What you'll hear in this episode

📊 The Age Proxy

Why a study of roughly 184,000 cosmetic procedures found no meaningful difference in complications between patients over 65 and everyone younger — and why age is standing in for the variables that actually predict outcomes.

⚠️ The Tummy Tuck Exception

The single operation where older patients did fare worse, and how a separate analysis of the same database independently identified age 55 as a risk factor within that procedure specifically.

⏳ The Estrogen Clock

Why the collagen loss that matters is measured from menopause rather than from your birthday, and how two women of the same age can arrive with entirely different tissue.

🩹 The Scar Distinction

What the healing evidence actually supports — slower scar maturation — and the claim it does not support: that the scars end up worse.

⬆️ The Upper Pole Problem

Why a standard mastopexy in this population often fails to hold upper pole fullness, why what goes up must come down, and when auto-augmentation becomes the better answer.

🔄 The Lifetime Device Question

Why choosing implants at 55 is really a decision about 65 and 75, and how that reframes the implant conversation after menopause.

💊 The Pill-Patch Divide

The one distinction that changes the hormone answer completely: why oral estrogen passes through the liver and nudges the clotting system, while transdermal estrogen appears not to — even in women with existing risk factors.

📅 The Four-Week Rule

Why stopping hormones the week before surgery is theater, how long the effect actually takes to clear, and exactly what Dr. Smith does in his own practice.

⚖️ Redistribution, Not Willpower

Why the midlife shift toward the middle is hormonal rather than a failure of discipline, and the hard limit on what liposuction can and cannot reach.

🧬 What Actually Settles

Why “wait until things settle” describes something real — the breast's fat-to-stroma balance stops shifting in the mid-fifties — and why the glandular tissue keeps changing after that.

🔍 Judgment Versus Evidence

Why you should want a surgeon who can tell you which of their rules are proven and which are judgment calls, and why uniform confidence across claims of very different quality is not expertise.

🔗 Resources and links

📍 Considering plastic surgery and wondering how menopause factors in? Schedule a consultation with Dr. Smith at the Ritz Tower, Park Avenue and East 57th Street, Manhattan.

🎧 The earlier episode referenced in this discussion: The Natural Lift: Everything You Need to Know About Auto-Augmentation Mastopexy.

🎙️ Plastics & Peptides, Dr. Smith's podcast with longevity medicine specialist Dr. Amanda Kahn — listen on Apple Podcasts or Spotify.

📚 References

Yeslev M, et al. Safety of cosmetic procedures in elderly and octogenarian patients. Aesthetic Surgery Journal. 2015;35(7):864-873. https://doi.org/10.1093/asj/sjv053

Winocour J, et al. Abdominoplasty: risk factors, complication rates, and safety of combined procedures. Plastic and Reconstructive Surgery. 2015;136(5):597e-606e. https://doi.org/10.1097/PRS.0000000000001700

Zomer HD, Cooke PS. Targeting estrogen signaling and biosynthesis for aged skin repair. Frontiers in Physiology. 2023;14:1281071. https://doi.org/10.3389/fphys.2023.1281071

Wilkinson HN, Hardman MJ. The role of estrogen in cutaneous aging and repair. Maturitas. 2017;103:60-64. https://doi.org/10.1016/j.maturitas.2017.06.026

Mittal P, et al. Venous thromboembolism (VTE) prophylaxis after abdominoplasty and liposuction: a review of the literature. Aesthetic Plastic Surgery. 2020;44(2):473-482. https://doi.org/10.1007/s00266-019-01576-2

Vinogradova Y, Coupland C, Hippisley-Cox J. Use of hormone replacement therapy and risk of venous thromboembolism: nested case-control studies using the QResearch and CPRD databases. BMJ. 2019;364:k4810. https://doi.org/10.1136/bmj.k4810

Mohammed K, et al. Oral vs transdermal estrogen therapy and vascular events: a systematic review and meta-analysis. Journal of Clinical Endocrinology and Metabolism. 2015;100(11):4012-4020. https://doi.org/10.1210/jc.2015-2237

Committee on Practice Bulletins — Gynecology. Prevention of venous thromboembolism in gynecologic surgery: ACOG Practice Bulletin No. 232. Obstetrics and Gynecology. 2021;138(1):e1-e15. https://doi.org/10.1097/AOG.0000000000004445

Skeith L, Bates SM. Sex hormone influences on venous thrombotic and cardiovascular risk. New England Journal of Medicine. 2026;394(15):1514-1528. https://doi.org/10.1056/NEJMra2202438

Abouharb ALZ, et al. Withholding of hormone replacement therapy prior to total joint arthroplasty surgery to reduce the risk of postoperative thromboembolic events: is it justified? A systematic review of clinical practice guidelines. Journal of Arthroplasty. 2024;39(2):541-548.e24. https://doi.org/10.1016/j.arth.2023.08.061

Greendale GA, et al. Changes in body composition and weight during the menopause transition. JCI Insight. 2019;4(5):e124865. https://doi.org/10.1172/jci.insight.124865

El Khoudary SR, et al. Menopause transition and cardiovascular disease risk: implications for timing of early prevention. A scientific statement from the American Heart Association. Circulation. 2020;142(25):e506-e532. https://doi.org/10.1161/CIR.0000000000000912

Sandhu R, Chollet-Hinton L, Kirk EL, Midkiff B, Troester MA. Digital histologic analysis reveals morphometric patterns of age-related involution in breast epithelium and stroma. Human Pathology. 2016;48:60-68. https://doi.org/10.1016/j.humpath.2015.09.031

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.

Full transcript and related resources

What you’ll hear in this episode:

• The Half-Truth of Textbooks: Why the common warning that implants always magnify asymmetry is true for position but false for volume.
• The Volume Exception: How the "arithmetic of proportions" can shrink a visible 10% volume difference down to a negligible 4.4% using identical implants.
• When the Warning Holds True: Why implants actually make positional issues, like uneven nipple heights or creases, more visible to the eye.
• The Post-Nursing Pattern: Why deflation after breastfeeding is the textbook case for using identical implants to restore symmetry.
• The Tuberous Deformity Trap: Why congenital asymmetry requires a specialized tissue release rather than a simple volume fix to avoid worsening the appearance.
• Chest Wall Dynamics: How rib cage flares or a sunken sternum create "recessed" breasts that require different implant profiles to correct.
• Landmarks vs. Ratios: Why the human brain focuses on nipple position even after the volumetric math has been solved.
• Visualizing the Math: How 3D imaging at the consultation stage sets realistic expectations by simulating identical versus different-sized implants.

Resources and links:

• Are you considering a Breast Augmentation?
• Learn more about Breast Asymmetry Correction in Manhattan.
• Explore options for a Breast Lift to correct positional asymmetry.
• Verify board-certified surgeons via the American Board of Plastic Surgery.
• Schedule a consultation at Dr. Darren Smith’s Practice in the Ritz Tower.
• Check out Plastics & Peptides, our sister podcast co-hosted by longevity expert and board-certified internist Dr. Amanda Kahn at https://podcasts.apple.com/ca/podcast/plastics-peptides/id1835192336

A note on how this episode was produced: Elements of this episode were produced using AI tools, allowing Dr. Smith to scale his educational reach beyond the operating room and consultation office. All medical content, clinical opinions, and recommendations have been personally reviewed and fact-checked by Dr. Darren Smith, a board-certified plastic surgeon with dual fellowship training in craniofacial and aesthetic surgery. Dr. Smith's commitment to leveraging AI isn't about cutting corners — it's about amplifying his educational bandwidth so that more patients have access to the honest, expert-level guidance they deserve before making life-changing surgical decisions.

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.

Full transcript and related resources

1. What you’ll hear in this episode:

• The Observer Paradox: Why children are the world’s best observers but worst interpreters, and how silence can lead them to "fill in the blanks" with scary stories.
• The Boo-Boo Framework: How to provide simple, physical reassurance to toddlers who only need to know that you’re safe and still here.
• Empowering the School-Age Child: Why giving your 5-to-8-year-old a "job" during your recovery can transform their anxiety into a sense of helpfulness and control.
• Agency vs. Inadequacy: The subtle shift in language for pre-teens that teaches them surgical choices are about personal autonomy rather than "fixing" flaws.
• The Transparency Framework: How to handle tough questions from teenagers about beauty standards while maintaining mutual trust and respect.
• The Confidence Mirror: Why your child’s reaction to your surgery is often a direct reflection of your own internal comfort or lingering guilt.
• Privacy vs. Secrecy: How to give your kids "portable language" for school playdates that protects your medical privacy without feeling like a heavy family secret.
• The Gentle Cuddle Position: Why establishing new physical boundaries before surgery prevents your child from feeling rejected during your healing process.

1. Resources and links:

• Are you considering a Mommy Makeover? https://www.darrensmithmd.com/procedures/body/mommy-makeover/
• Learn more about Abdominoplasty (Tummy Tuck) recovery and results. https://www.darrensmithmd.com/procedures/body/tummy-tuck/
• Explore Breast Lift options with Dr. Darren Smith. https://www.darrensmithmd.com/procedures/breast/breast-lift/
• Schedule a consultation at Dr. Smith’s Manhattan office. https://www.darrensmithmd.com/contact/
• Check out Plastics & Peptides, our podcast co-hosted by longevity expert and board-certified internist Dr. Amanda Kahn at https://podcasts.apple.com/ca/podcast/plastics-peptides/id1835192336

A note on how this episode was produced: Elements of this episode were produced using AI tools, allowing Dr. Smith to scale his educational reach beyond the operating room and consultation office. All medical content, clinical opinions, and recommendations have been personally reviewed and fact-checked by Dr. Darren Smith, a board-certified plastic surgeon with dual fellowship training in craniofacial and aesthetic surgery. Dr. Smith's commitment to leveraging AI isn't about cutting corners — it's about amplifying his educational bandwidth so that more patients have access to the honest, expert-level guidance they deserve before making life-changing surgical decisions.

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.

Full transcript and related resources

What you’ll hear in this episode:

• Why a national survey found that over 40% of women desire physical changes following a major life transition.
• Shifting the narrative from tabloid headlines to the clinical reality that post-divorce patients represent roughly 20% of a modern plastic surgery practice.
• Understanding why divorce ranks as the second most stressful life event on the Holmes-Rahe scale, surpassed only by the death of a spouse.
• Why men account for nearly 30% of patients seeking "divorce packages" to address appearance concerns before re-entering the dating world.
• How to identify if a patient is moving toward a positive goal or simply running away from emotional pain.
• An inside look at the five-factor screening tool used to predict surgical satisfaction and flag potential body dysmorphia.
• Why experts suggest waiting six months to two years after a major loss before making permanent surgical decisions.
• How correctly timed procedures lead to documented improvements in body image, self-esteem, and overall quality of life.

Resources and links:

• Are you considering a Mommy Makeover or Breast Augmentation?
• Explore Dr. Smith's approach to Liposuction and body contouring.
• Interested in facial rejuvenation? Learn about Facelifts and Eyelid Lifts.
• Schedule a personalized consultation to discuss your goals at https://www.darrensmithmd.com/.
• Check out Plastics & Peptides, our podcast co-hosted by longevity expert and board-certified internist Dr. Amanda Kahn at https://podcasts.apple.com/ca/podcast/plastics-peptides/id1835192336.

A note on how this episode was produced: Elements of this episode were produced using AI tools, allowing Dr. Smith to scale his educational reach beyond the operating room and consultation office. All medical content, clinical opinions, and recommendations have been personally reviewed and fact-checked by Dr. Darren Smith, a board-certified plastic surgeon with dual fellowship training in craniofacial and aesthetic surgery. Dr. Smith's commitment to leveraging AI isn't about cutting corners — it's about amplifying his educational bandwidth so that more patients have access to the honest, expert-level guidance they deserve before making life-changing surgical decisions.

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.

Full transcript and related resources

What you’ll hear in this episode:

• The Explant Evolution: Why breast implant removal procedures nearly doubled between 2017 and 2022 and how patients are shifting toward natural aesthetics.
• Defining Auto-Augmentation: A breakdown of the medical terminology—Auto (self), Augmentation (volume), and Mastopexy (lift)—and how they combine to reshape the breast.
• The Internal Support System: How surgeons rearrange existing breast tissue to fill the "upper pole" and restore a youthful contour without foreign materials.
• Ideal Candidate Profiles: Why this procedure is a game-changer for women experiencing breast changes after pregnancy, weight loss, or implant removal.
• The Architecture of a Lift: A step-by-step walkthrough of the operating room process, from precise sternal measurements to the elevation of tissue flaps.
• Understanding the Limitations: The honest truth about why this procedure redistributes volume rather than creating new size, and who might still need implants.
• What the Research Says: A look at peer-reviewed data showing high patient satisfaction scores and an objective doubling of breast projection post-surgery.
• Navigating Recovery and Scars: What to expect during the healing process, and how different incision patterns like the "lollipop" or "anchor" are chosen.

Resources and links:

• Are you considering an auto-augmentation mastopexy? Learn more about the procedure at darrensmithmd.com.
• Explore the global trends in aesthetic surgery via the International Society of Aesthetic Plastic Surgery.
• Verify board-certified surgeons and research safety data through the American Society of Plastic Surgeons.
• Check out Plastics & Peptides, our podcast co-hosted by longevity expert and board-certified internist Dr. Amanda Kahn at https://podcasts.apple.com/ca/podcast/plastics-peptides/id1835192336

A note on how this episode was produced: Elements of this episode were produced using AI tools, allowing Dr. Smith to scale his educational reach beyond the operating room and consultation office. All medical content, clinical opinions, and recommendations have been personally reviewed and fact-checked by Dr. Darren Smith, a board-certified plastic surgeon with dual fellowship training in craniofacial and aesthetic surgery. Dr. Smith's commitment to leveraging AI isn't about cutting corners — it's about amplifying his educational bandwidth so that more patients have access to the honest, expert-level guidance they deserve before making life-changing surgical decisions.

