Major tummy tuck surgery entails not just the removal of apron-like abdominal skin. To achieve more proportionate and natural-looking results, it typically combines other surgical maneuvers including liposuction (fat reduction), muscle repair, navel repair, and pubis lift.
Dr. Tarick Smiley, a celebrity Beverly Hills plastic surgeon, has recently posted a series of videos on Snapchat to demonstrate one case of major tummy tuck in which the female patient has large redundant skin following massive weight loss.
While the standard tummy tuck uses a hip-to-hip incision pattern, the patient has required an extended version, meaning the scar slightly extends into the side. Nonetheless, Dr. Smiley has made every effort to place it “beneath” the bikini area (i.e., very low) for its optimal concealment.
But prior to the removal of excess skin, Dr. Smiley had performed liposuction of the flanks in which the unwanted fat was removed with a cannula (straw-like device attached to a vacuum pump). This additional step would allow the patient to achieve a more slender, curvier side.
In the past, tummy tuck and liposuction performed at the same time was greatly discouraged due to the perceived higher risk of complications. However, recent clinical studies and surveys have shown otherwise. Provided that liposuction is not too aggressive (i.e., only a small amount of fat is removed) and it does not involve the area above the navel, the combo procedure is reasonably safe.
Meanwhile, large volume liposuction or extensive liposuction involving the area above the belly button is ideally performed 3-6 months after tummy tuck to allow the body, particularly its blood supply, to recover from the surgical trauma.
Going back to the topic of major tummy tuck’s components, it is also critical to reshape the belly button, which might become distorted or enlarged following massive weight loss or pregnancy. In the video, Dr. Smiley is seen creating an incision around the inner rim of the navel to improve its appearance and to look more proportionate with the slimmer waistline.
To further create more proportionate results, the patient received pubis lift (the area is susceptible to sagging after massive weight loss). The idea is to encourage a smooth transition between the mons pubis and the lower abdomen.
The plastic surgeon’s Brazilian buttock lift photos (before-and-after images) can illustrate his “eye for detail” and level of artistic skills. Of course, his education, board certifications, training, experience, and bed side manner will also matter when selecting a doctor.
Leading Beverly Hills plastic surgeon Dr. Tarick Smiley has shown a recent patient whose buttock lift photos depict natural-looking, proportionate results.
The patient has enjoyed a certain advantage—her pre-existing skin has good elasticity, meaning it can “take” more fat volume without predisposing her to increased risk of skin irregularities such as dents and cellulites.
Nonetheless, Dr. Smiley has ensured that the fat volume would not cause enormous weight and strain, which is the main culprit behind sagging and other signs of botched Brazilian buttock lift.
The profile view of the patient’s new buttocks reveals great projection, particularly in their upper half. The idea, according to Dr. Smiley, is to create an illusion of perkiness and to prevent sagging, which could happen when the lower half receives most of the fat volume (along with its additional weight).
In his previous educational videos posted on Snapchat, Dr. Smiley said the “most critical aspect of Brazilian butt lift is to respect the patient’s underlying anatomy, particularly her skin, septa (membrane that connects the muscle to the skin), and body frame.”
Meanwhile, the posterior view now reveals the appearance of curvier and fuller hips, which Dr. Smiley has created by allocating about one-third of the purified fat into the lateral aspect of the butt.
Having good skin elasticity offers another benefit: the liposuction sites where the donor fats are collected will appear tight and smooth.
Dr. Smiley said that during liposuction, some fats beneath the skin are removed with a straw-like device called cannula. It is important for the skin to shrink-wrap smoothly around the new contour lest the results will look disastrous (visible bumps and dents).
The celebrity plastic surgeon collected “unwanted” fats from the bra rolls, flanks, and lower back; these were later purified in which the oil and red blood cells were discarded to come up with the “pure, golden” fat that was later injected into the patient’s buttocks.
Dr. Smiley was able to collect a large amount of fat without predisposing her to surface irregularities due to her good skin elasticity.
In almost all Dr. Smiley’s patients, he treats the lower back and flank as liposuction-donor sites to further highlight the buttock’s shape and projection.
