Posts Tagged "orange county plastic surgery"

Breast implant sizers kit is one of the most effective methods to help patients select the “right” size based on their personal preference, body frame, and chest/breast dimension. Along with good patient-doctor communications, it can further provide results that will satisfy both parties.


Breast implant sizers are cup-like devices filled with soft but solid silicone gel; they are inserted in a bra to help patients during the implant selection process.


breast implant sizers kit


Patients are asked to try on different sizers (based on the amount or cubic centimeter), which can be as small as 125 cc or as big as 800 cc. Anecdotal reports show that the most popular size range is 300-500 cc.


Orange County plastic surgery expert Dr. Tarick Smiley says that while breast implant sizers kit can help patients describe their goals, it does not provide 100 percent accuracy since the implant placement, implant profile or forward projection, and chest/breast dimension (which to some extent can change by weight fluctuations) also have their effects.


For instance, a 300 cc high profile implant can appear rounder and fuller than a low profile implant of the same size.


High profile implants offer the most forward projection based on their base diameter, while low profile implants have the least amount of projection, says Dr. Smiley.


When trying on different types of breast implant sizers, most patients are encouraged to bring along their favorite or usual clothing, from casual outfit to cocktail dress.


With breast implant sizers kit, the patients can assess the ideal size range that will fit their body frame, particularly in terms of their weight, height, waist-to-hip ration, chest dimension, shoulder width, and so on. For this reason, petite women who are after the natural look are often encouraged to choose smaller implants, while taller ones with broad shoulders are more suitable for bigger implants.


To further help patients during the implant selection process, some doctors offer 3D imaging technology (e.g., VECTRA), which basically takes 3D photos of the patient, loads these into the system, and allows the surgeons to “morph” the images to reflect the most possible results of a certain implant size.


However, some doctors feel that 3D imaging technology is not as helpful as breast implant sizers kit because the altered image is not really a “photo,” but more like a diagram or “avatar” of the patient’s body.

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Poor neck lift results are generally caused by over-resection of skin and/or fat. Hence, the goal is not about removing optimal amounts of tissue, but more importantly, leaving behind enough to ensure that the results look natural and the scar will not spread or migrate.


Leading Orange County plastic surgery expert Dr. Tarick Smiley explains how he prevents poor neck lift results:


poor neck lift results


  • Use the right incision pattern based on the underlying problems and anatomy.


In an attempt to minimize scarring, inexperienced surgeons use shorter or fewer incisions despite the presence of large amounts of hanging skin. It is important to note that for most neck lift patients with loose skin, a small incision behind the ear, specifically within the natural folds of skin, is used.


To further create a smooth and youthful angle between the chin and neck, a small incision is placed underneath the chin.


Interestingly, the use of correct incision pattern based on the underlying anatomies (even though the incisions seem long and extensive) results in favorable scars as they remain hidden within the natural skin folds.


  • Over-resection of skin and fat must be avoided at all cost.


Poor neck lift results due to over-correction—i.e., removing too much skin and/or fat—is remarkably difficult to improve with a revision surgery. In fact, the patient might be advised to just wait for the skin to relax and “settle.”


However, qualified surgeons (i.e., they are board certified and are performing facelift and neck lift on a regular basis) know how to avoid the signs of over-corrected neck lift—e.g., skin asymmetries, gaunt appearance, and visible platysma muscle.


Skilled surgeons know that there should be at least 5 mm of fat beneath the skin to prevent surface irregularities and visible platysma muscle; hence, they will avoid over-aggressive liposuction.



  • Tighten the weak platysma muscle.


In young people the platysma muscle is tight but with aging it becomes weak and splayed, leading to the appearance of vertical neck bands. This “cosmetic” problem can also be a result of massive weight loss.


To create a smooth, youthful angle between the chin and neck, the platysma muscle needs to be tightened in the midline with the use of internal sutures. This is possible by placing a small incision underneath the chin.


  • Proper wound closure


Aside from correct scar placement, proper wound closure will also play a critical role to prevent surgical stigmata. The goal is to eliminate tension on the skin to preclude the scars from migrating or “pulling.”

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BBL fat transfer to hips? Is it possible?


BBL, or Brazilian butt lift, offers a unique advantage over buttock implant surgery: Aside from augmenting the patient’s “backside,” the procedure can also reshape the flat hips, resulting in a more feminine contour.


bbl fat transfer to hips

Before and after photos of patients who have had bbl fat transfer to hips.


And because BBL also incorporates liposuction—a critical step as it allows the surgeon to collect donor fats—the waistline, flanks, and lower back can be reshaped as well to further highlight the contour and projection of the patient’s “behind.”


Dr. Tarick Smiley, a celebrity Orange County plastic surgery expert, has recently posted a Snapchat video to demonstrate BBL fat transfer to hips.


The patient shown in the video had narrow hips and flat buttocks, which were further “concealed” by the fat rolls in the lower back and flanks. For this reason, the celebrity plastic surgeon performed liposuction in the said areas to create a smoother transition between the trunk and the buttocks.


