Plastic Surgery Blogs

Plastic surgery safety should be the utmost priority of any plastic surgeon, says Dr. Tarick Smiley who is the medical director of the California Surgical Institute.


Dr. Smiley has recently posted a series of Snapchat videos in an attempt to explain the importance of having one’s surgery at an accredited surgical facility, which is also referred to as ambulatory facility or same day surgery center.


“Plastic surgery is not just about doing the operation. Because we prioritize patient safety one of our most critical tasks is overseeing the facility centers. Currently, we have four accredited surgical facilities; they have been accredited for over 10 years. This means that they meet the strictest safety standard required by health regulators,” he said in the Snapchat video.


“Even the air ventilation system is designed to reduce risk of contamination and infection,” he added.


The list below explains the specific benefits of having one’s surgery at an accredited surgical facility:


  • It is fully equipped with medical apparatus and medications should a complication arise.
  • The staff members are certified in Advanced Cardiac Life Support.
  • Should the patient require an overnight stay, she will receive round-the-clock care by licensed medical staff.
  • The staff receives regular training to ensure patient safety.
  • The staff knows the emergency plan that is implemented should any complication arise that requires transferring patients to a hospital.


Dr. Smiley prides himself for being fastidious in terms of patient safety and comfort that all the blankets, covers, and even the fluids used by patients are “warmed” in a special storage, which he has shown in his Snapchat posts.


To further promote plastic surgery safety, Dr. Smiley said he regularly uses sequential compression device, which resembles a pair of leggings worn during surgery. It works by “massaging” the lower limb to promote good blood circulation, which in turn reduces the risk of deep vein thrombosis or blood clots.


Dr. Smiley’s accredited surgical facilities also contain state-of-the-art equipment to promote patient safety. For instance, Cell Saver processes the bodily fluids collected during liposuction and then filters out the red blood cells, which are re-infused into the patient.


With the use of Cell Saver, no or very little blood loss occurs after liposuction. Hence, patients can expect a shorter and more convenient recovery—i.e., no significant lethargy and nausea, which usually follows after large volume liposuction.

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Body contouring plastic surgery is a broad term used to describe any techniques employed by surgeons to improve areas of the body that have redundant skin and sagging appearance, which commonly occur after massive weight loss and pregnancy. Meanwhile, the aging process can also contribute to tissue laxity.


Body contouring after massive weight loss almost always entails skin removal. Good examples include arm lift, tummy tuck, lower body lift, and thigh lift. The vast majority of MWL female patients also warrant some type of breast enhancement—e.g., breast reduction and/or breast lift.


body contouring plastic surgery

Tummy tuck is arguably the most powerful tool in body contouring for MWL patients, according to the Inland Empire Plastic Surgery Institute. It removes the excess skin and fat between the navel and the pubic “hairline,” before redraping the skin in the upper abdomen to close the hip-to-hip incision.


All efforts are made to place the hip-to-hip scar very low so it remains concealed by the patient’s underwear. But for massive weight loss patients, the scar might be extended to their flanks or even around their entire torso, a technique referred to as lower body lift or circumferential lift.


A lower body lift basically combines tummy tuck, outer thigh lift, and buttock lift.


Meanwhile, body contouring plastic surgery also encompasses procedures to reverse the effects of pregnancy. Common examples include tummy tuck, breast augmentation, breast lift, and abdominal liposuction, which can help patients regain their pre-pregnancy body.


Whether liposuction is performed in MWL patients or individuals who have always managed a healthy weight but nonetheless have “stubborn” fat, skin elasticity—how much shrinkage it can allow—will determine the ideal amount of removed fat. Furthermore, it is important to preserve a thin layer of fat beneath the skin to avoid surface irregularities.


Implants are also used in body contouring plastic surgery. Their main objective is to increase volume of the “target” area, which could be the female breast, male chest, calf, and bicep.


Male patients who seek body implant surgery typically want to emphasize bulk; hence, a good number of them are body-builders. (Note: Some men do not have the muscle type that allows them to develop their calf, chest, or bicep muscle with weight lifting and other rigorous exercise routine, making them good candidates for implants.)


Women, meanwhile, generally seek body implants to improve their proportions. As a result they typically seek breast and buttock implants—two synthetic prostheses that can deliver a more feminine silhouette.

