OxygenChamber

Let’s talk about oxygen. You likely learned in your elementary school biology class that humans breathe in oxygen and breathe out carbon dioxide. The cells of the body use oxygen to produce energy and perform many of the functions that keep us alive. So, how does this relate to aesthetic medicine? Enter hyperbaric oxygen therapy (HBOT).

The natural, non-invasive treatment that simply requires you to, well, breathe has long been employed pre- and post-op across many fields of medicine thanks to its healing benefits, and there is a chance it may be a part of your plastic surgery recovery plan, too. Here’s what you need to know.

## **What Is Hyperbaric Oxygen Therapy?**
First, a quick vocabulary lesson: ‘hyper’ means increased and ‘baric’ refers to pressure. Hyperbaric oxygen therapy involves breathing 100 percent pure oxygen under higher atmospheric pressure, which can increase the oxygen concentration in the body by up to 1200 percent.

As you may have guessed, that boost has a host of [widely accepted](https://journals.lww.com/plasreconsurg/fulltext/2016/09001/An_Update_on_the_Appropriate_Role_for_Hyperbaric.15.aspx) positive health effects, including:

- Increased blood flow
- Encouragement of body tissue regeneration
- Decreased inflammation 
- Stem cell mobilization
- Improved infection fighting
- Killing of anaerobic bacteria 
- Enhanced ability to heal

“Hyperbaric oxygen therapy increases the amount of oxygen your blood can carry,” explains [Kevin Tehrani, MD](https://aedit.com/provider/kevin-tehrani-md-91), a board certified plastic and reconstructive surgeon and founder of [Aristocrat Plastic Surgery & MedAesthetics](https://www.aristocratps.com/) in New York. “An increase in blood oxygen temporarily restores normal levels of blood gases and tissue function to promote healing and fight infection.” 

## **Hyperbaric Oxygen Therapy in Plastic Surgery**
In the medical world, hyperbaric oxygen is generally used to address poor healing wounds. “It basically superdrives the healing,” Dr. Tehrani says of the therapy. He, like many aesthetic providers, began offering it at his practice because proper healing and recovery is critical to the success of plastic and reconstructive surgery procedures. “Some people smoke, some people have diabetes, or prior radiation, and all of those things make you not heal as well,” he explains. “I want you to heal perfectly. That’s where hyperbaric comes in.”

<CaptionImg url={https://images.ctfassets.net/zw35sfestf1t/6UnWR2NFJJxKYj4CF5WBeE/e0953147a1176accdaee0c2a6d7976bb/OxygenChamber.jpeg}>
  The outdoor hyperbaric oxygen chamber at Dr. Tehrani’s midtown Manhattan practice.
</CaptionImg>

The concept of HBOT is relatively straightforward (high pressure, meet oxygen), but the results can be extraordinary for patients who would otherwise face complications after surgery. “The high pressure dissolves the oxygen into your bloodstream, so the higher concentration of oxygen gets into the tissue that needs to heal,” Dr. Tehrani says. 

Research has shown this is particularly [beneficial for abdominoplasty patients](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6846320/), and Dr. Tehrani also encourages it for women undergoing [breast reconstruction](https://aedit.com/aedition/comprehensive-guide-to-breast-reconstruction-nipple-reconstruction-after-breast-cancer) after radiation and for those getting [fat transfer](https://aedit.com/aedition/why-everyone-is-talking-about-fat-grafting). “I do a lot of fat grafting for breast and bum, and the way that it takes is kind of like planting seeds in a garden — if you water it, it takes more. If you don’t water it, it dies,” he explains. “Oxygen is the water for fat, so we put them in the chamber to increase the take of the graft from, say, 60 percent to 80 percent, which is nice.” 

While he introduced his bubble-like HBOT chamber specifically for surgical patients, there are some purported wellness benefits that are of interest to non-surgical clients as well. “Anecdotal effects that people talk about are anti-aging and overall rejuvenation,” he shares. “Oxygen gives you a bit of a glow. It makes you feel better. There is a bit of an oxygen high, if you will.” 

A [recent study](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7293997/) even looked at the impact HBOT can have on patients with Alzheimer's disease and amnestic mild cognitive impairment. “There are a lot of cognitive things that are difficult to prove clinically but are out there,” he says.

### **Candidates for Hyperbaric Oxygen Therapy**
Wondering whether or not HBOT should be part of your [recovery plan](https://aedit.com/aedition/preparing-for-a-smooth-recovery-from-plastic-surgery)? “If I know someone is going to be healing poorly, then it’s recommended,” Dr. Tehrani says. “There are some people who are poor healers, and then there are some that I know will benefit.” The latter group refers to those undergoing procedures, like fat grafting, in which the result can be improved by treatment.

One group hyperbaric oxygen therapy is a must for? [Smokers](https://aedit.com/aedition/impact-of-cigarette-smoking-vaping-on-skin-hair-teeth-health). “Surgically, smokers have detrimental side effects — higher infection rates, higher wound healing problems, open wounds — that hyperbaric oxygen counteracts,” he explains. “We give them a choice: stop smoking before surgery or you need to do this to heal well.” 

At Dr. Tehrani’s practice, it is possible to tack a HBOT session onto non-surgical procedures, but it would purely be for the anecdotal beauty and wellness boost. “People who opt for it after Botox® or filler are those who believe in the anti-aging benefits,” he says. 

It should be noted that there is higher pressure in the chamber, so people with certain ear issues or trouble equalizing are not good candidates. Depending on the setup, those with a fear of tight spaces may also find themselves uncomfortable. “A relative contraindication is people who have claustrophobia,” Dr. Tehrani adds. HBOT in hospital settings often involves a small tank that patients go into. “It’s very claustrophobic,” he notes. “Ours has the same benefits, but it’s a nicer experience.”

### **Hyperbaric Oxygen Therapy Protocol**
Like so many aspects of aesthetic medicine, HBOT treatment protocols depend on the patient. Hyperbaric oxygen can be prescribed before and/or after surgery, and your surgeon will advise you on what’s best. “The results are short-acting, which is why, in some patients, we need to do it before surgery and in some we need to do it after surgery,” Dr. Tehrani explains. “The effects of it don’t last more than 24 to 48 hours.” 

Generally speaking, Dr. Tehrani’s post-op patients come in for daily sessions for the first seven to 10 days. Each treatment is 30 to 45 minutes and costs $300. “We do multiple sessions after surgery to get to the point where we say, ‘Okay, this looks great,’” he says.

## **The Takeaway**
Recovering from plastic surgery can be a daunting prospect, especially if you have had past difficulties with healing. When used before or after a procedure, hyperbaric oxygen therapy can significantly improve the chances of a more favorable outcome. Consult with your provider to determine if you are a candidate for HBOT and how it can benefit your post-operative plan.

Aesthetics

You learned in elementary school that the body uses oxygen to power up pretty much everything. So, what does this have to do with healing from plastic surgery? Allow us to explain.

