The use of compression garment after BBL, or Brazilian butt lift, is known to minimize swelling, decrease discomfort, and promote healing and smoother contour of the liposuction sites.
Most compression garments used after BBL resemble a girdle that extends from the upper back to just above the knee. However, it has a “butt out” design, meaning it has no or very little compression or tight fabric over the buttock region.
Leading Beverly Hills plastic surgeon Dr. Tarick Smiley says that excessive compression on the buttocks, which are the recipient of the fat grafts, can lead to low survival rate and less than optimal results.
However, the liposuction sites can benefit from some moderate amount of compression to keep swelling to a minimum. The idea is to compress the “empty” compartments where the fat has been removed to prevent edema or excess fluids from accumulating.
The right amount of compression over the liposuction sites can also help remodel the tissue and allow the skin to heal closer to the body, which in turn promotes the smoothest results possible, says Dr. Smiley.
While each doctor has his own specific instructions on how to use compression garment after BBL, many agree that it should be worn for at least three weeks religiously, meaning it is only removed when the patient uses the toilet or takes a shower.
The garments should fit snugly over the liposuction sites, causing no discomfort and pressure problems (the fabric or elastic edges should not dig into the skin).
As the swelling resolves as the patients move forward to their recovery, it is common to switch to a smaller garment or even a Spanx-like standard girdle provided that most of the postop symptoms are gone. Meanwhile, people with redundant skin and persistent swelling will have to wear them longer.
Chin and neck liposuction creates a sharper angle between the neck and jawline. When performed as a stand-alone procedure, it is mostly performed in “younger” patients (35-50 years old) who typically have good skin shrinkage.
But past the age of 55, chin and neck liposuction could result in saggy appearance unless performed concurrently with some type of facelift or neck lift. Also, when it is done too aggressively (too much fat is removed), it might unmask the platysma muscle, resulting in visible vertical bands.
Leading Beverly Hills plastic surgeon Dr. Tarick Smiley has recently demonstrated the surgery on his Snapchat. The patient shown in the series of videos had about 300 cc of excess fat removed behind her chin and neck, a procedure medically referred to as submental liposuction.
Submental liposuction typically uses a small around incision beneath the chin, specifically positioned within the natural skin fold for optimal scar concealment. However, the patient also required a pair of incisions below her earlobes due to the severity of her excess fat—i.e., it extended far beyond the center of her neck.
The additional two incisions placed behind the earlobes allowed Dr. Smiley to attack the excess fat from different directions and remove it in a fanlike fashion (multiple layers), paving way for smoother results.
Meanwhile, he left behind a sufficient layer of fat, particularly right beneath the skin, to prevent dents, bumps, and other surface irregularities. Meticulous liposuction would also ensure that the skin could shrink-wrap around the new contour instead of looking saggy.
To further promote smooth results, the celebrity plastic surgeon says he typically recommends patients to wear a compression garment (or chin-neck strap) for at least one week to help the skin heal closer to the body. This will also keep swelling to a minimum, which paves way for quicker recovery.
Tummy tuck with muscle repair ensures a flatter, more athletic abdomen after surgery. Recently, leading Beverly Hills plastic surgeon Dr. Tarick Smiley has demonstrated this technique on Snapchat as part of his patient awareness campaign.
The patient shown in the photos had extensive stretch marks, loose skin, and bulging tummy prior to surgery.
Tummy tuck is more commonly known as a surgery that removes the excess skin and fat hanging from the abdomen. However, this technique alone may not be enough to deliver optimal results unless complemented by muscle repair.
The excessive protrusion of her abdomen, according to Dr. Smiley, was caused by “weakness or poor integrity of the abdominal muscles.”
While the abdominal muscles are elastic, the fascia that holds them together is relatively inelastic; hence, some women with flat tummy may end up with barrel-shaped contour after pregnancy or large weight fluctuations.
Compared to most patients, the woman had a more severe case of abdominal wall weakness, which fittingly required additional suturing and tightening during surgery.
Dr. Smiley started the surgery with the creation of a hip-to-hip incision placed very low—i.e., a few centimeters below the pubic hairline. This incision placement would allow him to remove the excess skin and elevate the sagging mons pubis at the same time.
This is the suture pattern used to repair the loose rectus abdominis muscle. However, the patient’s oblique muscles are included as well due to the extent of her muscle weakness.
After the creation of the hip-to-hip incision, Dr. Smiley separated and lifted off the skin, revealing the loose abdominal muscles.
The celebrity plastic surgeon first worked on the rectus abdominis muscles. This is a pair of vertical muscles that is attached between the ribs and the pubis in the center of the abdomen. It should be noted that this anatomy is commonly repaired during standard tummy tuck.
But due to the extent of her abdominal wall weakness, she required additional muscle repair, particularly of the oblique muscles found on the more lateral side of the tummy.
