Your doctor may tell you to avoid strenuous exercise after undergoing a surgical procedure, but what does “strenuous” really mean? The truth is, what’s considered strenuous is going to be different for everyone.

So, now you’re probably wondering, “How do I determine what strenuous is for me?” A general rule of thumb is that strenuous exercise involves significantly elevating your heartbeat to about 80% or 90% of its maximum for a relatively extended period of time (usually about 20 to 60 minutes). Examples of strenuous exercise may include running and contact sports.

Each cosmetic procedure carries unique recovery parameters. Non-surgical procedures often allow patients to get back to their usual routine without any restrictions on activity. However, most surgical procedures require patients to rest and recover. Patients are often encouraged to start a slow walking routine starting the second day after surgery, gradually working back up to regular exercise in the weeks that follow. Rigorous exercise is often not allowed during the first 2 weeks following surgery in order to decrease bruising, swelling, and bleeding. For example, I tell my tummy tuck patients in Birmingham to avoid strenuous exercise for a month after surgery.

Please feel free to share your experiences or ask questions about exercising after surgery.

At my practice in Birmingham, Alabama, liposuction is a very popular procedure. Liposuction is meant to slim and reshape specific areas of the body, improving contour and proportion – and often enhancing self image. Despite the obvious appeal of the procedure, not everyone is an ideal candidate. There are a few basic requirements:

• Patients should be within 30% of their ideal weight
• Patients should not have a life-threatening illness or condition that could impair their ability to heal properly
• No smokers!
• Anyone pursuing the procedure should have realistic goals and a positive attitude

In addition to these requirements, however, there’s another very important factor to consider: skin quality. More specifically, patients with poor skin elasticity may need reconsider liposuction. Inelastic skin can cause wrinkles and sagging. Liposuction can make this worse. Although some liposuction techniques (such as laser-assisted liposuction) claim to help with skin retraction, evidence does not necessarily support these claims and, even if some skin retraction can be achieved, it is not enough for most patients with inelastic skin.

But don’t worry – for individuals with poor skin elasticity, there are still ways to achieve cosmetic improvement. Procedures such as tummy tuck and body lift that actually reduce loose, sagging, excess skin can simultaneously slim and smooth body contours.

It should also be noted that liposuction is not a treatment for obesity or a substitute for proper diet and exercise. Nor is liposuction a cure for cellulite, the dimpled skin often described as “cottage cheese.”

The issue of breast reconstruction after mastectomy is one that I find particularly important. It can be extremely valuable for the mastectomy patient and extremely rewarding for the reconstructive surgeon. However, surprisingly few women actually choose to undergo reconstruction, even though legislation requires all insurance policies to cover it. According to a study performed by Alicia Holt, MD, Surgical Fellow at City of Hope Medical Center in Duarte, California, only about 20% of eligible women opted for this procedure in 2007.

Why is this? As an Alabama plastic surgeon with years of experience performing breast reconstruction procedures, I have some ideas. I believe the main reason for the low percentage of women pursuing the procedure is lack of information. There are plenty of resources out there, but evaluating the information and understanding the options can be difficult. Here, the guidance of a qualified and caring doctor is absolutely essential.

Physicians should be clearly articulating the benefits of the procedure, which are substantial. First, there’s the obvious aesthetic improvement – breasts regain their shape, looking better both in and out of clothes. Then, there are the emotional and psychological benefits. After breast reconstruction, women report improved self-confidence. They also explain that breast reconstruction helped them feel “whole” again – so that they weren’t reminded of the trauma of their illness every time they looked in the mirror. Reconstruction can be an important stepping stone on the road to emotional, psychological and spiritual recovery.

At the end of the day, despite all the benefits, breast reduction is optional – and a woman’s informed choice not to pursue the procedure should be respected. However, women should actually be informed so that they can make the decision for themselves. They should know their options for reconstruction, even before mastectomy has been performed.

If you are a woman who has had a mastectomy, or if you have been told that you will need one, talk to your doctor about breast reconstruction. Don’t be afraid to ask questions and obtain more information about the different types of procedures offered, the benefits/drawbacks of reconstruction, and the various procedural options before making a final decision. It is important that you take the time to assess if this surgery is right for you, because every woman deserves a choice.

As an Alabama plastic surgeon, my work is not solely cosmetic. I am able to use my education and training to perform reconstructive surgery, an area of my practice that can be uniquely rewarding. One of my most memorable and fulfilling experiences as a reconstructive surgeon has been working with Robert Papong. For those who don’t know, I’d like to share Robert’s story and the impact that he had on me.

Robert Papong is a remarkable young boy from the Philippines who suffered severe skin burns, particularly on his right arm and leg, during a house fire. Due to these burns, his right leg was fused to his thigh and scar tissue contracted the muscles on his leg and arm. This resulted in both limbs being unable to function correctly. Doctors believed Robert would never walk again.

Thankfully, a nurse brought Robert to the United States, where I was able to become a part of his life. I knew that Robert’s case would be challenging, but I also knew that he deserved the chance to walk, run, and play again. I called upon all of my skill and experience in performing Robert’s reconstructive procedures and was thrilled that he proved to be a “plastic surgery miracle.” His limbs are now fully functioning and he even enjoys things such as playing basketball. Robert’s progress has exceeded all of my expectations, and I am thrilled to see that he is able to lead a full and active life.

To see and hear more of Robert’s story, click here.

By: Michael Beckenstein, MD

The old adage, “you get what you pay for” usually holds true for plastic surgery procedures like breast enhancement. As an Alabama plastic surgeon, I’m amazed to hear how some patients are choosing a cosmetic surgeon based solely on cheaper fees! The first question patients ask when inquiring about breast augmentation is “how much does it cost,” but patients seeking breast augmentation need to consider several factors in their choice:

• RESULTS: You must look at and compare the results of cosmetic surgeons performing breast enhancements. Before and after photos should be available on surgeons’ websites and more should be provided when you visit their offices. Breast augmentation results vary and you should choose a surgeon based on those obtaining the results you desire.
• EXPERIENCE: Plastic surgeons’ practices vary in the amount of experience in the use of breast implants. Birmingham has several plastic surgeons, but some have significantly more experience in breast augmentation than others. Would you choose a surgeon that performs 12 augmentations a year or one who completes 100 per year?
• FACILITIES: Some cosmetic surgeons perform breast augmentation in office-based surgical suites that use nurses to administer anesthesia. While office settings can be completely safe, if there is ever an emergency you would need to be transported to the nearest hospital. Breast augmentation performed in a Birmingham, Alabama hospital has real anesthesiologists tending to you and all the necessary staff that would assist you in an emergency are readily available in case you need them. This could be life saving!

When choosing a surgeon for your breast enhancement, the price should be secondary. You must seek a competent plastic surgeon who obtains good results, has a lot of experience, and operates in a safe facility, Sometimes the fees of these surgeons are higher; they are not the “$1999 specials” you may see advertised. You often get what you pay for, and your safety and a good result are well worth it!