before plastic surgery

Tummy tuck pre op markings can play a significant role in the final result. Not only they indicate where the tummy tuck incisions and the resulting scar should lie, they also highlight any pre-existing asymmetry, the center of the torso, and the position of the navel.


In a recent Snapchat video post, leading Beverly Hills plastic surgeon Dr. Tarick Smiley says he always marks his patients in a standing position to allow the gravity reveal the “imperfections” and cosmetic issues that need to be addressed. After all, people generally look at themselves in the mirror upright.


tummy tuck pre op markings

Thank to meticulous tummy tuck pre op markings and detailed surgical techniques, the patient enjoys natural looking results and hidden tummy tuck scars.


Meanwhile, tummy tuck is done in a supine position, causing the loose skin and fat to shift. But with meticulous markings, doctors nonetheless will have ease identifying the tissue that needs to be removed and reshaped.


Should the patient require a simultaneous liposuction, the treatment areas are also marked. Dr. Smiley says he often uses it as a complementary procedure to sculpt the flanks, allowing him to further narrow the waistline, which is the hallmark of a pleasing feminine physique.


Most patients will need the standard tummy tuck technique in which the resulting scar goes from hip to hip and is positioned very low that most swimwear designs and panties can hide it with ease. However, massive weight loss patients may have to accept a longer scar that extends into their posterior flanks, allowing their surgeons to remove more loose skin and fat and to sculpt their sides.


Another incision around the navel, specifically inside its rim to hide the scar, is created during tummy tuck so the surgeon can remove the loose skin above. Then, the upper abdominal skin is brought down (like a Roman window shade) so the wound/scar settles beneath the “bikini line.”


Occasionally, the mons pubis is lifted as well to create a smooth, natural transition between the pubic region and abdomen.

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Honest discussion and good communications during tummy tuck consultation are the foundations of any successful result, which is generally defined as a postop appearance that satisfies both the patient and her surgeon.


Leading Los Angeles plastic surgeon Dr. Tarick Smiley has explained the topics typically involved during the initial tummy tuck consultation.


tummy tuck consultation

  • Cosmetic goals and expectations


The patient must be able to explain in detail her cosmetic goals, allowing her surgeon to recommend ancillary procedures (such as liposuction of the flanks for a narrower waistline), adjust the incision pattern, and use the appropriate surgical maneuvers.


While a good surgeon respects and acknowledges his patient’s input, he must be able to explain certain limitations and caveats such as the appearance of the hip-to-hip scar, downtime, and risks associated with any surgery.


Meanwhile, patients who have unrealistic goals and expectations or cannot accept the ramifications that come with surgery are poor candidates for tummy tuck or any type of body contouring procedure.


  • Patient’s individual health


The patient’s candidness and commitment will play a critical role to the success and safety of her surgery. She must fully disclose her drug use (including supplements and recreational drugs), medical history and condition, previous surgeries, and drug allergies to her surgeon and anesthesiologist.


  • Incision pattern and other surgical maneuvers


During tummy tuck consultation, doctors conduct physical exam to determine the extent of pannus (loose abdominal skin), condition of the rectus muscle, navel appearance, shape of the flanks, and even the pubis. Not many patients realize that they will also need a pubic lift so the area will not detract from the smoother results.


After the physical exam, the surgeons will explain to their patients the length, shape, and position of their tummy tuck scar; all efforts are made to ensure that it will lie very low that it is easily concealed by the underwear.


  • Patient safety


A good surgeon must not only inform his patients about the benefits of tummy tuck, but also the potential risks. Nonetheless, he must be able to allay their concerns by explaining his contingency plan should problems arise during surgery or afterwards; and the preparation and surgical methods to prevent or at least minimize risk of complications.


Furthermore, reputable tummy tuck surgeons only conduct their operations in an accredited surgical facility and are always accompanied by board-certified anesthesiologists and highly trained medical staff during the operation.


  • Surgeon’s qualifications


Prudent patients can utilize tummy tuck consultation to their advantage. They must ask their plastic surgeons about their qualifications particularly relating to their board certifications (the American Board of Plastic Surgery is the gold standard), education, experience, and training.


Patients can evaluate the “artistic skills” of their surgeons through the before-and-after photos of their actual work and must insist to talk with at least two previous patients.


