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As you start to seriously consider cosmetic plastic surgery, you’ll most likely want to learn as much as you can about the procedure you’ve homed in on. Many, by the time they reach their consultation with a board-certified plastic surgeon, will have at least a basic understanding of what the procedure and recovery will be like.

Doing some homework before you meet with a plastic surgeon isn’t necessary, but it can help facilitate a more informed conversation and manage your expectations for the outcome.

Google can also be helpful in another regard: Filling in the patient’s perspective. Just remember to parse what you uncover. The internet can often seem like a place where only two kinds of opinions exist, the hopelessly negative and the over-the-top positive, particularly within social media circles. So, first and foremost, consider the source.

As an example, RealSelf, the online plastic surgery forum, recently published a story titled, What 7 Women Who Had a Brazilian Butt Lift Would Have Done Differently. As you’d expect, some of the opinions shared are fairly negative, but not in the way you’d think.

Editorial outlets, which RealSelf should be considered, can generally be trusted to tell their stories in an objective manner. Their main goal, in fact, is to explore a given topic from a well-rounded perspective, not to push an agenda.

In this particular instance, the Brazilian butt lift is a procedure that’s surged in popularity over the last few years. With that kind of interest, a not-insignificant number of people have rushed into—and out of—it. Consider the following quote from the RealSelf article:

“If I could go back, I would have lost more weight prior to the surgery. Because I was so heavy going in, even with my doctor taking the maximum amount of fat that he could take out, I was still left with a lot that I needed to lose. And I didn’t want to lose my reinjected fat cells, so I was just torn between losing my gut or my butt.”

And this one:

“I would definitely have chosen a different surgeon. I chose him because my co-worker and her friends highly recommended him—however, they had chosen him for different procedures, and he was known for wonderful tummy tucks and breast augmentations.”

There are important lessons to be learned here. And that’s a critical difference between editorial articles and the patient testimonials you typically find deep in the comments section or on a personal blog.

Learning as much as you can about a plastic surgery procedure is always a good thing. But it’s important to scrutinize the information along the way.

While liposuction remains the gold standard for quickly shedding stubborn pockets of fat, we’re also seeing the rise of non-invasive alternatives. With a number of them already well established and a host of others about to enter the market, non-invasive fat removal is considered to be one of the fastest growing segments of cosmetic plastic surgery.

CoolSculpting stands at the top of that particular mountain because it was among the first-available treatments. In the years since its arrival, its effectiveness has turned it into a household name.

CoolSculpting can treat just about any unwanted bulge, but it’s FDA-approved for the abdomen, love handles, thighs, upper arms, “bra fat,” back fat, “banana roll” underneath your butt, and double chin. It works by freezing fat cells in the targeted area, which then die and are eliminated by the body naturally. But that’s hardly the only way to go about it. Today, non-invasive treatments employ radiofrequency and ultrasound technology and even lasers to do the job.

So, how does CoolSculpting stack up? Let’s see.

The challenger: Venus Freeze

In spite of its name, Venus Freeze uses radiofrequency energy to heat up and shrink fat cells. It’s limited in its ability, however, to eliminate fat. That’s really a secondary benefit of the Venus Freeze, whose primary function is to spur the production of collagen, which will ultimately tighten sagging skin and reduce cellulite. In a head-to-head comparison, CoolSculpting is the more effective fat-reduction treatment.

The challenger: Liposonix

Liposonix destroys fat cells with ultra-high-frequency ultrasound. And it’s quite effective at doing so, with reports from those who’ve undergone the treatment that they’ve lost as much as one pants or dress size afterward. For comparison, CoolSculpting claims up to a 25 percent reduction of fat in the treated area. Where they differ most significantly is in how they’re used. Where CoolSculpting is fairly versatile, Liposonix can only be used on the abdomen. It’s also a relatively painful procedure, while CoolSculpting, beyond some initial numbing, is not.

The challenger: Laser Lipolysis

As its name implies, a high-powered laser melts fat cells in the targeted area. They’ll then be metabolized, or, for faster results, they can be removed through a process similar to liposuction. Laser lipolysis has the added benefit of also spurring collagen production, which will ultimately firm sagging skin—something that CoolSculpting does not do.

While both procedures are considered safe, laser lipolysis carries more risk than CoolSculpting, namely because the laser can damage surrounding blood vessels, nerves, and even organs. Usually, that merely equates to an extended recovery period. But even a minimal period is a lot compared to CoolSculpting, which entails little to no recovery.