Instead of throwing away the fats collected from the lower back and flanks, Dr. Smiley used them in order to augment the buttocks and “widen” the hips.


The hips received about a third of the collected fat, while the remaining was injected into the buttocks to improve their shape and projection, he says.


Aside from reshaping the flat hips to complement the improved buttock projection, fat grafts can also correct the appearance of lateral or side depressions, further creating a smoother and more natural transition between the hips and buttocks.


A growing number of surgeons these days prefer BBL to buttock implants due to its more natural results and feel and the perceived lower risk of complications since no synthetic material is used.


And with BBL, most implant-related risks can be avoided such as inadvertent displacement and protrusion.


Despite the notable benefits of BBL, its technical difficulties must be acknowledged. It is important to note that the survival rate of fat grafts varies depending on the purification and re-injection methods. Nonetheless, Dr. Smiley says that a good surgeon should at least deliver a 70 percent survivability rate.


The fat grafts must form their new blood supply; hence, during the re-injection process there must be minute spaces between them to allow blood vessel ingrowth.


Also, the patient must avoid direct pressure (i.e., prolonged sitting) for at least three weeks to prevent low survival rate of fat or inadvertent shifting of grafts, Dr. Smiley explains.

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The ideal mini tummy tuck candidate only requires minimal improvement—i.e., she has a small amount of excess skin above the pubic hairline that can be surgically removed. Oftentimes, this procedure results in a 4-6 inch scar that is concealed by the patient’s underwear.


The 4-6 inch scar is significantly shorter than the hip-to-hip scar resulting from the standard tummy tuck, as suggested by celebrity Orange County plastic surgery expert Dr. Tarick Smiley.


mini tummy tuck candidate

Before-and-After Photos of a Patient Who Have Had a Mini Tummy Tuck


But due to the natural diffusion of redundant skin caused by pregnancy and weight loss, only a small subset of patients are considered as a good mini tummy tuck candidate, says Dr. Smiley, therefore the vast majority should accept the appearance of hip-to-hip scar.


Interestingly, the resulting scar from the standard tummy tuck heals and fades better than “forcing” the use of a short-scar technique in patients who need a rather extensive “work,” explains Dr. Smiley.


Using mini tummy tucks despite the presence of an apron-like hanging skin extending into the hips can lead to the appearance of dog ears or skin puckering. To correct this type of skin irregularity, the patient will need her existing scar extended.


Dr. Smiley explains the ideal mini tummy tuck candidate:


* The patient only has a small amount of excess skin that is located in her lower abdomen. Unlike the standard technique, it cannot improve the appearance of the upper abdomen.


* The patient has no belly button “deformity”—i.e., it does not look stretched or “herniated.”


* The patient does not require extensive muscle repair, which is commonly incorporated during the standard tummy tuck. This additional step can further narrow the waist by suturing together the loose pair of muscle that runs between the lower and upper abdomen.


* The patient has no healing problem or other serious medical condition.


* The patient has realistic goals and expectations.


* The patient has already ruled out pregnancy in the future.


Important Note:


Removing more than 2 inches of excess skin below the navel with the use of mini tummy tuck can deform its shape and lead to dog ears appearance and other skin irregularities. A good rule of thumb is to preserve at least a 4-inch distance between the belly button and the pubic hairline.

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Arm lift with minimal scar has a certain appeal: The armpit’s natural skin fold conceals all the reminders of plastic surgery. However, not everyone is a good candidate for this incision technique, particularly someone who has lost a significant amount of weight.


It is important to note that massive weight loss patients have large amounts of redundant skin that inevitably requires longer incisions to allow for more extensive skin (and possibly fat) excisions to achieve a near normal appearance, as suggested by Orange County plastic surgery expert Dr. Tarick Smiley.


arm lift with minimal scar

Simply put, an arm lift with minimal scar that lies parallel to the natural skin fold of the underarm is only reserved for patients with mild sagging, i.e., they require just a third of their upper arms to be tightened.


But for most arm lift patients, they should accept a scar between their armpit and elbow. This technique allows the surgeon to remove more redundant skin and reshape the diagonal and vertical dimension of the upper arm.


Arguably, most elbow-to-armpit incision surgeries result in a vertical scar that lies on the inner aspect of the arm; hence, the reminders of plastic surgery are well hidden when the arms are at the patient’s side.


Occasionally, the long vertical scar is situated more posteriorly thus someone standing behind the patient would see it. Despite its more obvious location, sometimes it is a better option than placing the scar on the inner aspect of the arm especially if there is a need to remove large amounts of redundant skin.


Interestingly, placing the scar in a more obvious and posterior location allows it to heal better—i.e., it is less likely to spread—because the skin in the area is thicker than the skin on the inner aspect of the arm.


Regardless of the incision placement, all efforts are made to minimize tension on the wound to allow the scar to heal and fade well in the surrounding skin. Aside from proper suturing techniques, it is also critical to further reduce tension during the initial healing phase.


Using compression garments and silicone gel sheets for eight weeks is believed to promote favorable scarring. In addition, using sun protection, avoiding sources of infection, and achieving one’s optimal health prior to surgery can help the scars fade well.

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