Posts Tagged "Beverly Hills plastic surgeon Dr. Tarick Smiley"

With meticulous patient selection and surgical execution, male chest liposuction can result in a more athletic appearance, says leading Beverly Hills plastic surgeon Dr. Tarick Smiley.


But what constitutes the ideal male chest?

male breast reduction photo


As with any body contouring surgery, male chest liposuction demands a profound understanding of the established aesthetic guidelines. For instance, most cultures prefer a V-shaped male torso that exhibits broad shoulders and a defined chest that tapers to the flat waist.


Scientists recon that the athletic V-shaped male physique might serve as visible cue for health, virility, and good genes.


Knowing the aforementioned aesthetic guideline is one of the keys to achieve natural results from male chest liposuction. After all, men generally want an outcome that appears like they were born with it or at least work on their physique through good ol’ fashion exercise and healthy diet.


Dr. Smiley says one common mistake of inexperienced surgeons doing male chest liposuction is focusing only on the lower part of the chest wall, while ignoring other critical areas such as the lateral and outer aspect of the muscle. This results in “fullness” or indentation of the adjacent sites.


Due to the natural diffusion of superficial fat whose distribution is genetically predetermined rather than caused by poor lifestyle, male chest liposuction entails a larger surface area—i.e., the lower and lateral and outer areas of the muscle must be contoured as well to ensure smooth transition and natural results.


All efforts are made to promote natural results, as men are generally more reticent about their aesthetic plastic surgery than women.


To further ensure a more “cohesive” result, a good number of patients can also benefit from liposuction of their anterior abdomen and/or flanks. Compared to women, men in general require less fat volume removed due to the natural distribution of their fat and muscle composition.


It should be noted that male chest liposuction only works in normal weight men with pseudo-gynecomastia, which means that their overdeveloped breasts are caused by excess fat instead of glandular tissue, which does not come out with liposuction cannula (hollowed steel tube attached to a pump).


The only way to remove the excess glandular tissue is to create a short incision along the lower edge of the areola (dark pigmented part of skin). And over time, the scar is expected to fade into the background.

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Tummy tuck recovery takes three to eight weeks and during this period the internal scar tissue that holds the “new contour” is not yet as flexible as the normal tissue. Hence, coughing and sneezing may cause feeling of tightness or pain, or in rare instances even result in suture break along the abdominal wall.


Leading Beverly Hills plastic surgeon Dr. Tarick Smiley has recently posted a video on Snapchat to show how permanent sutures are used to “tighten” the rectus muscle. The pair of muscle between the lower and upper abdomen becomes separated due to pregnancy or large weight fluctuations, and thus suturing them together in a side-by-side configuration is one critical component to achieve flatter results from surgery.


Permanent sutures are used to tighten the abdominal wall, leading to flatter appearance and less bunching while sitting.

In the video, Dr. Smiley said the stitch right above the belly button is the most important aspect of muscle repair and may sometimes experience suture break due to abrupt force generated by a “strong” sneeze or an incessant cough.


To prevent too much tightness, pain, and accidental suture break during the critical period of tummy tuck recovery, Dr. Smiley recommends his patients to press a pillow against their abdomen when they feel that a sneeze or cough is imminent. The idea is to minimize the abdominal movement and ultimately the stress on the sutures and scar tissue.


Sneezing and coughing is not the only thing that can put stress on the healing tissue and sutures. Any activity that results in sudden tensing of the abdominal wall should be avoided for a minimum of eight weeks; hence, all patients are advised to postpone rigorous exercise until their scar tissue becomes more flexible.


In general, patients should wait eight weeks before they can gradually resume core body exercises. Nonetheless, light activity (walking and other light aerobics exercises) can be started sooner provided that the patient does not feel any pulling or discomfort.


Most of the tautness and discomfort following tummy tuck stems from muscle repair. Thus, many patients feel more comfortable when they are slightly bent at the waist within the first 10 days, but after this period most can stand up straight without any issue.

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Tummy tuck improves the appearance of the abdomen, which is not an ethnically “sensitive” area (unlike the face, particularly the nose and eyes). Nonetheless, ethnic skin or darker complexion is known to have an increased risk of hyperpigmentation and keloid scar.


Tummy tuck traditionally uses a hip-to-hip incision to remove the skin and fat rolls. Most patients can also benefit from muscle repair in which the two vertical muscles along the midline are sutured closer together, resulting in a flatter appearance.


ethnic tummy tuck

With muscle repair and the removal of excess skin and fat, a good number of patients can expect a more athletic appearance of their anterior abdomen (because of the small grooves caused by the two vertical muscles positioned in a side-by-side orientation).


While there is no ethnic tummy tuck per se, patients with darker complexion may entail a more proactive scar prevention and treatment due to the perceived higher risk of keloids. The use of silicone gel sheets over the [healed] incisions for several months is known to reduce the incidence of aggressive scarring, says leading Beverly Hills plastic surgeon Dr. Tarick Smiley.


Occasionally, the concomitant use of bleaching agents and/or laser could help prevent or reduce risk of hyperpigmentation of the scars.


Meanwhile, the inconspicuous placement of tummy tuck scar—it should be very low that it is easily concealed by the patient’s underwear—remains important regardless of one’s predisposition to keloids.


As with any body contouring surgery, the success of tummy tuck boils down to meticulous physical analysis and consultation. Another thing to keep in mind is that women of Hispanic and African descent often desire for fuller curves, while Caucasians usually prefer a more petite figure.


By being sensitive to culture-based beauty ideals and the patient’s cosmetic goals, doctors offering tummy tuck surgery typically achieve high patient satisfaction. After all, the purpose of any aesthetic surgery is to elicit a smile from patients.


To achieve fuller curves, some patients ask for a simultaneous Brazilian buttock lift, i.e., buttock augmentation via fat injection. In reality, this is not always a deviation from tummy tuck, which often entails liposuction of the flanks to remove the “fat rolls.”


Instead of discarding the fats collected during liposuction, these are purified and injected into the buttocks to improve their shape and projection. Of course, this additional procedure results in longer operative time and more cost.

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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.


fat transfer to nasolabial folds

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.

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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

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.


  • Facelift


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.


  • Rhinoplasty


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


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.

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