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.

Full transcript and related resources

What you’ll hear in this episode:

• [The 80-Year Oversight]: Why a condition identified at the Mayo Clinic in 1940 is still misdiagnosed in 80% of cases today.
• [The Cellular Saboteur]: How hypertrophied fat cells and "geloid" hyaluronic acid create a biological defense system against weight loss.
• [The M2 Macrophage Discovery]: What 2025 research reveals about specific immune cells that actively drive abnormal fat expansion in the thighs.
• [The "Cuffing" Effect]: How to use physical markers like ankle sparing and symmetrical distribution to distinguish lipedema from traditional obesity.
• [Beyond the Scale]: Why pain, tenderness, and easy bruising are clinical red flags of diseased tissue rather than simple caloric storage.
• [The Lymphatic Connection]: The progression from lipedema to lipo-lymphedema and why supporting fluid drainage is non-negotiable.
• [Surgical vs. Cosmetic Solutions]: The critical difference between traditional liposuction and specialized lymphatic-sparing procedures.
• [The GLP-1 Intersection]: How medications like Ozempic and Wegovy interact with a lipedema diagnosis when co-existing with obesity.
• [A Script for Your Doctor]: The five specific data points you need to share with your physician to trigger a proper clinical evaluation.

Resources and links:

• "Are you struggling with persistent lower-body swelling? Explore our Lipedema Treatment Options."
• "Verify board-certified surgeons and learn more about aesthetic excellence at darrensmithmd.com."
• "Seeking a specialist? Use the Lipedema Foundation Provider Directory."
• "Curious about the latest in longevity and aesthetics? Check out Plastics & Peptides, our sister podcast co-hosted by longevity expert and board-certified internist Dr. Amanda Kahn at https://podcasts.apple.com/ca/podcast/plastics-peptides/id1835192336"

A note on how this episode was produced: Elements of this episode were produced using AI tools, allowing Dr. Smith to scale his educational reach beyond the operating room and consultation office. All medical content, clinical opinions, and recommendations have been personally reviewed and fact-checked by Dr. Darren Smith, a board-certified plastic surgeon with dual fellowship training in craniofacial and aesthetic surgery. Dr. Smith's commitment to leveraging AI isn't about cutting corners — it's about amplifying his educational bandwidth so that more patients have access to the honest, expert-level guidance they deserve before making life-changing surgical decisions.

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.

Full transcript and related resources

What you’ll hear in this episode:

• The Balloon Analogy: Why rapid weight loss prevents skin from "snapping back" and how collagen fibers reach their limit.
• The Hidden Muscle Crisis: Why up to 40% of GLP-1 weight loss is actually lean muscle mass and how it impacts your final look.
• The Three-Tier Solution: How to navigate the spectrum of treatments from full surgical lifts to minimally invasive radiofrequency.
• Auto-Augmentation Mastery: How your own tissue can be used to restore breast volume and shape without the need for traditional implants.
• The AlloClae Breakthrough: Why patients with low body fat can now achieve volume restoration using purified donor fat products.
• Timing Your Transformation: When is the "goldilocks" moment to transition from weight loss to plastic surgery?
• Safety and GLP-1s: The essential protocols for pausing medications and stabilizing weight before heading into the operating room.
• The 61% Gap: Why a majority of weight-loss patients seek aesthetic help but haven't yet found the right surgical roadmap.

Resources and links:

• Are you considering plastic surgery after GLP-1 weight loss? https://www.darrensmithmd.com/body/plastic-surgery-after-glp-1-drugs/
• Explore how BodyTite uses radiofrequency to tighten skin from the inside out: https://www.darrensmithmd.com/procedures/body/bodytite-nyc/
• Learn about VASER Liposuction for precision sculpting and skin retraction: https://www.darrensmithmd.com/procedures/body/vaser-liposuction-nyc/
• Discover how Facial Volume Restoration can treat "Ozempic Face": https://www.darrensmithmd.com/procedures/face/
• Book your consultation at: https://www.darrensmithmd.com
• Check out Plastics & Peptides, our podcast co-hosted by longevity expert and board-certified internist Dr. Amanda Kahn at https://podcasts.apple.com/ca/podcast/plastics-peptides/id1835192336

A note on how this episode was produced: Elements of this episode were produced using AI tools, allowing Dr. Smith to scale his educational reach beyond the operating room and consultation office. All medical content, clinical opinions, and recommendations have been personally reviewed and fact-checked by Dr. Darren Smith, a board-certified plastic surgeon with dual fellowship training in craniofacial and aesthetic surgery. Dr. Smith's commitment to leveraging AI isn't about cutting corners — it's about amplifying his educational bandwidth so that more patients have access to the honest, expert-level guidance they deserve before making life-changing surgical decisions.

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.

Full transcript and related resources

2. What you’ll hear in this episode:

• The Combo Meal Myth: Why a Mommy Makeover is a bespoke combination of procedures—typically involving a tummy tuck, breast work, and liposuction—rather than a one-size-fits-all "package deal".
• The Childbearing Clause: The critical reason why you should be certain you are done having children before undergoing muscle repair and skin tightening.
• The Two-Week Support System: Why you need a definitive plan for childcare during the first fourteen days of recovery, as lifting more than ten pounds is strictly off-limits.
• The One-Year Horizon: Managing expectations around post-operative swelling and why your final results won't truly be visible for twelve months.
• The Scar Reality Check: A transparent discussion on hip-to-hip incisions and the year-long journey of scar maturation.
• Beyond "Getting Your Body Back": Why Dr. Smith views this procedure as a forward-moving evolution into a new version of yourself rather than a return to a pre-pregnancy state.
• The Price of Safety: Why choosing a surgeon based on "deals" or discounts is a significant risk when dealing with major surgery and general anesthesia.
• The Timing Sweet Spot: Why waiting six to twelve months after your last pregnancy or breastfeeding is essential for hormonal and physical stabilization.

3. Resources and links:

• Are you considering a Mommy Makeover?
• Learn more about the components of a Tummy Tuck.
• Explore your options for Breast Surgery.
• Verify board-certified surgeons via the American Board of Plastic Surgery.
• Check out Plastics & Peptides, our podcast co-hosted by longevity expert and board-certified internist Dr. Amanda Kahn at https://podcasts.apple.com/ca/podcast/plastics-peptides/id1835192336

A note on how this episode was produced: Elements of this episode were produced using AI tools, allowing Dr. Smith to scale his educational reach beyond the operating room and consultation office. All medical content, clinical opinions, and recommendations have been personally reviewed and fact-checked by Dr. Darren Smith, a board-certified plastic surgeon with dual fellowship training in craniofacial and aesthetic surgery. Dr. Smith's commitment to leveraging AI isn't about cutting corners — it's about amplifying his educational bandwidth so that more patients have access to the honest, expert-level guidance they deserve before making life-changing surgical decisions.

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.

Full transcript and related resources

Dr. Darren Smith breaks down one of the most misunderstood parts of recovery. Learn why implants start higher on the chest, how gravity and tissue relaxation shape your final result, and when you can finally expect your breasts to look and feel “settled.”

If you’re preparing for surgery or tracking your healing journey, this is the essential guide to understanding what’s really happening under the skin.

What You’ll Learn

• The real definition of “drop” vs. “fluff” — and why they’re two separate processes
• Why implants are placed slightly high during surgery
• The expected recovery timeline: 2 weeks, 1 month, 3 months, 6 months, and 1 year
• When it’s comfortable to wear a bikini top again
• How properly planned implant positioning ensures a natural, lasting result

Key Takeaway:

Beautiful breast augmentation results aren’t instant — they evolve. As the implant drops and your tissues fluff, your shape refines gradually into its final, natural form.

Learn more about the practice: darrensmithmd.com

Have questions? Contact us: https://www.darrensmithmd.com/contact-us/

Check out our ister podcast, Plastics & Peptides: https://plastics-and-peptides.captivate.fm/s2e2

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.

Full transcript and related resources

💡 Episode Highlights

What is AlloClae?

A revolutionary off-the-shelf fat graft derived from purified human donor fat. It allows for natural-feeling volume restoration without the need to harvest your own fat.

Who is it for?

Fit, lean patients who lack enough donor fat for traditional fat transfer

Individuals losing weight from GLP-1 medications (like Ozempic or Mounjaro) and seeking to restore volume in areas like the breasts or buttocks

Patients with liposuction irregularities or contour deformities who need precise, natural correction

Why it matters:

AlloClae offers instant, lasting volume enhancement under local anesthesia, often completed in under an hour with minimal downtime. Early data show 80–90% retention—a major leap forward in predictable outcomes.

🧬 The Science Behind It

AlloClae is built from a 3D matrix of intact donor fat that acts as a biologic scaffold, allowing your body to repopulate it with your own fat cells. The result: natural softness, visible volume immediately, and long-term integration that feels like your own tissue.

🩺 Recovery & Experience

Performed comfortably under local anesthesia

Minimal downtime — most patients can return to remote work the same day and in-office work within 48 hours

Instant, natural-looking results visible immediately after treatment

🔗 Resources & Links

Learn more about AlloClae:

👉 https://www.darrensmithmd.com/body/alloclae-nyc/

Listen to our sister show — Plastics & Peptides: https://plastics-and-peptides.captivate.fm/s2e1

🎧 Hosted by Dr. Darren Smith and longevity specialist Dr. Amanda Kahn, Plastics & Peptides explores the intersection of regenerative aesthetics, wellness, and performance medicine for those seeking to look — and feel — their absolute best.

💬 Connect with Dr. Darren Smith

Follow along for insights on advanced aesthetic surgery, regenerative treatments, and innovations like AlloClae:

📍 www.darrensmithmd.com

📸 Instagram: @nycplasticsdoc

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.

Full transcript and related resources

Originally published August 6, 2021. This episode describes examples from his practice at that time. Recovery varies by patient, procedure, and surgeon.

Key takeaways

🔎 Work demands matter.

Dr. Smith discusses a return to a desk job, not unrestricted exercise or physical labor.

🔎 Comfort varies.

He describes soreness that his patients often compared with a strenuous workout, alongside swelling and bruising.

🔎 The appearance changes gradually.

Early swelling can obscure the contour before improvement becomes visible.

🔎 Combined procedures can change aftercare.

He distinguishes liposuction alone from cases involving additional treatments, including BodyTite or VASER, when discussing compression.

🎧 Episode guide

00:00 — Introduction

00:47 — Desk work, soreness, and bruising

01:24 — Swelling and the final contour

01:54 — Compression and additional procedures

When will I see the final result?

In this 2021 recording, Dr. Smith describes noticeable improvement developing after the early swelling period and a final contour that may take three to six months to emerge. Those are examples rather than a guaranteed timetable. Feeling well enough for a desk job does not mean the swelling has finished settling.

How long should I wear compression?

The recording gives Dr. Smith's then-current protocol and explains that additional procedures can change it. Do not use an archival duration as a personal instruction: ask your treating team which garment, schedule, and showering plan apply to your operation.

ℹ️ Current related reading

Liposuction and recovery information | BodyTite | 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; follow your surgical team's current aftercare plan and contact them about recovery concerns. Show notes updated September 30, 2026.

Full transcript and related resources

The recording connects these treatments through their muscle-stimulation technology while distinguishing the body areas and goals involved. It also explains what radiofrequency adds to the NEO discussion.

Key takeaways

🔬 Original Emsculpt focuses on body muscles.

Dr. Smith describes electromagnetic stimulation in the context of muscle tone and body contour.

🔎 Emsella targets the pelvic floor.

The episode describes a clothed, chair-based treatment and discusses urinary leakage. This is a different clinical concern from changing abdominal or limb contour.

🔎 Emsculpt NEO combines technologies.

The recording explains the addition of radiofrequency heating to electromagnetic muscle stimulation, with fat reduction included among the treatment goals discussed.

🔎 The intended result depends on the area and protocol.

Dr. Smith distinguishes buttock treatment aimed at muscle and contour from protocols intended to reduce fat.

🔎 The episode introduces a combined approach.

He describes coordinating abdominal and pelvic floor treatments under the term core-to-floor. That discussion does not establish that every patient needs both.

💬 Questions answered

Are Emsculpt NEO and Emsella the same treatment?

No. In the recording, NEO is discussed for body muscles and contouring, while Emsella targets pelvic floor muscles. Shared electromagnetic technology does not make the treatments or their goals interchangeable.

Does every protocol discussed aim to reduce fat?

No. Dr. Smith specifically describes a gluteal protocol designed to emphasize muscle and buttock contour without targeting fat loss. A current consultation should identify the exact device, treatment area and intended effect.

ℹ️ Current context for this 2020 recording

The contraction comparisons, percentages and protocols in the audio are historical claims, not promised individual results. For body-contouring applications, the FDA explains that noninvasive contouring does not treat obesity or provide weight-loss health benefits and that magnetic-field treatments require screening for contraindications. Pelvic floor symptoms also need their own assessment; the episode does not diagnose the cause of leakage or guarantee continence or sexual-wellness outcomes.

🎧 Episode chapters

00:39 — Original Emsculpt and HIFEM

01:11 — How electromagnetic stimulation works

01:49 — Emsella and pelvic floor goals

03:02 — What Emsculpt NEO adds

04:37 — Gluteal protocols and core-to-floor discussion

🔗 Related information

Explore Emsculpt NEO information, Emsella information, nonsurgical treatment 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 December 2, 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

He emphasizes that the recording provides general context: each patient and procedure requires its own instructions. Choosing an appropriately qualified surgeon with experience in the planned operation is the starting point, followed by a plan tailored to your circumstances.

Key takeaways

⚠️ Discuss smoking early.

Dr. Smith explains its relevance to tissue circulation, healing and anesthesia. A cessation plan should be part of preparation rather than left until the day of surgery.

