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.
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.
Liposuction for bra fat, which is the unsightly bulges that show through tight clothing, poses a unique challenge. First and foremost, the fat is highly fibrous and thus difficult to remove with a hollowed tube attached to a vacuum pump (cannula).
Leading Beverly Hills plastic surgeon Dr. Tarick Smiley has recently posted a series of Snapchat videos to demonstrate liposuction for bra fat and the “meticulous” techniques required to help achieve smooth, natural-looking results from the surgery.
Before-and-After Photos of a Patient Who Have Had Liposuction for Bra Fat
“I use smaller cannula, or microcannula, when treating the bra fat and back rolls caused by fibrous fat, which is tough to remove and so it requires more effort,” he said.
It is important to note that certain anatomic areas are consistently more fibrous compared to the rest of the body; they include the back, male breasts, and around the navel.
“The use of microcannula makes it easier to penetrate the fibrous fat, as compared with the use of large cannula. Furthermore, its smaller body allows for more precision during the extraction of fat, leading to smoother contour and lower risk of surface irregularities,” Dr. Smiley added.
In the video, Dr. Smiley is seen pushing the microcannula back and forth with his right hand, while his left hand “feels” the treated area.
“Contrary to popular belief, liposuction is not mainly about seeing what you’re doing. A skilled surgeon will know how much fat he needs to remove by simply feeling the treated area while moving the cannula back and forth. With over 9,000 liposuctions I have already performed, the process has become a second nature to me,” he further explained.
The celebrity plastic surgeon said liposuction for bra fat has almost become a common “complementary procedure” of Brazilian butt lift in which the patient’s buttocks and hips are augmented and reshaped with the most natural material: her own fat.
Instead of discarding the fat collected during liposuction, it is processed and transferred to the buttocks.
By performing liposuction for bra fat, the back will not detract from the curvier, more feminine buttocks and hips, said Dr. Smiley.
To know more about liposuction and its ancillary procedures, interested parties may want to add Dr. Smiley on Snapchat. He regularly posts videos to spread patient safety awareness.
Brazilian buttock lift is basically liposuction with fat transfer to the buttocks. Instead of discarding the “unwanted” fats, these are injected into the patient’s backside and hips to achieve a more feminine figure.
Leading Beverly Hills plastic surgeon Dr. Tarick Smiley says a good result should present high symmetry between the left and right side, not just of the buttock, but also of the entire torso of the patient when viewed from the back.
After and before photos of a patient who have had Brazilian buttock lift. Hers was a special case due to her scoliosis.
In one of his recent Snapchat videos, Dr. Smiley has presented a rather special case of Brazilian buttock lift.
The female patient has scoliosis that her torso slightly “curves” to the right. Hence, her fat rolls and skin fold along this side were more prominent compared to the left side of her back.
In the video, Dr. Tarick Smiley said he almost always treats the lower back and flanks as donor/liposuction sites because of the areas propensity to accumulate “unwanted” fats that can show through tight clothing.
However, performing liposuction on the lower back and flanks of the patient with scoliosis could “highlight” the asymmetry between the left and right side of her torso unless “appropriate adjustments are made” during surgery, he explained.
To achieve a more symmetric result, Dr. Smiley removed more fat volume from the right side of the torso than its left side.
“It is important for any surgeon performing Brazilian buttock lift to have an eye for detail. Essentially, this is a combination of science and art,” he said.
After removing sufficient fat volume from the donor sites, Dr. Smiley purified it with the use of a centrifuge, a device that separates biomaterials based on their weight.
For instance, the lightest material is the oil, which floats above the fluid after centrifugation; this is discarded to achieve a high survival rate of fat graft (at least 70 percent).
Then, Dr. Smiley injected the purified fat into the patient’s backside, allocating about a third of the volume to reshape the hips and the remaining amount was used to improve the buttock’s shape and projection.
Moreover, Dr. Smiley smoothed out the visible indentations on the buttocks with meticulous fat injection techniques.
BBL surgery results should appear smooth—i.e., the skin surface must show uniformity and there should be a smooth transition between the buttocks and the “adjacent areas” such as the posterior thigh, hips, flanks, and lower back.
BBL, which is an acronym for Brazilian buttock lift, is basically a combination of two procedures: liposuction and fat transfer/injection.
Liposuction is the process of removing the “unwanted” fat, which is then re-used to augment and reshape the buttocks and hips to achieve a more feminine figure.
Fat injection, meanwhile, is the process in which the buttocks and hips are reshaped in a way that they look natural and proportionate to the patient’s underlying anatomy. The final results should also reflect the individual’s cosmetic goals and expectations, which she must be able to describe in details during the preoperative consultation.
Inland Empire plastic surgery expert Dr. Tarick Smiley, who performs over a hundred BBL surgeries every year, says that fat transfer is a meticulous process. Instead of dumping the fats all out once, the use of microdroplet injection technique is critical to achieve smooth results and high survival rate of fat grafts.
Any amount that survives after a few months of fat injection is expected to last a lifetime, he says in one of his recent Snapchat videos.
Dr. Smiley warns that incorrect fat injection and over-filling the buttocks can lead to a gamut of aesthetic-related problems such as cellulites, dents, and sagging appearance.