Benefits Of Hyperbaric Oxygen Therapy (HBOT) For Plastic Surgery Recovery

The Benefits Of Hyperbaric Oxygen Therapy After Surgery

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If you’ve ever read an article about aesthetic procedures on The AEDITION, you know we *always* encourage you to look for or ask to see before and after photos during the research and [consultation process](https://aedit.com/aedition/questions-to-ask-your-doctor-during-plastic-surgery-consultation). Why? Because they offer the chance to visualize a provider’s experience and aesthetic, in addition to being a great way to better understand what kind of results are possible. 

With the rise of [social media](https://aedit.com/aedition/march-2020-study-shows-relationship-between-social-media-cosmetic-surgery) (specifically, Instagram and TikTok), images and videos of patients before and after a procedure have become an indispensable educational and marketing tool for aesthetic providers. But how do you know if you can trust what you see? From what to look for to best practices, we’re breaking down everything you need to know about before and after photos in aesthetic medicine.

## **The Value of Before & After Photos in Aesthetic Medicine**
As it turns out, before and after photos are as much for the provider as they are for the patient. “Photos are critical in plastic surgery,” says [Jason Roostaeian, MD](https://aedit.com/provider/jason-roostaeian-md-449), a board certified plastic and reconstructive surgeon in Los Angeles. “They show the result in part so we can see it but also so we can be better surgeons.” As he explains, plastic surgery is a “visual art,” and before and afters give providers a chance to critically view their work and their technique across patients. 

And then there is the patient component. The imagery allows patients to get a sense of how often a provider performs the procedure(s) they are interested in, if they operate on people who share similar traits, and what their overall aesthetic is. In some cases, these photos — especially the ones featured on social media or a provider’s website — may serve as the patient’s first impression of the provider. They are looked at during the research and discovery phase (i.e. before a consultation is scheduled). The commercial value of these photos means there could be pressure to make results look as optimal as possible. Balancing business interests with [transparency and ethics](https://aedit.com/aedition/how-plastic-surgeons-balance-patients-cosmetic-surgery-desires-and-safety) is, needless to say, crucial. 

## **Are Before & After Photos Regulated?**
There are rules that govern patient photos, including before and after images. Firstly, patient confidentiality means that the provider must ask the patient for permission before sharing any photos. The gray space existis in how the photos are taken and where they can be shared once patients sign off.

In a [2018 article](https://journalofethics.ama-assn.org/article/when-advertising-plastic-surgeons-individual-brand-unethical/2018-04) in the *AMA Journal of Ethics*, the authors examine the issues of social media advertising for plastic surgeons in particular. The current lack of regulation surrounding the promotion of before and after photos on social media means that the onus is on the providers to represent their work honestly. In turn, it’s up to patients to look at the images with a level of caution. While there have been varying efforts to regulate the practice, no formal guidelines have been enacted to standardize the practice of taking and sharing before and after photos of cosmetic surgery results.

With that said, many providers take great care to ensure their photos are as accurate as possible. Practicing so-called ‘photographic hygiene’ is a good start. This includes:

- Setting up a dedicated photo space 
- Using a standardized backdrop
- Having controlled lighting 
- Maintaining consistent space between the patient and camera
- Taking and sharing multiple angles 

These steps go a long way toward allowing prospective patients to look at a provider’s work in a more complete manner. 

## **How to Look at Before & After Photos**
If you are wondering whether or not you can trust the before and after photos you see on social media, the answer is not simply yes or no. Instead, you should look at the images critically, and Dr. Roostaeian recommends the following: 

### **1. Be Mindful of Editing**
“As a doctor, you know when people use photoshop,” he says. But how is a patient to know? Try to compare several different photos of the same procedure; it can often help you spot which ones have been manipulated. Natural skin texture is a good indicator, too. If skin appears unnaturally smooth, it could be an indicator that the photo has been edited.

### **2. Look for Multiple Angles**
Best practices indicate that providers will take multiple photos from multiple angles of the same patient. “Look for six angles, including side views,” Dr. Roostaeian notes. “And make sure the photos are taken straight, not crooked.” While providers may only post a single angle on social media, they often feature more on their website. If you are interested in seeing more, message them or call their office.

### **3. Be Wary of the Zoom Effect**
We’re not talking about [the Zoom effect](https://aedit.com/aedition/aedit-survey-reveals-how-2020-altered-aesthetic-landscape) from our increased time on video calls, but rather the impact zooming in or out can have on how the before and after will present. As Dr. Roostaeian explains, using zoom can distort features, making them look bigger. On the flip side, zooming out can make features look smaller. A good rule of thumb is to observe whether all the photos of a particular procedure have been taken from the same distance.

### **4. Value Video**
“Video tends to be lower quality, so it’s more difficult for the patient to see results than in a still photo,” Dr. Roostaeian says. So while videos should not replace before and after photos, they can complement them. Even if you might not be able to see the patient in the same level of detail, you may be able to get a better sense of proportion and perspective. 

### **5. No Makeup Makeup**
Is the patient wearing makeup in some photos but not others? The reality is that it isn’t always possible for providers to get makeup-free before and after photos of every patient (and it may not even be necessary to). It is, however, worth keeping in mind that the results of some procedures may be affected by makeup.

## **The Takeaway**
When viewing before and after photos on social media or on a provider’s website, it’s important to do so with an informed eye. While the imagery is undoubtedly important, there is another important factor to consider when choosing a plastic surgeon or cosmetic dermatologist: [recommendations](https://aedit.com/aedition/category/how-i-found-my-plastic-surgeon). Dr. Roostaeian suggests reaching out to your network for referrals and to hear directly from patients about their experience.

With the rise of social media, before and after images have become indispensable tools for aesthetic providers to attract patients. But how do you know if you can trust what you see?

Importance Of Before And After Photos In Plastic Surgery, Aesthetic Medicine

Everything You Need To Know About Before And After Photos

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We’ve talked a lot about what to do before and after cosmetic and reconstructive surgery — [what foods to eat](https://aedit.com/aedition/meal-plans-diet-before-after-cosmetic-surgery), [what supplements to avoid](https://aedit.com/aedition/vitamins-supplements-to-avoid-before-cosmetic-surgery), and even [how to sleep](https://aedit.com/aedition/sleeping-better-after-cosmetic-surgery-aesthetic-procedures). So, when we heard that hypnotherapy could reduce pain and discomfort and speed up the healing and recovery process post-surgery, we were, well, *mesmerized*.

## **What Is Hypnotherapy?**
In the most basic sense, hypnotherapy is using hypnosis as a means to help patients overcome a mental or physical challenge. Hypnosis has been around since ancient times and became popular in the west around the turn of the nineteenth century, though it was long regarded as a mere parlor amusement.

