Breast implant consultation varies from patient to patient, although it usually lasts between 30 minutes and two hours. Others require more than one preoperative visit before they are completely comfortable going under the knife and have all their questions/concerns answered.
Dr. Tarick Smiley, a renowned Los Angeles plastic surgeon who performs cosmetic and reconstructive breast surgeries, gives his tips on how to make the most of your preoperative consultation.
After doing your own research by watching and reading contents from reputable sources, Dr. Smiley says the next step is to jot down the questions that will help you assess your surgeon’s qualifications, the most ideal breast implant size and design, and all the ramifications that come with the surgery.
You should bring this list of questions during your preoperative consultation so you would not overlook issues that are important to you, says Dr. Smiley.
Aside from the list of questions, Dr. Smiley says you should also bring the following during your consultation:
- A list of your complete medical history. This should include your previous surgeries, medical conditions, and drug allergies.
- You may bring along your spouse, friend, or family member. They may ask questions on your behalf that you may have overlooked.
- A list of medications you take. Remember that this should include not just prescription drugs but also over-the-counter medications, herbal supplements, and vitamins and minerals.
- Bring your “wish pics.” While these could help you explain your cosmetic goals more clearly, remember that the final results will still largely depend on your underlying anatomy.
- You may bring different types of clothing. Todays’ surgeons typically offer breast implant sizers that are worn inside an unpadded bra, allowing their patients to visualize the most likely results of their surgery.
Take note that you should not feel rushed during your consultation. In fact, you may meet with your surgeon as many times as you want should you still have lingering concerns.
Face and neck lift with fat transfer can provide a holistic facial rejuvenation effect by correcting not just the sagging skin and deeper soft tissue, but also the volume/fat loss that comes with aging.
Leading Inland Empire plastic surgery expert Dr. Tarick Smiley has recently posted a series of videos on Snapchat to demonstrate face and neck lift with fat transfer performed in a female patient with advanced signs of facing aging.
Dr. Smiley has described the patient’s facial aesthetic issues, which all required a customized approach to achieve the most rejuvenating effects without causing surgical stigmata such as flatness of the cheek, visible scars, and overly pulled countenance.
- drooping of the cheek
- loss of volume in the cheek, particularly the area between the mouth corner and the nostril
- recessed and sagging chin that almost disappeared from the neck
- appearance of jowl
- “heavy” neck due to excess skin
To improve the aforementioned aesthetic issues, Dr. Smiley used an incision pattern starting from the forehead area (behind the hairline) that went behind the tragus (small bump in front of the ear) and behind the earlobe and into the hairline at the nape; hence, all the scars would be hidden.
Afterwards, the celebrity plastic surgeon separated the skin from the SMAS, a layer of soft tissue that extends from the neck to the temple area. The SMAS and the platysma muscle of the neck move as a single unit, said Dr. Smiley in a recent Snapchat video.
“When doing the lifting, we have to do the deep lift, as a skin-alone lift is not enough to support the new elevated contour, Dr. Smiley further explained.
A deep lift also provides more natural results as the skin receives no or very little tension during wound closure, thus eliminating the risk of windswept appearance, overly flat cheeks, and other telltale signs of facelift, said Dr. Smiley.
Elevating the deeper layers of the soft tissue created immediate rejuvenating effects to the patient—i.e., her jawline appeared more defined, the upper cheek regained its “youthful plumpness”, and the angle or transition between the chin and neck was smoother.
To further improve the neck contour, Dr. Smiley created a small incision beneath the chin to access and tighten the platysma muscle towards the middle and side, thus creating a “sling effect on both directions.”
Because face and neck lift alone does not address facial volume loss, the patient also received fat transfer to the cheek, particularly the area between the nostril and mouth corner. The adjunct procedure was also used to create a smoother transition between the lower lid and the upper cheek.
Buccal fat extraction aims to slim a markedly rotund face by reducing the cheek fat pad. However, the buccal fat in the cheek region should not be entirely removed because years down the road an overly aggressive approach can lead to a very gaunt countenance.
Leading Beverly Hills plastic surgeon Dr. Tarick Smiley has recently posted a series of videos on Snapchat to demonstrate this procedure performed in a female patient with a markedly plump face due to her chubby cheeks and “heavy” neck.” Hence, she was also deemed as a good candidate for neck liposuction.
Prior to surgery, Dr. Smiley examines the facial anatomy of the patient whose face is markedly full due to her chubby cheeks and heavy neck.
Dr. Smiley first performed neck liposuction with a creation of a small round incision beneath the chin, specifically within the skin fold for optimal scar concealment.
The surgeon performed neck liposuction with microcannula, a hollowed steel probe used to remove the fat. However, he made sure to leave behind a layer of fat to conceal the platysma muscle; going the conservative route also made sense to anticipate the progression of age-induced facial volume loss.
