Latest Plastic Surgery Articles - Page 12




The primary aim of facelift surgery is to minimize the signs of aging in the face and neck, particularly the fat that has fallen, jowls, deep creases below the lower eyelids and between the corners of the mouth and nose, and sagging in the mid face.

In a 2011 survey released by the American Society of Plastic Surgeons, patients aged 55 years and older accounted for more than 65 percent of all facelift surgery.  On the other hand, the procedure is not so common among people in their 40s with the belief that they are too young for this invasive procedure.


But is 40 really too young for facelift?

Dr. Tarick Smaili, one of the leading Los Angeles plastic surgeons, believe that age per se does not determine if one is a bad or good candidate for the procedure.  In fact, he recommends it to younger patients who have already developed sagging skin and deep creases.

“Some people are prone to facial aging.  Some are caused by genetic factors while others develop sagging skin after massive weight loss.  It is not really necessary to wait until you reach your 50 or 60 to have a facelift.”

The world-renowned surgeon added that “early intervention” may be even more beneficial to some patients as those in their 40s tend to have a skin that is more elastic compared to older people, thus they could achieve a better result.

Another advantage of doing facelift surgery “earlier” than usual is that the patients could keep the procedure a secret as the transformation is only subtle.

On the other hand, older patients who receive facelift will most likely be asked about the reason for their visible transformation and the fact that their friends and family have already seen the severity of their sagging and facial creases.

But full facelift may be too invasive for forty-something, so plastic surgeons would most likely recommend “isolated” techniques like mid facelift, which targets the area around the nose and corners of the mouth, and the lower eyelids.  This procedure is particularly ideal for younger patients who only need cheek elevation, while their neck and chin area do not require lifting.

If needed, a mid facelift is performed in conjunction with eyelid surgery and lower facelift, helping patients achieve a more youthful appearance.  Meanwhile, non-surgical procedures such as laser skin resurfacing, medical-grade chemical peel, and dermal fillers could further improve the surgery’s result.



Male breast reduction surgery is performed on men who have overlarge breasts due to excess tissue, redundant skin, and/or superficial fat.  Meanwhile, the length of recovery depends on many factors such as the surgical technique and amount of correction.

Male-Breast-Reduction-011Also, healing varies from patient to patient; in general, younger men recover faster than older ones, i.e., 55 years and above.

The surgery comes in many techniques, depending on the type of correction a person needs.  Oftentimes, male breast reduction involves skin excisions to remove the excess tissue and fat, although others can benefit from liposuction-only procedure as long as the “enlargement” is primarily caused by fat and they have elastic skin.

And for some patients, they can benefit more with skin excision plus liposuction for further contouring, leading body contouring surgeon Dr. Tarick Smaili said.

With liposuction-alone surgery, patients can resume most of their normal activities just after three days.  This is because the procedure only involves the use of round incisions as small as a grain of rice where doctors remove the excess fat with a cannula, which is a slender steel probe attached to a vacuum pump.

But the traditional way to perform male breast reduction requires skin and tissue removal, thus it uses long incisions that are usually positioned within the natural breast crease and around the edges of areola.

Because of skin excisions, pain and discomfort is a normal part of recovery.  Most patients will need painkillers for three to four days to help them cope with the post-op symptoms.

Most doctors require their patients to take at least a week off from work to get enough rest and sleep during the most crucial period of their recovery.  While it is important to stay away from heavy lifting and strenuous exercises for a week or two, taking short gentle walks several times a day is highly encouraged because it improves healing and blood flow.

Walking and other light exercises can also reduce risk of blood clotting in the legs that may travel up to the lungs.

To support the new contour and protect the incision site, most patients are instructed to wear compression garments for at least three weeks.  And with continuous use, some doctors feel that it may improve the result to some degree as the skin heals closer to the body.

While the incisions may appear completely healed, it is not uncommon to have some minor skin irregularities or “bumps” that can persist for up to three weeks.  But as with any post-op symptoms, they are supposed to subside as the body heals itself.



Breast reduction surgery, while it reduces the breast weight and volume, is also commonly used to address physical symptoms linked to macromastia or overdevelopment of the breasts such as neck pain, postural problems, inability or difficulty to jog or engage in sports, back pain, and rounded shoulders.

Studies and surveys have suggested that breast reduction surgery provides the highest patient satisfaction rate because oftentimes the benefits are far beyond cosmetics.


