5 Things You Don’t Know About Recovering From Plastic Surgery

Announcer (00:00):
You're listening to the La Jolla Cosmetic podcast with Monique Ramsey.

Monique Ramsey (00:04):
You've read the pre-op packet and you've stocked your fridge with protein shakes and cleared your calendar. But what if I told you there are a few surprising things that could make or break your plastic surgery recovery, like keeping your dog or cat out of the room? Joining me today is Kayla, our clinic manager and lead nurse for Dr. Swistun, and she's going to help me dive into the things that you may not know about plastic surgery recovery, the small stuff that makes a big difference. Welcome, Kayla.

Kayla (00:38):
Hi. Thanks for having me again.

Monique Ramsey (00:41):
Oh, thanks for coming. So what inspired this episode was I have a friend who's thinking about surgery and we started talking and I said, oh, you can stay at my house and now if I'm gone, you can take care of my cats. And Ruthie our coordinator is maybe not. And I was like, what are you talking about? Well, so that's what inspired this episode. And I remember from, what was it, like 2018, there's a story about a man who lost all four of his limbs and most of his noses from a bacteria from his dog kissing him. So what's that about?

Kayla (01:20):
Yeah, so he contracted a bacteria after the lick from the dog saliva. He was in the hospital, he lost his limbs. And it's tragic because you are parents to these animals and you think just a simple kiss is going to be a simple kiss, and then down the road it could be this. And so at least a doctor said that he was very positive and as soon as he got home, he cuddled with his dog. But hopefully no more licks. It's just a tragic story.

Monique Ramsey (01:53):
And it's super rare that this would happen. But it was I guess a pretty, what's the word? Just like a common mouth bacteria in animals. So it wasn't like the dog had some strange disease and then one thing led to another and it was funny because the articles were like, and he kept the dog. I'm like, of course you keep the dog.

Kayla (02:19):
Yeah, we're in this together.

Monique Ramsey (02:21):
Yeah, which I thought was weird, but we'll put a link to the article in the show notes and then you can look it up from, I mean, he's on different videos and stuff, but it's just really tragic. And so when that happened, that led to us changing our protocol about animals. And that's not super obvious and I forgot all about it and I didn't realize we even changed our protocol. I just remember the story. And so why do we want to keep our furry friends at a distance and what do we recommend in terms of what are okay things and what are not okay things with the animals?

Kayla (02:54):
So I always ask patients if they have pets at home and you just never assume cat or dog. You don't really know. I mean, you can have any sort of animal these days. I always ask, do you have pets in the home? And they'll let me know they have a cat, dog, bird, rabbit, whatever. But it is so important to keep the sheets clean. So I tell patients don't wash 'em once, maybe wash 'em twice because the fur, you have incisions that just take a couple weeks to really seal and heal. And of course we have Steri ships covering the incisions, but sometimes those steri ships get wet and sometimes they can fall off and be exposed. And although we're monitoring our patients closely, I really do think it's important for patients to make sure that their sheets are clean, that the clothes that they're going to be wearing, especially early on out of surgery, that they don't have any fur on them, that they have guests to come in or someone to help walk the dog or change the litter box. You just don't want to run the risk of any bacteria associated or coming near to the incisions or anything fresh from surgery.

Monique Ramsey (04:07):
And is it kind of the same advice for dog owners or cat owners or do you guys really say keep them out of the room for X amount of days?

Kayla (04:15):
Yeah, so definitely I think it's just the same all around for both cats and dogs. I think keep them out of the room. Don't go home and snuggle with them at least two to three weeks while things are fresh. I know patients want to jump back into bed with their dogs and this is when they really need their support because restricting them, don't do this after surgery, don't do that. And so now it's a good time to Netflix and chill with your animals, but everything is very fresh and you don't want to run the risk. And we always want to be more risk adverse and be ahead of any risk. And so with that, it's just best to keep the pets out of the room, especially during sleeping hours because they can jump on you. And actually what comes to mind is a patient, well, it's happened maybe a handful of times, but patients have said, my cat just stormed through my drain that was hanging from my tummy tuck. And that is just one of the reasons why I stay away from the animals because that is very painful. And then they come back, you have to put a new drain in. And so it's not fun to start from beginning or the start.