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What do plastic surgery scars look like? This is arguably the most pressing concern of patients who want to go under the knife to improve their body or face, or to address medical conditions such as the redundant skin after massive weight loss that is causing non-healing irritation and poor hygiene.


Leading Upland plastic surgery expert Dr. Tarick Smiley explains the most important issues involving surgical scars.


what do plastic surgery scars look like

* All efforts are made to place the plastic surgery scars within the natural skin fold or at least beneath the “bikini area.” For instance, breast augmentation incisions are placed inside the armpit, parallel to the breast crease, or at the areola’s junction.


In body lift after weight loss, the incisions are best positioned within the groin (inner thigh lift), close to the pubic line and hidden by the patient’s underwear (tummy tuck), or along the bra strap (back lift) for optimal scar concealment.


* Judicious surgical incisions and wound closure. Dr. Smiley will make every effort to place the incision parallel to the “most relaxed” skin tension or placing them in joint creases (e.g., armpit) to reduce the risk of scar contracture.


To further promote good scarring, he often uses irregular incisions such as the Z-shaped technique. For instance, when making a brow lift incision along the front of the hairline, he utilizes the serrated incision to eliminate tension and encourage normal healing and fading of the scar.


* Fair skinned patients are at an advantage in terms of scar appearance. About a year or two, their scars can fade into a color that closely resembles their skin. Ethnic patients, meanwhile, typically require a more proactive approach to promote favorable scarring because of their perceived susceptibility to hyperpigmentation (scars darkening permanently) and keloids.


* The use of a proactive scar treatment can lead to better results. The use of silicone sheets and scar creams can help the scar heal and fade better. However, scar treatments must only be used once the wound is completely healed—i.e., the scabs have fallen off by themselves—which happens around 2-3 weeks.


* Sun protection. What do plastic surgery scars look like may largely depend on the quality of wound care. A good rule of thumb is to avoid UV rays (by using sunscreen and protective clothing) for at least six months because they could trigger the skin to produce copious amounts of melanin, leading to the permanent darkening of scar.

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The amount of bruising after facelift surgery varies from patient to patient due to a gamut of factors affecting the recovery time, e.g., individual health and nutritional habits, surgical techniques, use of adjunct procedures (such as fat grafting), and quality of postop care.


However, most patients will look social presentable, i.e., no outward signs of surgery such as noticeable swelling and bruising, about two weeks postop.


bruising after facelift surgery

Minimizing bruising after facelift surgery requires advance planning. In general, products with blood thinning properties (aspirin, ibuprofen, anticoagulants, alcohol, some type of antidepressants, and certain herbal supplements and remedies) must be avoided or at least reduced at least two weeks prior to surgery and during the initial healing stage.


Also, the use of tobacco products must be discontinued for at least three weeks to prevent extensive bruising and poor healing.


After surgery, it is important to further avoid products with blood thinning properties for 1-2 weeks or until most of the bruising has subsided.


The quality of postop care will also determine the amount of bruising, and ultimately the recovery time.


Celebrity Beverly Hills plastic surgeon Dr. Tarick Smiley has shared some tips that can reduce the amount of bruises after facelift surgery.


* Head elevation for a few days postop. While propping up one’s head with some pillows will suffice, some people swear by the additional comfort and “stability” provided by bed wedge pillows.


* In the first 48 hours the use of cold compress can reduce the amount of bruising, which could shorten one’s social recovery.


* Taking things slow. A good rule of thumb is to avoid over-straining, heavy lifting, bending from the waist, and strenuous activities for at least three weeks. Nonetheless, it is important to walk and move around throughout the day (instead of taking prolonged bed rest) to control swelling and reduce the risk of blood clots.


* Herbal remedies. While not every facelift surgeon recommends the use of bromelain and arnica montana, proponents suggest that taking them a few days before and after surgery can reduce bruising and swelling to some extent.


* Superb diet. A good rule of thumb is to increase protein intake (it should account for 15-25 percent of the total calorie intake. Meanwhile, avoid processed carbs and foods high in refined sugar and salt because they can suppress the immune function and contribute to lethargy, swelling, and weight gain.


A diet high in sodium is particularly detrimental to one’s recovery as it triggers the body to hold on to more water, resulting in more swelling, which usually accompanies bruising.

