The appearance of brachioplasty scar is perceived to be a major concern of patients with sagging skin in their upper arm caused by significant weight loss. Nonetheless, most feel that the “tradeoff” of having scars is worth it, particularly when the main goal is to have more slender arms that look proportionate to the body.
Leading Inland Empire plastic surgeon Dr. Tarick Smiley has recently posted a Snapchat video to demonstrate the appearance of brachioplasty scar resulting from the “standard” technique.
The female patient shown in the video has “flabby” upper arms due to large amounts of redundant skin that extended down to her elbow. For this reason, she required an incision pattern technique that extended from the armpit down to her elbow.
Dr. Smiley was able to remove a large wedge-shaped excess skin along the inner arm between the biceps and triceps. The brachioplasty scar from this technique is hidden as people usually hold their arms by their sides.
While placing the brachioplasty scar on the inner aspect of the arms is perceived to be the most ideal technique, sometimes having it more posteriorly (i.e., back of the arm and thus more visible) may provide a better contour. Nonetheless, the patient may have to ponder on the ramifications of each scar technique/placement.
A scar placed more posteriorly is also perceived to heal and fade better because of the reduced tension. The inner aspect placement, meanwhile, is believed to be slightly more susceptible to wound separations due to the natural tension in the area.
However, Dr. Smiley remains partial to the inner aspect scar placement because there are many ways to reduce tension on the wound and thus ultimately promote “better” scars. For this reason, he encourages his patients to take a proactive approach in scar treatments that typically include the use of compression garments, silicone gel and/or sheets, and sunscreen.
Dr. Smiley advocates the use of scar gels and other treatments containing silicone, which hydrates the skin and helps the scar fade better and remain thin and flat. (Note: Wound is known to heal better in a moist environment; hence, the mucosal skin of the mouth has almost zero risk of scarring. The same “line of thought” can be applied to keeping plastic surgery scars unobtrusive with the use of silicone gel and sheets.)
The Brazilian butt lift results can be more impressive when the hips, which in essence are the lateral aspect of the buttocks, are included as well. For this reason, leading Beverly Hills plastic surgeon Dr. Tarick Smiley almost always includes the area to create a nice curvature.
Improving the hips contour at the same time will also give an illusion of a rounder, fuller backside, says the celebrity surgeon. As a result, he allocates about a third of the donor fats collected through liposuction to the hip area, while the remaining is injected into the actual buttocks.
In his recent Snapchat video post, he has shown a female patient with noticeable side indentations and flat hips that further worsened the appearance of her flat buttocks.
The female patient required liposuction of the lower back and flanks not just to remove the appearance of “fat rolls” but also to “curve out a more feminine silhouette” in which the hips and buttock profile are further “emphasized.”
In the video, the celebrity plastic surgeon is seen filling out the lateral depressions along the hips to create a smoother transition between them and the buttocks. Also by improving the hip contour, the butt’s posterior view is further enhanced.
Aside from liposuction of the lower back and flanks, Dr. Smiley also collected donor fats from the “bra rolls” for a more holistic improvement of the feminine curvature.
To achieve high survival rate of fat grafts, Dr. Smiley uses centrifuge to separate and remove biomaterials (e.g., blood) and “broken” fat cells so that only the purest and healthiest fats are transferred to the buttocks.
Structural fat grafting injection further ensures high survival rate and smooth results. This technique involves “micro-injection” of fat (less than 0.1 cc) to gradually build up new soft tissue and ensure blood vessel ingrowth.
Without blood vessel ingrowth, the fats will simply die and become absorbed by the surrounding tissue.
Aside from meticulous handling of fat, Dr. Smiley says the survival rate will also depend on patient cooperation. A good rule of thumb is to avoid direct sitting (i.e., the patient should make every effort to sit on her posterior thigh with the use of boppy pillow or U-shaped cushion) for at least three weeks.
And during sleep, the patient must assume a fetal position in which she must lean more toward her stomach to prevent inadvertent shifting of fats along her hips.
Liposuction tips for smoother, more natural results as explained by leading Beverly Hills plastic surgeon Dr. Tarick Smiley (as seen on his Snapchat videos).
Instead of using large cannulas or hollowed flexible tubes when removing the “unwanted” fat, Dr. Smiley prefers microcannulas whose outside diameter is significantly smaller (2.5 mm or even less).
While the use of microcannulas makes the process of fat extraction longer, they make up for the high degree of precision. For this reason, they can significant minimize the risk of dents and other untoward side effects of over liposuction.
Dr. Smiley highlights the importance of leaving enough fats beneath the skin to deliver smooth and natural results from liposuction.
- Moving the microcannula at correct speed
After posting several videos demonstrating how he delivers smooth results from liposuction, many viewers asked the celebrity plastic surgeon why he “moves his cannula in a rather quick manner.”
In his recent Snapchat video post, he explained the importance of moving the cannula from one area to another in a fairly swift method to avoid removing too much fat.
“When the cannula stays too long in one area, it may remove way too much fat that the skin would collapse much like a Swiss cheese,” he said.
- Liposuction may actually entail simultaneous fat transfer
Dr. Smiley had corrected indentations from a previous botched liposuction performed by another surgeon. The female patient had visible dents in the abdomen caused by removing too much fat to the point that her skin “collapsed.”
He corrected these skin irregularities with microcannula, which he moved back and forth parallel to the skin and in a rather quick manner. And instead of throwing away all the collected fats, he re-injected some of them into the indentations to smooth them out.
- The success all boils down to correct patient selection
One of the most critical liposuction tips, he said, is to choose the “ideal” candidates—i.e., they are of normal, stable weight; they understand the importance of healthy lifestyle as a long-term approach to maintain the cosmetic results; they have no serious medical condition; and their skin has a good level of elasticity or “shrinkage.”
