage diet pill and plan to have liposuction in 1 1/2 weeks. I'm not getting put under, only giving a Valium. Do I need to quit taking the diet pill? I'm not ingesting anything that could have some effect on my blood clotting, etc. (i.e. Vit. E). From what I've read, the diet pills can interfere if you're getting put under or put in a twilight, which I'm not. What would you recommend? Why aren't diet pills allowed?

  Answer:  we suggest you be off any diet pills for one month to avoid problems. JG 3.21.06

• Hi Dr Garcia, I am going to have my second consultation with a ps about blepharoplasty. Would you say that most clients are satisfied with the results of this surgery? Also, any recommendations for aging hands? Cream or otherwise? thanks!

  Answer:  I would say most are happy with their choices. As to aging hands, YAG laser for the brown spots and maybe filler for the thinness. JG 3.20.06

• I've posted so many questions on your website and have yet to thank you for this great service. Thank you. Your honesty about the new procedures out there has greatly help me in making informed decisions. You're wonderful.

  Answer:  I appreciate your comments and hope I have been able to seperate the wheat from the chaff for you. JG 3.18.06

• I had just asked you about the fat that has acculmulated at the lower part of my face, around my chin and under my lip. It's not bad (I'm not an overweight person) but it is causing my skin to sagg slightly (I'm only 32). I had looked at the before and after pictures of facial lipo and that seemed the perfect answer for tightening the area, but you said it might cause premature aging. I also know that contour threads don't work and the two doctors I've spoke with said it's way to early for any type of face lift. What would you recommond? I'm still getting lipoed under my chin, will that tighten my skin above it? Also will fillers in my nasal fold maybe help?

  Answer:  lipo of the neck will not tighten the skin of your cheeks, you may need to settle for a temporary imnprovement with the lipo now with the understanding that you may need a facelift at a younger age later if it is bothering you that much. Fillers in the nasolabial folds should help if done well.JG 3.18.06

• I'm having under my chin liposuctioned in a couple of weeks and am thinking of asking the doctor to also lipo right above my jawline on my face and around my upper chin area, right under and on the sides of my lower lip. It seems as if I have a bunch of fat just resting on the lower part of my face, falling around my mouth. Would you advise this procedure? What are the risks and side-affects?

  Answer:  I think that the additional areas may give you some short term benefit but may lead to early aging in time, so I would avoid it. JG 3.17.06

• Hi Dr. Garcia, will blepharoplasty help wrinkles and smile lines under and around the eyes?. I definitely have some sagging eyelid skin, so I know it will help that area. Thanks.

  Answer:  yes, some but it really removes excess skin, and does not improve skin quality of the skin that remains. JG 2.26.06

• Hi. Dr. Garcia, I have been having problems sending my questions. I am considering getting my eyes done (upper & lower) and I have a consultation next week. This Dr. (in San diego) focuses exclusively on eye surgery only(cosmetic & otherwise). His name is Charles Stephenson. Do you know the name? He has writen books on eye surgery. What are pertinent questions I should ask him? Is it appropriate to ask to speak to one of his clients who has had the surgery? Thanks for your input. Also, what is a reasonable recovery period for this type of surgery?

  Answer:  I am not familiar with him. I do think talking to other previous patients is a great idea along with seeing his before and afters. Best of luck. JG 2.23.06

• Hi Dr. Garcia, I had 2 rhinoplasty one year ago, and now there are some scar tissues formed inside and around my nose tip. It doesn't make my nose elegant. Is there anyway to help shrinking these scar tissues? Thanks, Natalie.

  Answer:  Some doctors will inject kenalog into the tip but it is not always reliable. JG 2.20.06

• Hi Dr. Garcia, I am 46 and the lines and sagging around my eyes has been getting increasingly worse the past year. I have been considering blepharoplasty for the past 3 years and I think I am ready to

  Answer:  Hard to say without pictures are examining you in person, but it might be an option. JG 2.20.06

• Are there any non-surgical treaments for lower eyelid festoons?

  Answer:  nope, sorry. JG 2.19.06

• Hello, SF here again. My upper/lower bleph scheduled for March 17 and I'm nervous...I had mentioned to my surgeon that I was reading about fat repositioning (for my lower eyelids); that I thought it would look better to have a little less fat in one spot and a little more in another. He said that I was talking about something very new and not really perfected as yet. He said that we could use filler later in the hollow area beneath the fat pad area that he reduces.....what are your thoughts on that answer. He did say that on my upper eyelids he was going to release some fat on one eye to make it more symmetrical with the other...Is the fat on the upper eyelids more easy repositioned than on the lower eyelids. Thank you very much. 2/16/06

  Answer:  I do not think fillers work well to fill in over resected fat from the eyelids. I actually have never heard of repositioning fat on the upper lids, but fat repositioning of the lower has been around for about 8-10 years now. Sounds like you have to think about things. JG 2.16.06

• Having upper/lower bleph in March.Asked my 0p/s if the skin under my eyes will look loose after fat removed..he says not likely...only in a very small number of cases...said if that happens, he can laser later.I'm 53.My skin already seems loose there.He's doing it from inside of the lid. He said I don't have that much fat there to cause droopiness...that good skin care will keep it looking fine.

  Answer:  if you are already a little droppy then it will only get worse once the swelling goes down. Maybe laser it at the same time. JG 2.7.06

• Hello again, Dr. Garcia. You noted that saline may or may not be effective in reducing/removing Sculptra lumps on the upper cheekbone. What about steroid injections? I absolutely need/must get rid of these lumps. Should I consider surgery. Your recommendations are highly respected. Thank you Ruth

  Answer:  I think they could cause more problems than help and will not dissolve the collagen formed. It will just help swelling. The surgery is an option but then you will have scars. JG 2.7.06

• I'm 25 years old and have had severe eyebags since my teens. Surgery such as blepharoplasty is too invasive for my tastes. I'm investigating whether I can now get Thermage treatment on the under-eye area just to help reduce the look of my fat pads. However in Europe, we don't have the new 0.25cm tips as yet, but one my friends have had under-eye treatment with the larger tips with reasonable results and I wondered whether this was advisable or risky. My area is not on the eyelids itself, but the 1/2-inch area directly beneath the eye.

  Answer:  I don't think Thermage, with or without the small tips will do the trick I am afraid. JG 1.30.06

• 1/27 DSL--- I had a Lifestyle Lift in Pittsburgh last December/2004. First of all the procedure lasted 4 hours not 1 like they said. I looked horrible after the procedure and was told I could return to work. Ha!Ha! I had so much swelling, pain it was terrible. After 1 month I went back and was told to wait longer for results. After 5 months I went back and the doctor said he would redo the procedure because I still had the jowls. When I called to make an appt. for that they were gone. The phone said no longer in service. I would not recommend this to anyone. What I need to know what procedure I should ask for from a regular plastic surgeon. I want the jowl to be gone.

  Answer:  at least a cheek lift but may need a full face lift. Best of luck. JG 1.30.06

• I am interested in a midface lift. Hollow eye sockets and it looks like the tear trough is extending and splitting my checks in two sections. I'm interested in the endotine midface lift. Are the results better and the recovery quicker than suture secured midface lifts.

