Plastic Surgery Science


Brazilian buttock lift is basically a body contouring procedure that combines liposuction and fat injection. Liposuction allows the surgeon to collect unwanted fats, which are then used to reshape and augment the patient’s backside.

 

Despite its name, in no way that the Brazilian buttock lift can “lift” sagging buttocks, which typically follows massive weight loss. Nonetheless, augmenting the upper half of the butt in a way that it projects more than the lower aspect can give an illusion of a lifting effect provided that the patient has no skin and tissue laxity.

Brazilian buttock lift and hips

Before and after photos of Dr. Smiley’s patient who have had Brazilian buttock lift. She is very happy with the final contour, particularly of the curvier hip appearance.

However, creating great results from Brazilian butt lift entails more than just injecting fats. An equally important goal is to reshape the backside in which it looks proportionate to the rest of the body, and wherein there is a smooth transition to the adjacent areas—e.g., lower back, flanks, posterior thigh, and hips.

 

Leading Los Angeles plastic surgeon Dr. Tarick Smiley says that Brazilian buttock lift and hips enhancement are almost always combined to achieve a smoother, more feminine physique. The idea is to not just improve the anterior “projection” but also give additional lateral bulge.

 

The hips, or to be more specific, the lateral aspect of the buttocks, typically receive about one-third of the fat volume injection, while the rest goes to the “anterior” projection and shape, says Dr. Smiley in his previous videos on Snapchat.

 

In general, patients will need at least 800 cc of purified fat (liposuctioned fats that have been filtered) on each butt cheek to achieve visible improvements in their buttocks and hips. In fact, Dr. Smiley says that a good portion of his patients have had more than 1000 cc on each side to achieve their desired results.

 

However, the celebrity plastic surgeon has warned that too much fat injection—i.e., there is too much stress on the skin and fascia, which in turn leads to sagging buttocks, cellulites, and dimpling—is to be avoided to ensure that the results are near permanent.

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Several studies have been conducted to evaluate long-term liposuction results. In this procedure, the unwanted fats—specifically the subcutaneous fat found beneath the skin—are suctioned out with the use of a flexible tube called cannula.

 

Some studies have suggested grim findings: After about a year all the benefits of liposuction were gone.

 

liposuction results

Nevertheless, several studies have also shown that good old-fashioned exercise can preserve liposuction results and prevent patients from regaining fats elsewhere in their body (i.e., areas not treated by the surgery). Of course, physical activities must always be complemented by superb diet, which is an equally critical aspect of long-term weight management.

 

To shed light on the long-term results of liposuction, a team of Brazilian researchers conducted a study in which 36 healthy but inactive women aged between 20 and 35 had undergone the surgery.

 

These non-obese participants had 2.5-3 lbs. of abdominal fat removed through liposuction. Afterwards, they were divided into two groups: half were asked to stick to their old habits, while the other half were required to follow a moderate exercise routine.

 

By six months after liposuction, the first group had regained all the fats previously removed by surgery. And not only that, they developed additional visceral fat—or fat deposition in organs such as the liver and intestines—and thus predisposed them to increased risk of insulin resistance (diabetes), inflammation, and a wide range of health problems.

 

The uptick in the percentage of visceral fat was notable—about 10 percent more compared to their pre-surgery level.

 

However, the participants who were asked to perform moderate exercise for four months did not regain fat and even achieve additional health benefits. (Note: The exercise regimen was “doable”—an hour of cardio and weight lifting three times a week.)

 

Furthermore, the women included in the “exercise group” have improved insulin sensitivity and physical fitness.

 

The researchers have concluded that exercise can prevent the body from [over] compensating for the abrupt change in the fat composition and distribution caused by liposuction. It is believed that the body has a strong predisposition to defend its fat stores, and a sedentary lifestyle can aggravate this propensity.

 

Meanwhile, separate studies have suggested that a sedentary/poor lifestyle after liposuction may cause the patients to regain fats in other parts of their body not treated by liposuction, which of course could lead to a disproportionate appearance.

 

The liposuctioned areas, meanwhile, were less likely to regain fat unless in the event of significant weight gain (i.e., more than 20 lbs.)

 

With these findings, Dr. Tarick Smiley, a board-certified plastic surgeon who has performed over 9,000 liposuctions, says the long-term success of surgery will always boil down to patient’s commitment to healthy lifestyle.

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Breast implant strength is one of the most pressing concerns of women who consider undergoing breast augmentation surgery. To shed light on the issue, leading Beverly Hills plastic surgeon Dr. Tarick Smiley has recently posted a series of Snapchat videos in order to demonstrate how durable this artificial prosthesis can be.

