Plastic Surgery: Before and After

Is breast augmentation the same as breast implant surgery? Breast implant surgery is one form of augmentation; fat transfer is another way to add breast volume. Darren M. Smith, MD, a board-certified plastic surgeon in New York City, explains the distinction and compares the practical limits of each approach.

Originally published October 7, 2020. Implant brands, preferences and cost comparisons in the recording reflect that period. Confirm current options and implant-specific information during consultation.

Key takeaways

🧩 Augmentation options

Augmentation describes increasing breast volume; it does not specify that an implant must be used.

🔎 Implant materials

Silicone gel and saline implants differ in their filling material. The recording notes that both have silicone shells, so saline does not mean silicone-free.

🔄 Fat transfer process

Fat transfer uses liposuction to collect the patient's own fat, followed by processing and placement in the breasts.

📏 Donor fat and retention

Available donor fat and how much transferred tissue survives limit the achievable volume. A general retention estimate cannot predict an individual's result.

🎯 Personal treatment priorities

Appearance, feel, desired volume and cost should be discussed together. Neither technique is automatically the right choice for everyone.

🎧 Episode guide

00:00 — Introduction

00:36 — Implant types and filling materials

02:36 — Fat transfer as another form of augmentation

03:38 — Volume limits and graft survival

05:25 — Appearance, feel and cost

06:51 — Surgical versus nonsurgical enlargement

💬 Common questions

Can breasts be augmented without implants?

Yes. The episode describes fat transfer as an alternative for selected patients. The person must have suitable donor fat, and the desired change must fit what the technique can reasonably provide.

Is fat transfer a nonsurgical way to enlarge breasts?

No. Using your own tissue does not make the procedure nonsurgical: the recording describes harvesting fat with liposuction and then placing it in the breasts. Risks and recovery still need an individualized discussion.

Can fat transfer provide the same increase as any implant?

Not necessarily. Dr. Smith explains that donor-fat availability and variable graft survival constrain fat transfer. Implant dimensions also need to fit the patient's tissues and goals; neither approach offers unlimited enlargement.

🔗 Related information

Compare current information about breast augmentation, fat transfer breast augmentation, and breast implant options, or schedule a consultation.

About the host — current biography

Darren M. Smith, MD, FACS specializes in mommy makeover surgery, breast surgery, and body contouring in Manhattan. He was named to Newsweek’s America’s Best Plastic Surgeons 2026 and has co-authored authoritative peer-reviewed publications on combined breast surgery and abdominoplasty and the surgical care of postpartum patients.

Educational information, not individualized medical advice. All procedures have risks; volume, recovery and results vary. Show notes updated September 30, 2026.

Full transcript and related resources

How can you reduce the chance of a poor plastic surgery experience? Start by evaluating the clinician, facility, anesthesia plan and communication before committing to a procedure. Darren M. Smith, MD, a board-certified plastic surgeon in New York City, explains practical questions to ask while stressing that even excellent care cannot guarantee a perfect result.

Originally published October 4, 2020. The recording describes Dr. Smith's selection principles and practice setup at that time; verify current credentials and arrangements directly.

Key takeaways

🎓 Training and certification

Understand the clinician's training and the exact board certification being claimed. A marketing title alone does not tell you that history.

🏥 Facility and anesthesia team

Ask about the surgical facility's accreditation and monitoring, who will be present and how anesthesia will be provided.

🔎 Proposal review

Evaluate a full proposal rather than being led only by a discount, impressive advertisement or before-and-after photograph.

💬 Patient feedback

Look for patterns in patient feedback, while recognizing that reviews alone cannot establish surgical quality.

🧳 Travel and follow-up

Travel requires planning for support, costs and follow-up. Feeling comfortable asking detailed questions remains important wherever care takes place.

🎧 Episode guide

00:00 — Introduction

01:20 — Why no result can be guaranteed

03:17 — Training, certification and selection signals

07:09 — Travel and support planning

09:11 — Facility, anesthesia and staffing questions

12:22 — Communication and comfort with the care team

💬 Common questions

Can a surgeon promise a perfect result?