Monique Ramsey (05:24):
No. And they chew on things too. Cats will, I had a cat way back in the day when we had landlines and my husband was talking to a call, this very important call from Germany, and it was this whole thing in the middle of the call the cat. So Coco, all of a sudden the call disconnected and we found out she had chewed through the phone card. So it was like, but then on a drain it'd be super tempting for a cat.

Kayla (05:52):
They think the bulbs are toys just hanging and then they just think, let me just run right through the drain. And then their claws or even dogs, their paws can get stuck onto a garment and it's painful.

Monique Ramsey (06:08):
True, true.

Kayla (06:09):
You are already kind of going through this recovery period. Don't add to it. Don't take the risk.

Monique Ramsey (06:15):
Now, what's something else that maybe patients don't prepare for at home that ends up being or could end up being a big deal during recovery?

Kayla (06:25):
So I would say patients don't really plan for their bowel movements because anesthesia is not fun when it comes to a bowel movement. It takes a while, it takes a few days to really wake up the bells. And so I would say you can do something as simple as MiraLax, but then if you're really constipated in the next few days, you could even do a ducolax suppository. You want to try that because it's uncomfortable. You're already uncomfortable and moody from surgery sometimes. And so then to add that to the mix is just be efficient with all of your planning. And so I would say definitely plan for the bowel movement and hydration, definitely hydration, stock up on your water, stock up on your electrolytes. And I'm trying to think if there was something else. Meal prepping. Meal prepping is a huge help. Make sure you have high protein, high fiber, and just overall good nutrients that are going to get you through the days. So you need the energy. You also need to sleep well. And like I said, you need to have the bowel movements. So those are just a few things that come to mind.

Monique Ramsey (07:41):
Well, I think the bowel movement topic, people don't assume they don't really know. And part of it's like you say, the anesthesia, the painkillers, all of those kind of stop you up. You're maybe not drinking and being as hydrated as you need to be. And also you just don't have the motility, your movement when you are walking around the house and the more movement you do that gets things going. Well the first couple days you're maybe not as mobile as you would normally be, and then everything slows down. It's like when people talk about when they travel and why is it every time I take a plane ride and I go on a trip that everything becomes irregular? Well, you might have been on a plane for eight hours and things aren't normal. And so I think that's great advice to just sort of think, okay, what are the things I'm going to need? You don't want to be, especially having surgery, whether it's your face or your body bearing down and pushing, that raises your blood pressure and that's not good.

Kayla (08:44):
Exactly.

Monique Ramsey (08:45):
So what is maybe something that patients think is going to be helpful during surgery, but maybe it really isn't that helpful?

Kayla (08:56):
Planning to clean the closet, that's never helpful. Doing laundry and doing laundry, and I say it of like, oh, I'm just going to sit here and fold the clothes. But that's the thing, it's like repetitive motion. You folded one load and now you've got three more. And patients also don't realize that after anesthesia and surgery, you're just tired. And so what you would normally do in your day-to-day could feel like you are working at it for three days straight. So just a simple task as folding laundry. So I would say anything that with repetitive motion and also rearranging your cabinets, it's like I'm just going to move these dishes over to this cabinet or rearranging the bathroom drawers. I'm not really doing much, I'm just standing here moving things side to side. But again, it's repetitive motion. So all of those household chores that you thought you can wait to do for when you have just more time in the house, those are the things you don't want to do. You want to protect your investment.

Monique Ramsey (09:58):
Well, and you could be sabotaging your recovery without even really realizing it. You're thinking, I think all of us are, there's always those projects, those back burner projects that you're like, oh, I'll get around to that sometime. And you want to be efficient, right?

Kayla (10:12):
Yeah, this is my time off. What do you mean? I took two weeks off work. This is perfect timing and it's just not.

Monique Ramsey (10:20):
Well, and it's like you pay all this money, you take all this time, you do all this prep and you don't want to undo it with some silly thing, right? It's like don't be tempted and you think you feel well. And I know because I have a family member who's not going to be named, who's a Dr. Swistun patient who went on a walk and she shouldn't have, and I told her not to. And Dr. Swistun told her not to and you told her not to.

Kayla (10:44):
Yep. I am also, anyway, but I'm speaking from experience too because when I had surgery, it was right around a two week window of my daughter's birthday and I'm going to go to the zoo, this is perfect. We're just walking. We're just walking.

Monique Ramsey (10:58):
All the hills at the zoo.