🩹 Review existing health concerns.

The episode encourages addressing ongoing medical conditions before elective cosmetic surgery.

🔎 Consider nutrition and physical readiness.

Dr. Smith discusses adequate nutrition and conditioning as part of preparing for recovery, without providing an individualized diet or exercise program.

🎯 Plan the practical commitment.

Finances, time away from work and help during the early recovery period deserve attention before scheduling.

🩹 Prepare your recovery space.

Some procedures have specific positioning or pressure-related instructions. Ask how to arrange your home around the instructions for your operation.

💬 Questions answered

Does everyone need a nurse at home after plastic surgery?

No. Dr. Smith describes arranging nursing care for selected operations in his 2020 practice and support from a friend or loved one for other situations. The level of assistance depends on the procedure and the person's needs; confirm the current plan with your team.

When should I plan time off work?

Before the procedure, as part of scheduling and recovery planning. The episode encourages allowing for the necessary recovery period rather than assuming work can resume on the same timetable for every operation.

ℹ️ Current planning context

The ASPS smoking-risk guidance supports individualized planning that considers vaping and other nicotine exposure as well as cigarettes. The four-week smoking example and aftercare arrangements in this 2020 recording are historical, not personal clearance. Follow your team's current written preparation and recovery instructions.

🎧 Episode chapters

01:34 — Why instructions must be individualized

02:16 — Smoking and surgical preparation

03:07 — Health, nutrition and finances

04:23 — Preparing a recovery space

05:17 — Help at home and time off work

🔗 Related information

Explore the practice’s preparation guide, patient guides, Dr. Smith’s qualifications, 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 November 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

Originally published November 18, 2020. Device examples and adjunct treatments discussed in the recording reflect practice at that time.

Key takeaways

🔎 Fat and skin concerns

Fat and loose skin are different concerns. The episode describes liposuction for fat and direct removal of excess skin as distinct parts of treatment.

📏 Arm lift incisions

A standard arm lift often involves an incision along the inner upper arm, while an extended procedure can address tissue toward the armpit and side of the chest.

🩺 Mini arm lift

A mini arm lift uses a shorter incision for selected, more limited skin concerns; it is not interchangeable with a full arm lift.

🩹 Scar planning

Scars may fade but remain permanent. The expected location and extent deserve discussion before surgery.

🧩 Laxity and treatment options

Dr. Smith discusses less invasive tightening for selected mild-to-moderate laxity and explains why greater skin excess may need excision.

🎧 Episode guide

00:00 — Introduction

00:38 — Addressing arm fat and excess skin

01:57 — Standard, extended and mini arm lifts

03:08 — The permanent scar tradeoff

03:52 — Less invasive options for selected laxity

💬 Common questions

Can liposuction replace an arm lift?

It depends on what is causing the concern. Liposuction removes fat, while an arm lift directly removes excess skin. The recording explains why skin quality and the amount of laxity matter when comparing approaches.

Will the scar disappear?

No. Dr. Smith explicitly describes the arm-lift scar as permanent, even when it heals and fades. Scar appearance varies, and the improvement in contour must be weighed against the incision required.

🔗 Related information

Compare current information about arm lift surgery, arm liposuction, and BodyTite, 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. Surgical and device treatments have risks, and results and recovery vary. Show notes updated September 30, 2026.

Full transcript and related resources

Originally published November 11, 2020. These are historical practice examples, not a current personal aftercare schedule. Current context: the practice no longer offers Emtone, which is mentioned in the recording; the related page below explains its current approach.

Key takeaways

🩹 Arrange help during early recovery.

Dr. Smith describes assisted movement after the procedure and support during the first shower.

🎯 Ask about your compression plan.

He explains his then-current rationale and notes that adding skin tightening can change the instructions.

🔎 Work and exercise are different milestones.

The discussion separates desk work, gentle activity, and a full workout routine rather than treating recovery as one deadline.

🩹 Incision healing matters.

Swimming, bathing, and scar products are discussed in relation to wound closure and follow-up assessment.

⏳ The contour develops over time.

Returning to everyday activities can happen before swelling has settled and the final shape is apparent.

🎧 Episode guide

00:00 — Introduction

01:56 — The historical compression protocol

03:21 — Showering and altered sensation

04:33 — Exercise and incision follow-up

05:53 — Massage and recovery devices

07:44 — Swelling and the final contour

When can I bathe or swim?

In the episode, Dr. Smith ties submerging incisions to their being completely healed and checked at follow-up. He notes that some patients need longer. A calendar date or suture removal alone should not replace your treating team's clearance.

Is lymphatic massage required?

Dr. Smith says that he did not routinely recommend it in his 2020 practice. He presents that as his approach, rather than a rule for every patient or procedure. Ask your surgeon whether any additional recovery treatment has a specific role in your case.

When will swelling finish settling?

The recording describes changes emerging gradually and final contour sometimes taking several months. Individual recovery varies. Dr. Smith also discusses nutrition, alcohol, weight stability, and sleeping position as questions to address during postoperative care.

ℹ️ Current related reading

Liposuction and recovery | Preparing for plastic surgery | Emtone explained and the practice's current alternatives | 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; follow your surgical team's current instructions and contact them with recovery concerns. Show notes updated September 30, 2026.

Full transcript and related resources

Originally published November 4, 2020. Recovery examples, prices and safety discussion in the recording reflect that period.

ℹ️ Updated safety context

BBL carries significant risks, including potentially fatal fat embolism. The 2022 joint statement from ASPS and partner societies supports fat placement only in the subcutaneous layer above the gluteal muscle fascia, real-time ultrasound monitoring during injection, appropriate surgical credentials and postoperative care. These measures do not eliminate risk. This later guidance supplements the original recording.

Key takeaways

📍 Donor fat planning

The amount and location of donor fat are planned around the patient's anatomy and goals.

🧩 Lipo 360 and BBL

“Lipo 360” describes torso liposuction; adding a BBL is a separate decision about transferring fat to the buttocks.

🔄 Fat graft retention

Transferred fat is living tissue. Not all of it survives, and the eventual volume cannot be predicted by applying one percentage to every patient.

🗓️ Recovery instructions

Sitting, sleeping, clothing and return to work need individualized instructions that protect healing tissues.

⏳ Swelling and final contour

Changes in swelling and retained volume mean the early appearance is not the final result.

🎧 Episode guide

00:00 — Introduction

00:51 — Fat harvest, preparation and transfer

03:29 — Healing and survival of transferred fat

07:53 — Sitting, sleeping and pressure during recovery

09:35 — The original BBL safety discussion

11:21 — How appearance changes during healing

💬 Common questions

Does every BBL include Lipo 360?

No. Dr. Smith says donor areas are chosen with the patient; the torso is a common source, but other areas may be considered. A procedure name does not define the full plan.

Can I sit normally immediately afterward?

The episode emphasizes that positioning depends on where fat was placed. Follow your surgeon's specific instructions; the recording's examples are not a universal sitting or sleeping protocol.

Will all transferred fat remain?

No. The recording describes variable survival of transferred tissue and the possibility of further treatment. Final shape and volume evolve as healing progresses.

🔗 Related information

Read current information about Brazilian butt lift surgery, liposuction, and Lipo 360, 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. Suitability, risks, recovery and results vary. Show notes updated September 30, 2026.

Full transcript and related resources

What is Emtone, and how was it intended to address cellulite? Darren M. Smith, MD, a board-certified plastic surgeon in New York City, explains a combination of radiofrequency heating and pressure-wave treatment, and discusses why individual cellulite patterns matter when evaluating options.

Originally published October 28, 2020. Treatment availability, protocols, comparisons and invitations in the audio are historical.

Key takeaways

🧬 Cellulite texture and anatomy

The episode distinguishes dimpling and wavy skin texture and describes the role of skin, underlying fat and fibrous connective tissue.

⚙️ Radiofrequency and pressure

Emtone combines warming from radiofrequency energy with mechanical pressure or tapping.

🔎 Treatment complexity

Dr. Smith emphasizes that cellulite is difficult to treat and that different patterns may call for different approaches.

🗓️ Sessions and maintenance

The recording discusses a treatment series and possible maintenance, rather than a one-time permanent removal of cellulite.

🧩 Historical combination treatments

The historical discussion of combining treatments does not establish current availability or guarantee faster recovery from surgery.

🎧 Episode guide

00:00 — Introduction

01:05 — Cellulite appearance and contributing factors

02:47 — Radiofrequency and pressure-wave treatment

04:34 — Why assessment matters

05:30 — The treatment experience

06:14 — Historical treatment series and maintenance

💬 Common questions

Does the episode describe permanent cellulite removal?

No. Dr. Smith discusses variable response and periodic maintenance. The audio's optimistic durability statements should not be taken as a guarantee that cellulite cannot return.

What does the treatment feel like?

The recording describes warmth and a tapping sensation from the external handpiece. Comfort varies, so this description is not a promise that treatment is painless.

Can I book Emtone at this practice now?

The practice's current page says it does not offer Emtone. A consultation can instead address the underlying concern and available options.

ℹ️ Current related information

See current information about Avéli cellulite treatment and BodyTite for skin laxity, or schedule a consultation. These are current related resources, not additions to the original recording.

Qwo, also mentioned in the audio, is historical context: Endo announced the end of Qwo production and sales in December 2022.

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. Treatment risks, suitability and results vary. Show notes updated September 30, 2026.

Full transcript and related resources

Originally published October 21, 2020. Performance figures, comparisons, treatment schedules and complimentary demonstration offers in the recording reflect its launch period.

Key takeaways

⚙️ Original Emsculpt and NEO

Original Emsculpt uses high-intensity focused electromagnetic energy to stimulate muscle contractions; NEO adds radiofrequency heating.

🎯 Muscle and fat goals

The recording describes the two components as addressing muscle stimulation and localized fat reduction within one treatment platform.

⚖️ Treatment comparisons

Dr. Smith compares this approach with cold-based fat reduction and other heat-based devices, drawing on early data and his personal experience.

📊 Historical study averages

The percentages cited in the audio are reported averages from that period, not promised changes in an individual's muscle or fat.

🗓️ Treatment course

The episode discusses a series of treatment sessions. Its description of one device should not be interpreted as a promise that one appointment delivers every stated result.

🎧 Episode guide

00:00 — Introduction

00:53 — How original Emsculpt led to NEO

02:03 — Launch-era performance comparisons

04:58 — A treatment series using one platform

05:54 — Adding radiofrequency heating

08:00 — Comparing heat, cooling and muscle stimulation

💬 Common questions

How does NEO differ from original Emsculpt?

The central difference discussed is the addition of radiofrequency energy to electromagnetic stimulation. Dr. Smith describes heating the treatment area while the electromagnetic component stimulates muscle contractions.

How is that different from CoolSculpting?

The episode contrasts a combination of heating and muscle stimulation with cooling-based fat reduction. Its enthusiastic launch-era comparisons are not a current finding that one device is best for every person or treatment area.

Does the episode guarantee a specific percentage change?

No individual outcome can be inferred from the quoted averages. The recording's figures and comparisons need to be interpreted in the context of the studies, device and treatment protocol being discussed.

ℹ️ Current context and related information

Noninvasive body contouring is not weight-loss treatment. The FDA explains benefits, limitations and technology-specific risks. Ask which device, applicator and treatment area are proposed and whether the plan is appropriate for you.

Read current practice information about Emsculpt NEO and, as a separate surgical approach to fat removal, liposuction, 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. Risks, comfort and results vary. Show notes updated September 30, 2026.

Full transcript and related resources

Originally published October 14, 2020. The episode also announces a Facebook group; that invitation is historical.

Key takeaways

💬 Questions at each stage

Questions are useful when first researching a procedure, after a consultation and during recovery.

🗒️ Understanding the plan

Understanding the plan helps clarify expectations and identify concerns to discuss with the surgeon.

🩺 Individual medical care

General education and other patients' experiences do not replace an individual doctor-patient relationship.

🎧 Episode guide

00:00 — Introduction

00:34 — Asking questions and aligning goals

02:17 — Education versus individual medical advice

💬 Common questions

What kinds of topics can I ask about?

The recording names how procedures work, preparation, recovery and which approaches may address different concerns.

Can an online group provide my personal treatment plan?

No. Dr. Smith explicitly distinguishes general discussion from advice for an individual's medical situation. Personal decisions belong with the treating clinical team.

🔗 Continue the conversation

Explore current patient guides and the preoperative preparation guide, 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. Good communication supports informed decisions but cannot guarantee a result. Show notes updated September 30, 2026.

Full transcript and related resources

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

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

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

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

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

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

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

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

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

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

Originally published September 7, 2020. This is an educational discussion of surgeon selection, not a ranking or an award claim.

Key takeaways

📚 Experience and volume

Years in practice and procedure volume can inform an assessment, but neither tells the whole story about an individual surgeon's approach.

💬 Online reviews

Online reviews can reveal patient experiences, while star counts alone do not establish the quality or suitability of care.

🧭 Referrals and priorities

A friend or physician's referral is a starting point. Ask whether the recommendation concerns the same procedure and the same priorities you have.

🔎 Visibility and marketing

Search placement, social media popularity and frequent mentions in online groups are visibility signals, not proof of surgical quality.

🏥 Office and care experience

The office experience and staff can matter to your overall care, but should be considered alongside the surgeon's experience, communication and alignment with your goals.

🎧 Episode guide

00:00 — Introduction

01:38 — Years in practice and procedural experience

06:32 — Online reviews and search results

08:51 — Personal and physician referrals

12:20 — Social media and other visibility signals

16:56 — Finding the surgeon who fits your goals

💬 Common questions

Should I choose whoever performs the most procedures?

Dr. Smith explains that experience can be valuable, but volume by itself does not establish quality. He encourages evaluating the surgeon from several perspectives and considering their experience with the particular procedure you want.

Is my friend's surgeon automatically right for me?

