A Double-Blind Study

The Influence of Permanent Magnetic Field Therapy on Wound Healing in Suction Lipectomy Patients

Plastic & Reconstructive Surgery: Volume 104(7) December 1999 pp 2261-2266
Man, Daniel M.D.; Man, Boris M.D.; Plosker, Harvey M.D.

Boca Raton, Fla. 851 Meadows Rd., Suite 222; Boca Raton, Fla. 33486

From the Aesthetic Plastic Surgery and Laser Center. Received for publication April 8, 1999; revised June 11, 1999.

Article Outline

• Abstract
• Patients and Methods
• Patient Selection
• Surgical Procedure
• Study Design
• Statistical Analysis
• Results
• Discussion
• Conclusions
• Acknowledgment
• REFERENCES

Figures/Tables

• Fig. 1
• Table I
• Fig. 2
• Fig. 3
• Fig. 4
• Fig. 5
• Fig. 6

Abstract (top)

The authors present their experience with the healing influence of permanent magnets on postoperative wounds. The responses of 20 patients who underwent suction lipectomy and postoperative negative magnetic field therapy were studied in a double-blind fashion. Magnets in the form of patches (10 patients) or sham magnet patches (10 patients) were placed over the operative region in each of the patients. Pain, edema, and discoloration (ecchymosis) were evaluated at 1, 2, 3, 4, 7, and 14 days postoperatively. Our results show that the treatment group had significant reductions in pain on postoperative days 1 through 7, in edema on days 1 through 4, and in discoloration on days 1 through 3 when compared with the control group. These results demonstrated that commercially available magnets have a positive influence on the postoperative healing process in suction lipectomy patients.

Modalities potentially capable of improving wound healing carry great interest in plastic surgery. Despite the effort devoted to investigating the effects of different physical modalities on wound healing, few significant advances in the use of any of these new modalities have occurred.

The processes involved in cell and tissue repair and regeneration represent one of the most fundamental properties of complex organisms. Any physical or chemical process capable of improving wound healing merits thorough investigation. In comparison with the advancement and acceptance of magnetic instruments in many other scientific fields, the use of magnetic field energy in the practice of medicine remains extremely limited, despite the fact that magnets for medical treatment are readily available commercially. Both static and time-varying magnetic fields have been successfully applied to treat a variety of musculoskeletal problems. For example, after its description over 25 years ago, the use of electromagnetic fields to help trigger the healing of fracture nonunions1-3 has become an accepted clinical practice worldwide.

Currently, a great deal of activity and interest in studying the effects of magnetic fields on biological organisms exists. On the one hand, grave concerns have been voiced about the potential negative health effects of electromagnetic fields.4,5 On the other hand, many claims are made regarding the use of permanent magnets to treat various types of painful conditions.5-8

Although well-controlled studies have been performed on the stimulation of bone growth by electrical and magnetic fields, the effects of magnetic fields on soft tissues remain unclear; they represent the next frontier in electromagnetic biology and medicine. It has been demonstrated in animal experimental wound models that these modalities can promote healing and increase wound tensile strength.9-12 Electrical and magnetic fields have been associated with a number of demonstrable effects advantageous to wound healing, including increased collagen deposition, enhanced fibroblast migration, increased migration of macrophages and leukocytes leading to decreased bacterial counts, decreased sympathetic vasoconstriction, increased cellular oxygen delivery, and increased wound epithelialization.9-12

Evidence exists that magnetic field therapy can be effective in improving some of the most important factors in wound management, namely, the optimization of the supply of nutrients and oxygen to the treated area. This is of major importance in the case of surgical skin flaps. It is well known that skin flaps exhibit progressive ischemia, with potential tissue necrosis, toward their distal end. An accumulation of neurotransmitters follows the transection of sympathetic nerves during flap elevation, with the resultant vasoconstriction inducing a temporary capillary occlusion within the flap. This sequence of events further involves ischemia followed by reperfusion in the transition zone between adequately perfused proximal tissue and inadequately perfused distal areas. It has been shown in animal studies that the treatment of skin flaps with electric current or magnetic fields may prevent severe ischemia, thus avoiding ischemia/reperfusion injury. However, there are no reports on the use of magnetic fields for the treatment of postsurgical skin flaps in humans.

Any factor that is capable of improving the healing process, especially in the absence of significant side effects, would be of particular interest in plastic surgery. Herein, we present our experience with such a technique: the use of permanent magnetic field therapy in plastic surgical patients.