Kayla (10:59):
And all of the hills. And there I was back in the OR with a hematoma. So take advice from someone that's been there, done it, it's not worth it. It's not worth to start over and you want to be safe about it. And this is something that, like you said, you've put the time into it, it's an investment for yourself and so you deserve to take some time to rest and you'll get to the finish line. It just, you've got to take care of yourself first.

Monique Ramsey (11:28):
Now, do you have any random or quirky tips or something you swear by that wouldn't maybe be obvious or show up in the standard post-op instructions or a hack?

Kayla (11:41):
So I would say pregnancy pillows, wedge pillows where there's these wedge pillows where you can, if patient has BBL or even any fat transferred to the lower extremities. So there's a wedge pillow where you can literally just place it at the side of your hips. And so it takes all the pressure off of the area that you fat grafted on that same area and on the opposite side too, and you're still able to sleep on your side. So those are really helpful. Pregnancy pillows are helpful because we tell patients don't sleep on your side, so it helps kind of position you better. I would also say boxer briefs for patients that have had tummy tuck, it sounds so silly, but I've told our patients, just pick up some boxer briefs. Like those disposable ones, you are not going to care what they look like, how they're comfortable. Your drain is oozing on it, so it doesn't matter. They're not your nice,

Monique Ramsey (12:37):
You don't care.

Kayla (12:37):
They're not your nice underwear, who cares? And then they kind of apply a little bit more compression and over the abdominal area so it's perfect. It goes right over the binder or it goes right over the garment. So a little bit more compression without it being too snug is perfect. The other one I would say, and I forget the name of this all the time, but we've all been there, all done it, all of us that have kids, but after pregnancy you have those squeezy bottles that you can fill with water and you just use them to wash.

Monique Ramsey (13:10):
Oh yeah, I know what you're talking about. Yes,

Kayla (13:12):
Those are perfect. I tell all of our patients that are having any body contouring because they can't really shower or bathe before the drains are out.

Monique Ramsey (13:21):
Be clean.

Kayla (13:22):
Exactly. So taking one of those soap and water, rinsing the areas is perfect. So those are some helpful tricks.

Monique Ramsey (13:32):
Especially if you have, sometimes you have a shower where it has the detachable

Kayla (13:39):
The hand held?

Monique Ramsey (13:39):
Washer thingy, the handheld thing where it could be on very lightly, not strong, but if you don't have one of those, that's a really good idea. Really good idea. And would you say having a friend to help you is, I know you have to have somebody with you for 24 hours, but where kind of in the post-op experience, is it good to have your friend help with certain things like getting you up maybe or helping in the shower?

Kayla (14:10):
I would say the first three days beyond that, as long as you have some meals made, you have an alarm set on for your prescriptions. But everyone is different. I would say the first three days, you should absolutely have someone with you until you get the hang and the rhythm of what does this look like in your day to day when you're going to eat is everything kind of accessible in the home without having to reach really high above shoulders or kind of behind the back. So as long as the home is prepared and set up, I really don't think having someone 24 hours all day every day beyond the three days, I think friend or a family member popping in twice a week is perfect.

Monique Ramsey (14:56):
Now if you are going into surgery, you think you've done all the prep and you've bought all the things, is there always something that, one last thing they might be forgetting?

Kayla (15:06):
I would say their prescriptions. So it's always helpful.

Monique Ramsey (15:10):
Seriously?

Kayla (15:10):
Yeah, helpful to bring the prescription so that our PACU recovery nurses can cover exactly what they're going to take when they get home. And just the person that's going to be picking them up from surgery has a better understanding when it's visually right in front of them. So going through the steps of the medications. And the second part to it is just the emotional rollercoaster of surgery is just being nice to yourself. Give yourself some grace. Remind yourself before you go under, you're not going to, you're probably not going to feel that great when you wake up and that's okay. And you don't have to one know it all when you wake up. You don't have to know exactly what's going to happen as soon as I leave here. That is not for you to worry about.

(15:58):
That's for your caretaker to take care of. And just know that the next few days are not going to be so fun. You're going to be tired, you're going to have to give yourself some grace and you're going to have to be okay with just resting. So definitely the emotional rollercoaster of it. And I say emotional rollercoaster for anyone that's doing elective surgery or surgery that isn't elective going under and preparing to have these restrictions of you're going to have some downtime, you can't do this, you can't do that. That is an emotional rollercoaster in itself. And so

Monique Ramsey (16:33):
Yeah, that's a good point. Are there any myths or assumptions that patients have that you want to set the record straight about?