To better understand the benefits and other ramifications of the surgery, the California Surgical Institute has provided a list of results most patients should expect:

  • Compared with other body sculpting procedures, breast reduction involves a more straightforward recovery as it does not require the muscle to be manipulated and the breasts tend to be less prone to surgery-related pains.  For this reason, patients can resume most of their activities within a week or two.
  • Physical symptoms caused by overlarge breasts are immediately resolved because they are now smaller and lighter that the patients can perform activities and exercises with much ease and comfort.
  • All surgeries will leave permanent scars, although in breast reduction a good plastic surgeon will make every effort to make them less visible, i.e., placing the incisions within the natural fold of skin and around the edges of areola.  And to promote good healing and avoid ugly wide scars, they also minimize the tension in the skin through various techniques.
  • In terms of body image and self-esteem, studies after studies have shown the positive impact of breast reduction due to a more balanced figure.
  • Some patients experience reduced sensation or complete numbness in their nipples and/or breast mound (making it hard or even impossible to breastfeed in the future) that may or may not improve over time.  If one finds this risk unacceptable, breast reduction surgery should not be attempted.
  • Patients who are experiencing difficulty or inability to perform certain activities will find much ease when exercising, making it easier for them to maintain a healthy, stable weight over the long term.
  • With smaller and lighter breasts, they are less prone to the effects of gravity that contribute to the saggy appearance.  The surgery itself also creates a lifting effect because the internal structure of the breast is reshaped and the nipple-areola complex is repositioned to a higher, more youthful appearance.



As its name suggests, breast reduction or reduction mammoplasty reduces the breast volume through tissue and fat removal.  Aside from creating a smaller size, the surgery is also performed to address physical symptoms caused by macromastia, manifested by overlarge breasts, such as back pain, rounded shoulder, and poor body posture.

While the primary goal of reduction mammoplasty is to make the breasts smaller, body sculpting expert Dr. Tarick Smaili said the surgery—because its incisions are the same with breast lift—can also create a lifting effect.  A properly executed procedure, he added, also includes repositioning and reshaping of the areola complex or the pigmented part of skin.

110912 breast reduction

The standard technique, also called the anchor-shaped reduction because of its incision pattern, provides plastic surgeons the most control over the final breast size and appearance.  It uses a vertical incision between the nipple and inframammary fold, a horizontal cut within the natural crease, and another one around the edges of areola complex.

A less invasive technique called the vertical or lollipop reduction, which removes the horizontal incision across the natural fold, can also effectively reduce the breast size and at the same create a lifting and narrowing effect, making this particularly ideal for improving a markedly wide breast.

While a “true” breast reduction always involves skin excision and tissue removal, some doctors attempt to reduce the breast size with liposuction alone, a procedure that eliminates the fat through the use of a slender steel probe attached to a vacuum pump.  For a vast majority of patients, the approach will not provide them the desired result and may even lead to a saggy appearance.

In essence, liposuction does not create any lifting effect because it does not reshape the ligaments or tighten the skin.  But for a few carefully selected younger patients, the procedure can reduce the breast size and make it lighter, which could help the skin shrink to a certain degree.

While breast reduction creates a lifting effect [almost] the same way as the breast lift surgery because they share the same incision techniques, the latter does not reduce the breast volume and only aims to correct the saggy appearance.

Aside from the “weakened” breast ligaments and stretched skin, the saggy appearance is also caused by the excessive weight.  For this reason, some breast lift patients can benefit more if their doctors will also make their breasts smaller and less prone to the effects of gravity.



Facelift surgery or rhytidectomy is commonly performed to minimize the appearance of wrinkles, gaunt areas, and other signs of aging.  However, some massive weight loss patients may also need the procedure to address skin laxity and other forms of deformities after shedding large amounts of excess weight.

With one-third of US adults considered obese, the number of weight loss or bariatric surgery patients has been steadily increasing over the past several years.


While weight loss surgery can decrease the risk of obesity-related illnesses and even death, almost all patients will experience deformity at a varying degree.  In fact, it is not uncommon to develop hanging, loose skin in the tummy area that even reaches the pubic region, causing tissue breakdown, non-healing irritation, and foul odor.

However, the face and neck area are also not spared from the effects of massive weight loss, leading plastic surgeon Dr. Tarick Smaili said.

The right timing is important to enjoy the full benefits of post-bariatric facelift surgery.  While most patients are able to shed most of the excess weight between eight and 12 months, the general rule is to wait at least one to two years after weight loss surgery to make sure the weight has already stabilized.

Aside from waiting until the weigh has stabilized, Dr. Smaili said it is also important to make sure that prior to facelift, the patients are no longer malnourished from the sudden change in their diet and lifestyle.

Because each patient has a different anatomy and “problem” area, a good doctor will examine the skin quality, wrinkles and fat pad to come up with an individualized technique, which can help achieve the best result possible.

For massive weight loss patients, their facelift is often complemented by neck lift to achieve a more balanced result.  In general, the goal is to refine the jowls, eliminate or reduce the appearance of wrinkles and saggy skin, and raise the displaced cheek pads.

