Seattle Plastic Surgeon recommends a WALKER for recovery from tummy tuck and body lift surgery.
Years ago I did a body lift on a patient who had lost over 100 pounds. She advised me to advise other patients to consider getting a walker for post surgical recovery. She found it so much easier to get up and putter around like we ask our patients to do the very first day after surgery.
Patients who are able to be up and about are much less likely to develop problems with blood clots or areas of lung collapse after surgery. These can both be very serious which is why we never like a patient to take to bed and not move after surgery. It’s not that we like to see patients suffer any more than necessary, we just don’t want any complications.
A patient may feel a little silly using one of these for a week or so but it will make recovery faster and safer and even easier. I’ve seen walkers at second hand stores and even new, they aren’t terribly expensive or maybe there is a family member who has access to one.
Keep an open mind and consider getting a walker for your recovery.
Seattle Plastic Surgeon breaks the ice at a party with her Tuzzie Muzzie!
There’s a Tuzzie Muzzie to complement any party frock.
Last Friday I attended my very first Twelfth Night Party. It was a fancy affair with cocktails, dinner, dancing, and dessert buffet at Seattle’s Women’s University Club.
You readers of my blog may find this a little hard to believe, but I am quite shy and I was a little concerned that I only would know one person at this fancy affair. I needed a little wardrobe courage so I wore my playful Tuzzie Muzzie. This little, whimsical party hat is a great ice breaker and conversation piece. It has served me well over the years.
Shorty after walking in the door into a sea of strangers, I was approached by a lovely gentleman who knew a lot about this particular party accouterment. I learned that the generic name for these fancy head pieces is “Facinator” and they are all over the place in the British party scene and the Kentucky Derby. I had no idea. I guess this Seattle gal needs to get out more or at least pay more attention of Royal Weddings and horse races!
I had a lovely time at the party and I know that my Tuzzie Muzzie was a big help.
I now feel lucky that Seattle has it’s own Facinator milliner. You can either shop online or go to Crackerjack in Seattle’s Wallingford Center and try one on. And make sure to wear it to your next party, especially if you won’t know many people and are a little on the shy side.
Thanks for reading! The rather shy Dr. Lisa Lynn Sowder
Permanent weight loss – here’s what I’ve learned from my patients
How to lose weight for good according to Dr. Lisa Lynn Sowder’s weight loss patients.
I am a bit of an expert on weight loss, not because I have ever had major weight loss, but because I know so many patients who have and have been able to maintain their weight loss. These are patients who come to me for body contouring procedures such as abdominoplasty, breast lift, upper arm lift, thigh lift, flank lift, lower body lift and so forth.
I always ask them how they managed to finally lose the weight and keep it off. I ask them to go into some detail. This is not because because I want to write the next “diet bestseller” and buy a small island in Greece (although that would be nice) but because I want to pass on their secrets of success to other patients who struggle.
About 40% of my weight loss patients have undergone weight loss surgery. That’s another blog. The other 60% have done it through life style changes. Here is what that 60% have told me:
Without exception, they have all sworn off sweets and refined carbohydrates.
Many have embraced a very low carb diet – think Adkins diet.
Almost all have maintained regular aerobic exercise – walking and biking are the most popular with my patients.
A few of my patients have been helped with nutritional guidance from a physician or nutritionist.
I cannot remember a patient who mentioned a prepackaged food or liquid diet system.
And here are a few patients I will never forget:
One gentleman lost 60 pounds when he quit drinking with the help of Alcoholics Anonymous.
One lady was able to stay 180 pounds overweight despite her gastric bypass through continuous and careful overeating. She finally dropped her weight 150 pounds when she addressed her emotional issues with a psychologist and the help of Overeaters Anonymous.
One lady lost over 100 pounds by jogging. She started really, really slow and got faster and faster as she lost weight. She became addicted to a runners high which I guess is better than most addictions.
Several of my patients were able to slim down only after leaving a dysfunctional relationship.
One teenager lost 40 pounds just by giving up soda.
One lady in her 60’s lost 100 pounds after having bilateral knee replacements. She had been very, very sendentary and once pain free, became more active.
So there you have it folks; Dr. Sowder’s Guide to Slow, Deliberate, Difficult, Soul Searching, Sweating, Hungry but Long Term Weight Loss. Just think, I could have written that best seller and here I am just giving it away.
Seattle Plastic Surgeon, Dr. Lisa Lynn Sowder blogs about patient satisfaction.
