Fat transfer to nasolabial folds or “laugh lines” can provide the same effect as traditional fillers like Juvederm and Restylane, or sometimes even give better results because it uses the most natural material—your own fat.
Leading Beverly Hills plastic surgeon Dr. Tarick Smiley has recently posted videos on Snapchat to demonstrate a female patient who received fat injection to smooth out her laugh lines.
The appearance of laugh lines stems from two things: The sagging of your skin and other soft tissues, and facial volume loss.
In “younger” patients—i.e., 50 years and below—the nasolabial folds are mainly caused by facial volume or fat loss. Hence, they can avoid or at least postpone facelift, which relies on tightening the skin and soft tissue, and instead resort to volume restoration treatments such as conventional fillers and fat injection.
Fillers made of hyaluronic acid products like Restylane and Juvederm have impressive safety record because HA is naturally found in the body; in fact, it gives the skin its youthful glow and texture. However, the improvement only lasts 4-6 months on average, says Dr. Smiley.
If you are looking for a more permanent solution for your nasolabial folds, or any depression that primarily stems from volume loss, using your fat is a much better approach. Just a few teaspoons of unwanted fat from your tummy or thigh is enough to conceal your laugh lines.
And since your body does not treat your fat as a foreign material, your immune system will not attack it. This is not always the case with facial implants and synthetic, non-degradable fillers like ArteFill.
Aside from the long-term results of fat transfer to nasolabial folds, Dr. Smiley says the approach tends to provide more natural results than facial implants and conventional fillers. Moreover, fat shrinks and expands as you lose or gain weight, further leading to its natural effects.
The fat is also rich in stem cells and so the skin in the areas where the fat has been grafted will experience “visible” improvements, says Dr. Smiley.
It may come as a surprise that not every facial plastic surgeon offers fat transfer despite its more natural and longer-lasting effects compared to conventional fillers. Take note that it entails a steep learning curve to ensure high survival rate of fat grafts.
Conventional fillers, meanwhile, are much easier to perform than fat injection.
In 2016, about 215,000 cosmetic plastic surgeries were performed in men, accounting for 13 percent of all aesthetic procedures; their popular requests included facelift, eyelid lift, and rhinoplasty (nose job), according to a survey released by the American Society of Plastic Surgeons.
Aside from gender-based beauty standards, men’s facial plastic surgery is different from women’s due to their underlying anatomy. For instance, their skin is more vascularized and thus more susceptible to bleeding and bruising compared to females.
Men’s facial plastic surgery requires a different approach than women’s.
Furthermore, any scar that may result from facial plastic surgery is more difficult for men to hide since they do not wear makeup, as most women do.
Another notable difference is the men’s tendency to ask for subtler results because unlike women, they are less likely to disclose their plastic surgery to other people probably due to “double standard” stigma.
Fortunately, achieving subtle and natural results from men’s facial plastic surgery is possible with correct surgical maneuvers and deep understanding of universal guidelines of facial proportion and masculine beauty.
Leading Beverly Hills plastic surgeon Dr. Tarick Smiley explains the three most commonly sought facial plastic surgeries of men and the core principles that help him deliver natural and gender-appropriate results.
Men are more prone to hair loss than women, making it more challenging to hide the scar. It is important to note that facelift typically uses incisions within or behind the hairline to hide the scar, which can be difficult in patients with receding hairline, unless a short-scar or mini lift is used.
Another issue with male facelift is the surgical stigmata—e.g., flat cheeks, overly pulled appearance, and hollowing of the lower lid. However, these can be avoided with the correct vector of pull.
Aging causes the vertical descent of the skin and other soft tissue; hence, the correct vector of pull should be oblique and not a “blunt” horizontal.
By lifting the skin at a 45-degree angle, several wonderful things happen: the jowling is reduced, the softness of the cheek fat pad is restored, and the face appears tighter but not too taut.
Another nuance of male facelift is the propensity of patients to ask their surgeons to maintain a few small wrinkles for a more realistic, natural result.
Men generally seek nose-reshaping surgery to reduce their hump and refine their tip without causing them to lose the masculinity of their face. Hence, great surgeons avoid over-resection of the tissue, which is also linked to increased risk of nasal collapse and other deformity.
The ideal nose is defined by universal beauty tenets instead of a highly rigid set of rules. The goal is to reshape the nose that will fit the face of the patients, respect their gender and ethnicity, and meet their aesthetic goals.
Several studies have attempted to describe what constitute an ideal male nose and these are some of their findings: It is “biologically” bigger than female’s possibly due to men’s increased muscle mass that requires more oxygen; it has a prominent dorsum or bridge; its tip has an angle of rotation around 90 degrees giving it a straighter profile (a slight upturned appearance is enough to feminize the face); and the overall profile appears strong instead of delicate.
Eyelid surgery eliminates the hooding of the upper lid and the under eye-bags. However, even the slightest error—i.e., removing just a few millimeters of fat or skin than intended—can lead to stigmata such as lid retraction, deep tear trough, and abrupt lower lid-cheek transition.
To deliver natural and gender-appropriate results, doctors ensure that after surgery the upper lid appears “heavier” and lower compared to women’s, and there is a smooth lower lid and cheek junction.
And to preserve smooth transition between the lower lid and cheek, eyelid surgery is now commonly performed together with fat injection.
Another issue with male eyelid surgery is the risk of scar. This can be avoided by placing the incision precisely at the skin fold of the upper lid, and very close to the lower lash line margin.
All efforts are made to ensure that the scar remains concealed because men do not wear makeup to hide surgical stigmata.
Liposuction scar generally fades into negligible “marks” after 6-12 months, although patient commitment to recovery remains critical to achieve the best results possible. For instance, sun exposure must be avoided for at least six months since UV rays can cause hyperpigmentation in which the scars turn dark.
