Liposuction


The ideal neck liposuction incision placement will depend on the extent and location of excess fat. Nonetheless, all efforts are made to position the scar, usually 2-5 mm diameter, in concealed areas such as beneath the chin and behind the earlobes.

 

Renowned Inland Empire plastic surgeon Dr. Tarick Smiley regularly performs neck liposuction and other surgical enhancements whose aim is to create a more youthful, smoother transition between the neck, chin, and jaw line.

 

neck liposuction incision

Recently, he performed extensive neck liposuction on a female patient with a full-looking neck. Hence, instead of the usual single incision placed behind the chin (specifically at the natural skin fold for optimal scar concealment), he also created a pair of incisions behind the earlobe.

 

With three small incisions, Dr. Smiley says the excess fat can be accessed from different angles, leading to smoother and more natural results.

 

To further promote smooth results, he moved the microcannula (a blunt-tipped hollowed tube) back and forth in a fan-like motion and avoided staying too long in one area so as to prevent surface irregularity.

 

Extensive neck liposuction may involve as much as 300 cc of fat, while a minor correction may just remove as little as 20 cc. Contrary to popular belief, the success of liposuction boils down to how much fat remains after surgery, as opposed to how much the surgeon removes. After all, over-correction can lead to “cosmetic” disasters—e.g., surface irregularities, sagging appearance, and visible platysma muscle.

 

The platysma muscle along the neck may show through the skin if all the fats, which serve as a carpeting, are removed during surgery.

 

In general, neck liposuction, especially if it involves large amounts of fat, is only reserved for younger patients who typically have good skin shrinkage, whereas neck lift (excision-based) is more suitable for individuals with loose skin. Occasionally, they are combined in one surgery to achieve the most desired results.

 

After neck liposuction, Dr. Smiley says he recommends the use of chin strap (compression garment) for at least a week to help remodel the skin and to keep swelling at a minimum.

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Abdomen liposuction on female patients is quite different than that of men due to gender-based beauty ideals and anatomies, says leading Los Angeles plastic surgeon Dr. Tarick Smiley.

 

Men’s athletic abs have square-shaped ridges that are closely packed together, whereas in women’s there is often a pair of “soft” vertical indentations flanking the navel.

 

Also, women with athletic physique often have prominent anterior hipbone due to their low body fat percentage.

abdomen liposuction

Dr. Smiley performs pre-operative marking to ensure natural and symmetric contours.

Recently, Dr. Smiley has performed abdomen liposuction on a female patient who specifically requested for a more athletic physique. She also had a concurrent Brazilian buttock lift in which the unwanted fats were injected into her buttocks and hips.

 

Dr. Smiley performed pre-operative marking while the patient was in a standing position; this would allow him to deliver symmetric results, “highlight” certain features, and ultimately create a more athletic but nonetheless feminine physique.

 

During the pre-operative marking, Dr. Smiley explained to the patient their surgical plans: create a soft parallel indentation on each side of the abdomen through high-definition liposuction, and to make the anterior hipbone slightly visible.

 

Her liposuction also included the lower back, flanks, bra rolls, and upper arm. Because she asked for a simultaneous Brazilian buttock lift, multiple donor sites were necessary to collect sufficient volume of fat.

 

During the actual surgery, which has been shown on Dr. Smiley’s Snapchat, he used microcannula, a stainless steel tube with blunt tip dotted with several small holes to suction the unwanted fat.

 

Dr. Smiley moved the microcannula parallel to the skin in a fan-like, back and forth motion to remove fats uniformly, which is the key to ensure smooth skin and natural contours.

 

After collecting large volume of unwanted fat, Dr. Smiley purified it—i.e., he removed the anesthetic solution, red blood cells, oil, and other biomaterials—before injecting it into the patient’s hips and buttocks.

 

Aside from improving the patient’s waist-to-hip ratio, which is the hallmark of feminine physique, Dr. Smiley was also able to improve the indentations in the buttocks.

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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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Both Kybella injection and chin liposuction can improve the double chin appearance. These treatments remove the excess submental fat that lies below the chin, according to California Surgical Institute website.

 

While both treatments have the same goal, they have different mechanics. Consequently, doctors perform physical exam to identify the patient’s underlying anatomies, which determine the ideal approach.

 

Kybella vs Liposuction

 

Kybella is an FDA-approved injectable drug that is similar to a naturally occurring compound in the body that helps absorb fats. When injected into the tissue, it destroys the fat cell membrane; however, it requires meticulous injection (it should only be used by a licensed health care professional) because it can also inadvertently damage other types of cells, such as the skin, when used incorrectly.

 

Most patients will need at least 2-3 treatments performed not less than four weeks apart. Each session costs around $650 and when summed up the price is almost the same or sometimes even more than the average cost of chin liposuction.