Incisions are always needed to reshape the skin and underlying tissue, but to hide the scars they are typically positioned in front of and behind the ears, extending behind the hairline.

Compared to traditional facelift, the renowned plastic surgeon has noticed that post-bariatric facelift typically involves more skin removal to correct the deformity caused by dramatic weight loss.

Despite the facial “deformity” caused by excess skin after significant weight loss, all facelift surgeries are considered cosmetic procedures so health insurers do not pay for their cost.



Surgical hair restoration or hair transplant, while it comes in two basic techniques, always involve transferring bald-resistant hair follicles from the back and side of the scalp to the crown and front hairline.

Over the past 10 years, the follicular unit graft or FUG has been the gold standard practice despite the growing popularity and media hype surrounding a relatively new technique called the follicular unit extraction or FUE.


In FUG, doctors collect a strip of scalp behind the head before they dissect each hair follicle one at a time under a microscope.  The graft is then planted into tiny incisions in the balding spots or areas that need coverage.

On the other hand, the relatively new technique FUE involves the use of a small round puncher to harvest hair grafts one at a time and plant them into the areas where hair is thinning out.

Proponents of FUE always highlight the technique’s ability to harvest hair grafts without creating long incisions, which can lead to scar, at the back of the scalp.  While there is some truth behind it, there are still notable advantages that make FUG still the gold standard approach.

Despite the use of long incisions to collect a strip of scalp, a well-executed FUG leads to a very thin scar, about 1-2mm wide, that is easily covered by the surrounding hair. Simply put, visible scarring is rarely a problem.

In terms of better coverage and higher survival rate of hair grafts, the FUG is superior over FUE, 90-95 percent vs. 75-80 percent.

The higher graft survival rate in FUG is attributed to its shorter time procedure, meaning the hair follicles are less exposed to the “elements.”  Meanwhile, in the FUE the grafts are outside the body for a longer period of time, leading to a lower regrowth rate.

The amount of coverage in FUG is also superior because it allows doctors to collect as many as 3,000 grafts, versus 500 grafts in FUE.

Because FUE is more time consuming and it often involves multiple procedures to achieve the desired result, its cost can be 50 percent higher than FUG which is a much simpler and more effective hair transplant technique.

But even with a well-executed FUG, patients should also do their part to further increase the graft survival rate and avoid the wide scar in the donor site; this typically involves proper care and washing of the hair to remove scabs, and avoiding strenuous activities and heavy lifting for at least two weeks after surgery.



Tabloid writers and showbiz bloggers are all saying that Lara Flynn Boyle, who starred in Men in Black 2 and Wayne’s World,” had received facelift surgery and dermal fillers that resulted in a pillow-face appearance.


Last week, the 43-year-old actress was photographed shopping with her mother in Los Angeles.  The pictures showed her face, lips, and neck “unusually” swollen, which some people claimed to be the works of excessive injection of dermal fillers.

Celebrity news website TMZ has reported it contacted Boyle’s friends to confirm the “alleged” plastic surgery but they all said the actress “looked fantastic” and did not divulge more information about her.

Rumors about Boyle’s alleged plastic surgery have been circulating the Internet over the past several years due to her seemingly changing appearance.  But despite the allegations, the actress has never publicly denied or admitted any surgical enhancement.

Meanwhile, over the past years Boyle has been touted as one of the worst celebrity plastic surgeries, getting the same public derision Melanie Griffith, Meg Ryan, and Madonna have been receiving.

Boyle seems have managed to remain “cool” and “mum” despite years of harsh criticisms that have started in the late 90s when bashers said she was too thin and “appeared to have starved herself” that she was a poor role model for young children.



Facial plastic surgeries such as faceliftrhinoplasty (nose job), cheek or chin implant, and fat graft are performed on patients who want to reduce the signs of aging and/or create a more balanced appearance.

The most notable benefit of having multiple procedures all performed in one day is the lower surgical cost than getting them separately since you only have to pay for one surgical facility and anesthesia fee.  The convenience of one post-op recovery is another advantage with this approach.


In spite of the obvious benefits of “combo procedures,” double board certified Dr. Karan Dhir said safety is the main issue rather than the number of surgeries performed in one day.

The consensus among board certified plastic surgeons, according to Dr. Dhir, is to perform cosmetic or elective surgeries under five to six hours in an attempt to avoid or at least reduce the likelihood of developing complications such as increased bleeding, high surgical trauma, and general anesthesia-related risks.

Meanwhile, it is not uncommon for plastic surgeons to further limit the operative time when dealing with older patients, i.e., 55 years and above, and individuals who have certain medical conditions that may increase the risk of complications.