Patients and Methods (top)

The protocol for this double-blind, randomized study was approved by the Essex Institutional Review Board, Inc. Written informed consent was obtained from 20 patients scheduled to undergo suction lipectomy of various body regions. Patients were randomly assigned to either the treatment group or the control group.

Patient Selection (top)

Enrollment was limited to patients of either sex between the ages of 18 and 75 who were scheduled to undergo suction lipectomy and who had major medical problems. Exclusion criteria included the following:

• Patients unable to give informed consent
• Patients with electronic cardiac pacemakers
• Patients with open wounds
• Patients with infection
• Major medical problems
• Patients with metallic implants at the treatment site
• Skeletal immaturity

Surgical Procedure (top)

The same surgeon performed all suction lipectomies. The areas suctioned included the abdomen, saddlebags, love handles, and thighs, with a variety of areas being suctioned in different patients. A tumescent technique was used in all cases; a 2:1 ratio of tumescent solution was used to aspirate. Ultrasound-assisted suction lipectomy was performed in all patients, and internal ultrasound was employed.

Study Design (top)

The treatment group received magnetic field treatment postoperatively with magnetic devices in the form of patches (Tectonic, Magnetherapy, Inc., North Palm Beach, Florida), which varied in size from 5 ? 15 to 20 ? 30 cm, and in shape (including both square and rectangular). The patches contained ceramic magnets oriented unidirectionally within them, with a total magnetic field strength of from 150 to 400 gauss, depending on the size of the magnetic patch used. The control group had sham patches placed. These sham patches were identical to the magnetic patches in all respects, including having the same ceramic material inside, but they possessed no magnetic activity. All patches were fixed with compressive dressings, with the negative pole of the magnet placed against the skin. The patches were placed on the skin overlying the areas that had been suctioned, with various sizes and shapes of magnets used so as to best fit the area being treated. The patches were applied immediately postoperatively, and they were left in place for a total of 14 days, with the treated areas inspected on postoperative days 1, 2, 3, 4, 7, and 14.

All postoperative assessments were made by the same blinded observer. The patients, surgeon, and observer were all blinded as to which patients had the real or sham magnetic devices.

Discolorations (ecchymoses) within the limits of the area covered by the magnetic patches and the area outside were compared and documented by the same observer on a scale of 0 to 10, with 0 representing a completely normal skin color, with no discoloration at all, and 10 representing severe ecchymosis covering the entire area, with a dark blue/violet color and no normal skin color showing through. Edema was also assessed by the same blinded observer on a scale of 0 to 10, with 0 representing no edema when compared with neighboring regions that had not undergone any surgery, and 10 representing marked swelling, with a shiny skin surface due to stretching of the overlying skin.

Pain was assessed by means of a visual analog pain scale throughout the study period. While in the facility, this was recorded by our blinded observer. Once the patients were discharged, this was accomplished by having the patients keep a log of their pain scores on a daily basis.

Statistical Analysis (top)

All data were subjected to statistical analysis, and the results are presented as means and standard deviations. On the basis of the nature of the data and its distribution, nonparametric statistical tests were used in analyzing the data. Discoloration, edema, and pain scores were compared between groups at each time interval using the Wilcoxon rank sum test and the Kruskal-Wallis test. p < 0.05 was considered statistically significant.

Results (top)

Patient demographics were similar between the two study groups with regard to age, sex, volume of tumescent solution used, and volume aspirated.

In the treatment group, a statistically significant decrease (p < 0.05) in discoloration occurred when compared with the control group on postoperative days 1, 2, and 3. The magnitude of the reduction in discoloration was also clinically significant, ranging from 43 percent on postoperative day 1 to 28 percent on postoperative day 3. By postoperative days 4, 7, and 14, there was no longer any significant difference in discoloration between the two groups (Fig. 1; Table I).

Fig. 1. Postoperative discoloration after suction lipectomy in patients treated with magnet patches versus placebo patches. Values are means and standard deviations.

Table I. Postoperative Edema, Discoloration, and Pain after Suction Lipectomy in Patients Treated with Magnet Patches or Placebo Patches

With regard to edema, a statistically significant decrease (p &.05) in edema occurred in the treatment group when compared with the control group on postoperative days 1, 2, 3, and 4. The reductions in edema on days 1 through 4 were clinically significant as well, varying from 40 to 53 percent when compared with the control group. By postoperative days 7 and 14, although there continued to be some decrease in edema, it was no longer statistically significant (Fig. 2; Table I).