When looking for tummy tuck surgeons, it doesn’t hurt to seek second or third opinion until the patient has found the doctor she finds to be the “right fit.”


  • Patient’s responsibility and commitment


During tummy tuck consultation, the surgeons explain to their patients that the success of their surgery also boils down to their commitment. For instance, most known healing problems can be minimized by avoiding tobacco products, aspirin and other drugs/supplements with blood thinning effects, and poor lifestyle/diet well in advance of the surgery.


Furthermore, the patients should be committed to their recovery. The general rule of thumb is to avoid rigorous activities, smoking, certain drugs and supplements, and unhealthy diet (particularly foods high in sodium as they can lead to persistent swelling).

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Male breast reduction preparation aims to ward off infection or any other types of complications, and to help patients achieve the best results possible, says leading Beverly Hills plastic surgeon Dr. Tarick Smiley.


Male breast reduction, or medically referred to as gynecomastia surgery, usually involves a small U-shaped incision at the lower border of the areola to remove the excess breast tissue, ultimately correcting the appearance of woman-like breasts. Occasionally, it is combined with liposuction.


male breast reduction preparation


Liposuction uses a few small puncture wounds where a flexible tube (cannula) is moved back and forth to remove the “unwanted” fat. These round incisions heal and fade into almost invisible scars.


Anytime the skin is cut open there is always a risk of infection and wound healing problems.   For this reason, Dr. Smiley requires all his patients to undergo lab screening to ensure that they are healthy enough for the surgery and can handle the ensuing recovery.


Should lab screening show any medical condition (anemia, bleeding disorder, hypertension, etc.) known to impede healing, Dr. Smiley says he will not proceed with the surgery unless it becomes well under control by diet, change in lifestyle, weight management, and/or medications.


Patients who pass their lab screening are then instructed to “prepare” for the surgery. Dr. Smiley recommends complete discontinuation of smoking and smoking cessation products, and aspirin and other drugs and supplements with blood thinning properties.


For clarity, Dr. Smiley provides his patients written instructions of things and activities they have to avoid two weeks before and after surgery.


But sometimes, male breast reduction preparation can take more than two weeks. For instance, patients who are markedly overweight are generally instructed to shed the extra pounds first before they undergo the knife. The idea is to allow the skin to snap back to the best of its ability, making it much easier to achieve a tighter, more masculine breast appearance.


Nonetheless, some patients who are slightly or even moderately overweight may proceed with the surgery provided that they are healthy and are happy with their weight or are not expecting to lose significant amount of body mass, says Dr. Smiley.

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One critical aspect of your tummy tuck preparation is being near your ideal weight. Hence, you should be committed to healthy eating and regular exercise, which can help you maintain a stable weight long term and thus preserve the surgery’s results.


Leading Beverly Hills plastic surgeon Dr. Tarick Smiley warns that large weight fluctuations that often happen when the patient lacks commitment to healthy living can affect, if not, reverse the results of tummy tuck.

tummy tuck preparation

Photo Credit: imagerymajestic at

However, the general rule of thumb is to avoid strenuous exercise—particularly involving your core—within a week of your surgery to prevent additional postop soreness and injuries. Also in the event that you sustain any type of injury, you may need to reschedule your surgery.


After surgery, most patients are advised to avoid strenuous exercise for 6-8 weeks, although it is a case-to-case basis and so you must only stick to your doctor’s recommendations.


Meanwhile, some people resort to exercise in an attempt to correct diastasis recti, a condition in which the membrane holding the pair of abdominal muscle splits apart due to pregnancy, large weight fluctuations, or over-straining.


The consensus is that a gap of more than two-finger spaces is considered diastasis recti, which contributes to the less than optimal shape of the waistline.


Contrary to popular belief, crunches and intense core abdominal exercise can even aggravate diastasis recti, a condition that is easily addressed during tummy tuck surgery.


Dr. Tarick Smiley corrects diastasis recti with the use of permanent sutures through an individual stitch technique (as opposed to a running or one continuous stitch) known for its extra strength.


The splayed abdominal muscle is tightened and sutured starting from the breastbone and down to the pubic area, says the celebrity plastic surgeon.


