A few things I wish I knew before surgery

Post-op constipation is real.

The combination of narcotic pain medications, decreased activity, and poor dietary intake can lead to some serious constipation, so drink all the water, eat all the fiber, and walk, walk, walk. Unless you have other medical issues, you’ll need 2-3 liters of water (sorry, your coffee doesn’t count), and 20-30 grams of fiber every day. For reference, a serving of bran cereal has about 5.5 grams; fiber supplements like Metamucil can help you meet your goal and are actually pretty tasty these days.

As for walking, we like our patients up and walking the same evening of surgery (but always defer to your doctor’s instructions). Walking not only staves off constipation, it’ll also help prevent potentially fatal blood clots, so win-win.

What you eat, drink, and do can affect wound healing.

We already discussed the copious amounts of water and fiber you’ll be consuming, but there are other nutrients you’ll need to be aware of to help maximize your recovery. Low fat protein, zinc, calcium, and vitamins C & D are important factors in wound healing. And while it’s always better to get your nutrients from whole food sources, supplements may be beneficial to some people. Try a calorie tracking app on your phone to see how your nutritional intake stacks up.

On the flip side, there are a few things you should avoid, as they are known to delay or complicate wound healing. Nicotine is the biggest “NO” out there, but you should also monitor your intake of caffeine (like that coffee we talked about), alcohol, and excessive salt and sugar. A balanced diet of fresh fruits, veggies, and lean protein is almost always best.

What about lymphatic massage? We get asked this a lot. Lymphatic massage purportedly helps relieve pain and swelling, break up scar tissue, and improve blood flow to the area, thus promoting healing. There isn’t much data available to back up these claims, but some people swear by it (while others find it painful). We tell our patients they are welcome to try it if they’re interested, but we can’t promise any specific results from it.

Post-procedure depression can happen.

A lot goes into your emotional wellbeing after surgery, such as a personal history of depression/anxiety, reaction to medications, concerns about recovery, feelings of guilt for depending on others, or financial stress. For some people, these negative emotions can linger to become post-op depression. If you can’t shake the negativity or if you’re having excessive fatigue, changes in appetite or sleep, increased irritability, or any other symptom of depression, it’s important to get the help you need. Talk to your doctor if you have concerns about post-operative depression.

Good help will be invaluable and meal prep is a life saver.

In the days leading up to your surgery, go over your needs and expectations during recovery with your primary caregiver. Will you need dressings or other supplies? Get them now. Depending on the surgery, you might want to have gauze, medical tape (look for soft fabric or paper tape, not plastic), and maybe some “chux”/puppy pee pads  – those absorbent pads you can put down to catch drainage, etc. Have some gloves available if you need help with dressing changes. Check with your doctor to see what you might need. Don’t forget your personal hygiene needs during this time as well. You might want to pick up some dry shampoo, baby wipes, or body powder if full showers are limited. A bidet attachment on your toilet might be worth the investment – they’re under $50 and easy to install. Do you have periods? Stock up on your supplies and discuss any assistance you’ll need with your caregiver.

Also use this time to meal prep – whip up some big pans of lasagna or casserole to freeze for later. Stock up on easy to eat, nutritious foods like whole grain toast with peanut butter, soups, and produce. If you know you’re prone to nausea, crackers and ginger ale are good to have on hand. Fresh out of anesthesia, the B.R.A.T. (bananas, rice, applesauce, and toast) diet is nutritious and easy to digest.

One last consideration is maneuverability in your home. If you’re going to need assistance – whether it’s another person or it’s equipment like a walker or crutches – you’ll probably need to make space. Take some time to move trip hazards like area rugs or power cords and consider if you’ll need things like grab bars in your shower or near your toilet.

Written by Jennifer “Coop” Cooper MS, APRN, AGACNP-BC, Sergeant, US Army (veteran)

Click here for the original blog post written by Jennifer Cooper MS, APRN for BuildMyHealth.

The post Postop Recovery Tips first appeared on Plastic Surgeon San Francisco | Pacific Heights Plastic Surgery.

Myths after surgery: Don’t get your incisions wet!

How many times have you been told not to get your incisions wet?! And while I’m only speaking on behalf of me and my patients, what is so terrible about getting incisions wet? If you don’t get them wet, does that mean it’s better to allow them to get sweaty and grimy after several days of not bathing?!

I think getting incisions wet can be a good thing in the right circumstances. For example, we tell our patients to shower the night after their surgery, as in, later that day. Specifically, we recommend showering and letting antibacterial soap and water run over the incisions. This keeps them clean and washes away any drainage or “sitting” grime. While we’re big fans of showers, we don’t want patients taking baths initially. Compare the two. Showers allow bacteria to wash off the patient. Baths on the other hand result in patients submerging and soaking in their own dirty water! Big difference in which one contributes to infection.

Myths after surgery: You can’t reach your doctor

Since I began practicing, I call our cosmetic patients after surgery. In the process of calling them, they can see my number. That way, they can reach me if necessary. After surgery, patients are scared and don’t always know what to expect.