Fig. 2. Postoperative edema after suction lipectomy in patients treated with magnet patches versus placebo patches. Values are means and standard deviations.

When compared with the control group, pain was significantly decreased (p < 0.05) in the treatment group on postoperative days 1, 2, 3, 4, and 7. By postoperative day 14, although the pain scores continued to be lower in the treatment group, the difference was not statistically significant (Fig. 3; Table I). The patients in the treatment group felt noticeably better, demonstrating a 37 to 65 percent decrease in pain when compared with the control group, leading to a decreased consumption of analgesic medications.

Fig. 3. Postoperative pain (as measured by visual analog scale scores) after suction lipectomy in patients treated with magnet patches versus placebo patches. Values are means and standard deviations.

There was no difference in the incidence of adverse events between the treatment group and the control group throughout the study period. No side effects were observed in either group.

Figures 4 through 6 illustrate patients after suction lipectomy and demonstrate the virtually complete disappearance of ecchymoses 48 hours after the application of the magnet patch, except beyond the border of the magnet patch where discoloration was still visible.

Fig. 4. (Left) Abdomen 48 hours after suction lipectomy, with magnet patch in place. Note ecchymosis and discoloration of the abdomen. (Right) Abdomen 48 hours after surgery and the application of the magnet patch, with discoloration markedly diminished in the area covered by the magnetic patch.

Fig. 5. (Left) Ecchymosis and discoloration 24 hours after suction lipectomy and treatment with the magnetic patch. (Right) Operative site 72 hours postoperatively. Note the virtually complete disappearance of discoloration, other than that beyond the borders of the magnetic patch, at both intervals.

Fig. 6. (Left) Thigh 72 hours after suction lipectomy, with magnet patch in place. Note the marked ecchymosis and discoloration. (Right) Thigh 72 hours after suction lipectomy with magnet patch removed, showing markedly diminished ecchymosis and discoloration within the area covered by the magnetic patch.

Discussion (top)

Much of the theoretical basis for the postoperative use of magnetic stimulation is based on the work of Becker,5 who theorized the existence of an electromagnetic system in the body that controlled tissue healing. When the electrical balance of the body is disturbed by an injury, an injury current is generated, with the resulting shift in the body\’s current triggering a set of biological repair systems. As healing progresses, this current of injury decreases until it reaches zero, at which time the healing process is complete.8 This is the basis of the manner in which externally applied magnetic fields are thought to stimulate biological homeostatic feedback mechanisms and trigger the events that result in tissue repair.

The healing process is accompanied by many dynamic processes and events, the most obvious and troublesome of which include pain, swelling, erythema, and diminished function. The beneficial effects of magnetic fields that may be of particular benefit to surgical patients include a reduction of edema, an increase in cellular oxygen delivery, an anti-inflammatory effect, and an analgesic effect.9-12 One possible mechanism by which magnetic fields may exert these effects is by enhancing blood flow to the site of injury, thereby increasing oxygen delivery and speeding the overall healing process.13,14

In our group of study patients, magnetic field therapy was quite remarkable in both the prevention and treatment of these signs and symptoms and also in the alleviation of pain itself. The magnitude of the reduction in postoperative pain was quite significant, allowing for a decrease in the need for analgesic medication. In procedures in which significant ecchymoses or hematomas occur, one would normally expect manifestations such as these to take at least 2 to 3 weeks to resolve, whereas with the use of magnetic field therapy, they resolved in 48 to 72 hours, as is well demonstrated by the photographs (Figs. 4 through 6).

Although the application of any padding has the potential to reduce edema and ecchymosis, we think that our control group, who used identical, nonmagnetized pads, demonstrated that this factor alone did not account for the improvement. This is evidenced by the significantly greater reduction in edema and ecchymosis found in the treatment group.

Conclusions (top)

In this first attempt to use postoperative magnetic field therapy in plastic surgical patients, a beneficial effect was clearly exerted; it markedly ameliorated many of the undesirable factors associated with the healing process, with no side effects observed. In view of this apparent efficacy and the freedom from adverse effects, this modality certainly appears promising, and it merits further investigation.

Daniel Man, M.D.

