Preparation for mommy makeover surgery is critical to achieve optimal results and reduce risk of complications. The idea is to help the patient reach her highest normal range of health, says leading Inland Empire plastic surgeon Dr. Tarick Smiley.
Mommy makeover is considered a “large” surgery because it typically combines two or more procedures in one surgical setting. Common combo techniques include breast augmentation with lift, tummy tuck with some type of breast enhancement, and tummy tuck with liposuction of the flanks.
While any body contouring surgery entails being near one’s ideal weight, drastic weight loss in the month leading up to the operation is greatly discouraged because of the ensuing malnutrition, muscle loss, and possible dehydration (due to low calorie diet), which can all affect healing.
If the patient is overweight, weight loss should happen gradually (just 1-2 lbs. per week) and is started way ahead of the surgery.
Following superb diet months prior to surgery can also make a huge difference in healing. A good rule of thumb is to increase protein consumption (it should account for 15-25 percent of the total calorie intake) and avoid or at least limit processed carbs and foods high in refined sugar, sodium, and fats.
Some doctors recommend supplementation about a month before and after surgery to ensure that their patients are getting enough iron, vitamin A, vitamin C, vitamin B12, and other micro-nutrients that play a critical role in healing.
Before taking any supplementation or herbal remedy, a prudent patient should always ask for her doctor’s permission first. It is important to note that some vitamins and supplements are known to increase bleeding or interfere with anesthesia or painkillers.
Aspirin, non-steroidal anti-inflammatory drugs, anticoagulants, and some antidepressants can also increase bleeding and aggravate the amount of postop bruises. The general rule of thumb is to avoid them 2-3 weeks ahead of the surgery and about a week afterward.
Smoking also has detrimental effects on healing. Not only it increases the risk of bleeding, infection, and skin necrosis, it also makes smokers susceptible to heart disturbances and lung-related problems following a surgery. For this reason, complete cessation for a minimum of three weeks before and after surgery is critical.
Lab screening is another important aspect of preparation for mommy makeover. It is ideally performed not later than 10 days prior to surgery to ensure the patient has achieved her optimal health.
The preparation for liposuction aims to eliminate or at least control risk factors, allowing the patient to achieve optimal results from the surgery, as suggested by leading Beverly Hills plastic surgeon Dr. Tarick Smiley.
The list below explains a rather comprehensive guideline on how to prepare for the surgery.
6-12 months (mainly applies to individuals experiencing weight fluctuations)
As with any body contouring surgery, being near one’s ideal weight will play a crucial role in the long-term success of liposuction in which the superficial fat (beneath the skin, as opposed to the visceral deeper fat linked to obesity) is suctioned out with the use of a flexible hollowed tube called cannula.
The weight must be stable for a minimum of six months, although some patients are encouraged to wait a bit longer to ensure that they can stick to a healthy lifestyle, or their skin has fully redraped to their new contour (after weight loss).
Most experts suggest consulting with at least 2-3 doctors before liposuction or any other forms of body contouring surgery. The idea is to select the “best” surgeon based on experience (over a hundred procedures performed every year is the ideal scenario), eye for detail (before-and-after photos can shed light on this issue), and bedside manner (the surgeon must exhibit enviable qualities such as trustworthiness and respectfulness).
By three weeks the patient must have already chosen the surgeon who will provide her a list of lab tests (e.g., blood work) that will be required prior to surgery.
Most patients are instructed to discontinue all tobacco and smoking cessation products to prevent increased bleeding, poor healing, and higher risk of infection.
To further achieve optimal health, all products with blood thinning properties (a gamut of herbal supplements and vitamins, aspirin and aspirin-like products, ibuprofen and other non-steroidal anti-inflammatory drugs, contraceptive pills, certain antidepressants, etc.) are best avoided 2-3 weeks before surgery and about a week afterward.
The lab exam is a critical aspect in preparation for liposuction. Ideally, it is performed not later than 10 days prior to surgery to ensure that the patients are in their optimal health.
This period is also the best time to arrange for child or house care (patients should take it slow in the first three weeks postop to avoid healing problems); purchase all the necessary supplies (medications, compression garments, foods, bottled water, etc.); file their vacation leave; and make all the arrangements to allow for a convenient recovery.
Avoid or at least limit alcoholic and caffeinated drinks because they could interfere with anesthesia or cause dehydration.
All the “details” that can pave way for a more pleasant recovery are reviewed to ensure that nothing is overlooked.