Leading Beverly Hills plastic surgeon Dr. Tarick Smiley shares his scar management tips that will further ensure that your liposuction scar will blend well into the background.
The after photo on the right shows no visible scar, which contributes to high patient satisfaction.
* Minimize tension on the skin. When there is no or very minimal tension on the scar, it tends to heal nicely. Hence, the use of surgical tape and/or Steri-strips can be helpful as they eliminate the stress and “pulling” that can delay healing or cause the scar to widen.
* Achieve your optimal health well in advance of the surgery. When you’re healthy, there is less risk of infection, which can affect the appearance of your scars. Simply put, liposuction or any other body contouring surgeries will require commitment to superb diet and healthy lifestyle.
* Eliminate risk factors of infection. Each doctor has his own specific wound care instructions, although there are generally agreed upon guidelines such as never submerging your incision in water for at least three weeks; not using any topical product unless with the approval of your surgeon; and avoiding smoking.
* Treat infection immediately. In the hands of a board-certified plastic surgeon, infection is extremely rare because of the use of tumescent fluids injected into the fatty area prior to extraction. But should it occur, it must be treated immediately to prevent complications and poor scarring. Common signs of infection include asymmetric swelling, fever, chills, and drainage of pus.
* Use of topical treatments containing silicone. Once the incisions are completely sealed, which happens around three weeks postop, patients may choose to apply topical products such as silicone sheets and creams known for their hydrating effects. Scars that heal in a moist environment usually heal better and fade quicker.
* Use sun protection for one year. While staying out of the sun is the best way to reduce risk of hyperpigmentation, this is generally difficult or even impossible to accomplish. Hence, the use of sunscreen, protective clothing, and makeup products that offer SPF protection remains valuable.
Liposuction for bra fat, which is the unsightly bulges that show through tight clothing, poses a unique challenge. First and foremost, the fat is highly fibrous and thus difficult to remove with a hollowed tube attached to a vacuum pump (cannula).
Leading Beverly Hills plastic surgeon Dr. Tarick Smiley has recently posted a series of Snapchat videos to demonstrate liposuction for bra fat and the “meticulous” techniques required to help achieve smooth, natural-looking results from the surgery.
Before-and-After Photos of a Patient Who Have Had Liposuction for Bra Fat
“I use smaller cannula, or microcannula, when treating the bra fat and back rolls caused by fibrous fat, which is tough to remove and so it requires more effort,” he said.
It is important to note that certain anatomic areas are consistently more fibrous compared to the rest of the body; they include the back, male breasts, and around the navel.
“The use of microcannula makes it easier to penetrate the fibrous fat, as compared with the use of large cannula. Furthermore, its smaller body allows for more precision during the extraction of fat, leading to smoother contour and lower risk of surface irregularities,” Dr. Smiley added.
In the video, Dr. Smiley is seen pushing the microcannula back and forth with his right hand, while his left hand “feels” the treated area.
“Contrary to popular belief, liposuction is not mainly about seeing what you’re doing. A skilled surgeon will know how much fat he needs to remove by simply feeling the treated area while moving the cannula back and forth. With over 9,000 liposuctions I have already performed, the process has become a second nature to me,” he further explained.
The celebrity plastic surgeon said liposuction for bra fat has almost become a common “complementary procedure” of Brazilian butt lift in which the patient’s buttocks and hips are augmented and reshaped with the most natural material: her own fat.
Instead of discarding the fat collected during liposuction, it is processed and transferred to the buttocks.
By performing liposuction for bra fat, the back will not detract from the curvier, more feminine buttocks and hips, said Dr. Smiley.
To know more about liposuction and its ancillary procedures, interested parties may want to add Dr. Smiley on Snapchat. He regularly posts videos to spread patient safety awareness.
The Benelli lift with breast implants basically accomplishes two things: create an “illusion” of a perkier appearance, and provide more breast volume.
The term “illusion” is an appropriate way to describe the effects of Benelli lift, which unlike the standard breast lift, does not manipulate and reshape the actual breast tissue. It simply relies on repositioning the areola higher on the breast.
Meanwhile, a standard breast lift actually “lifts” and re-anchors the sagging breast tissue.
For this reason, the Benelli lift only suits patients with pseudo or fake breast ptosis or sagging—i.e., the upper breast pole appears “empty” but the areola has not yet sagged below the breast fold.
To demonstrate the effects of Benelli lift with breast implants, leading Beverly Hills plastic surgeon Dr. Tarick Smiley has recently posted a series of Snapchat videos involving the technique.
The patient shown in the video had enlarged areolas, which were positioned lower than ideal, although they had not yet drooped beyond the breast crease. Moreover, her breast size was disproportionately small for her body and thus she requested for a simultaneous augmentation surgery.
Dr. Smiley started off the surgery with the creation of a smaller areola. He used a round cookie-cutter device to make an imprint of the new areolar complex. Then, he created an oblong-shaped incision outside of the same cut.
With the aforementioned incision pattern, Dr. Smiley was able to remove some of the dark pigmented skin of the areola, ultimately reducing its size. Of course, he lifted it a few centimeters from the breast crease to achieve a perkier, more youthful appearance.
According to studies, the ideal distance between the nipple and the sternal notch (visible dip between the neck and the collarbone) is between 17-21 cm. But if there is a larger gap, the breasts are perceived to be saggy.
After improving the shape, size, and placement of the areola, Dr. Smiley positioned the implants to give the patient more breast volume. These prostheses are propelled into their pockets through the previously created incision around the nipple area, thus avoiding additional scar.
The resulting scar from the Benelli lift, meanwhile, lies precisely at the dark-light skin junction and so it will blend into the background after six to 18 months, Dr. Smiley said in one of his Snapchat videos.