Plastic Surgery Blogs

Large volume liposuction is almost a prerequisite for patients having a Brazilian buttock lift in which the basic principle is to collect and transfer unwanted fats to improve body proportions. Scientists and artists alike suggest that a waist-to-hip ratio of 0.70, or at least near this volume distribution, is the most ideal feminine physique.


Having a 0.70 WHR means that the waist circumference is 70 percent o the hips measurement.


large volume liposuction before and after photos

The “after” photo shows the results of Brazilian buttock lift preceded by large volume liposuction.


Recently, leading Beverly Hills plastic surgeon Dr. Tarick Smiley has shown large volume liposuction before and after photos on his Snapchat account. Fat transfer to the buttocks and hips was immediately performed thereafter.


The patient shown in the photos had liposuction to her abdomen, flanks, lower back, “bra rolls,” and axilla (around the armpit).


In regard to cosmetic goals, African-American patients tend to ask for curvier results and so they typically require large volume liposuction. Caucasians, meanwhile, often prefer subtler improvements—i.e., they are focused more on improving the shape of their buttocks, with minimal to moderate amount of augmentation.


Despite strong predilection to certain beauty goals due to cultural influence, Dr. Smiley says it remains imperative to identify the specific goals of patients through an honest and comprehensive consultation with them.


“It is inimical to assume that everyone has a standardized beauty ideals. Hence, I always ask my patients about their specific goals. After all, elective surgeries are here to elicit a smile from them, says Dr. Smiley on his previous Snapchat post.


As seen in the recent videos, Dr. Smiley injected tumescent fluids into the fatty area to help expand the fat cells, paving way for their gentler and more precise extraction. The solution also contains epinephrine, a drug known to reduce bleeding by up to 90 percent compared to the dry technique.


Dry liposuction is an antiquated technique in which no wetting solution is infiltrated into the fatty area.


Meanwhile, epinephrine works by constricting the blood vessels, which in turn provides another auspicious consequence: It prolongs the numbing effects of local anesthesia, thus allowing the patients to avoid or at least take less pain relief in the first few days post-op.


Thanks to large volume liposuction, Dr. Smiley was able to inject more than 1,000 cc of purified fat into each butt cheek to meet the patient’s desire for additional augmentation. Furthermore, he injected about one-third of the fat volume into the hips, which is basically the outer-lateral aspect of the buttocks, to deliver a more feminine physique.

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Hip augmentation fat transfer aims to improve the waist-to-hip ratio; this is particularly true if the donor or liposuction sites include the waistline (e.g., abdomen, flanks, and lower back).


Studies have found a strong preference for a WHR near 0.70, which interestingly does not rely on dress size. For instance, full-bodied celebrities like Beyoncé and Marilyn Monroe and lithesome beauties such as Keira Knightly and Jessica Alba all conform to this beauty hallmark that almost always transcends culture and milieu.


hip augmentation fat transfer


Leading Inland Empire plastic surgeon Dr. Tarick Smiley has recently performed hip augmentation fat transfer on a female patient with narrow hips although her buttock profile was relatively good.


The patient had a previous liposuction performed by a different surgeon, which made it more challenging to collect sufficient donor fats. To compensate for this, Dr. Smiley treated more surface areas that included the flanks, bra rolls, lower back, and anterior abdomen.


He used power-assisted liposuction technique, meaning the cannula (steel tube) has a vibrating tip that made fat collection gentler, quicker, and more precise.


Afterwards, he purified the fats in order to remove the dead fat cells, red blood cells, anesthetic solution, oil, and other biomaterials and impurities. This was primarily done with a centrifuge, which separated materials based on weight.


With centrifugation, Dr. Smiley was able to collect the healthiest fat cells along with stem cells, which can increase the survival rate of fat grafts and improve skin texture and appearance thanks to their “healing properties.”


The celebrity plastic surgeon created a small puncture hole on each side of the outer-lateral buttock (i.e., hips) to make the area appear curvier. The vibrating cannula was again used to inject fat grafts through a microdroplet technique—i.e., they are compartmentalized, with minute spaces between them in order to promote blood vessel ingrowth.


To further promote high survival rate and near permanent results, Dr. Smiley inoculated the fat grafts into varying layers.


Meanwhile, the patient was instructed to avoid pressure on the fat grafts for at least three weeks to further promote high survival rate and to ensure highly symmetric results.

