Dr. Tarick Smiley Plastic Surgery Articles and News

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Liposuction massage after surgery is believed to improve healing and possibly result in smoother appearance. However, not every doctor recommends this practice so be sure to always check with your plastic surgeon or physical therapist first.

 

Lymphatic drainage massage (LDM) is particularly helpful in promoting healing. Some doctors recommend it 4-5 days after surgery while others feel that it should only be attempted in the beginning of the second week of recovery.

 

liposuction massage

Photo Credit: Patrisyu at FreeDigitalPhotos.net

While instructions differ from surgeon to surgeon, proponents of LDM suggest that massaging the lymphatic system can help the body flush out the excess fluids (seroma) caused by surgery. For this reason the postop swelling is reduced and the recovery is expected to be shorter.

 

The lymphatic system consists of lymphatic vessels (almost similar to blood or circulatory system’s vessels) that transport a special fluid that fights off infection.

 

Lumpiness is fairly common in the liposuction sites; this is primarily caused by surgical trauma and inflammation resulting from the cannula or blunt-tipped probe used to remove the excess fat beneath the skin.

 

The area where the fat has been extracted will be filled with fluids, which result in lumpiness and swelling. While these symptoms often resolve on their own, sometimes the fluids and residual fats may harden—a condition called fibrosis—between one and three weeks after liposuction.

 

The idea of liposuction massage is to move these fluids into the lymph passages and preclude the formation of fibrosis. Of course, the end results will be a smoother skin surface.

 

Contrary to popular belief, liposuction massage in the initial healing stage must be gentle to prevent causing additional injury to the treated site. For this reason LDM involves soft and relaxing rhythmic massage that simulates the way lymphatic system functions—i.e., pushing the fluids from the congested tissue into the blood stream where the body can flush them out naturally (through the excretory system such as sweat and urine).

 

Aside from liposuction massage, other ways to control swelling and ultimately promote healing include low-sodium diet, medical-grade compression garments, good hydration, and light exercise such as walking, as suggested by Orange County plastic surgery experts.

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Minor revision rhinoplasty (nose reshaping surgery) generally entails a shorter “social recovery” compared to the initial operation. Nonetheless, some patients may still experience extensive swelling and bruising in the first 1-2 weeks; this is particularly true for individuals with markedly thick nasal skin and those who bruise easily.

 

The amount of swelling and the length of social recovery will also depend on where the revision is performed, as suggested by leading Beverly Hills plastic surgeon Dr. Tarick Smiley.

 

minor revision rhinoplasty

In general, minor revision rhinoplasty just involves the removal of a very small piece of cartilage (a flexible but firm connective tissue comprising the lower two-thirds of the nose). At the same time, the surgeon may also elect to remove some excess scar tissue to further refine the results.

 

Meanwhile, a small subset of patients may require a non-surgical type of revision; hence, there is no or very little downtime. For instance, dermal filler injection can hide small irregularities along the profile of the nose.

 

Medical literature suggests that about 5-10 percent of rhinoplastic patients will have minor issues during the healing process. For these individuals minor touch-ups in general can provide sufficient improvements.

 

On the other hand, major revisions are often caused by over-resection of the tissue. For this reason the structural integrity of the nose must be preserved through a combination of different techniques.

 

In minor revision rhinoplasty, Dr. Smiley says that closed rhinoplasty is often enough to deliver the desired appearance. This technique places all the incisions inside the nostrils, i.e., parallel to the half of the nostril lining to reveal the cartilaginous framework of the nose.

 

The celebrity plastic surgeon says that closed rhinoplasty results in less postop swelling and bruising and ultimately shorter social recovery (compared to open rhinoplasty) that most patients can go out in public 7-10 days after surgery. He has demonstrated this technique in some of his previous Snapchat video posts.

 

Open rhinoplasty, meanwhile, makes an incision along the wall of tissue between the nostrils. Because it results in more “tissue disturbance” and bleeding, the technique leads to more postop swelling and bruising than closed rhinoplasty, he says.

 

While the surgeon’s techniques and skills will have a large effect on how long the recovery will be, factors such as skin thickness, age, diet, and postop care can also influence healing, Dr. Smiley adds.

