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.
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.
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.
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.
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 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.
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.
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.
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.
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.
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.
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.
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.
Over the past several years there has been a hype over mommy makeover surgery, which is a combination of two or more procedures that improve the post-pregnancy body of women. However, a new trend is now emerging, which some surgeons dubbed as grandma makeover surgery.
According to a survey released by the American Society of Plastic Surgeons, patients aged 55 years and older accounted for 23 percent of the total cosmetic plastic surgeries performed in 2016. This means that last year alone, more than 387,000 procedures were performed in seniors, a 4 percent increase from 2015.
Eyelid lift, facelift, and forehead lift, all off which are facial rejuvenation procedures, were the most commonly performed surgeries on seniors. Nonetheless, body contouring surgeries such as tummy tuck, breast lift, and liposuction were also popular, according to the survey.
Contrary to popular belief, the patient’s chronological age does not increase the risk of postoperative complications, says leading Los Angeles plastic surgeon Dr. Tarick Smiley. However, he warns that patients over the age of 65 are more likely to suffer from certain conditions as compared to younger people.
In an attempt to ensure patient safety during grandma makeover surgery, Dr. Smiley highlights the importance of conducting lab screening and consultation to determine any risk factors, many of which can be eliminated or at least controlled through lifestyle changes and medications.
In general, the right candidates for grandma makeover, says Dr. Smiley, are healthy seniors who have realistic goals and expectations.
Another common safety protocol is to limit the operative time to four hours. A team of researchers at UT Southwestern Medical Center in Dallas, Texas, has suggested that after 4.5 hours of surgery the risk of complication could triple.
And after about seven hours, the risk of complications following a surgery increased 4.7 times.
Aside from the operative time, other independent risk factors include smoking and use of blood-thinners (aspirin and non-steroidal anti-inflammatory drugs) well in advance of the surgery. Hence, it has become a common practice among plastic surgeons to require their patients to avoid them 2-3 weeks before and after their operation.
Despite some of the challenges in grandma makeover surgery, a study involving patients who have had some type of facial plastic surgery has suggested that seniors scored significantly higher in satisfaction rate compared to younger people. The researchers attributed this result to the older patients’ more realistic goals and expectations.