No. Dr. Smith explains that surgery involves living tissue, blood supply and healing, which introduce uncertainty. Understanding those limits is part of making an informed decision.

How can I check a plastic surgeon's board certification?

The episode specifically discusses certification by the American Board of Plastic Surgery. Its current public certification search provides a way to verify that claim rather than relying only on advertising.

What should I ask about anesthesia?

Ask who will administer it, their qualifications, who will monitor you and how the team is organized. The recording distinguishes selected procedures performed with local anesthesia from those involving sedation or general anesthesia; the appropriate arrangement depends on the procedure and setting.

🔗 Related information

Read Dr. Darren Smith's training and background and the preoperative preparation guide, or schedule a consultation to discuss your procedure and care plan.

About the host — current biography

Darren M. Smith, MD, FACS specializes in mommy makeover surgery, breast surgery, and body contouring in Manhattan. He was named to Newsweek’s America’s Best Plastic Surgeons 2026 and has co-authored authoritative peer-reviewed publications on combined breast surgery and abdominoplasty and the surgical care of postpartum patients.

Educational information, not individualized medical advice. Careful preparation can support informed decisions but cannot eliminate surgical risks. Show notes updated September 30, 2026.

Full transcript and related resources

Lipo 360 generally means liposuction across selected areas on the front, sides, and back of the torso. It is not a precise description of every area included in an operation. New York City board-certified plastic surgeon Darren M. Smith, MD, FACS explains why he asks patients to describe their individual concerns rather than relying on the label alone.

Originally published October 1, 2020. Prices, anesthesia preferences, and recovery protocols in the recording are historical examples from his practice, not current quotes or personal instructions.

Key takeaways

🔎 Define the treatment areas.

The episode discusses the abdomen, waist, flanks, underarm region, and upper and lower back as possible components.

🔎 Assess each area separately.

Dr. Smith considers the amount of fat, skin quality, and the patient's goal for each region before assembling a plan.

🔎 Multiple areas affect logistics.

He explains anesthesia choices, markings, and repositioning during the procedure as described in his 2020 practice.

🔬 A BBL is a separate fat-transfer component.

The recording discusses combining procedures, rather than treating buttock fat grafting as an automatic part of Lipo 360.

🔎 Ask what a quote includes.

Treatment extent, the clinical team, facility, monitoring, and planning are part of the conversation.

🎧 Episode guide

00:00 — Introduction

01:00 — Areas described by Lipo 360

02:44 — Planning each treatment area

04:35 — Anesthesia and the procedure

07:20 — Combining liposuction with a BBL

09:16 — Historical pricing and questions to ask

Does Lipo 360 include every part of the torso?

Not necessarily. Dr. Smith's central point is that the term can mean different things unless the exact areas and goals are specified. A consultation should turn the broad label into a defined plan.

Does Lipo 360 automatically include a BBL?

No. The episode describes BBL as a procedure that can be combined with liposuction by transferring harvested fat to the buttocks. It requires its own assessment and planning.

How much does Lipo 360 cost?

The quoted figures in this recording are from 2020 and should not be treated as current prices. Dr. Smith explains why the term's variable scope makes a single price misleading. Use the current cost guide and an individualized consultation to understand a proposed quote.

ℹ️ Current related reading

Lipo 360 in NYC | Liposuction cost factors | Brazilian butt lift | Request a consultation

About the host — current biography

Darren M. Smith, MD, FACS specializes in mommy makeover surgery, breast surgery, and body contouring in Manhattan. He was named to Newsweek’s America’s Best Plastic Surgeons 2026 and has co-authored authoritative peer-reviewed publications on combined breast surgery and abdominoplasty and the surgical care of postpartum patients.

Educational information; candidacy and recovery vary. Follow your treating team's current instructions. Show notes updated September 30, 2026.

Full transcript and related resources

AccuTite is a minimally invasive radiofrequency procedure that uses a small probe beneath the skin to deliver energy to selected tissues. In this episode, Darren M. Smith, MD, a plastic surgeon in New York City, explains its use in the discussion of smaller areas of skin laxity and how it differs from FaceTite and skin-removal surgery.