Most patients are instructed to fast 6-8 hours before surgery. Furthermore, their last meal before liposuction should be light but still protein packed. Meanwhile, they should avoid foods high in processed sugar and fats because too much of these can suppress the immune function and aggravate the postop swelling.
Body lift after extreme weight loss entails advance planning to produce optimal results and prevent or at least minimize risk of complications. The goal is to achieve one’s optimum health and weight before any body contouring surgery is attempted, as suggested by celebrity Los Angeles plastic surgeon Dr. Tarick Smiley.
Dr. Smiley explains the most favorable “schedule” for body lift after extreme weight loss.
* Your weight has been stable for at least six months, although it would be better if you’re able to manage it for about a year or two—a strong proof that you can stick to a healthy lifestyle, which is the key to maintain the surgery’s results.
Aside from being near your ideal weight, it is also critical that no further [significant] weight loss is expected. The idea is to let your skin shrink to the best of its ability before attempting any body contouring surgery.
* Wait until you have achieved your optimal health. It is important to note that massive weight loss patients often have some type of malnutrition (anemia, muscle loss, and dehydration) because of their lower calorie diet. For this reason, even if you have already achieved your ideal weight you may still have to postpone your surgery until your body has adapt to your “new lifestyle.”
* Cooler weather, i.e., December through March, is generally perceived to be an ideal time to undergo most type of plastic surgery as it allows for bulkier clothing—e.g., thick trousers and sweaters—to hide obvious or sudden changes in your body. This is particularly true for anyone getting lower body lift, breast reduction, and tummy tuck.
Furthermore, cooler weather typically coincides with long holidays, allowing the patient to enjoy more time off.
* You are emotionally and psychologically prepared. Expect some postop blues, lethargy, excitement, feeling of doubt, resolution—pretty much mixed emotions—during the initial healing stage. Take note that having supportive family and friends can make the recovery less nerve-racking.
* You have time to recuperate. Rushing one’s recovery can have a detrimental effect on your healing. A good rule of thumb is to take at least a three-week off, avoid strenuous activities for about a month, and to expect lethargy to a varying degree for 6-8 weeks.
To avoid too much stress, you may ask to work part time or telecommute until you regain your preoperative energy level.
Facelift preparation primarily aims to prevent or at least reduce risk of complications, and thus allow the patient to achieve optimal results from surgery. Sometimes, it entails waiting until one has controlled certain medical conditions (e.g., hypertension and obesity) before going under the knife.
Inland Empire plastic surgery expert Dr. Tarick Smiley has explained the generally agreed upon guidelines on facelift preparation.
- Control medical condition prior to surgery
Patients with medical conditions known to increase the risk of healing problems are poor candidates for any type of plastic surgery such as facelift until these are controlled through medications, diet, weight loss, and/or lifestyle change.
Hence, it is of utmost importance to notify the surgeon if one has medical conditions no matter how seemingly simple or innocuous they seem. Previous surgeries, past and current medications, use of supplements, and smoking should also be disclosed to prevent risk of complications.
- Discontinue drugs known to inhibit healing
Some drugs and nutritional supplements are known to increase bleeding, interfere with anesthesia and painkillers, or cause cardiovascular disturbance. In general, these must be discontinued at least two weeks prior to surgery, and two weeks afterward or until most of the postop bruising has subsided.
Aspirin, ibuprofen, birth control pills, and a gamut of supplements including ginger, green tea, ginkgo biloba, kava kava, St. John’s wort, and ginseng are known to cause increased bleeding.
- Discontinue smoking and avoid second-hand smoke
While the general rule of thumb is to avoid tobacco products and second-hand smoke for a minimum of three weeks prior to surgery, some doctors are stricter that they require patients to discontinue them for a few months to ensure their “full commitment.” During the initial healing stage, i.e., 2-3 weeks postop, nicotine is best avoided as it is causes the blood vessels to shrink, inhibiting the oxygen-rich blood from effectively reaching the wound.
While sticking to a diet rich in micronutrients, i.e., vitamins and minerals, is the “universal” guideline, some doctors feel that increasing protein intake can also improve healing as it plays a critical role in tissue repair.
Meanwhile, it is best to avoid or at least minimize the consumption of salty, sugary, and highly processed foods because they suppress the immune function and aggravate postop swelling.