  Answer:  I do not use endotines as I do not feel they offer any advantages and I don't think a mid facelift will correct the hollows although it should help the crease in your cheek, as a regualr facelift would also. JG 1.22.06

• i am a 69 year old female with good skin who who would like to firm the lower part of my face{jowels,lines at sides of mouth andsagging neck with separation of platysmal muscle]. I am not looking for total perfection at my age but improvement and considering the lifestyle lift or contour thread lift and would like your thoughts as which would be more effective. e.f. 1.16.06

  Answer:  I think they wil not give you the amount of improvement you desire, I fear you may need a full facelift. JG 1.16.06

• Can the excess fat on the area of frontal part of the chin be taken out by liposuction? I have a fleshy chin but not much fat under the chin.the chin bone itself is not big but there is some excess flesh there that gives it the appearence of it jutting out.Is there anything that can be done if not liposuction?

  Answer:  not really, just the fat below the jaw line. That is a difficult area to reduce as there can be injury to the muscle there and that would be a major problem. JG 1.11.06

• hi, is it right that in the transconjuctival lowereyelid surgery the herniatedd fat pads can be seen after making the incision and whatever is herniated can be clipped off? the fat that is not herniated has to be teased out to be removed. is that information correct?my surgeon said she will not go looking for the fat but will remove whatever fat has herniated.

  Answer:  yes, that is how it goes. You do not want to remove too much. JG 1.10.06

• hi, my question is about the minilift. is it effective for midface sagging.is only the outer layer of skin tightened or the muscles are pulled up and tightened also? i am nearly forty and my surgeon tells me the slight bags are prominent due to the slight sagging of my cheeks? will minilift help? my face contantly has the look of either tired or scared? tiny bit hollows under the eyelids show up sometimes . cant be me in the mirror!

  Answer:  Usually a mid-face lift is done mostly for sagging cheeks and it involves skin lifting and in some cases also tissues below the skin. Whether a mini lift will fix the bags depends on where the bags are. It may be what you want or need. JG 1.5.06

• Hi Dr. Garcia, Which board, American Society of Plastic Surgeons or American Board of Surgeons, has the most strigent criteria and requires the most credentials? Is one considered better than the other in peer circles? Thanks!

  Answer:  You need to be board certified by the American Board of Plastic Surgeons to apply to the plastic surgery society. I think by the American Borad of Surgery you mean the American College of Surgeons and in the long run, there are more continuing medical education needs and ethical needs to remain a member of the Plastic Surgery Board. JG 12.28.05

• Would an under eyelid lift help depressed tear troughs and an hollow orbital area? If not, what would? A mid-face lift?

  Answer:  Nope, neither one will really help much, it is very difficult to fix I am afraid. JG 12.28.05

• Correction on question below...American Society of Plastic Surgeons (ASPS) Thanks!

  Answer:  please see above

• And another question: Is the American Society of Plastic Surgeons, Inc. equivalent to American Board? Thanks.

  Answer:  No, there is an American Board of Plastic surgery and then the American Society of Plastic Surgeons. JG 12.28.05

• sorry the american society of laser medicine and surgery

  Answer:  Anyone can be a member of the American Board of Laser Medicien and Surgery, you just pay a fee and show that you have training in doing lasers, it is not that exclusive. No testing is required. JG 12.23.05

• what is the difference between american board of plastic surgery and the american society of surgery. does a surgeon have to be a board certified to be a member of american society of surgery

  Answer:  I am not familair with the Amrican Society of Surgery. It must be a misquote by the surgeon. The only surgeons recognized by the Ameriican Board of Medical Specialists as plastics surgeons are those certified by the American Board of Plastic Surgery of which I am one. JG 12.23.05

• also is transconjuctival a better or easier way to remove fat from the lower eyelids.

  Answer:  transconjunctival is an easy way to remove fat, yes. JG 12.22.05

• dr garcia which is a simpler operation lower or upper blepharoplasty? the dr i went to said she is not authorized to show the pictures of the patients and had only three upper bleph patient pictures. is that normally what the surgeons response is.

  Answer:  No, he must not have many patients. Typically the upper eyelids are easier to perform. JG 12.22.05

• I read that you have always mentioned that blepharoplast be done conservatively? thankyou for that. would you be able to recommend a plastic surgeon in new jersey area?

  Answer:  Due to potential legal issues, and some doctors wanting to know why I referred a patient to someone else and not them, I think you are best to go to this website and look for a plastic surgeon in the area you desire. I wish you all the best. JG 12.12.05 www.surgery.org/public/findasurgeon.

• is it possible to fix the uneven fat herniation in the lower eyelids with blepharoplasty taking out as little fat as possible?

  Answer:  yes, it is possible. JG 12.11.05

• how long does the eyelift last on the average for a 40 year old?

  Answer:  probably about 10 years, give or take. JG 12.11.05

• About the new minilifts, what is the difference between the Lifestyle lift, Quicklift, and S-lift? You said it won't last as long as advertised and the healing is also longer. What kind of recovery time am I looking at and how long should the results last?

  Answer:  Recovery time is about 5-7 days and they are all essentially the same thing, just doctors giving similar things different names to make it look diferent from what everone else is doing. I think results may last 1-3 years, the older you are the less it lasts. JG 12.10.05

• dr garcia, my surgeon tells me my cheeks have sagged slightly but i am still five to ten years away from facelift and slight swelling under my eyes can be treated with restylane. is it possible to just llift up the sagging lower eyelids slightly . she says the hollows are under the eyelids

  Answer:  A conservative blepharoplasty or eye lift may be an option. I am apprehensive about the injections for the hollows on the lower eyes. JG 12.9.05

• What do you think of the Quicklift or Lifestyle lift? It seems that tissue and fat have moved from my midface to my lower face and chin. I have folds around my nose and mouth with very, very hollow undereyes. I'm only 32.

  Answer:  nice procedure, takes a little longer to heal from than what the doctor advertises and does not last as long as the doctor says, but for someone your age may be enough. JG 12.9.05.

• i have a lot of fat on top of my chin , not sagging but fat chin. i was wonderin what is the best treatment available for removal of fat from the area.i have heard of lipselection being better than liposuction. mesotherapy or lipodissolve. i am really confused.

  Answer:  I don't think liposuction is a good option in that area I am afraid and lipodissolve and mesotherapy do not really work, sorry. JG 12.7.05

• I'm interested in a contour thread lift. I'm 31 and am having more sagging of my lower face than I think I should at this age. I don't know if I want to go through the downtime of lipo and fat injections on my face. What is your opinion about the safety and results of the contour thread lift? How long does it last? Is it easily reversible?

  Answer:  pretty safe but I have been unimpressed with how long it lasts for the cost involved. I have seen no one last more then 12 months and many patients just last a number of weeks. It is reversible by cutting the threads out though a tiny incision on the face. JG 12.4.05

• Thank you for the response about grey hair and hair loss, earlier. Another question, that I forgot to ask is about eye puffiness. I have much puffiness under my eyes but no dark circles and my eyes always feel like they are tired, not awake like the rest of my body. It doesn't matter if I go to bed early or late. I feel like this all day. It's very disconcerting. I look older and feel older. (I'm 56 and general good health.