The key distinction is access beneath the skin. Although the handpiece is small, this is a medical procedure that penetrates the skin, with recovery and risk considerations.

Key takeaways

🔎 AccuTite uses bipolar radiofrequency.

The recording describes energy delivered between an internal and an external component, with heat intended to produce a tissue response over time.

🔎 Handpiece size affects the discussion.

Dr. Smith contrasts the smaller AccuTite handpiece with FaceTite and describes selected facial and body treatment areas.

🔎 Small access points still involve a procedure.

The episode describes a skin puncture and a probe under the skin. This should not be interpreted as completely noninvasive or guaranteed scar-free treatment.

💬 Feeling well and looking ready for an event are different milestones.

Swelling can affect social or professional plans even when someone feels able to resume activities.

🎯 Goals matter when comparing options.

AccuTite and excisional surgery do not promise the same degree of change. Dr. Smith discusses balancing the desired result, recovery and cost.

💬 Questions answered

What is the difference between AccuTite and FaceTite?

The recording describes related radiofrequency technology with different-sized handpieces. AccuTite is discussed for smaller areas, while FaceTite is used in the examples involving larger regions. The choice still depends on anatomy and the treatment plan.

What recovery does the episode describe?

Dr. Smith discusses swelling and the possibility of needing time away from visible social or work obligations. His five-to-seven-day example is from the 2020 recording, not an individual recovery promise. Changes in contour also develop over time.

How much does AccuTite cost?

The recording gives a historical 2020 estimate of $2,000-$4,000 per treated area, depending on the area and provider. This is not a current quote. A consultation should clarify the proposed treatment, included fees, risks and realistic limits of the expected change.

🎧 Episode chapters

00:26 — What AccuTite is

01:10 — How radiofrequency is delivered

02:12 — AccuTite versus FaceTite

03:12 — Swelling and recovery

04:00 — Historical pricing

04:25 — Comparing the desired change with surgery

🔗 Related information

Explore FaceTite and AccuTite information, neck lift surgery, facial plastic surgery options, or request a consultation with Dr. Smith in New York City.

About the host — current biography

Darren M. Smith, MD, FACS is a board-certified plastic surgeon in Manhattan specializing in mommy makeover surgery, breast surgery, and body contouring. He was named to Newsweek’s America’s Best Plastic Surgeons 2026 and has co-authored authoritative peer-reviewed publications on combined breast surgery and abdominoplasty and the surgical care of postpartum patients.

Originally released September 28, 2020. Show notes updated September 30, 2026. This is general education. Current recommendations, suitability, risks and expected results require an individual assessment.

Full transcript and related resources

Rectus diastasis, also called diastasis recti, is widening between the paired rectus abdominal muscles as the connective tissue along the midline stretches. In this episode, Darren M. Smith, MD, a plastic surgeon in New York City, explains the abdominal wall, the difference between diastasis and a hernia, and approaches discussed for persistent concerns.

The recording focuses on changes associated with pregnancy, possible abdominal bulging and core weakness. It separates the abdominal wall from the fat and skin over it, helping explain why different causes of abdominal fullness need different assessments.

Key takeaways

🔬 The rectus muscles are a paired structure.

They run vertically along the abdomen and contribute to core function.

🔎 Pregnancy can stretch the midline.

Dr. Smith describes the expanding uterus and changes in the abdominal wall as a common scenario in his practice.

🔎 Diastasis and hernia are different.

With diastasis, the midline tissue is stretched; a hernia involves a defect in the abdominal wall through which tissue can protrude.

🔎 Function and appearance both enter the discussion.

The episode addresses core-strength concerns alongside abdominal contour.

🎯 Treatment needs an individual plan.

Dr. Smith discusses physical therapy, a historical Emsculpt approach and surgical plication in the context of a tummy tuck. These options should not be assumed to provide equivalent anatomical repair.

💬 Questions answered

Is diastasis recti the same as an abdominal hernia?

