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Dr. Joseph M. Perlman Advanced Plastic Surgery Centre

Choosing a Surgeon

I see hundreds of patients in my practice every year who want body contouring. By that, I mean liposuction, tummy tucks, and removal of excess skin and fat from the upper arms and thighs. Some of the patients are overweight, and others have lost significant weight through diet and exercise, or surgical procedures such as gastric banding and gastric bypass. Most of the patients follow an exercise regime and diet to some extent. I explain to my patients that surgery is not an alternative to proper diet and exercise. It is not a quick fix. There are some patients who are extremely overweight and need to be “debulked”, to reduce their overall size, so that they can exercise properly. Others are extremely self-conscious about their appearance and would exercise more if they weren’t so heavy.

It’s important that patients continue to exercise and eat properly in the perioperative period. Having good muscle tone and good cardiovascular capacity will help them through the postoperative period. Proper nutrition is essential to good healing. I encourage my patients to eat a lot of fresh fruits and vegetables, particularly during the summer, as well as have adequate protein intake with fish, meat, and soy products. Multi-vitamins are also important since many patients are lacking trace minerals such as zinc in their diet. Iron supplements are important, especially for women and endurance athletes such as long-distance runners, cyclists, and swimmers. Those athletes tend to be on the anemic side. Being anemic limits the oxygen-carrying capacity of your blood and could affect wound healing.

My patients who are active exercisers always ask “When will I be able to start exercising after surgery?” I try to encourage them to be up and walking on the day of surgery to minimize the development of venous thrombosis (blood clots) in their legs as well as to improve their breathing and decrease the chance of developing postoperative respiratory problems. More extensive procedures such as tummy tucks will require limiting the exercise routine in the first 10 days. I follow my patients very closely in the early postoperative period and will gauge their progress and allow them to exercise accordingly. It’s important to start slow and gradually increase your exercise routine. I don’t want a patient to put too much stress on a suture line and increase the risk of hypertrophic scarring or wound separation.

Postoperatively, it is also important to drink a lot of water, to help flush out the anesthetic drugs from your system. Stool softeners and fresh fruits are important in patients taking painkillers like hydrocodone. High-protein diets and diets rich in vitamins C and E. are also important after surgery. I myself eat 5-6 small meals per day instead of large meals. I call it “grazing”, but it keeps your metabolism at a high rate and makes you feel less sluggish.

I always tell my patients that surgery is only part of the overall plan to improve their appearance. Proper diet, exercise, and a positive attitude are just as important in helping you to look your best and feel your best.