Medical & Trade Publications

September 2006

by Amy M. Ortega, M.D.
Medical / Plastic Surgery

Great Expectations

While on the elevator going up to my office, out of the blue, someone asked if I could perform miracles!

The answer, of course, is "no". I can make a nice improvement, but not perform a miracle.

Cosmetic plastic surgery is about looking like yourself, just a little better. It's making the most of what you have. It's the best that you can look for your body type, weight, skin type, age, etc. I always tell people I can only work with what you bring in the door.

This is true for demeanor as well as physical features. A person may bring good communication skills, a great attitude, and realistic expectations. On the other hand, she might bring impatience, depression and a secret hopefulness that her surgery will save her marriage. Which patient is more likely to be happy with the results?

Preparation

"Preparation is the only shortcut you will ever need to take."

This was plastered on the wall in a tiny rat lab in Louisville, KY, where surgeons from all over, including myself, travel to spend a week learning micro-surgery. (I will save the lab and rats for another day.) The quote, however, will always stick out in my mind, and I think of it every time I encounter someone who is simply unprepared.

I tell my patients that it's all about how you prepare yourself physically, mentally and emotionally for cosmetic plastic surgery, which will greatly affect potential results.

Patients should consider the true motivations for cosmetic surgery and make sure they are doing this for themselves and not for anyone else.

Physical preparation

There really is something to just taking good care of yourself. Exercise. Eat right. This is common sense. Take a multivitamin. Do not take a bunch of high-dose vitamin or herbal supplements. Many of them thin the blood and/or could make you very sick.

The key is everything in moderation. Getting to a weight proportionate to your height is ideal. If a patient is not in that club, then he or she needs to get to a stable weight. Patients shouldn't stress over losing those last 10 pounds before a consultation or surgery. In my experience, it doesn't make a difference in the results.

If a patient has ongoing medical problems (e.g., diabetes, etc.), he or she should visit with a primary care doctor to get things under control. And if the patient is a smoker, he or she must quit, and not just for cosmetic surgery.

However, since we're talking about cosmetic surgery, then I must emphasize strongly that smoking can greatly increase the risk of complications such as healing problems, producing open wounds. This is because of smoking's effect on the blood supply to the skin. The substances in cigarettes cause blood vessels to constrict, lessening the blood flow all over your body. This doesn't sound like much until you envision an open wound on your face, say, after a facelift. Just quit smoking!

Mental preparation

There are two components to mental preparation: gearing your thought process in a positive way, and educating yourself about what you are about to do.

Many people suffer from depression and have moods that go up and down. If that's the case, then the patient should visit his or her doctor to get that under control. In addition, worriers need to educate themselves well enough to be informed and confident.

Each patient should have a 'support person' who will help them through the entire surgery process.

I tell my patients to prepare for their consultations by bringing their lists of questions and open minds. You may think you need one thing, however, your doctor may not agree.

I try to listen to where my patients want to be, and then tell them the best way to get there. However, to accomplish this, patients must be prepared to tell the surgeon where they want to be.

"I need liposuction," isn't enough. "I would like to have a slimmer waist," makes more sense. After all, patients visit the doctor to get an experienced opinion, not to tell them what to do.

I tell my patients to have an end-result in mind and be able to communicate it. This helps the surgeon recommend the best way to go.

Emotional preparation

I recommend to patients that if they have anything major going on in their lives that is constantly on their minds, to try to resolve it prior to surgery. Patients have enough stress thinking about surgery and recovery without worrying about other things.

Patients should consider the true motivations for cosmetic surgery and make sure they are doing this for themselves and not for anyone else. It will not buy happiness, get you a new job, or save a marriage.

Make sure expectations for results are realistic. Expect improvement, not perfection.

Patients should identify a "surgery support person." To start, discuss plans with a significant other or best friend. Ideally, this person may be the one taking you home from surgery and taking care of you.

Take your support person with you to your consultations and preoperative visits. This person is there to be your cheerleader. It is best to discuss your plans with them ahead of time and determine whether they are qualified for the job. If you have a stick-in-the-mud who cannot really offer support, patients should graciously find someone who can be there for them.

As with all aspects of health and life, I remind the patient to do his or her part to help the cosmetic surgery experience become a success. It will make all the difference.

Amy M. Ortega, M.D., is a board-certified, double-fellowship trained cosmetic plastic surgeon with special interest in cosmetic surgery of the face, breast and body. Her office is located in Franklin and Nashville Tennessee, GA. To reach her, call (404) 751-2500. For more information about Dr. Ortega, visit her website, www.franklinplasticsurgery.net.