After suctioning the excess fat in the neck area, Dr. Smiley proceeded to buccal fat extraction with the creation of a small intra-oral incision on each side of the cheek. No external incision was used and so the risk of visible scar was eliminated completely.
Dr. Smiley said the intra-oral incisions should avoid the submandibular duct and the salivary glands to prevent excessive swelling and other complications.
The patient receives buccal fat extraction and neck liposuction for a more balanced result.
During the creation of incisions, the celebrity plastic surgeon used a cautery device, which also sealed off the blood vessels and tissues, resulting in minimal bleeding and ultimately shorter recovery.
Instead of removing the entire buccal fat pad, he just reduced its size in order to slim the face without making it look too gaunt and unhealthy. As stated earlier, conservative removal has always remained safe and “predictable.”
While the results of buccal fat extraction with neck liposuction are often immediate, the final outcome takes 1-3 months as the residual swelling takes a while to subside.
Patients with aging countenance face this common dilemma: What works better, Botox or facelift?
One should realize that facial aging is a multifaceted process. The skin sags and thus creates jowling, the cheek fat pads deflate leading to a gaunt look, the face experiences soft tissue atrophy or shrinkage that results in the appearance skeletonized eye socket and concave temple, and the wrinkles become more prominent, says renowned Los Angeles plastic surgeon Dr. Tarick Smiley.
Dr. Smiley says that Botox and facelift work differently in erasing or at least minimizing the signs of facial aging. Botox paralyzes the muscles responsible for the appearance of dynamic wrinkles, while facelift surgery elevates the skin, fat, and soft tissue all as a single unit.
Occasionally, Botox is used to paralyze the muscle that is pulling down the brow, allowing the one responsible for elevating it to work more efficiently.
Botox, whose effects typically last 3-4 months, appeals to male patients who generally dislike going under the knife and the ensuing recovery. This approach also suits people who cannot afford the prolonged downtime of surgery.
However, Botox cannot improve a markedly sagging skin, which entails facelift. Also, this non-surgical treatment cannot reposition the drooping cheek fat pad nor improve the soft tissue deflation that comes with aging.
Facelift is generally the ideal choice for patients with more advanced signs of facial aging. Nonetheless, Dr. Smiley says that individuals as young as 45 can be a good candidate, particularly if they are seeking for subtle improvements and want their surgery to be “discreet.”
Postponing facelift until one has full-blown facing aging can lead to discernable and drastic changes that refuting surgery would be impossible. Hence, some “younger patients” resort to mini facelift and then undergo minor touch-ups down the road to maintain their youthful appearance in a more discreet manner.
Today’s facelift is commonly performed with fat grafting or injection, a critical component in holistic facial plastic surgery. This complementary procedure prevents surgical stigmata such as gaunt cheeks, abrupt lower lid-cheek transition, and overall pulled appearance.
Hence, facelift with fat injection is dubbed as 3D facelift surgery because it not just corrects soft tissue descent (i.e., skin sagging) but also loss of facial volume.
Selfies and social media are driving the popularity of lip augmentation, as people nowadays see their online photos regularly and might feel the pressure to always look good, says leading Beverly Hills plastic surgeon Dr. Tarick Smiley.
In 2015 alone, about 27,450 lip implant surgeries were performed in the US. On top of that, lip fillers accounted for a large percentage of the 9.2 million facial injection procedures, according to data released by the American Society of Plastic Surgeons.
This patient receives lip augmentation via Restylane, an FDA-approved filler commonly used to correct facial volume loss.
Dr. Smiley says that the vast majority of patients today desire for a more natural look, which can be achieved when there is a profound understanding of what constitutes an ideal “pout,” which of course is determined by gender factors and the pre-existing facial features.
And despite varying views on the ideal lips, Dr. Smiley says that recent studies have shown that most people found attractive “pouts” had their the lower lip about two times bigger than the upper lip. Also, female lips that took up about 10 percent of the lower third of the face scored higher in terms of attractiveness.
While most lip augmentation patients are women, there has been a significant increase in the number of men seeking some type of lip enhancement procedure. This new trend has a ramification—i.e., surgeons should understand the subtle but key differences between attractive female lips and male lips.
For instance, lip augmentation involving men should not create a well-defined “Cupid’s bow” shape; however, a slightly prominent bottom lip sulcus (dip) is perceived to be attractive. Also, a one-to-one lip corners ratio is desired to prevent feminine-looking lips.
Another “beauty” parameter, according to a recent study conducted by German researchers, is that female lips have a lower ratio between the lower vermillion height (lower lip) and the chin-nose distance than attractive male lips. This means that attractive female faces have a bigger “pout” in relation to the lower third of their face compared to men.
While several studies have pointed out that lips play a crucial role in the perceived facial attractiveness, Dr. Smiley says that other features also have their influence, adding that the “attractive faces are greater than the sum of their parts.”