Many people already know that brow lift surgery can elevate the sagging brow, leading to a more youthful appearance. However, not everyone knows that it can inadvertently alleviate migraine, improve perceived personality traits, and reduce the hooded appearance of the upper lid.
Leading Orange County plastic surgery expert Dr. Tarick Smiley has explained the lesser-known brow lift benefits.
before and after photos depicting great results from brow lift surgery
- Alleviate or even eliminate migraines
Surgeons say that some patients who have had brow lift, also referred to as forehead lift, reported less frequent migraine attacks or even complete remission. Experts have concluded that elevating the sagging tissue may release the pressure that is “pinching” or “irritating” the nerves responsible for chronic headache and its secondary symptoms such as light and nose sensitivity, blurry vision, and nausea.
Researchers at the New York University have conducted a survey showing that people with high eyebrow, which is medically referred to as high oblique frame or wide brow-lid complex, were perceived to be more honest and trustworthy by others.
Whereas people with furrowed brow, either caused by aging or as an inherited feature, scored lower in the perceived trustworthiness reviews.
Aging causes the brow particularly the lateral or tail end to sag, which can lead to an angry or sad appearance, depending on the degree or angle of droop.
Most patients will only need their brow’s tail end elevated, with no or very little advancement of the inner or medial aspect, to achieve a more refreshed appearance.
A youthful female brow lies slightly above the bony orbital rim of the eye socket, and also comes with a soft lateral arch. But with aging, the soft tissue sags causing the tail end to lose its height, leading to a more horizontally oriented shape of the brow.
Therefore, most brow lifts just require conservative elevation of the tail end to restore the lost arch.
- Reduction of wrinkled skin in the upper eyelid
Occasionally, the drooping brow causes skin wrinkles and “heaviness” along the brow-upper lid complex. Hence, lifting the tail end of the brow could make the eyes appear more alert and more youthful without resorting to a separate procedure in the form of upper eyelid (blepharoplasty).
Most plastic surgeons recommend BBL compression garments to control swelling of the liposuction or donor sites and to help remodel the tissue of the buttocks and hips.
Leading Orange County plastic surgery expert Dr. Tarick Smiley often recommends his patients to wear a one-piece compression garment that covers the upper back to the knee level.
The vast majority of Dr. Smiley’s patients require liposuction of the bra rolls, lower back, flanks, and anterior abdomen to collect large volume of fat, which is immediately purified and injected into the buttocks and hips.
Swelling due to edema is not uncommon after liposuction because once the “compartments” are depleted with fat, bodily fluids have the tendency to take over. Hence, effective compression garments should fit snug but not too tight as to cause pressure problems.
Symptoms of pressure problems include skin discomfort, difficulty of moving around, and inability to sleep due to excessive tightness.
Excessive pressure (more than 10 lbs. of force) is particularly detrimental to the buttocks and hips or any recipient site. It takes about three weeks for the fat grafts to form their new blood supply needed for their long-term survival, and another month or two before they fully stabilized and become well integrated with the surrounding tissue.
While many BBL compression garments cover the buttocks, there is no or very little pressure around them. Also, they often come with a “crotchless” design so the patients can use the toilet without having to remove or pull down their garments.
In general, compression garments are worn the entire time (unless when bathing) for three weeks, which are the most critical period. Afterwards, patients may use the second-stage compression, which has less pressure since at this time swelling has subsided to a significant degree.
Nonetheless, each surgeon has his own instructions that they deem fit.
Tummy tuck scar is almost always positioned within the groin and pubic hairline so it is well concealed by the patient’s panty or swimwear. Nonetheless, it remains imperative to apply surgical techniques and postop care that aim to encourage the scar to heal into a faded, thin line.
Orange County plastic surgery expert Dr. Tarick Smiley has recently posted Snapchat videos demonstrating an African-American patient who asked for tummy tuck. Due to her previous C-section surgery, she had keloids across her lower abdomen.
The patient’s keloid scar is caused by her previous C-section surgery. During tummy tuck, Dr. Smiley removes it together with the loose skin and fat.
Since the patient has a previous history of keloid, Dr. Smiley says she is at an increased risk of unfavorable scar after tummy tuck, which typically uses a hip-to-hip incision to remove the hanging skin and fat. Another incision made inside the navel’s rim is created in order to remove any excess skin from the upper abdomen.
Dr. Smiley says that tummy tuck and keloids risk is closely tied to genetics and darker complexion, although several risk factors can be controlled or at least minimized to help patients achieve the most favorable scar possible.
During surgery, Dr. Smiley created a hip-to-hip incision to remove the excess skin, together with the C-section keloid scar. Then, he closed the wound line and ensured that it is positioned very low that even low-rise jeans and panties have no problem concealing it.
