Liposuction scar generally fades into negligible “marks” after 6-12 months, although patient commitment to recovery remains critical to achieve the best results possible. For instance, sun exposure must be avoided for at least six months since UV rays can cause hyperpigmentation in which the scars turn dark.
Leading Beverly Hills plastic surgeon Dr. Tarick Smiley shares his scar management tips that will further ensure that your liposuction scar will blend well into the background.
The after photo on the right shows no visible scar, which contributes to high patient satisfaction.
* Minimize tension on the skin. When there is no or very minimal tension on the scar, it tends to heal nicely. Hence, the use of surgical tape and/or Steri-strips can be helpful as they eliminate the stress and “pulling” that can delay healing or cause the scar to widen.
* Achieve your optimal health well in advance of the surgery. When you’re healthy, there is less risk of infection, which can affect the appearance of your scars. Simply put, liposuction or any other body contouring surgeries will require commitment to superb diet and healthy lifestyle.
* Eliminate risk factors of infection. Each doctor has his own specific wound care instructions, although there are generally agreed upon guidelines such as never submerging your incision in water for at least three weeks; not using any topical product unless with the approval of your surgeon; and avoiding smoking.
* Treat infection immediately. In the hands of a board-certified plastic surgeon, infection is extremely rare because of the use of tumescent fluids injected into the fatty area prior to extraction. But should it occur, it must be treated immediately to prevent complications and poor scarring. Common signs of infection include asymmetric swelling, fever, chills, and drainage of pus.
* Use of topical treatments containing silicone. Once the incisions are completely sealed, which happens around three weeks postop, patients may choose to apply topical products such as silicone sheets and creams known for their hydrating effects. Scars that heal in a moist environment usually heal better and fade quicker.
* Use sun protection for one year. While staying out of the sun is the best way to reduce risk of hyperpigmentation, this is generally difficult or even impossible to accomplish. Hence, the use of sunscreen, protective clothing, and makeup products that offer SPF protection remains valuable.
Extended tummy tuck surgery with PAL liposuction is generally reserved for patients who have lost a significant amount of weight, leaving them with large pannus or apron-like skin along their abdominal area. Pannus not just causes unsightly rolls beneath one’s clothing, but it also results in skin breakdown, non-healing irritation, and foul odor due to the trapped sweat and moisture.
Compared to the standard technique in which the resulting scar goes from hip to hip, the extended tummy tuck uses an incision pattern that goes a bit longer and so the scar may be visible along the flanks (or lower back).
Leading Beverly Hills plastic surgeon Dr. Tarick Smiley says the length of tummy tuck incision must cover the “entire rolls of skin and excess tissue” to achieve a smooth and natural contour. Attempting to use a shorter scar technique despite the extensiveness of the redundant skin, meanwhile, will inevitably result in poor outcome due to the residual rolls.
In Dr. Smiley’s previous Snapchat post, he showed one patient who had extended tummy tuck and PAL liposuction as its ancillary procedure. The idea is to further contour the flanks and achieve a more feminine silhouette.
PAL, which is an acronym for power-assisted liposuction, uses a cannula (straw-like device) that has a vibrating tip that makes fat extraction more precise and quicker, thus leading to shorter operation, improved safety, and less surgical trauma.
He first performed PAL liposuction along the lateral aspect of the torso before placing a flank-to-flank incision. The idea was to remove the unwanted fats, allowing the skin to “shrink down” before removing the pannus through an extended tummy tuck technique.
Liposuction uses tiny round incisions about the size of a grain of rice. The goal is to remove the excess superficial fat beneath the skin. It is important to note that it cannot suction out the obesity-related visceral fat (it is positioned deep within the abdominal organ and cavity) that only responds to real weight loss.
After liposuction, Dr. Smiley proceeded to tummy tuck to remove the pannus and then performed muscle repair in which the idea was to tighten the pair of vertical muscle by suturing them in the midline, further contributing to the cinching effect on the waistline.
Before closing the tummy tuck incision (ensuring that the scar would lie very low that it is hidden beneath the patient’s underwear), Dr. Smiley injected Exparel, a drug that can numb the surgical site for up to four days.
