Posts by California Surgical Institute


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ABOUT DR. TARICK SMAILI

 

Dr. Smaili is an active member of the American Society of Plastic Surgeons of which only board certified plastic surgeons can be admitted. He is also an active member of the Plastic Surgery Foundation for which he has received 1st place awards for his publications and presentations in 2001.

Tarick K. Smaili, MD, a native of Ohio, graduated from Whitmer High School in Toledo, received his Bachelor of Science from Ohio State University in 1989, and received his Medical Doctor degree from the Medical College of Ohio in 1994.​ As Medical Director of California Surgical Institute, one of the fastest growing private medical partnerships specializing in cosmetic surgery in the state of California, he is committed to setting the highest standards for quality of care in the field of plastic surgery.

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The main goal of tummy tuck surgery, also known as abdominoplasty, is to create a flatter and more toned abdomen. This is achieved by removing the excess skin and tissue, and possibly restoring the separated muscles caused by previous pregnancies or massive weight fluctuations.

However, some would-be patients are put off by the tummy tuck scars, which typically span from hip to hip across their lower abdomen.

To hide the appearance of tummy tuck scars, plastic surgeons will make every effort to lower them to an area covered by their patients’ bikini. Nevertheless, postop variables remain important to further achieve “favorable” scarring.

Leading Beverly Hills plastic surgeon Dr. Tarick Smaili explains the four basic ways to help tummy tuck scars fade quicker, with most of them performed at home.

  1. Scar massage. The idea is to break up the scar tissue that may form within the dermis, although it should only be attempted when the incision wound is healed enough, which happens around four weeks after surgery.

The general rule of thumb is to pull the scar line horizontally and perpendicularly. Another technique is to stretch the skin next to it in a circular motion, clockwise and counterclockwise, for optimal results.

  1. Wound care. Avoid factors that can increase the risk of infection such as poor hygiene, dirty bed linen, soiled dressings, poor diet, and smoking. To further reduce its incidence, some doctors also recommend antibiotics.

Take note that proper wound care is a case-to-case basis, so you have to stick to your surgeon’s instructions.

  1. Sun protection. While the usual recommendation is to avoid exposing your incision under the sun for at least six months, it would be better to do this for a full year to further minimize the risk of hyperpigmentation in which the scars become darker and more obvious.

If you need to go outside, use protective clothing and/or sunscreen even in cloudy days because the sun’s UV rays can penetrate through clouds.

  1. Scar creams and topical treatments. Many surgeons prefer products that contain silicone and mild steroid (hydrocortisone) because these agents are known to reduce redness and/or hydrate the skin, leading to “better” scars.

Silicone tapes or sheets are also helpful because they constantly provide pressure that prevents or at least reduces scar tissue formation. Some doctors believe that combining them with scar tissue massage could further promote good scarring.

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A successful facelift surgery result not only looks more youthful and refreshed. An equally important goal is to create a natural-looking visage, with no telltale signs of the said procedure, as suggested by Los Angeles plastic surgery expert Dr. Tarick Smaili.

Simply put, the result of facelift should not “scream” plastic surgery.

Dr. Smaili explains the four most common telltale signs of facelift surgery and the “principles” he uses to avoid them.

1. Weird-looking ears. Most facelift techniques involve an incision that runs around the ear, particularly within the natural folds of skin to hide the scars. This will allow the surgeon to remove some excess skin, tighten the deeper facial tissue, and pull the skin to reduce the saggy appearance.

However, excessive tension on the skin and incorrect direction of pull could lead to pixie ear deformity in which it appears too elongated. Raisin-like wrinkles in the earlobe, meanwhile, are often caused by poor wound closure.

Avoiding excessive skin tension and incorrect wound closure can prevent wrinkly or elongated earlobes. For this reason, it is crucial to reshape the deeper structures of the face so the new contour will have a stronger support, with no or very minimal strain on the superficial layer.

2. Weird facial expression. The late Joan Rivers has been the poster child of botched facelift surgery because of her perennially surprised visage.

A “surprised” and “windswept” appearance is often caused by incorrect direction of pull and/or excessive tension on the skin. To avoid this look, the leading Los Angeles plastic surgery expert advocates the use of three-dimensional facelift approach in which fat grafting or dermal filler injection is used to create a more natural visage.

The idea is to restore the facial volume and rely less on skin pulling, which if done aggressively can backfire, Dr. Smaili warns.

3. Poorly placed scars. Facelift scars are positioned behind the hairline and around the ears to hide them. However, problems can arise when they migrate due to excessive skin tension, or thicken due to incorrect wound closure or because of the patient’s susceptibility to keloids.

Aside from minimizing skin tension during surgery, Dr. Smaili says proper wound care also plays a crucial role. The idea is to avoid infection, pressure, and other factors known to inhibit healing and lead to aggressive scarring.

But if the facelift scars remain persistent, Dr. Smaili recommends steroid injections, laser treatments, silicone tapes, or scar revision surgery.

4. Hair loss. Incisions are typically positioned behind the hairline so the scars remain hidden. However, incorrect or aggressive wound closure and failure to elevate the facial skin could lead to hair loss and unnatural hairline.

To avoid the aforementioned problems, the hair follicles and the surrounding blood supply should not be exposed to excessive trauma at the time of surgery.

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Sami B. Hamamji, M.D

Like many physicians, Dr. Hamamji chose a career in medicine because of his sincere desire to help people get well, feel good, and maintain a healthy, vibrant lifestyle.  He also strives to provide the most advanced medical technology with the highest level of compassion and care to his patients.

