Everything You Ever Wanted To Know About Plastic Surgery, By An Expert

Cosmetic Treatments

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Cosmetic procedures are becoming the norm. It’s been widely reported that many plastic surgeons have seen a huge increase in women in their twenties having lip fillers and cosmetic procedures, which they credit to influencers and social media. As a result, we’ve had tons of questions about plastic surgery!

If you’ve been considering getting any type of cosmetic enhancement, make sure it is purely for yourself and not for anyone else. Next, make sure you’ve done your research! We got the rundown from celebrity plastic surgeon, Dr. Marc Mani, from our Panel of Experts, so you could ask anything you wanted to know and be better informed. From lip fillers and lipo to rhinoplasty, boob lifts, and face contouring, here’s what you wanted to learn more about.

Lip fillers: What are the best fillers, and how long should they last?

Dr. Mani: Hyaluronic acid fillers like Juvederm and Restylane are the best fillers for lips and usually last around six months or more for most people. Hyaluronic acid fillers allow finer sculpting and give a soft touch finish as long as too much isn’t used at once. Within each filler brand, there are now different types of filler as well, with varying degrees of softness or “flexibility.”  But even more importantly, the result depends on the artistry of your plastic surgeon’s eye and hand.

I love fat transfer in very conservative amounts in the face, but for lips, it’s not as precise, and it’s harder to shape the lips with finesse using fat, but it is an option that lasts longer. The main thing I will urge you to be VERY CAUTIOUS about is using silicone or any other “permanent” or long-term filler in your lips (and other places, but most of all in the lips). These routinely cause irreversible deformities. Do not do them.

Lipo: Are there risks, how long is recovery, and what are the best methods? 

Dr. Mani: Liposuction of two or three areas usually takes two hours or less, while more extensive lipo can take four hours. The recovery time is a week or less. Any surgery or procedure carries risks; infection and bleeding are potential risks of liposuction, but both are very rare.  More common risks are irregularities in the contour of the area being liposuctioned, like asymmetry or scar tissue forming, but this is still unlikely in the hands of a surgeon certified by the American Board of Plastic Surgery.

There are different types of fat removal, such as Coolsculpting and Sculpsure, which work by freezing or heating fat, respectively. They are non-invasive and can work, but they also have less predictability than simple liposuction, which is tried and true and relatively risk-free in the hands of a plastic surgeon. Of the noninvasive techniques, I have seen the most improvement (and least complications) from Coolsculpting.

Nose jobs: What are the alternatives, how long is the recovery?

Rhinoplasty surgery is very safe in the hands of an experienced plastic surgeon. There are two types of surgery: closed surgery, where no external incisions are made, and open rhinoplasty, which involves folding the skin of the nose in half (a bit like opening a garage door), although there are many other different methods of open rhinoplasty.

Closed rhinoplasty recovery: Most closed rhinoplasty patients can go back to work after one week, but full recovery depends on the type of surgery and the technique of your surgeon. Very gentle tissue handling and closed technique really help the nose look much more normal after the first week. There will be some swelling, which can increase a bit after the second week, but it’s usually not that noticeable for most patients. The splint or hard plastic cover on the nose comes off after seven days in most surgeons’ hands. There is bruising after a week in about a third of my patients, but many don’t have any bruising after that week, and what remains can generally be covered with makeup. Because I do closed (scarless) rhinoplasty in all cases, the healing time is significantly reduced as there’s no external incision to heal.

Open rhinoplasty recovery: Open rhinoplasty increases swelling and healing time, and as a result, recovery can take much longer. The swelling can remain for three to four months, although the vast majority will go in two to three weeks. Open rhinoplasty also increases the risk of tip necrosis (death of tissue and loss of the tip of the nose), which is virtually unheard of in closed rhinoplasty.

Alternatives to surgery: Filler is an alternative to invasive techniques in certain situations; it can be used to disguise a hump for example. However, filler is temporary – I use it mostly for people who want to see what their result will look like in situations where a slight augmentation above or below a hump will disguise it. Nasal asymmetry (from a previous fracture) can be restored with a rhinoplasty.