  Answer:  It might be herniated fat pockets around the eye that may benefit from surgery to remove it. JG 12.4.05

• I'm interested in lip augmentation and have been informed that liquid silicone is legal in my state for off-label use. Silicone scares me because of the early 90's controversy with silicone brest implants...but the before and after pictures of silicone injected lips look better and more natural than the other ones. Is silicone safe?

  Answer:  Silicone is not safe for lip augmentation and I am sure the pictures you have seen do not include the numerous patients who's lips have been destroyed from silicone, don't do it. In addition, I think any doctor that is willing to break the law to make money by injecting silicone when it is illegal to do so should lose his medical license. Don't go there. JG 12.3.05

• Is soof lift more expensive than blepharoplasty? Is it safe?

  Answer:  it is more expensive than a blepharoplasty and has a higher complication rate than the eye lid surgery, like excessive downward drift of the cheek tissues resulting in excessive eye exposure. JG 12.01.05

• Dr Garcia, is it possible to leave a little bit of herniated fat untouched and just tighten the loose skin in the undereyelids without any side effects.

  Answer:  yes, that can be done. JG 12.01.05

• Dr Garcia, how mwny times can blepharoplasty be performed on the lowe eyelids? i had one done at age 29 and now at age 39 I have some loose skin and a slight bag under one eye only.I also have some fat loss in one eye which makes me look tired and old. can blepharoplasty be performed to lift up the loose skin and make my face look fresher.the bag under one eye is very minor. will any lasers help tighten up the skin?i have a mediun tone skin on the lighter side.

  Answer:  It all depends on how much skin is removed at each time. Having it done more then once is not rare. Laser or conservative skin removal can be considered. JG 11.30.05

• Have injectable fillers been used successfully to straighten the dorsal line and add depth in the upper portion for a more vertical aspect in the profile view?

  Answer:  yes, they can be used for that purpose. JG 11.29.05

• Hi, i am looking to have chin augmentation done however am nervous about surgical implant procedure. I have found on the net a non-surgical procedure in the U.S. using Radiesse. I live in Australia however cannot seem to find anyone who uses radiesse here. What is your opinion of chin augmentation using Radiesse, and why is it not available in australia? Thanks julie

  Answer:  May be difficult to get the shape you desire as the muscle will move the calcium around, not something I would suggest really. JG 11.29.05

• What can I do about sagging cheeks and especially the small area below the cheekbone that has developed an indent or hollow area? Is there any facial exercises or minor surgery to reverse or slow the

  Answer:  I am sorry but muscle exercises will probably not work and will not last, and the surgery will not be a minor one. Fillers may fill in the indentation for a few months. JG 11.28.05

• If you are quoted a price of $300 per area for botox, and you are getting it done on crows feet around your eyes - is that $600 or still just $300?

  Answer:  normally just the $300. JG 11.21.05

• I have heard there is a procedure that is done on the skin above the lip that pulls the lip up and makes it look bigger. Do you recommend that procedure? Do you know the approximate cost?

  Answer:  We do that procedure, its called a lip lift. Prices vary depending on the type of anesthesia the patient wants. JG 11.21.05

• Doctor, Other than a mid-face lift,(as I am too young) is there any other procedure to tighten the cheeks? Thanks in advance.

  Answer:  Fat injections, Sculptra injections, or cheek implants. JG 11.21.05

• Hello. I was wondering what you would recommend for forehead crepiness. Thank you.

  Answer:  Depends on how severe, it could be lasers or Botox COsmetic or a forehead lift. JG 11.20.05

• I used fertility drugs for my in-vitro cycle over two years ago. Since then, I've delivered two beautiful babies, but my skin looks old and dry. Do you think that Restalyn injections will help the fine lines around my eyes, mouth, and forehead? I don't remember looking this old, and having such dry skin prior to using the drugs.

  Answer:  I think it is a good option to try. JG 11.15.05

• Hello Doctor, I am 25 with deepening tear troughs that extend out onto my cheeks and when I pull the lower eyelid skin up, they disappear. I have been to a few Dr.s regarding this and they all had different treatment approaches. I was wondering if laser resurfacing the lower lid to tighten the skin, thermage with fillers or surgery would be the best route to go. Thank you!! LP

  Answer:  Laser resurfacing will unfortunately not replicate what you are doing with your finger. I think some type of material will need to be placed in the tear trough either through injection or surgery to correct the problem. JG 111.5.05

• Wouldn't your own fat be best for lip augmentation? I've read that you only retain about 30% of it, but wouldn't it be the most natural way to augment?

  Answer:  Well, there is normally no fat in your lip so my answer is no, it is used, but I don't think it is the most natural. JG 11.07.05

• I just want to make sure I have interpreted your answer below correctly. The improvement a thread lift gives only lasts for approximately 3-6 months. is that correct?

  Answer:  at best, sometimes less. Ask the doctor to show you pictures of people past 6 months. JG 11.07.05

• Dear Dr. What are your thoughts on the Thread Lift? Does it help much with cheek sag? Also, how long do the results typically last for? Thank you very much.

  Answer:  very mild and short acting, if done the way it is usually done, percutaneously.From what I have seen and heard, it can give 3-6 months at most in the majority of cases. Some cases less, some more. JG 11.06.05

• Dear Dr. Is it typical that a PS wouldnt perform such invasive surgery at my age? Should I wait till atleast my thirties? Thank you again. LP

  Answer:  it all depends on what is wrong and what can be done safely, it is a clinical judgement I feel. JG 11.06.05

• Im a 20 year old female who's always had chubby cheeks recently my cheeks got smaller but fat always seems to deposit in the whole chin area. I'm a skinny girl with a double chin. Is there a nonsurgical way to get rid of this fat?

  Answer:  I am afraid there is not a reliable way to remove the fat non-surgically. JG 11.05.05

• hi doctor i have birth marks on my hand and my collars they looks very bad i want to remove hem s there any immwdiate treament?

  Answer:  The only immediate treatment is to have them cut out but it will leave scars. JG 11.01.05

• Although PLLA is a biogradeable material, some web-sites inform that Sculptra lumps do not always disappear on their own? This is worrying. My clumps and lumps are fairly recent, 8 weeks since first appointment/3 weeks from second. I've only been aware of them for about 7 days but, already I am feeling great concern. Particularly when they can be added to by the onslaught of lumps that can appear 6-12 months after treatment and, even more so after reading they may never go away. Obviously, people like myself who go for Sculptra treatment are already insecure about their looks. Therefore, when things go wrong in the quest for improvement, it is difficult to keep things in perspective (this is my second posting to your site). That's where I am at the moment. Feeling very, very insecure. Dreadfully disappointed that after two treatments, where I thought 3 treatments were going to produce the new me, I have the new me sooner than expected although, not an improved me. I have massaged the clumps and lumps both on the surface of the skin and inside my mouth and cheeks for hours on end. The clumping in the cheeks runs down one smile line. The clumping in the mouth is heavier on one side and on the surface obvious to the eye. The other lumps and bumps are only obvious to the touch and to anyone brave enough to look inside my mouth. I feel it is pointless continuing with any more massage as the lumps are too hard. I Dread going to the Dentist. Along with my depression I am trying to retain (much like they say a 'Clown' does) a sense of humour but it's not easy. Once again I am looking to this board for re-assurance or, should reassurance not be appropriate, at least the truth. Something I feel, being perhaps partly (along with myself) responsible for my present negativety, that

