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.
There is a growing mommy makeover trend: Today’s patients are more well versed in plastic surgery that they are demanding for more natural and more proportionate results.
Mommy makeover surgery, which is basically a marketing term, refers to multiple surgery procedures that restore or at least improve the post-pregnancy bodies of patients. Leading Beverly Hills plastic surgeon Dr. Tarick Smiley says the most common “combination surgery” involves tummy tuck and some type of breast enhancement.
Dr. Smiley, who regularly posts Snapchat videos to spread patient awareness and to share his knowledge with medical students and colleagues, has provided a list of mommy makeover trend that generally favors “subtle” and “realistic” results.
- Curvier and slender waist with tummy tuck
In the past, most patients simply wanted the removal of their apron-like skin that hangs from their abdomen. But nowadays, women are more fastidious in terms of cosmetic results—they want the “corset effect” on their waistline.
To achieve a curvier and more defined waistline, Dr. Smiley highlights the importance of suturing the pair of splayed abdominal muscle, which prior to pregnancy is lined up closely side-by-side.
But during pregnancy that causes the abdominal wall to expand, the fascia (connective tissue) holding it together becomes weak, leading to a gap that could even become palpable. This gap is also causing the barrel-shaped waist that used to have an hourglass figure.
For additional contouring effect, Dr. Smiley pulls and tightens the abdominal skin “centrally.” And if needed, he also performs liposuction of the flanks to achieve a more hourglass figure.
- Breast augmentation beyond size increase
Modern breast augmentation is focused not just on size increase, but also on the final shape and projection. The goal is to achieve the most natural results possible, which all boils down to implants settling in their most ideal position.
Due to the growing demand for natural and “realistic” breast augmentation results, it is now commonly performed together with breast lift. The idea is to achieve optimal breast shape so the “fullness” will look natural.
Dr. Smiley warns that failure to address pre-existing sagging or asymmetry can lead to surgical stigmata like “Snoopy deformity,” excessive lateral bulge, and bottomed-out appearance.
Aside from breast lift, other common ancillary procedures of implants include areola reduction and fat transfer.
- Fat transfer for a more feminine figure
Fat transfer has revolutionized the way surgeons perform body contouring surgery, particularly buttock augmentation.
The growing popularity of fat transfer is attributed to the refinements in the purification techniques, allowing surgeons to increase the survival rate to more than 70 percent. It is important to note that any amount that remains about three months after injection is expected to persist long term.
Fat transfer as a way to augment the buttock is also a powerful body contouring procedure. Because it involves liposuction (in order to harvest the “unwanted” fats), it can contour the waistline at the same time, which in turn results in a more hourglass figure.
Male body contouring surgery can range from liposuction, breast reduction, to tummy tuck and other types of body lift following massive weight loss. While the goal is to achieve a more masculine physique, which possesses fundamental traits as suggested by several studies, the results will still depend on the patient’s “starting” anatomy.
Renowned Beverly Hills plastic surgeon Dr. Tarick Smiley, who regularly posts educational videos on Snapchat tackling the issue of male body contouring surgery, has provided a list of the most popular procedures and the corresponding ways to achieve gender-appropriate results.
- Liposuction —i.e., body contouring surgery in which the unwanted fat beneath the skin is removed with a hollowed tube
Unlike women who generally seek liposuction to appear more slender, men are more interested in looking more toned. Hence, male patients require less fat reduction.
Male liposuction typically entails a small amount of fat removal just to “reveal” the underlying muscle (like the appearance of six pack abs).
About 27,760 male breast reductions were performed in 2016, according to a survey released by the American Board of Plastic Surgery.
Gynecomastia, a condition in which the male breasts appear overdeveloped, affects up to 60 percent of men although in the vast majority of cases it disappears after puberty (or when the hormonal levels stabilize) or after cessation from drugs causing the woman-like breasts.
But for men whose enlarged breasts that persist longer than two years and even after the elimination of “possible contributing factors” (e.g., obesity, hormonal imbalance, drug, and medical condition), surgery might be a good option provided they are healthy.
All male tummy tuck patients have lost a significant amount of weight, leading to the redundant skin that may not just affect the abdomen, but also the flanks and back. Therefore, they typically require longer incisions, which of course lead to longer scars.
Tummy tuck not just removes the apron-like skin; if needed, the surgery may also involve muscle repair in which the pair of muscle extending from the breastbone to the pubic region is tightened in the midline.
Due to the natural diffusion of redundant skin and tissue laxity that commonly follows drastic weight loss, most tummy tuck patients also need arm lift, buttock lift, and lower body lift for a more proportionate result.
While body contouring can help patients achieve a more masculine physique—which is generally defined as an inverted triangle torso as it tapers from the shoulders to the waist—it is important to note that their underlying anatomies will still have a large effect on the final results.
Therefore, the right candidates for male body contouring surgery must be able to explain their “realistic” goals in details to their surgeons.
The ideal plastic surgery aftercare facility will depend on several factors such as individual health, type of surgery, and operative time. Nevertheless, a good number of patients are permitted to go home following a short period of observation, an “arrangement” known as outpatient procedure.
However, outpatient procedures only suit healthy patients whose surgery is completed less than five hours. Meanwhile, individuals with risk factors (multiple surgeries operation, borderline anemia, etc.) are typically required to have an overnight hospital stay.
Leading Beverly Hills plastic surgeon Dr. Tarick Smiley explains the different types of plastic surgery aftercare facility or “arrangement.”
Photo Credit: stockimages at FreeDigitalPhotos.net
Overnight hospital stay
While plastic surgeries are typically performed as an outpatient procedure, occasionally an overnight hospital stay is recommended to ensure patient safety. This is particularly true for individuals who are having multiple surgeries that may take more than six hours to complete.
There is also a perceived higher risk of complications among older patients (i.e., 55 years and older) and so an overnight hospital stay might be advised.
Accredited recovery facility
Some patients with risk factors (multiple surgeries, advanced age, underlying condition such as borderline anemia, etc.) are released from the hospital to a licensed recovery facility, which is staffed by qualified nurses or specially trained medical professionals who will monitor their health.
As previously stated, a good number of plastic surgery is performed as an outpatient surgery. After a brief period of monitoring the patients are allowed to return home, provided that they will have a designated driver and a capable caregiver who will stay with them for at least 24 hours after surgery.
With the growing popularity of medical tourism—patients traveling long distances seeking expertise or cheap procedures—hotels and spas can serve as a venue for recuperation.
Patients traveling alone for plastic surgery are often advised to hire a licensed healthcare professional who can monitor their recovery at least in the first 1-2 days following their surgery.
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.
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.
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.