 

Chin and neck liposuction results

 

Nonetheless, Kybella’s zero downtime is something that cannot be discounted, making it ideal for patients with underlying health problem that precludes them from having an elective surgery, and people with hectic schedule. Chin liposuction, meanwhile, involves 1-2 week recovery due to postop pain, swelling, and bruising.

 

(Note: Kybella may also result in minimal swelling, or sometimes even bruising, which can last a few days.)

 

But as with any non-surgical procedure, Kybella does not suit patients who need a lot of work. For people with large amount of fat that extends into the lateral side of their neck, liposuction provides the most predictable and impressive results.

 

Chin liposuction typically entails a small puncture hole right beneath the chin, specifically within the natural skin fold. However, patients with “heavy neck” may need two more incisions, each of them placed behind the earlobe for optimal scar concealment.

 

Chin liposuction also suits patients with loose skin and/or neck muscle; since it is already a surgical procedure doctors can easily combine neck lift and platsyma muscle repair.

 

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Liposculpture vs liposuction. Are they two different procedures?

 

While both terms are often used interchangeably by plastic surgeons, they have some subtle differences, says Orange County plastic surgery expert Dr. Tarick Smiley.

 

liposculpture vs liposuction

 

Liposuction strictly concerns itself with the removal of superficial fat that sits beneath the skin, while liposculpture also uses the same method although with the intent to sculpt the body and so it is sometimes referred to as high-definition liposuction.

 

A good example of liposculpture would be abdominal etching in which fats are removed in order to create grooves that resemble the “washboard abs.”

 

Recently, Dr. Smiley performed liposculpture on a female patient who was relatively thin prior to surgery and thus a standard liposuction—i.e., debulking the area of fat—may not be able to deliver the amount of definition she desired.

 

The patient specifically requested for an improved waist-to-hip ratio, which translates to having a narrow waist juxtaposing the curvy hips. Several studies have found a strong preference for a WHR near .70, which means that the waist circumference is 70 percent of the hips measurement.

 

While liposuction and liposculpture can narrow the waist, Dr. Smiley has warned that it is impossible to go past the muscle and bone; hence, the final results also depend on the patient’s underlying anatomies.

 

Since the goal was to narrow the waist and create smooth flanks, Dr. Smiley made multiple puncture holes to access the unwanted fats from different angles, which is one of the keys to achieve smooth results.

 

To further ensure smooth, natural-looking results, the celebrity plastic surgeon has emphasized the importance of “feathering technique” and moving the cannula (thin hollowed tube) in a fan-like and criss-cross fashion.

 

In liposculpture or liposuction, feathering means that the areas adjacent to the actual treatment site are “slightly” included to ensure a smooth transition. Preserving the natural contours of the body is one of the keys to high patient satisfaction.

 

To further ensure a more feminine physique, Dr. Smiley injected some of the fat volume into the hips.

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Fibrosis from liposuction happens because the body invariably creates scars in the areas where the cannula (or suction tube that removes fats) has passed through. This creates adhesion that results in surface irregularities and firmness, which tend to improve with time.

 

In a nutshell, most patients can expect smooth results as the scars remodel and soften with time, says leading Beverly Hills plastic surgeon Dr. Tarick Smiley.

 

fibrosis from liposuction

Dr. Smiley uses gentle liposuction techniques to minimize injury and internal scarring, which is tied to surface irregularities.

However, a small number of patients can have fibrosis that can last for many years (or even permanent) and thus they necessitate some type of revision. The flanks and upper abdomen are areas believed to be susceptible to this problem.

 

If excessive scars form internally under the skin surface and do not improve with time, subcision can help minimize skin puckering or firmness. This is a rather straightforward procedure in which a special needle is inserted adjacent to the scar and is moved back and forth in a fan-like motion to release the fibrous bands.

 

Nonetheless, there are ways to prevent aggressive formation of fibrosis, which is tied to contour irregularities and other surgical stigmata. For instance, Dr. Smiley highlights the importance of correct motion when using the liposuction cannula.

 

  • The cannula is moved back and forth in a criss-cross fashion to remove fats uniformly.
  • Avoid being too close to the skin. Meanwhile, the cannula must be moved at varying levels to achieve smooth results and to avoid dermal damage, which is tied to excessive scarring or fibrosis.
  • Use microcannula, as opposed to large cannula, because it removes smaller bits of fats and causes less amount of trauma.
  • Prolonged aspiration in one spot should be always avoided.

 

Aside from meticulous surgical techniques, the celebrity plastic surgeon says other modalities can further promote smooth results and prevent fibrosis from liposuction. These include the use of good-fitting compression garment for at least two weeks, massage to control swelling, VelaShape, or a combination of them.

 

VelaShape, which is an FDA approved non-surgical treatment, is particularly ideal after liposuction. This uses a handheld device that improves contour deformities through massage, suction, infrared light, and radio frequency.

 

Most patients will need 4-6 weekly VelaShape treatments to achieve smoother skin surface following liposuction surgery.

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