Even today, there is often a misconception that people in a hypnotic trance are somehow under the control of the hypnotist. That’s simply not true. In fact, patients who are hypnotized are actually experiencing a heightened state of self-awareness. “It’s an opportunity for us to help people restore safety and balance and process information in a way that feels safe and manageable,” says [Pierre-Etienne Vannier, MSc, CHt](http://www.pevannier.com/), a French-born mind-body practitioner. “Regulating the nervous system means you’re learning how to feel safe within yourself.” 

## **How Hypnotherapy Works**
A hypnosis session works by connecting the conscious and subconscious minds, enabling us to delve deeply into the underlying causes of behavior or tap into the root of emotional distress. To experience the benefits of hypnotherapy, patients and therapists need to connect. “Resilience happens in relationships,” he explains. While mindfulness apps are great, they don’t provide the same benefits as a professional treatment. “When you work with a practitioner who’s able to guide you through that process and create a safe space, you’re able to rest, recuperate, regenerate and heal,” Vannier shares. “I see it as a path to self-empowerment.”

During a treatment, the body experiences “a cascade of chemical reactions,” Vannier explains, including the release of neurotransmitters and hormones like endorphins and oxytocin. Learning how to regulate the nervous system leads to a sense of centeredness and control — key components of overall well being. “I teach my clients and patients how to manage stress and emotions,” he says. “The crux of the practice is bringing the nervous system back into balance.”

## **Hypnotherapy & Surgery**
Scientists have long been experimenting with hypnotherapy during surgery. As we’ve explored, [hypnosedation](https://aedit.com/aedition/future-of-hypnosis-hypnosedation-as-anesthesia-in-plastic-surgery) was used to pacify patients before the advent of anesthesia drugs. More recently, researchers have explored hypnotherapy’s potential to holistically help patients pre-op jitters and intraoperative anesthesia to post-surgery pain management and recovery.

“A lot of patients feel like a ‘project,’” Vannier says. “Clinical hypnotherapy empowers patients in their own healing and recovery journey.” Based in Los Angeles, Vannier has been helping people — from HIV/AIDS patients and those with chronic pain to substance abusers and war survivors — cope with stress for over a decade. He cites not only his professional experience but the numerous studies that prove patients who practice hypnotherapy experience less pain and heal quantifiably faster from a surgical procedure as proof of the therapy’s credence. 

### **Pre-Operative Hypnotherapy**
Patients who practice hypnotherapy prior to a procedure (aesthetic or otherwise) are doing both themselves and their medical team a favor, Vannier says. “‘Before’ is a really important step because, when you're able to reduce anxiety and tension, you help your body be ready for the procedure,” he explains. “When you have a more regulated nervous system, it makes the work much easier for everybody.”

Vannier touches on a misconception that many of us have about medicine. “Doctors can’t give health,” he says. “Health comes from within.” No matter whether the procedure is medically necessary or elective, the same principles apply. Hypnotherapy can help make the process smoother by bolstering the immune system, easing preoperative anxiety, and preparing the patient — both mentally and physically — for surgery.

### **Hypnotherapy During Surgery**
Hypnosedation, the practice of using hypnosis in the operating room to relax a patient and reduce their pain, has been making a comeback. [Numerous studies](https://pubmed.ncbi.nlm.nih.gov/31251709/) examining the technique during procedures like breast cancer reconstruction, liposuction, and facial cosmetic surgery point to quantifiable reductions in the need for traditional pain medications. “Research from UCLA shows you can reduce blood loss during surgery,” Vannier adds. Reducing the need for drugs and ensuring the patient remains more stable during surgery “is a gift not just to the patient but to the entire surgical team,” he notes.

### **Post-Operative Hypnotherapy**
In the immediate aftermath of surgery, a decrease in blood loss and the lack of need for anesthetics translates into a measurable reduction in side effects. A [study of cosmetic surgery patients](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5011203/) headed by hypnotherapy pioneer Dr. Marie-Elisabeth Faymonville, showed that only 1.2 percent of those who used hypnosedation during their procedure experienced postoperative nausea and vomiting, as compared to over a quarter of those who had only intravenous sedation.

“It’s very empowering for people to be able to be in control of their pain and recovery,” Vannier says. This feeling of empowerment improves healing. Harvard psychologist and researcher Carol Ginandes, PhD, has been studying the effects of hypnotherapy on healing for decades. In 1999, she and Daniel Rosenthal, MD, a Harvard radiologist, [documented](https://pubmed.ncbi.nlm.nih.gov/10069091/) that ankle fracture patients who practiced hypnotherapy showed objective improvement in healing (as evidenced by medical imaging) compared to patients who did not use hypnotherapy. They also experienced quicker recovery times, greater mobility, and less pain, which translated into less pain medication.

Ginandes later repeated the study with breast reduction patients. This time, she separated women into three groups: those who received support from a psychologist, those who underwent hypnotherapy, and those who received no additional therapy. The women who received hypnotherapy healed the fastest, as objectively measured by anonymous photographic evaluation of their scars. “Since clinical hypnosis is a non-invasive, non-drug treatment, finding that it can speed healing of wounds and other conditions could lead to fewer visits to doctors’ offices and faster return to normal activities,” Ginandes [told The Harvard Gazette](https://news.harvard.edu/gazette/story/2003/05/hypnosis-helps-healing/) at the time.

Vannier has heard similar results from his own clients. “I hear this anecdotally from so many of my patients,” he says. “Their doctors are telling them they’re recovering so much faster than expected.” The positive emotions associated with feeling in control of the recovery process reinforces the physiological response. In other words, knowing you can make yourself feel better makes you feel better.

### **Hypnotherapy for Pain Management**
Vannier believes in the potential of hypnotherapy to alleviate the reliance on [post-surgical (and post-injury) painkillers](https://aedit.com/aedition/opioid-crisis-plastic-surgery-recovery-pain-management). “A significant percentage of people get hooked on opioids from a prescription,” he says. “We’re telling people, ‘If you’re in pain, you have to take these drugs.’” The latest research focuses on integrating mind-body techniques. “It’s not one or the other. You can do both,” Vannier explains. “But, if you’re able to recover faster, you don’t need to be taking the opioids.”

## **How to Find a Hypnotherapist**
So, how does one go about finding a qualified hypnotherapist? Vannier is affiliated with Huntington Hospital in Pasadena, California and is the founder of [Healing Studio Online](https://www.healingstudioonline.com/), which he created “to provide people with a space to learn, practice together, and empower each other.” To find a professional in your area, he offers these tips:

- **Seek Referrals**: Find out if friends and family have any recommendations. This is often the best way to choose a provider of any kind.
- **Ask Your Doctor**: Medical practitioners are becoming increasingly aware of the benefits of hypnotherapy. Ask your physician if they can refer you.
- **Consider Credentials**: A certificate from a weekend seminar isn’t enough, Vannier stresses. It takes about 700 hours of training to become a clinical hypnotherapist. 
- **Experience Matters**: Vannier suggests choosing a therapist who’s been practicing for at least three to five years.

