The success of your liposuction or any type of body contouring largely depends on the skills of your plastic surgeon. But what are the qualifications you should really look into and how you should weigh each of them to come up with a sound decision?
Liposuction Los Angeles expert Dr. Tarick Smaili shares his tips on how you should select your doctor.
- Focus on the experience of your liposuction doctor.
The general rule of thumb is to select someone certified by the American Board of Plastic Surgery (ABPS). You can visit their website to check if your doctor is board certified.
It is equally important that your doctor is performing liposuction on a regular basis for at least five years. Take note that experience is the best way to sharpen anyone’s skills, which are crucial in cosmetic plastic surgery which combines art and science.
Meanwhile, avoid non-specialists and doctors whose only qualification is a five-day training because they account for the vast majority of botched results.
- Look at his before-and-after photos.
Pictures can reveal a lot about your doctor’s artistic skills, or lack thereof. Nowadays, many surgeons post their “works” online to brandish their talents.
The “after” photos should look natural and should have no sign of over-correction—i.e., gaunt appearance. The results must also look smooth and tight, with no residual fat rolls and visible skin asymmetries.
- Choose a surgeon who will prioritize your safety above all else.
Prudent surgeons know that there is a safety limit on the maximum amount of suctioned fat, and will discourage or turn down anyone who insists to undergo large volume liposuction performed on a single day.
Good surgeons also give much importance to proper patient selection, preparation, conservative approach (i.e., avoiding unrelated procedures at the time of surgery), and postop care.
- Choose a doctor who only performs surgeries in a hospital or accredited surgical center.
All “bona fide” plastic surgeons are required to have their surgeries in hospitals or accredited surgical facilities, which adhere to patient safety standards and building codes.
- Avoid over-confident surgeons.
While liposuction safety has significantly improved over the past several years, take note that any surgery has its own risks particularly if the surgeon fails to recognize the anatomical limits and attempts large volume fat removal due to his belief that he has the best training.
Choose a liposuction surgeon who thinks that your safety is the be-all and end-all of his practice.
Question: Could I have breast surgery and Brazilian butt lift at the same time?
Surgeon’s Answer: In many cases it is cost-effective to perform two or more plastic surgeries in one setting since the patient will only pay for one anesthesia and facility fee. However, it does not apply to breast surgery and Brazilian butt lift.
Breast surgery—such as augmentation, lift, or reduction—requires that you sleep on your back for at least six or eight weeks postop. The idea is to prevent pulling on the wound and causing harm to the recovering tissue, which could happen if you lie on your stomach or chest.
Recovery after a Brazilian butt lift, meanwhile, requires that you avoid any pressure on the buttocks, which could kill the fat grafts and lead to low survival rate of fats and asymmetric shape. The general rule of thumb is to avoid sleeping on your back for two to three weeks.
Prolonged sitting while the fat grafts have not yet formed their blood supply can also lead to poor results.
The best sleeping position following a Brazilian butt lift, which in essence is a buttock augmentation via fat grafting technique, is to lie on your stomach or side, ideally leaning more forward to avoid “accidents.”
The problem can arise if you have breast surgery and Brazilian butt lift in one surgical setting. It may be difficult, if not impossible, to find a comfortable sleeping position that will not compromise your results.
Take note sleeping in your stomach during the initial stage of breast augmentation recovery is particularly detrimental because of the increased risk of implant shifting and sagging. Also, pressure on the area can lead to late-onset bleeding, persistent swelling, and pain, which can jeopardize the results.
You may argue that you can lie on your side and remain still during sleep, so combining these two procedures is acceptable. However, take note that most Brazilian butt lifts involve transferring fat to the hips or lateral side of the buttocks to achieve a more attractive silhouette, and placing pressure on this area can lead to less than optimal results.
The general rule of thumb is to stage the surgeries. For instance, you may want to have a buttock augmentation or Brazilian butt lift first and then wait for at least three months for your breast surgery.
Also, make sure that both surgeries are performed only by certified plastic surgeons who specialize in body contouring procedures.
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.
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.
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.
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.
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.
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.