 

In the first trial, Dr. Smiley asked a 125 lbs. woman to step on two breast implants, putting all her weight on them (one was saline-filled, while the other was silicone-filled). No leak or rupture occurred after the experiment.

 

In another trial to assess breast implant strength, Dr. Smiley asked one of his assistants to throw saline and silicone implants out the window four stories high. When picked up and closely observed, again, no rupture was seen.

 

To further demonstrate how strong [FDA-approved] breast implants can be, Dr. Smiley conducted another trial in which he literally ran his car over saline implant, then silicone implant. Both prostheses remained intact; the only sign that showed they were subjected to extreme load was the tire mark.

 

breast implant strength

The weight of this large sedan is not enough to cause implant rupture.

To further take it to the next level, he asked one driver of an SUV to pullover and run over saline implant, which instantly burst. Simply put, it would take about 4,200 lbs. of force or weight before the breast implants rupture or “explode.”

 

Dr. Smiley posted these trials on Snapchat to bust common myths about breast implants.

 

* The changes in air pressure during flight will not cause the implants to instantaneously explode.

 

* Weight lifting, strength training, rigorous aerobic exercises, and the likes will not affect implant durability.

 

* Modern breast implants have impressive durability that in the event of replacement, leak only accounts for a very small percentage. More common reasons for breast revision or replacement include capsular contracture, implant displacement (e.g., sagging), wrinkling, and wanting to downsize/upsize.

 

In an attempt to preserve the results of breast augmentation or at least minimize the revision rate, the celebrity plastic surgeon said he makes all the efforts to prevent capsular contracture, a condition in which the scar capsule around the implant becomes copious due to the over-production of collagen (scar tissue).

 

The body is believed to produce excessive scar tissue around the implant when the latter comes into contact with microbes and other “irritants.” Hence, Dr. Smiley said he utilizes all techniques to reduce risk of implant contamination at the time of surgery.

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While breast augmentation trends come and go, there are universal guidelines that help surgeons achieve natural-looking results and minimize risk of complications, particularly relating to aesthetic issues such as sagging or bottoming-out, and rippling.

 

Leading Inland Empire plastic surgery expert Dr. Tarick Smiley, who performs over a hundred breast augmentations every year, has provided basic explanations of the current breast augmentation trends.

 

breast augmentation trends

 

Although many trends and new technologies have paved way for safer, longer-lasting implants, Dr. Smiley says the ideal choice still boils down to patient compatibility, meaning that one’s underlying anatomy and aesthetic goals must be in line with her implant type, design, and size.

 

  • Breast implants that “acknowledge” and “respect” patient lifestyle

 

Patients who participate in sports and fitness programs generally seek breast augmentation to achieve a more balanced figure, instead of having a “cup size” that will be the focal point of their physique. For this reason, they choose the conservative route—i.e., breast implants not bigger than 350 cubic centimeter or cc.

 

While cc is not directly correlated to the final breast size (due to variables such as pre-existing tissue, chest shape, and other anatomy), patients with an active lifestyle typically ask for a full B or small C cup result, or simply want to restore the lost volume in their upper breast pole following pregnancy.

 

  • Gummy bear breast implant

 

This is a marketing term used to describe fifth generation silicone implants. But instead of a “runny” silicone gel, it uses solid silicone whose molecules have stronger crosslinks and so it is highly cohesive just like a gummy bear candy.

 

The solid silicone will keep its form when cut in half and so the risk of rupture is markedly low, with one study suggesting it is only 2.6 percent within a nine-year period.

 

  • Fat injection

 

While fat injection is a growing trend in buttock augmentation surgery, it is rarely used as a primary method to reshape and increase the breast size. Unlike the butt area, the breast can only “take” a lower volume of fat.

 

Nonetheless, fat injection—which involves liposuction as a way to collect unwanted fat, and purification prior to re-injection to achieve a high survival rate—can serve as an additional soft tissue coverage to prevent or minimize risk of rippling and palpability.

 

  • Postoperative breast massage

 

A 2016 survey conducted among active members of the American Society of Plastic Surgeons has shown that more than half of the 1,067 respondents recommended postoperative breast massage, which basically requires pushing the implants into the outermost corners of the pocket.

 

The idea is to retain the thinness and softness of the scar tissue sac encapsulating the implant, which in turn prevents capsular contracture and high riding implants.

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It is important to note that the latest plastic surgery trends should not supersede patient safety and satisfaction. Therefore, the goal of any prudent plastic surgeon is to enhance one’s appearance based on her “realistic” goals and, of course, within the safe limit.

 

Dr. Tarick Smiley, who is the medical director of the renowned California Surgical Institute, has explained some of the latest plastic surgery trends in Beverly Hills.