If your combo procedures will take a lot of time, take note that a good surgeon will most likely recommend performing them separately in an attempt to minimize the risk.

You also have to consider that certain facial procedures cannot be done at the same time because doing so could lead to “unpredictable” results, cosmetically poor outcome, and delayed healing.  For instance, many surgeons feel that a full facelift surgery should not be combined with an immediate fat graft because the “added volume” might move.

However, mini or “isolated” facelifts may be combined with fat graft as long as it is used in uncompromised areas—the skin and underlying facial muscle are not lifted and reshaped.

Some mini facelift patients may also undergo rhinoplasty at the same time as their surgery if they want to correct their “aging” nose manifested by the drooping tip and/or more pronounced humps in the nasal bridge.

Whether you decide to have multiple procedures performed all at the same time or have them separately, the number one rule is to only consult a board certified surgeon who specializes in facial plastic surgery; stay away from non-specialists as they accounted for the majority of botched cosmetic procedures.



The abdomen is the most commonly treated liposuction area because it is where the fat “rolls” and “bulges” tend to accumulate even in healthy, normal weight individuals who exercise regularly and eat a balanced diet.

Body sculpting expert Dr. Tarick Smaili said the abdominal liposuction is “reasonably” safe as long as the patients are carefully selected and the procedure is performed by a board certified surgeon.


A good surgeon, Dr. Smaili said, should be able to know the risk factors in an attempt to make the abdominal liposuction safer and help patients achieve a cosmetically pleasing result.

To better understand the procedure, particularly in terms of safety, the world-renowned plastic surgeon has explained the risk factors in abdominal liposuction, and ways to minimize the likelihood of developing a complication:

*  Abdominal hernia or muscle separation increases the risk of accidental penetration of the liposuction cannula into the intestine or liver in the abdominal cavity.  For this reason, a good doctor will not attempt the procedure unless the condition is repaired.

In most cases, an abdominal hernia repair is a simple procedure performed under local anesthesia.  A CT scan can help doctors diagnose the condition prior to a liposuction surgery.

*  While the risk of accidentally penetrating the abdominal cavity is very small with liposuction, another surgery performed inside the abdomen may result in unnecessary risks.  Simply put, performing abdominal liposuction-alone is the best way to make the surgery safer.

*  The standard liposuction technique, which injects a tumescent solution into the fatty area, has allowed plastic surgeons to perform the procedure under local anesthesia, which is safer than general anesthesia.

But some doctors use general anesthesia, particularly if liposuction is performed simultaneously with other procedures such as tummy tuck, or if it involved multiple areas of the body.  However, this approach may be counterintuitive if the goal is to minimize the risk of complications.

*  While a secondary abdominal liposuction can still provide good results, each time the procedure is repeated the more difficult it becomes due to the presence of internal scar tissue within the remaining superficial fat.  For this reason, a good patient should stick to a healthier lifestyle after surgery to preserve its result.

*  Over-liposuction, or removing more than 3-4 liters of body fat in one session, is generally avoided by good surgeons because of the “unnecessary” risks.  Just to be on safe side, they prefer two or more separate procedures performed months apart to minimize the surgical trauma and bleeding.



A new brand of silicone breast implants will be equipped with a radio frequency microchip that can help patients and doctors access crucial information about the device, including its serial number, implant size, manufacturer’s name, and other related data.

To activate and “read” the microchips of the silicone implants, which are marketed by Florida-based Establishment Labs, doctors need to use a handheld device that will release radio waves.


In a press release, Establishment Labs said the new product, which they call Motiva Implant Matrix Ergonomix, will soon become available in 28 European countries.  Meanwhile, the company is currently seeking approvals from health regulators in Asia, South America, and Middle East to sell their silicone breast implants.

The company’s CEO, Juan Jose Chacon-Quiros, said in a statement that the microchip-equipped silicone implants aim to “give women the power of verification and control” throughout the life of the devices.

The official added that his company “is currently in talks with the biggest clinics” in Europe to further improve the safety of patients who choose to undergo breast augmentation or reconstructive surgery with the use of breast implants.

Meanwhile, currently available breast implants in the US come with a “device identification card,” which the patients must keep in a secure place so they can show it to their doctors in case they need a revision surgery or other procedures.

Experts suggest the new technology will provide an additional safety measure after health scares involving French-made breast implants that were found to contain industrial-grade silicone gel filler used for making mattresses.

According to the most recent report, about 300,000 women in Europe and South American were affected by the health scare, although some experts have suggested it could be higher since the substandard PIP breast implants were “repackaged” and sold under different names.

Health authorities have been recommending routine removal of PIP implants due to their high failure rate.

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