A simultaneous fat transfer for face wrinkles allows facelift patients achieve a more natural, three-dimensional rejuvenating effect.
Celebrity Beverly Hills plastic surgeon Dr. Tarick Smiley says many of his facelift patients benefit from fat transfer for face wrinkles. This is particularly true for older individuals (55 years and above) and massive weight loss patients who generally experience significant facial volume loss.
In a series of Snapchat videos, Dr. Smiley has demonstrated two female patients who benefited greatly from facial fat transfer.
One of the patients had a lower eyelid surgery with simultaneous fat transfer to address the abrupt lid-cheek junction and the deep nasolabial folds, or in layman’s term, “laugh lines.”
Another female patient had facelift combined with fat transfer to conceal her deep tear trough and to create a softer cheek appearance. For additional rejuvenating effect, the sagging or displaced cheek fat pad, which had almost reached her jowl, was elevated during surgery.
For the vast majority of Dr. Smiley’s patients, he harvests the “unwanted” fat from the tummy area, which is later purified and re-injected into the face to correct its deep lines and hollowed regions.
In one of the recent videos, Dr. Smiley is seen placing the collected fats in tubes so the red blood cells will settle to the bottom (due to the effects of gravity), being the heaviest material. This is always discarded, together with oil and other impurities, to come up with the purest “golden” fat.
Afterwards, the fluids are put in a centrifuge to further remove other impurities before the purest fat is placed in a syringe with a blunt needle.
The special blunt needle allows precise placement of bead-like fat with the least amount of trauma, which in turn promotes the highest survival rate of grafts.
With gentle collection and injection of fat, combined with meticulous purification method, Dr. Smiley says that about 70 percent of the fat volume is expected to persist long term (average of 12-15 years, as suggested by studies and anecdotal reports).
Aside from the high survival rate of fat graft, Dr. Smiley also focuses on delivering natural results, which are achieved by precisely filling in the deep lines and wrinkles and avoiding the hyper-inflated appearance.
Crescent lift with implants basically involves slight elevation of the areola and a simultaneous breast augmentation. It is important to note that it only suits patients who do not require an actual breast lift.
Breast lift surgery, in the truest sense of the term, elevates the breast tissue with internal sutures. At the same time, the nipple area is repositioned higher, making sure that it lies above the submammary fold, to achieve more proportionate, perkier results.
Meanwhile, a crescent lift does not involve actual elevation of the breast tissue. Basically, it just raises the nipple area slightly with the creation of a concave shaped incision at the upper border of the areola; hence, the resulting scar precisely lies at the dark-light skin junction and is almost invisible when completely healed.
Leading Beverly Hills plastic surgeon Dr. Tarick Smiley has recently posted a series of Snapchat videos to demonstrate crescent lift with implants.
The patient shown in the videos has no “real” breast ptosis (sagging), which is medically defined as having a nipple area drooping below the submammary fold. However, she could benefit from a slight elevation of her areola and so Dr. Smiley performed a simultaneous crescent lift.
Some surgeons are hesitant to use the crescent lift due to the perceived risk of areola distortion (it may appear asymmetric, wider, or elongated after surgery). However, Dr. Smiley said in the video that poor results generally arise when excessive tension is put on the skin.
In the video, Dr. Smiley is seen closing the concave shaped incision with the use of absorbable suture. But instead of “picking up” the skin, all the stitches were made “inside” or beneath the skin layer.
Meanwhile, the skin’s edges were simply allowed to “kiss other” so the scar will remain thin and inconspicuous as it lies precisely at the areola’s border.
“Favorable or invisible scar can be achieved if there is no or very little tension on the skin. We simply respect the skin during wound closure,” he said in the Snapchat video.
There is a growing mommy makeover trend: Today’s patients are more well versed in plastic surgery that they are demanding for more natural and more proportionate results.
Mommy makeover surgery, which is basically a marketing term, refers to multiple surgery procedures that restore or at least improve the post-pregnancy bodies of patients. Leading Beverly Hills plastic surgeon Dr. Tarick Smiley says the most common “combination surgery” involves tummy tuck and some type of breast enhancement.
Dr. Smiley, who regularly posts Snapchat videos to spread patient awareness and to share his knowledge with medical students and colleagues, has provided a list of mommy makeover trend that generally favors “subtle” and “realistic” results.