Boob lifts: How does a breast lift work and how long does it take to heal? 

Dr. Mani: A breast lift is done by removing skin under the nipple/areola and repositioning the areola into a higher position. The areola is left attached to the breast gland and not removed from the breast. Recovery for both a circum-areolar lift and a lollipop breast lift, in the sense of continuing usual work activities, is a week in both cases. Exercise is usually delayed for at least two weeks, and only light exercise is allowed until six weeks.

Breast lifts can be done with an incision just around the areola (the pigmented skin around the nipple) in more moderate cases of drooping, and with a lollipop-shaped incision with more dropping (an incision around the areola and below the nipple). I never use the old “anchor” incision anymore, and I don’t think anyone should because the lollipop just gives a better shape in artistic hands. If your reason for avoiding “major surgery” is to be able to breastfeed, this should not be a concern because breastfeeding is still possible after a breast lift, as the nipple and glands are still intact. There are newer alternatives like “Bodytite,” which uses bipolar radiofrequency to tighten the area, and this works for minor dropping to a minimal degree.

Face contouring: Are you able to contour cheeks without a cosmetic procedure?

Dr. Mani: Buccal fat pad removal is the latest craze for defining your cheekbones, and it’s a hugely popular procedure that a lot of models and actresses have had. The quick surgery reduces the size of round cheeks by eliminating one of the main causes, the buccal fat pad. In my opinion, this is a much better option to filler for defining cheekbones, since filler is temporary and often noticeable to people who have a good eye for natural facial features and movement. The surgery is scarless, and involves just a small incision inside the mouth, only about a centimeter or two long, and no incision on the outside. The fat pad is gently teased out of its pocket deep in the cheek with special instruments, and removed through the inside of the mouth. The total volume of the buccal fat (both cheeks combined) usually adds up to about the size of a golf ball.

If you wanted to slim your face without undergoing a cosmetic procedure you could, in theory, do facial exercises – you can find lots of exercises online, and there are devices you can try as well.

Surgery scars: What are the best ways to fade scars?

Dr. Mani: There are scar creams, which can help improve scarring. bioCorneum is the main scar treatment I recommend, other than silicone sheeting, and the only gel formula I’ve seen good results from. I use it for facelift incisions in about 10 percent of patients, and only after the incisions have passed their initial healing phase (about four to six weeks post op). Sometimes I use it for breast lifts, and abdominoplasty (tummy tuck) scars if the scar appears red. I ask patients to try it for a week and then have them come back so I can make sure it’s not increasing the redness, which does happen in a small percent of cases. If surgery scars are raised, silicone sheeting works best: It sticks onto the scar and is worn for around half the day, and it softens and flattens the scar, in most cases. It should not be used if there are any (even small) openings, for example, where sutures have poked through the skin.

Tummy tucks and pregnancy: Can you do a tummy tuck after and before another child?

Dr. Mani: A tummy tuck or abdominoplasty is the removal of excess abdominal skin and usually involves the repair of muscle separation in the midline of the abdomen. You can have a tummy tuck before having another child. I tell patients if they are planning to have another child anytime in the next couple of years to wait, but if their plans are long-term or indefinite, to go ahead and do it – if they are a good candidate, of course. After birth, you might need at least another repair of the muscle separation after another pregnancy, but it can be safely done.

Sunken eyes: Are fillers the only option?

Dr. Mani: Fillers can make the eyes look as though they’re sitting further forward, and it’s the most affordable method. I tend not to do this and prefer lower blepharoplasty (which is scarless and permanently solves the problem), or fat transfer because fillers under the eyes cause thinning of the tissues over time, and this is irreversible.

TLDR: We don’t encourage anyone to have plastic surgery, but we do believe it is 100% your choice. We hope this blog has opened your eyes and given you some interesting information for you to make informed decisions about whether plastic surgery might be the right step for you. Thank you so much to all of you who left questions and inspired this post; we hope we’ve answered your questions. Got more questions? Leave your comments below or head over to Dr. Marc Mani’s Instagram page here.