 

latest plastic surgery trends

 

  • Bigger bum

 

Thanks to recent improvements in fat transfer—allowing most of the grafts to persist long term—buttock augmentation is now more commonly performed with the use of the most natural material available—i.e., the patient’s very own fat.

 

In 2016, board-certified plastic surgeons performed about 18,000 buttock augmentations via fat transfer, a 26 percent increase from the previous year. The growing popularity of this procedure, also dubbed as Brazilian butt lift, is attributed to curvy celebrities like Kim Kardashian, Jennifer Lopez, and Beyonce Knowles.

 

  • Sayonara to the over-inflated breasts

 

In the past decade, a good number of breast augmentation patients sought for an over-inflated chest appearance (e.g., DD and E cup). But with more women today following a healthier and more active lifestyle, it is not surprising that they now gravitate towards smaller “improvements.”

 

With smaller breast implant sizes, the results generally appear more natural and proportionate. In addition, they do not interfere with the patient’s active lifestyle.

 

“Instead of simply augmenting the breasts, most patients today want something more, but subtle. They desire for a more natural appearance and so they are also focused on improving their breast shape. Therefore, implants are now typically combined with some type of breast lift,” says Dr. Smiley.

 

  • Subtle facelift results

 

In the past, facelift received notoriety due to its unnatural effects—flat cheeks, lateral skin pleating, overly tight face, and weird brow position. However, things have changed when surgeons started recognizing that simultaneous procedures like fat transfer, neck lift, and eyelid lift can make a huge difference.

 

Dr. Smiley typically combines facelift with fat transfer—a method dubbed as three-dimensional facelift—to achieve a more natural, more youthful result.

 

To further achieve natural results, Dr. Smiley highlights the importance of the correct vector of pull. In his previous Snapchat video posts, he demonstrates how pulling the skin at a 45 degrees angle can restore the softness of the cheeks (as opposed to making them flat and gaunt) and provide impressive rejuvenating effects.

 

  • Quick fix facial procedures

 

Some patients, particularly men, deter the idea of surgery and the ensuing recovery and so they resort to Botox, dermal fillers, and Kybella injection (i.e., double chin eliminator).

 

According to a survey conducted by the American Board of Plastic Surgery, about 7 million Botox injections, and 2.6 million dermal fillers were performed last year alone.

 

Simply put, one of the latest plastic surgery trends favor non- or minimally invasive methods.

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Today’s facial plastic surgery trends favor more natural results, as opposed to looking “done”—hyper-inflated lips, overly tight face, ethnically inconsistent nose, eyelid retraction, and over-elevated eyebrows.

 

Leading Beverly Hills plastic surgeon Dr. Tarick Smiley has explained some of the current facial plastic surgery trends and the growing consumer preference.

 

facial plastic surgery trends

  • Smoothing out wrinkles with volumizers without creating the hyper-inflated look.

 

Volumizers such as dermal fillers and fat injections have received notoriety because too much of them can lead to hyper-inflated look—e.g., chipmunk cheeks and trout pout. However, all of these can be avoided with meticulous microdroplet injection in which the primary goal is to smooth out wrinkles and lines, as opposed to “thoughtless” augmentation of the deflated facial regions.

 

  • Simultaneous fat injection during facelift

 

Facelift alone does not address all signs of facial aging, particularly relating to soft tissue atrophy (shrinkage) and fat loss. Hence, Dr. Smiley typically combines facelift with fat injection, particularly when the patient has abrupt transition between the lower lid and cheek, deep tear trough, or flat cheeks.

 

  • Selfies and the proliferation of social media

 

Studies have suggested that selfies have contributed to the growing popularity of non-invasive and surgical procedures to improve facial features.

 

Furthermore, there is an uptick in the number of patients seeking “liquid” facelift, which is basically dermal filler injection such as Restylane and Juvederm, a trend also attributed to selfies.

 

  • Non-surgical alternatives to facelift

 

The truth is, there is no “real” alternatives to facelift that can exactly replicate its rejuvenating effects. Nonetheless, non-surgical treatments remain good options in patients who have minimal signs of aging or want to postpone surgery in the meantime.

 

While the rejuvenating effects of non-surgical treatments do not compare with the benefits of facelift, combination therapy (e.g., Botox injection with dermal fillers) can help doctors address more signs of facial aging—without surgery.

 

  • Ethnic “nose job”

 

Rhinoplasty, or nose job in layman’s term, was previously criticized for westernizing the face of non-Caucasian patients. However, over the past decade there have been revolutionary ideas acknowledging that beauty has no linear and strict definition.

 

With ethnic rhinoplasty, the goal is to enhance the nose’s appearance in a way that the result looks ethnically consistent with the rest of the face.

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