Facelift for laugh lines, or medically referred to as nasolabial folds, requires going deeper than the skin to achieve natural results that can last for many years. It is important to note that relying on skin alone will lead to a short-lived outcome due to the relative weakness of this layer.
Leading Beverly Hills plastic surgeon Dr. Tarick Smiley says that a youthful face has its malar fat pad attached to the cheekbone high, giving it a relatively plump look.
The high cheekbone appearance gives younger faces an inverted triangle shape, which aging gradually reverses, he adds.
Aging causes the facial skin and supportive structures to lose their strength, which in turn also causes the malar fat pad to descent. Dr. Smiley says this contributes to the nasolabial folds, which run from the corner of the nostril down to the mouth.
Facial volume loss can further aggravate the appearance of nasolabial folds, making the patient appear perennially tired or even angry. On top of that, repeated smiling (and other facial expressions) deepens this fold throughout life, he adds.
Facelift for laugh lines warrants elevating the SMAS, a layer overlying the muscle. With this facelift technique, the celebrity plastic surgeon says the skin, malar fat pad, and tissue are raised all at the same time, leading to more natural, longer-lasting results.
Moreover, the SMAS facelift technique allows the surgeon to eliminate most of the tension on the skin, further contributing to favorable scars and better wound healing.
The sagging cheek fat pad that contributes to the laugh lines is pulled upward so it will lie over the cheekbone. To further smooth out these “folds,” Dr. Smiley says that some patients require a simultaneous fat injection in which the goal is to replace lost facial volume.
Fat injection for the correction of laugh lines can serve as a stand-alone procedure in patients whose mid face has not yet sagged to a significant degree. Another option is dermal fillers (e.g., Perlane, Radiesse, Restylane, and Juvederm) whose effects last an average of 4-6 months and so they require regular touch-ups.
The results of fat injection, meanwhile, can last 12-15 years, says Dr. Smiley.
While the upfront cost of fat injection is higher than most dermal fillers, in the long run it is less expensive because it does not require touch-ups.
Rhinoplasty hump reduction, aka, nose-reshaping surgery to eliminate or reduce the fullness along the bridge, entails a set of meticulous surgical techniques to achieve proportionate and natural results, which are primarily achieved when the patient’s gender, ethnicity, and facial features are all taken into account.
Leading Beverly Hills plastic surgeon Dr. Tarick Smiley has recently posted a series of Snapchat videos involving a female patient who asked for rhinoplasty hump reduction. But to achieve a smoother, more proportionate nasal profile, he also performed a simultaneous tip refinement.
The patient, who had been involved in an accident that left her nose broken, had visible hump along her nasal bridge that looked incongruous with her feminine features.
Dr. Smiley was able to improve her nose—i.e., remove the hump and refine and slightly elevate the tip, ultimately resulting in a more feminine appearance—with the use of closed rhinoplasty technique, which basically means that all incisions are made inside the nostril; hence, the risk of visible scar is almost eliminated.
During a closed rhinoplasty technique, incisions are made within the lining of the nostril, which in turn exposes the cartilage that comprises the lower two-thirds of the nose. The upper one-third, meanwhile, is made up of bone.
In the video, Dr. Smiley is seen removing a small piece of cartilage to refine and narrow the tip. Afterward, he trimmed the offending nasal bone that was causing the excessive fullness or hump along the bridge.
Instead of the discarding the cartilage collected during surgery, the celebrity plastic surgeon reshaped it so it could be used to reinforce the tip, a technique that allows the results to persist long term and to prevent collapsed or pinched appearance.
To further create a gender-appropriate nose during rhinoplasty hump reduction with a simultaneous tip refinement, Dr. Smiley slightly raised the tip. According to studies, the ideal angle between the upper lip and nose is 105-110 degrees for women, while in men it should be 90-105 degrees.
The amount of reduction that can provide the most natural results, Dr. Smiley said, is largely determined by how much skin shrinkage is expected to occur. In general, markedly thick nasal skin does not redrape as good as thin skin.
However, thin skin is less forgiving as it shows even the tiniest contour irregularities.
Hence, patients whose skin is considered “medium thickness” enjoy certain advantage: Their skin shows the “details” and improvements without the increased risk of contour irregularities.
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.
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.