Dr. Hamamji received his medical degree from St. Joseph University in Beirut, Lebanon.  He then completed his General Surgery training at the University of Montréal in MontréalQuébec, Canada and became Certified in the field of General Surgery and a Fellow of the Royal College of Physicians and Surgeons of Canada.

After moving to California, Dr. Hamamji obtained certification from the American Board of Surgery and became a Fellow of the American College of Surgeons. He is also a Fellow of the American Society for Metabolic and Bariatric Surgery.

Today, he specializes in Advanced Laparoscopic Surgery and applies these skills, amongst other things, in the field of weight loss surgery.  Due to his desire to provide the most advanced techniques, Dr. Hamamji continues to incorporate cutting-edge technologies in his practice including the use of the Da Vinci Robot and the newest improvements in the continuously advancing arena of minimally invasive surgery such as the Single Site Robotic Assisted Laparoscopic Cholecystectomy.  As such he was the first surgeon in Orange County to adopt this technique and is looking forward to the introduction of new instrumentation on the DaVinci Robot in the near future in order to develop new areas that would benefit from this advanced technology, providing the best care with the ultimate cosmetic outcome of a major abdominal surgery without any visible scar.

But while he may incorporate newer state-of-the-art technology, his level of compassion and genuine care for his patients remains constant.

Dr. Hamamji has been living in Orange County for over twenty years now. He is married and has one son. When not working, he enjoys classical music, contemporary authors and fine arts. He is fluent in English, French and Arabic.

EDUCATION

·      Bachelor of Science, Collège Mont La Salle, Beirut, Lebanon

·      Medical Doctorate, St. Joseph University, Beirut, Lebanon

·      Internship, Hôpital St. Luc, University of MontréalMontréalQuébec

·      Residency, General Surgery, University of Montréal, Montréal, Québec

ADDITIONAL TRAINING

·      Upper and Lower GI Endoscopy

·      Basic and Advanced Laparoscopy

·      Laparoscopic Bariatric Surgery

·      Robotic-Assisted Laparoscopic Surgery

·      Single Site Robotic-Assisted Laparoscopic Cholecystectomy

 

CERTIFICATION

·      Board Certified, Diplomate, The American Board of Surgery (ABS)

·      The Royal College of Physicians and Surgeons of Canada (FRCSC)

·      The Board of Medical Examiners

·      The Medical Council of Canada

·      The Educational Commission for Foreign Medical Graduates

LICENSES

·      State of California

HOSPITAL AFFILIATIONS

·      St. Joseph Hospital, Orange, California

PROFESSIONAL COMMITTEES / SOCIETIES / APPOINTMENTS

·      Fellow, American College of Surgeons (FACS)

·      Fellow, The Royal College of Physicians and Surgeons, Canada

·      Fellow, American Society for Metabolic and Bariatric Surgery (ASMBS)

·      Member, California Chapter American Society for Metabolic and Bariatric Surgery

Member, California Medical Association an

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Since the introduction of Keller Funnel in 2009, the device has received nothing but praises from breast augmentation surgeons because it can significantly reduce the risk of breast implant contamination, which leads to other benefits.

The Keller Funnel resembles an icing bag whose internal surface has an oily coating that paves way for a quick and efficient implantation, explains one of the leading breast augmentation surgeons Dr. Tarick Smaili. Right after opening the silicone implant from its sterile package, it is poured inside the device which is then squeezed a couple of times to propel the implant into the pocket.

breast-augmentation-keller-funnel

These are the top five reasons why Keller Funnel breast augmentation is good for you:

  1. It prevents the implants from touching the skin.

The cone-shaped device allows the transfer of breast implant into the pocket without allowing it to touch the skin around the incision site, which is known to harbor bacteria that could lead to shell contamination and infection.

The narrower end of the cone is positioned about 1 cm into the center of the breast pocket before it is squeezed several times to propel the implant into its proper place.

According to studies, compared to finger-push implantation the use of Keller Funnel can reduce the risk of bacterial contamination by up to 200 percent.

  1. The technique lowers the revision rate.

With no implant contamination or “deep” infection, the risk of capsular contracture or tissue hardening can be minimized as well. The theory is that a low-grade infection triggers the body to “over-react” and produce a copious amount of collagen around the implant, eventually leading to visible deformity and pain.

  1. Shorter incision is possible.

The main appeal of saline implants, which are filled with sterile salt water once inside the pocket, is the use of smaller incisions, about 1.4 inches or sometimes even shorter. Nevertheless, their results are not as natural as the silicone implants, which are always prefilled by their manufacturers.

With finger-push method silicone implants require an incision usually longer than 2 inches, but with Keller Funnel device they can be introduced into the pocket through the same opening as required by saline implants, leading to a shorter and less conspicuous scar.

  1. It can significantly reduce the amount of force.

Excessive force applied to any portion of the implant could affect its long-term stability (i.e., more prone to rupture), which is often unavoidable with the use of finger-push method.

But with Keller Funnel, the force is efficiently redistributed around the implant shell at the time of insertion. As a result, the stability of the prosthesis is relatively unaffected after surgery.

  1. This breast augmentation technique can reduce tissue trauma.

The insertion of silicone implant with Keller Funnel on average only takes 10 seconds, which reduces surgical trauma and at the same time shortens the surgery by 10 to 20 minutes, as suggested by several studies.

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