Posts Tagged "Body Contouring"


Brazilian butt lift is a good or sometimes even better alternative to butt implant surgery. In this procedure, excess fat is harvested from another part of the body and then purified and re-injected to the patient’s backside to augment and reshape it in a way that it should look natural.

To promote high survival rate of fat graft, celebrity Los Angeles plastic surgeons usually recommend at least three weeks of no sitting. Nevertheless, a quick bathroom trip is acceptable.

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The idea is to avoid direct pressure on the buttocks while the fat is still in the stage of forming new blood supply. Once the fat grafts have revascularized, there is less concern about the compression on the surgical site.

Aside from low fat survival rate, another concern with sitting too soon is that it may distort the shape of the buttocks or cause fat grafts to shift, a problem that entails a complex and usually expensive revision surgery.

During the initial healing period, renowned body contouring expert Dr. Tarick Smaili says the “right” sleeping position is also important to avoid pressure on the buttock area that could compromise fat survival. The general rule of thumb is to lie on one’s side, chest, or stomach, he adds.

While fetal position is often acceptable, it is ideal to lean more toward the tummy (as opposed to the back) to avoid compression on the lateral side of the buttock that is usually reshaped at the time of surgery, explains Dr. Smaili.

After three weeks, most Los Angeles plastic surgeons allow their patients to sleep in any position or sit, although preferably on a soft surface and/or with the use of a donut- or cigar-shaped pillow.

A cigar-shaped pillow is placed under the thighs in an attempt to minimize the pressure on the buttocks. Any type of postop cushion can be used for six to eight weeks to protect the fat grafts from compression that can lower their survival rate and lead to an overall poor result.

Once the fat grafts have formed their blood supply, the result of Brazilian butt lift is near permanent for most patients.

Arguably, the most commonly mentioned benefit of this procedure is the more natural result compared with the use of buttock implants, which are made of solid silicone. Aside from the natural “feel,” the technique is also noted for its ability to reshape the entire buttock and even the hips, if needed.

Butt implants, meanwhile, are positioned above the sitting area so only the upper third of the buttock is augmented and reshaped.

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All elective surgeries such as mommy makeover require the patient to be of normal weight and healthy. And since visual appearance is not an accurate indicator of health, leading Los Angeles plastic surgeon Dr. Tarick Smaili always highlights the importance of a comprehensive physical and lab exam.

Normal healing is one of the crucial prerequisites in mommy makeover surgery, which is a broad term used to describe any surgical enhancement used to reverse the “cosmetic” effects of pregnancy; examples include breast lift and augmentation, tummy tuck, and abdominal liposuction.

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The mommy makeover Los Angeles expert believes that weeks or even months of preparation can significantly reduce risk of complications. The goal is to improve healing through lifestyle changes and to control a medical condition or risk factor, if there is any, through the use of medications.

Being of normal weight prior to body contouring surgery not only leads to optimal results. Studies have also suggested that a person of normal weight is less likely to experience wound healing problem compared to significantly overweight or obese individuals. The theory is that a high body fat percentage increases the risk of infection and other complications.

Dr. Smaili always instructs his patients to stop smoking and smoking cessation products like nicotine gum and patch at least three weeks prior to surgery. The idea is to give the body enough time to flush out the nicotine and other harmful chemicals, which are known to reduce the oxygen levels and nutrients going to the wound.

Carbon monoxide found in smoking is particularly detrimental because it deprives the wound with the much-needed oxygen for tissue repair. This is further aggravated by nicotine, which is a vasoconstrictor chemical, meaning it constricts the blood vessels and impedes the normal flow of nutrients toward the wound.

A study published by the Journal of Plastic, Reconstructive & Aesthetic Surgery has suggested that smokers are 3.3 times more likely to develop wound infections than non-smokers. Exposure to the chemicals of smoking has also been found to significantly increase the risk of skin necrosis or death of skin tissue, and “overall” chance of complications.

Some medications and supplements have also been found to impede healing. Examples include aspirin and ibuprofen—also referred to as blood thinners—,birth control pills, hormone replacement drugs, fish oil, gingko biloba, green tea, and wide a range of homeopathic drugs.

These medications and supplements must be avoided at least three weeks prior to a mommy makeover surgery.

Dr. Smaili also emphasizes the importance of eating healthy to improve healing and the body’s barrier to infection. But since the typical diet of Americans lack “diversity,” he says that preoperative supplements, especially those containing vitamin C and zinc, might be prescribed.

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Male bodybuilders with abnormal breast enlargement might benefit from a body contouring procedure called gynecomastia surgery but only after medical conditions such as hormonal problem have been ruled out.

According to a study published by Plastic and Reconstructive Surgery medical journal, gynecomastia surgery performed on bodybuilders results in high patient satisfaction, although in general they require a different surgical approach from “ordinary” patients.

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The study involved more than 1,000 male bodybuilders whose age ranged from 18 to 51, with about 15 percent of them have joined professional bodybuilding competitions.

Prior to surgery, all patients were free of diseases such as tumors and kidney failure that might cause male breast enlargement. Meanwhile, some took steroids or supplements containing hormones during their younger years that resulted in gynecomastia (which more often than not a temporary condition) that become a permanent problem.

The author of the study has concluded that high patient satisfaction among bodybuilders would require a different approach and special attention to prevent bleeding, which is an issue because a well-developed chest muscle is highly vascularized.