  Answer:  Well, scar tissue may not dissolve but will get softer in time and there are reports by some individuals that the actual Sculptra did not dissolve but we have used that material for years as a suture and in time they all dissolve by using the body's own white blood cells. In areas where there is no or little blood supply that can take longer but the face has exuberant blood supply. It is normal to get panicked in these scernarios but I encourage you to massage every so often, at least a few times per week and give it some time, I think it will get better without any intervention. JG 10.25.06

• Dr. Garcia I'm 46 & noticed my neck has started to lose it's former tautness. Is plastic surgery or thermage the only way to stop it or can exercises help? Also will doing light weights make it worse? How fast does the neck fall - I'm panicking about it. Thank you for your website. 14/10/05 MP

  Answer:  light weights will not affect it and Thermage will not tighten it too much so surgery will be your best option for a reliable result. The results should last 5-10 years. JG 10.13.05

• Dear Dr. Garcia: I am 39 years old and I had rhinoplasty to correct a fractured nose about 5 months ago. Days following the surgery, I had very swollen black eyes. The black under the eyes slowly subdided after a couple of weeks. But now, I have constant dark rings under my eyes. They look like a pattern and it doesn't seem to go away no matter how much I sleep or how rested I am. My doctor hasn't been much help, offering no explanation or solution to the problem. Can you recommend something to help reduce the black rings? It is making me look older and tired. Thanks so much.

  Answer:  it may be some staining from the blood under the skin after the surgery. It may require some bleaching creams or at times a laser to help fade them if it was due to the blood. JG 10.9.05

• I am 26 and am starting to have sag on my face. I would like to get a cheek lift and an endoscopic brow lift in the next couple of years and i was wondering if that was unheard of at my age. Do doctors perform such surgeries as needed on persons in the late twenties. Thank you so much.

  Answer:  doing surgery on a patient all depends on the individual and their skin and tissues.If needed, doctors wil perform it but you seem very young and I would need to see why it is that you have had such sagging before anyone should proceed. JG 9.22.05

• Dr. Garcia I am still waiting for undereye puffy bag to go down after botox after-effects since June 6 - my question this time is can a blepharoplasty lessen the eyebag area? Also can some crow's feet be taken away at the same time? Thanking you. PM 11/9/05

  Answer:  A blepharoplasty can remove the puffiness if it is due to excess fat in the eye area. The surgery will do little to nothing to the crow's feet though. JG 9.11.05

• the lower half though remains tight. Can I have this re-done to improve the upper part?..Thanks...Linda

  Answer:  It may be that the skin has loosened or that you have gained fat inside your abdomen below the muscle which cannot be removed with liposuction. Hard to say without seeing and examining you. Surgery may help but you may need to lose some weight also. JG 9.3.05

• I have had a tummy tuck and liposuction done several years ago. The result was fairly good. Now I am a little older and my midrift has become flabby and my waist has disappeared. The lower half tho

  Answer:  It may be that the skin has loosened or that you have gained fat inside your abdomen below the muscle which cannot be removed with liposuction. Hard to say without seeing and examining you. Surgery may help but you may need to lose some weight also. JG 9.3.05

• Thank you Doctor. In response to my aptos thread question, If I went through with the procedure, the results would only last six month or less? To keep up the reults, does that mean continually going back to have more threads put in or can they tighten the ones that are already under the skin? Do you know anything about the procedure Cosmolift? Thank you!

  Answer:  That is correct, if you want to maintain the results, you need to keep going back. You cannot merely keep tightening eeh sutures as they are slipping and are not holding any longer.The Cosmolift is the same concept, just a different name used for marketing. JG 8.28.05

• Hello. Do aptos thread lifts help contour the cheek? I would like to smooth out my tear trough and slightly elevate my cheek and lower lid area and was wondering if this would improve with the thread lift? Can it be done on persons in their mid twenties? Thank you!

  Answer:  They help but they last 12 months or less. This is from the doctor who has used them the longest. Age is not a restriction on the procedure. JG 8.27.05

• What types of creams or lasers would you suggest for a saggy neck Idon't want to do the lifestyle lift since you don't feel it would be effective. Do you sell any creams that would help me? I really respect your opinion. Thanks

  Answer:  Lasers are not safe to do on a neck and creams will not tighten loose tissues, just small wrinkles. I wish I had a cream that would do the job for you. I think if you have loose skin the only thing that will work is a surgical intervention. JG 8.23.05

• I had three Sculptra injections starting this past April. About two weeks after the last one I developed two sizeable lumps on either side of my mouth. Will cortisone injections help and will they ever go away on their own? Thanks for any info.

  Answer:  They will go away on their own in time. Cortisone can be injected but it may cause some tissue loss so I try not to do it if possible. JG 8.23.05

• I have n next week for the lifestyle lift procedure for the wrinkles in my neck- i guess the doctor does a little lipo suction first then makes an incision in front of and in back of the ear to tighten the skin-it only takes 1 hour and costs about 4,000 what is your opinion of this- i had the titan laser done about 6months ago and it didn't work so i figured i would try this but i need your honest

  Answer:  I think the liftsyle lift may improve your cheeks but if you have any significant sagging in your neck it may not correct it all. JG 8.23.05

• I have had a tummy tuck which worked well. However 1 year later (after swelling ect is gone) my Dr did lipo on my fat area that was moved down because of the tummy tuck. I also wear a band and or tight panties to help in keeping my tummy in while healing per my Dr. Is this normal? Should I have to do this? I usually wear it all the time for the first 2 months them only during the day for the next 2 months.

  Answer:  I have my patients wear the girdle for one month,wearing it longer is not a wrong thing ot do.JG 8.18.05

• About that little cartilage...It was the Dr's idea to put it in. I was happy with the way it looked before the implant. I have been unhappy with it since it's been put in, and I have tried to give it a chance, but I'm tired of putting make-up over it to hide that it can be seen under my skin in certain light. He can make me happy by simply taking it out as I have prepared myself to do so tomorrow. Don't you believe that he is the best person to take it out since he is familiar with putting it there to begin with? 8-17-05

  Answer:  The original surgeon is always the best one to go back as they know what they did and what it looks like. JG 8.17.05

• What would cause the tip of one's nose to droop after having poor rhinoplasty surgery? Is it the surgery itself that causes the support or the septum to droop? In other words, does every nose job have to include reshaping the tip because scar tissue or something else causes the tip to droop or become larger? 8-8-05

  Answer:  At times the supporting ligaments of the tip are cut and the scar tissue that forms is not strong enough to hold it and sutures need to be placed. Not every nose needs tip surgery and if the septum caused the droop, it would have had it before the surgery. JG 8.8.05

• Hello. I want to get a cheek lift done for hereditary sagging and was wondering at what age it can be done on. I am in in my mid twenties. Thank you very much.

  Answer:  I doubt that at that age you have sagging of the tissues, it may a genetic thing that the bones of your face are not as prominent as they could or should be. If in fact you do have a genetic problem where your tissues are sagging that fast, then if you have them lifted, they will not stay there as long as you may hope for. JG 8.3.05

• Hello. Is a cheek lift an invasive procedure? Also, can you be in your late 20's to get it done, I have hereditary sagging in this area. Thank you.

