Many times patients want to address multiple parts of the body at once. “this combination like surgery in women can often referred to as mommy makeover” with massive weight loss patients it may include addressing the trunk as a whole, arms & legs in a separate operation. these procedures “require a lot of time in the operating room and a little bit longer of a recovery” and planning for those is very important so helps to have an infrastructure available (their office and staff).
Mommy Makeover — for their patients, they typically keep a patient overnight after surgery in their recovery suite “so that we can maintain the patient in a comfortable environment and monitor them” and keep them safe and look out for anything odd “because usually if something is going to happen in the recovery period, it happens within the first 24 hours”. after that, patient goes home and then comes into the office the next day and then check in once or twice a week to monitor healing. “We encourage all of our patients to move and be active” after surgery because it helps to promote healing. He and his colleagues are very intense in the recovery process and the progressively they back off as the patient returns to normal activities.
Important for combination procedure patients that after they achieve their surgical goal “to reinvent themselves from a lifestyle standpoint” in order to complement their surgical outcome in order to really achieve full rejuvenation. It’s the important thing to get a great result.
“We always tell patients that we do 70% of the work and the other 30% of the lifting is going to be on them”. After recovery and things are stable, patients who go the extra mile to “protect their investment” such as improving their lifestyle through healthy diet and consistent exercise. they actually have a wellness program in their practice with a wellness physician who will do a deep dive into the patient from all angles including body composition, metabolic rate, VO2 Max and lab values for lipids and inflammation and “adjust a patient’s lifestyle in combination with surgery so that you get a synergistic effect”. So, if you compare a patient on which they just did an abdominoplasty versus a patient on whom they did an abdominoplasty and wellness deep dive with subsequent lifestyle changes, the first result may be amazing but the later is jaw dropping and almost feels not real. Combination of the two works better than surgery alone. “it’s changed us because we’re actually helping our patients from an overall health standpoint”.
For patients with facial aging, there are a lot of thing that can be done. They have quite a few new devices but sometimes, the ideal treatment is the classic face and neck lift. While they are thought of as a “big” procedure, one of the more amazing things is that it can sometimes be performed under local anesthesia with a pretty well tolerated recovery “there’s typically very little pain. From the standpoint of performing daily activities, you can do most normal things”. There can be bruising and swelling so you may decide to hide out so that no one knows that you had a facelift. There are some external sutures that will come out at 2 weeks post op at which point, you will begin to look more normal. But the nice thing about the new facelifting techniques today is “gone are the days when we were just pulling people back”. Really what doing is resetting the clock back and have patients bring in photos of when they were younger in order to mimic that look by repositioning the skin and soft tissue pulling in same vector as the same face — and adding back a little fat with micro-fat grafting so adding fat where volume has been lost such as around the temples, cheeks, nasolabial folds, lips. “and really what we’re getting is a much more soft, natural looking result” that people don’t necessarily notice. The days of pulling tight and looking like you had a facelift are gone. “patients don’t want an unnatural looking result. patients want to fly under the radar and look like themselves”. SMAS layer.
“We want our patients to look beautiful, natural and not look operated on and with the different techniques that we’re using, we’re avoiding that”. Patients will often ask how much younger am I going to look? Giving them a firm number is difficult but 10-15 years is typically. However, also depends on where the patient is on the aging spectrum. If the patient has a ton of loose skin, getting rid or improving the turkey waddle, for example, can make a patient feel 20 years younger. “I think it’s a little bit variable. One of the things that I really try to stress is that this is a long term relationship” so he will do tweaks after the facelift to maintain your results.
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