As the stay-at-home orders lift and we collectively begin to ease into our new normal, there’s bound to be some residual anxiety. After all, we’re still in the grips of a pandemic, and some seem to be taking that notion more seriously than others.

Rest assured that, if you were planning to consult a board-certified plastic surgeon before all this, or if you had been doing so on an ongoing basis, we’ve implemented a number of measures intended to facilitate social distancing and ensure a clean, sterile environment. And we’ll be updating these protocols as new developments surrounding COVID-19 emerge.

For now, here’s an idea of what you can expect at your next visit.

In-person appointments may take a little longer to schedule

In addition to rescheduling backlogs of appointments that accumulated while plastic surgeons’ offices were closed across the region, many are seeing fewer patients a day in order to prevent them from crossing paths, as much as possible. In fact, most practices are eliminating their waiting areas altogether. Extra time between appointments is also needed to allow for new decontamination protocols to be carried out.

Basically, it may take longer to schedule an appointment with your plastic surgeon than it did before March.

To varying extents, that will be offset by virtual consultations. In recent months, online consults have become de rigueur across almost every branch of healthcare. Until a vaccine is available, that’ll likely remain the case in certain scenarios, like discussing a future surgery or following up on a past procedure.

Everybody will be screened and probably tested

Also to varying extents, plastic surgeons will be screening every patient, both prior to their appointment and upon their arrival. Ahead of your appointment, you can expect to be asked about your current health, recent symptoms, COVID-19 exposure or diagnoses, sick family members, travel history, and so forth. Upon your arrival, you’ll likely  be asked the same questions again. You’ll also have your temperature taken, which is meant to detect asymptomatic carriers with low-grade fevers.

If there’s any question as to whether someone presents a risk, they’ll be asked to reschedule.

All hospital-based outpatient surgeries will require a pre-operative COVID-19 diagnostic lab test. (It’s the one with the deep nasal swab that detects active virus particles.)

Most plastic surgery societies, looking to emulate hospital policy, are advising their members not to perform office-based treatments or operate in private ORs without a negative COVID-19 diagnostic lab test. But, because the swab tests are still difficult to come by, many will be relying on antibody blood tests (the rapid finger-prick kind, most commonly) to flag patients who’ve been exposed to the virus.

Doctors will be performing the tests on a regular basis on themselves and their staffs as well, in addition to daily temperature and symptom checks.

While some of this may feel like an inconvenience, please know that these are safety measures. Every reputable plastic surgeon in this pandemic is approaching reopening in a methodical manner and with the intent to take every precaution possible to protect our patients.

If you’re looking for a little (or a lot) more oomph from your backside, the Brazilian butt lift is a highly customizable procedure with a relatively minimal recovery period. That fat is liposuction-ed out of another area of concern to facilitate the whole thing creates a kind of two-for-one scenario, where you’re contouring one spot and gaining a shapelier butt in the process.

If you’re beginning to gravitate from simply Googling the procedure to seriously considering it, there are a few things (beyond reading this blog post) you’ll want to do to make sure you’re properly prepared, mentally and physically.

Schedule a consultation

First things first, schedule consultations with a couple board-certified plastic surgeons. Feel free to meet with as many as you can, but it’s important to have some basis for comparison. You’ll better appreciate the sometimes-slight variances in demeanor and styles that way. When you start your search, let experience be your preliminary filter. Any doctor who doesn’t list the Brazilian butt lift among the procedures they perform is likely ill-equipped to help you.

Dial in your diet

In the meantime, focus on eating a healthy, balanced diet, drinking lots of water, and cutting back on (or even temporarily eliminating altogether) alcohol and desserts. While the Brazilian butt lift does include liposuction, the surgery isn’t designed to be a weight-loss procedure. You’ll want to be within about 30 pounds of what you consider to be your target weight to best position yourself to achieve the results you desire. Eating healthy also supports a strong immune system, which is going to be an important ally in your recovery.

Go into vacation-prep mode

You know how before a big vacation you’ll spend a few days making sure everything’s in order so that you won’t have to think about anything later on? Approach your procedure with the same mindset. Get your prescriptions filled, shop for a week’s worth of groceries, and start drinking prune juice or taking stool softeners. (It’ll help with any constipation that the prescriptions may cause.) At the very least, it’s peace of mind. You’ll be able to go into your procedure knowing that you can fully focus on your recovery.

And don’t be shy about contacting your plastic surgeon before or after your procedure with any questions you may have. Google may seem like it has all the answers, but only your doctor has your best interest in mind.

