Explore Plastic Surgery

Elective plastic surgery procedures, such as tummy tucks (abdominoplasty), extensive liposuction, breast reductions, and full facelifts, place great stress on the body in an effort to heal the extensively traumatized tissues. Such operations are prone to ‘wound complications’ such as small open areas and delayed healing as the body is stressed to meet the nutritional needs of the recovering tissues. Many patients are not optimally prepared from a nutritional standpoint for such procedures and may be more prone to such postoperative problems.
I like to think of preparing for surgery as an athletic event. Being at a good weight, if possible, in reasonable physical shape, and in good nutritional balance will help improve the surgical outcome, lessen the risks of certain complications, and have a faster physical recovery. Any edge that a patient can gain is fair game when it comes to your own surgical experience. For this reason, I advise my ‘big surgery’ patients to begin nutritional supplements 3 weeks before surgery including high doses of Vitamin C (2 grams per day) and Maxitropin supplements.
Maxitropin is targeted nutrition therapy that contains a patented blend of amino acids that function as ‘secretagogues’, which are designed to stimulate growth hormone release and support wound healing through collagen and protein synthesis. Such targeted nutrition therapy can help improve surgical outcomes through enhanced wound healing. One packet (two scoops per day) provides the following:

Glutamine 6g. : Its most important function is to strengthen the immune system and prevent muscle loss.
Arginine 1g. : Helps build muscle, enhances fat metabolism and mobility and fights off infection.
Lysine 1g. :The human body cannot produce it on its own, and it is critical for the growth and production of hormones, enzymes and antibodies.
Glycine 1g.: Essential for the formation of DNA, collagen, phospholipids and the release of energy.
Ornithine 1g. : Reduces fat and increases muscle mass, stimulates the immune system and enhances wound healing.

Suggested Use: Dissolve 2 scoops in your favorite juice or beverage 1-2 times daily on an empty stomach for optimal absorption. (half hour before a meal or 1-2 hours after a meal)

Nutritional intervention that increases collagen and protein synthesis, supports immune function, and rebuilds lean body mass is a fundamental part of promoting wound healing.

Amongst the many adverse effects of smoking on the body is its detrimental impact on wound healing. This phenomenon has been recognized since the late 1970s when a correlation between smoking and an increased risk of wound problems in surgery was established.This is quite important in plastic surgery where large skin flaps area raised, resulting in a decreased blood supply to the raised skin as the circulation is cut off from below and skin survival is dependent on blood flow coming in from raised skin only. Cosmetic plastic surgery procedures such as facelifts, tummy tucks, and breast reductions in particular, are particularly prone to healing problems from smoking.
For this reason, the identification of smoking on a patient’s history is very important. It is often one of the first things that I look for on the intake medical history after allergies and medications. Whether the amount of tobacco use listed is accurate is up for debate. I figure most patients put down what they would like it to be, not necessarily how much tobacco they are exposed to every day. I strongly urge patients that they must refrain from all tobacco use at least three to four weeks before and after surgery. Some plastic surgeons refuse to operate at all on smoking patients for certain procedures such as a tummy tuck. I even know some that get a nicotine level several days before surgery. I don’t go quite that far but I can understand this concern. No plastic surgeon wants to deal with avoidable complications. On the surface, no patient wants to either but the addiction of smoking is quite strong even in the face of making smart decisions when you are venturing thousands of dollars in an investment in your body.
There is little question that smoking affects wound healing. I have seen a disproportionate number of patients who said they stopped smoking, but when they developed wound problems such as a dehiscence (separation of the incision line), they casually admitted that they had not stopped completely or had slipped in a few in the past few days to ‘calm them down’. Although I have no scientific evidence to support it, my feeling is that the effects of smoking probably takes many months (not just 3 or 4 weeks) and even up to a year after quitting to become ‘normal’ from a wound healing standpoint.
A recent journal article in Plastic and Reconstructive Surgery (May 2008) now implicates smoking as a cause of increased infections as well. I must say I am not surprised.
Dr. Barry Eppley
http://www.eppleyplasticsurgery.com
http://www.ologyspa.com
Clarian North Medical Center, Carmel, Indiana
Clarian West Medical Center, Avon, Indiana
Indianapolis