Complete smoking cessation a few weeks leading up to plastic surgery has become a common practice to reduce risk of skin necrosis, pulmonary- and heart-related complications, and poor healing and scarring, according to the California Surgical Institute website.
However, a recent study published in Plastic and Reconstructive Surgery has found that many patients receiving smoking cessation instructions had kick the habit for good or at least smoked less frequently years after their surgery.
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Researchers at the University of British Columbia, Vancouver have suggested that “surgeons who request pre-operative smoking cessation may influence patients’ long-term smoking status.”
The researchers enlisted 47 patients who responded to a 5-year follow-up survey, although five social smokers were later excluded to make sure that the study only involved “bona fide” daily smokers. Most respondents were women whose average age was 40.
Most respondents requested for tummy tuck, breast lift, and facelift.
In the follow-up survey, 25 percent of patients had quit smoking since their cosmetic surgery, while 40 percent said they smoked less. Most patients said the frequency of their cigarette use was reduced to a varying degree, citing their surgery as a strong motivation to live a healthier life.
The authors of the study have concluded that people were more likely to quit smoking or at least reduce their tobacco use when they were presented with “specific negative effects of smoking” rather than with “general health benefits of smoking cessation.”
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.
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.
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.
Male plastic surgery trends favor natural, subtle results. This is not surprising since men are less comfortable talking about their surgical enhancements compared to women, as suggested by leading Beverly Hills plastic surgeon Dr. Tarick Smiley.
Dr. Smiley has cited a recent survey conducted by the American Society of Plastic Surgeons showing the most popular male plastic surgery trends and procedures. (The list is in no particular order.)
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- Breast reduction
- Rhinoplasty, aka, nose-reshaping surgery or nose job
- Blepharoplasty or eyelid surgery
About 27,760 male breast reduction surgeries were performed in 2016, a 36 percent increase compared to 2000. This procedure involves the removal of excess tissue beneath the areola, which causes it to appear puffy.
For most patients, breast reduction results in inconspicuous scar at the lower edge of the areola. The scar lies precisely at the dark-light skin junction and so it is almost invisible.
To achieve smoother and more proportionate results, breast reduction might be combined with liposuction of the flanks and anterior abdomen. The idea is to prevent the “adjacent areas” from detracting from the more masculine breasts.
Aside from the aforementioned body contouring techniques, male patients are also lured by facial plastic surgeries, particularly rhinoplasty, facelift, and eyelid surgery.
Men seeking rhinoplasty, or nose job in layman’s term, generally desire for subtle effects and the preservation of their masculine appearance. Hence, some male patients ask to maintain some fullness or small bump along their nasal bridge.
Facelift, eyelid surgery, and other facial rejuvenation procedures (Botox and fillers) are also popular among men, although compared to women they ask for much subtler improvements in an attempt to keep their “enhancements” a secret.
For instance, men abhor the overly tight appearance and so most find it acceptable to have some [minimal] facial lines afterwards as long as the results look natural.
To achieve more natural results, facelift might be combined with some type of volumizers (e.g., fat transfer and dermal fillers) to create a smooth transition between the lower eyelid and cheek, address the flat or gaunt cheeks, and correct the appearance of deep tear trough.
Facelift is also typically combined with eyelid lift, neck lift, and other facial rejuvenation techniques to create more “congruous” results.
Breast augmentation techniques vary from patient to patient because each one has unique underlying anatomies (i.e., soft tissue coverage and body frame) and cosmetic goals from the surgery.
Nonetheless, a recent survey published by journal Plastic and Reconstructive Surgery shows that certain techniques and breast implant designs are favored by many board-certified plastic surgeons.
The survey was based on the answers of more than 1,000 board-certified plastic surgeons who were asked to fill out an electronic questionnaire.
The survey has shown general agreement in several breast augmentation techniques, which are explained below:
* The inframammary fold incision site is the most preferred entry point. Aside from the precise visibility that minimizes risk of asymmetry, its popularity is also linked to favorable scars as they are hidden within the natural fold of skin.
A good number of patients also need their breast crease to be slightly readjusted, which makes the inframammary fold technique an ideal choice for many.
* The submuscular technique is the most recommended implant placement. Proponents suggest that positioning the implants behind the thick layer of muscle is one effective way to minimize palpable rippling, scar capsule formation (capsular contracture), and unnatural contour.
Meanwhile, placing the implants above the muscle—so only the breast tissue and skin cover and support them—has become a less popular choice because of the increased risk of rippling, especially in small-breasted and thin women.
* Silicone breast implants are the most popular choice. They provide a more natural result and feel than saline implants because of their cohesive filler material, making them an ideal choice for women with little breast tissue to begin with.
Silicone implants that come in smooth surface and round shape (or more like a flattened sphere) are believed to further make the result look and feel natural.