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Facial plastic surgery recovery differs from patient to patient. Factors such as individual healing, type of procedure, age, and lifestyle will also influence the length of downtime.

 

Celebrity Los Angeles plastic surgeon Dr. Tarick Smiley has shed light on what to expect in facial plastic surgery recovery. It is important to note that the guidelines stated below are generalizations and may not apply to each patient.

 

facial plastic surgery recovery

  • Brow lift – 1-2 weeks
  • Eyelid surgery – 2 weeks
  • Facelift – 2 weeks
  • Facial fat transfer – 2 weeks
  • Rhinoplasty or nose job – 1-2 weeks

 

(Note: They all pertain to social recovery, i.e., the patient can go out in public without drawing unwanted attention.)

 

While most patients can return work after 1-2 weeks, some may need a longer time off if their tasks include heavy lifting and some strenuous activities, which are best avoided for 3-4 weeks. Nonetheless, it is important to take short walks throughout the day as good circulation can lead to improved healing, lower risk of deep vein thrombosis, and reduced lethargy and constipation (and other side effects of narcotic pain meds).

 

It is important to note that rushing one’s recovery can lead to persistent swelling and bruising, poor healing, and poor scarring.

 

While time remains the best “healing agent,” certain things are known to keep swelling and bruising at a minimum, ultimately resulting in quicker recovery. For instance, head elevation while sleeping and resting in the first few days can help decrease postop symptoms.

 

Cold therapy, good hydration, relaxation, and superb diet can also promote healing.

 

The ideal diet during facial plastic surgery recovery must be low in sodium and fat while rich in protein and micronutrients such as antioxidants, minerals, and fat and water soluble vitamins.

 

Some doctors also recommend homeopathic remedies such as Arnica montana and bromelain, which are believed to trigger the body’s natural healing response. While the instructions may differ from doctor to doctor, the consensus is to use them sparingly.

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The armpit or transaxillary breast augmentation recovery is generally quicker and possibly less painful compared to other incision sites such as the peri-areolar (through the armpit) and the inframammary crease (through the breast fold) techniques.

 

Celebrity Beverly Hills plastic surgeon Dr. Tarick Smiley attributes the shorter transaxillary breast augmentation recovery to its unique advantage: It allows the implants to be positioned beneath the chest muscle without actually injuring or cutting this layer.

 

transaxillary breast augmentation

This method places the incision in the armpit, specifically within the natural folds of skin for optimal scar concealment. Dr. Smiley has demonstrated this technique in his recent Snapchat video post, which he uses as part of his patient safety and awareness campaign.

 

The armpit incision allows doctors to lift and open up the natural tissue planes to position the implants beneath the muscle. This implant placement particularly favors small-breasted patients because the additional coverage provided by the muscle reduces the risk of rippling and palpability.

 

Without cutting the muscle, there is less bleeding and surgical trauma, and ultimately quicker recovery. Nonetheless, other factors such as individual healing, implant size, and pain threshold will also influence the length of downtime, says Dr. Smiley.

 

With the armpit incision, most patients will only need oral painkillers in the first few days. Some women can also return to their desk job as soon as three days postop, although it will really depend on the abovementioned variables.

 

The patient shown in the Snapchat video received 370 cc silicone breast implants (which is a conservative size) via transaxillary incision technique.

 

She has expressed great satisfaction with the results because despite the conservative implant size its high profile design (i.e., more forward projection and narrower base dimension) gives the much-coveted fullness especially in the upper breast pole.

 

The use of overlarge silicone breast implants is not ideal because it requires an equally larger scar that could become visible particularly in petite patients. However, this is not an issue with saline implants because they are propelled into the pocket while still empty, only to be inflated with saline (sterile saltwater solution) once they are properly positioned.

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Facelift or fat injections? Arguably, this is one of the most common dilemmas of patients seeking some type of facial rejuvenation surgery.

 

The truth is, there are several variables that affect the most ideal approach such as the patient’s underlying anatomies (i.e., skin elasticity and facial volume), personal preference, and even the “acceptable” tradeoffs particularly pertaining to downtime.