  Answer:  A cheek lift is considered an invasive procedure, yes. I can't imagine someone in their 20's needing it though. JG 8.3.05

• Referring to you last post regarding Festoons or swelling of the Cheek area, you said a Feather lift will not correct this problem. What will correct the problem of Festoons?

  Answer:  At times the only thing that will correct them is to have them directly cut out whch will leave a scar where the festoon was. JG 7.27.05

• I posted a question on the board regarding a mid face-lift or cheek lift for the treatment of hereditary cheek bags that are starting to form at the age of 24. I was wondering if the new Featherlift will help at all with this and what age most people get this done at? Thanks again!!

  Answer:  The heridiatry bags you refer to are most likely festoons, which are areas of chronic swelling that do not respond very well to surgery, and a mid face lift or a Threadlift will not correct them. JG 7.25.05

• Dr. Garcia -- can implants (7/03) that are adjustable but no longer have the tube, can they be still be adjusted through minor surgery? WCL 7/22/05

  Answer:  No, it would be a major undertaking to re-introduce the injection port. JG 7.25.05

• When performing a medial thigh lift, has it become standard procedure for most plastic surgeons to anchor the fascia when suturing, as in an anchor thighplasty? Do you use this method, & if so, does it really keep the incision from migrating down the thigh? Also, is extending the incision around the back of the thighs & under the buttocks an effective way to remove fat & tighten the skin of sagging, dimpled buttocks, or does the method of doing a buttock lift with the incisions above the buttocks give a more lifted & rounded look to the buttocks? It seems that putting the incision under the buttocks hides the scar well, but may make the buttocks look flat instead of round. Is injecting fat into the buttocks to make the buttocks look more rounded, which is part of the procedure, not only safe but does that last long term? And finally, can Maderma or Scar Guard significantly lighten & minimize the appearance of the scars both in the inner thigh/groin junction & under the buttocks? Thank you so much for your information & opinion! 7/21/05C.

  Answer:  It is usual for an anchoring suture to be placed to attempt to avoid the downward drifting of the scar outside of the inguinal area. Unfortunately it does not always work, although I do use them. A scar in the buttocks crease will not elevate the buttock nor will it take care of cellulite dimples. Buttocks elevation must be done from above. Fat injections can help with the dimples and may need to be done more then once. I believe both MedDerma nd ScarGuard are good products for scars. JG 7.25.05

• About the scar tissue after removing the small 3-year old grafted cartilage from the bridge of my nose: you mentioned having scar tissue from the surgery. Or is the scar tissue from peeling the now in-grown cartilage away from the blood vessels? And will this scar tissue make my nose look bigger? I heard some cosmetic surgeons inject cortisone so that the nose doesn't look bigger? Is that right? Thank you. HS 7-14-05

  Answer:  It would be mostly scar tissue form the old surgery but some small amount form the new one also. I don't think your nose will be any bigger then it is at present though. Cortisone at times is injected to soften and minimize scar tissue. JG 7.24.05

• Hi Dr Garcia, In your opinion do the 'non-surgical' facelifts such as CACI and GENIE work? You mention in your archives that exercising the facial muscles can actually make the wrinkles worse. Many Thanks JM 07/12/05

  Answer:  I think those things have not shown any potential improvemnt beyond some temporary swelling. JG 7.13.05

• Thank you Dr. Garcia. One last question about the cartilage removal: is there a chance that the nose will look different than it was before the cartilage placement there? Or after removing it, can I expect to see my nose look the same as it was before placing that cartilage there? HS 7-13-05

  Answer:  I think it will look at worst the same as it did before the graft, but more likely not all of the depression will come back as there is some scar tissue there now so all will not be lost. JG 7.13.05

• Is there a possibility that the implanted piece of cartilage over my nose would ever reabsorb or shrink over time? And if not, why would a piece of cartilage not reabsorb when one's won body fat reportedly does? HS 7-13-05

  Answer:  it can shrink a little and warp, but not really dissolve all the way. The reason it differs form fat is cartilage does not need much blood supply to survive while fat does. JG 7.13.05

• Thank you Dr. Garcia. Regarding the cartilage implant: yes, it was put there for cosmetic reasons. Therefore, what can I expect to go thru after removal? The same downtime as it was to implant it, or will it be faster recovery and less downtime? Also, is this an easy procedure for the doctor to do? I appreciate your answers. H.S. 7-12-05

  Answer:  Well, the biggest thing is that there may be a depression where the cartilage used to lift the skin up. Downtime and recovery should be about the same as the placement, I would imagine being back to most things in 3-4 weeks. I think it should be a straightforward thing for the docotor to do. JG 7.12.05

• Are there any risks both cosmetically and functionally with removing a small 3-year old implanted piece of cartilege on the bridge of the nose? H.S. 7-12-05

  Answer:  Well, it depends on what it was placed there for. If it was placed for cosmetic reasons, there should be no problem with removal. If it was placed to bolster or support a broken nasal valve, then it could cause difficulty breathing. JG 7.12.05

• I am a 32 year old woman who wants to have my top lip lifted so there is more of the vermillion showing and my cupid's bow is more noticeable. Through my research I have found that there is a procedure which can be performed in the plastic surgeon's office under local anesthetic. In one the incision is made at the lip border and in the other the incision is made under the nose. Both are supposed to leave small scars that heal over time. Do you know anything about either one of these and the cost and how effective and safe they are? Thank you, I would really appreciate any input you can give in this matter.

  Answer:  I prefer the one underneath the border of the nose as it leaves a better scar. It is very effective and the cost is $1750. The one where the incision is done at the vermillion tends to make the white roll flatten and does not look as good long term. JG 7.12.05

• Do you think the lifestyle lift is effective for wrinkles on the neck-I had the titan and it really didn't make much of a difference and I am using your DMAE cream over the Vitamin C cream and don't see much in results. Should I still continue the VitC cream and DMAE ; should I also use the tretonoin cream .1%?

  Answer:  I think the lifestyle lift will be good for cheeks but the improvement in the neck will be much less. The DMAE and Vitamin C works for small wrinkles but will not tighten skin that is loose, especially in the neck, although it may slow the progression of the superficial wrinkles. Retin-A would add a little but is sounds from what you are saying that your neck is too far gone for a non-invasive option. JG 7.7.05

• Thank you for your speedy response Dr Garcia. On the subject of my pronounced nb folds....if the Restylane filler did not totally remove the folds would surgery be the only other option? In which case do you think (re my vitiligo) an invasive procedure as such could result in loss of skin pigment. Thank you for such an interesting web site and access to your expertise. 07.07.05

  Answer:  Well, surgery will not remove them totally either, even babies have them so total removal will not only be almost impossible, but will not look normal. I do not think surgey would create any worsening of your vitiligo though. JG 7.7.05

• In your opinion which gives more visible result the minilift or thermacoo, (thermage). Thank you

  Answer:  A minilift will give you more dramatic changes. JG 7.6.05

• I just read about the lifestyle lift and there are so many different opinions about it- what do you think?

