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Podcast: How NOT to Ruin Your Plastic Surgery Results

Home/Blog / Podcast: How NOT to Ruin Your Plastic Surgery Results

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No matter who does your surgery or how smoothly it goes, recovery always comes with risks. So why not control what we can? 

Dr. Houssock and Val share the most important plastic surgery recovery do’s and don’ts, so you can heal safely and get the best results possible.

We’ve got you covered in the operating room, but recovery? That’s on you. Think of it like training for a marathon: you need to fuel up on protein, get your body ready, and plan ahead.

Find out what to do:

..And what NOT to do:

Transcript

Dr. Houssock (00:04):
You are listening to another episode of Perfectly Imperfect. Hi Val.

Val (00:09):
Hi Dr. Houssock.

Dr. Houssock (00:11):
Welcome back to the Perfectly Imperfect Podcast.

Val (00:15):
Thank you for having me again. I’m excited to be here.

Dr. Houssock (00:18):
It has been so long since I’ve seen you a good 30 seconds since we left the OR together.

Val (00:22):
Yeah, I got fresh hat hair.

Dr. Houssock (00:24):
I know we were supposed to record yesterday and we were all ready to go and then we just had a technical difficulty and so I had my hair done, my hair was done, we were ready and here we are. And so we’re fresh out of the operating room, patient’s still recovering and if there’s nothing more real than a podcast that is just done like this, so.

Val (00:47):
This is us baby.

Dr. Houssock (00:48):
This is us, this is us. So we love this topic. We love a lot of topics, but Val and I are really passionate about this topic and it means a lot to us because we talk about how outcomes are created in or all the time, and there are parts of your outcome that we are responsible for and there are parts of your outcome that you are responsible for. And so today we’re going to talk about the part that you are responsible for. When Val and I prepare for surgery, it’s like the number one thing we’re thinking about, right?

Val (01:27):
Definitely. Absolutely. Because if you’re prepared, everything is going to come into place, your recovery is going to be great, your whole experience is going to be great. So it all starts as soon as you book that surgery preparation starts.

Dr. Houssock (01:41):
Yes. And I would argue that while I appreciate Val’s positive attitude of it being great, what it really is is that you’re going to minimize your risk and you’re going to maximize your outcomes. And so there is a part of your recovery that neither we or you have control over, and that is what your body does naturally, and that’s a part of surgery that is the risk. And every surgical procedure has that risk. Doesn’t matter who’s doing your surgery and it doesn’t matter how good you take care of yourself, there are risk of complications that we can’t control.

(02:19):
And because of that, if we know that there are definitely at baseline already risks, why not minimize the things that we can control? So we’re going to go through some good do’s and don’ts. What you can do to really maximize what your outcomes are going to look like and then what you shouldn’t do. So the do’s and don’ts are super important. When we meet in consultation, we really do start going over a lot of this stuff, but then Val takes over and Val gets on the phone with you. We also give you documentation to tell you this as well, what things you should and should not do. But we really do bang this into you to the point where if our rules aren’t followed, we know that we’ve done the best we can preparing you. So it’s on you, baby. It’s on you, right?

Val (03:06):
Absolutely.

Dr. Houssock (03:07):
So the first thing I’m going to do is I’m going to talk about nutrition and I’m going to take that one because we have a lot of patients now coming in with these miraculous changes when it comes to their health and wellness when it comes to weight loss. And we are full supporters of this new generation of medications that is able to take you on that weight loss journey and we are huge proponents of great diet and exercise and maintaining health. But one of the things that you have to think about whenever you’re doing any type of weight loss program, whether it is using medications, if it’s gastric bypass, if it’s you’re just doing it on your own, a simple diet and exercise regimen, is that you have to put yourself in a deficit in order to get your weight to come off. That’s just how it works. So that’s great for weight loss, but that deficit is not great for surgery. So number one in nutrition is that I tell patients that they need to prepare for their surgery like they’re preparing for a marathon. So what do I mean by that? You need to maximize your nutrition when you’re preparing for recovery and healing.

(04:12):
So we need high protein, we need you to not be in a deficit. Your body has to have the nutrients that it needs in order to heal your wounds and minimize your infection rate. And so you cannot come into the surgery in a deficit. So we ask you to do your weight loss and when then we ask you to stabilize with a stable diet and exercise for a good three months before you dive into surgery. And then if you happen to be taking medications for weight loss, we usually have you hold them before and after surgery for how long, Val?