Hypnotherapy treatments vary in price, depending upon the therapist and location. Expect to pay somewhere between $100 and $300 per session. “It’s about striking a balance,” he says. “It shouldn’t cost an arm and a leg. But, at the same time, there’s a person working with you and spending time with you. There’s an exchange of energy.”

Generally, Vannier suggests surgery patients meet for three to four sessions over the course of a month, both before and after surgery. The goal is to give patients the skills they need to manage their own healing process. “It’s like a lifeline,” he shares. “It’s like somebody is drowning and we’re coming in the middle of the situation and saying, ‘Take that rope. Let me help you. Let me teach you how to swim.’”

Wellness

We’ve talked a lot about what to do before and after cosmetic surgery. So, when we heard that hypnotherapy could reduce pain and speed up the recovery process, we were, well, mesmerized.

Hypnosis And Hypnotherapy For Pre-Surgery, Recovery, Pain-Management

The Healing Power Of Hypnotherapy

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Preparing for any surgical procedure requires more than just [finding the right surgeon](https://aedit.com/aedition/finding-the-right-plastic-surgeon-dermatologist-or-cosmetic-dentist) and filling out paperwork (though, those are the vital first steps). There are pre- and post-operative health measures that need to be taken in order to prepare for a smooth procedure and recovery. 

Pre-op instructions from plastic surgeons and dermatologists already require cutting out alcohol, smoking, and even [vitamins and supplements](https://aedit.com/aedition/vitamins-supplements-to-avoid-before-cosmetic-surgery) before going under the knife. But how does nutrition fit into these pre- and post-procedure plans? Working in conjunction with nutritionists, more and more aesthetic providers are advising patients to adopt a proper diet before and after surgery to ensure the best results. 

So, what is the ideal way to eat before and after a cosmetic procedure, and when should one start to make these changes? The AEDITION asks the experts. 

## **The Role of Nutrition in Aesthetic Medicine**
During the [consultation process](https://aedit.com/aedition/questions-to-ask-your-doctor-during-plastic-surgery-consultation), doctors will examine patients to ensure their health makes them a viable candidate for whatever procedure they are interested in. To guarantee that the body is healthy enough to undergo surgery and recover successfully, the [patient's body mass index (BMI) and lifestyle](https://aedit.com/aedition/why-you-should-lose-weight-before-plastic-surgery) will be examined before [a surgeon chooses to proceed](https://aedit.com/aedition/reasons-plastic-surgeon-will-not-operate-on-patient). 

“If patients do not have a healthy lifestyle before getting a surgery, they’re not going to be able to maintain those results,” says [Richard J. Brown, MD](https://aedit.com/provider/richard-brown-md-4646), a Scottsdale, Arizona-based board certified plastic and reconstructive surgeon and author of *[The Real Beauty Bible](https://www.amazon.com/Real-Beauty-Bible-Navigating-Journey/dp/1599329980)*. “Our goal is for patients to have one operation, to have great results, and to have those results last a lifetime.”

Needless to say, a patient’s diet can play a big role in that success. “Optimizing nutrition can have a dramatic impact on the body’s healing abilities and immune defense mechanisms,” explains [Adam Kolker, MD](https://www.drkolker.com/), a New York-based double board certified plastic surgeon. Along with the recovery benefits, a balanced diet can lead to a better mental state, which is tremendously beneficial pre- and post-op.

Dr. Brown, who is spearheading a wellness center at his own practice, notes that proper diet and exercise is essential to achieving and maintaining cosmetic results. As such, it is increasingly important that providers offer patients services that can ensure they are as healthy as possible heading into a procedure — no matter how long it takes to get there. “I work with a macronutrient coach, so when somebody comes to me, I always point them to her,” he explains. “We are going to have a meal-planning service and an exercise routine, so the patient can have a holistic experience with a one-stop-shop to set them up for success.”

## **What To Eat Before a Procedure**
You’re likely starting to understand that a smooth pre- and post-op experience requires a commitment to health and wellness that starts weeks, months, or even years in advance. “I’ve heard from doctors and practice managers, anecdotally, that they can tell which patients take care of themselves and which don’t by how they heal,” says Tatiana Boncompagni, the co-founder and CEO of healthy delivery meal program [Eat Sunny](https://eatsunny.com/). “Nutrition can support healing.”

And, for those who are ready to go under the knife (or needle!), the weeks leading up to their procedure require that same diligence. “I advise a balanced diet consisting of carbohydrates, protein, and healthy, largely plant-based fats,” explains Dr. Kolker of his pre-procedure protocol. He recommends lean protein comprise approximately 30 percent of the diet alongside large amounts of green leafy vegetables. “While there is some controversy regarding the efficacy of supplemental vitamins, I do believe in adding vitamin C, vitamin D, B-complex, and zinc to an individual’s routine perioperatively,” he adds.

Just as important as what you do eat in the lead up to a cosmetic procedure is what you don’t eat. “Pre-operation, you don’t want to consume high doses of omega-3s because that thins the blood,” Boncompagni warns. Instead, she encourages boosting the intake of vitamin C through plant-based sources. “Found in cauliflower, kale, red peppers, as well as berries and citrus fruits, [vitamin C is important for skin and tissue healing](https://aedit.com/aedition/guide-to-topical-vitamin-c-in-skincare), and other antioxidants — like A and E — neutralize free radicals so your cells can function optimally,” she explains. “You also want to consume anti-inflammatory foods to help with post-surgical inflammation and watch your sodium intake.” 

### **Eat This:** 

- Lean protein
- Plant-based fats
- Unprocessed carbohydrates
- Antioxidant-rich fruits and vegetables (think: vitamins A, C, E)

### **Not That:** 

- Alcohol
- Omega-3 fatty acids
- High-sodium foods 
- Smoking and vaping

Leaving the food planning to a professional can take the guesswork out of meal prep. [Eat Sunny](https://eatsunny.com/), for example, focuses on delivering a well-balanced meals inspired by the Mediterranean diet, which has been [cited as a good source](https://www.heart.org/en/healthy-living/healthy-eating/eat-smart/nutrition-basics/mediterranean-diet) of unprocessed carbs, proteins, and fats. The company offers vegetarian and flexitarian menu options in three- or five-day increments and is partnering with aesthetic providers to offer patients a more holistic pre- and post-op experience. 

## **What To Eat After a Procedure**
“Post-operative nutrition is of equal importance,” Dr. Kolker explains. “Avoiding a catabolic state with appropriate preoperative preparation continued into the postoperative phase will maximize healing and recovery.” After the body experiences trauma, adequate nutrition helps it heal and recuperate. Since vitamins and supplements are generally frowned upon in the weeks following, properly fueling your body with food is more important than ever. 

### **Eat This:** 

- Lean protein
- Fiber-rich foods (i.e. whole grains, farro, oatmeal, berries)
- Anti-inflammatory spices (think: turmeric) 
- Probiotics like yogurt, miso, and fermented foods
- Prebiotics like garlic, onion, and sunchokes

### **Not That:** 

- High-sodium foods
- Alcohol
- Sugar
- Smoking and vaping

“Eat plenty of fiber to keep the digestive system — which can slow down after anesthesia — moving,” Boncompagni shares, adding that anti-inflammatory spices (think: turmeric) are useful, too. 