  Answer:  Mild improvement with little down time, may last a couple of years and the change may not be very impressive. Remember, mini lifts give mini results. JG 7.5.05

• Hello Dr. Garcia. I am 52 years old and went through a quick menopause due to chemo (breast cancer). I'm now noticing that my upper arms are losing skin tone very quickly; the upper arm skin is wrinkling and sagging so significantly that I am too self conscious to wear sleveless shirts. I am not overweight and have not had significant weight loss. Please advise me of non-surgical, as well as surgical options. Thanks, DH

  Answer:  Surgically you could have what is called a brachioplasty where the skin is removed and tightened. There are also non-invasive techniques that people are studying like Thermage to tighten that skin but it is still experimental. It has probabaly been accelerated due to the loss of estrogens in your body which impacts the skin to a great degree. JG 6.15.05

• Hi Dr. Garcia,I had a nose job a few years ago and the scarring from the surgery is very noticeable to the point that people ask me about it. The scars are white and in the crease of my nostrils, unfortunately with my nose my creases are very visible. Is there any solution to this problem? I would even go back under the knife if there were no other solutions, please help! CLS6/14/05

  Answer:  Hard to say without looking at you, possibly the scars could be cut out and reclosed, but that does not always make them look better I am afraid. JG 6.14.05

• i have have a double chin and fat cheeks i cant get a facelift or liposuction i want it to go away so i dont feel ugly how can i loose this fat and is it possible without a facelift or liposuction?

  Answer:  I think it would be difficult to do without surgery I am afraid. JG 6.8.05

• I've had a cheek lift exactly 4 months ago. Sometimes I think I look good, sometimes not so good. My cheeks are sort of pointy and stick farther out in front on my face if that makes sense. My husband believes that there is something called rakes inside my cheeks on top of the bone or muscle and that they will desolve and thus my cheeks will go down more. I hope this is true....I thought this was to make my cheeks go up but not to increase the cheekbone size. I believe that I'm still healing inside. Maybe two more months....sure takes a long time to see final results if that is the case. And I heal fast and am in very good health. Thanks so much for your time.....Seattle

  Answer:  What you describe is normal post operative swelling and will go down over the next few months, just give it some time, the cheeks will flatten out. JG 6.5.05

• After two male breast surgeries the aerolas keep keloiding. Does steroid injections really help or are there other procedures that can be done?

  Answer:  I think kenalog injections are certainly worth a try in that area, but it has to be injected into the scar itself for it to work. JG 5.18.05

• Dr. Garcia I am currently 23 years old and when I was 17 I had my left eyebrow pierced for only about 2 months. And over time I have noticed that the eyebrow I had pierced is a little saggy. It appears to hang lower than the brow that was never pierced. What are some options to correct this?

  Answer:  Difficult to say, certainly a half forehead lift is an option but fairly aggressive at your age, maybe an endoscopic lift, or a temple incision lift. Hard to advise without seeing you in person I am afraid. JG 5.17.05

• Hello. Research on anti-aging products has lead to me being even more confused than when I started. I read that a face lift can result with skin that ages even faster. Is this true? What do you feel i

  Answer:  A facelift will not accelerate the aging process, but the skin continues to age so a facelift will not last forever. JG 5.11.05

• how can i reduce the size of my breasts with out any surgery?

  Answer:  sorry but there is no way to reduce the size of your breasts unless you lose weight everywhere. JG 4.28.05

• My mom just had eye surgery to remove hanging skin from her upper lid and bags/festoons. She looks amazing (despite the bruising/swelling). I am only in my early 20s but I already have a lot of skin on my upper lid (I can pull it out over my lashes) that will eventually start to hang down like hers and I have (what I feel is) significant undereye bags. My question is, should I try to have the surgery as soon as possible (as like a preventive or early corrective measure) or should I wait until my bags are permanent (they only get bad with allergies or crying) and my upper lid actually hangs? Thanks.

  Answer:  I would wait, if you did it now, it would have to be very conservative and you would need it done again. JG 4.27.05

• Also, if I sent you a pic- would you be able to tell (atleast what you could tell) if it appears to be moderately deviated or mild?

  Answer:  external pictures cannot always tell if there is a deviated septum. JG 4.25.05

• And lastly- do I need to see an Ear, Nose and throat Dr. or is a PS fine?

  Answer:  Some plastic surgeons do septal surgery but nearly all ENT's do it. JG 4.25.05

• I notice that when I have sinus trouble that the left side clogs sooner and when I used to wear contacts the left one got cloudy faster. Could this be from the septum problem?

  Answer:  It could possibly be due or aggravated by the deviated septum. JG 4.25.05

• What is the average cost of the deviated septum surgery?

  Answer:  I am sorry but that surgery is usually covered by insurance and we do not accept insurance payments. You would need to ask someone who is on your provider list. JG 4.25.05

• How invasive is deviated septum surgery? Is it done totally on the inside?

  Answer:  It is done totally from the inside and in experienced hands is a straightforward surgery. JG 4.25.05

• Is a deviated nasal septum are hard thing to fix?

  Answer:  In experienced hands, it is a straight forward surgery, but at times it cannot be totally straightened out as the cartilage has memory and tries to go back to the shape it was before. JG 4.25.05

• I am 28 and want to try using a non surgical facelit home kit. Is this advisable?

  Answer:  I think it would be a waste of time and money for you. JG 4.25.05

• I had my upper eyelids done and a lower face and neck lift. I can now see my eyelids. THe dr. did not perform lyposucton, he said he cut fat out. The problem is that i see no change to my face or neck i still have the same jowels and pockets or creases around my mouth. The surgery was feb 10, 2005. My dr. took after shots to see if there is a difference, however, you cannot actually tell the before shots from the after shots. He admits this too. He says he did everything right and does not know why. I am very depressed over this. I was never advised that it may not work. I spent alot of money time and pain for these results. And the dr. says nothing else can be done, no mini tucks or anyting. I cant believe this. I did look very tired before the surgery. I want to look more refreshed and younger. These results have not been obtained. I am 49 years old and this is my first cosmetic surgery. I do not get tans or have not tanned since my teenage years. My skin has a nice qualiaty, but is dry. Please advise me. I am lost and do not know what to do. I can send you copies of the before and after if you like. thanks lisa

  Answer:  well, it is always easier to do more as a touch up rather than undo some things. Certainly I have had patients where I did what I thought was entirely right and the difference afterwards was not as dramatic as I would have wanted. I think I would suggest to wait about 6 months and see what happens as you still have some swelling that needs to resolve and then possibly see if your surgeon is willing to do some more work for you to try to get you to the place where you want to go. JG 3.28.05

• I'm only 18, but since I've had my baby boy 10 months ago my breasts sag...more than I'd like. What can I do or buy to eliminate this problem?

  Answer:  If you are not planning on having any more children, then a breast lift would be a good option. But if you are going to have more children, my advise is to wait until you are done as if you have a breast lift now and then get pregnant again you will need the breast lift redone. JG 3.8.05

• Dr. Garcia, for the reason of looking junger older adults resort to plastic surgery. How does the skin and body change and what can be expected after surgery in the long term? U. Anderson, Australia

  Answer:  Well the skin will be removed, and at times there are some small dilated veins in the skin, but they appear anyway with time and age. Besides that, there are very few changes in the long run. JG 2.21.05

• Hello Dr. Garcia,I recently had malar implants in my cheeks. It is an improvement but would like to add more fullness. I know they are not available just yet, but upon approval would I be able to get aquamid or bio alcamid over the implant or would the implant prevent this because I know they are supposed to be injected deeply.