Val (04:43):
So we usually have them stop them two weeks before and then resuming two weeks after.

Dr. Houssock (04:47):
Yeah, and the reason for that is number one, the two weeks before is because we want to make sure that you have the appetite you need to maximize what you’re eating. You’re taking in good protein, you’re not at that deficit. But also for anesthesia purposes, one of the other things this medication does is slows your transit time of your bowels, meaning that things will stay in longer and we worry about that with the risk of what’s called aspiration in the OR. And so we don’t want you to have that risk during the operating room, so we say hold that for two weeks. And then the two weeks after is directly related to your wound healing. I want you to be hungry, I want you to eat well. And so I’m not telling you that you can’t go back on it, but I am saying that I do want at least two weeks after surgery to make sure that you’re healing well before we let you get back on that weight loss medication, which may hinder your appetite.

Val (05:35):
Yep, definitely.

Dr. Houssock (05:37):
What about all those recovery items and things that they need, Val? How do you go through that when you call them and go through it with them?

Val (05:44):
Depending on what type of procedure they’re getting, when we first talk to them a month in advance, we go over this so they can prepare and do all their necessary shopping. So some of the prescriptions will come from us and then over the counter stuff they should get is Tylenol, ibuprofen because we love rotating between those two medications along with the narcotic. When you’re rotating between those three medication, that really helps with pain management and the inflammation for sure. Then obviously after surgery, starting back on your vitamins and supplements also too will help with recovery as well to get all those good nutrients for sure. As far as sleeping, a lot of my patients will get the wedge pillow to help prop them up really well and keep the nice and comfortable because ideally patients are not going to sleep how they normally sleep after surgery.

(06:30):
So having that support either in a recliner or propped up in bed can really help with getting them good sleep because sleep is important for recovery. So that’s why I always like to make sure that you’re nice and comfortable at home and you have a good setup where you’re going to sleep. Other items, it’s good to have bandages or gauze pads just in case if you need to change anything kind of topical creams like A + D ointment or bacitracin is also good to have on hand. Obviously we’ll let you know when it’s safe to start using those things, but I think it’s good just to be prepared to have that stuff. Ice packs, gel packs, frozen veggies, ice is your best friend as far as helping with swelling and inflammation as well too. So we really love icing starting as soon as you’re leaving us and you’re discharged and really doing it as long as it feels good. If patients are preparing with these things, they’re going to be pretty good afterwards as far as staying on top of their recovery.

Dr. Houssock (07:26):
The good news is that those things are easy to get and it’s always nice to just have them ahead of time. The vast majority of patients who we take care of need those things. So having a little kit for yourself ready to go is just going to make it easier for when you head home. We do provide you of course the prescriptions that you need ahead of time and so you’ll be utilizing those on top of everything else. We do provide you with a compression garment that you’ll leave the operating room with, but then sometimes as things are progressing, I’ll suggest things as I see you that you may want to get. And it’s so easy these days to get things from Amazon that most of the time you can have it next day. So it’s not like you have to stress about that. And I think the most important thing is is that we’re going to give you everything you really need. There are things that of course make life easier, like she said, the ice packs, the wedge pillow, the basic over the counter medications, but when it comes to the stuff you really, really need, we’re going to be providing that to you so you don’t have to stress too much about that.

Val (08:28):
And then going back on nutrition, I love when patients prepare food ahead of time.

Dr. Houssock (08:34):
Good call.

Val (08:34):
That way they can cut down the amount of work they need to do during recovery. So if you have the time before surgery and you gather the foods you like, increasing your carbs and your protein for good nutrients, trying to prep that food beforehand just really minimizes that stress and it’s done. You get home and it’s all set.

Dr. Houssock (08:55):
Totally. And that goes back to just having life prepared. So it’s easy to say you want to have a surgery and you’re excited to do it, but we always, always, always say, have surgery when it makes sense for you and your family.

Val (09:08):
Absolutely.