Not necessarily. Your friend may prefer a different aesthetic result, value different parts of the experience or have undergone a different operation. The episode uses that distinction to explain why a personal recommendation still needs an individual consultation.

Do followers or five-star reviews identify the best surgeon?

No. The recording discusses how these signals can be incomplete or influenced by marketing. They can help generate questions, but do not replace a thorough assessment of the clinician and proposed care.

🔗 Continue your research

The episode builds on the earlier discussion, “How Do I Choose a Plastic Surgeon?” For current practice information, read Dr. Darren Smith's training and background and browse the patient guides. You can also schedule a consultation to discuss your procedure, expectations, alternatives and questions.

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 or a guarantee of outcomes. Show notes updated September 30, 2026.

Full transcript and related resources

Originally published September 4, 2020. Implant availability, practice preferences and safety statements in this recording reflect that time; current context appears below.

Key takeaways

🎯 Breast shape preferences

The episode distinguishes a gently sloping upper breast from a fuller upper pole. These are aesthetic preferences to discuss, not a single ideal everyone should share.

🔎 Implant shape options

Round and anatomically shaped implants distribute volume differently. Rotation of an anatomical implant can change its appearance.

📏 Implant size and coverage

Implant size and tissue coverage affect how prominent an implant looks; the implant's label alone does not predict the result.

📅 Historical implant preference

Dr. Smith describes his preference in 2020 for smooth, round implants and explains how he approached different aesthetic goals with them.

🔄 Healing and implant changes

Breasts can change during healing, but rupture, capsular contracture or implant movement can also change appearance and require evaluation.

🎧 Episode guide

00:00 — Introduction

02:02 — Shape, size and placement

03:47 — Rotation, texture and the 2020 safety discussion

05:47 — Implant size and tissue coverage

09:20 — Settling during recovery

10:34 — Rupture and other causes of shape change

💬 Common questions

Can round implants produce a sloping upper breast?

Dr. Smith explains that they can in an appropriately planned augmentation. The discussion centers on selecting dimensions and placement in relation to the patient's body and goals rather than assuming that only a teardrop implant can create that look.

Do implants change position after surgery?

The episode describes gradual settling during healing and notes that its timing varies. It also distinguishes settling from complications that can change shape. New or concerning changes should be assessed rather than automatically attributed to normal settling.

ℹ️ Current implant safety context

The FDA states that BIA-ALCL risk is higher with textured than smooth implants. The recording's absolute statement about smooth implants should not be taken as a current zero-risk assurance. Implant-specific risks and alternatives belong in an informed consultation.

For silicone implants, current FDA guidance on rupture recognizes ultrasound as an alternative to MRI for screening patients without symptoms. Confirm a follow-up plan for your implant; the original MRI discussion is not a complete current monitoring plan.

🔗 Related information

Read current information about breast implant options, breast augmentation, and augmentation recovery, 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. Implants are not lifetime devices, and results and risks vary. Show notes updated September 30, 2026.

Full transcript and related resources

Originally published September 1, 2020. This is a historical clinical perspective, not a current head-to-head trial or a ranking of every device generation.

Key takeaways

🌡️ Cooling and heating

CoolSculpting uses controlled cooling, while the SculpSure and truSculpt approaches discussed use heat.

🎯 Fat and muscle goals

These treatments target localized fat. Dr. Smith distinguishes them from original Emsculpt, which he discusses primarily in relation to muscle tone.

📅 Historical device preference

His stated preference for CoolSculpting in this recording is based on personal experience with the devices and their tolerability.

⚖️ Liposuction comparison

He also compares noninvasive options with liposuction, which removes fat through small incisions and entails different risks and recovery.

🧩 Treatment selection

Matching the goal to the treatment is more useful than assuming every form of body contouring addresses the same concern.

🎧 Episode guide

00:00 — Introduction

01:03 — What body contouring aims to do

02:54 — Muscle toning versus fat reduction

03:58 — Cold-based versus heat-based treatment

05:05 — Personal experience and treatment comfort

08:08 — Comparing device treatment with liposuction

💬 Common questions

Does the recording prove that one device is best for everyone?

No. Dr. Smith explicitly presents his own clinical experience. His explanation focuses on comfort and completing the planned treatment, rather than establishing a universal result for every patient, device or applicator.

Is muscle toning the same goal as fat reduction?

No. The episode separates original Emsculpt's muscle-focused purpose from the localized fat-reduction goals of CoolSculpting, SculpSure and truSculpt iD. Anatomy and the desired change should guide the discussion.

ℹ️ Current safety context

Noninvasive body contouring is not a weight-loss treatment and is not risk-free. The FDA describes technology-specific risks, including paradoxical adipose hyperplasia after fat freezing: treated fat can enlarge instead of shrink and may require surgery. This context supplements the original discussion.

🔗 Related information

Explore current information about liposuction and the distinct, later-generation Emsculpt NEO, or schedule a consultation. Inclusion in this archival episode does not confirm current availability of every named device.

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. Benefits, risks and results vary. Show notes updated September 30, 2026.

Full transcript and related resources

Originally published August 29, 2020. The combination described uses original Emsculpt, not Emsculpt NEO. It is a historical discussion, not a current package offer or individualized treatment recommendation.

Key takeaways

🧬 Post-pregnancy tissue layers

Dr. Smith organizes post-pregnancy concerns into three layers: skin laxity, fat distribution and the abdominal wall.

🩺 Tummy tuck planning

A tummy tuck can directly remove excess skin and address abdominal wall laxity. Liposuction may be combined with it to address selected fat deposits.

🧩 Tissue treatment options

The episode explores BodyTite for selected skin-laxity concerns, liposuction for fat and original Emsculpt for muscle stimulation.

🔎 Incisions and access

Both liposuction and BodyTite involve access incisions. The entire combination is not a noninvasive treatment.

⚖️ Procedure limits

Dr. Smith repeatedly stresses that this approach does not replace a tummy tuck when more substantial correction is needed.

🎧 Episode guide

00:00 — Introduction

01:11 — Skin, fat and abdominal wall changes

02:23 — What a tummy tuck addresses

03:09 — Who might consider a smaller procedure?

05:35 — BodyTite and liposuction

07:12 — Muscle stimulation and the limits of the combination

💬 Common questions

Why discuss skin, fat and muscle separately?

Each layer can contribute to a different concern. The recording's central point is that a treatment aimed at one layer may leave another concern unaddressed, so the plan should follow the anatomy rather than a device name.

Is the combination equivalent to a tummy tuck?

No. Dr. Smith explicitly describes a more limited change for selected mild-to-moderate concerns. The muscle-stimulation discussion should not be read as a promise to surgically repair abdominal separation or remove substantial excess skin.

Does avoiding a tummy tuck mean avoiding surgery entirely?

Not in the approach discussed here. Liposuction removes fat through small incisions, and BodyTite uses an applicator beneath the skin. Those procedures still require a discussion of risks, recovery and suitability.

🔗 Related information

Compare current information about tummy tuck surgery, BodyTite, and liposuction, or schedule a consultation to discuss your anatomy, goals and recovery constraints.

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. Outcomes, risks and recovery differ between patients and procedures. Show notes updated September 30, 2026.

Full transcript and related resources

Originally published August 26, 2020. The device comparisons reflect Dr. Smith's experience at the time. He explicitly distinguishes those preferences from comparative research evidence.

Key takeaways

🔬 The underlying procedure removes fat through a cannula.

Dr. Smith first describes access incisions, numbing medication, and suction before explaining the additional terminology.

🔎 Tumescent and power-assisted describe different features.

One refers to the fluid placed in the treatment area; the other to mechanical movement of the cannula.

🔎 Energy devices are not interchangeable labels.

The recording discusses laser energy with SmartLipo, ultrasound with VASER, and radiofrequency approaches including BodyTite and J-Plasma.

🔬 Fat removal and skin laxity are separate planning questions.

Dr. Smith discusses why easier fat removal does not automatically establish how much skin tightening an individual will achieve.

🎯 Patient selection remains central.

He explains that substantial loose skin may exceed what an adjunctive tightening treatment can address.

🎧 Episode guide

00:00 — Introduction

02:11 — Tumescent solution

02:56 — Power-assisted liposuction

04:10 — Laser, ultrasound, and radiofrequency devices

06:51 — Experience versus comparative evidence

08:49 — Skin tightening and patient selection

What does tumescent liposuction mean?

It refers to the solution injected into the treatment area as part of the procedure. In the recording, Dr. Smith explains how the term relates to the tissue becoming firm after that fluid is introduced.

What is power-assisted liposuction?

It uses a motorized cannula that moves rapidly to help the surgeon remove fat. Dr. Smith describes it as mechanical assistance within liposuction, rather than a separate approach to weight loss.

Will an energy device eliminate loose skin?

That cannot be assumed from the device name. The episode emphasizes the degree of laxity, patient selection, and the operator's experience. Its 2020 comparisons should not be read as a current ranking of every available device.

ℹ️ Current related reading

Liposuction technologies and the practice's current approach | Liposuction | BodyTite | 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; the appropriate technique and expected outcome require an individual assessment. Show notes updated September 30, 2026.

Full transcript and related resources

Originally published August 23, 2020. Longevity estimates in the recording are historical examples, not guarantees or fixed replacement schedules.

Key takeaways

🗓️ Aging and facial change

Facial rejuvenation can reposition tissues or restore volume, but it does not stop future aging.

⏳ Injectable duration

Botox and fillers have temporary effects. Dr. Smith discusses how the product and treatment location can influence duration.

⚖️ Weight and body contour

Liposuction removes fat from a treated area, but later weight changes can still change its contour. The episode emphasizes maintaining results over time.

🔎 Breast implants and change

Breast appearance can change after augmentation, and implants can develop complications such as rupture or capsular contracture.

⏳ Breast lift over time

Breast lift results are also influenced by tissue quality and ongoing changes; a lifted breast does not become immune to future sagging.

🎧 Episode guide

00:00 — Introduction

01:03 — Facial rejuvenation and continued aging

03:14 — Botox and filler duration

05:35 — Liposuction and weight changes

07:36 — Breast augmentation and implant longevity

09:19 — Breast lift longevity and tissue quality

💬 Common questions

Does a facelift stop aging?

No. Dr. Smith uses the idea of resetting a clock to explain a change in appearance while time continues to pass. The number of years of visible benefit varies and cannot be promised from a general discussion.

Can weight gain change liposuction results?

Yes. The recording explains that fat remains after liposuction and that subsequent weight gain can alter treated and untreated areas. A lasting reduction of fat in an area does not mean its size and shape will never change.

Are breast implants lifetime devices?

No. Current FDA guidance on breast implant risks states that implants are not lifetime devices and that complications may lead to additional surgery. This current context supplements the recording; the life of an individual implant cannot be predicted from a single year estimate.

🔗 Related information

Read current information about liposuction, breast augmentation, and breast lift surgery, or schedule a consultation to discuss expected longevity and follow-up for your chosen procedure.

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. Recovery, risks and results vary. Show notes updated September 30, 2026.

Full transcript and related resources

Originally published August 20, 2020. Surgical techniques and anesthesia examples in the recording reflect Dr. Smith's practice at that time.

Key takeaways

🧬 Nipple and areola anatomy

The nipple is the projecting central structure; the areola is the surrounding pigmented skin. Their size, shape and position are separate features.

🩺 Nipple procedure options

Nipple reduction and inverted nipple correction address different concerns. Dr. Smith notes that inversion can recur and may require further treatment.

💬 Sensation and breastfeeding

Nipple procedures can affect sensation and breastfeeding ability. These tradeoffs deserve discussion before surgery.

📍 Areola and breast position

Areola reduction or reshaping concerns the pigmented skin, while a low nipple-areola position associated with breast drooping may require a breast lift.

🩺 Anesthesia planning

Some isolated procedures may use local anesthesia. A breast lift is a more extensive operation, and anesthesia planning depends on the procedure and patient.

🎧 Episode guide

00:00 — Introduction

00:45 — Nipple and areola anatomy

02:17 — Projection and inverted nipples

03:39 — Recurrence, sensation and breastfeeding

04:33 — Areola size, shape and position

07:55 — Anesthesia and procedure scope

💬 Common questions

Can inverted nipple correction affect breastfeeding?

Yes. The recording specifically identifies possible effects on breastfeeding and nipple sensation as issues to discuss with the surgeon. The technique, anatomy and future feeding goals matter.

Is reducing the areola the same as lifting the breast?

No. Dr. Smith distinguishes making the areola smaller or more regular in shape from addressing a low position on the breast mound. He discusses breast lift surgery for the latter when breast drooping is the underlying concern.

Can men have nipple or areola procedures?

Yes. The episode notes that these concerns occur in men as well as women, although the appropriate plan depends on individual anatomy and goals.

ℹ️ Current health context

A new nipple or breast change should be medically assessed before assuming it is only cosmetic. Many breast changes are benign; the National Cancer Institute explains changes to discuss with a clinician. This context is separate from the cosmetic discussion in the recording.

🔗 Related information

Read about inverted nipple correction and breast lift surgery, 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. Risks, recovery and results vary. Show notes updated September 30, 2026.

Full transcript and related resources

The discussion focuses on restoring contour through a repair designed for the individual ear. It does not make every repair the same procedure or promise an exact return to an earlier appearance.

Key takeaways

🔎 Stretching has different causes.

The recording discusses heavy earrings, changes in skin elasticity over time and deliberately enlarged piercings.

🔎 A split earlobe differs from an enlarged hole.

A tear extending through the lower edge changes the repair needed to rebuild the earlobe's outline.

🔎 Gauge repair can be more complex.

A larger opening and stretched tissue may require a more involved reconstruction than a straightforward piercing-hole repair.

🔎 Local anesthesia is often discussed.

Dr. Smith describes office procedures performed while a patient is awake, with the area numbed. The actual anesthesia plan depends on the case.