  Answer:  Once available, that woult be a viable option and should not be affected by the implant as the injections go above the muscle and the implants are below the muscle, so all would be OK. JG 2.21.05

• What can you tell me about breast augmentations? I am looking in to a lift and enhancement and am 35 years old, having nursed four children.

  Answer:  Well, it may be a good procedure for your individual case. A breast lift and a breast augmentation do different things and some people need both. One thing that contributes to how well the scars heal in a procedure is how much tension there is on the wound when closing it with sutures. We typically do the breast lift first and then the augmentation as a second procedure 3-6 months down the road. The helps the scars heal better and in some cases, the breat augmentation may not be needed once the tissues are lifted. The scars from a lift can at times be quite long, depending on how much skin needs to be excised. JG 1.27.05

• 12/18/04 - I've just had my 3rd and LAST child 8 weeks ago. I'm currently weighing 160lbs. My ideal everyday weight after I started having children has been 130-135lbs. I've just set up an appt. for a consultation on liposuction. I have 2 questions....#1 - Should I try and lose as much weight as I can before getting liposuction..try to tone the areas? #2 - What are the longterm affects of liposuction? As long as I continue to eat healthy and exercise, should the surgery last for years, or will the fat build up in the same places again??? I'm looking to get the surgery by April 2005 (stomach, outer thighs, upper arms)

  Answer:  You should tone and lose as much weight before the liposuction as you can. The long term effects of liposuction are essentially none, except if you continue to overeat after the surgery, you will gain fat in new areas that may be difficult or impossible to remove. You would need to stay on a good diet and exercise program after the surgery. Looking forward to seeing you next year! JG 12.18.04

• Dr. Garcia, what do you think about a Feather Lift? Is it a viable solution for sagging skin? I am a female, 56 years old and have had a face lift almost 10 years ago. There is a need for something else. Also, would you know of a surgeon who performs this procedure? Thank you for your time.

  Answer:  It is a temporary lift of sagging tissue, very little effect on skin. It sounds that the better option would be another facelift, although the featherlift could give you maybe a year of improvement. I am unaware of surgeons that are doing the procedure where you are as I am not sure where you are located. JG 12.13.04

• I am 28 and have had two kids I had a breast augment two years ago and they are seeming to sag now and I would like to get them redone. I also am looking to lipo the saddle bags on my hips because they don't seem responsive to consistant work out. Although I have had the augment before this time I seem terrified. I would like to know if you know the ratio of complications versus non complications and are these sort of surgeries safe? I feel as though I work out constantly and yeild no results in those problem areas. I would like to get the surgery to boost my self esteem and feel good about how hard I work to stay in shape but am afraid of the risk and espeacially with having young children...Please help, should I be this afraid?

  Answer:  well a little fear is always good. As to the areas of liposuction, it sounds like they are good areas to treat in that way. As to the breast, I must say that larger implants will not raise the breast that is saggy, it only makes it larger and still saggy. If what you need is to lift the breast, then a mastopexy is what is indicated and the scars from that are more extensive and more visible than a breast augmentation. Thee are also more risks with that than a breast enlargement so you need to think carefully about your desires. JG 12.7.04

• Hello Dr. Garcia, I am a 20 year old male and developed this fatty excess skin under my eyes is there anything I can do its so frustrating, it totaled my social life with girls, I don't wanto go through surgery because of the cost and I dont think my parents would approve. Does excersise help? please anything you know share with me

  Answer:  Exercise will do nothing for the fat deposits, they are genetic and will require surgery to remove, that is if they are directly below the eye and above the cheek bone. This is not an uncommon genetic thing, nothing to be ashamed of. JG 12.6.04

• I read a recent post from you concerning featherlift lasting only 11 months. I have had the procedure and am disappointed with the results. Do you know if it is really true that I can have a conventional surgical lift without removing the threads? I am very concerned because I am three months out and the threads will become more difficult to remove, if necessary, as times passes.

  Answer:  There will be not problem for a regular surgical lift to be done and the threads will be easy to remove if surgery is done, or the can be left in place. JG 12.6.04

• dr. garcia hi: can you tell me of a good really good dermatologist in lexington or louisville that does this procedure? I went for a consult about a month ago in louisville at aesthetics alternatives and they said the whole face cost 3500 forget it did you say you charged 1800? and my face is reaaly not so saggy just like a little lift if it is worth it. thanks

  Answer:  I am sorry but I don't know any doctors in that area. You can contact the company on the web at www.Thermage.com and they may be able to refer you to someone. JG 9.9.04

• Dr. Garcia: Just recently discovered your website- I find it interesting and informative. I am a 54-year old female who is considering a mini face-lift in the near future. Recently, on Oprah, the show focused on antiaging issues and solutions. I learned about Thermage and how it can be used for sagging skin. I have a saggy area under my chin. In your opinion, would the Thermage work well in that area or would liposuction be better? Thanks! ML 09/09/04

  Answer:  Well, liposuction for under the chin will help only if there is excess fat and if you are a little older, then liposuction if done alone may leave the skin more saggy. Theramge certainly can tighten skin but it is a mild improvement. Infortunately, many of the photos of before and after Thermage are after multiple treatemtns and the doctors are not revealing that. Thermage is a nice option for mild skin sagginess, but will in no way replace a mini-facelift, that is false advertising. It all depends on what you are willing to go through for the end result. Thermage is certainly an option if you are looking for mild improvements. JG 9.9.04

• dR.GARCIA, I AM 52 YRS. OLD HAVE SOME SAGGING SKIN I DO NOT WANT A FACE LIFT BUT A LITTLE LIFT. HOW MUCH DOES THERMAGE COST AND HOW LONG DOES IT LAST AND DO YOU THINK IT GIVES SOME LIFT?

  Answer:  It will give you some lift, but not super impressive, maybe 25-35% tighter. It may last 3 years or so. Another option is something called an S-lift which is a 1 1/2 hour surgical procedure that tightens the cheeks, it is a little less than a mini-face lift, you are out and about in 8-9 days with minimal bruising, and should last 5 years or more. Please let me kow if there is anything else I can answer for you. JG 9.9.o4

• Hello Dr. Garcia, I am a 22 yr. old black/hispanic male with very noticeable uner eye bags.I started to see them appear about 6-7 months ago, and now they are just horrific to look at. I used to be a heavy drinker and was told that my bags could be a result of that, but ive quit drinking. Another theory is that its hereditary, which i dont really beleive. what i would like to know is how much woul

  Answer:  Eyelid surgery to tighten skin and remove bags is $2300, Heredity can play a part if the bones are smaller than they should be. It will take about one week to be presentable. JG 8.9.04

• I am 69 and had silicone injections in my face years ago. Is perlayne better?