Meanwhile, teardrop implants, which always have a rough or textured outer shell to prevent rotation, are less popular because of the increased risk of palpable rippling and asymmetry if they flip over.
In addition, the most popular breast implant size range is between 300 and 350 cc, as suggested by the survey.
* Recent technologies. Despite the growing popularity of 3D imaging technologies in plastic surgery that allow patients to preview their possible results, they are not commonly used by breast augmentation surgeons.
Also, the respondents do not routinely use fat grafting, either as an adjunct procedure of breast implant surgery or as a stand-alone augmentation technique.
Liposuction procedure removes the excess fat underneath the skin with the use of suction. Nonetheless, it is not a weight loss surgery since it is too risky to remove the deeper visceral fat, which only responds to “real” weight loss—regular exercise and healthy diet.
According to a recent report published by the Plastic and Reconstructive Surgery journal, the safe amount of fat to remove during liposuction is determined by the patient’s body mass index or BMI.
While the perceived safe volume during liposuction surgery is up for debate, with current guidelines suggesting that no more than 5 liters of fat should be removed per treatment, the study has shown that people with higher BMIs who had a greater liposuction volume experienced a lower complication rate.
Patients with lower BMIs who had a greater liposuction volume, meanwhile, experienced an increased risk of complication arising from seromas or collections of fluids beneath the skin.
Nevertheless, patients who had large-volume liposuction—or removing more than 5 liters of fat in one surgical setting—had the highest complication rate: 3.7 vs. 1.1 percent.
The study analyzed data of around 4,500 patients who had liposuction in which the overall complication rate was 1.5 percent, with no death reported. Meanwhile, the average amount of removed fat was approximately 2 liters.
Aside from the amount of removed fat relative to the patient’s BMI, liposuction risks are also tied to concomitant procedures (breast augmentation, tummy tuck, body lift, etc.), length of surgery, and overall health of the patients, as suggested by the researchers.
Celebrity LA plastic surgeon Dr. Tarick Smaili, who is not part of the study, also suggests that liposuction risks are also higher among smokers because the nicotine found in tobacco products constricts the blood vessels, thus retarding wound healing and leading to poor oxygen circulation.
Other risk factors include hypertension and medical conditions that can affect healing, use of blood-thinners, malnourishment/undernourishment, and excessive surgical trauma due to unrelated procedures performed at the same time as liposuction, he further explains.
The number of men having plastic surgery is on the rise, with a recent survey showing that they accounted for 13 percent of all cosmetic surgical enhancements, or about 205,000, last year alone.
The survey, which was conducted by the American Society of Plastic Surgeons, has shown that rhinoplasty or nose surgery, eyelid surgery, and facelift were included on the top five list of the most commonly performed procedures in men.
Celebrity LA plastic surgeon Dr. Tarick Smaili says the growing popularity of male plastic surgeries, particularly those aiming to create a more youthful and more balanced face, is due to the declining stigma on surgical enhancements.
Another contributing factor, according to a recent survey, is the growing job insecurity. In an attempt to look more competitive and youthful, male patients are commonly citing this reason for having cosmetic plastic surgery.
But since there are certain aesthetic characteristics that typify the masculine face—including “heavier” and lower brow, more horizontally-oriented forehead, thinner lips, and bigger nose compared with women’s—Dr. Smaili says facial plastic surgery should always take into consideration one’s gender, in addition to other factors such as the rest of the facial features, ethnicity, and motives and expectations.
When treating male patients who want to have a more youthful visage through facelift, Dr. Smaili warns that excessive tension on the skin can lead to fake results, or worse, a more feminine appearance.
While too much tension on the skin has detrimental effects on both genders, over-correction is particularly detrimental to men because it not only feminizes the face, but also leads to unnatural side burns, hairline, and ear (pixie ear deformity or “stuck-on” appearance).
Compared to women, male facelift generally requires a more conservative jaw line contouring to preserve their masculine appearance. Some “seasoned” plastic surgeons even retain a few wrinkles to create a somewhat mature, but still attractive male face.
By being on a conservative side, the leading LA plastic surgeon says it is easier to achieve more natural results and avoid the dreaded windswept and perennially surprised appearance.
In brow lift surgery, Dr. Smaili says being conservative is also beneficial to men. The idea is to create a more horizontally-oriented, “heavier” brow to preserve the masculine appearance.
A more curved, arched brow, on the other hand, only works for female brow lift surgery.
There is also a stark difference between male rhinoplasty and female nose surgery. According to a recent study, an attractive male nose is a bit bigger and wider, and has an angle of rotation close to 90 degrees to give it a stronger, straighter tip.
On the other hand, creating a more upturned nose has a feminizing effect which must be avoided when performing a male rhinoplasty, explains Dr. Smaili.