Dr. Smiley says he always closes tummy tuck wound in multiple layers, with the deepest layer receiving most of the tension, while the skin is spared from unnecessary tautness, which is the key to favorable scar and fast healing.
To further minimize risk of keloids, the celebrity plastic surgeon uses surgical tapes to hold the skin edges together until the wound is considered clinically healed (about three weeks).
Around three weeks postop, new skin tissue forms over the wound; for patients with a strong history or propensity to aggressive scarring this is a precursor to keloids.
Hence, for the said patient Dr. Smiley says he recommends steroid injection right after the tummy tuck wound is considered clinically healed, instead of waiting for it to become established.
“For this particular patient, I would use early steroid injection as a preemptive measure,” says Dr. Smiley.
To further promote the best scar possible, the surgeon also recommends silicone sheets, sun protection, and scar massage.
The key to stable and longer-lasting facelift is going beyond the skin; this entails lifting the deeper structures of the face as a single unit. Occasionally, a concurrent fat injection or fat grafting is also performed to correct facial volume shrinkage that comes with aging.
Dr. Tarick Smiley, one of the pioneers of three-dimensional facelift in Orange County plastic surgery, has recently posted Snapchat photos depicting facelift after one year.
About a year ago, the patient simultaneously received facelift, neck lift, and fat grafting performed in one of Dr. Smiley’s accredited surgical centers. Upon closer inspection, the scar that curves around her ear curvature is imperceptible thanks to meticulous incision placement and suturing technique.
Dr. Smiley always positions the facelift scar in discreet areas—i.e., behind the temporal hairline, which then extends behind the tragus (small bump in front of the ear) and curves behind the ear. Sometimes, this incision line is extended into the nape area, although it still remains hidden by the hairline, should the patient need a simultaneous neck lift.
Facelift scar is well hidden within the ear’s curvature.
The patient’s imperceptible scar is not the only thing that makes her “extremely ecstatic with the results.” She has also maintained the appearance of taut jawline, youthful cheek (i.e., right amount of volume/plumpness), tight neck, and smooth chin-neck transition.
Furthermore, the patient has avoided the windswept or overly pulled appearance, which gives facelift a bad rep. This surgical stigmata, according to Dr. Smiley, can be prevented by lifting and pulling the SMAS (layer beneath the skin) at around 45 degrees angle.
The 45 degrees angle is the best direction of pull as it restores the lost volume of the cheek, softens the appearance of nasolabial folds or “laugh lines,” and creates a tauter jawline.
Her simultaneous fat grafting to the cheeks and lower lid-cheek junction has further fostered natural and more youthful results.
While the surgeon’s technique has the most influence on the facelift results and longevity, the impact of underlying anatomy cannot be discarded nonetheless. For instance, the patient has enjoyed a certain advantage because even before surgery she has a relatively good skin quality.
“When the skin has significant photo damage caused by the sun, after facelift it will not redrape as good as the skin that has been taken care of,” said Dr. Smiley in a previous video on Snapchat.
Liposculpture vs liposuction. Are they two different procedures?
While both terms are often used interchangeably by plastic surgeons, they have some subtle differences, says Orange County plastic surgery expert Dr. Tarick Smiley.
Liposuction strictly concerns itself with the removal of superficial fat that sits beneath the skin, while liposculpture also uses the same method although with the intent to sculpt the body and so it is sometimes referred to as high-definition liposuction.
A good example of liposculpture would be abdominal etching in which fats are removed in order to create grooves that resemble the “washboard abs.”
Recently, Dr. Smiley performed liposculpture on a female patient who was relatively thin prior to surgery and thus a standard liposuction—i.e., debulking the area of fat—may not be able to deliver the amount of definition she desired.
The patient specifically requested for an improved waist-to-hip ratio, which translates to having a narrow waist juxtaposing the curvy hips. Several studies have found a strong preference for a WHR near .70, which means that the waist circumference is 70 percent of the hips measurement.
While liposuction and liposculpture can narrow the waist, Dr. Smiley has warned that it is impossible to go past the muscle and bone; hence, the final results also depend on the patient’s underlying anatomies.
Since the goal was to narrow the waist and create smooth flanks, Dr. Smiley made multiple puncture holes to access the unwanted fats from different angles, which is one of the keys to achieve smooth results.
To further ensure smooth, natural-looking results, the celebrity plastic surgeon has emphasized the importance of “feathering technique” and moving the cannula (thin hollowed tube) in a fan-like and criss-cross fashion.
In liposculpture or liposuction, feathering means that the areas adjacent to the actual treatment site are “slightly” included to ensure a smooth transition. Preserving the natural contours of the body is one of the keys to high patient satisfaction.
To further ensure a more feminine physique, Dr. Smiley injected some of the fat volume into the hips.