Cellulites and other skin surface irregularities are generally caused by “disturbing” the fascia system, which resembles a cluster of threads connecting the muscle into the skin.
When too much fat volume has been injected into the buttocks, the extra weight causes the fascia to weaken and the butt cheek to sag. This “problem” can be further aggravated by aging and large weight fluctuations.
To avoid skin irregularities and sagging appearance, Dr. Smiley says he never injects “fat volume that goes beyond the capacity of the patient’s fascia system and other relevant anatomies.”
“The key to achieve natural, proportionate BBL surgery results is to respect and acknowledge the anatomical limits. This core principle has also helped me avoid most known complications,” he says.
To further avoid “unnecessary weight” that could make the buttocks susceptible to sagging, Dr. Smiley says he avoids or at least minimizes fat injection into the lower aspect of the butt cheek, focusing more on the upper half portion and the lateral side (hips) instead.
Liposuction blood loss is often minimal thanks to the introduction of tumescent technique. This involves injecting tumescent fluids, which contain epinephrine that constricts the blood vessels during surgery and prolongs the numbing effects of lidocaine (i.e., local anesthesia).
However, some patients bleed more than others due to some underlying medical condition. Also, large volume liposuction—i.e., removing more than 4 liters of fluids in one day—is also linked to increased bleeding and possibly longer recovery.
Reducing liposuction blood loss is the first and most crucial step to make the surgery safer, says leading Los Angeles plastic surgeon Dr. Tarick Smiley who has performed over 9,000 liposuctions.
He explains how me reduces the amount of bleeding with the techniques shown below:
He requires all his patients to pass a rigorous set of physical exam to ensure that they can handle the surgery. Furthermore, any medical condition that could lead to increased bleeding and poor healing such as anemia is treated ahead of the operation.
Moreover, Dr. Smiley’s board-certified anesthesiologist requires his patients to pass another lab screening.
Once the patients have passed the lab screening, they are instructed to discontinue all blood thinning medications and supplements (aspirin, ibuprofen, fish oil, ginko biloba, etc.) 1-2 weeks before surgery to reduce bleeding and postop bruising.
Furthermore, the patients are required to discontinue smoking and smoking cessation products a few weeks prior to surgery. It is also helpful when they avoid or at least cut back on caffeine and alcohol.
- Tumescent liposuction technique
Dr. Smiley always injects the fatty area with tumescent solution, which contains epinephrine to constrict the blood vessels and ultimately minimize the amount of bleeding.
Despite all efforts, small capillaries are slightly injured during surgery and thus bleeding still occurs, although oftentimes this is just minimal.
Some patients require large volume liposuction to achieve their desired results. However, it comes with one caveat: more bleeding.
To prevent significant liposuction blood loss, Dr. Smiley uses Cell Saver, a piece of equipment that can filter out and collect the red blood cells that have been removed during surgery. These cells are then re-infused into the patients as if no blood loss has occurred.
- Never rush one’s recovery
All patients are instructed to avoid over-exertion for at least three weeks after surgery to prevent postop bleeding and persistent bruising and swelling.
Preventing buttock augmentation risks should be the main objective of any prudent surgeon, said leading Beverly Hills plastic surgery expert Dr. Tarick Smiley on his recent Snapchat post.
To demonstrate a poorly done buttock augmentation surgery, Dr. Smiley has posted photos of singer Nikki Minaj clad in a scanty two-piece bikini.
Dr. Smiley said the star’s backside clearly shows buttock implants that are too big for her underlying anatomy, particularly relating to her soft tissue coverage, skin elasticity, and body frame.
The hugely disproportionate buttock implants, he said, are clearly visible beneath the skin that they have also caused the tissue to become thin and over stretched, inevitably causing her “derriere” to droop, a complication medically referred to as ptosis.
Whether buttock augmentation surgery is performed through butt implants or fat transfer, Dr. Smiley said the patient’s anatomy, particularly the “elasticity and resiliency of the skin,” must always be respected to achieve natural-looking results and to avoid most known complications.
“The loss or weakness of the fascia system, which holds the skin and the overall shape of the buttocks, can cause ptosis,” he further explained.
“We should not overdo it. The weight of the implants or the amount of fat injected into the buttocks must always respect the anatomy lest the results will look terrible,” he warned.
To further minimize buttock augmentation risks, Dr. Smiley said he now prefers butt augmentation via fat transfer (or Brazilian buttock lift in layman’s term) to the use of implants, which he only reserves for a very small percentage of patients.
Brazilian buttock lift uses the most natural material—i.e., the patient’s own fat—to reshape and augment not just her backside, but her hips as well, leading to a more proportionate, feminine figure.
Despite the perceived benefits of Brazilian buttock lift, Dr. Smiley said it remains important to avoid over-filling the backside since too much weight can cause ptosis, which can happen right after surgery or years down the road.
To further prevent ptosis, Dr. Smiley said most of the fat volume should go to the hips and the upper half aspect of the buttocks (as opposed to its lower aspect). This fat volume “allocation” results in a heart-shaped backside, especially when the unwanted fats from the lower back and flanks are removed as well.
Liposuction is the surgical technique that allows the surgeon to harvest the “unwanted” fats from two or more donor sites; the fats are then purified and re-injected into the patient’s buttocks, said Dr. Smiley.