While incorporating muscle repair at the same time as tummy tuck does not actually “strengthen” it, at least it allows it to regain its normal function. Furthermore, some patients have reported finding relief from back pain, postural problems, and recurrent bloating and constipation after surgery.


The aforementioned symptoms occur when the abdominal organs are supported by weak muscle and fascia.

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Liposuction preparation aims to prevent complications and achieve optimal results from the surgery. While most patients already know about the importance of achieving their prime health and weight through superb diet and regular exercise, not everyone knows the importance of prepping up the skin.


It is important to note that skin quality, along with the surgeon’s skills and experience, will play a crucial role in the final results. First and foremost, the skin must shrink-wrap smoothly around the new contour to achieve a tight, natural-looking appearance.


liposuction preparation

Experts at the California Surgical Institute have provided a list of ways to prepare the skin before liposuction surgery.


  • Stop smoking


Apart from increasing the risk of poor healing and skin necrosis, smoking causes skin dryness and premature aging and thus may preclude the patient from achieving optimal results from liposuction.


While the general rule of thumb is to discontinue smoking for three weeks before surgery and about a week afterward to reduce the risk of healing problems, complete cessation remains the best route to prevent premature aging of the skin.


  • Avoid or at least cut back on alcohol


Alcohol causes dry skin (thus it appears ashy) and may aggravate postop bruises. A good rule of thumb is to avoid or cut back on alcohol three weeks before surgery.


  • Avoid Tanning


Tanning booths, sunbathing, and even self-tanning products must be avoided for a minimum of three weeks before surgery. The goal is to help the skin achieve its healthiest and least sensitive state.


  • Avoid skin irritants


Patients undergoing facial liposuction are generally instructed to avoid facials, skin peeling, steaming masks, and other similar treatments for at least three weeks before surgery.

  • Purchase “recovery” supplies weeks or days ahead of the surgery


Aside from dressing and compression garments, “recovery” supplies should also include sunscreen, protective clothing (with special fibers that offer SPF protection), and scar creams and silicone sheets.


  • Ensure that the skin is in its optimal health


A prudent patient should immediately notify her surgeon’s office if she develops any skin infection or pustules, or if she develops any type of illness within a week prior to her surgery.

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A circumferential body lift, also known as lower body lift, removes the redundant skin and fat around the frontal abdomen, hips, and back, resulting in a belt-shaped scar that is generally concealed by the patient’s underwear, says leading Beverly Hills plastic surgeon Dr. Tarick Smiley.


Circumferential body lift is almost always performed after massive weight loss and basically combines three major surgeries, namely, tummy tuck, outer thigh lift, and buttock lift. For this reason, it is only reserved for healthy patients with no healing problems.


circumferential body lift


While most patients having some type of body lift already know the basic preparations—e.g., 8-10 hour fasting prior to the operation, eating healthy, reaching the ideal weight, avoiding tobacco products and drugs with blood thinning properties (aspirin and ibuprofen)—they may not be aware of some seemingly trivial details explained below.


  • Donate blood


Due to the invasive nature of circumferential body lift, the amount of bleeding might be an issue. For this reason, some patients may need blood transfusion during surgery; however, in the ideal scenario they can donate blood at least four weeks ahead of time and have it stored in case they need it.


  • Some natural remedies can affect healing


Some natural remedies and herbal supplements not just affect healing or increase bleeding, but may also may interact with anesthesia and painkillers. Furthermore, their effects are still widely unknown and so a good rule of thumb is to avoid them altogether at least 2-3 weeks before surgery and about a week afterward.


  • Caregivers are life-savers


In the first few weeks postop, the patient should only focus on her recovery. Everything else—e.g., childcare, house chores, and office work—are put on the sidelines.


A good rule of thumb is to line up two or more caregivers, who can help the patient get around during recovery.


  • Have loose clothing


Loose soft clothes (button down shirt and loose-fitting pants) that are easy to put on and take off are important during recovery especially when the patient is made to wear compression garments and surgical drains.


  • Ask for the surgeon’s shopping list


Most surgeons will provide a shopping list that typically includes painkillers, compression garments, scar creams, and even healthy snacks and drinks to help their patients plan their recovery well ahead of their surgery.

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