851 Meadows Rd., Suite 222; Boca Raton, Fla. 33486; info@drman.com

Acknowledgment (top)

We thank Edsel Baker, M.S., of the Statistics Department at the University of Florida for the statistical analysis.

REFERENCES (top)

1. Friedenberg, Z. B., Harlow, M. C., and Brighton, C. T. Healing of nonunion of the medical malleolus by means of direct current: A case report. J. Trauma 11: 883, 1971.
2. Bassett, A. C. Fundamental and practical aspects of therapeutic uses of pulsed electromagnetic fields (PEMFs). Crit. Rev. Biomed. Eng. 17: 451, 1989.
3. Sharrard, W. J. W. A double-blind trial of pulsed electromagnetic fields for delayed union of tibial fractures. J. Bone Joint Surg. Br. 72: 347, 1990.
4. Wilson, R. Risk assessment of EMF on health. IEEE Eng. Med. Biol. 15: 77, 1996.
5. Becker, R. O. Cross Currents, The Perils of Electropollution, The Promise of Electromedicine. New York: G. P. Putnam’s Sons, 1990.
6. Altman, L. K. Study on using magnets to treat pain surprises skeptics. New York Times, December 9, 1997.
7. Horstman, J. Explorations: Magnets. Arthritis Today 12: 48, 1998.
8. Vallbona, C., Hazelwood, C. F., and Jurida, G. Response of pain to static magnetic fields in postpolio patients: A double-blind pilot study. Arch. Phys. Med. Rehabil. 78: 1200, 1997.
9. Foulds, I. S., and Barker, A. T. Human skin battery potentials and their role in wound healing. Br. J. Dermatol. 109: 515, 1983.
10. Jaffe, L. F., and Vanable, J. W., Jr. Electric fields and wound healing. Clin. Dermatol. 2: 34, 1984.
11. Weiss, D. S., Kirsner, R., and Eaglstein, W. H. Electrical stimulation and wound healing. Arch. Dermatol. 126: 222, 1990.
12. Markov, M. S. Electric current and electromagnetic field effects on soft tissue: Implication for wound healing. Wounds 7: 94, 1995.
13. Lednev, V. V. Possible mechanisms for the influence of weak magnetic fields on biological systems. Bioelectromagnetics 12: 71, 1991.
14. Mayrovitz, H., and Larsen, P. B. Effects of pulsed electromagnetic fields on skin microvascular blood perfusion. Wounds 4: 197, 1992.

1999 American Society of Plastic Surgeons

Look Better, Feel Better:

Anti-Aging Breakthrough Techniques

Everyone wants to be at his or her best. Men and women all over the country strive to get rid of fine lines, wrinkles, crows feet. Basically, a battle has been waged over the past few years to restore the vitality and effortless beauty of youthfulness. Since the beginning of the 21st century, cosmetic techniques and practices have gained momentum in terms of popularity, and more importantly, acceptance.

Although, cosmetic surgical techniques and procedures are constantly being improved with safer procedures that are less traumatic and more effective, we are in a highly charged environment these days with fast paced lifestyles. It can seem as if there is never enough time to do those little nagging tasks of importance, much less take a few weeks out for a surgical recovery.

More individuals are turning to less invasive procedures such as “Lunchtime Procedures” so that they can erase those pesky frown lines in an hour then dash to their appointment, event, function, etc. These days with the dawn of the non-invasive fillers such as the ever-popular Botox, Collagen, Fat Injections, and the recent recommendation of Restylane approval to the FDA’s advisory panel, men and women alike are looking great in no time flat. These lunchtime procedures or quick fixes are rapidly becoming the norm. It would not be surprising to see these injectables becoming as routine as your manicure, pedicure, and your trip to the hair salon.

YOUR EASY REFERENCE TO QUICK FIXES:

Botox

PROS:
-FDA approved.
-Great for smoothing wrinkles on forehead, (glabellar region)
-A quick fix.
- I personally love Botox!