I can usually tell when a patient really, really likes the result of their breast or body contouring surgery, at least if they have had any sun lately. I just take a look at their tan lines! (Those of you who read this blog regularly know that I am totally anti-tan and I am not advocating any activity that causes tan line nor do I advocate non-tan line nude sunbathing!)
Sometimes I’ll have a patient who is super picky about a very minor imperfection but who has tan lines that tell me he/she is comfortable not wearing much at the beach or pool. Once I had a tummy tuck patient, well into her 50s, that was upset that her string bikini didn’t cover her bikini line scar. That is what I call a happy problem!
Hey, thanks for reading and stay away from those tanning beds. More on that in an upcoming blog. Dr. Lisa Lynn Sowder
Seattle Plastic Surgeon tells it like it is for obese women seeking breast surgery.
A recent article published in The Journal of Plastic & Reconstructive Surgery caught my attention. This article looked at breast surgery outcomes in 7982 patients (that would be almost 16,ooo breasts!!!!) and divided the patients in obese and non-obese. Their results were not surprising to me but they may be surprising to you. The obese patients had a nearly 12 fold increase in postoperative complications when compared to non-obese patients.
Breast reduction is the most common breast operation performed in obese women. That operation has a nearly 9 fold increase in postoperative complication in obese women compared to the non-obese.
This is not news for those of us who do a lot of reductions. The sort of problems that obese women tend to have are fluid collections (seroma), bleeding, delayed healing and infection. These complications sometimes require a trip back to the operating room and they always require many, many postoperative visits. Despite a rocky postoperative recovery, many obese women are still glad they had a reduction after everything is healed up.
So what’s the big deal? All’s well that ends well, right? Let’s look at this from an few different points of view. If insurance pays for the reduction, they don’t want to see more bills for a hospital readmission to stop postoperative bleeding or a bajillion office visit bills to treat an infected wound. And insurance companies are looking more closely at surgical outcomes and costs and using this information to rate surgeons.
If the reduction is private pay, the surgeon is unlikley to bill for increased postoperative visits which can run into 10 – 20 additional visits during recovery. This can get very time consuming and expensive.
And for the patient it is no picnic having to pack an area along the suture line that either became infected or fell apart. Post operative complications are just a total bummer all around, especially when the surgery is totally elective.
And here another issue. Let’s say an obese lady has 5 pounds of breast tissue (which is 99% fat) removed and her weight drifts back up to her preoperative weight which almost always happens. This means that she has gained 5 pounds of fat. If that fat is just external fat, say on her hips, it’s not a big health issue but if it isintraabdominal fat a.k.a. belly fat a.k.a. visceral fat, it is a huge health risk. Her breasts may no longer be killing her neck and back but her belly fat may literally be killing her.
So what am I really trying to say here. Obese patients need to understand that breast reduction has a high rate of complications and that a reduction may actually make them less healthy if they gain back their weight as belly fat.
So this is a real sticky wicket. Obese reduction patients are usually helped with back and neck pain with a breast reduction but weight loss would also help those back and neck pain issues. Non surgical weight loss has no surgical risk and is accompanied by a host of improvements in a patients health. Think high blood pressure, type 2 diabetes, arthritis, high cholesterol, etc.
So if you are obese and want a breast reduction from me, you will get a little weight loss lecture from me and may get turned down for surgery until you are able to shape up and slim down a little. You may be willing to accept a high risk for a postoperative complication but I may not be.
Thanks for reading. And if you have a quick, easy way to lose weight, please let me know. I’m all ears.
Seattle Plastic Surgeon blogs about spitting stitches a.k.a stitch abscesses a.k.a. a real pain for both patient and surgeon
Healing after surgery in most cases is uneventful. (Uneventful is a good thing when it comes to surgery and flying.) But sometimes uneventful healing can be interrupted by a stitch abscess which always looks way worse than it actually is.
Spitting stitches can occur whenever stitches are left in after surgery. In plastic surgery, we often close incisions just under the surface of the skin with stitches that dissolve over several months. If one of these stitches is a little too close to the skin surface, or works its way up towards the surface, it can cause a stitch abscess which is the skin’s reaction to a foreign substance (in this case the stitch). This is a lot like having a splinter in your foot or finger. It won’t get better until the splinter is removed. The same for a stitch abscess. It won’t get better until the stitch is removed. If you have had surgery and have a little area like in the photo above, give your surgeon a call and make an appointment to be seen. In the meantime, put some warm, moist compresses on the area and don’t freak out! It will be okay!
