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HOW TO SPEED UP EYELID SURGERY RECOVERY

 

The length of your eyelid surgery recovery, or to be specific, the moment when you look socially presentable, may take about a week. However, you may still need to use camouflage make-up or large sunglasses to cover the bruises and swelling around the eyes.

Dr. Karan Dhir, one of the leading Beverly Hills plastic surgeons, believes that certain steps can help speed up your recovery and avoid the inconvenience of persistent bruising and swelling.

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For a “quick” recovery, the general rule of thumb is to minimize eyelid motion in the first two to three days. Ideally, you should try to relax and listen to your favorite music, and avoid watching TV, reading books, and using computer because these activities will force the lids to open and close more frequently, which can increase postop bruising.

Aside from taking things slow, another way to speed up your recovery is to follow a strict diet—i.e., very little salt, lean protein, and more vegetables and fruits. Salty and fatty foods, meanwhile, can aggravate the swelling and possibly impede with your healing.

Some herbal and vitamin supplements are also known to aggravate bruising such as green tea, ginseng, and fish oil, although some doctors suggest that taking a small dose of arnica montana and bromelain can control postop symptoms and lead to quicker recovery.

While the effectiveness of arnica and bromelain is still up for debate, most Beverly Hills plastic surgeons agree that head elevation in the first 48-72 hours can do wonders. The idea is to help the swelling caused by the excess fluids to go down by relying on the gravity’s effect.

Cold compress is also believed to control swelling, although you should not put ice directly on your bare skin to prevent cold burns and blisters. For this reason, some doctors prefer using washcloth slightly moistened in ice water, a technique that eliminates the risk of frostbite.

But since time is the best treatment, a month after surgery there is no difference between a patient who did head elevation and cold compress versus someone who skipped these postop care.

And lastly, it is important that you avoid heavy lifting, bending over from the waist, and doing strenuous activities for at least three weeks because doing so can elevate your blood pressure and eventually lead to bleeding and poor healing. Just to be on the safe side, ask for your doctor’s approval before returning to your normal routine.

HOW LONG IS THE SOCIAL RECOVERY AFTER FACIAL PLASTIC SURGERY

 

Facial plastic surgery such as facelift, rhinoplasty (nose job), fat grafting, brow lift, and eyelid lift involves postop bruising and swelling that may prevent anyone to join social activities for a couple of weeks.

Take note that healing from such procedures takes many forms—e.g., social recovery, physical recuperation, and return of normal sensation.

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For many patients, the hardest part of the recovery is not really the postop discomfort, which can be easily controlled by painkillers, but the interruption in their social activities.

The list below explains the length of social recovery after a specific type of facial plastic surgery and what kind of postop symptoms one should expect during the initial healing phase:

  • Facelift. Five to seven days after surgery, the swelling and bruising will rapidly improve that most patients can return to their social activities by eight day, although usually with the “assistance” of camouflage make-up and/or fashion accessories such as sunglasses and scarves.
  • Rhinoplasty. The postop bruises are the most apparent around the eyes and will take a week to subside to a significant degree. However, social recovery greatly varies from patient to patient, with some people able to look “more acceptable” within a week, while others have to wait for two to three weeks especially if they have a thick nasal skin.
  • Fat grafting. This involves injecting a small amount of fat into the area that needs more volume, leading to mild swelling and bruising that can last for seven days, although some patients may have to wait for another week to appear “socially presentable.”
  • Eyelid surgery. This involves a rather straightforward recovery with the use of very fine incisions made within the natural upper eyelid crease and close to the lower lash margin. For this reason, most patients can have “dinner with friends” after about five days, although big sunglasses remain helpful to hide any residual swelling and bruising, and to protect the scars from harsh elements.
  • Brow lift.   With endoscope or small camera probe, the procedure will only need several small incisions that can lead to about a week of social recovery; however, the initial healing phase could take longer with the standard technique in which one continuous incision from ear to ear, behind the hairline, is used.

WHAT HAPPENS TO THE INTERNAL SUTURES IN TUMMY TUCK SURGERY?

 

Tummy tuck surgery, or abdominoplasty, not just involves skin removal to create a flatter, more toned abdomen. For many patients, they will also require muscle tightening to achieve a smoother contour, as suggested by leading LA plastic surgeon Dr. Tarick Smaili.

Massive weight loss patients and mothers who have developed splayed muscle due to previous pregnancies often need muscle tightening or repair. While this additional procedure contributes to most of the pain and discomfort, and possibly longer recovery, most patients consider its benefits worth it.

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To tighten the splayed muscles, doctors either use permanent internal stitches or slow-dissolving absorbable sutures.

Nowadays, absorbable sutures are becoming popular because they are believed to cause less problems compared to permanent nylon stiches that tend to create small tears in the muscle over time.

Dissolvable sutures work by holding the muscles in place until scar tissue forms or the healing process permanently “secures” them. For most patients it takes about six weeks for the muscles to heal together.

While permanent sutures can still provide good results in the hands of skilled surgeons—since their knots are tight and strong and are relatively easy to handle—they might cause problems such as chronic irritation and infections.

The aforementioned complications rarely occur in absorbable sutures because there is no foreign material that stays longer after the surgery. Nevertheless, using them requires great care to prevent knots breaking or becoming loose.