🩹 Healing instructions matter.

Soreness, sutures and follow-up are part of the recording's recovery discussion. The treating clinician should provide current wound-care and activity instructions.

💬 Questions answered

Can elongated earlobes be shortened?

Yes, the episode describes removing a planned amount of tissue to shorten an elongated lobe. Dr. Smith discusses this as either a standalone procedure or, in selected cases, part of a broader facial surgery plan.

What is recovery from earlobe repair like?

Dr. Smith describes temporary soreness and a follow-up visit for removal of non-dissolving sutures in the cases discussed. His specific showering, swimming, stitch-removal and return-to-work examples reflect the original practice discussion; follow the instructions for your own repair rather than a universal timetable.

📅 Historical cost discussion

In this August 2020 recording, Dr. Smith gives NYC examples of about $750-$1,000 for one earlobe and $1,500-$2,000 for both for straightforward repairs. He notes that gauge repairs can cost more because of their complexity. These are archival figures, not current prices or an individualized quote. Location, provider and the work required affect the estimate.

🎧 Episode chapters

00:26 — What earlobe repair can address

01:25 — Stretching, tears and gauges

02:39 — Local anesthesia and the office procedure

03:28 — Recovery and follow-up

04:42 — How repair differs by the problem

07:22 — Historical cost discussion

🔗 Related information

Explore earlobe repair information, facial plastic 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 August 17, 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

The episode distinguishes the position of the mouth corners from lines extending toward the jaw. Muscle activity, tissue support, surface changes and deeper folding can call for different approaches.

Key takeaways

🔬 Mouth-corner position involves a balance of muscles.

Dr. Smith describes muscles that raise and lower the corners, and how changes in soft-tissue support can affect their resting position.

🔎 Mild concerns may prompt an injectable discussion.

The recording describes Botox directed at the depressor anguli oris (DAO), and selected uses of filler or fat grafting to support the area.

🔎 Surgery is a separate decision.

Dr. Smith reserves discussion of surgical mouth-corner repositioning for more severe cases and emphasizes a detailed conversation about risks and experience.

🔎 Marionette lines vary in depth.

The episode compares resurfacing for superficial lines with filler or fat grafting for some deeper concerns.

🔎 Substantial folds and jowling involve more than a surface line.

A facelift or extended neck lift may enter the discussion when tissue descent is the main concern.

💬 Questions answered

What are marionette lines?

They are lines or folds that extend from the corners of the mouth toward the jawline. Dr. Smith distinguishes them from the position of the mouth corners themselves.

Does everyone with downturned mouth corners need surgery?

No. The recording discusses less invasive options for selected mild concerns and a different risk-benefit discussion for surgical repositioning. The appropriate choice depends on anatomy, the degree of change sought and the limitations of each option.

ℹ️ Current context for this 2020 recording

The DAO Botox use described here is outside the approved indications in the current BOTOX Cosmetic prescribing information. An off-label treatment still requires individualized assessment and informed discussion of risks.

The episode also mentions Morpheus8. The FDA's October 2025 safety communication on certain RF microneedling uses reports serious complications including burns, scarring, fat loss and nerve damage. This update is separate from the original recording. None of the treatments discussed guarantees a particular expression or outcome.

🎧 Episode chapters

01:15 — Mouth corners and marionette lines

03:31 — Muscles and resting mouth position

05:43 — Injectable options for selected mild concerns

06:55 — Surgical mouth-corner repositioning

07:40 — Matching treatment to marionette-line depth

10:07 — Deep folds, jowling and lift surgery

🔗 Related information

Explore Botox information, dermal fillers, facial fat grafting, 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 August 14, 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

Originally published August 11, 2020. The recording reflects treatment approaches and practice preferences at that time. Part two addresses the lower face.

Key takeaways

🔎 Resting and movement lines

Lines visible at rest and lines produced by movement are different findings. Dr. Smith explains why they may call for different approaches.

👁️ Brow position

A descended brow can make upper eyelids look heavy. Removing eyelid skin alone may not address the main cause.

👁️ Upper eyelid anatomy

Upper eyelid assessment includes skin, fat and muscle, as well as whether the eyelid itself lifts normally. Eyelid ptosis is distinct from excess skin.

🔎 Under-eye shadows

Under-eye darkness can involve pigment, contour-related shadowing or a combination. The episode discusses why treatment depends on the cause.

📷 Photography and lighting

Before-and-after photographs should have comparable lighting. Small changes in light can make eye-area shadows and contours look very different.

🎧 Episode guide

00:00 — Introduction

01:40 — Forehead lines and brow position

05:44 — Brow heaviness versus eyelid concerns

07:56 — Eyelid function and ptosis

09:08 — Lower eyelids and under-eye shadows

16:21 — Comparing before-and-after photographs

💬 Common questions

How do a brow lift and an eyelid lift differ?

A brow lift addresses the position and laxity of forehead and brow tissues. Blepharoplasty addresses selected eyelid tissues. Dr. Smith describes examining their relationship because brow descent can contribute to apparent upper eyelid heaviness.

Are dark circles always a pigmentation problem?

No. The recording distinguishes darker skin pigment from shadows produced by the shape of the lower eyelid and surrounding tissues. It discusses options such as adjusting fat or filling a depression when anatomy supports that approach, without presenting one treatment as appropriate for everyone.

What should I look for in eyelid surgery photographs?

Dr. Smith recommends checking whether lighting is comparable, including the reflections visible in the eyes. Images can help illustrate an approach, but cannot predict an individual's result.

🔗 Related information

Read about brow lift surgery, eyelid surgery, and facial fat grafting, or schedule a consultation to discuss the cause of your concern and the risks and limits of possible treatments.

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. Treatment suitability, recovery and results vary. Show notes updated September 30, 2026.

Full transcript and related resources

Originally published August 7, 2020. This recording describes Dr. Smith's recovery protocols and observations at that time. Follow your own surgical team's current instructions rather than treating the episode as a personal aftercare plan.

Key takeaways

🩹 Recovery starts before going home.

Dr. Smith explains how local anesthesia, sedation, or general anesthesia may affect time in the recovery room.

🔎 Early care has its own stages.

The episode discusses compression, drainage from small incisions, and showering within his then-current protocol.

💬 Feeling ready for work is not the same as seeing a final result.

He contrasts early activity with swelling that settles over a longer period.

🔎 Discomfort varies.

Many patients in his description compare soreness with a strenuous workout, but that observation does not predict every patient's experience.

🔎 Noninvasive does not mean sensation-free.

His comparison with CoolSculpting focuses on temporary numbness, burning, and other altered sensations he encountered in practice.

🎧 Episode guide

00:00 — Introduction

00:36 — Anesthesia and recovery-room time

01:50 — Early soreness and compression

03:55 — Work, swelling, and final contour

05:39 — Habits discussed during recovery

06:09 — Comparison with CoolSculpting

When will I see the result?

In this recording, Dr. Smith describes swelling masking the early change and the contour becoming clearer over the following months. The appearance soon after treatment is therefore not the final result; the extent of treatment and individual recovery matter.

How soon can I return to work?

Dr. Smith gives examples of a short return-to-work interval for selected patients in his 2020 practice. That is not a guaranteed deadline or clearance for strenuous activity. Your procedure, recovery, and job demands need to be considered with your treating team.

🔗 Related reading and consultation

Liposuction and recovery information | Lipo 360 | 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; recovery times and protocols vary. The historical CoolSculpting comparison is not a complete current safety guide. Show notes updated September 30, 2026.

Full transcript and related resources

Originally published August 4, 2020. The examples and candidacy preferences described are from Dr. Smith's practice at the time of recording.

Key takeaways

🔬 Fat-cell size and fat removal are different concepts.

Dr. Smith uses an expandable-storage-box analogy to explain how fat cells change with weight gain and loss, then contrasts that with removing fat from a treatment area.

🔬 Removing fat does not change eating or activity patterns.

The episode discusses why surgery should not be used as a substitute for a weight-management plan.

🔎 Weight gain can affect a treated area.

Liposuction does not make someone immune to later changes in body size or proportions.

🎯 Weight stability helps planning.

A substantial change after surgery can alter the proportions on which the original contouring plan was based.

🔬 Skin quality remains part of the assessment.

Dr. Smith discusses how additional weight loss may reveal laxity that was not part of the original plan.

🎧 Episode guide

00:00 — Introduction

01:02 — The fat-cell analogy

02:50 — What liposuction removes

06:24 — Weight gain after liposuction

07:46 — Planning around a stable weight

08:35 — Weight loss and loose skin

Can I gain weight after liposuction?

Yes. The recording explains that remaining fat cells can enlarge and that weight changes can affect the appearance of both treated and untreated areas. The amount and pattern of change vary; the discussion is not a promise that future weight gain will be invisible.

Do I need to reach an exact goal weight first?

Dr. Smith favors planning around a fairly stable body shape and discusses selected exceptions in consultation. His numerical examples in this 2020 recording are not universal eligibility rules. The useful question is how your goals, anticipated weight changes, and skin quality affect the proposed plan.

🔗 Related reading and consultation

Liposuction and candidacy | Stomach liposuction | Request a consultation with Dr. Smith

This episode is educational and does not establish an individual weight target or treatment plan. Show notes updated September 30, 2026.

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.

Full transcript and related resources

Originally published August 1, 2020. The recording's treatment schedules, prices and early study statistics reflect that period and are not a personalized treatment plan.

What you will learn

🎯 Treatment targets

Emsella and Emsculpt use related electromagnetic technology, but target different muscle groups: the pelvic floor and body muscles respectively.

🪑 Chair-based treatment

The recording describes sitting on a dedicated chair while its magnetic field stimulates pelvic floor contractions.

💬 Urinary leakage

Dr. Smith discusses leakage associated with activity or laughing, including concerns people may notice after childbirth or with age.

🩺 Pelvic floor physical therapy

He describes how device treatment may be considered alongside pelvic floor physical therapy rather than treating these as mutually exclusive approaches.

🧩 Combined treatment planning

The episode introduces the practice's then-current concept of combining abdominal muscle treatment and pelvic floor treatment.

🎧 Episode guide

00:00 — Introduction

01:44 — A clothed, chair-based treatment

03:21 — Urinary leakage discussion

04:12 — What treatment involves

05:06 — Historical treatment schedule and cost

05:37 — Physical therapy and pelvic floor goals

💬 Common questions

Does Emsella require an internal probe?

No internal probe is described in the recording. The patient stays clothed and sits on the treatment chair. An assessment is still needed to decide whether the treatment is appropriate.

How many sessions are discussed?

In this 2020 episode, Dr. Smith describes six approximately 30-minute sessions over three weeks. That is a historical example; a current clinician should confirm the protocol, contraindications and expected benefits for the individual patient.

Can it be paired with pelvic floor physical therapy?

Yes, Dr. Smith discusses that possibility. The episode is not a diagnosis of the cause of leakage or a promise that one treatment can address every pelvic floor concern.

🔗 Related information

See the practice's current Emsella information and, for the separate abdominal body-contouring treatment, Emsculpt NEO information. You can also schedule a consultation to discuss suitability.

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. Benefits, risks and responses vary; intimate-wellness claims in the audio are not guarantees. Show notes updated September 30, 2026.

Full transcript and related resources

Originally published July 29, 2020. This recording concerns original Emsculpt, not Emsculpt NEO. Device features, treatment schedules, prices and practice preferences should be confirmed for the specific treatment offered today.

Key takeaways

⚙️ Electromagnetic stimulation

External applicators deliver high-intensity focused electromagnetic energy to stimulate muscle contractions.

🎯 Muscle tone goals

Dr. Smith describes muscle tone and definition as the central goal. He cautions that someone primarily seeking substantial fat reduction may need a different option.

📍 Treatment areas

He distinguishes abdominal treatment goals from buttock treatment protocols and discusses why the amount of overlying fat affects visible definition.

🗓️ Timing and maintenance

Results develop over time and require maintenance. The episode does not present treatment as a permanent substitute for physical activity.

🔎 Tissue assessment

Loose skin, muscle definition and fat volume are separate concerns; an individualized assessment helps determine which needs attention.

🎧 Episode guide

00:00 — Introduction

01:05 — Electromagnetic muscle stimulation

05:11 — Treatment areas and goals

08:33 — Patient selection

13:18 — Results and maintenance

14:40 — Skin laxity and combination treatments

💬 Common questions

Is Emsculpt mainly a fat-removal treatment?

Dr. Smith frames the original device primarily as a way to address muscle tone. He discusses fat changes, but specifically cautions against choosing it when reducing a substantial amount of fat is the main goal.

Are results permanent?

The recording explains that muscle-related effects can diminish without ongoing maintenance. The frequency of any further treatment depends on the person, device and treatment plan.

Does it tighten loose skin?

Dr. Smith does not consider original Emsculpt a skin-tightening treatment. He explains that increased underlying muscle volume can sometimes change how mild laxity looks, which is different from treating excess skin itself.

ℹ️ Current context and related information

The FDA's body-contouring overview explains that magnetic-field treatments can cause soreness or cramps and require screening for contraindications. Noninvasive body contouring is not weight-loss treatment.

Read about the practice's current Emsculpt NEO information, liposuction, and BodyTite, 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. Suitability and results vary. Show notes updated September 30, 2026.

Full transcript and related resources

Originally published July 26, 2020. The discussion reflects Dr. Smith's practice at that time; an examination is needed to apply it to an individual.

Key takeaways

🎯 Start with the goal.

Dr. Smith distinguishes changing the contour of an area from trying to lose a substantial amount of weight.

🔬 Fat location matters.

The episode separates subcutaneous fat beneath the skin from visceral fat around the organs, which liposuction does not target.

🔬 Assess the skin as well as the fat.

Liposuction removes fat; it relies on the skin's ability to adapt to a smaller contour.

🔎 Additional procedures serve different purposes.