  Answer:  I feel Perlane,(which is from the same comapny as Restalyne) when available here int the US will be a safer option than silicone. Silicone is illegal to use for injections in many states, including Nevada. Perlane should be approved later this year for use in the US. JG 5.26.04

• I am 56 and am thinking about a face lift, I am in good health and exercise and eat properly, can you give me an idea of how much it costs, do you finance, and how long the recovery time would be? Thank You, Dee Swenson at Ralphwatton@aol.com

  Answer:  The fee for a facelift is $8700. That includes all blood tests, chest X-ray and EKG, operating room, surgical fees, anesthesia fees, one night at the hospital, and 6 ultrasound massagese to enhance resolution of swelling. We have a few companies that we work with that do patient finanacing and can be done over the internet. As to felling better, usually in 10-14 days most patients are back to work and out in public but not to full activity for one month. Please call us if you have any further querstions. JG 5.26.04

• DR.GArciaI am 80 yrs. old. I had a complete face about 13 years ago & was very pleased. Please tell me would thermage or another procedure be best. Thank you.

  Answer:  Without seeing you it would be difficult to say. Certainly if the looseness of the skin were mild, Thermage would be nice as it is quick and requires no anesthesia. It would help if I could see you in person or see a picture. Also, any medical problems you may have or medications you take can influence our suggestions. JG 3.17.04

• i have a line under my cheeks that i can't get rid of. I have tried everything, and it just always seems to be there.

  Answer:  if it is the line right below the edge of the eye socket, it can be quite difficult to correct as it is due to am adherence of the tissues to the underlying bone. At times the only thing that will improve the area is some type of filler injection like Collagen or Restalyne. They are temporary, with Restalyne lasting about 50% longer than collagen, usualy taking 2 injections per year to soften the wrinkle. JG 2.12.04

• Dr Garcia I was not talking about the amount of time the zyderm and cosmoderm last i was asking you if the consistency is the same it seems like it takes more of the cosmoderm than of the zyderm i was curious

  Answer:  The consistency is a little different, but the amount required to fill a wrinkle should be fairly close. The Cosmoplast is more translucent so there will be a difference there as the color will reflect differently between the somewhat clear Cosmoplast and the off-white Zyplast

• Dr Garcia, i have seen people getting the cosmoderm and cosmoplasty and it seems like it takes more than the zyderm have you notice this or are they about the same. also curious abut the restalyne thanks for your response

  Answer:  Cosmoplast and Cosmoderm last the same amount of time as Zyplast and Zyderm, the bovine based collagen prodcuts. As to restalyne, the FDA approved its use on 12/12/03 and we anticipate the company begining to ship in January for patient use.

• Dear Dr: I got restalyne injected in my lip lines about 2 months ago. Is it common for it to swell up now after such a time? One side looks swollen. Thanks.

  Answer:  That is very uncommon for the Restalyne injections to swell up this far out. You should see the doctor who injected the Restalyne and make sure there is not something else going on. Swelling should be at a maximum after the injection and then go down over time.

• I saw a news broadcast that indicated Restalyne was not yet approved for use. Is this true? My email is BBBsuzie@aol.com

  Answer:  The FDA panel just yesterday voted 6-3 for approval, but the actual release for sale has not been given yet, only a recommendation for approval. You will still have to wait in the US for an injection to be done legally

• how long does restalyne injections last, compared to collagen injections?? sv

  Answer:  The claims made by the manufacturer are longer than what doctors have seen in live patients. It depends on the area you are having the injections done, but whereas collagen in the lips lasts 3-6 months, Restalyne will last about 8-10 months. Areas of the face where there is less motion, it may last a bit longer, but I feel Restalyne will last maybe 50% longer than bovine collagen from the reports I have seen from doctors who have used it for the past few years

• What would be the most effective non surgical treatment to sagging of tne chin and neck area. I am 52. Thank you.

  Answer:  There are some new developments in the use of radiofrequency waves through the skin to attempt to tighten collagen without surgery and without removing the outer layer of skin. We are getting our machine in the next few days, but in all honesty, it would still be experimental in that area and I cannot give you any percentage of degree of improvement of that area after a treatment. It is done with some oral pain medications and takes about 1 hour for me to do. Improvements may take upto 4 months before they are seen

• Dr Garcia, I wanted to know with the cosmoderm if you only use half of the syringe can you save the rest for another visit like you can with zyderm collegan thanks

  Answer:  I think it should be fine to hold for a while

• Do you believe mini-face lifts or small incision lifts of the area under the chin work? I saw some photos on the internet that were very impressive, but not all surgeons do this procedure.

  Answer:  We do perform mini facelifts and minimal incision techniques. The limiting factor is usually the patient. If the amount that needs to be done is too large, then doing a mini procedure can look fake or artificial. But for the right patient, it can lead to a great result with less downtime. I welcome you to make a personal appointment where we can assist you in your decision making further, otherwise, you can forward some photos to us via email and we can give you a better idea if we think a mini procedure would work in your particular case.

• Dr Garcia, I saw Good Morning America today and saw a woman who got botox and restalyne in her face. This dr. said he could do the neck area and make the turkey neck go away i thought you could only do this wiht lipo suction what are your thoughts.

  Answer:  Firstly, it is still illegal to inject Restalyne in the US as it has not been approved by the FDA, but may doctors are breaking the law and doing it. As to Botox being injected into the neck, it will weaken the muscle, so in some people the muscle band will go away, in others it will get worse, in some others they will have trouble swallowing. I think for some individuals for a short amount of time, it is indicated, but I would not suggest Botox as a prolonged treatment for neck wrinkles. Restalyne for neck wrinkles will not be effective due to the amount needed to be injected.

• Good Morning Dr Garcia! I am a physician interested in learning more about the new drug Restalyne. Longer half life than Botox??? Better???Due for FDA approval anytime soon??? Please e-mail me anything you have on it to Medweightcontrol@aol.com Thanks

  Answer:  I have sent you an email response

• I had an upper and lower blepharoplasty in 1981. Recently I had a phenol peel and suddenly I have puffiness under my left eye. It is only puffy on the right and left corners of the eye but not in the middle. My opthamologist tells me they are fat pads and it is because of age (62years). Perhaps he is correct. I have been told there is a new treatment awaiting approval from the FDA which will dissolve the fat pads. Can you tell me if there is such a procedure, and the cost. Would you recommend another blepharoplasty? Thank you for your help. Ms. White

  Answer:  The aging process can make the fat pads in the eyes become more prominent. The lateral aspect fat pads that your refer to are the most troublesome. Unfortunately, a phenol peel will not help that. Another bleparoplasty would probably be the best thing. Possibly the fat can be removed through an incision inside the eyelid in order to minimize any trauma and injury to the muscle which closes the eye. The healing from that transconjuctival blepahroplaty is also quicker. As to the solution that has been spoken about in the news to dissolve fat, it is at present not FDA approved, nor is any company attempting to obtain FDA approval. There are doctors that are injecting the material illegaly though. One of the fears is that no one knows if it works, and if it does, no one knows why or how it works, or the potential long term effects of the injections, so I would suggest avoiding them. Hope this helped

• Dr. Garcia, I had an eyelift on upper and lower lids. The upper look fine but the skin under my eyes looks like saggy rings. Can anything be done to remove these wrinkles?

  Answer:  Sometimes a chemical peel or a laser procedure can be done to tighten the skin a bit furhter and improve the character and quality of the skin

• I have had botox on my forehead for about the last year and a half. Now at the top of my forehead I have an indention at the top that i have never had before. What can be done about this and have you ever seen this before.

  Answer:  sometimesyou can lose a little of the tissue and in time it may come back, its from the swelling putting pressure on the spot. If it does not improve in time, we can do collagen inections inot the area to plump the skin out

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