Dr. Houssock (09:09):
You might want to have surgery next month, but if the truth is is that your children are going to be better taken care of during the summer months and you have more support then and then you can take more time off, then we always, always suggest, we always say we’re not going anywhere. Make sure that everyone is on board that really is a do, have the support planned. Everyone has to be in your corner. You have to have support for the children if you have them, the pets if you have them because you’re not going to be able to walk them like you typically do. Your house is going to have to have people who do the things around the house. You need to plan ahead and that may or may not be a spouse, it might be a friend, it might be a family member, but making sure that you plan to have someone there with you at least the first few days and then someone helping you to take care of stuff for the first few weeks. Right?

Val (09:56):
Yes, definitely minimizing that stress and that workload is really going to help just cut down all that and help but just recover so that you can just focus on that and not have to worry about anything else.

Dr. Houssock (10:07):
Totally, totally. And it’s kind of a non-negotiable, right? So yes, you need to have somebody come get you, but your recovery just starts when you leave us. And so during that time period you have to know and be prepared to ask for help and have all of that settled for you. And that’s a super super do. Have your village, you’re going to need a village for sure.

Val (10:27):
Oh yeah, definitely take a village for sure.

Dr. Houssock (10:29):
Another do, which isn’t so much that something you’d be ready for, but something that is really important on both my end and your end is your expectations of surgery. So what does recovery really look like? Are you understanding that you’re not going to be that after on the first day after a surgery? Those afters take weeks and weeks and weeks. So the photos are so important, and oftentimes Danielle will even show you photos of people in the mix of recovery. I oftentimes show patients on the table, not because I want to show what the result is going to be on a patient, but what you look like when you leave the OR, which is nothing like you will look like when you’re finally healed. So expectations are super important and we take that very seriously. So number one, what can you expect? How much pain will you be in? Which is oftentimes subjective, but we’ll talk about what to expect for pain, what to expect for the incisions? When will you feel yourself? All of those things, we will go through that. But I would say realistic expectations to what recovery is going to look like is also just as important as you being prepared for it, right Val?

Val (11:37):
Absolutely. And if you’re not prepared, then we’re not doing our job. And that is our biggest thing here is we want to make sure that you’re fully prepared so that way you have the best outcome possible.

Dr. Houssock (11:48):
Yeah, if I just say you’re not going to have any pain and then you wake up and you have all this pain, that doesn’t help anybody. It doesn’t help anybody. So I’m a stickler for that. I may be too honest about that and I don’t even know there’s such a thing as too honest because I think you should know what to expect. Generally speaking, there are some surgeries that really aren’t that painful and we’ll be honest about it. And then there are some that are surprisingly painful and we tell you that too.

Val (12:10):
And with the surgeries we’ve done, we’ve been patients too. So we’re always happy to talk about our experience too and what to expect and what worked for us during recovery, what didn’t work for us. So I’m always happy to share my experience so that way somebody else can do it better than I did it or just avoid things that they don’t really need to do.

Dr. Houssock (12:29):
A hundred percent. And some of the things that we do now for patients is directly related to what we experienced in our, as being patients. There’s bras that I suggest that I personally used for my recovery or compression that I used for my, so it is, it’s like, there’s nothing like being a patient. And so not only do we experience being the ones operating on you, but we have been through it. So that does help for sure. Alright, we’re going to switch a little bit to the things we don’t want you to do. So what not to do and these nots are probably, they might be more important than the dos. I’ll be honest. I’m going to just really dive into one of the more popular issues, which is alcohol and tobacco. So my rules are based on straight up science. I don’t make up my rules.

(13:23):
And so as frustrating as sometimes it can be for some patients and especially because not all surgeons will adhere to these rules. I am a stickler for science. And so number one, any type of nicotine, whether it’s vaping, gum, patches, et cetera, needs to be stopped at least four weeks before our operation. It needs to continue at least four weeks after. And there is a scientific reason for that. And the scientific reason is that the nicotine in cigarettes or vape actually can contract the miniature minuscule vessels at the edge of an incision. And when it contracts those vessels, the blood supply does not get to that area. So it will delay your healing, it will promote and increase your risk of infection and ultimately could lead to a worse outcome. So that is at the minimum and at the maximum, especially in places of the face, areas that are really tenuous with blood supply, it can lead to tissue death.