Dr. Smith discusses radiofrequency tightening for selected cases and skin-removal operations when laxity is more pronounced.

🔎 Cellulite is a separate concern.

He explains that changing fat volume does not predictably resolve cellulite.

🎧 Episode guide

00:00 — Introduction

00:35 — Contour goals versus weight loss

04:19 — Superficial fat versus visceral fat

06:42 — Loose skin and elasticity

08:22 — Tightening and skin-removal options

09:12 — Liposuction and cellulite

Can liposuction treat a “beer belly”?

That depends on what contributes to the abdominal fullness. Dr. Smith explains why fat under the skin differs from fat deeper inside the abdomen. The pinch example in the recording illustrates that distinction; it does not establish surgical candidacy without an examination.

What if I already have loose skin?

The amount of skin laxity can change the plan. The episode describes a spectrum from liposuction alone to combining contouring with tightening or skin excision. Age, health, smoking history, and the condition of the skin are discussed as assessment factors.

🔗 Related reading and consultation

Liposuction in NYC | BodyTite skin tightening | Tummy tuck surgery | 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, not an individual treatment recommendation. Procedures and outcomes depend on your anatomy and health. Show notes updated September 30, 2026.

Full transcript and related resources

What causes cellulite, and why do treatments differ? Darren M. Smith, MD, a board-certified plastic surgeon in New York City, explains how fibrous bands tether skin and contribute to dimpling. This episode explores Qwo at the time of its introduction and distinguishes discrete dimples from broader wavy skin texture.

Originally published July 23, 2020. This is an archival discussion of a then-new treatment, with current context added above.

Key takeaways from the recording

🧬 Cellulite anatomy

Cellulite involves the relationship between skin, fibrous bands and underlying fat; simply removing fat does not address every contributing feature.

💉 Historical Qwo treatment

Qwo was an injectable collagenase treatment intended to affect the fibrous bands involved in dimpling. Its approved indication was moderate to severe buttock cellulite in adult women.

📚 Evidence in 2020

Dr. Smith reviews the early evidence and uncertainty available in 2020, rather than reporting long-term experience with the product.

🧩 Treatment approaches

He compares approaches that release individual bands with treatments aimed at skin laxity and broader contour irregularities.

⚖️ Weight and skin changes

Weight changes do not predictably improve cellulite; loss of volume can also make skin laxity more apparent.

🎧 Episode guide

00:00 — Introduction

00:37 — What causes cellulite?

02:36 — Qwo and its proposed mechanism

05:54 — Early results and recovery discussion

09:20 — Dimpling versus wavy cellulite

12:11 — Weight changes and cellulite

💬 Common questions

Is this episode an invitation to book Qwo?

No. The wait-list invitation in the original audio predates Endo's decision to stop production and sales. A current consultation can address available options and whether treatment fits your particular concern.

Will losing weight get rid of cellulite?

The episode explains that the response varies. Less fatty volume may reduce prominence in some people, while accompanying skin laxity can make irregularities more visible in others.

ℹ️ Current related information

For today's practice information, see Avéli cellulite treatment and BodyTite skin tightening, or schedule a consultation. These links provide current context; Avéli is not part of the original recording.

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. No cellulite treatment guarantees complete removal or identical results. Show notes updated September 30, 2026.

Full transcript and related resources

Originally published July 20, 2020. Treatment schedules and practice preferences described in the recording reflect that period.

What the episode explains

🧬 Skin laxity factors

Aging, substantial weight loss and loss of volume after liposuction can leave skin that does not fully contract.

🔎 Neck bands and skin

Vertical muscle bands and excess skin are different concerns. Dr. Smith discusses Botox for softening bands, rather than removing loose skin.

⚙️ RF microneedling

Radiofrequency microneedling, including Morpheus8, uses needles and heat. It penetrates the skin and should not be described as completely noninvasive.

⚙️ FaceTite and AccuTite

FaceTite and AccuTite deliver energy through small access incisions; they are minimally invasive procedures with risks and recovery considerations.

🩺 Neck lift options

For more substantial laxity, Dr. Smith discusses a neck lift or a facelift that includes the neck. The choice depends on anatomy and goals.

🎧 Episode guide

00:00 — Introduction

00:53 — Why neck skin becomes loose

04:22 — Botox and neck bands

06:07 — Radiofrequency microneedling

07:26 — Minimally invasive tightening

09:24 — When a neck lift enters the discussion

💬 Common questions

Can Botox remove loose neck skin?

The recording distinguishes skin laxity from muscle-related neck bands. Dr. Smith describes Botox as an option for reducing the appearance of bands, not a treatment that removes excess skin.

Is FaceTite a treatment without surgery?

Dr. Smith describes it as a minimally invasive procedure involving small incisions and a probe beneath the skin. That distinction matters when comparing it with microneedling or a surgical neck lift.

ℹ️ Current safety context

In October 2025, the FDA warned of reported serious complications with certain uses of RF microneedling, including burns, scarring, fat loss and nerve damage. Discuss the specific device, treatment area, expected benefit and risks with a qualified clinician. This update is separate from the original recording. Read the FDA safety communication.

🔗 Related information

Explore current information about Morpheus8, FaceTite and AccuTite, and neck lift surgery, 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. Suitability, risks and results vary. Show notes updated September 30, 2026.

Full transcript and related resources

In this episode of Plastic Surgery: Before and After, board-certified New York City plastic surgeon Darren M. Smith, MD breaks down the factors behind a liposuction estimate. He explains why two procedures described as liposuction may involve different amounts of work, staffing and equipment.

Key takeaways

💬 Separate the fee components.

The episode distinguishes the surgeon's fee, anesthesia fee and operating-room or facility fee.

🔎 Define the actual treatment.

The number of areas, the volume being treated and the complexity of the case can affect the estimate.

🔎 Previous treatment can add complexity.

Dr. Smith discusses scarring from prior liposuction and other factors that may make revision work more involved.

🔎 Ask why a technology is included.

The recording covers power-assisted, laser-assisted, ultrasound-assisted and radiofrequency-assisted approaches. Additional equipment and procedure time can add cost.

🔎 Consider the setting and team.

Anesthesia staffing, surgeon training and qualifications, and geographic location are all part of the discussion.

💬 Questions answered

What liposuction prices are quoted in the recording?

Speaking about his New York City experience in 2020, Dr. Smith gives a surgeon's-fee example of approximately $3,000–$6,000 for a first treatment area, with lower per-area pricing as areas are added. He discusses anesthesia and facility fees separately. These are archival examples, not today's rates, an all-inclusive package, or a quote for your care.

Why can revision liposuction cost more?

The episode explains that previous liposuction and scar tissue can make a case more difficult. The amount of time, anatomical complexity and equipment needed are part of planning the procedure and its estimate.

Do I need every available liposuction add-on?

Dr. Smith recommends asking what specific problem an added technology is intended to address. His preferences in this 2020 discussion are not a rule that every patient needs laser, ultrasound or radiofrequency treatment.

🎧 Episode chapters

02:21 — How liposuction technology can affect cost

09:46 — Anesthesia options and staffing

12:49 — Number of areas, treatment volume and complexity

15:04 — Surgeon qualifications and geography

16:29 — Surgeon, anesthesia and facility fees

17:14 — Historical 2020 New York City price examples

🔗 Related information

Review current liposuction cost factors, read about liposuction and liposuction methods, or request a consultation with Dr. Smith in New York City for an individualized assessment and current quote.

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.

Originally released July 18, 2020. Show notes updated September 30, 2026. This is general education. Current pricing, suitability, risks and expected results require an individual assessment.

Full transcript and related resources

Originally published July 16, 2020. The examples reflect his practice at the time; the decision to combine or stage procedures requires an individual assessment.

Key takeaways

🩹 A shared recovery can be convenient.

One period away from work or one trip for surgery may suit some patients, while recovering from several procedures can also be more demanding.

💬 Some costs may be shared.

Dr. Smith discusses operating-room setup, anesthesia, travel, and postoperative support as factors, rather than offering a universal package price.

🔎 Longer operations introduce additional considerations.

Position changes, technical complexity, and clot-prevention planning are part of his discussion.

🎯 The procedures should complement the goal.

Examples include multiple-area liposuction, breast and abdominal surgery, augmentation with a lift, and nose and chin surgery for facial balance.

🔎 Experience with the combination matters.

Dr. Smith encourages a detailed conversation about whether the proposed procedures work together and how recovery will be managed.

🎧 Episode guide

00:00 — Introduction

01:05 — Potential benefits of combining procedures

04:38 — Complexity and operating time

05:45 — Blood-clot risk considerations

07:21 — Examples of combined procedures

13:59 — Planning with your surgeon

Can a breast augmentation and lift be combined?

The episode describes this as an option for selected patients who want both increased volume and a change in breast position or shape. Dr. Smith explains that choosing an implant and planning a lift involve related but distinct decisions.

Will combining procedures always save money?

It may reduce some duplicated expenses, but it does not establish what your own operation will cost. Dr. Smith's examples concern shared setup, travel, and recovery needs. The extent of surgery and support required still need to be defined in an individualized quote.

What should I ask at consultation?

Discuss the goals for each procedure, whether the surgeon recommends combining or staging them, the anticipated operating time, and the help you will need afterward. The episode emphasizes this planning conversation rather than choosing a combination from its name alone.

🔗 Related reading and consultation

Combined or staged mommy makeover | Mommy makeover | Breast augmentation | 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; surgical risk, recovery, and the appropriate combination vary. Show notes updated September 30, 2026.

Full transcript and related resources

Originally published July 14, 2020. Techniques, prices, and outcome estimates discussed are historical examples, not current quotes or guarantees.

Key takeaways

🔬 The graft is living tissue.

Dr. Smith explains how transplanted fat initially depends on the surrounding tissue before developing a blood supply.

🔎 Harvesting and placement are distinct steps.

The episode describes obtaining fat with liposuction, preparing it, and placing it in a recipient area.

🔬 Fat transfer has several uses.

Examples include facial volume, breast reconstruction, breast augmentation, and selected combinations with other operations.

🔎 Retention is variable.

Some fat can be absorbed, and another procedure may be considered after the result settles.

🔎 The intended volume change matters.

Dr. Smith discusses donor-fat availability and why fat transfer alone may not match the goals of someone seeking a large breast-size increase.

🎧 Episode guide

00:00 — Introduction

02:42 — Breast and facial applications

04:48 — Harvesting and preparing fat

07:56 — Retention and repeat treatment

09:15 — BBL and its distinctive risks

12:48 — Breast volume and symmetry considerations

Will all transferred fat remain?

No. The recording emphasizes that survival is incomplete and variable, which affects the eventual volume and symmetry. Its numerical retention estimates should not be treated as a personalized forecast.

Can fat transfer replace breast implants?

It can be considered for selected volume and contour goals, but the episode describes limits related to available donor fat and the amount retained. Dr. Smith also discusses combining an implant with fat transfer to refine particular areas of the breast.

Why is a BBL discussed separately?

The episode highlights the distinctive risks of gluteal fat grafting, including fat embolism. Current context: the 2022 multisociety safety statement supports real-time ultrasound guidance to help keep fat placement above the gluteal muscle fascia. This does not eliminate risk. Read the ASPS joint safety statement alongside this archival discussion.

🔗 Related reading and consultation

Facial fat grafting | Fat-transfer breast augmentation | 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; suitability, retention, recovery, and risk vary. Show notes updated September 30, 2026.

Full transcript and related resources

He explains how loss of skin elasticity contributes to laxity, then discusses the different goals of improving skin appearance, stimulating a tissue response and removing excess skin. The device and pricing discussion reflects his practice at the time.

Key takeaways

🔬 Moisturizing and removing loose skin are different goals.

Dr. Smith describes a temporary improvement in appearance from hydration while explaining the limitations of creams for substantial laxity.

🔬 Energy-based treatments rely on a tissue response.

The recording discusses radiofrequency microneedling through Morpheus8 and procedures using BodyTite, FaceTite and AccuTite. These are different techniques with their own risks and limitations.

⏳ Changes can take time.

Dr. Smith explains that the healing response develops over months; the episode's examples should not be treated as a promised result or schedule.

🔬 Surgery removes excess skin.

Examples include face and neck lifts, arm lifts and tummy tucks. Significant laxity can require a different approach from a less extensive concern.

🔬 Fat and skin need separate assessment.

Liposuction may enter the discussion when excess fat contributes to the contour, alongside consideration of the skin.

💬 Questions answered

Will a skin-tightening procedure also remove unwanted fat?

That depends on the procedure and the tissue being treated. The episode explains why Dr. Smith sometimes discusses liposuction separately: changing the skin does not automatically address the amount of underlying fat.

Are device treatments equivalent to surgical skin removal?

No. The recording distinguishes the goals and limits of device-based treatment from excisional surgery. The degree of laxity, expected change, recovery and scar tradeoffs belong in an individual consultation.

ℹ️ Current context for this 2020 recording

The FDA's October 2025 RF microneedling safety communication reports serious complications with certain uses, including burns, scarring, fat loss and nerve damage. It concerns RF microneedling specifically, rather than every radiofrequency procedure. Microneedling penetrates skin and should not be described as completely noninvasive.

The recording also discusses platelet-rich plasma (PRP). The FDA states that microneedling devices are not approved to deliver blood products such as PRP into skin. Discuss the evidence and risks for any proposed combination. All dollar amounts and treatment schedules in the audio are historical examples, not current quotes or individualized recommendations.

🎧 Episode chapters

01:21 — Skin elasticity and topical products

03:51 — Energy-based skin treatments

09:24 — Surgical skin removal

10:30 — Liposuction and PRP discussion

12:47 — Historical pricing and treatment schedules

14:19 — Risks and home-treatment claims

🔗 Related information

Explore Morpheus8 information, BodyTite information, 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 July 12, 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

In this July 10, 2020 episode of Plastic Surgery: Before and After, board-certified New York City plastic surgeon Darren M. Smith, MD discusses common reasons patients ask about their inner, or medial, thighs, including rubbing and concerns about shape. He outlines his approach to focused fat removal and explains when skin treatment enters the conversation.