More than 310,000 breast augmentations were done in 2018, the most recent year for which data is available. That’s enough to make it the most widely performed cosmetic surgery in the United States by a pretty wide margin. (Liposuction is the runner-up, at nearly 260,000 procedures, according to the American Society of Plastic Surgery.)

Still, for all that appeal—not to mention, mainstream acceptance—women tend to arrive for their consultations under-informed and surprised by the nuances of the procedure. So, over the next couple of posts, I’ll be taking a closer look some key aspects that, hopefully, will aid the decision-making process for anyone considering breast augmentation. We’ll start here with the different types of breast implants.

Why silicone

Basically, there are two kinds of breast implants: silicone and saline. Each has its own set of benefits and drawbacks. I’ll start with silicone because it’s the most popular. According to one recent estimate, silicone breast implants were used in 70% of the breast augmentations performed in the US.

While their potential for ruptures is well-known at this point—the risk is relatively minimal, though it’s recommended that MRIs are done roughly every couple of years for the life of the implant in an effort to detect leaks at their onset—silicone implants have become increasingly popular in recent years as the prevailing preference has gradually shifted from dramatic outcomes (think Baywatch in the nineties) to subtle, natural-looking enhancements. Of the two types, silicone implants are the softest and feel most like natural breast tissue. They’re also available in both round and teardrop shapes.

Highly-cohesive silicone implants are different from the standard kind in that the silicone gel has a thicker consistency, which makes them firmer to the touch. But they’ve also proven to hold up better and be less susceptible to rupturing.

Why saline

Saline implants are filled with sterile saltwater, which means, if they should ever rupture, the implants’ contents will be absorbed by the body without any ill effects.

Beyond the safety aspect, saline implants are favored by women who prioritize upper pole fullness and projection with their new breasts. In other words, they prefer a dramatic result to a subtle enhancement. Keep in mind, saline implants are heavier than silicone, which may cause the breasts to become bottom-heavy over time.

And because they’re not prefilled, unlike silicone implants, a smaller incision may be warranted. There is, however, some additional risk with this particular type of incision. With silicone implants, the incision is larger, but it’s hidden in the breast crease, which is considered optimal not only for aesthetic purposes but also because it affords the surgeon prime access to the breast pocket.

Finally, if cost is a consideration, saline implants are generally the less expensive option.

In my next post, I’ll go a bit deeper into implant shapes and outline some of the thinking that’s involved in positioning the implants.

Breast augmentation has remained the most popular type of cosmetic plastic surgery in the United States because the procedure has evolved. The shift in preferences from dramatic-looking breasts to subtler enhancements coincided with the emergence of a range of new implant shapes, diameters, and projections, which allowed—for the first time—for a truly tailored, customized look and feel.

With those nuances comes a host of decisions. In an effort to prepare you for your breast augmentation consultation with a board-certified plastic surgeon, I’m exploring a few key aspects of the procedure. In my last post, I unpacked the benefits and drawbacks of the different kinds of implants. Here, I’ll get into the roles that implant shape and positioning play.

Subtle enhancement or dramatic makeover?

There are two basic breast implant shapes, round and teardrop, also known as anatomical and contoured, though, within each, there are many degrees of difference in terms of both size and profile. The reason for choosing one shape over another will hinge largely on your aesthetic goals, but it’ll also be influenced by the implants’ placement and your preferred incision location.

Your anatomy—body type, sternum width, chest-wall contour, and existing breast tissue—will also play a big part in the decision-making process.

Round implants, which resemble a compressed ball, tend to be favored for their fullness, lift, and resulting cleavage. Because they’re circular and uniform, there’s minimal variation in fullness or projection between the top and bottom of the implant. In other words, round implants will project, or stick out, further from the body than teardrop implants, for a more dramatic silhouette.

Teardrop implants, on the other hand, mimic the shape of natural breasts. They’re thinner at the top than they are at the bottom, and they gradually slope down from the top to the middle. It’s favored by women who want their breasts to look a little fuller or perkier. In fact, it’s an ideal choice for those who want to correct mild sagging. The implant itself can provide sufficient lift. For those with more significant sagging, a breast lift may need to be combined with the augmentation.

Positioning brings it all together

Both shapes come in a variety of sizes and profiles, which is the term that refers to how far the breast projects from the chest wall. A high-profile implant has the smallest base width and produces the most pronounced silhouette. While a moderate-profile implant has a wider base width and a more modest projection.

Heading into your consultation, it’s good to have a general visual of what you want your breasts to look like, but there’s no need to settle on a size or even a shape until you’re able to review specific examples with your plastic surgeon. I also take a series of measurements that help guide that decision and ensure that the implant is precisely placed in proper relation to the shoulders and nipples. Think of it as equal parts art and science.