(14:26):
So nobody wants that. Nobody wants a dead face. So nicotine is a hard no four weeks before, four weeks after. It’s for your own good. It’s not negotiable. It’s absolutely not negotiable. So if you’re not willing to quit nicotine for me, then we aren’t meant for each other. That’s that.

Val (14:46):
It’s for your safety.

Dr. Houssock (14:46):
Correct. The other one that is a tough for some is alcohol. And this one is a little different. The reason for alcohol is for the thinning that it does to the blood and it can promote hemorrhage or bleeding. And so we do a lot of really large soft tissue procedures and additional bleeding in those areas can lead to major problems, can lead to hematomas. You having to go back to the operating room. And so for that reason we ask you to hold your alcohol two weeks before and then depending on the surgery, it’s usually a week or two after. It just depends on the operation. And I use my own discretion. That is also a non-negotiable. Yes, I can tell if you’ve drank. It can be dangerous to you if you have alcohol on board and I cut into your skin. And so we again are sticklers for that as well. And that’s all type of alcohol. It doesn’t matter what kind it is.

Val (15:42):
Yep.

Dr. Houssock (15:43):
What are your other real hard no’s Val?

Val (15:45):
Going off of the blood thinning, any aspirin products. So like aspirin, Aleve, Motrin, Excedrin, ibuprofen, Excedrin, all of those also thin your blood too. So ideally we’d like those to be stopped two weeks prior as well. And that’s also just to decrease complications with bleeding along with alcohol. Tylenol is totally fine. So if a headache does happen during that timeframe, we’re totally fine with Tylenol or acetaminophen, but those other medications I named do need to be stopped, especially since they cause blood thinning. So also vitamins and supplements, some of them can hinder clotting factors as well too. Just to be safe, we have all those stopped as well. And then I get the feedback, well what about preventing sickness and stuff? Well, if you’re eating well and you’re getting in those good nutrients, then you should be going into surgery healthy and in good shape and then not being prepared before surgery.

(16:36):
And I know when I do my phone call the night before if they read their instructions, Danielle’s really great about sending their consents and your pre and post-op instructions ahead of time. When I talk to you at four weeks before, I will ask you just to read everything ahead of time so that way when I do call the night before, I’m going to go through exactly what she sent and I can always tell who has read it and who hasn’t. So being prepared is just going to make this whole experience that much better and your recovery that much better. So we write these things up because it’s important and we take time in writing these things up to make your recovery easier. So definitely be good about reading all your stuff ahead of time for sure.

Dr. Houssock (17:17):
Yes, for sure. It’s like a what not to do. It’s, it sounds like a double negative, but it’s like if you’re not prepared, that’s not good. And I don’t mean this in a derogatory way. I always say this is not getting a manicure pedicure. You are having a surgical operation and sometimes that’s hard to disconnect from because it’s not a mandatory surgery, it is an aesthetic procedure. We’re an aesthetic practice. So you’re doing it for beauty or for some type of cosmetic purpose, but just because it’s for that reason and it’s not because your gallbladder removed does not mean that you don’t come with risk. You come with a lot of risk. So you have to take it seriously and we really want to make sure that you know that. Our number one is that you’re going to be safe. While I want to make you look beautiful, I also need to keep you safe.

(18:02):
And so you need to be on board with that. Absolutely, for sure. One another absolute no is starting physical activity or anything that I ask you to do too early. And we have seen it way too many times. I think we scare patients enough. I think we’re good at scaring you enough to make you understand. But there’s a real reason why we don’t want you doing physical activity too quickly. You can severely injure yourself. You could end up back in the operating room where not only is it more time that you’re having to now put into recovery, but also unfortunately financially you could really hurt yourself. And we’ve seen it. We’ve seen it where patients have started being active too early, lifting things too early and they end up back in the operating room with bleeding or some other type of infection or something else.

(18:52):
And there’s a real reason that we ask you to please listen to our, we’ve done this for years, it’s based on science and I promise you it’s not just to be annoying to tell you that you can’t get on the treadmill. There’s real reasons for it. And sure you could risk it and possibly be okay, but we’re not here for risk. That’s not the game we’re playing. So we’re here to make sure that you get the best absolute best experience and the best result in the safest way possible and you need to be on board with that. If you can’t listen to that, well we’re not for you. It’s just very simple. It’s very simple.