While many surgeons do not recommend specific or special skin care regimen, they all agree that using sunscreen prior to surgery can improve skin healing. It is important to note that excessive sun exposure can make the skin extra sensitive.
Others require mild glycolic acid and Retin-A treatment a month prior to facelift to promote collagen grown in the skin.
Preparation before eyelid surgery guidelines, as explained by celebrity Beverly Hills plastic surgeon Dr. Tarick Smiley.
* Review the patient’s medical history. Honest communications between the parties are critical to avoid or at least minimize risk of complications.
The surgeon must explain the possible risks (which come with any surgery) and the risk factors such as diabetes, blood disorder, allergies, glaucoma, dry eyes, and thyroid problems.
* Listen to the patient’s personal preference and cosmetic goals. Both parties should agree on the same aesthetic problems that can be realistically improved by eyelid surgery.
* Conduct physical and vision exam. It is important to get the tiniest anatomical details and eyelid dimension to achieve the desired result. Occasionally, a vision test is also needed to support insurance claims.
Should the hanging upper eyelid skin affects the patient’s peripheral vision, insurance may cover the cost of surgery, provided that there is medical documentation demonstrating that the procedure is medically necessary.
* Be honest and tell every thing to the surgeon, particularly pertaining to medical conditions, use of drugs (prescription, recreational drugs, and supplements), and cosmetic goals.
The patient must notify his doctor about her use of medications (including tobacco products and herbal supplements), previous surgeries, and past and current medical conditions.
* Discontinue blood-thinners that include but not limited to ibuprofen, aspirin, and naproxen. Some herbal supplements and homeopathic remedies are also known to increase bleeding. For this reason, a prudent patient will only take medications approved by her doctor.
* Arrange for at least a two-week off. Most of the swelling and bruising is gone after two weeks, although some patients may choose to return to work after 5-7 days. Meanwhile, it is best to avoid strenuous activities for at least three weeks to prevent healing problems.
* Quit smoking. A good rule of thumb is to avoid smoking for at least three weeks. It is important to note that tobacco products contain nicotine, which is a very strong vasoconstrictor—i.e., they cause the blood vessels to shrink in size. For this reason, smokers generally experience poor healing and higher risk of unfavorable scars, infection, and skin necrosis.
Preparing for body lift surgery may vary from patient to patient. Nonetheless, the goal is to avoid or at least reduce the risk of complications such as poor healing, nasty scarring, and infection.
Leading Brea plastic surgery expert Dr. Tarick Smiley explains the details involved in preparing for body lift surgery, which is generally performed after massive weight loss (i.e., shedding 80 pounds or more of excess weight either through “traditional” or natural methods or bariatric surgery).
Before-and-After Photos of a Satisfied Patient Who Have Had Body Lift Surgery After Massive Weight Loss
- Initial consultation and medical evaluation
During consultation, the patient shares his goals, medical history, use of drugs, and concerns. The collected information will then allow the surgeon to assess the type of medical evaluation (i.e., lab tests) that would be appropriate.
Lab tests typically include CBC, blood chemistry, stress test, and EKG. But to further ensure patient safety, some doctors even require medical certification from bariatric surgeon, endocrinologist, cardiologist, and/or primary care physician.
- Stop tobacco and smoking cessation products
Smokers must stop tobacco and smoking cessation products like nicotine gums and patches for at least 3-4 weeks. It is important to note that even a few “sticks” can have a detrimental impact on healing.
- Avoid aspirin, diet pills, certain herbal supplements and vitamins
These can delay healing and increase the risk of bleeding. Hence, during consultation the patients must disclose their use of medications, including “natural remedies” (herbal and homeopathic supplements) and recreational drugs.
- Achieve one’s optimal health and most stable weight
Ideally, the weight should be stable for at least a year before any type of body lift surgery is considered. Occasionally, it is even recommended to wait longer to ensure that the patient has recovered from malnutrition (example: iron deficiency) resulting from massive weight loss.
Aside from proper diet and regular exercise, achieving one’s optimal health may also require the use of vitamins and supplements, which must be tailored based on one’s specific needs or health status.
- Create a strong support system
Preparing for body lift surgery requires creating an environment that will make recovery a more convenient and less stressful experience. A good rule of thumb is to assign capable adults (several people if possible) who will provide care and emotional/physical support during the most critical stage of recovery (1-2 weeks).
Sometimes, professional nursing might be a better option, particularly if the availability or “stamina” of the caregivers is an issue.