Protein continues to be important, as do hydrating, water-rich foods. “You also want to make sure you are eating enough protein, as protein is the building block for tissue,” Boncompagni explains. “Eat low-sodium foods to reduce bloating and drink plenty of water for hydration and to help with slowing digestion and bloating.” She also recommends probiotics (in the form of yogurt, miso, fermented foods) and prebiotics (such as garlic, onion, and sunchokes) to [boost immunity](https://aedit.com/aedition/at-home-wellness-routine-for-immunity-mental-health-stress) — an important part of healing.

## **Remember: No Diet Is One-Size-Fits-All**
The only diet that works for a patient is the one they can stick to. Yo-yo and crash diets that focus on weight loss through a caloric deficiency or immediate results can be stressful on the body, which is why both nutritionists and surgeons recommend starting slowly. “It’s hard on the body and it’s hard on the psyche, too, because it sets up food as the enemy,” Boncompagni says. “Food is our friend. It can and should be a source of pleasure, satisfaction, and nutrition.”

Meal plans and meal prep can be foolproof ways to ensure that access to vital nutrients are easily maintained throughout the pre- and post-op process. Programs like [Daily Harvest](https://www.daily-harvest.com/), [Sakara](https://www.sakara.com/), and [Eat Sunny](https://eatsunny.com/) offer options that can be tailored to suit a patient’s lifestyle, taste, and capability (or lack thereof!) in the kitchen. And the benefits of planning go beyond just convenience. Here are a few reasons why being prepared can make a difference:

### **1. Maintaining Balance** 
Monitoring portions keeps patients on track without eating too much or too little. “We appropriately portion our meals — each meal is about 400 calories and the snacks come in at about 200 calories — so you don’t have to worry ‘Am I eating too much?’ and can just take pleasure from your food,” Boncompagni says of Eat Sunny. Rather than focusing on what you are cutting out, focus on what you are gaining through micro and macronutrients. 

### **2. Saving Time & Energy**
With everything going on in our day-to-day lives, food often becomes an afterthought. But nutrition cannot be overlooked. Following a meal plan or prepping food in advance will save time and energy during the recovery process, when preparing food from scratch may prove difficult. 

### **3. Instilling Healthy Habits** 
Before a procedure, unhealthy habits (think: smoking and drinking) need to be curbed in favor of good ones. Having a plan in place — pre- and post-op — should help the patient to stick to healthier choices long term. After all, the outcome of the procedure depends on it. 

## **The Takeaway**
Food plays an important role in the healing and recovery process, and good results require a commitment to health that begins long before the first consultation. A pre- and post-op dietary game plan – alone or with assistance from a coach or meal service – can optimize the body’s healing abilities and help a patient recover comfortably. “If patients don’t have a healthy lifestyle with quality eating habits, they will not be able to maintain results,” Dr. Brown concludes. 

Preparing for a procedure means eliminating alcohol, smoking, and supplements — but what about food? Nutrition plays a big role in the pre- and post-op process, and The AEDITION spoke to experts to find out which diets work best.

Meal Plans And Food To Eat Before And After Cosmetic Surgery 

Here’s What To Eat Before And After Cosmetic Surgery 

adam-niescioruk-hWzrJsS8gwI-unsplash

When filling out paperwork in a doctor’s office, do you ever list your vitamins and supplements in the space dedicated to ‘current medications’? If you are like most patients, the answer is likely no. But that innocent lack of disclosure could adversely affect your care. In the case of cosmetic surgery, it could negatively impact your results. 

In today’s wellness era, the question certainly needs to be rephrased. From a multivitamin to adaptogenic herbs, tonics, tinctures, everything you put into your mouth on a daily basis is of great interest to your provider. The general rule when it comes to cosmetic surgery is to steer clear of taking vitamins and supplements pre-op to minimize bleeding, which, in turn, will help to keep bruising and swelling at a minimum, too (who doesn’t want that?). 

But that is not to say all supplements are off limits. Before a cosmetic procedure, your provider will go over a pre- and post-op checklist to ensure the treatment is safe and effective. “Pre- and post-op instructions are a crucial step in the overall outcome of your surgical procedure,” says [Lesley Rabach, MD](https://aedit.com/provider/lesley-rabach-md-17912), a double board certified facial plastic and reconstructive surgeon and co-founder of LM Medical in New York City. “I can do my job to get the best outcome for my patients, but I need my patients to commit to following the directions for optimal results. It’s a two-way street.”

While a pre-op consultation with your board certified dermatologist or plastic surgeon is necessary to receive the exact requirements for your procedure, we’re breaking down what is generally okay and not okay to take before and after going under the knife and needle to avoid complications and improve recovery.

## **What Are Vitamins & Supplements?**
To begin, let’s define what vitamins and supplements are. Vitamins are a part of the supplement family and add nutritional value to your diet. They come in tablet, powder, capsule or gummy form. Besides vitamins, supplements include ingredients like herbs, amino acids, enzymes, and minerals. Some of the most popular include ginkgo biloba, feverfew, St. John’s wort, and ginseng, as well as vitamins C, D, and E.

## **Pre- & Post-Op Supplement Recommendations**
“The pre-op course predicts how your post-op course is going to go,” Dr. Rabach explains.  Preparing for a cosmetic surgery or procedure can be compared to training for a marathon. “You commit to an end goal and need to train and feed your body properly leading up to it, so you have the predictable outcome you’re looking for,” she continues. Vitamins and supplements play a role in this. 

### **Two Weeks Pre-Op**
Two weeks before your surgical procedure, Dr. Rabach recommends laying off supplements (with a few key exceptions), as taking them increases the risk of bleeding, which could cause complications during surgery and slow the recovery process. Because most supplements aren’t regulated by the United States Food and Drug Administration (FDA), the concentration and quality of them are unknown. Those inconsistencies add unnecessary risk to the procedure process.

CBD, however, remains up for debate. Some [surgeons recommend skipping it](https://aedit.com/aedition/use-of-cbd-cannabinoids-products-in-wellness-fitness-recovery) due to the lack of regulation. Others, like Dr. Rabach, say you can continue to take it because she hasn’t seen any increased bleeding in her patients that use it. As with any vitamins and supplements, tell your providers exactly what you use and when you use it, so you can weigh the risks against the rewards together. If you’re ingesting CBD to calm your nerves — especially before surgery — Dr. Rabach believes it’s better than being anxious and having your heart rate skyrocket. Of course, every patient and procedure is unique.

At this time, doctors also recommend discontinuing products that contain aspirin and ibuprofen, as well as wine and foods like beans, garlic, ginger, strawberries, and tomatoes for the same reasons — they can increase the chance of bleeding. Do not, however, discontinue the use of necessary medications or antidepressants without the knowledge of your doctor. 