CONS:
-3-6 months lasting ability depending on the individual
-In rare cases could cause bruising or side effect of a droopy eyelid

Collagen

PROS:
-FDA Approved.
-Great for lips and nasal labial folds
-Fills wrinkles, scars and lines on face and around lips
-Immediate results
-Lasts up to six months depending on the individual

CONS:
-Could be Costly
-Not permanent
-Patient has to be skin tested for possible allergic reaction

Fat Injections

PROS:
-Taken from your own fat, which is great
-No allergic reaction
-Results are variable, but can be permanent

CONS:
-Body absorbs own fat
-Patient should retain approx. 25-30% depending on the individual
-Could be costly

Restylane / Perlane

PROS:
-I personally love restylane/perlane. It is MY personal choice.
-Recent recommendation of Restylane approval to the FDA’s advisory panel.
-Great soft tissue filler that adds volume.
-Rarely ever an allergic reaction.
-Can last up to one year.

CONS:
-Can be costly
-Not permanent

Injectable Silicone

CONS:
-Not approved for cosmetic use in the United States
-In 1991 the FDA banned its use for wrinkles and facial defects
-Injectable silicone tends to harden, migrate, inflammation and skin necrosis
-In my personal opinion, DO NOT USE

Confidentially speaking, I believe injectables are a great quick fix because there is no downtime. If you would like to find a Board Certified plastic surgeon to fit your specific needs, please call Helen Elliott Enterprises, Inc., toll-free at (888) 433-9091 or (310) 285-8505.
It would be our pleasure to assist you. We believe that the more informed you are the more positive your experience will be.

Cosmetic Surgery Offers a Second Chance

We only get one chance at a first impression, and the person who projects the best self-image makes the best impression. In today’s competitive society, people recognize the importance of self-improvement, whether it is for social or professional reasons. Exercise, skin care and nutrition are important but can only do so much. Real structural change requires more. In a sense, cosmetic surgery offers a second chance – the opportunity to defy both the calendar and genetics. Here I have compiled some of the most successful techniques used to achieve this goal.

Rejuvenation Techniques

Facelift (rhytidectomy)
Over the past few years, the term facelift has become a topic of increased interest and discussion. The cumulative effects of time, gravity and heredity show on any face. The facelift operation itself, also known as rhytidectomy, is performed to correct double chins and sagging jowls. The modern-day, long-lasting facelift operation, involves the permanent removal of undesirable accumulations of fat. As well, sagging muscles and connective tissue are repositioned and re-supported.

Because excess fat is now removed in the operation, patients no longer need to lose weight before surgery. In fact, for people who previously had chubby cheeks or a fat neck, one of the benefits of facelift surgery is an apparent loss of weight following surgery. The overall effect is a younger, fresher and more vibrant (yet natural) appearance.

Often lumped under the term facelift are a group of operations designed to rejuvenate faces that show signs of aging. These include blepharoplasty (eyelid surgery), brow and forehead lift, mid-face lift, and skin resurfacing, among others.

48 year old woman before and after
facelift, browlift, and chin augmentation

Blepharoplasty
Americans stress eye contact and believe that they can judge a person?s character by what they see in their eyes. While people talk most about facelifts, the most popular age reversing operation among my patients these days involves the eyelids. Heavy, ?hooded? (drooping) upper eyelids and baggy lower eyelids make people look tired, old, and certainly past their prime. The surgical correction known as blepharoplasty can remove the fatty pouches that cause these unfortunate problems. When present, skin that has become stretched over the years can also be removed. Upper eyelid drooping, which sometimes partially obscures vision, is corrected by removal of excess skin, muscle and fat. Incisions follow natural contour lines in the upper eyelids, and in the lower lid can be made on the inside, so there is no scar at all. In some cases, circles under the eyes can be filled in and the lids tightened.

Brow and Forehead Lift
A pleasing eyebrow shape and arch is associated with youth and beauty. On the other hand, an unfavorable eyebrow shape and angle can make a person look tired, worried or angry. The brow and forehead lift, in addition to lifting the eyebrows back to where they belong, smoothes out a deeply furrowed and pinched forehead. I prefer the high-tech endoscopic method, which is a big improvement to older more invasive surgery, because it requires only very small incisions within the hair. A tiny video-connected scope is then passed under the skin; the tissues are released, repositioned, and secured into position. With this advanced procedure I no longer make the old fashioned long incision across the top of the head and never remove scalp or hair. The benefits are brighter, more open eyes, a fresher, and more pleasant and alert demeanor.

Mid-Face Lift
The mid-face is the area immediately below the eyes, next to the nose and above the lips. It is left behind by the facelift discussed above, which benefits the jowls, under the chin, and the neck. The mid-face lift corrects sagging in this important area in the center of the face, helps circles under the eyes, and enhances cheekbone definition. I perform the mid-face lift with the only incisions in the scalp and inside the mouth under the lip. In other words, it can be done with no facial scars. The mid-face lift can be done alone or in combination with any of the other facial rejuvenation procedures.