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A chiseled jawline complemented by a defined chin is almost a prerequisite for a strong and attractive male face, says prominent Los Angeles plastic surgeon Dr. Tarick Smiley.


Meanwhile, the appearance of weak chin that threatens to disappear from the neck, or the tapered jaw that resembles a Disney princess’ might obliterate the masculinity of the face.


male facial plastic surgery

Superman actor Henry Cavill is known for his strikingly handsome chiseled face.

Of course, the double chin appearance and jowling also prevent men from achieving a more chiseled appearance, which is generally defined as having prominent features and angular face.


These are some of the options used in male facial plastic surgery to achieve a chiseled jawline and a distinguished chin.


  • Kybella injection


This FDA-approved fat melting drug is made of a synthetic form of salt found in the gallbladder, an organ which helps digest food. Kybella, meanwhile, is created to digest excess fat behind the chin.


Kybella typically requires 2-3 treatments before it can eliminate the double chin appearance.


  • Chin and neck liposuction


Chin and neck liposuction is reserved for patients who need the most amount of correction—i.e., their chin fat extends to the neck or their unwanted fat is 300 cc or more.


This surgery typically involves a small round incision placed behind the chin, precisely at the skin fold for optimal scar concealment.


  • Radiesse for a more defined jawline


Radiesse injection uses a calcium compound that can augment the bone structure. When injected into the jawline, focusing more on the area below the ear, it can create a more angular and chiseled visage, which is generally perceived to be attractive in men.


Occasionally, Radiesse is also injected into the chin to bring it forward, further complementing the appearance of an angular jaw.


  • Chin and jaw implants


Chin implants are primarily designed to improve the chin profile (or forward projection) instead of giving additional vertical height. Jaw implants, meanwhile, correct the tapered jaw that can feminize the face.


Some patients require both chin and jaw implants to achieve proportionate results.


It should be noted that some male patients who receive rhinoplasty (nose job) can benefit from a simultaneous chin augmentation. After all, studies have suggested that the nose and chin have a large effect on facial proportion and perceived attractiveness.

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In his posh Beverly Hills plastic surgery clinic, renowned surgeon Dr. Tarick Smiley has noticed a new trend: Plastic surgery for seniors is becoming more popular than ever thanks to older people living longer and staying healthier.


Dr. Smiley has also mentioned that cultural and economic shifts—i.e., more seniors working past their retirement age and are being more active in dating and social activities than their predecessors—may also contribute to the growing number of plastic surgery patients aged 55 years and older.


plastic surgery for seniors

This is the standard incision technique used in facelift.

In recent years, both surgical and non-surgical facial rejuvenation procedures have grown. Seniors who are not ready for facelift and other invasive methods can opt for Botox, dermal fillers, Ultherapy, and chemical peels, which have lower risk of complications and entail no or very little social downtime.


According to data released by the American Society of Plastic Surgeons, last year patients aged 55 years and older accounted for about 23 percent of all cosmetic surgeries, with facelift, eyelid lift, and forehead lift included on the top five list of the most commonly performed procedures for this age group.


More than 387,000 cosmetic surgeries and about 3.7 million non-surgical treatments, the vast majority of which were intended to reduce facial aging, were performed on patients aged 55 years and older in 2016.


Among non-surgical treatments, Botox injection and dermal filler were remarkably popular, with about 1.6 million and 902,000 procedures performed, respectively.


Experts believe the trend will continue in the next coming years due to the aging Baby Boomers and the growing acceptance of elective procedures. Looming job insecurities among seniors further boost such trend.


Contrary to popular belief, Dr. Smiley says the vast majority of older patients do not want to look like someone who can be passed for 20 or 30 years old.


“Most patients want to look more rejuvenated, not significantly younger. After all, the appearance of drooping brows, jowling, and deep facial wrinkles can make someone appear perennially angry or sad. Fortunately, a meticulously performed facelift can address such facial discord,” says the celebrity plastic surgeon.


One caveat of plastic surgery for seniors is that increasing age is often linked to certain medical conditions. Hence, Dr. Smiley says lab screening, blood work, and stress test are almost mandatory prior to surgery to make it reasonably safe.


Nonetheless, he says that chronological age is not the main issue during patient selection but rather the individual’s health.


“I’ve seen some people in their sixties who are much healthier than someone half their age because they adhere to good lifestyle,” he says.