### **Two Weeks Pre-Op to Two Weeks Post-Op**
In the two weeks leading up to your procedure and the two weeks following it, Dr. Rabach suggests patients add two natural remedies to their regimens that help prevent bruising and swelling:

- **Arnica**: The herb has been used for hundreds of years in pain management, and Dr. Rabach specifically recommends placing [Boiron Arnica](https://www.amazon.com/Boiron-Montana-Pellets-Homeopathic-Medicine/dp/B013JKW8Z2) under the tongue four or five times per day for the month.
- **Pineapple**: A daily dose of fresh pineapple or fresh pineapple juice helps combat inflammation thanks to the enzyme bromelain.

Forgoing your regular supplements in favor of one of the options above should decrease downtime and improve recovery time. 

### **One Week Post-Op**
One week after your surgery or procedure, you’re able to resume your supplement routine. “That’s about the time the stitches come out,” Dr. Rabach says. “And if all pre-op instructions were followed, swelling should be at a minimum.”  

## **The Takeaway**
From the time of your first consultation through your final post-op appointment and beyond, the relationship between a doctor and patient is a true partnership. To ensure the best experience, it is important that the treatment plan is strictly adhered to. “We’re in an age where you can achieve perfection through cosmetic surgery, but the methodology needs to be followed in order to achieve it,” Dr. Rabach concludes.  A commitment on both ends will always yield the best results.

Did you know your daily supplement intake can play a role in how you recover from cosmetic surgery? The AEDITION spoke with a board certified facial plastic surgeon to find out what to stock up on and what to avoid before going under the knife or needle. 

Vitamins And Supplements To Take And Avoid Before Cosmetic Surgery

Why You Should Stop Taking Supplements Before Surgery

consultations

Setting up a consultation or appointment with a medical professional used to involve a phone call and a calendar check. Conducting the consultation or appointment, meanwhile, required an in-person trip to the provider’s office. But, with the advent of modern technology, the scheduling of and participation in consultations and check ups now have a virtual twist. Doctors and patients are increasingly conversing from the comfort of their own homes when time is of the essence or circumstances prevent them from meeting face to face. The concept of telemedicine is nothing new, but, in the wake of the [COVID-19 pandemic](https://aedit.com/aedition/message-from-aedit-founder-regarding-covid-19-coronavirus-pandemic), it's more important and useful than ever. 

With elective surgeries cancelled in many states and private practices closed due to coronavirus, video chats have become an integral part of healthcare and aesthetic medicine. For cosmetic dentists, dermatologists, and plastic surgeons, telemedicine is a way to connect with patients from the very first consultation to ongoing post-op care. 

If you’re interested in setting up a virtual appointment with a provider but don’t know where to start, we’re here to help. To break down the logistics of what telemedicine can and cannot address, how patients need to prep for appointments, and what happens after the call, The AEDITION spoke to [board certified](https://aedit.com/aedition/medical-board-certification-in-plastic-surgery-cosmetic-dermatology) dermatologists, plastic surgeons, and dentists to understand the ins and outs of virtual consultations. 

## **Virtual Consultations in Aesthetic Medicine**
In aesthetic medicine, virtual consultations have long been a way for providers to connect with and assess out-of-town patients. “The purpose of a virtual consultation is to identify the patient's chief complaint and determine what additional information is needed to address the problem,” says [Alina Lane, DDS](https://aedit.com/provider/alina-lane-7794), a cosmetic dentist and director of All Smiles Dentistry in New York City. 

While there are certainly some screen-induced limitations, virtual consultations generally offer both patients and providers an opportunity to get to know one another and discuss areas of concern, aesthetic goals, and possible solutions. Many doctors find that they’re able to treat their patients with the same care despite the lack of proximity. 

Generally speaking, here’s how telemedicine works for aesthetic specialities:  

### **Virtual Consultations With a Dermatologist**
Whether you’re worried about a rash or need a refill on your [Retin-A](https://aedit.com/aedition/guide-to-vitamin-a-retinol-retinoids-in-skincare) prescription, dermatologists can address both medical and cosmetic concerns during a telemedicine appointment. Technology doesn’t yet allow for virtual injections (sorry, [Botox®](https://aedit.com/aedition/everything-you-need-to-know-before-getting-botox-for-the-first-time) fans!), but a dermatologist can assess your skin and prescribe a treatment plan to address unexpected flare-ups (think: acne, eczema, psoriasis), soften fine lines and wrinkles, or maintain a youthful glow between in-office appointments. 

For those worried about a troubled mole or a sudden rash, virtual consultations still serve a purpose — though they may just be a first line of defense. “Yes, we can make a diagnosis and evaluate basic skin conditions,” says [Morgan Rabach, MD](https://aedit.com/provider/morgan-rabach-md-17913), a board certified dermatologist and co-founder of LM Medical in New York City. “[But for] something like a melanoma, which is life-threatening has to be treated immediately, the patient would be seen in person because it is medically essential.”

### **Virtual Consultations With a Dentist**
“By its nature, dentistry is a very interactive medicine,” says Dr. Lane, who [offers virtual consults](https://www.allsmilesnyc.com/). “Many dental diseases require in-office procedures to treat.” While regular dental check ups are needed at least once a year, unexpected issues can arise that require immediate attention. “Dental pain, facial swelling, abscesses, and broken teeth are all major indicators that an in-office appointment is needed,” she notes. “However, during this time of shelter-in-place, the urgency of these matters can be evaluated first by a virtual consultation.”

Those dealing with dental emergencies will first be evaluated virtually to confirm if immediate care is needed. “If there is a dental emergency, we will determine whether we can manage it remotely or if an in-office visit is required,” she explains. “During a time when hospitals are being strained due to the COVID-19 outbreak, our goal as dentists is to [minimize all emergency room visits](https://aedit.com/aedition/how-to-treat-plastic-surgery-emergencies-lacerations-during-covid-19) due to dental problems, which will help to reduce strain on the medical system and minimize patient exposure to infected persons.” As such, many dental offices have remained open to treat emergencies.

### **Virtual Consultations With a Plastic Surgeon**
While a telemedicine appointment might not allow quite the same level of interactivity as an in-person consultation, they still provide a meaningful way for providers and potential patients to get to know one another. “Virtual consults are a good first step for someone to see if they are interested and also get a chance to know me and what we can offer,” says [Jaime Schwartz, MD](https://aedit.com/provider/jaime-schwartz-md-19201), a Beverly Hills-based board certified plastic and reconstructive surgeon who also has a [practice in Dubai](https://drjaimeschwartz.com/).

During this time of social distancing, the virtual meeting is also a good chance for providers to interact with the caregiver who will be tending to the patient once he or she heads home to [recover](https://aedit.com/aedition/how-long-does-it-takes-to-recover-from-cosmetic-surgery-procedures) post-op. “It can help to have a family member or spouse available for the consultation as well, so that they can be informed on what to expect after the procedure if the consultation is for a surgery,” says [Craig Baldenhofer, MD](https://aedit.com/provider/craig-baldenhofer-md-20), a New York City-based board certified plastic and reconstructive surgeon. 