Key takeaways

🔎 Start with the cause of fullness.

The episode separates extra fat from extra skin rather than treating every inner-thigh concern the same way.

🔎 Focused liposuction is one option.

Dr. Smith describes a local-anesthesia procedure using small groin-crease incisions and a cannula to remove targeted fat.

🔬 Skin quality matters.

Existing laxity can become more noticeable when the volume beneath it decreases.

🔎 Different degrees of looseness need different discussions.

The recording covers radiofrequency for selected laxity and a medial thigh lift for more substantial excess skin.

🔎 Preferences also matter.

Dr. Smith discusses CoolSculpting for people who do not want surgery while explaining his own preference for focused liposuction.

💬 Questions answered

Can inner-thigh liposuction be done while I am awake?

The episode describes local anesthesia as an option for selected patients in Dr. Smith's practice. The anesthesia and extent of treatment need an individual assessment; the example is not a recommendation for every patient.

Will removing fat also remove loose skin?

No. Dr. Smith explains why fat removal can leave loose skin behind. He discusses a separate skin-tightening approach for some patients and skin-removal surgery when the excess is more significant.

How is a thigh lift different from liposuction?

Liposuction targets fat. A medial thigh lift removes excess skin. The recording describes the additional scar and recovery involved in choosing a lift, particularly after substantial weight loss.

🎧 Episode chapters

00:30 — Why patients ask about inner-thigh fullness

01:20 — Is the concern fat, loose skin or both?

01:38 — Focused liposuction and the 2020 procedure example

03:16 — The discussion of noninvasive alternatives

04:12 — Why skin laxity changes the plan

05:41 — When a medial thigh lift may be considered

🔗 Related information

Read about thigh liposuction, BodyTite and liposuction more broadly, or request a consultation with Dr. Smith in New York City.

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.

Originally released July 10, 2020. Show notes updated September 30, 2026. This is general education. Recovery instructions, suitability, risks and achievable contours require an individual assessment; no particular thigh shape is guaranteed.

Full transcript and related resources

The dollar amounts in this recording are historical, not a current quote. Dr. Smith describes examples ranging from about $6,500 to $13,000–$15,000 in the New York City area at the time. Those figures do not establish today's prices or guarantee what any particular package includes.

Key takeaways

💬 The surgeon's fee reflects the operation being planned.

Anatomy, prior breast surgery and case complexity can affect the work involved. Training and experience are also discussed as pricing factors.

💬 Anesthesia has its own cost.

The recording describes the setting, anesthesia provider and length of surgery as contributors.

💬 The facility fee covers more than a room.

Supplies, processing equipment and operating-room time contribute. Items such as a surgical bra or an overnight stay may be included or billed separately.

🔬 Implant choice affects the quote.

Dr. Smith discusses saline, silicone and a structured saline brand available at the time. Implant selection also involves anatomy and goals.

🔎 Location affects pricing.

Geographic differences help explain why an estimate from one community may not translate directly to another.

💬 Questions answered

Is the surgeon's fee the total cost of breast augmentation?

No. The episode separates that fee from anesthesia, facility and implant charges. Ask which components are included in the written quote and which are separate before comparing totals.

Can previous breast surgery make a new augmentation more expensive?

It can change the complexity and time required. Dr. Smith contrasts a straightforward first augmentation with a case involving previous implants or other breast surgery; an individual examination is needed to estimate the actual work.

ℹ️ Current planning context

The FDA advises that breast implants are not lifetime devices and that additional operations may be needed. Current implant counseling includes risk information and a patient decision checklist introduced after this recording. Discuss ongoing follow-up and potential future costs alongside the initial surgical quote.

🎧 Episode chapters

00:26 — Four components of the price

01:21 — Surgeon fee and case complexity

04:34 — Anesthesia fees

07:47 — Facility fees and included items

10:22 — Implant choices

11:50 — Geography and historical NYC prices

🔗 Related information

Explore breast augmentation, breast implant cost information, breast implant 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 July 9, 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

In this July 8, 2020 episode of Plastic Surgery: Before and After, board-certified New York City plastic surgeon Darren M. Smith, MD takes a head-to-toe tour of common treatment areas. He explains why each region needs its own anatomical assessment and why a label such as Lipo 360 is not enough to define the plan.

Key takeaways

🔎 The source of fullness matters.

The male-chest discussion distinguishes fat from breast tissue, which may require a different approach.

🔬 Abdominal fat has different compartments.

Liposuction targets subcutaneous fat above the abdominal wall, not the visceral fat around internal organs.

🔎 Neighboring areas affect overall contour.

Dr. Smith discusses planning the abdomen and waist together and considering the different sides of the thighs.

🔎 Name each treatment area.

Ask whether a proposed Lipo 360 plan includes the abdomen, flanks, upper back, lower back or other specific regions.

🔬 Fat is only part of the assessment.

Existing skin laxity and underlying muscle tone influence the result. The episode also discusses skin-removal procedures and historical adjuncts such as BodyTite and Emsculpt.

💬 Questions answered

Can liposuction remove all of my abdominal fat?

No. Dr. Smith distinguishes the superficial fat beneath the skin from deeper visceral fat around the organs. His explanation emphasizes an examination to determine which compartment contributes to the abdominal shape.

Is chin liposuction actually performed on the chin?

In this discussion, chin liposuction refers to the submental area beneath and behind the chin. Dr. Smith describes treating fullness there as part of an assessment of the jawline and lower facial profile.

Does Lipo 360 always include the same areas?

The episode warns that the term alone can be too vague. Dr. Smith recommends a clear discussion of the actual regions being treated so the patient and surgeon share the same expectations.

🎧 Episode chapters

01:08 — Chin, male chest, underarms and arms

04:29 — Abdominal liposuction: superficial versus visceral fat

06:32 — Planning the waist and back

09:02 — Why Dr. Smith asks what Lipo 360 actually includes

11:18 — Thigh regions and selected calf treatment

14:18 — Skin laxity, muscle tone and historical adjuncts

🔗 Related information

Explore current practice information on liposuction, chin liposuction and thigh liposuction, or request a consultation with Dr. Smith in New York City.

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.

Originally released July 8, 2020. Show notes updated September 30, 2026. This is general education; suitability, the extent of treatment, risks and expected results require an individual assessment.

Full transcript and related resources

Someone seeking more visible muscle definition may have a different concern from someone bothered by hanging skin after weight loss. The recording walks through exercise, fat removal, energy-based skin treatment and surgical skin removal without treating them as interchangeable procedures.

Key takeaways

🔬 Muscle provides the foundation.

Dr. Smith discusses exercise and, in the context of his 2020 practice, Emsculpt as approaches to muscle conditioning. Neither discussion makes loose skin the same problem as muscle tone.

🔬 Fat can obscure definition.

Arm liposuction removes localized fat. Dr. Smith describes local anesthesia as an option for selected cases.

🔬 Skin quality changes the plan.

If excess skin is the main issue, removing fat alone does not address that tissue. The episode discusses BodyTite for selected patients with less extensive laxity.

🔬 An arm lift removes excess skin.

A full brachioplasty involves a longer incision along the inner arm, with a permanent scar to weigh against the contour change.

🔎 A smaller operation fits a smaller problem.

The mini arm lift discussed in the recording targets more limited excess skin near the armpit. It is not presented as suitable for every arm.

💬 Questions answered

How are arm liposuction and an arm lift different?

Liposuction addresses fat beneath the skin. An arm lift, or brachioplasty, removes excess skin. Dr. Smith explains that some patients have both concerns, so the consultation should identify which tissues are contributing to the shape.

Can a mini arm lift replace a full arm lift?

Only when the distribution of excess skin fits the smaller procedure. The episode describes a mini lift for limited upper-arm skin near the armpit, while more extensive laxity may require a longer incision.

The device protocols, compression instructions and rapid recovery examples in this 2020 recording describe the original discussion. A current plan should specify the procedure's risks, scar placement, expected limitations and individualized activity restrictions.

🎧 Episode chapters

00:33 — The three layers that shape the arms

01:30 — Muscle conditioning and exercise

03:22 — Arm fat and liposuction

05:14 — Skin laxity and BodyTite discussion

07:07 — Full and mini arm lifts

🔗 Related information

Explore arm liposuction, arm lift surgery, BodyTite treatment 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 July 7, 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

Key takeaways from the episode

🔎 Botox and fillers work differently.

Botulinum toxin products reduce selected muscle activity; the hyaluronic acid fillers discussed in the episode add volume.

⚠️ A familiar ingredient does not establish safety in pregnancy.

Hyaluronic acid occurs naturally in the body, but that alone does not answer whether an injectable product is appropriate during pregnancy or breastfeeding.

💬 Elective and medical uses raise different questions.

Dr. Smith mentions uses such as migraine and muscle spasticity. A decision about an ongoing medical treatment requires its own assessment.

🔎 The recommendation in the audio is precautionary.

It should not be interpreted as evidence that every exposure causes harm, or as a statement that all products and uses have been studied equally.

💬 Questions answered

Why does Dr. Smith recommend waiting for cosmetic injections?

He weighs an elective appearance benefit against uncertainty about pregnancy and breastfeeding safety. The recording's recommendation is to wait rather than assume that a small dose or a naturally occurring filler ingredient settles the question.

Does this episode provide a treatment plan for migraine or spasticity?

No. Dr. Smith mentions these medical uses but does not give an individualized treatment plan. The clinician treating the condition should assess the relevant benefits, uncertainties and alternatives.

ℹ️ Current context for this 2020 recording

The FDA does not recommend cosmetic botulinum toxin injections during pregnancy or lactation. The FDA also states that dermal filler safety during pregnancy and breastfeeding is unknown.

Lactation evidence has developed since the recording. The September 2026 LactMed review describes limited human data on onabotulinumtoxinA and notes guidance supporting its use for chronic migraine during breastfeeding. Those findings do not establish safety for every toxin, dose or indication, and breastfeeding evidence does not establish pregnancy safety. Discuss your specific treatment and circumstances with your prescribing and obstetric or lactation care teams.

🎧 Episode chapters

00:36 — What botulinum toxin does

02:49 — The original precautionary recommendation

03:45 — Cosmetic versus medical uses

04:29 — Hyaluronic acid fillers and timing

🔗 Related information

Explore Botox treatment information, dermal filler 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 July 6, 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

Dr. Smith explains why someone can have submental fullness despite regular exercise or a healthy weight. Weight change may affect the area, but exercising a particular body part does not selectively remove its fat.

Key takeaways

🔬 Identify fat versus skin.

Removing fat and addressing skin laxity are different goals; some people have both concerns.

🔎 Nonsurgical options have tradeoffs.

The recording discusses fat freezing and injectable treatment, including the possibility of multiple sessions and recovery after treatment.

🔬 Chin liposuction targets fat.

Dr. Smith describes it as an option for selected patients with localized fullness, sometimes performed with local anesthesia.

🔬 Skin treatment depends on the degree of laxity.

The discussion includes radiofrequency treatments and, for more substantial loose skin, neck lift surgery.

🔎 A combination may be considered.

The appropriate approach depends on anatomy and goals, rather than assuming one treatment fits every double chin.

💬 Questions answered

Can chin exercises get rid of a double chin?

The episode explains that targeted exercise cannot selectively remove fat from the chin. Overall weight change may alter fullness, but inherited fat distribution and loose skin can remain relevant.

Will liposuction also remove loose neck skin?

Liposuction removes fat. Dr. Smith distinguishes that goal from treating skin laxity and discusses additional procedures when loose skin is a separate concern. An assessment is needed to determine whether fat removal alone is suitable.

ℹ️ Current context for this 2020 recording

Kybella is an FDA-approved prescription drug containing deoxycholic acid for fat beneath the chin in adults; it is not an enzyme. Suitability and risks require a clinician's assessment.

In October 2025, the FDA issued a safety communication about certain uses of radiofrequency microneedling, reporting complications including burns, scarring, fat loss and nerve damage. This specifically concerns RF microneedling, which the episode discusses through Morpheus8; it should not be read as a finding about every type of radiofrequency procedure. Treatment preferences, prices and recovery examples in the recording reflect its original date.

🎧 Episode chapters

00:33 — Why a double chin develops

01:59 — Exercise and targeted fat loss

03:12 — Nonsurgical fat treatments

06:01 — Radiofrequency microneedling discussion

07:42 — Matching liposuction and skin treatments

12:13 — Neck lift and historical cost discussion

🔗 Related information

Explore chin liposuction, FaceTite and AccuTite, neck lift 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 July 5, 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

The discussion moves from the specialty's historical roots to modern operations involving skin, fat, muscle and bone. Its central idea is that plastic surgeons work with tissue to improve form, function or both.

Key takeaways

🔎 The name describes shaping.

The Greek root plastikos refers to molding or giving form. Synthetic materials do not define the specialty.

🔎 Reconstructive and aesthetic surgery share techniques.

Reconstruction addresses missing, damaged or differently developed structures; aesthetic surgery focuses on changes to appearance.

🔎 Microsurgery expands reconstructive options.

Dr. Smith describes using a microscope to reconnect tiny blood vessels when transferring tissue, including an example involving breast reconstruction.

🔎 Craniofacial surgery addresses the head and face.

Examples in the recording include cleft lip and palate and differences in skull development.

🔎 Training can connect these fields.

Dr. Smith discusses how his craniofacial and aesthetic fellowships inform his approach to facial anatomy and surgery.

💬 Questions answered

Does plastic surgery always involve implants or artificial materials?

No. The name refers to reshaping tissue. The episode describes operations that work with a person's own tissues, including reconstructive tissue transfer and craniofacial surgery.