How much skin removed during tummy tuck? Arguably, this is one of the most common concerns of patients with apron-like abdominal skin resulting from previous pregnancy or massive weight loss.
The truth is, the real issue is not how much skin removed during tummy tuck, but how much tissue is left behind that will allow for a safe wound closure.
Leaving sufficient tissue after surgery also preserves the natural contours and valleys of the abdomen and promotes favorable scarring—i.e., it appears thin and faded.
Most tummy tucks result in a hip-to-hip scar that is positioned immediately above the pubic hairline and thus easily covered by the patient’s underwear or bathing suit. Despite the media hype purporting the benefits of modified techniques (i.e., a much shorter horizontal scar), their contouring effects are rather limited.
Simply put, mini tummy tucks are only reserved for a very small subset of patients because the redundant skin following massive weight loss or pregnancy generally affects the entire abdomen, sometimes even the flanks.
It is important to note that mini tummy tucks can only remove a very small amount of loose skin in the lower abdomen, thus any “bulging” in the upper and lateral aspect remains after surgery, warns leading Beverly Hills plastic surgeon Dr. Tarick Smiley.
After removing all the loose skin, the remaining tissue is then pulled down and sutured to the pubic hairline. Dr. Smiley says that precision during skin removal surgery is the key to preserve a smooth transition between the lower abdomen and the mons.
Over-resection of the tissue, he warns, can lead to surgical stigmata such as abrupt transition between the lower abdomen and the pubic hairline, scar migration (riding higher that the underwear no longer hides it), and unnatural contour.
To further achieve a smoother contour, some patients will need a simultaneous liposuction (fat removal), but only if they require minimal “correction.” This ancillary procedure is only reserved for patients with excess fat in their upper abdomen and flanks.
It is important to note that the standard tummy tuck automatically removes the excess fat in the lower abdomen as it trims away the loose skin in the area.
However, large volume liposuction is best performed separately to avoid compromising the blood supply in skin and thus preventing wound healing problems.
The best facelift surgeon for you is not just determined by his experience, clinical skills, and training. Good rapport and great bedside manner would also play a critical role in achieving the best results possible, according to California Surgical Institute website.
Here is a guideline that could help you find the best facelift surgeon:
Contrary to popular belief, state medical board certification does not automatically make someone qualified to perform facelift and other forms of plastic surgery. Take note that there is no law that prohibits a surgeon who has no specific training in “surgical enhancement” procedure to perform facelift. Nevertheless, non-specialists account for the vast majority of botched results.
A good rule of thumb is to choose a facelift surgeon who is a member of the American Board of Plastic Surgery, which is known for its extra strict requirements, background checks, and rigorous oral and written exam taken every 10 years.
To further ensure that you’re in good hands, your surgeon must be performing facelift and its ancillary procedures—e.g., facial fat grafting, dermal fillers, eyelid surgery, facial implants, and brow lift—on a regular basis. Bear in mind that plastic surgery is a very broad practice.
Ideally, your surgeon must be performing over a hundred facelift surgeries (and its ancillary procedures) every year.
- Deep understanding of beauty ideals and natural results
The key to a good facelift result is subtlety; hence, skilled surgeons know the importance of using highly customized techniques to avoid overly tight skin, abrupt transition between the lower lid and cheek, and other surgical stigmata.
Your surgeon’s before-and-after facelift photos will shed light on his personal style and “aesthetic values.”
- Patient safety guidelines
The best facelift surgeon for you should prioritize your safety above anything else. For this reason he only performs surgeries in accredited operating rooms staffed by licensed and well-trained medical professionals and are fully equipped with emergency/key life support system.
Extensive physical exam, preparation prior to surgery (e.g., avoiding tobacco products and aspirin at least three weeks before facelift) and regular follow-up care would also play a critical role in patient safety.
Your surgeon’s attitude towards his patient will have a large effect on how satisfied each visit would be and even the final results. For these reasons you must find someone who respects and acknowledges your input.
Otoplasty long term results are possible with the right surgical techniques. In this procedure, the surgeon corrects the appearance of ears that stick out too much from the face.
Otoplasty is sometimes referred to as ear pinning surgery as it reduces its “sticking out” appearance. But the truth is, the procedure is highly technical and must be customized based on the patient’s underlying anatomies.
Dr. Tarick Smiley, a celebrity Beverly Hills plastic surgeon, has recently posted a Snapchat video to demonstrate how to achieve long-term and natural-looking results from otoplasty.
In the video, the surgeon placed an incision behind the ear, specifically within the natural fold of skin for optimal scar concealment. This would allow him to remove the excess cartilage that was causing the conchal or bowl of the ear to stick out significantly from the side of the face.
After removing the excess cartilage, he pinned the ear closer to the face with the use of sutures.
One of the most common mistakes of inexperienced surgeons, Dr. Smiley says, is that they stitch the ears closer to the face without removing the excess cartilage. The problem with this technique, he further explains, is that the cartilaginous framework has a “strong memory,” hence the results are usually temporary.
The male patient shown in the video had his ears not just significantly sticking out from his face; there was also visible asymmetry as the right ear protruded more than the other.
To create a more symmetric result, Dr. Smiley removed a larger piece of cartilage in the right ear.
To further produce a more symmetric appearance, the surgeon ensured that the lower aspect of the ear (i.e., earlobe) would protrude 1 ½ cm while the upper aspect would jut 1 cm from the face. Using a measuring stick, he also made sure that both the right and left ears would almost have the same projection.
Dr. Smiley says that the goal of otoplasty is to pin it closer to the head; it does not change the actual size of the ear bowl.