## **Setting Up a Virtual Consultation**
Ready to book? Here are six things to keep in mind ahead of your appointment:

### **1. Prepare For Paperwork & Pictures**
“Prior to the consult, patients fill out the standard office intake forms; are emailed copies of the procedure consents, pre-operative and post-operative instructions to review; and are given instructions on how to provide photographs for me to review prior to the telemedicine visit,” Dr. Baldenhofer explains. The dermatologists we spoke to follow a similar protocol, so be ready to take lots of pictures. “We have a photo guide that explains how to take pictures of the face and body that is sent to our concierge team who evaluate the images,” says [Jason Emer, MD](https://aedit.com/provider/jason-emer-md-722), a board certified cosmetic dermatologist in West Hollywood, who frequently travels to New York to treat his East Coast patients. “If they’re not good quality, they’re sent back. There’s different positioning and different lighting that’s needed.”

Precisely shot photographs will likely be necessary for any and all consultations, but they are especially vital when patients are looking to consult about concerns below the neck. For breast and body procuedres and surgeries, providers can review photos submitted ahead of time, rather than examining the area during the video chat.

### **2. Consider Your Safety First**
When it comes to virtual consultations, patient privacy and safety are the top priority. “We have always had the capability and use Skype or FaceTime for consults for out-of-town patients,” says [Lesley Rabach, MD](https://aedit.com/provider/lesley-rabach-md-17912), a double board certified facial plastic and reconstructive surgeon and co-founder of [LM Medical](https://lmmedicalnyc.com/). “However, now we are using [Doxy.me](https://doxy.me/), which is a better-secured platform for physicians to do our telemedicine consults.”

In fact, the [Health Insurance Portability and Accountability Act (HIPAA)](https://www.hhs.gov/hipaa/for-professionals/privacy/laws-regulations/index.html)-compliant platform is quite popular due to its security *and* convenience. “It can be used with any computer or smartphone with a camera,” Dr. Baldenhofer says. “Patients are emailed or texted a link to a virtual waiting room and told to be available at the prearranged time. Once they are in the waiting room, I am alerted and can start the consult.” If you have any questions or concerns about the security of your virtual consultation, ask your provider what platform they use and the protocols they have in place to protect your privacy.

### **3. Be Mindful Of Your Set Up**
Treat the call as if you were going into the provider’s office. You’d want the environment to be quiet and serene — without interruption — so try to do the same with your home surroundings. “I have had patients try to have a virtual consult while driving their car and that was not ideal,” Dr. Baldenhofer shares. While the photos provided ahead of time will play the biggest role in your consultation, there are some things you want to keep in mind when considering where you are going to sit for your appointment. In addition to being in a well-lit location, place the screen at a comfortable height and distance to avoid the so-called ‘selfie’ effect that can distort the appearance of certain facial features. 

### **4. Know Who You’re Speaking To**
Though a patient might set up their video consultation through a web portal or by calling the doctor's office, the consultation will likely be with the doctor. “I perform all of my consultations — virtual and in real life,” explains New York City-based board certified plastic and reconstructive surgeon [Melissa Doft, MD](https://aedit.com/provider/melissa-doft-md-63). “I enjoy meeting with patients beforehand to understand their aesthetic goals.” With that said, some practices may have a nurse or patient coordinator kick off or join the call, so feel free to ask about who you will be meeting with when you schedule the appointment.

### **5. Come Prepared**
As with any consultation, be prepared with questions, a clear vision, and an open mind. “By the time the telemedicine visit starts, I have already had the opportunity to review the patient’s medical history and photographs,” Dr. Baldenhofer says of [his pre-consultation protocol](https://www.craigbaldenhofermd.com/). “Therefore, It’s more of a conversation to go over any questions and discuss the risks and benefits of the procedure.”

<RelatedContent
  title={15 Questions To Ask Your Doctor During A Consultation}
  slug={questions-to-ask-your-doctor-during-plastic-surgery-consultation}
/>

Similar to a regular visit, any concern can be discussed during a telemedicine visit, but assessing can be tricky. “Any aging face consults are very easy to do during a virtual call – especially if the patient can send in photos of themselves in certain positions prior,” Dr. Lesley says. “For [rhinoplasty](https://aedit.com/aedition/difference-between-cosmetic-rhinoplasty-vs-functional-rhinoplasty) cases, I cannot examine the inside of the nose, however, I can still see the external nose and make assessments.” In the case of medical dermatology inquiries (think: a concerning mole),  the provider can discuss the area of the concern, but will not be able to diagnose without a biopsy. “[Melanoma] are impossible [to diagnose] by visual sight,” Dr. Emer says. “If you have a problem spot, I will recommend you to a [Mohs surgeon](https://aedit.com/aedition/all-about-mohs-surgery-for-skin-cancer).”

### **6. Ask About Consultation Fees** 
The cost of a consultation — virtual or otherwise — depends on the doctor. Some do not charge for the initial meeting, while others do. In the latter case, the fee usually goes a long way. “We charge the same cost for a virtual consultation as an in-office consultation,” Dr. Doft shares, adding that the fee ([$350 in her case](https://doftplasticsurgery.com/coronavirus-update/)) is applied to the cost of the procedure. The consultation fee usually helps to confirm a patient’s seriousness and likeness to to follow through with the procedure. At Dr. Emer’s practice, a virtual consultation with one of his aestheticians, skincare specialists, or physician assistants results in a personalized product regimen and [credit to shop](https://emeragecosmetics.com/products/virtual-consultation). “They pay $150 per consultation, but that goes towards the credit of the product,” he says. “They’re getting recommendations for products that will treat almost any concern and help them treat it from home.”  

## **What Happens After a Virtual Consultation**
After a virtual consultation, the best thing to do is to follow doctors orders. For those whose concerns are skin-related, dermatologists will outline the necessary steps that can be undertaken and [products that can be used at home](https://aedit.com/aedition/aestheticians-dermatologists-share-at-home-skincare-tips) before they can come in for an in-office treatment. “We offer skincare solutions, such as peels, that can be applied during a virtual consultation with an esthetician,” Dr. Emer says. “At-home peels prime and prepare patients for laser treatments and it will significantly improve their skin in one treatment.”

Patients looking to go under the knife, meanwhile, should note that further consultations will be needed. “I will never operate on anyone until I see them in person and we review our plans and make sure we are both 100 percent on the same page,” Dr. Schwartz says. The follow-up appointments will also allow surgeons to assess if any pre-op testing is needed. “Sometimes, depending on the age, medical history, and other factors, the patient will need pre-operative testing prior to the surgery,” Dr. Lesley explains, adding that, in some cases, patients will ask for additional face-to-face meetings prior to scheduling a surgery.