So I say it’s better for them to have the doctor’s number to reach out for any concerns. Could that be painful with patients calling all the time? I guess it’s possible but most patients don’t call, they text. And thus far, they are respectful of not over-texting. An open line of communication avoids a lot of problems. Because if a patient can’t reach the doctor, they’re more likely to go to the ER. Which is a huge waste of time and money.

Consider the options. Responding to a simple text and allaying a patient’s concerns. Or allowing things to escalate wherein they go to the ER. Then the ER calls you and you have go in to the ER and address an unnecessarily overblown issue that could have been addressed via text. It’s a no brainer.

So when considering who you choose as your doctor, ask if you’ll have easy access to them after surgery. Or will you have to go through multiple layers of bureaucracy… the last thing you want to do while recovering from surgery!

Click here for the original blog post written by Dr. Kaplan for BuildMyBod.

The post Dispelling two myths after surgery first appeared on Plastic Surgeon San Francisco | Pacific Heights Plastic Surgery.

Postop recovery on the cheap!

As the video below suggests, there are two options to accomplish each postop goal. When it comes to where you recover, sure, you can go to a postop recovery “house.” These can be expensive and the level of care is not always assured. You may be best simply going home and getting in your own bed initially. But don’t stay in bed too long. You should also get up and move around to avoid getting blood clots in the legs.

The other potential problem with a recovery house is they may do something different than what your doctor recommends. Whereas if you go home and do what your doctor tells you to do, there’s no one suggesting otherwise.

To buy a booty pillow or not to buy a booty pillow

There are many websites that sell booty pillows for your post-BBL recovery. The idea is that when sitting on a booty pillow, it keeps the pressure off the buttocks while recovering from a Brazilian Butt Lift. The reason sitting directly on the buttock is supposedly bad is it hinders blood supply to the newly transplanted fat cells.

Rather than sitting on a booty pillow to reduce pressure, you can sit on anything that accomplishes this same goal. For example, you can take the decorative round pillow from your couch and place it under your thighs. This will provide the same result.

Check out the video below to see our perspective on a host of other recovery options.

Video: Keeping it real during your postop recovery

Click here for the original blog post written by Dr. Kaplan for BuildMyBod.

The post Postop recovery on a budget [video] first appeared on Plastic Surgeon San Francisco | Pacific Heights Plastic Surgery.

We had a recent postoperative patient compliment us on our blog and how informative it is. However, she pointed out that one thing she couldn’t find was a blog post on what to expect after surgery. So here goes!

What you should expect from yourself and your surgeon after surgery

This listicle should serve as a general outline of expectations after surgery. These include things you shouldn’t be surprised about also what you should expect from your surgeon.

1. You may have drainage from your incisions regardless of the type of surgery. That’s normal.
2. You may have redness immediately around your drain or incision but that often represents inflammation not infection. If the redness spreads further, contact your doctor, which leads to the next expectation…
3.  You should have access to your doctor after surgery either via text, email or phone. It’s the 21st century! There’s no excuse for not being able to get in touch with your doctor after surgery.
4. Pain is normal so take pain medication as needed. But don’t set an alarm to wake up to take pain medication because if you’re sleeping, you’re not in pain.
5. Have some gauze available at home after surgery.
6. After a breast reduction, breast lift or tummy tuck, the incision may have some pleating. That’s normal and will flatten out with time.
7. If you have a breast augmentation, it’s normal for the implants to sit high initially but don’t worry, they will drop.
8. Drains need to be “stripped” or “milked” to avoid clotting.
9. It’s critically important to walk around after surgery to avoid blood clots in the legs.
10. Ask your doctor, but showering is recommended in our office to keep incisions clean.

Again, see what your doctor recommends but if they don’t provide you with a way to contact them postoperatively, seek out another doctor!

Click here for the original blog post written by Dr. Kaplan for BuildMyBod.

The post What you should expect from yourself and your surgeon after surgery first appeared on Plastic Surgeon San Francisco | Pacific Heights Plastic Surgery.

1. The pills

The Goodie Bag should have pain medications (Percocet). No, not a prescription! The actual pills. The doctor’s office can include an extra written prescription in case the patient needs just a little more pain management after surgery, but the initial supply of pain medications should be right there in the bag. Additionally, they should include anti-nausea medications for those patients who are sensitive to opioids. This way, there’s no need to stop by the pharmacy on the way home from surgery. Patients can just head home and get some rest.

2. The garments

Right after the procedure, the patient is typically dressed in a post-surgical garment to preserve the surgery. However, the Goodie Bag should contain a second garment so that the patient can alternate between washing and wearing them. For my patients, I suggest our patients wear their garments for at least a month after surgery, so having two of them is useful. Plus, the last thing we want is for our patients to be wearing dirty garments after their surgery! The only time the patient takes off the garments are while showering.