Val (19:30):
And that goes back to, with the heavy lifting, being okay with accepting help from others, going back to your village. So having that help will definitely decrease the amount that you need to do or lift. And then as far as working out, give your body that time to recover. And it’s not like when you go back to working out it’s muscle memory. So it’s going to come back and yes, it’s going to be slow, but you just need to listen to your body. Dr. Houssock and I love to lift. And that was the biggest thing too with surgery is not being able to do that for four, six weeks. It kind of messes with your head like, oh my gosh, I made all this progress and now I’m going to go back and not be able to lift anything and it definitely sucks.

Dr. Houssock (20:13):
But it’s wrong. I’m going to straight up tell you that that’s not how it works. So you say it sucks, Val, but that’s not how it works. Your body doesn’t work that way. Your body will probably really be encouraged and happy to have the break because most people who really stress about the lack of exercise for the few weeks really honestly needed it. And I will tell you 100% of the time, the minute you go back, you are probably better than you were when you left because you had the rest you needed. Not to mention, a lot of times I’m putting your core muscles back where they needed to be or I’m doing something that actually makes workout more effective. So it doesn’t suck because in the end you’re better for it. And the other part about it is is that as every single patient of ours who exercises gets really stressed about this lack of exercise for a few weeks, it’s very common. But I will tell you personally as a patient and I love exercise, once you’re in it, once you’re in your recovery, you do not miss it like you think you will. Your body doesn’t, you are so tired, you are sore, your body isn’t like, I got to get this done. Now there are some cases where we do surgeries that do make you feel pretty good pretty fast, and those are the ones of you that we really have to warn. We know you feel great but you’re not healed yet, right?

Val (21:30):
Yes, definitely.

Dr. Houssock (21:31):
For sure, for sure. Breast aug is one of those where it’s like you feel so good so fast, but those are the ones that we’ve had to take back to the OR at two weeks because they bled because they did too much too soon. So there’s real rules for real reasons.

Val (21:45):
Give your body that time. It does fly, it goes by very fast.

Dr. Houssock (21:49):
Totally. And then one of the other do nots for me because we live in an area where people vacation a lot, especially summertime, whatnot, and a lot of our patients vacation. I don’t like you planning your surgery close to a vacation or close to a huge event. And I pretty much over the years have kind of identified eight weeks as the best amount of time to do between a surgery and a big event or a vacation. And the reason for eight weeks is that gives me plenty of leeway if God forbid you do have a complication, your healing is hindered. You also probably want to have some type of result that you can enjoy during that event or during that vacation. And so giving yourself a good eight weeks between that is the absolute minimum to me that you should do. If you can’t do that, if we’re seeing you and you’re like, well in six weeks I have, well then that’s no problem.

(22:43):
Do it when you get back then. Don’t put that on yourself that you’re going to have it, God forbid a wound that you’ll have to baby while you’re in Cancun. We don’t want you to have to do that. So that’s the big thing. I think preparing at the right time for you, but also making sure that we’re thinking ahead, what do you have coming up? Make sure that this is a time, that doesn’t mean for eight weeks you’re going to be sitting at home, but I just don’t want you to miss out on something really great because you’re recovering from an operation.

Val (23:11):
Going off of vacationing, also going into bodies of water too early with wounds that are not completely healed. Water’s got some nasty bacteria in there.

Dr. Houssock (23:21):
Totally.

Val (23:21):
So just making sure that you get the okay from Dr. Houssock that you can go swimming or bathe in a bathtub not too early, just wait for everything to be nice and healed that can decrease the risk of your infection.

Dr. Houssock (23:33):
Yes. And then it goes back to just like we talked about with nutrition before surgery, nutrition after is just as important if not more. So making sure that even though you’re more sedentary, realize that your metabolism is a treadmill right now, healing your body and really needs nutrition, really, really needs nutrition. After surgery is not the time to back off on your carbs. It’s not the time to back off on your protein. You want to make sure that your body has the building blocks that it needs to heal your wounds and heal your body. So do not go on some kind of diet right after surgery. That is not the right time, definitely not the right time. Overall, it sounds overwhelming but truly a lot of it is so self-explanatory once you’re in it. Meaning you’re going to be hungry, you’re not going to feel like exercising like crazy.

