Posts by Dr. Tarick Smiley


Each doctor has a specific set of rhinoplasty recovery tips. Nonetheless, they all boil down to controlling the amount of swelling and bruising, and preventing injuries during the healing phase to achieve optimal results from the surgery.

 

Most patients already know the basics of rhinoplasty recovery tips—the drugs and supplements to avoid a few weeks before and after surgery, the foods and drinks to limit, and the activities that could jeopardize their results. Hence, the list below explains the not-so-popular guidelines that can promote healing.

 

rhinoplasty recovery tips

 

  • Manage your stress

 

Chronic stress can put a toll on your immunity. For this reason, a longer time off from work might be more ideal than returning to office just 10-14 days after surgery, or once the outward signs (bruising and swelling) are gone.

 

If a longer leave of absence is not possible, you may ask to work part-time until you regain your pre-surgery energy level, which often takes 4-6 weeks after surgery. The goal is to control your stress level, according to experts at the California Surgical Institute.

 

Of course, managing stress also boils down to adapting a positive attitude in life.

 

  • Use of bed wedge pillow or recliner bed

 

Head elevation all day long and during the night can keep swelling to a minimum and can also promote healing. Many patients have noted the convenience of using a bed wedge pillow or a recliner bed, as opposed to the soft standard pillows.

 

  • Watch out for bumps

 

You may want to sleep alone in your bed and avoid pets and small children for the time being because even the slightest bump may cause bleeding or interfere with healing.

 

Other things to avoid while not yet fully healed include wearing eyeglasses, blowing your nose, making excessive facial expressions, and applying too much pressure when brushing your teeth. Moreover, it makes sense to wear button down shirts or wrap-around dresses during the initial healing stage to avoid accidental bumps on the nose.

 

  • What you eat matters

 

Aside from consuming more fiber-rich foods and lean protein, it is important to follow a low-sodium diet. It is important to note that too much salt causes water retention, which can aggravate the amount of postop swelling.

 

Empty calorie foods laden with sugar and fats can also suppress your immunity and aggravate constipation, which is not uncommon after any type of surgery due to narcotic painkiller use.

 

  • Sun protection

 

Sun protection is one of the most critical rhinoplasty recovery tips. It is important to note that after surgery the nose is extra sensitive to UV rays and thus the risk of discoloration or hyperpigmentation is perceived to be higher.

 

If you cannot stay away from the sun, try to slather on sunscreen with at least SPF 30 or use a wide-brimmed hat.

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One of the most common Brazilian buttock lift risks involves having a poor shape and projection, which can be avoided by creating a strong foundation, as suggested by leading Beverly Hills plastic surgeon Dr. Tarick Smiley.

 

Dr. Smiley, who performs over a hundred Brazilian buttock lifts every year, has recently posted Snapchat videos to demonstrate how he achieves natural, long-lasting results from the procedure by following the most basic principle: Always respect the patient’s underlying anatomies.

 

The celebrity plastic surgeon says that a poorly done Brazilian buttock lift can lead to sagging and cellulites (dents and dimpling), citing the poor results (dimpling and sagging) of reality TV star Kim Kardashian.

 

brazilian buttock lift

Photo of a Brazilian buttock lift patient one week postop (she is wearing a compression garment). Dr. Smiley has created wider hips and fuller, rounder buttocks without compromising the underlying foundation of the butt cheek. Hence, the patient can expect great results that are not susceptible to gravity and aging.

To prevent the sagging appearance after surgery, he highlights the importance of creating a strong foundation and avoiding too much volume (or overdoing fat injection) because the additional weight makes the buttocks susceptible to the effects of gravity, aging, and weight fluctuations.

 

Dr. Smiley says the buttock skin is supported by vertical septae, which look like small threads attached to the muscle and bone. They also serve as a compartment for fat globules.

 

However, the vertical septae can lost their strength and elasticity, which can lead to cellulites and sagging, when too much fat has been injected into the buttock—particularly the lower half aspect. To prevent these complications, he avoids over-injection of fat near the gluteal fold (the crease between the butt cheek and the posterior thigh).

 

Too much volume and weight on the lower half of the butt cheek, just like in the case of Kim, is the most common cause of poor shape and dimpling, says Dr. Smiley.

 

The celebrity plastic surgeon has also surmised that Kim’s poor results might also stem from liposuction of the posterior thigh, which has further weakened the “foundation” of the buttocks and thus contributed to the sagging appearance.

brazilian buttock lift risks

Kim Kardashian’s backside has visible dents and sagging, which could be a result from over-filling the lower half aspect of the butt cheek, and liposuction near the gluteal fold.

Dr. Smiley says he generally avoids liposuction of the posterior thigh due to risk of saggy buttocks and surface irregularities.

 

Nevertheless, liposuction remains an integral part of Brazilian buttock lift because it allows surgeons to collect “unwanted” fats from two or more donor sites; the fats are later re-injected into the buttocks.

 

Dr. Smiley says he almost always treats the lower back and flanks as a viable donor site of fats because contouring these “adjacent” areas further improve the profile and shape of the buttocks, and so there is no need to perform over-aggressive fat injection in an attempt to achieve great projection.

 

He believes that having a deep understanding of the buttock anatomy can prevent most, if not all, Brazilian buttock lift risks.

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The appearance of navel after tummy tuck can make or break the results. The goal is to avoid surgical stigmata such as misaligned belly button, visible scar around it, or perfectly round shape, as suggested by renowned Beverly Hills plastic surgeon Dr. Tarick Smiley who has performed more than 7,000 surgeries to date.