No. The episode distinguishes widening of the midline from an actual defect in the abdominal wall. An examination is needed to determine the cause of a bulge and whether a hernia is also present.

What does plication mean in this discussion?

It refers to surgical tightening with sutures to bring the stretched midline tissue closer together. Dr. Smith describes this as part of the abdominal-wall repair performed during selected tummy tucks.

ℹ️ Current context for this 2020 recording

Postpartum separation can improve during recovery after childbirth, although the degree and timing vary. The NHS postpartum guidance discusses this improvement and assessment for persistent concerns. This should not be generalized to every chronic or adult diastasis.

The European Hernia Society's 2021 guideline states that physiotherapy may be considered before surgery. A current assessment should guide rehabilitation and any surgical discussion; the recording's device comments do not establish that Emsculpt substitutes for that care.

🎧 Episode chapters

00:26 — Abdominal-wall anatomy

02:06 — Pregnancy and abdominal separation

02:43 — Diastasis versus hernia

04:22 — Nonsurgical treatment discussion

05:45 — Plication and tummy tuck surgery

🔗 Related information

Explore tummy tuck surgery, post-pregnancy contouring information, body-contouring procedures, or request a consultation with Dr. Smith in New York City.

About the host — current biography

Darren M. Smith, MD, FACS is a board-certified plastic surgeon in Manhattan specializing in mommy makeover surgery, breast surgery, and body contouring. He was named to Newsweek’s America’s Best Plastic Surgeons 2026 and has co-authored authoritative peer-reviewed publications on combined breast surgery and abdominoplasty and the surgical care of postpartum patients.

Originally released September 25, 2020. Show notes updated September 30, 2026. This is general education. Current recommendations, suitability, risks and expected results require an individual assessment.

Full transcript and related resources

Smoking increases risks around plastic surgery, including impaired wound healing, tissue loss and complications related to anesthesia and recovery. In this episode, Darren M. Smith, MD, a plastic surgeon in New York City, explains why discussing smoking early is part of planning an elective procedure.

The central issue is blood supply. Healing skin and tissue need oxygen and nutrients delivered through small blood vessels. The recording describes how smoking can interfere with that process, particularly when surgery has already changed the circulation supporting an area.

Key takeaways

🩹 Incisions depend on circulation to heal.

Dr. Smith uses a construction-site analogy: blood flow brings the materials needed for repair.

🩹 The concern extends beyond a delayed scar.

The episode discusses loss of skin or other soft tissue when its blood supply is inadequate.

🔎 Different operations create different demands.

Tummy tucks, breast reductions, breast lifts and facelifts are examples used to explain why tissue circulation matters.

⚠️ Heart, lung and clotting risks also matter.

Smoking is discussed in the wider context of anesthesia and recovery, not only the appearance of an incision.

🎯 Make a cessation plan with the surgical team.

Dr. Smith encourages using the preparation period as an opportunity to seek support for quitting.

💬 Questions answered

Why can smoking cause tissue loss after surgery?

The recording explains that tissue needs an adequate blood supply to survive. When a procedure changes that supply, smoking can further compromise circulation and increase the risk of serious healing problems.

How long before and after surgery does Dr. Smith discuss stopping?

In this 2020 recording, he describes approximately a month before and after a procedure. That is a historical practice example, not personal clearance to proceed or resume smoking. Your team should set the plan for your operation and health circumstances.

ℹ️ Current context

The ASPS 2024 smoking-risk guidance also addresses nicotine from vaping and other products, while noting that management varies by procedure and patient. Tell your team about cigarettes, vaping and nicotine replacement products so cessation support and surgical timing can be planned together.

🎧 Episode chapters

00:58 — Three categories of smoking-related risk

01:25 — Blood supply and wound healing

03:32 — Why tissue can be lost

04:36 — Anesthesia and systemic risks

06:02 — The original cessation recommendation

🔗 Related information

Explore preparing for plastic surgery, patient guides, the practice and surgical setting, or request a consultation with Dr. Smith in New York City.