Is all plastic surgery cosmetic?

No. Cosmetic surgery is one part of a broader specialty. Reconstruction can address function as well as appearance, and the recording explains why knowledge from reconstructive work can inform aesthetic procedures.

Historical reference: The American Society of Plastic Surgeons' history of the specialty provides additional background on the name and the relationship between aesthetic and reconstructive surgery.

🎧 Episode chapters

00:08 — Why the specialty has this name

01:35 — The reconstructive mission

02:45 — Reconstruction and microsurgery

03:40 — Craniofacial surgery

04:26 — Aesthetic surgery and fellowship training

🔗 Related information

Explore Dr. Smith’s background and training, facial plastic surgery, breast 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 July 4, 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

In this July 3, 2020 episode of Plastic Surgery: Before and After, board-certified New York City plastic surgeon Darren M. Smith, MD explains breast lift surgery, also called mastopexy. He introduces breast ptosis, or drooping, and the tradeoff between reshaping the breast and accepting permanent scars.

Key takeaways

🔎 A donut lift uses an incision around the areola.

The episode calls this a periareolar or circumareolar mastopexy and discusses it for limited lifting.

🔎 A lollipop lift adds a vertical incision.

This circumvertical pattern extends from the areola down toward the breast fold.

🔎 An anchor lift adds a fold incision.

The inverted-T or Wise pattern includes a horizontal component along the fold beneath the breast.

🔎 Nipple position helps describe drooping.

Dr. Smith explains the relationship between the nipple and the inframammary fold.

🩹 Pregnancy plans and scars belong in the discussion.

Future pregnancy can change the breast again, and a lift leaves scars even when they fade.

💬 Questions answered

Is a mastopexy different from a breast lift?

No. Mastopexy is the medical term for breast lift surgery.

Can I choose a donut lift just to avoid a longer scar?

The episode describes a donut lift as a more limited approach. The incision pattern needs to match the amount of correction being considered; a smaller incision is not automatically the right operation.

Will the scars disappear?

No. Dr. Smith explains that scars can become less noticeable over time, but they are permanent. Their likely position and the shape change you hope to achieve are part of the decision.

🎧 Episode chapters

00:37 — Goals of mastopexy and pregnancy considerations

01:57 — Understanding breast ptosis

02:47 — The donut or periareolar lift

04:11 — The lollipop or circumvertical lift

04:35 — The anchor or inverted-T lift

06:14 — Permanent scars and the shape tradeoff

🔗 Related information

Explore breast lift surgery, breast procedure information, or request a consultation with Dr. Smith in New York City.

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.

Originally released July 3, 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

In this July 2, 2020 episode of Plastic Surgery: Before and After, board-certified New York City plastic surgeon Darren M. Smith, MD describes how tummy tuck surgery and follow-up were organized in his practice. He repeatedly notes that arrangements and recovery decisions vary by patient and practice.

Key takeaways

🩹 Understand the scar tradeoff.

Dr. Smith describes a low horizontal scar and a scar around the belly button for the operation discussed. Scars remain even as their appearance changes.

🎯 Plan the early support.

The episode covers anesthesia, the recovery room and postoperative nursing arrangements used in his practice at that time.

🔎 Drains have a purpose.

He explains that drains remove fluid during healing and discusses monitoring before removal.

🩹 Recovery happens in stages.

The conversation separates gentle walking, the initial recovery period, desk work and exercise.

🔎 Appearance continues to evolve.

Swelling and the tissues' adaptation to the new contour take longer than the initial time away from work.

💬 Questions answered

Does a tummy tuck leave permanent scars?

Yes. The episode emphasizes that scars are part of the decision to have surgery. Their location and visibility should be discussed before choosing the operation.

When does Dr. Smith describe returning to work and exercise?

In this 2020 recording, he gives examples of about two weeks before desk work and four to six weeks before regular exercise, while emphasizing individual clearance. These historical examples are not instructions for your own recovery.

When is the final contour apparent?

Dr. Smith explains why the early appearance is not the final result. He describes changes over six months to a year as swelling settles and tissue adapts, rather than promising that everyone follows the same schedule.

Preparation note: Obtain current written fasting, medication, drain-care and activity instructions from your surgical and anesthesia teams. The recording describes an older practice protocol, not instructions to follow independently.

🎧 Episode chapters

00:28 — What a tummy tuck addresses

01:49 — Incisions and the scar tradeoff

02:43 — Anesthesia and the day of surgery

04:15 — Recovery-room assessment and early support

06:49 — Early healing, drains and activity

08:31 — Why the contour keeps changing

🔗 Related information

Explore tummy tuck information, preparing for plastic surgery, or request a consultation with Dr. Smith in New York City.

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.

Originally released July 2, 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

In this July 1, 2020 episode of Plastic Surgery: Before and After, board-certified New York City plastic surgeon Darren M. Smith, MD explains why evaluating the skin is as important as evaluating the fat. He uses a balloon analogy to make the relationship between volume and the surrounding skin easier to understand.

Key takeaways

🔬 Less volume does not automatically mean tighter skin.

Liposuction reduces fat, while the skin's response depends on its condition before treatment.

🔎 An examination matters more than a blanket prediction.

The episode discusses elasticity, existing looseness and the amount of fat being considered for removal.

🔎 Some patients need an additional approach.

Dr. Smith describes radiofrequency treatment alongside liposuction for selected patients with limited skin laxity in his 2020 practice.

🔬 Substantial excess skin is a different problem.

The discussion considers a tummy tuck, arm lift or thigh lift when removing extra skin may be more appropriate.

💬 Questions answered

Will my skin automatically tighten after liposuction?

Not necessarily. The episode distinguishes skin with good elasticity from skin that is already loose and may not retract enough. A consultation helps estimate that response, but it cannot guarantee a perfectly smooth result.

Can radiofrequency replace a tummy tuck or body lift?

Dr. Smith discusses radiofrequency as an option for selected, less severe laxity. For more substantial excess skin, he describes an excisional procedure, which physically removes skin. The recording does not present these approaches as interchangeable for every patient.

Is this only an issue with abdominal liposuction?

No. Although the abdomen illustrates the explanation, the episode also discusses the arms and thighs. The relevant question in each area is whether fat removal alone addresses the anatomy or whether excess skin needs its own treatment.

🎧 Episode chapters

00:26 — Will liposuction leave loose skin?

00:46 — The balloon analogy: fat volume and the skin envelope

01:58 — Why existing skin elasticity matters

02:43 — What the consultation assesses

03:49 — Radiofrequency for selected skin-laxity concerns

04:15 — When skin-removal surgery may be considered

🔗 Related information

Read current practice information about liposuction, BodyTite and tummy tuck surgery. For an individualized discussion, request a consultation with Dr. Smith in New York City.

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.

Originally released July 1, 2020. Show notes updated September 30, 2026. This is general education; current treatment options, suitability, risks and expected results require an individual assessment.

Full transcript and related resources

In this June 30, 2020 episode of Plastic Surgery: Before and After, board-certified New York City plastic surgeon Darren M. Smith, MD compares the approaches and explains his preference for surgical contouring in many patients. His opinions, numerical estimates and practice examples belong to that recording; they are not universal outcome guarantees or a current price quote.

Key takeaways

🎯 Start with the goal.

Dr. Smith describes liposuction as a shape-change procedure for localized concerns, rather than a way to lose weight.

🔎 The treatment methods differ.

He contrasts a surgeon working across an area and its transitions with fat freezing delivered through applicators.

🔎 Consider the complete treatment course.

The discussion compares one surgical procedure with potentially repeated nonsurgical sessions, including time and cost.

⚠️ Noninvasive does not mean risk-free.

The episode discusses pain, altered sensation, contour problems and paradoxical fat growth after fat freezing, alongside surgical complications of liposuction.

🎯 The bonus segment addresses a different goal.

Dr. Smith introduces Emsculpt and its muscle-focused role in his 2020 body-contouring practice.

💬 Questions answered

Is CoolSculpting the same procedure as liposuction?

No. The recording distinguishes surgical removal of fat from an applicator-based cooling treatment. The appropriate approach depends on the specific concern, anatomy, preferences and willingness to undergo surgery.

Can fat freezing cause fat to grow instead of shrink?

The episode describes paradoxical adipose hyperplasia, in which treated fat enlarges. The FDA's patient guidance notes that this complication may require surgery. See the FDA's current overview of noninvasive body-contouring risks.

Which option costs less?

A meaningful comparison includes the areas treated and the full course of sessions. Dr. Smith discusses this in the recording, but his 2020 comparison cannot establish today's price or the number of treatments an individual will need.

🎧 Episode chapters

01:00 — Candidates and the goals of body contouring

02:24 — Surgical contouring versus applicator-based treatment

05:52 — Time to results and recovery experiences

07:59 — The historical cost and session comparison

09:20 — Risks of liposuction and fat freezing

12:35 — Bonus: Dr. Smith's 2020 discussion of Emsculpt

🔗 Related information

Explore current information about liposuction, liposuction cost factors and nonsurgical care, or request a consultation with Dr. Smith in New York City.

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.

Originally released June 30, 2020. Show notes updated September 30, 2026. This is general education, not a complete current risk comparison. Suitability, risks and expected results require an individual assessment.

Full transcript and related resources

In this June 29, 2020 episode of Plastic Surgery: Before and After, board-certified New York City plastic surgeon Darren M. Smith, MD explains why the same procedure list will not fit everyone.

Key takeaways

🔎 Breast changes differ.

The episode distinguishes volume loss, drooping, increased volume and combinations of those changes.

🔎 The breast procedure follows the concern.

Dr. Smith discusses augmentation, a lift, augmentation with a lift, and reduction as different possibilities.

🔎 Assess three abdominal components.

He explains the roles of fat, skin laxity and separation of the rectus muscles, known as rectus diastasis.

🎯 The plan can extend beyond the breasts and abdomen.

The recording also discusses other fat deposits and changes involving the nipples, areolas and genital tissues. These are optional topics for an individualized consultation.

💬 Questions answered

Does every mommy makeover include breast implants?

No. In the episode, implants are considered when additional breast volume is desired. A lift, reduction or another plan may better match a different concern.

Does everyone need a tummy tuck?

No. Dr. Smith describes examining abdominal skin, fat and muscle separation before selecting a procedure. The discussion contrasts a tummy tuck for substantial skin or abdominal-wall concerns with less extensive options for selected patients.

Is a mommy makeover the same combination for every patient?

No. The episode's central point is that pregnancy affects people differently. The term alone does not specify which procedures are appropriate or promise a return to a previous body shape.

🎧 Episode chapters

00:00 — What the term mommy makeover means

01:06 — Breast changes and procedure choices

02:26 — Abdominal muscle, fat and skin changes

03:48 — Matching abdominal treatment to the anatomy

05:03 — Additional areas and the individualized plan

🔗 Related information

Explore mommy makeover information, breast lift surgery, tummy tuck surgery, or request a consultation with Dr. Smith in New York City.

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.

Originally released June 29, 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

In this short June 28, 2020 episode of Plastic Surgery: Before and After, board-certified New York City plastic surgeon Darren M. Smith, MD describes early recovery examples from his practice.

Key takeaways

💼 Work and leave

The discussion focuses on early time away from desk work.

🗓️ Exercise and recovery

Dr. Smith describes soreness and a period of exercise restriction.

🧩 Combined procedures

He allows more recovery time when a breast lift is combined with augmentation because more tissue is involved.

💬 Questions answered

Does everyone return to work after 48 hours?

No. The recording's short return-to-work example is a historical practice observation, not a guarantee. Your procedure, recovery and job duties determine the appropriate plan.

Does returning to work mean I can exercise?

No. The episode treats those decisions separately. Obtain your surgeon's current clearance for exercise, especially upper-body activity.

🎧 Episode chapters

00:36 — Early recovery and desk-work examples

01:21 — How adding a breast lift changes recovery

🔗 Related information

Explore breast augmentation recovery information, breast lift information, or request a consultation with Dr. Smith in New York City.

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.

Originally released June 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

In this June 27, 2020 episode of Plastic Surgery: Before and After, board-certified New York City plastic surgeon Darren M. Smith, MD outlines five areas to examine: word of mouth, reviews, before-and-after photographs, training and credentials, and communication during a consultation.

Key takeaways

🔎 Use referrals as a starting point.

A friend or colleague's experience may identify a surgeon worth meeting.

🔎 Read reviews for context.

Dr. Smith recommends looking beyond a simple star count and discussing concerns directly during the consultation.

🔎 Explore relevant photographs.

A gallery can help you discuss the surgeon's aesthetic approach and experience with the procedure that interests you.

🔎 Check credentials.

The episode emphasizes certification by the American Board of Plastic Surgery, along with the surgeon's training.

💬 Pay attention to communication.

Dr. Smith describes surgery as a collaboration in which questions, expectations and a comfortable working relationship matter.

💬 Questions answered

Should a surgeon's limited online presence rule them out?

Not automatically. The episode explains that some experienced surgeons have few online reviews. Dr. Smith recommends considering their other qualifications and meeting them rather than judging only by digital visibility.

Can I ask to see more before-and-after photographs?

Yes. Dr. Smith notes that some patients permit their photographs to be shown privately in the office but not published online. Ask about examples relevant to the procedure you are considering; another person's result is not a guarantee of your own.

Where can I verify plastic surgery board certification?

The American Board of Plastic Surgery's official search provides certification information. Certification is one important credential to evaluate alongside the rest of the consultation and your specific needs.

🎧 Episode chapters

00:31 — Five considerations when choosing a surgeon

02:07 — Reading online reviews in context

04:17 — Using before-and-after photographs

05:33 — Communication at the consultation

06:01 — Training and board certification

🔗 Related information

Explore Dr. Smith's training and background, practice information, or request a consultation with Dr. Smith in New York City.

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.

Originally released June 27, 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