The décolletage has traditionally been a point of frustration for many. It’s nearly as susceptible as the face and hands are to sun damage and the earliest signs of natural aging (think crepe-y wrinkles and mildly sagging skin), yet it’s been distinctly more difficult to treat. But that’s changed in recent years, thanks to a slew of innovations. Here’s an overview of some of the most effective ways to remedy décolletage wrinkling and restore a more youthful appearance.

Injectables

Dermal fillers can improve and enhance an ever-expanding spectrum of features. They’re still most commonly used for the face, but with an experienced plastic surgeon and the right filler—Sculptra, a versatile L-lactic acid filler, and hyaluronic acid fillers are generally the go-tos—the same effect can be achieved with the décolletage (read: wrinkle-free skin).

Depending on the filler that’s used, you can expect the results to last between six months and two years. And, of any of the methods highlighted here, injectables provide the most immediate results—and with zero downtime, no less.

Lasers

Similarly, carbon dioxide lasers, which superficially vaporize skin, and other non-ablative lasers are most popular for treating facial wrinkles, but they’re also being used more and more to treat décolletage wrinkles, scarring, and hyperpigmentation that can result from sun damage.

Most patients achieve their desired results within two to six sessions, which can be paired with skin-tightening treatments to minimize the recovery time.

Micro-fat grafting

This is a two-part procedure, where a small amount of excess fat is removed from another part of the body (the abdomen, thighs, or arms, most commonly). It’s then cleaned and injected into several points across the décolletage. Though not expressly a skin-tightening treatment, the injections will have a plumping effect, which will naturally tighten the surrounding skin, resulting in a smooth, youthful-looking décolletage.

The grafts are considered to be longer-lasting than dermal fillers. And, because it’s your own tissue that’s used, there’s no risk of an allergic reaction.

Chemical peels

A formula comprised of several acidic chemical components removes the outermost layer of the skin, revealing the smooth layer beneath. Chemical peels are considered to be one of the most effective ways to treat mild wrinkling and sun damage on the face. The same formulas are typically employed for the collarbone and décolletage.

Most patients achieve their desired results after three or four peels, which are administered several weeks apart.

As different as this summer will feel this year, it’ll remain the same in lots of ways, too. We’ll still enjoy soaking in the sun’s warmth for a passing moment and the cool stillness that arrives at dusk. We’ll still savor the unique sensations of grass and sand between our toes and the scent of something, anything, grilling nearby.

And we’ll still hate the way our butts look in shorts and especially bathing suits.

No such poll exists, but if it did, I’m sure it would indicate that the butt is one of the features that many of us want to change most about ourselves. It wasn’t a surprise when, a few years ago, butt enhancement surgery became one of the fastest-growing cosmetic surgery procedures in the United States.

At its height, there was a buttock procedure being performed every 30 minutes, on average, in this country, according to the American Society of Plastic Surgeons. That included both butt implants and butt augmentation, or the Brazilian butt lift. While implants were largely responsible for that initial surge, doctors have been steering their patients more toward the Brazilian butt lift over the last couple of years because it’s considered to be a much safer procedure, the recovery’s a lot easier, and the results tend to be far more positive.

What’s the difference between the two procedures?

For implant surgery, implants are placed beneath the gluteal muscle through an incision in the buttock cheeks. It’s typically a two- to three-hour procedure. Afterward, patients are encouraged not to sit directly on their implants for three weeks because the pressure could cause them to shift out of position. And the recovery period generally lasts about two weeks.

The Brazilian butt lift is done in two parts. First, fat is liposuction-ed out of the patient’s abdomen, hips, or thighs. It’s then cleaned and separated and injected into the patient’s butt. It’s about a one-hour procedure. And patients are usually back to work and their normal lifestyle 24 hours later.

Why is the Brazilian butt lift trending?

Since the grafted fat is being taken from another area of the body, the Brazilian butt lift is kind of a two-for-one procedure: Contour an area of concern and gain a shapelier butt in the process. Plus, since the grafted fat is your own tissue, there’s no risk of an allergic reaction or rejection.

The procedure also allows for more flexibility. Depending on the amount of available fat, you can upgrade to a Kim Kardashian-esque butt or simply add a touch more curve to your natural shape. Implants, on the other hand, are molded to specific sizes and volumes.

If you’ve always thought of butt enhancement surgery as something a small group of women somewhere are having done, it’s much more widespread than that. And that’s because they’ve discovered a wealth of confidence in finally addressing a feature they longed to change and never thought they could.