Facelift at 70 can provide impressive rejuvenating effects with proper patient selection. But since at this age sagging skin is not the only problem—most patients also have turkey wattle neck appearance and loss of facial volume or fat—simultaneous procedures such as neck lift, fat transfer, and eyelid surgery are generally warranted to achieve more natural, balanced results.
Leading Los Angeles plastic surgeon Dr. Tarick Smiley says one of the most common misconceptions is that the patient’s chronological age has a large influence on one’s candidacy.
In his recent Snapchat video post, the celebrity plastic surgeon has shown a 70-year-old female patient who had facelift and neck lift about six months ago; she came to his office for a follow-up visit.
The patient shown in the video has expressed her satisfaction with the result. When viewed from the side, there is now a smooth angle between her chin and neck, as Dr. Smiley had incorporated her facelift with a highly individualized neck lift.
The patient’s postop appearance is a significant improvement from her “before” photos when the sagging skin along her jowl made her chin almost “disappear” from the neck, said Dr. Smiley.
Dr. Smiley had also tightened her platysma neck muscle in the midline using sutures. He was able to access this anatomical layer by creating a hidden incision precisely made at the chin’s natural skin crease for optimal scar concealment.
To further achieve a smooth transition between the neck and chin, he had also removed the fat pad beneath the platysma muscle.
While facelift at 70 can provide impressive results, health remains the most important issue since aging comes with increased risk of diabetes and other age-related conditions. For this reason, Dr. Smiley are extra strict when dealing with patients over the age of 65—i.e., he requires them to present medical clearance and to undergo comprehensive physical evaluation to ensure that they can handle the surgery.
To further ensure the safety of facelift at 70, aspirin, non-steroidal anti-inflammatory drugs, and supplements with blood thinning properties are discontinued 2-3 weeks before surgery and a week afterward, said Dr. Smiley.
The axillary lift is a type of body lift commonly performed in massive weight loss patients. This procedure deals with the redundant skin and fat along the armpit, which not only causes unsightly bulges but also poor odor, skin rashes, and non-healing irritation.
Leading Los Angeles plastic surgeon Dr. Tarick Smiley has recently demonstrated the axillary lift on his Snapcat account. He performed the surgery in a female patient who had lost a lot of weight and so she was left with redundant skin.
The celebrity surgeon created a wedge-shaped incision covering the armpit and the lateral chest, thus allowing him to remove a large amount of skin and fat. The wound was then closed in a way that the resulting scar would lie parallel to the transverse armpit fold.
Dr. Smiley says it is of critical importance to remove just the right amount of redundant skin to allow for proper wound closure and to prevent limited activities of the arm.
“We should strike the perfect balance between creating a tighter, smoother armpit area and avoiding too much tension, which happens after an over-aggressive skin resection,” says Dr. Smiley.
Hence, he highlights the importance of the surgeon’s experience and “eye for details” when performing any type of body contouring surgery after weight loss.
The resulting scar from the axillary lift could migrate or appear conspicuous if there is too much tension on skin. For this reason, Dr. Smiley always closes the wound in several rows so the tension on the superficial layer is mitigated, which also allows for good healing.
To further promote favorable scars, he recommends silicone sheets and gels as they hydrate the skin. Wound that heals in a moist environment is known to fade better.
Occasionally, the axillary lift is combined with other body contouring surgeries such as brachioplasty (arm lift), arm liposuction, and even breast surgery, says Dr. Smiley.
Eyelid surgery after care may differ from surgeon to surgeon, thus a prudent patient will only stick to her doctor’s specific advice. The main idea of postop care is to keep swelling and bruising to a minimum, ultimately resulting in shorter social downtime.
Leading Los Angeles plastic surgeon Dr. Tarick Smiley explains his eyelid surgery after care tips.
* Pain Control. Most patients will only experience minimal discomfort that can be easily managed through acetaminophen such as Tylenol for a few days. Others do not even require medications.
* Head elevation for a few days. The goal is to keep swelling to a minimum and thus promote shorter social recovery, which typically occurs after 1-2 weeks.
* Cold therapy. In the first 48 hours cold therapy can control the amount of swelling; however, it should not be applied for more than 15-20 minutes at a time to avoid cold burns and blisters.
* Avoid or at least limit the consumption of alcohol and salty foods during the initial healing stage (2-3 weeks). They can cause fluid retention and thus aggravate the amount of swelling.