 

Most people think that tummy tuck simply removes the pannus, an apron-like skin that can sometimes reach the pubis, leading to skin irritation, foul odor, and poor hygiene. However, Dr. Smiley says that the surgery is more than that.

 

navel after tummy tuck

 

Aside from pannus removal, tummy tuck also typically incorporates muscle tightening, liposuction of the flanks, navel repair, and sometimes even hernia repair.

 

The correct anatomic position of the navel must be determined to achieve the most natural results possible. Hence, surgeons generally do not detach the belly button from its stalk and main blood supply during the entire surgery.

 

After removing the excess skin in the lower abdomen with a hip-to-hip incision, the skin in the upper abdomen is pulled down to close the wound and a new hole is cut out to inset the navel. Meanwhile, the scar lies inside the rim of the belly button for its optimal concealment.

 

Simply put, the navel remains in its original placement, although it may appear a bit higher or lower after removing the loose skin around it.

 

Meanwhile, the hip-to-hip scar is made very low that even the lowest “low rise” jeans and underwear can cover it. Over time and possibly with the use proactive scar treatments (e.g., silicone sheets and scar massage), it is expected to fade into the background.

 

Dr. Smiley says that a good number of tummy tuck patients need some type of navel repair, e.g., reducing its size and/or width or turning an outie into an innie. It is also critical to preserve its natural shape—i.e., with a small hooding at around 2 o’clock or 10 o’clock, and it should be somewhat vertically oriented.

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Buccal fat removal surgery basically reduces the cheek fat pad, as opposed to removing it entirely. The goal is to achieve a more chiseled appearance without resulting in a gaunt-looking face, which happens after an over-aggressive approach.

 

Leading Beverly Hills plastic surgeon Dr. Tarick Smiley has recently demonstrated buccal fat removal surgery on his Snapchat account. The patient shown in the video has excessive fullness in her lower cheeks, giving her the appearance of “chipmunk” cheeks. To further achieve a proportionate result, he also contoured the jawline and chin with “conservative” liposuction.

 

buccal fat removal

Reality TV star Kylie Jenner has long been rumored to have undergone buccal fat removal surgery. However, she denies having any facial plastic surgery.  (Photo Credit: Lifestyle.one)

 

He performed buccal fat removal by creating incisions inside the mouth so the risk of visible scar has been completely eliminated. It is important to note that he only reserved this surgery for patients who have an extreme case of “moon-like” round faces.

 

Meanwhile, people with a milder case of accentuated cheek fat pad are generally discouraged to have the procedure because of the long-term substandard result. Advancing age causes some of the facial fatty tissue to “shrink” and thus resulting in bony faces later in life.

 

Aside from strict patient selection, the success of buccal fat removal also lies in a more conservative route—i.e., ensuring that some fats remain after surgery so the patients will not end up with a gaunt appearance years down the road.

 

To achieve a smoother, more contoured appearance, the patient also received minimal liposuction along her jawline and chin.

 

(Note: The buccal fat pad lies deeper in the cheek muscle; this is different from the superficial fat beneath the skin, which can be removed via liposuction procedure.)

 

Just like in buccal fat removal surgery, the celebrity plastic surgeon followed a conservative route during liposuction—i.e., ensuring that a thin layer of fat remains afterward—to offset and “anticipate” facial volume loss that comes with aging.

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There are lots of terminologies thrown around as regards to facelift surgeries—weekend lift, SMAS facelift, deep plane, skin-only lift, just to name a few—which add up to the confusion. For this reason, leading Los Angeles plastic surgeon Dr. Tarick Smiley says prudent patients should ask their doctors about the specific details of their surgery.

 

Dr. Smiley says he prefers the SMAS facelift technique due to its long-lasting, natural rejuvenating effects. It involves tightening the layer called superficial muscular aponeurotic system, which extends from the neck to the temple area.

 

The SMAS layer lies beneath the facial fat and skin and so tightening it means the deeper structure receives most of the tension, which in turn promotes good scarring as the skin receives very little of the “opposing” pull.

 

Meanwhile, older techniques (skin only lifts) can be problematic in terms of scar appearance and longevity. Because most of the tension is placed onto the skin, scar widening and overly tight appearance (done or fake look) are the usual results.

 

Furthermore, the skin is susceptible to the effects of gravity and continuous aging; hence, the celebrity plastic surgeon stays away from the procedure due to its unstable, usually short-lived results.

 

Dr. Smiley regularly posts educational videos on his Snapchat account to demonstrate the impressive results of SMAS facelift.

 

One patient was particularly impressed with her results that she allowed Dr. Smiley to showcase her outcome on social media.

 

smas facelift

 

The 60-year-old female patient had come to Dr. Smiley because of her sagging mid face, sunken lower lid, significant jowling, laugh lines (medically referred to as nasolabial folds), and neck bands. To address these problems, the celebrity surgeon performed SMAS facelift and neck lift.

 

He placed the incision “inside” the hairline (around the temple area), which extended behind the tragus (small bump in front of the ear) and then curved behind the ear for optimal scar concealment.

 

With SMAS facelift, Dr. Smiley was able to restore the softness over the cheekbone and reposition the sagging cheek fat pad, which in turn eliminated the laugh lines. Moreover, the technique allowed him to tighten the jawline and thus erase the appearance of jowling, and to improve the neck as well.

 

The SMAS facelift typically entails 3-3.5 hours of operative time and a social recovery (all the outward signs of surgery are gone) of two weeks. Nonetheless, all is worth it as it can erase up to 20 years off from one face, with the results expected to last 12-15 years.

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