Nutrition Tips For Perfect Plastic Surgery Results
by Christine Gerbstadt, MD, RD
Reap the success of your weight loss by looking as great as you feel! Although large weight losses may leave sagging skin in the abdomen, arms, thighs, buttocks and face, you don’t need to keep this reminder of your former self. Cosmetic surgery, often covered by insurance, can remove excess skin and return a youthful appearance to your new healthy body. A multitude of factors, including how much weight you lost and how good your nutrition is before cosmetic surgery will affect your healing after surgery. Eating healthy can improve your results and prevent unwanted complications like wound infections and poor incision healing. Here are tips to get the best plastic surgery results with good nutrition.Your pre-operative consultation
Congratulations! You have maintained your goal weight long enough to decide it is time for plastic surgery. You and your Board Certified Plastic Surgeon will discuss your surgical options to decide upon a plan. Board Certified Plastic Surgeon Lori Cherup, MD at Radiance™ near Pittsburgh, PA, explains that your ability to “trust your plastic surgeon and be a good patient will create a platform for success.? (www.drcherup.com) Good nutrition is vital in the weeks or months before and after surgery, because with good nutritional health, you will heal better. It is likely you will need general anesthesia for your procedure, even if it is scheduled as an outpatient. At Hillstrom Facial Plastic Surgery in Sarasota, FL (www.HillstromPlasticSurgery.com) preoperative surgery and anesthesia evaluations include a history and physical examination, an EKG and possibly a chest X-ray to evaluate your heart and lungs, and blood tests. Laboratory results help evaluate your nutritional status by looking at iron (hemoglobin), protein (albumin), liver (AST, ALT) and kidney (creatinine) function. If any problems are identified, it is usually best to correct the problem before surgery to avoid infection and poor incision closure, even if this postpones your surgery. This is NOT a time to intentionally try to lose additional weight.
The major 10 nutrients for good nutrition and plastic surgery
- Iron: Low iron will cause iron-deficiency anemia and reduce the oxygen delivered to healing tissues. This can create risk for infection or for the incision to not close properly, called wound dehiscence. Lean beef, pork, chicken and fish are the best food sources of iron to get the 18 mg per day that adult women need. After WLS, absorption of iron by mouth may not be adequate to keep iron levels normal. Occasionally intravenous iron may be needed, but you will generally discover this problem within the first 6 to 12 months after WLS surgery.
- Protein: You may already be taking protein supplements such as whey or soy protein. Adequate protein intake before surgery helps to ensure that you will heal properly. Typically, protein intake from 0.5 to 1.0 grams per pound of body weight, which is 85 to 175 grams daily for a person weighing 175 pounds, will be adequate. A three ounce serving of lean meat provides 21 grams of protein.
- Calcium: Low calcium absorption after WLS greatly increases risks for weakened bones. One cup of skim milk provides 300 mg calcium, but after WLS, a supplement may be needed to get the adult DRI of up to 1200 mg per day. Be sure to have your bone density checked after major weight loss and blood work to monitor ongoing calcium absorption.
- Zinc: Zinc is one mineral that may be poorly absorbed from plant compared to animal foods, and also after WLS or a major weight loss. Inadequate zinc intake can result in retarded growth, delayed wound healing, loss of taste sensation and skin conditions. Zinc supplementation in the pre and postoperative period can improve wound healing. Aim for at least 8 to 12 mg per day from foods like beef, pork, cheddar and parmesan cheeses.
- Magnesium: Magnesium powers more than 300 functions in the body, including normal muscle, nerve, heart rhythm, immune system, and bone function. Magnesium also helps regulate normal blood sugar and blood pressure, as well as energy metabolism and protein synthesis. The adult DRI for magnesium is up to 420 mg per day. Halibut, spinach and whole grains like wheat and soy, and nuts and sesame seeds are rich magnesium foods.
- Potassium: Normal potassium levels are critical for blood pressure control and proper heart function under anesthesia. The adult adequate intake (AI) for potassium is 4.7 grams, and there is no upper limit (UL) with normal kidney function. Abnormal potassium levels in the blood can lead to serious heart disorders. Blood work can monitor your levels, and supplements may be indicated. Aim for nine servings daily of fruits and vegetables, including potassium rich potatoes, soy beans, spinach, apricots and peaches.
- Vitamin B 12: The vitamin for healthy nerve function is found in animal protein foods such as meats, eggs, fish and dairy products. Some WLS patients cannot absorb the 2.4 mg daily requirement for vitamin B 12 from food. Luckily, a blood test can detect this, and a shot can correct the deficiency.
- Vitamin D: The DRI of 600 IU per day is a good minimum for vitamin D, and current research suggests that up to double this amount may improve health. The main function of vitamin D in humans is to regulate calcium and phosphorus metabolism. Its deficiency in adults leads to osteomalacia, a disorder of bone. Salmon, tuna and sardines have around 400 IU per three ounce serving. Fortified milk is another reliable source.
- Vitamin A: The adult male DRI is 900 micrograms per day of Retinol Equivalents (1 RE retinal = 1 microgram.) Pro-vitamin A, found in dark green, yellow and orange fruits and vegetables like broccoli, pumpkin, sweet potato and spinach cannot be toxic like preformed vitamin A found in organ meats.
- Vitamin E: This powerhouse vitamin, found in avocado, blackberries, almonds, hazelnuts, peanuts and Brazil nuts, acts as an antioxidant in the body and also promotes healthy wound healing. According to Roberto Gonzalez, MD a Board Certified Plastic Surgeon in Altoona, PA, you will probably be asked to stop taking vitamin E preoperatively because it may lead to increased bleeding during surgery. (www.blairplasticsurgery.com) Be sure to ask when you can resume this supplement to get the 15 mg per DRI.
Post-operative nutrition promotes better healing
You took the plunge and had cosmetic surgery to reveal the beautiful body you had hidden under excess skin folds. Now you want the best conditions to reduce risks like infection, poor wound closure and unsightly scarring. Good nutrition is critical to getting the best result. Eat small, frequent, well-balanced meals like you ate post-WLS. Try to eat protein from lean meat, chicken, fish or eggs at every meal and snack. Your body is in overdrive with healing and regenerating activity, which requires nutrients like vitamins, minerals and protein. Try to maintain your weight to prevent malnutrition. This is NOT a time to intentionally try to lose additional weight beyond the pounds that were removed during surgery. If pain pills or surgery have decreased your appetite, a low sugar whey protein shake may help get important nutrients in with little volume. This is also a time to maintain fluid intake of at least three to four quarts daily between meals to prevent dehydration. Low sugar meal replacement beverages can help boost calorie intake if you are losing weight. Resume your exercise routine as soon as your doctor gives the OK.
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Christine Gerbstadt, MD, RD, is a Board Certified Anesthesiologist, Registered Dietitian and President of Nutronics™, Inc. She can be reached at www.NutronicsHealth.com.