Botox
Botox is used for the treatment of frown lines, forehead furrows, “crow?s feet”, and lines and wrinkles of the lower face. Botox has proven to be a very popular nonsurgical cosmetic treatment. The type of lines and wrinkles that respond to Botox injections are those caused by muscles?specifically those muscles that contract during facial expressions such as frowning or squinting. It works by relaxing the muscles that cause the lines so wrinkles smooth out. There is no downtime, and patients can immediately resume normal activities.

Skin Resurfacing
Skin resurfacing uses either a laser or special chemicals to smooth the skin, reduce wrinkling, and even out the complexion. I personally use the newer Erbium: YAG laser, which has proven to be a kinder and gentler alternative, with much faster recovery than the CO2 laser.

Some people prefer to correct one thing at a time — what one of my patients once called “weeding the garden.” Others want a more dramatic improvement; they have as much done as necessary and feasible at once so as to achieve maximum benefits. It is an individual choice, and one of the reasons a thorough consultation with a well-qualified, experienced, sympathetic plastic surgeon is so important. I have found that video imaging assists in creating plans for facial surgery that meet each individual’s specific needs and desires.

Breakthroughs in anesthesia methods and monitoring devices have made it possible for all of these operations to be performed on an outpatient basis. This is a positive step because patients feel more comfortable and heal faster in this environment. In addition, outpatient procedures reduce expenses overall.

Techniques for the Body

Body Contouring Surgery
In the months leading up to the summer, I see an influx of women seeking to re-contour their figures. They are usually trying to plan ahead, getting their ?problem areas? taken care of well in advance of spring and summer’s more revealing clothing styles.

According to statistics kept by the prestigious American Society of Plastic Surgeons, Liposculpture, more commonly known as liposuction, has become the most frequently performed cosmetic surgery procedure. I choose to perform the tumescent form of liposculpture, which can be done on an outpatient basis.

In liposculpture, a combination of saline (saltwater) and local anesthetic is first flooded into the areas to be contoured. Working through tiny incisions just large enough to fit the thin liposculpture vacuum tube, fat cells and some fluid are then gently swept away by suctioning back and forth under the skin. Liposculpture is truly a matter of sculpting the human form; it effectively removes unwanted fat from areas that are often resistant to diet and exercise. These can include the neck, upper arms, chest, sides, abdomen, thighs, hips, knees and ankles.

Other procedures for figure improvement include abdominoplasty (tummy tuck), breast lift, breast reduction, and–last but not least–cosmetic breast surgery. Saline implants, which have now replaced silicone gel implants, are used both to enlarge and to enhance shape. Following surgery, many of my patients are particularly happy that the tops of their bathing suits fit as well as the bottoms.

Any of the procedures described in this article can potentially help to improve physical appearance and enhance self-image. But no matter what procedure you choose, be sure to do your homework and choose a qualified, experienced plastic surgeon.

The Art of Cosmetic Plastic Surgery Recovery

Advice To Prepare For Post-Op Success

When you have cosmetic surgery, you are tricking Mother Nature and she is not going to be happy about it. If you are not properly prepared, you can hurt yourself! After working with post-op patients for over twenty years I thought I knew exactly what to expect from the post-op experience. I was wrong.

My husband had to go to the store 6 times in 36 hours to buy things I wasn’t told I needed, and those waiting hours were painstaking! Be careful…it could happen to you!

You need to know your post-operative and recovery instructions. These will include suggestions to eat lightly, starting with liquids for two days and moving onto soft solids. When the surgical procedures involve your face, you need to be reminded to keep your head elevated to control swelling. To sleep on your back ,elevated by three pillows, for at least a week. I hated that part! Most of my clients complain that sleeping on their back elevated is a great strain. Most patients do not understand that they won’t be able to strain themselves in any way, including motions requiring bending, lifting or exercise of any kind.

I consider it my job to make sure they get it. I am always surprised how many patients write to me to ask if they should take their pain medications regularly as well as the antibiotics prescribed.

The amount of information that was never told to me was astonishing in retrospect. Without really chastising any surgeon’s criteria for preparing their own patients for post-op, most don’t tell you all you really need to know, because they are afraid to overwhelm their patients. My advice? Tell them everything…no surprises please!

