• Dr. Megan Dreveskracht

PLANNING YOUR PLASTIC SURGERY PROCEDURE


They say timing is everything and, when it comes to your Plastic Surgery procedure, it can be. One of the most common questions I get asked is “when is the best time for plastic surgery?” While this can vary depending on the patient and the procedure, there are some common factors to consider when deciding the timing of your surgery. Below are the top factors I advise my patients to consider before scheduling surgery.


#1: Your weight

Now while we all hate talking about our weight, this is an important consideration when determining the optimal timing for Plastic Surgery procedures. No, Plastic Surgeons aren’t out to shame you for not being at your ideal weight, but Body Mass Index (based on body weight and height) plays an important role in safety, healing, and in getting the best surgical outcomes. Some Plastic Surgery practices even screen patients for their BMI over the phone and have hard, fast cutoffs for weight with their patients. Below are the reasons why weight (more specifically BMI) are important:

  • Weight changes directly affect our skin. When we lose weight, we lose fat. The skin, however, rarely tightens with weight loss--once it’s stretched out significantly, it tends to stay loose. Since most plastic surgery procedures involve some form of skin tightening, losing weight before your procedure gives us a better chance of removing all the excess skin in a single procedure and avoiding revisions down the road. Thus, being as close to your realistic goal weight as possible is ideal. There is one big exception to this. I do get patients who are smack in the middle of their weight loss journey but have stalled out due to an inability to exercise and discomfort from all of their loose skin. In these special instances, something like a Tummy Tuck might just be the ticket to helping boost them to reaching their goals.

  • Breast volume can fluctuate with weight. Now this isn’t true for all women, but weight changes can have a dramatic effect on breast volume. If you are considering a breast procedure (lift, augmentation, reduction), it’s best to have a steady baseline breast volume when devising a surgical plan.

  • Safety during surgery. During most plastic surgery procedures, some form of a tube (ET tube or LMA) is placed in the airway to assist with breathing while a patient is under anesthesia. Higher BMI’s can be associated with difficulties placing or removing the tubes as well as making sure air can flow through the lungs. Patient safety should always be front and center in a procedure, and in these circumstances a hospital setting is safest and most appropriate.

  • Complications. Higher BMI’s are associated with higher postoperative complications. Since these are elective procedures, lowering the BMI to decrease the risks of having such complications makes sense to achieve the best outcome possible.


#2: Plan for a Proper Recovery

You’re investing a lot of time, energy and emotion into having your Plastic Surgery procedure. You owe it to yourself (and your wallet) to carve out the time you will need in order to recover properly. I get it--I’m go, go, go too. But, if you want the best results from your surgery, you need to take it down a notch and follow the limitations we set forth for patients postoperatively. Most of my patients are mothers and we all know you cannot turn off being ‘mom’ at home. So what do you do? You PLAN! Ask family to come stay, work out a schedule with your significant other, or ship those kids out to grandma's house. If these aren’t realistic options for you, you may want to consider waiting to have surgery until your kids are a bit older and can care for themselves more.


#3: Family Planning.

There is no hard, fast rule that you need to have kids before Plastic Surgery (and this really only pertains to breast and body procedures). I would argue that for most procedures, you are going to get more years of benefit in terms of improved self-esteem and confidence by having these procedures done at a younger age rather than waiting till you are older. But, the unavoidable reality is that having kids has a couple of predictable consequences for us and our bodies that bear remembrance-- stretching out our abdominal skin and possibly our ab muscles, deflating our breasts, and keeping us really, really busy. For abdominal procedures, it makes sense to wait until after those little bundles of joy have given us all the stretch marks and loose skin they can before turning around and cutting it all off. Breast procedures are a little trickier. We know that having kids will likely change our breasts but it's hard to predict just how. Some women get larger, lots of women get smaller, and most of us get a bit saggier. However, my patients who undergo breast procedures before having kids report a high rate of satisfaction even if, after having kids and breastfeeding, their results are a little less great or they need some sort of revision.


In decision making, I think everything largely boils down to a cost-benefit analysis. If the satisfaction you will get from your procedure now highly outweighs the possibility of your results changing or needing a revision later then I say go for it! Plastic surgery is all about restoring and building confidence, and making you the absolute best version of yourself possible.


Have a topic you would like me to discuss? Leave it in the Comments section!

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