Mommy makeover surgery is any combination of body contouring surgeries performed simultaneously to improve the post-pregnancy body of patients. Common combination procedures include tummy tuck with liposuction of flanks, tummy tuck with some type of breast enhancement, and breast lift with implants.
The results of body contouring surgeries are near permanent, provided that the patient manages her weight through regular exercise and superb diet. It is important to note that fad diets and pills almost always don’t work long term and so weight management should be a lifelong commitment, says leading Beverly Hills plastic surgeon Dr. Tarick Smiley.
After muscle repair, precise skin removal, and liposuction along the flanks, this patient is ecstatic with the results.
To shed light on the issue, Dr. Smiley has recently posted several mommy makeover surgery pictures on his Snapchat.
One patient received tummy tuck to remove the redundant skin between her mid and lower abdomen. To further achieve a flatter contour, the underlying muscle between the sternum and below the navel was tightened with the use of internal permanent sutures known for their additional strength (compared with absorbable sutures).
To further achieve a more feminine silhouette—i.e., cinching effect on her waistline—she also received liposuction along her flanks. Dr. Smiley started off the surgery with this procedure so he could tighten and pull more skin during tummy tuck.
When looked closely, the “after” photo (taken six months postop) reveals some muscle definition, which contributes to the more athletic but still feminine appearance of the abdomen. Furthermore, the new navel looks smaller and more proportionate compared with the “before” photos.
Tummy tuck and breast lift give this patient a more feminine and more youthful physique.
The second sample of mommy makeover surgery pictures shows a patient who had tummy tuck and breast lift performed simultaneously. Due to her underlying anatomy—there is a great distance between the lowest rib and hip—Dr. Smiley was able to significantly “reshape the sides” or flanks, leading to the hourglass appearance of her body.
And as seen from the “after” photos, tummy tuck has given her a flatter tummy, a significant improvement from her previous barrel-shaped torso.
To further complement the cinching effect of tummy tuck, she also had a breast lift in which her actual breast tissue, not just the skin alone, was elevated and reshaped with the use of internal sutures. Aside from the perkier appearance, Dr. Smiley has also created better cleavage and additional upper pole fullness of the breast.
When doctors mention 360 degree liposuction, they generally refer to a fat reduction surgery that encompasses the entire waistline—i.e., the four quadrants of the abdomen, flanks, and lower back. The idea is to create a cinching effect that is one of the most coveted features of a feminine physique.
When combined with Brazilian butt lift, the contouring effects of 360 degree liposuction are further enhanced. Instead of discarding the “unwanted” fat, doctors “recycle” them in order to enhance the patient’s backside with the most natural material.
Basically, Brazilian butt lift is buttock augmentation via fat injection. With this technique, patients can avoid the risks they would carry if synthetic implants were used instead.
Leading Beverly Hills plastic surgeon Dr. Tarick Smiley has recently posted a series of snapchat videos and images on Snapchat to demonstrate a patient who have had Brazilian butt lift right after her 360 degree liposuction.
Due to the fibrous fat commonly found along the flanks, around the navel area, and back, Dr. Smiley has used the power-assisted liposuction (PAL) technique.
“PAL cannula [straw-like device attached to a vacuum pump] has a vibrating tip, making it ideal for treating tough areas,” he said in one of the Snapchat videos.
(Note: When doctors use the term fibrous or “tough” fat, they refer to fatty areas with more connective tissue that a thick cannula cannot easily penetrate through. Hence, these areas are best treated by a thin PAL cannula.)
The tiny vibrations released by PAL cannula makes fat extraction gentler and more precise, which in turn results in less surgical trauma and bleeding, and minimal postop swelling and bruising. Thus, the recovery is also perceived to be quicker compared to other liposuction techniques.
After collecting adequate amounts of fat, Dr. Smiley placed them in tubes and allowed the red blood cells to settle to the bottom, thanks to gravity. These were discarded so he could only use the purest “golden” fat, and ultimately promote high survival rate of grafts—about 70 percent or even higher.
It will take about three weeks for the fat grafts to re-establish their blood supply and the extracellular matrix holding them together to achieve its full strength, allowing the grafts to endure the pressure from sitting, squatting, and stretching.
Tummy tuck and BBL (acronym for Brazilian buttock lift, which is essentially buttock augmentation via fat transfer) can be performed under one surgical setting, provided that the patient is physically fit and is committed to healthy lifestyle.