By tightening the oblique muscles, Dr. Smiley says the patient “can expect more tightening effect and less bulging of the tummy every time she sits down.”
To complement her flatter abdomen, Dr. Smiley reduced the size of her navel with the use of an incision made inside its rim to hide the scar.
Patients seeking tummy tuck want to have a flatter, more athletic abdomen without any surgical stigmata such as “high-riding” scar, unnatural navel shape or placement, overly tight appearance, and residual fullness of the flanks or upper abdomen.
Leading Beverly Hills plastic surgeon Dr. Tarick Smiley says that fake tummy tuck results can be avoided with meticulous surgical methods specifically created for the patient’s underlying anatomy and cosmetic issues.
The after photo depicts impressive tummy tuck results; there is no visible scar, the feminine curves have been preserved, and the new navel size complements the flatter abdomen.
The incisional placement used in tummy tuck can make or break the results. All efforts are made to ensure that the scar lies very low to the point that it is covered by the patient’s underwear. Also, it should encompass the loose skin to prevent residual fullness and dog ears appearance in which the skin around the scar appears “puckered.”
Due to the natural diffusion of loose abdominal skin caused by pregnancy or massive weight loss, Dr. Smiley says the vast majority of patients will have to accept the hip-to-hip incision pattern to achieve the most natural contouring effects. The short-scar or mini tummy tuck technique, meanwhile, rarely works because it removes just a minimal amount of skin—i.e., only one-third of the anterior abdomen.
Aside from visible or high-riding scar, another common insignia of a fake tummy tuck result is the overly tight transition between the navel and the mons pubis. First and foremost, there should be a gentle curve between these two “points” to ensure natural-looking results.
Overly tight navel-mons junction often stems from over-correction; either too much skin has been removed or the mons pubis has been lifted too much, resulting not just in unnatural tightness but also in pubic hairline “riding higher” and poking out the edges of the underwear.
Nonetheless, some patients need a conservative elevation of their mons pubis, which has the tendency to sag following massive weight loss and pregnancy.
Unnatural belly button also leads to the appearance of fake tummy tuck results. Hence, all efforts are made to preserve its original position, which is done by removing the excess skin around it without cutting it off completely from its stalk (and main blood supply). After excising the redundant skin and fat, the skin above the belly button is pulled down and a small round incision is created in order to expose it.
Furthermore, the scar should be made inside the navel’s rim to prevent visible “stitch lines.” Oftentimes, its size is also reduced to complement the patient’s flatter and more athletic abdomen.
Complementing tummy tuck with liposuction of the flanks and/or muscle repair is another sure way to keep the results as natural as possible. The idea is to create smooth “transitions” between the lower and upper abdomen, and between the anterior abdomen and flanks.
All efforts are made to hide the neck liposuction incisions to promote high patient satisfaction. After all, people do not want telltale signs of plastic surgery such as visible scars, skin irregularities, and unnatural contour, says leading Beverly Hills plastic surgeon Dr. Tarick Smiley.
Dr. Smiley has recently performed neck liposuction in a female patient and posted her surgery on Snapchat.
Dr. Smiley uses one small incision precisely placed within the natural skin fold for optimal scar concealment.
The patient said she was bothered by her “heavy” neck and “double chin” appearance caused by the excess fat. Meanwhile, she had a decent skin shrinkage and so she was deemed as a good candidate for a neck liposuction-alone approach.
(Note: Patients with poor skin elasticity may need a concomitant excision-based surgery—e.g., facelift and neck lift—as a liposuction-alone approach may aggravate the appearance of sagging neck or jowl.)
To create a more slender neck, Dr. Smiley performed liposuction, which also included the patient’s chin to achieve a smooth, natural transition between these areas. He also removed some fats along the jawline to deliver a more chiseled appearance. This was all done with the use of a small round incision (about 1 cm) beneath the chin, specifically within the natural skin crease to further hide the scar.
Occasionally, the under the chin incision is complemented by a pair of incisions below the earlobes. This approach is particularly ideal for patients whose neck fat extends significantly beyond the center.
Dr. Smiley says that neck liposuction requires a “highly meticulous approach” to prevent surface irregularities.
To achieve smooth results, Dr. Smiley highlights the importance of “cross feathering” technique in which the liposuction cannula (stainless steel tube to remove the fat) is moved back and forth quickly and at varying angles.
The idea of cross feathering, Dr. Smiley explains, is to promote uniform removal of the excess fats, and to ensure that some fats remain after surgery to preserve a smooth skin surface.
Contrary to popular belief, the celebrity plastic surgeon says that neck liposuction is not about removing the entire fat. In fact, doing so could lead to visible bands caused by the lack of “carpeting” to the point that the platysma muscles show through the thin skin, he warns.
To preserve smooth surface and natural neck contours, he highlights the importance of leaving behind enough fat beneath the skin.