- Curvier and slender waist with tummy tuck
In the past, most patients simply wanted the removal of their apron-like skin that hangs from their abdomen. But nowadays, women are more fastidious in terms of cosmetic results—they want the “corset effect” on their waistline.
To achieve a curvier and more defined waistline, Dr. Smiley highlights the importance of suturing the pair of splayed abdominal muscle, which prior to pregnancy is lined up closely side-by-side.
But during pregnancy that causes the abdominal wall to expand, the fascia (connective tissue) holding it together becomes weak, leading to a gap that could even become palpable. This gap is also causing the barrel-shaped waist that used to have an hourglass figure.
For additional contouring effect, Dr. Smiley pulls and tightens the abdominal skin “centrally.” And if needed, he also performs liposuction of the flanks to achieve a more hourglass figure.
- Breast augmentation beyond size increase
Modern breast augmentation is focused not just on size increase, but also on the final shape and projection. The goal is to achieve the most natural results possible, which all boils down to implants settling in their most ideal position.
Due to the growing demand for natural and “realistic” breast augmentation results, it is now commonly performed together with breast lift. The idea is to achieve optimal breast shape so the “fullness” will look natural.
Dr. Smiley warns that failure to address pre-existing sagging or asymmetry can lead to surgical stigmata like “Snoopy deformity,” excessive lateral bulge, and bottomed-out appearance.
Aside from breast lift, other common ancillary procedures of implants include areola reduction and fat transfer.
- Fat transfer for a more feminine figure
Fat transfer has revolutionized the way surgeons perform body contouring surgery, particularly buttock augmentation.
The growing popularity of fat transfer is attributed to the refinements in the purification techniques, allowing surgeons to increase the survival rate to more than 70 percent. It is important to note that any amount that remains about three months after injection is expected to persist long term.
Fat transfer as a way to augment the buttock is also a powerful body contouring procedure. Because it involves liposuction (in order to harvest the “unwanted” fats), it can contour the waistline at the same time, which in turn results in a more hourglass figure.
Male body contouring surgery can range from liposuction, breast reduction, to tummy tuck and other types of body lift following massive weight loss. While the goal is to achieve a more masculine physique, which possesses fundamental traits as suggested by several studies, the results will still depend on the patient’s “starting” anatomy.
Renowned Beverly Hills plastic surgeon Dr. Tarick Smiley, who regularly posts educational videos on Snapchat tackling the issue of male body contouring surgery, has provided a list of the most popular procedures and the corresponding ways to achieve gender-appropriate results.
- Liposuction —i.e., body contouring surgery in which the unwanted fat beneath the skin is removed with a hollowed tube
Unlike women who generally seek liposuction to appear more slender, men are more interested in looking more toned. Hence, male patients require less fat reduction.
Male liposuction typically entails a small amount of fat removal just to “reveal” the underlying muscle (like the appearance of six pack abs).
About 27,760 male breast reductions were performed in 2016, according to a survey released by the American Board of Plastic Surgery.
Gynecomastia, a condition in which the male breasts appear overdeveloped, affects up to 60 percent of men although in the vast majority of cases it disappears after puberty (or when the hormonal levels stabilize) or after cessation from drugs causing the woman-like breasts.
But for men whose enlarged breasts that persist longer than two years and even after the elimination of “possible contributing factors” (e.g., obesity, hormonal imbalance, drug, and medical condition), surgery might be a good option provided they are healthy.
All male tummy tuck patients have lost a significant amount of weight, leading to the redundant skin that may not just affect the abdomen, but also the flanks and back. Therefore, they typically require longer incisions, which of course lead to longer scars.
Tummy tuck not just removes the apron-like skin; if needed, the surgery may also involve muscle repair in which the pair of muscle extending from the breastbone to the pubic region is tightened in the midline.
Due to the natural diffusion of redundant skin and tissue laxity that commonly follows drastic weight loss, most tummy tuck patients also need arm lift, buttock lift, and lower body lift for a more proportionate result.
While body contouring can help patients achieve a more masculine physique—which is generally defined as an inverted triangle torso as it tapers from the shoulders to the waist—it is important to note that their underlying anatomies will still have a large effect on the final results.
Therefore, the right candidates for male body contouring surgery must be able to explain their “realistic” goals in details to their surgeons.
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.)
Photo Credit: alexisdc at FreeDigitalPhotos.net
- 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.