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BBL surgery, also referred to as Brazilian butt lift or butt augmentation via fat injection, is a two-step body contouring surgery. Doctors first perform liposuction on multiple donor sites (e.g., lower back, flanks, bra rolls, and tummy) to collect large volume of fat, which is then processed and injected into the patient’s buttocks and hips.


While bruising is a normal part of recovery, leading Beverly Hills plastic surgeon Dr. Tarick Smiley says that all efforts are made to minimize this postop symptom to promote high survival rate of fat grafts.


bbl surgery

Dr. Smiley recommends the use of compression garments for at least eight weeks. The idea is to control the swelling in the liposuction sites and to help remodel the tissue in the recipient site or buttocks.


Postop bruising happens when blood from ruptured capillaries or small blood vessels leaks out under the skin, resulting in a red or purplish mark that turns into green or yellow discoloration as the patient moves forward to her recovery.


In a recent Snapchat video, Dr. Smiley says that too much bruising causes “excessive pressure and tension, which is not good for the fat grafts.”


One way to control the amount of postop bruising and swelling, Dr. Smiley says, is to use gentle and correct fat injection technique; this also ensures high survival rate and smooth, natural contours of the buttocks and hips.


“It is important to inject fats in multiple layers of the muscle and subcutaneous tissue, and in a way that separate containers are being created. This technique results in less bruising and allows the buttocks to take more fats. About 70 percent is expected to survive long term, provided that fat injection is done in a highly meticulous manner,” Dr. Smiley says.


Aside from meticulous fat injection, the celebrity plastic surgeon highlights the importance of using medical grade compression garments, which are typically worn for eight weeks. The idea, he says, is to keep the swelling and bruising to a minimum, and ultimately to promote healing and smooth results.


The garments worn around the buttocks are designed to provide minimal compression, as too much pressure may “kill the fats” and lead to less than optimal results; however, the garments for the liposuction sites are usually tauter to control swelling and to prevent edema (fluid formation) beneath the skin.


While compression garments can aid in healing, Dr. Smiley says that most patients can see the final results about six months after surgery, as it takes a while for the skin to fully shrink-wrap to the new contour and the residual swelling from the tumescent fluids to subside completely.

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The success of Brazilian buttock lift surgery largely depends on how meticulous the surgeon is during physical exam and consultation. The goal is to identify the patient’s pre-existing anatomy and ascertain her aesthetic needs, says leading Beverly Hills plastic surgeon Dr. Tarick Smiley.


In Dr. Smiley’s recent Snapchat video post, he demonstrated a patient with noticeable asymmetry between her left and right hips, poorly projecting buttocks, and excess fat along her flanks and lower back that further “concealed” her derriere.


brazilian buttock lift surgery

Prior to surgery the left hip appears flatter compared with the right hip. Furthermore, the patient has pre-existing surface irregularities, which must be addressed at the same time as the surgery.


Dr. Smiley says it is critical to identify any pre-existing asymmetry prior to surgery to customize the procedure and achieve the most balanced results possible. For instance, the patient’s left hip was significantly flatter in comparison to the right side. Furthermore, her oblique and profile view showed that the buttocks were almost at the same level as the lower back.


before bbl

Prior to surgery, the patient’s buttocks are flat that they are about the same level as the lower back.

During physical exam, Dr. Smiley also assessed the patient’s skin quality, particularly its elasticity and shrinkage, an anatomical aspect that would help him determine how much fat volume the buttocks could carry without resulting in sagging appearance or other surgical stigmata.


The pre-existing skin elasticity would also determine how much fat volume that could be harvested from the donor sites without predisposing the patient from surface irregularities and other telltale signs of liposuction.


“The skin of the liposuction or donor sites should be able to retract or shrink nicely. This is possible when the surgeon is able to assess the patient’s skin shrinkage,” says Dr. Smiley.


For the vast majority of patients, Dr. Smiley says the lower back and flanks “carry a large amount of excess fat, which makes them a great donor site,” adding that contouring them creates a more feminine “S” curve and a smoother transition between the back and upper buttocks.


Aside from the lower back and flanks, the celebrity plastic surgeon also collected fat from the patient’s “bra rolls” and tummy, areas that often carry excess fatty tissue as well.


Dr. Smiley allocated about one-third of the fat volume into the outer-lateral side of the buttocks, since the patient requested for curvier hips, while the rest was injected to improve the buttock’s profile.

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