Kayla (16:43):
That when you wake up, that's your final result? That is what it looks like. So patients sometimes can get a little impatient with how things are settling and just know that it takes time for tissues to settle and remodel. It takes time for swelling to resolve. It just depends on the procedure that you're having. But around three weeks you have an idea of what things are going to look and feel like. Even more so at six to eight weeks where majority of the swelling has resolved about 80% or so, but then you've still got the six months to a year to really have that final result. But then also scars are another side of things that patients are like as soon as they see a scar, it's like, oh, is this what it's going to look like? But no, scars have to break down. Your body's going to do all the natural healing. You have to give them a year before you really judge the scars.

Monique Ramsey (17:43):
Yeah, that is so true. And it's crazy how much they change. And you forget too. So it's, you forget even sometimes what you look like before surgery. You're like, oh, but I haven't changed that much or this, but oh, when you see you're side by side, so it's good to take some little progress photos because then you're like, oh wow, I really have come a long way. Because I think you lose perspective and maybe it's because you're in the middle of it all. And like you say, your brain's a little crazy, your emotions are crazy and things are your body's busy healing, so maybe less reinforcements are going to your brain and more going to that area. It's trying to heal and you're a little loony for a couple days. But like you say, giving grace, I think that's a great way to put it, giving yourself grace, giving yourself time to heal knowing that we've all been there.

(18:37):
And that's where I think having the support of the staff and the surgeons, really, almost all of us have had something done at one time or another or more things than just one thing. And we can all say from our own point of view what we felt like or what, oh gosh, you're going to feel this way, but trust me, it's going to pass. And that quintessential feeling that I think every surgery patient goes through is the next day they're like, why did I do this? I was fine yesterday. What in the world was I thinking, why did I do this? Totally normal everybody.

Kayla (19:15):
And then you get the six to eight weeks and you're like, let's do it again.

Monique Ramsey (19:20):
It's so funny. Let's do it again. And it's just like clockwork. Everybody feels that way. And so whatever's going on inside know that it's normal and okay. And I think you have that pre-op visit about two weeks before surgery and your nurse goes through everything with you and it's a lot. And we give you a whole book to take home. So it's like you have your little booklet and it's going to walk you through. But that thing's really helpful because when you're pre-op, you're not digesting that first 24 hours, what that's going to be like. But when you're in the middle of the first 24 hours or the next 48 that you can look at the book. Oh yeah. Okay. And it refresh your memory. That's super helpful.

(19:59):
And I would say my biggest piece of advice, I mean I have lots of them, but one of them is having a sheet with all your meds, especially if you have drains. So my meds and this one's every four to six hours or this one's this much and taking off because you think you're going to remember and you don't. Or like, oh, the drains, okay, I did 'em at this time and here's how much. I mean, you got to, so having a little chart, even if it's hand drawn or we give you a piece of paper and with where you're going to record all this information because like I say, you think you're going to remember and you don't. And so you're like, oh wait, which pill did I take? The Keflex? Did I? You just dunno.

Kayla (20:42):
Which is what?

Monique Ramsey (20:43):
Right. So I think and having that by your bed, and I think that's a really important thing to do because of course your helper's going to be helping you do that, but then at some point you're going to take over.

Kayla (20:58):
Yeah, you're going to be doing it yourself. And we give patients the drain log and the medication log. But I would say the third thing that's really helpful is just setting an alarm for those medications. But yeah, that was my last note there is just to set alarms for those medications. So there's no way you can forget.

Monique Ramsey (21:19):
That's right. It's just going to bing at you and yeah. Well thanks Kayla. This was so interesting. And we'll put in the show notes, the links to some of the things we talked about. Let's get some of those links to the special pillows you were talking about or wedges and some of that, if you have 'em, can think of it. And then we'll put a link to the story about the guy with a dog, which makes me so sad, but he's like, what a trooper. And he got himself through it. But one thing he said, he's like, I thought I had the flu. He didn't feel well. He thought I had the flu and it wasn't that. So always pay attention to your body, call your, and so anyway, well thanks Kayla. This was super informative and everybody in the audience, thanks for listening. We hope you subscribe and if you subscribe, you just have to show us, come into the office and we'll give you $25 off of any product of 50 or more. So that's kind of a nice little treat and we thank you all for listening and we'll see you on the next one.

Kayla (22:23):
Thank you.

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