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Thigh lift recovery tips primarily aim to keep swelling to a minimum and minimize the risk of wound separation, according to California Surgical Institute website.


The first and most critical step to minimize risk of wound healing problems and other complications following thigh lift is to conduct strict patient selection. First and foremost, the surgery is only reserved for near normal weight, healthy individuals whose cosmetic goals can be achieved by surgery. This “core principle” applies to any elective plastic surgery.


thigh lift recovery tips

The first 2-3 weeks postop is the most critical period in which the patient must be moving slowly to prevent pulling on the incisions. It is important to note that small wound separations are not uncommon after thigh lift surgery due to tension, effects of gravity, and thigh’s susceptibility to swelling.


All efforts are made to prevent “compromising” the wound, which typically extends from the groin down to the knee, because wound separations take time to heal.


Once the incisions are clinically healed, which happens 2-3 weeks postop, it may be safe to surmise that the most challenging part of recovery is over. Nonetheless, it remains critical to “keep things slow” (i.e., avoid heavy lifting, sudden movement, and strenuous activities) for about 4-6 weeks.


Keeping swelling to a minimum is one of the most critical thigh lift recovery tips. The use of compression garments is particularly helpful as they prevent or at least limit seroma (fluid formation) and thus promote healing.


Furthermore, a balanced diet, particularly low in sodium, can keep postop swelling to a minimum. It is important to note that too much salt triggers the body to hold on to more water, thus aggravating the swollen appearance.


Propping up the legs with “bed wedge pillow” while resting or sleeping can also control the amount of swelling. While ordinary pillows can also be used, wedges are sturdier and are more convenient to use.


Meanwhile, the scar must not be exposed to the sun for at least six months to help it fade into a fine line. To further promote “favorable scarring,” many surgeons also recommend silicone sheets, scar gels, and other similar modalities.

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The truth is, the success of Brazilian butt lift procedure not only relies on the surgeon’s skills and qualifications, but also on patient cooperation. This applies to all cosmetic or elective plastic surgeries.


Experts at the California Surgical Institute explain patient responsibility in Brazilian butt lift procedure:


brazilian butt lift procedure

Before and After Photos of Patient Who Have Had Brazilian Butt Lift Procedure


  • Honest and transparent communication


No patient should hide or omit medical information, i.e., previous surgeries, medical conditions, past and current medications, and use of alcohol and tobacco products, as doing so not only precludes their doctors from delivering optimal results but also increases the risk of complications.


  • Practice due diligence


A prudent patient will choose her doctor based on qualifications (board certifications, experience, reputation, etc.) and not on the lowest fee.


When the price is way too low than the average (as of this writing, the average cost of Brazilian butt lift procedure is $5,000-$9,000), most likely the surgeon has made some compromises in patient safety—e.g., not having the surgery performed at an accredited facility, or there is no licensed anesthesiologist to supervise the surgery.


  • Eliminate or at least control factors linked to increased risk of complications


A good rule of thumb is to discontinue aspirin and other blood platelet inhibitors for at least three weeks prior to surgery and until most of the postop bruising has dissipated. The goal is to prevent increased bleeding at the time of surgery and healing problems.


Other factors that are linked to poor healing and increased infection risk include obesity, uncontrolled medical condition such as diabetes and hypertension, and tobacco use. Hence, patient responsibility always includes following doctor’s recommendations strictly.


  • Strict patient cooperation during the initial healing stage


Brazilian butt lift involves fat injection (with the unwanted fat usually derived from the abdomen, flanks, and lower back) into the patient’s backside. The first 2-3 weeks is the most critical stage when blood vessel formation is needed to achieve long-term results.


Without blood vessel ingrowth, fat grafts will die within a few weeks or months of injection. For this reason, direct, prolonged sitting is best avoided during the initial healing stage.


Aside from pressure (from direct sitting) that prevents blood vessel ingrowth, smoking is also known to impede with this “critical process.” Studies have suggested that it limits the amount of oxygen-rich blood going to the tissue, which is important in achieving long-term results from Brazilian butt lift procedure.


  • Pay for the surgery


As with any elective and cosmetic plastic surgery, patients seeking Brazilian butt lift are not eligible for financing. Simply put, all is paid out of pocket. Nonetheless, some plastic surgeons accept medical or regular credit cards or even offer some financing options.

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