Here’s some great tips for plastic surgery recovery. Gather these items well in advance so you are completely prepared:

-Lots of pillows, including one at the base of their spine and one under their knees. I also needed a pillow under my buttocks for extra softness. My tush ached after only one day of immobility. (Who would have thought my natural padding wouldn’t be enough!)

-Mouthwash to rinse their mouth. It will be days until a toothbrush can fit into their mouth after a facelift. All efforts toward normalcy concerning hygiene are imperative to your patient’s overall sense of well-being.

-Safe skin-care products to wash their face with for the first time. Make sure that all of their skin care is hypo-allergenic and specifically formulated for sensitive and dry skin. The cleanser must have a moisturizing component too.

-Gentle, effective creams to use on the incisions and laser surgery sites, if needed. This will include a triple antibiotic cream, a cream to massage the into scars, a moisturizer for their lips with vitamin E, an emollient body lotion, and possibly petroleum jelly. If they need the petroleum jelly, tell them to look for one in a tube versus a jar. It is so much easier to use.

-A stool softener or mild laxative since the pain medications are usually binding. What can also be binding is the inactivity. Having a tough time performing even the most rudimentary body functions is a bore!

-An over-the-counter aid for sleeping. I recommend Melatonin to all my clients. I’ve been taking it for years to help me sleep through my husband’s snoring! In the morning I wake up quickly and without any grogginess. Remind your patients that rest and sleep are imperative to their healing process. If they have trouble falling asleep under normal conditions like I do, postoperative sleep will probably not come easy, even with the pain medication. Ask them.

-Homeopathic remedies used for healing the surgical wounds, reducing the bruising and detoxification from the anesthesia. Many or your patients may not be aware of the growing respect alternative healing products have in today’s modern medical practice. As you know, homeopathy is a natural pharmaceutical science that uses extremely small, nontoxic doses of substances from the plant, mineral, animal and chemical kingdoms. Homeopathic remedies are curative because they aid the body’s overall defenses rather than simply treating the symptoms. These remedies stimulate the person’s immune system thereby strengthening the individual’s ability to heal. Join the ranks of progressive surgeons by recommending such remedies as part of your healing philosophy.

-Soft foods and water-including protein shakes, fruit to be pureed, applesauce, oatmeal, yogurt, etc.

-Plenty of juice. Tell them to be careful with highly acidic juices like orange and grapefruit juice that could sour their stomach. The last thing you want is having your patients throw up immediately after surgery.

-Flexible straws. The straws will need to have flexible ends so they can drink liquids easily in a reclining position.

-A hand-held showerhead in their tub or shower enclosure plus a plastic chair to sit on. This is a must! There will be no other way to safely bathe or have their hair washed for the first time without these two essential items.

-Mild hair products to wash their hair for the first time including a leave-in hair conditioner. They will also require tools to unsnarl their hair-a pick and a vented hair brush work very well. Recommend brand new items since they will be used over newly sutured areas.

-A telephone with a speaker near their bed. Holding a phone to their ears will be impossible immediately after a facelift. Being able to communicate on their own, without help, will be such a gift. Especially when they need to speak to you. It also helps those patients who have older parents that don’t live close enough to come and see how they are on their own. Keeping the family stress free greatly helps your patients to concentrate on themselves.

-Lubricating eye drops. From surveying my clients, I found that most had dry eyes from the anesthesia whether or not they had procedures involving their eyes. The drops feel great and make it easier for them to blink and focus.

-All of your prescription drugs in the house before you need them. I loved being told to remember to take the pain medication, as if I could forget!

-Two large bags of frozen peas and six large self-sealing plastic storage bags to make cold packs. Suggest that they make at least six cold packs since they could use as many as three at a time and will need to replace them after 20 minutes.

-Lots of patience and a sense of humor! These may be the most vital requirements of all. Guide your patients to rely on their family and friends to help them out. My clients tell me that hugs help immensely, as long as they are administered gently!

The majority of these requirements seems pretty straightforward, yet you would be amazed by how many things are overlooked or never even considered when planning your cosmetic plastic surgery recovery needs. Most people are consumed with the more obvious issues such as covering for their absences at work and at home. This coverage is vital so you can take the time off to have surgery and recover from it. Don’t allow yourself to diminish your focus on all the items you will need for a successful recovery. Being prepared is what it’s all about.