About the host — current biography

Darren M. Smith, MD, FACS is a board-certified plastic surgeon in Manhattan specializing in mommy makeover surgery, breast surgery, and body contouring. He was named to Newsweek’s America’s Best Plastic Surgeons 2026 and has co-authored authoritative peer-reviewed publications on combined breast surgery and abdominoplasty and the surgical care of postpartum patients.

Originally released September 22, 2020. Show notes updated September 30, 2026. This is general education. Current recommendations, suitability, risks and expected results require an individual assessment.

Full transcript and related resources

Men can consider a broad range of aesthetic procedures, with the choice guided by anatomy, health and personal goals. In this episode, Darren M. Smith, MD, a plastic surgeon in New York City, gives an overview of options for chin and neck contour, chest fullness, the abdomen and waist, muscle definition and facial lines.

The discussion's central theme is matching the treatment to the tissue involved. Fat, glandular breast tissue, skin laxity and muscle activity call for different assessments.

Key takeaways

🔬 Chin fullness and loose neck skin are separate concerns.

Dr. Smith discusses liposuction for fat, selected skin treatments and neck lift surgery when the degree of laxity warrants that discussion.

🔎 Chest fullness needs evaluation first.

The episode emphasizes considering possible medical causes before planning gynecomastia surgery, or male breast reduction.

🔬 Fat and glandular tissue may need different approaches.

Liposuction is discussed for fat, while glandular tissue may require excision. Excess skin adds another planning consideration.

🔎 Treatment can be staged.

Dr. Smith describes selected chest cases in which he reassesses skin contraction after the initial procedure before deciding whether further skin treatment is needed.

🔎 The overview extends beyond surgery.

Original Emsculpt is discussed for muscle conditioning, and Botox for forehead lines, crow's feet and frown lines. These address different goals from fat removal.

💬 Questions answered

Can liposuction alone treat an enlarged male chest?

It depends on what is creating the fullness. The recording distinguishes excess fat from glandular breast tissue and loose skin. An examination and evaluation of possible underlying causes help determine which approach, if any, is appropriate.

Can chest and waist contouring be considered together?

Yes. Dr. Smith discusses combining chest reduction with abdominal and waist liposuction in selected patients. Whether to combine or stage treatment requires an individual plan rather than assuming one package fits every person.

This 2020 recording describes device preferences and recovery examples from that period. Rapid return-to-work or exercise examples are not a personal recovery schedule, and original Emsculpt should not be confused with later device versions. For additional background on chest surgery, see the ASPS overview of gynecomastia surgery.

🎧 Episode chapters

01:25 — Chin and neck contour

02:34 — Chest fullness and gynecomastia assessment

04:45 — Abdominal and waist contouring

05:41 — Muscle conditioning and skin treatment

06:45 — Botox and facial lines

🔗 Related information

Explore liposuction for men, chin liposuction, Botox information, or request a consultation with Dr. Smith in New York City.

About the host — current biography

Darren M. Smith, MD, FACS is a board-certified plastic surgeon in Manhattan specializing in mommy makeover surgery, breast surgery, and body contouring. He was named to Newsweek’s America’s Best Plastic Surgeons 2026 and has co-authored authoritative peer-reviewed publications on combined breast surgery and abdominoplasty and the surgical care of postpartum patients.

Originally released September 19, 2020. Show notes updated September 30, 2026. This is general education. Current recommendations, suitability, risks and expected results require an individual assessment.

Full transcript and related resources

Stomach liposuction removes selected fat beneath the abdominal skin through small access incisions using a thin cannula. It does not remove loose skin or target visceral fat around the organs. In this episode, New York City board-certified plastic surgeon Darren M. Smith, MD, FACS explains the procedure and the anatomy that shapes the plan.

Originally published September 16, 2020. The step-by-step account describes his practice at that time, particularly abdominal liposuction under local anesthesia.

Key takeaways

🎯 Anesthesia is part of the planning discussion.

Dr. Smith describes local anesthesia for selected abdominal cases, as well as sedation and general anesthesia options.

🔎 The procedure follows a sequence.