(24:19):
But all that being said, the rules that Val and I come at you with are tried and true, tried and true and because of it, thank goodness we have very little complications in our practice and I don’t have wood.

Val (24:35):
I do.

Dr. Houssock (24:35):
But really because of it, truly, yes, of course complications happen. Any surgeon who says they have zero complications is a liar. But there are two things about complications. Number one, we have very little of them, but number two, because of all the rules that we make and because of the connection we have with you after a lot of patients have Val’s cell phone number. They can call us anytime at the office, 24/7, I’m available. Because of that if you have a complication and we have that open communication with you, the faster we get to it, the smaller of a deal it is. So just because we’re telling you that you do all this and you do it all right, and you still might have a complication, but if you do, your risks are going to be that much less that it will be a big complication if you follow the rules, right?

Val (25:25):
Absolutely. I know I always say after surgery it’s not like, hi, bye, see you later. We’re a part of this journey with you, so we’re here for you if you need anything. And not many patients are in the medical field so they don’t understand these things. So I really like my patients to know that you’re not alone. You have a lot of support and we’re here if you have any questions or anything like that. So yeah, that’s why I like to give my cell phone number out to patients before surgery so they know I’m here for them.

Dr. Houssock (25:50):
We’re always here for you and you’re part of the family. Alright Val, so let’s say, let’s finish up with this. We both have had surgery before, but we’re not, we’re human. Though we know all our rules, we’re human. Okay, so what is the one thing that you may have done after surgery that looking back now with all these things that we tell patients you think you could have done better?

Val (26:12):
I had my aug the week of Thanksgiving and I hosted and I didn’t tell my family.

Dr. Houssock (26:22):
Oh man.

Val (26:24):
And I was super stressed. I was having all these people at my house, I had just had surgery, I’m taking my medications and I’m uncomfortable, I’m not going to lie. And I remember just walking around holding my boob and everyone’s like, are you okay? And I’m like, yep, totally fine. I just hit myself on the barbell.

Dr. Houssock (26:43):
Lord have mercy.

Val (26:44):
And I just wish I was honest with my family and didn’t host Thanksgiving. So don’t host big events after surgery. It’s just a lot of stress. So yes, that was the one thing that.

Dr. Houssock (26:57):
Yes, my advice, don’t put that mental and physical on yourself.

Val (27:00):
Don’t put pressure.

Dr. Houssock (27:00):
Totally. I am also a bad patient. I can honestly say that moving forward I would not do this, but both times I’ve had surgery, I went back to work way too early. And I tell all of my patients, you’re taking at least a week off, if not two, but somehow thought that I was different and the first time I got away with it and that’s probably why I got cocky. Then the second time I had surgery, cosmetically I ended up with a complication. I ended up with a seroma and it had to be drained and I was too active too soon, meaning I went back to, I didn’t lift, I am pretty good about that, but I went back to work too soon and probably just did not give my body the real rest it needed.

(27:43):
I’m not special just like every other patient. I really needed to listen to my surgeon and myself. And so I 100%, anytime I have surgery moving forward will take off the time that I tell my patients to take off because I paid the price. I definitely paid the price. So yeah, we’re human too, so don’t think that we’re like we get it and we also get that life happens and there’s some things that you’re going to have to do that you don’t plan on doing. But be honest with us because even if you have to do something, we want to work with you to make sure that you minimize your risk. So don’t be ashamed if you’ve done something or you may not have listened to a rule, we’d rather know because if there is something that could have gotten messed up, the sooner we know the better. We can help you. So no pressure, just know we’re human too. We’ve made mistakes too and we know the rules. So know judgment here, right?

Val (28:35):
Not at all. Not at all. This is a safe place.

Dr. Houssock (28:38):
Alright, Val, love you. Carry on.

Val (28:40):
Love you too. Carry on

Dr. Houssock (28:43):
Perfectly Imperfect is the authentically human podcast navigating the realities of aesthetic medicine. JEV Plastic Surgery is located in Owings Mills, Maryland. To learn more about us, go to JEVplasticsurgery.com or follow us on Instagram @DrCareHoussock, or just look in the show notes for links. If you enjoyed this episode, please share it and subscribe to Perfectly Imperfect on YouTube, Apple Podcasts, Spotify, or wherever you’d like to listen to podcasts.