It is important to note that healthy lifestyle, particularly relating to weight management, is the most important factor to maintain the results of tummy tuck and BBL or any other types of body contouring plastic surgery.
Leading Los Angeles plastic surgeon Dr. Tarick Smiley has recently posted a series of videos to illustrate one patient who have had tummy tuck and BBL performed together.
Dr. Smiley first required the patient to undergo a comprehensive lab screening to ensure that she could handle the extent of surgery and its ensuing recovery. To further guarantee her safety, her operation was performed at an accredited surgical facility under the supervision of board-certified anesthesiologist and licensed/highly trained medical staff.
The celebrity plastic surgeon started off the “combo surgery” with liposuction in which the goal was to collect adequate amounts of fat from the bra rolls, flanks, and lower back. Then, the fat was purified—all the red blood cells and oil were discarded—before it was injected into the buttocks.
Basically, BBL is a reversed liposuction. Instead of discarding the fat, it is later utilized to improve the shape and projection of the patient’s backside with the use of the most natural material.
After BBL, Dr. Smiley and his staff moved the patient into supine position to begin the tummy tuck operation.
The patient required the standard or hip-to-hip incision tummy tuck technique, which allowed Dr. Smiley to remove most of her stretch marks (including those above her navel), repair the loose abdominal muscle, correct the herniation above her belly button, and give a cinching effect on her waist.
Despite the length of her tummy tuck incision, it is expected to fade into a thin, barely detectable line after 1-2 year. Moreover, the scar is positioned very low that her underwear or bikini bottom can easily conceal it.
While multiple-surgeries procedure typically entails a “tougher recovery,” it offers benefits such as lower cost and one-time healing period. Nonetheless, Dr. Smiley only reserves this for patients who have achieved their optimal health prior to surgery.
Several studies have been conducted to evaluate long-term liposuction results. In this procedure, the unwanted fats—specifically the subcutaneous fat found beneath the skin—are suctioned out with the use of a flexible tube called cannula.
Some studies have suggested grim findings: After about a year all the benefits of liposuction were gone.
Nevertheless, several studies have also shown that good old-fashioned exercise can preserve liposuction results and prevent patients from regaining fats elsewhere in their body (i.e., areas not treated by the surgery). Of course, physical activities must always be complemented by superb diet, which is an equally critical aspect of long-term weight management.
To shed light on the long-term results of liposuction, a team of Brazilian researchers conducted a study in which 36 healthy but inactive women aged between 20 and 35 had undergone the surgery.
These non-obese participants had 2.5-3 lbs. of abdominal fat removed through liposuction. Afterwards, they were divided into two groups: half were asked to stick to their old habits, while the other half were required to follow a moderate exercise routine.
By six months after liposuction, the first group had regained all the fats previously removed by surgery. And not only that, they developed additional visceral fat—or fat deposition in organs such as the liver and intestines—and thus predisposed them to increased risk of insulin resistance (diabetes), inflammation, and a wide range of health problems.
The uptick in the percentage of visceral fat was notable—about 10 percent more compared to their pre-surgery level.
However, the participants who were asked to perform moderate exercise for four months did not regain fat and even achieve additional health benefits. (Note: The exercise regimen was “doable”—an hour of cardio and weight lifting three times a week.)
Furthermore, the women included in the “exercise group” have improved insulin sensitivity and physical fitness.
The researchers have concluded that exercise can prevent the body from [over] compensating for the abrupt change in the fat composition and distribution caused by liposuction. It is believed that the body has a strong predisposition to defend its fat stores, and a sedentary lifestyle can aggravate this propensity.
Meanwhile, separate studies have suggested that a sedentary/poor lifestyle after liposuction may cause the patients to regain fats in other parts of their body not treated by liposuction, which of course could lead to a disproportionate appearance.
The liposuctioned areas, meanwhile, were less likely to regain fat unless in the event of significant weight gain (i.e., more than 20 lbs.)
With these findings, Dr. Tarick Smiley, a board-certified plastic surgeon who has performed over 9,000 liposuctions, says the long-term success of surgery will always boil down to patient’s commitment to healthy lifestyle.