 

facelift or fat injections

Photo Credit: American Society of Plastic Surgeons

Nowadays, fat injections are no longer treated not as an afterthought but an integral part of facelift surgery. They are particularly helpful in correcting soft tissue atrophy or “shrinkage,” as suggested by leading Beverly Hills plastic surgeon Dr. Tarick Smiley.

 

Dr. Smiley has demonstrated how fat injection or fat grafting further refines the effects of facelift.

 

In one of his recent Snapchat videos, he performed facelift with fat injections in a male patient.

 

He started off with neck liposuction to eliminate the excess fat responsible for its “full appearance.” But instead of throwing away the fats, he later injected them into the deep tear trough and nasolabial folds, or more commonly referred to as laugh lines.

 

Fat injections are typically performed simultaneously with facelift surgery so the patient will experience recovery just once. (Note: Structural fat grafting is performed right after the completion of facelift.)

 

While the results of fat injections, particularly the survival rate of fat grafts, may greatly vary from surgeon to surgeon, Dr. Smiley says that he aims to achieve at least 70 percent survivability rate through gentle collection of fat cells, meticulous purification methods, and gradual re-injection of purified fats.

 

The healthiest purified fats are injected in very small amounts one at a time (about 0.1 cc) to gradually build up the soft tissue and to achieve a smooth result. This technique also creates minute spaces between the grafts that promote blood vessel ingrowth, which plays a critical role in their long-term results.

 

For the reasons stated above, Dr. Smiley feels that the question pertaining to which provides better results, facelift or fat injections, gives an “illusion” that one is more important than the other even though they are actually complementary procedures.

 

Medical literature suggests that the results of facial fat injection last an average of 8-10 years, although some doctors have noted that patients on the thinner side and vegetarians may not achieve the same longevity.

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Full tummy tuck is just one of the many variations of abdominoplasty, a body contouring procedure in which the excess abdominal skin and fat is removed with a customized incision pattern based on the patient’s underlying anatomies and personal preference.

 

Leading Los Angeles plastic surgeon Dr. Tarick Smiley has recently posted a Snapchat video to demonstrate how a full tummy tuck is accomplished.

 

full tummy tuck

Full Tummy Tuck Before and After Photos of a Satisfied Patient

 

The female patient shown in the video has a significant amount of excess skin both in the upper and lower abdomen. The upper abdominal aspect required more contouring because of the large “bulge” caused by the redundant tissue.

 

Aside from the redundant skin, the patient also has an overlarge navel and a loose abdominal muscle, which runs in the midline between the pubic region and the breastbone.

 

Full tummy tuck was particularly ideal for the said patient who obviously required a great deal of work. Dr. Smiley created a hip-to-hip incision very low to the pubic hairline so the resulting scar would be concealed by her underwear.

 

With the hip-to-hip incision pattern, Dr. Smiley was able to remove a large amount of redundant skin both in the upper and lower abdomen. Afterwards, he pulled down the remaining skin tissue and created a “hole” where the navel would be positioned.

 

Because the preoperative navel was large, Dr. Smiley sutured it in a way that its new size would be smaller and thus more proportionate to the flatter, narrower waistline. He also attached it to the abdominal wall to create an “innie” appearance, as opposed to an “outie” one.

 

To further deliver a contoured silhouette, the patient received muscle repair simultaneously with her tummy tuck. While some doctors treat it as an “afterthought,” Dr. Smiley says that in his practice it has become an integral part of the surgery.

 

Muscle repair, which is accomplished by using internal sutures to hold the “separated” pair of vertical abdominal muscle, can minimize the impact of inadvertent pregnancy and minimal to moderate weight gain, says the celebrity Los Angeles plastic surgeon.

 

Meanwhile, tummy tuck also comes in several variations that require a smaller incision pattern so the scar could be as short as 4-6 inches. Nonetheless, they rarely work unless the patient has very little excess skin that is limited to her lower abdomen.

 

Dr. Smiley says that pregnancy and massive weight loss generally affects both the upper and lower abdomen, hence full tummy tuck has become today’s gold standard.

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