Another consideration is that bodybuilders, compared to ordinary patients, have higher expectations and goals from their surgery.

The study, which claimed that most respondents were extremely satisfied with the results, also looked into the most ideal techniques to prevent increased bleeding, poor cosmetic outcome, and recurrence of gynecomastia.

Aside from using a 1-inch incision to reduce the risk of increased bleeding and poor scarring, the plastic surgeon who conducted the study said that removing all the glandular breast tissue could prevent gynecomastia from recurring.

Another factor contributing to the success of gynecomastia surgery, according to study, is the “right” preparation to minimize increased bleeding and poor scarring. For instance, blood-thinners, supplements known to affect healing (e.g., fish oil, vitamin E, green tea, ginseng, and gingko biloba), and steroids must be avoided months before the procedure.

Meanwhile, the study has shown that complications after gynecomastia surgery were either uncommon or just minor. About 6 percent of the patients experienced hematoma or accumulation of blood within the surgical site.

However, most of the complications reported by patients are less likely to occur with the right preoperative and postoperative care such as avoiding steroids and other supplements/medications known to affect healing, stopping all rigorous activities while the body has not yet fully recovered from the surgical trauma, and performing only light exercise such as walking during recovery.

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Around 300,000 women in the US undergo breast augmentation surgery annually, making it the most commonly performed surgical enhancement over the past several years.  While some surgeons claim that fat transfer is a good alternative to breast implants, using them remains the most preferred choice because they are better in larger augmentations and provide a more predictable result.

However, the use of breast implants entails long-term maintenance because there is no guaranty that they can last a lifetime, explains body contouring expert Dr. Tarick Smaili.

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As of this writing, the US Food and Drug Administration only allows two types of breast implants: silicone and saline implants which have the same silicone outer shell, with their filler material being the only difference.

As its name suggests, silicone implant is filled with a plastic gel (medical-grade silicone), while saline implants is inflated with saline (sterile salt water).

With silicone breast implants, health authorities recommend MRI exam three years after the initial surgery and subsequently every two years for the rest of the prostheses’ lives.  On the other hand, women with saline implants are not required to undergo the same postop maintenance.

MRI scans are used to detect “silent” or asymptomatic silicone gel leak, which could go undetected for years if the patient only relies on “visual” symptoms because the filler material may just be contained inside the breast pocket.  Meanwhile, saline implants will have immediate manifestation in case they leak because the surrounding tissue can absorb saltwater in just a few hours from the time they rupture.

While silicone implants provide a more natural look and feel than saline implants, the cost of regular MRI breast scan must be always taken into consideration.  According to a recent survey, its average fee is $2,500 to $3,500.

Breast implant maintenance also involves follow-up visits even when there is no sign of any problem.  However, Dr. Smaili says that some patients who are happy with their results think that these are pointless, a belief that must be changed.

Whether a woman has an augmented or natural breast, Dr. Smaili advocates the practice of regular breast exam to detect cancer and other abnormalities.  But since the presence of implants may affect the result of mammograms, the leading surgeon recommends breast X-rays and other screening tests.

Regular breast exams for cancer detection are often recommended for women aged 40 years and above, although individuals who are considered “high risk” are often advised to start them at a younger age whether they have augmented or natural breasts.

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The traditional way to perform mastopexy, or more commonly referred to as breast lift surgery, is through an inverted-T scar pattern in which the incisions go around the nipple-areola complex, from the bottom of the nipple to the inframammary fold, and within the “natural crease.”

The standard breast lift is reserved for patients with poor skin quality, noticeable amount of drooping (e.g., NAC falls far beyond the inframammary fold), and breasts that are on the larger side.

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With the rather extensive use of incisions in the standard technique, some women choose to undergo a modified form of breast lift that results in shorter scars and possibly quicker recovery.

A technique called donut breast lift, which is also referred to as Benelli mastopexy, only uses incisions around the NAC where the scars can heal and blend well.  But despite the apparent benefits in terms of the scar appearance, the procedure is not for someone with a true case of breast ptosis or drooping, explains leading body contouring expert Dr. Tarick Smaili.

In essence, a donut lift does not lift the tissue itself but rather only reposition the NAC by 1-2 cm on the breast “mound.”  For this reason, the vast majority of women asking for mastopexy will not benefit from this technique and in fact may even lead to deformity especially in the upper aspect of the breast.

Another common problem with the donut lift technique, according to Dr. Smaili, is that over time the nipple area has the tendency to expand.

Nevertheless, for a few patients with pseudo-ptosis—i.e., the NAC is at the level of their inframammary crease—a donut lift may be an option.  In some cases, it is performed in conjunction with breast augmentation, which provides additional volume and potentially some lifting effect.

For most breast lift patients, the renowned surgeon says that internal re-arrangement and tightening of the tissue is the ideal choice because it results in a highly predictable breast shape, which is achievable with the use of standard technique and vertical lift.

With vertical lift the incisions go around the NAC and vertically between the nipple and inframammary fold, leading to a lollipop-shaped scar, thereby it is also referred to as a lollipop lift.

The vertical incision allows the surgeon to tighten a good amount of breast tissue and skin, and in fact may favor patients who have a markedly wide breast, says Dr. Smaili.

And by eliminating the horizontal incision within the inframammary crease, the plastic surgeon says the vertical lift tend to result in quicker recovery than the standard approach.

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