* Never rush one’s recovery. A good rule of thumb is to avoid rigorous activities that can result in increased heart rate and blood pressure for a minimum of three weeks. Nonetheless, bed rest is not good because it can lead to lethargy and may even aggravate swelling.
* Avoid activities that can dry the eyes. In the first week postop, activities that may dry up the eyes—e.g., using computer, watching TV, reading, and wearing contacts—must be avoided.
* Wear large dark sunglasses. The idea is to protect the sensitive eyes from harsh elements such as the wind, sun, and small particles.
* Expect 1-2 weeks of social downtime. Some patients may return work a week after their surgery, although they will most likely need a camouflage make-up to hide the outward signs of their surgery. At 2-3 weeks of their recovery, meanwhile, they can go outside without wearing eye make-up.
* Avoid drugs and supplements with blood thinning properties. These are best avoided 2-3 weeks before surgery and about a week afterward to prevent bleeding and persistent swelling and bruising.
High profile breast implants offer the most amount of forward projection relative to their [narrow] base diameter. For this reason, petite women—i.e., having slender torso and chest width—might be a good candidate for such design; this is particularly true if they want more obvious upper pole fullness.
Another perceived benefit of high profile breast implants is they appear bigger than low or moderate profile implants of the same size. Hence, patients with very little tissue who want to go big but are concerned about the increased risk of palpability and rippling may choose this “route” instead.
Despite the perceived benefits of high profile breast implants, the truth is they are not suitable for everyone. To achieve natural results and avoid a gamut of complications, a good rule of thumb is to measure the patient’s anatomy, particularly relating to breast and chest width and soft tissue coverage, during the implant selection process.
Leading Los Angeles plastic surgeon Dr. Tarick Smiley says he always starts the implant selection process by taking the breast and chest dimension. The goal is to use implants that are not too wide nor too narrow for the chest wall, he further explains.
Should the implant is too wide on the chest, the result is a top heavy appearance, and when too narrow for the torso the breasts may look like a torpedo. Simply put, a good surgeon must be able to strike the perfect balance between meeting the patient’s cosmetic goals and delivering natural-looking results by respecting the anatomy.
High profile implants in general do no suit women with wider chest wall because the diameter of their base is not enough to occupy the breast’s horizontal dimension, which in turn could lead to a torpedo-like breast. For these individuals, low or moderate profile implants are the right choice.
Low profile implants have the least amount of forward projection in relation to their [wide] base diameter. They suit women with a markedly wide chest wall.
Meanwhile, moderate profile implants are perceived to provide the most natural result (i.e., what “un-operated” attractive breasts look like) because they provide no excess upper pole fullness.
While the patient’s underlying anatomies will play a critical role in the implant selection process, Dr. Smiley says having lengthy consultation and honest communication between a surgeon and his patient will further ensure results that will satisfy both parties.
A good surgeon will make every effort to eliminate or at least control risk factors associated with deep vein thrombosis or DVT in plastic surgery. This serious complication occurs when blood clots form in deep veins in legs, pelvis, or arms.
All surgeries carry some risk of DVT, although there are several ways to reduce its chances of developing, says leading Los Angeles plastic surgeon Dr. Tarick Smiley.
Photo Credit: Shutterstock
The celebrity plastic surgeon explains the preparations, surgical techniques, and postop care that can reduce DVT in plastic surgery.
Plastic surgery is only reserved for patients who have achieved their optimal health through superb diet, regular exercise, and healthy lifestyle choices. For this reason, Dr. Smiley requires comprehensive lab test and blood work to rule out medical conditions linked to higher risk of DVT or any other types of complication.
It is important to note that obesity and blood disorder are linked to higher risk of DVT.
There is a strong link between smoking and increased risk of DVT in plastic surgery. A good rule of thumb is to avoid tobacco and smoking cessation products (patch and gum) for a minimum of three weeks prior to surgery and the entire duration of recovery (1-4 weeks). However, it remains ideal to quit the habit for good as the bulk of risk is perceived to be at three months postop, as suggested by recent studies.
- Safety protocols during surgery
Surgical guidelines known to reduce risk of DVT include limiting the operative time (less than 5-6 hours); and using sequential compression device (stocking-like device that “massages” the limbs to promote good blood circulation in the area).
- Light exercise after surgery
Instead of bed rest or prolonged immobility, which could increase the risk of DVT, light exercise such as taking short walks throughout the day is highly recommended. Moving around is also ideal to control the amount of postop swelling, which further minimizes the risk of blood clot formation.
- Use of medical-grade compression stockings
They are known to control the amount of swelling, which in turn reduces risk of DVT.