Some surgeons only choose one type of sutures, while others “vary” their choice depending on the underlying anatomies and the patient’s cosmetic goals and expectations.

Other plastic surgeons also use mesh in addition to one or two layers of sutures to further create a stronger support. According to previous studies, the additional “scaffolding” is suitable for massive weight loss patients.

The use of several layers of closure is important to remove or at least minimize the tension on the skin, thus promoting “good” scarring—i.e., thin, flat, and faded scars.

By removing most of the tension on the skin, the wound can heal more efficiently and the scars are less likely to spread, become uneven, or migrate higher (thus becoming more visible), explains Dr. Smaili.

Aside from avoiding external sutures when doing the surgery, many surgeons these days are also using steri-strips and/or silicone tapes. The idea is to further eliminate tension on the skin to promote favorable tummy tuck scars.

GUIDE TO ACHIEVE SMOOTH TUMMY TUCK RESULTS

 

One of the goals of tummy tuck surgery, or abdominoplasty, is to deliver smooth skin—i.e., no hanging and redundant skin, bulges from incorrect wound closure or residual fats, or thick scars.

Impressive results from the surgery also preserve the natural valleys and shapes of the abdomen. For instance, the flanks or contours on the sides should appear smooth, and the area between the rib cage and pubis should have no fat rolls or any sign of asymmetry.

tummy-tuck-scarsLeading Beverly Hills plastic surgeon Dr. Tarick Smaili says smooth results are achieved by removing just the right amount of excess skin. Too little and the hanging appearance will remain, and too much the abdomen will look overly tight and fake.

The amount and location of redundant skin will dictate the tummy tuck scars and their pattern, although Dr. Smaili says the general rule of thumb is to position them beneath the bikini area so they remain discreet.

Most patients are suitable for the standard tummy tuck in which a U-shaped or relatively straighter scar from hip to hip is used, while massive weight loss patients may have to accept a longer scar that reaches their flanks for an additional amount of contouring.

Dr. Smaili says it is crucial to examine the quantity and quality of skin, which will dictate the scar pattern and length. Failure to acknowledge this anatomy—such as using shorter incisions despite the apparent need for a large correction—will lead to skin asymmetries, destruction of the abdominal contour, weird-looking navel and other “stigmata” of surgery, and poor healing.

Aside from the condition of skin, the leading Beverly Hills plastic surgeon highlights the importance of examining the abdominal fat, which may contribute to the appearance of lower pooch, muffin tops, and unsightly rolls. For this reason, he occasionally combines tummy tuck surgery with liposuction.

But if one requires large-volume liposuction, Dr. Smaili suggests staging the procedure to limit the surgical trauma, minimize the risk of complication, and achieve a more predictable result (liposuction first then followed by tummy tuck weeks or months afterward).

Nevertheless, over-correction or aggressive liposuction of the flanks and the quadrants of the abdomen is counterproductive especially if the goal is to achieve smooth results, Dr. Smaili warns.

And lastly, it is important to repair or tighten the muscles (with the use of internal sutures) that have become separated due to massive weight loss or pregnancy, he adds.

BREAST REDUCTION INSURANCE REQUIREMENTS

 

For some women, breast reduction is not a cosmetic plastic surgery, but rather a medically necessary procedure to address their neck and back pain, postural problem, non-healing skin irritation along the inframammary crease, and other symptoms of disproportionately large breasts.

While this procedure is usually covered by insurance, the requirements are becoming more and more restrictive. Nevertheless, a board-certified plastic surgeon who regularly performs the surgery can help you get pre-approval as he is familiar with the “process.”

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Los Angeles plastic surgeon Dr. Tarick Smailisays breast reduction insurance requirementsdiffer from issuer to issuer, and state to state. Nevertheless, they have common “denominators” such as:

  1. Extreme downsizing. The problem with this requirement is that some patients might be forced to get too much reduction just to satisfy their insurance issuer, leading to breasts that are too small for their liking.

However, even some reductions may relieve symptoms such as back and neck pain, rounded shoulder, and headaches. This is particularly true of petite women whose breasts are too large in proportion to their body.

  1. Proportion of the breast size to the body. This requirement is less restrictive as it allows smaller reductions because the patient’s height and weight are taken into account.
  1. Strict numbers. A growing number of health insurance issuers are becoming stricter when it comes to breast reduction coverage that some will only pay if the weight of the removed soft tissue is at least 500 grams per breast. This could pose a problem in small-framed women with overlarge cup size.
  1. Medical evidence. The more medical evidence a patient is able to present, the higher the chance of pre-approval. The general rule of thumb is to secure letters and recommendations from experts—such as board-certified plastic surgeon, chiropractor, internist, and orthopedic surgeon—attesting that the surgery can relieve one’s physical symptoms.
  1. Alternative non-surgical treatments. It is not uncommon for health insurance issuers to require policyholders to have tried weight loss and physical therapy first; however, this is a “tricky” requirement since women with overlarge breasts find it hard, if not too painful, to perform even the easiest exercise.

Nevertheless, it remains helpful to be near one’s normal weight prior to breast reduction or any type of body contouring procedure because it is easier to predict the results, particularly the proportion of the breast to the body frame.

Despite the challenges of securing insurance pre-approval, Dr. Smaili says a patient can always demand an appeal if the first request is denied.

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