In most cases, a gentle probing with some sterile tweezers locates the offending stitch and it can be easily removed and the abscess resolves quickly. Sometimes, I will put a patient on antibiotics for a week or so if the inflammation is pretty wide spread or the patient feels lousy and/or is running a fever.
Back in the old days when silk and cotton sutures were used in the deep layers, patients could spit a stitch decades after surgery. Fortunately that is really rare these days although I have had a few patients myself spit permanent stitches years after surgery. It’s just one of those things that can happen but once the suture is removed, healing occurs quickly. Learn more here.
Seattle Plastic Surgeon, Dr. Lisa Lynn Sowder gives a tip for a more comfortable postoperative recovery.
Today I saw a lady for her preoperative visit for her upcoming tummy tuck. During this visit, I review the operative plan, do a physical exam, check any necessary lab work, write prescriptions, make sure all the patient’s questions are answered and make sure all of the paperwork is done.
I also use this preoperative visit to discuss recovery with the patient so they really know what to expect. I’ve been under the knife a time or two myself, so I really know what I’m talking about!
I often will recommend that tummy tuck and breast surgery patients buy a body pillow if they don’t already have one that they used during pregnancy. The body pillow can be used to make side sleeping more comfortable and safer for those patients who just cannot sleep on their back as recommended after surgery. They are also useful for keeping that man on his own side of the bed. When I was expecting, my husband referred to my BFF body pillow as the “Berlin Wall”.
Seattle Plastic Surgeon Blogs About Trees and Mommy Makeovers – Again.
I returned from my two weeks away on Sunday night after dark. The next morning as I was getting into my car, I caught the most lovely scent wafting across my drive way. Lo and behold, our harlequin glorybower tree had bloomed while I was away. This lovely little late bloomer does a good impression of being dead until late spring and then slowly leafs out and just when everything else in the garden is looking a little boring, tah dah, it bursts into bloom with the most lovely pink blossoms that then turn this otherworldy red and colbalt blue. It scent is heavenly for weeks. Come late fall, the leaves turn a purpilish orange and if you crush them, they smell like peanut butter!
So what on earth does this have to do with plastic surgery?
Well, my first day back I saw a lady who described herself as a late bloomer. She’s forty-something and just sent her youngest off to college. After years of taking care of her family, she’s ready to do a little something for herself, in this case a mommy makeover. This is something she has wanted to do for years but with a busy household to run, never had the time for the surgery or the recovery. Now she’s finally has the time to bloom.
Seattle Plastic Surgeon is shocked, shocked! at the size of these marshmallows.
As a plastic surgeon, I am often asked what I think is causing the obesity epidemic. I’m not an epidemiologist or an endocrinologist but I am a mom who shops for her family and I think I know the answer.
Last weekend, I was shopping for our Fourth of July celebration and the makings for S’Mores was on my list. The grocery store had a nice display of everything one needs for these tasty campfire treats including these gigantic marshmallows. I estimate they are four times the size of a “normal” marshmallow. Yikes! What is next? Graham crackers and chocolate bars the size of an ipad?
One of my sons thought these supersized marshmallows were great until he roasted one. Due to the decrease in surface area/size of these monsters, the inside does not get gooey enough unless the outside is over-roasted. This makes for an unsatisfactory S’More that is too thick to fit into even the largest mouth.
So we’re giving a thumbs down to the supersized marshmallows and hopefully to the expanding waistline. It’s easy for my growing, active kids to burn up the calories from all of our oversized food. But for those of us of a certain age, it would take 12 minutes on the rowing machine to burn off one of these sugar bombs.
A flak jacket is good protection for breast implants! Just don’t forget your post-operative sports bra.
Seattle Plastic Surgeon just loves a woman in uniform.
Western Washington is home to several military bases so it is no surprise that as a Seattle plastic surgeon, I see quite a few soldiers (female and male) who are interested in having a variety of procedures. The military has excellent plastic surgeons who are fully capable of doing just about any operation but the wait for a purely elective procedure is so long, a lot of military folks will seek care outside. Also, there is a bit more privacy on the civilian side.
These fine men and women in uniform usually are great patients because they are in excellent shape and because they are really, really good at following pre-operative and post-operative instructions. And (this is what I really love) they often refer to me as ma’am, as in “Ma’am, when can I wear my flak jacket and do a 10 mile march with a full pack?” I find that a nice change from “Hey, doc, when can a get back to my kite board?”
Thanks for reading! Seattle Plastic Surgeon, Lisa Lynn Sowder, M.D.
@lisalynnsowder