The recording covers markings, preparation, small incisions, tumescent numbing solution, fat removal, and checking the contour.

🩹 Early recovery is different from the final result.

He describes soreness, swelling, compression, and drainage within his then-current aftercare protocol.

🔬 Skin quality can change the operation.

Depending on the amount of laxity and the patient's goals, the discussion may include tightening or a tummy tuck.

🔎 Not all abdominal fullness is accessible to liposuction.

Dr. Smith distinguishes fat above the abdominal wall from deeper visceral fat.

🎧 Episode guide

00:00 — Introduction

00:56 — Anesthesia options

02:26 — Tumescent solution and fat removal

03:51 — Early recovery and swelling

07:22 — Skin laxity and treatment goals

09:16 — Superficial versus visceral fat

Can stomach liposuction be done while awake?

Dr. Smith describes local anesthesia as an option for selected cases involving the abdomen alone. That does not mean every patient or treatment extent is suited to it. The recording also explains other anesthesia options.

What if I have loose abdominal skin?

The episode emphasizes both anatomy and goals. Some patients prioritize a change in clothing fit despite residual laxity; others want loose skin addressed directly. Dr. Smith discusses BodyTite and tummy tuck surgery as different possibilities, not automatic additions for everyone.

🔗 Related reading and consultation

Stomach liposuction in NYC | BodyTite skin tightening | Tummy tuck surgery | Request a consultation with Dr. Smith

About the host — current biography

Darren M. Smith, MD, FACS specializes in mommy makeover surgery, breast surgery, and body contouring in Manhattan. He was named to Newsweek’s America’s Best Plastic Surgeons 2026 and has co-authored authoritative peer-reviewed publications on combined breast surgery and abdominoplasty and the surgical care of postpartum patients.

Educational information, not personal aftercare instructions. Compression, showering, activity, and additional treatments should follow your surgical team's current plan. Show notes updated September 30, 2026.

Full transcript and related resources

Elective cosmetic surgery may be worth postponing when the decision is driven by outside pressure, health concerns need attention, or life circumstances make recovery difficult. In this episode, Darren M. Smith, MD, a plastic surgeon in New York City, explains how motivation, timing and preparation influence the decision to proceed.

He is discussing elective aesthetic procedures such as liposuction, breast augmentation and tummy tucks. The episode does not set a timetable for medically necessary reconstructive care.

Key takeaways

🎯 The goal should be your own.

Dr. Smith cautions against changing your appearance primarily to satisfy a partner or parent, or treating surgery as a solution to distress after a major life event.

🩹 Physical health needs assessment.

The recording discusses heart and lung conditions, diabetes, nutrition and smoking as factors relevant to anesthesia, healing and recovery.

🩹 Mental health belongs in the conversation.

Dr. Smith encourages discussing eating disorders or body-image concerns with the surgeon and an appropriate mental health professional. Readiness requires individual evaluation.

🎯 Planned body changes affect timing.

Significant weight change or pregnancy can alter the result of breast or abdominal contouring. Stable goals and a realistic plan are important.

🔎 Practical preparation matters.

Consider the full financial commitment, time away from work, childcare and help during recovery. Ask about staff, monitoring and the surgical facility when comparing practices.

💬 Questions answered

Should I have cosmetic surgery because someone else wants me to?

Dr. Smith advises making the decision for a personal goal rather than under pressure from another person. He encourages stepping back from advertisements or an exciting consultation to consider whether the procedure fits your own priorities.

Why discuss future pregnancy or weight loss before a tummy tuck?

Both can change the skin and abdominal contour after surgery. The episode explains why the expected timing and extent of those changes should be part of planning, rather than assuming the result will remain unchanged.

Does the lowest or highest price tell me which practice to choose?

The recording encourages looking beyond the price and asking what care is being provided. Qualifications, the facility, staffing and monitoring need direct assessment; a dollar amount by itself does not establish those features.

The waiting periods and practice protocols mentioned in this 2020 recording are historical examples. Discuss current timing with your treating team. For additional decision-making information, see the ASPS patient safety resources.