3. The scar cream

Doctors want those incisions to be as invisible as the patients do! The Goodie Bag should contain Silagen scar refining cream. It is a 100% pure silicone gel that will help flatten, soften and smooth scars, while reducing redness, discoloration, itching and pain. It also increases hydration to provide an optimal environment to normalize collagen production. We personally advise our patients that they can start applying this gel two weeks after their surgery to help minimize the appearance of their surgical incisions.

4. The instructions

Lastly, but most importantly, the patient should go home with specific instructions regarding their procedure. It may be hard to remember all the instructions given by the staff and surgeon after waking up from anesthesia. So it’s best if it’s all written out for the patient and family. It should have the date and time of the patient’s first postoperative follow up appointment.

What’s in your Goodie Bag?!

The recovery time after surgery isn’t the easiest or most pleasant experience. But hopefully these little things can make a difference!

Thanks to @japsiecam for writing this article!

Click here for the original blog post written by @japsiecam for BuildMyBod.

The post What’s in your goodie bag?! [video] first appeared on Plastic Surgeon San Francisco | Pacific Heights Plastic Surgery.

While not everyone wants a bigger butt, keep in mind that many want a more shapely figure. That means the buttocks don’t have to be huge but some volume will help patients fit their clothes better. In other words, don’t judge!

How to sit after a BBL video

As showcased in the video above, you want to avoid direct pressure on the buttocks for about six weeks. That means laying on your side or on your stomach. However, what do you do for work? You probably can’t stand at work all day. As seen in the video, you can place a narrow or round pillow under your thighs. That way when you sit, you’re placing pressure on the thighs, not the buttocks. May seem awkward at first but it also has the benefit of encouraging good posture.

To check pricing on a BBL from Dr. Kaplan, click here.

Click here for the original blog post written by Dr. Jonathan Kaplan for BuildMyBod.

The post How to sit after a BBL [video] first appeared on Plastic Surgeon San Francisco | Pacific Heights Plastic Surgery.

Why do surgeons hate fingernail polish for surgery?!

One of the least invasive ways to monitor the oxygen level in your blood is with a pulse oximeter. See the photo above. A pulse oximeter, or ‘pulse ox’ for short, lightly clamps onto the finger tip and monitors the level of oxygen in your blood in real time. This is certainly easier than drawing blood from the patient’s artery every time the anesthesiologist wants to check the level of oxygen.

The pulse ox needs clear access to the blood vessels in the fingertip and nail polish can affect the readings. This study set out to assess how these 10 different colors affect pulse ox readings:

“Ten different colors of Wet ‘n’ Wild (Pavion; Nyack-on-the-Hudson, NY) fingernail polish were used: red, yellow, dark blue, green, black, purple, fuchsia, light blue, brown, and white.”

According to the study, black and brown were the only colors to alter the readings to a statistically significant degree. However, even in those circumstances, if the pulse ox was placed on the finger in the ‘side-to-side’ direction rather than the normal ‘top-to-bottom’ direction of the finger, the readings were again accurate.

So next time you go to surgery, you have 3 options:

1. 1. don’t wear any nail polish.
2. 2. allow the OR staff to remove your nail polish.
3. 3. argue with the staff and cite this article and tell them to place the pulse ox in the side-to-side position if you’re wearing black or brown nail polish. Or the top-to-bottom position if wearing any of the other 8 colors above.

 
I would recommend against the 3rd option. Arguing with OR staff before your operation is bad karma!

Click here for the original blog post written by Dr. Jonathan Kaplan for BuildMyBod.

The post Do you really need to remove fingernail polish for surgery? first appeared on Plastic Surgeon San Francisco | Pacific Heights Plastic Surgery.

What to wear for surgery

Determining what to wear for surgery requires knowledge of what happens in the operating room. Obviously the surgeon needs access to the area where the operation is occurring. Is it the chest, arms or abdomen? Maybe the face. So you want to make it as easy as possible to get out of your clothes upon arrival. But more importantly, you want to wear clothes that are easy to get back into after surgery.

For example, if you’re having facial surgery, you should wear a button down shirt so you don’t have to pull a shirt over your head. If you’re having breast surgery, there’s no reason to bring a bra because your surgeon will probably place a postop garment on you after surgery. There’s no need to wear tight jeans because you don’t want to put yourself in the situation where you have to struggle to put your pants back on. In light of these situations, you should focus on baggy clothing. That includes a button down shirt for the reasons mentioned above and sweat pants. Slip on shoes are best so it’s easy to get back on after surgery.

But what about accessories?

I know you want to look as pretty as possible for surgery but you really don’t need to wear any makeup or jewelry. It’s best if piercings are removed but I understand non-traditional piercings can be difficult to remove. For patients that have nipple rings, we cover these with a sterile dressing during surgery if we’re not making incisions around the areola. By allowing the patient to keep those piercings in place, there’s less frustration for the patient and it avoids a delay in surgery trying to get them out!

Don’t forget to wear similar loose-fitting clothing for your postop appointment so it’s easy for your doctor to examine your surgical site. Best of luck!

Click here for the original blog post written by Dr. Jonathan Kaplan for BuildMyBod.

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