-By Julio L. Garcia, MD, FACS

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Many different emotions go through a person’s mind when they look in the mirror and see something they wish they didn’t see. They see possibly sagging skin, loose tissues, excess or disproportionate deposits of fat, or skin with fine lines and a dull appearance. The list can go on and on. When we encounter such things we don’t like in other parts of our life like our house, car or clothing, the decision to change them are much more easily made. Yet, when it comes to us, many times doubt creeps in.

Am I just being vain?

Do I really need this?

Why can’t I just accept the way things are as I age?

What will my friends and family say?

The list can be paralyzing, and make people not take action. It is for that reason that the last 15 to 20 years have seen such an explosion in non-invasive or minimally invasive techniques to improve those small flaws. In the olden days, it was really only a surgical intervention that could be offered: a tummy tuck, a facelift and/or eyelid lift, liposuction, etc. The thought of something so drastic appears so large, and for some people a sign of “defeat.” I use the word defeat because maybe they should have known better in terms of avoiding the sun, stopping smoking, eating healthy, or a myriad of things that we now know can help prevent or slow the progression of these issues.

So what is one to do?

I have always thought that getting as much education about a subject before making a decision is of paramount importance. That is what the physician is truly supposed to do. In this case, it would be a doctor. Some of you may not know that the word “doctor” comes from the Latin root word for teacher. So truly, that is what a doctor should do first: teach. It can mean teaching prevention, treatment…a litany of things. But learning what the teacher has to say is important.

In my office, I feel discussing the causes of the problems and any potential pitfalls of the available treatments is of a great help to patients. In my experience, a well-informed patient will feel better about their decision, understanding that measures taken to “look better” can many times be attached to feeling better. That is what I deal with on a daily basis…patients who are seeking a physical improvement in order to feel better. That “feeling better” extends to greater levels of confidence, a concordance of looking on the outside like you feel on the inside. For that reason I think that patients seeking information about an aesthetic or cosmetic procedure should see a physician who performs the whole gamut of procedures, from the surgical, to non-surgical, to minimally invasive. If one sees a physician that only does fillers, for example, then they will offer only filler as the option. But the truth is, not everyone is a candidate for fillers…just as not everyone is a candidate for surgery.

In our office, we offer a full range of aesthetic enhancements, and it is for that reason that I feel our patients receive a good education about their options…options that are tailored to their wishes, desires and needs. At times, the injectable non-surgical options can forestall the day of surgery or prolong the longevity of an appearance achieved with surgery. The reason for this is that the aging process is not just a matter of loosening skin. It is a result of loose skin shifting, or lost tissue below the skin, excess fat in some areas, or loss of fat in others. And surgery is not always the correct choice. When we can address the individual components, we see a more harmonious appearance. An appearance that does not look “too filled-up,” too tight, too pulled, or an appearance that leaves them looking like a different person. Cosmetic surgery and the ancillary techniques I speak of can then be offered to make sure the mixture is right, just like the porridge was for Goldilocks: not too hot, not too cold, but just right.

I invite you to see us at our office for a private and confidential consultation where your concerns and desires, as well as fears, can be discussed, and we can then offer you a set of options. With that information you then can decide if the time has come for a subtle or a bigger step. We look forward to seeing you soon.

Julio L Garcia, MD FACS, is the founder of the Regenerative Medicine Institute of Nevada, which is dedicated to helping patients with adipose-derived cell therapies for the treatment of acute and chronic medical issues. For more information about Dr. Garcia, please visit his websites at and, or contact his office by calling 1-888-FACES-89 or (702) 870-0058