🎧 Episode chapters

02:27 — Personal goals and outside pressure

05:26 — Physical health and smoking

08:04 — Psychological readiness and weight stability

09:59 — Pregnancy and procedure timing

12:35 — Cost, staff and facility questions

15:07 — Planning support for recovery

🔗 Related information

Explore preparing for plastic surgery, Dr. Smith’s qualifications, the practice and surgical setting, or request a consultation with Dr. Smith in New York City.

About the host — current biography

Darren M. Smith, MD, FACS is a board-certified plastic surgeon in Manhattan specializing in mommy makeover surgery, breast surgery, and body contouring. He was named to Newsweek’s America’s Best Plastic Surgeons 2026 and has co-authored authoritative peer-reviewed publications on combined breast surgery and abdominoplasty and the surgical care of postpartum patients.

Originally released September 13, 2020. Show notes updated September 30, 2026. This is general education. Current recommendations, suitability, risks and expected results require an individual assessment.

Full transcript and related resources

Body contouring is an umbrella term for procedures intended to change body shape. The right category depends on whether the goal involves fat, loose skin, muscle definition or added volume. In this episode, Darren M. Smith, MD, a plastic surgeon in New York City, compares surgical, minimally invasive and noninvasive approaches.

He also explains two terms patients may encounter: high-definition liposuction and contouring after substantial weight loss. These labels describe different goals and do not identify one standard operation.

Key takeaways

🔬 Skin-removal surgery addresses excess tissue.

The episode includes tummy tucks, arm lifts, thigh lifts and lower body lifts, with different incision and recovery tradeoffs.

🔬 Liposuction and fat grafting serve different purposes.

Liposuction removes localized fat; fat grafting transfers a person's fat to add volume elsewhere. Both require a procedure-specific assessment.

⏳ Skin elasticity affects the plan.

Dr. Smith explains why removing fat does not automatically address loose skin and why selected cases may prompt discussion of additional treatment.

🔬 Noninvasive devices target different tissues.

The recording discusses fat freezing separately from the muscle-conditioning goal of original Emsculpt. Device treatment is not interchangeable with surgical skin removal.

🔎 Contouring after major weight loss can be more extensive.

Substantial excess skin may require an operation designed for its location and distribution, rather than assuming a small-incision treatment will suffice.

💬 Questions answered

What does Lipo360 mean?

Dr. Smith describes it as a broad term often used for liposuction around the torso. He prefers naming the exact areas, such as the abdomen, flanks or portions of the back, so patient and surgeon agree on the treatment plan.

Can liposuction remove loose skin?

Liposuction targets fat. The recording emphasizes evaluating skin elasticity and the amount of excess skin separately. Some patients may need a different or additional procedure to address that concern.

ℹ️ Current context for this 2020 recording

The discussion includes buttock fat grafting, or BBL. Small incisions do not imply low risk: an ASPS-led joint safety statement highlights serious risks, including fatal fat embolism, and supports real-time ultrasound and fat placement above the muscle. These measures do not eliminate risk. The episode's device preferences and comparisons are historical opinions, not guarantees of superiority or current treatment availability.

🎧 Episode chapters

01:26 — Surgical body contouring

04:01 — Liposuction, Lipo360 and fat grafting

07:58 — Skin elasticity and tightening

11:08 — Noninvasive fat and muscle treatments

14:15 — High-definition liposuction

15:58 — Contouring after substantial weight loss

🔗 Related information

Explore body-contouring procedures, liposuction, tummy tuck surgery, or request a consultation with Dr. Smith in New York City.

About the host — current biography

Darren M. Smith, MD, FACS is a board-certified plastic surgeon in Manhattan specializing in mommy makeover surgery, breast surgery, and body contouring. He was named to Newsweek’s America’s Best Plastic Surgeons 2026 and has co-authored authoritative peer-reviewed publications on combined breast surgery and abdominoplasty and the surgical care of postpartum patients.

Originally released September 10, 2020. Show notes updated September 30, 2026. This is general education. Current recommendations, suitability, risks and expected results require an individual assessment.

Full transcript and related resources