As in-person consultations and surgeries are off the table at the moment, surgeons are cognizant of their patients’ desires, budgets, and safety. “We plan to have follow-up in-person consultations once the crisis is over, but the virtual consultation allows us to start communicating with patients, sending in packages to insurance companies for approval, and making the fall schedule,” Dr. Doft says. “Once elective surgeries can occur again, there will be a major rush for operating room space, and we want to make sure our patients do not have to endure long wait times.” 

## **The Takeaway**
Whether you’re near or far, a virtual consultation is a viable option for anyone looking to explore their options or get to know a provider. While not every procedure or concern can be addressed virtually, telemedicine allows patients and doctors to communicate their goals, desires, and potential treatment plans. At the end of the day, a video call cannot fully replace an in-person appointment, but Dr. Lesley and Dr. Morgan maintain that there is no reason to not try it. “They are easy and fun,” they say. “It is an amazing way to be productive during this time when we all have to physically be home.”

Now Trending

Virtual consultations (or telemedicine) are nothing new for many plastic surgeons, dermatologists, and cosmetic dentists, and The AEDITION is answering all your questions about how they work and what they can treat.

A Guide To Virtual Consultations And Telemedicine In Plastic Surgeon, Dermatology, And Cosmetic Dentistry

Here’s What You Need To Know About Virtual Consultations

shutterstock 1138384403 (1)

At last, it’s here. After all the research, consultations, and the preparations, your cosmetic surgery day has finally arrived. You’re reclining on a gurney in the pre-op area wearing nothing but a surgical gown and a disposable purple hairnet, trying to daydream about how fabulous you’re going to look and feel when all is said and done. But between the bustle of the nurses and anesthesiologists and the buzzing of the unfamiliar sounds surrounding you, it’s tough to find your zen space.

Suddenly your plastic surgeon appears from behind the curtain — smiling and reassuring — asking if you have any last-minute questions. After the small talk and run-through of post-op instructions, your surgeon asks you to stand up, perhaps sans flowered gown. You probably already have butterflies, and now you’re standing there being stared at intently.

As your surgeon scrutinizes the surgical area, he or she is reaching for a package that is sitting on a metal tray beside your bed. They unseal the plastic, pop off the cap, and proceed to draw on you — all. over. you.

Welcome to the wonderful world of surgical markings.

## **The Purpose of Surgical Markings Before Cosmetic Procedures**
“Sometimes patients get a little panicked,” says UCLA board certified plastic surgeon [Jason Roostaeian, MD](https://aedit.com/provider/jason-roostaeian-md-449). “I can see it in their eyes. They’re wondering: ‘Is that where you’re going to cut me?’” Dr. Jason often eases his patients’ nerves by cracking a joke about the markup process.

So what, exactly, do all of those circles, x’s, numbers, meandering lines, and dashes of different colors actually signify? “We use marking pens to plan out the surgery and indicate the landmarks,” explains Beverly Hills-based board certified plastic surgeon [Leif Rogers, MD](https://aedit.com/provider/leif-rogers-md-578).

Because our bodies look different lying down in the operating room than they do normally, creating a surgical roadmap while the patient is standing upright is optimal. “In some cases, the process of numbing the patient or injecting tumescent solution can obscure some of the landmarks,” Dr. Rogers adds. 

Markings can signify a multitude of things: incision sites, existing landmarks, areas to be altered, as well as those to be avoided. “We need to make sure we don’t disrupt certain anatomy during surgery,” Dr. Jason shares. But, just as every procedure is unique to the patient, every marking is specific to the provider.

Surgeons use markings in their own unique way,  so there’s no standardized system in place. “You go through your training and watch how your attending does it,” Dr. Jason says. “But everyone adopts their own personal style.”

This explains why some surgeons use multiple colors, while others stick to the stereotypical purple pen. Some doctors do use Sharpies, but the markers are usually specially formulated for use on skin — so they’re not exactly surgical Sharpies. As Dr. Rogers notes, the marking pens “tend not to wash off when the patients are being prepped for sterility.” Speaking of sterility, it’s also worth noting that surgical markers are sterile and single-use only.

## **How Surgeons Markup Common Cosmetic Procedures**
While surgeons have their own style, there are some markings that almost always accompany a certain procedure. Below, Dr. Jason shares some of the typical markings he makes for different surgeries. He draws on all of these patients while they are standing, with the exception of rhinoplasty (because the nose position remains relatively unchanged).

### [Breast Surgery](https://aedit.com/procedure/breast-augmentation-with-fat-transfer)
- The breast fold
- Ideal nipple placement

### [Facelift](https://aedit.com/procedure/subperiosteal-facelift)
- The jawline
- Facial folds for fat grafting

### [Neck Lift](https://aedit.com/procedure/direct-neck-lift)
- The midline of the neck
- Extent of skin dissection

### [Rhinoplasty](https://aedit.com/procedure/revision-rhinoplasty)
- Position of nasal bones
- How much of the hump to take down
- Ideal tip angle

### [Liposuction](https://aedit.com/procedure/smartlipo)
- Highest to lowest fat concentration

While many procedures require a series of dashes and straight lines, liposuction is illustrated using curved shapes. “We create a topographical map using concentric circles,” says Dr. Jason of the fat removal surgery.

Just as there is no standard markup methodology, there’s also no such thing as a ‘typical’ pre-op patient mindset. “Patients’ reactions are as different as their personalities,” Dr. Rogers says. “Some want smiley faces. Others are ticklish.” And, while some patients can’t wait to scrub off those markings, others happily snap pre-surgery selfies for social media.

## **How to Remove Surgical Markings Post-Op**
As Dr. Rogers shared, markup pens are meant to survive the sterility and surgical process. So, just how does one go about removing those surgical signatures post-surgery? Both docs say alcohol swabs work best — though patience is key. That ink is often stubborn, and it may hang around as you heal. If you’re in a hurry, Dr. Rogers recommends “light scrubbing in the shower” to facilitate removal over the course of a few days.

Expert Opinion

You’ve likely seen pre-op pictures of cosmetic surgery patients covered in dashes, x’s, and o’s. But what exactly is the surgeon mapping out with their marker? The AEDITION asked the experts.

What Your Plastic Surgeon Is Doing With That Markup Pen During Cosmetic Surgery

Connecting The Dots: What Your Surgeon Is Doing With That Markup Pen

shutterstock 650887000 (1)

You’ve done your homework and decided you’re interested in getting a surgical or non-surgical [cosmetic procedure](https://aedit.com/aedition/difference-between-plastic-surgeons-and-cosmetic-surgeons). So, what comes next? A consultation with a board certified plastic surgeon.

Just as you wouldn’t buy a car without test driving it, you should not choose a doctor for your cosmetic surgery, procedure, or treatment without exploring your options. An initial consultation allows you to do just that. In addition to learning more about the procedure you are interested in, it is also an opportunity for you to get a sense of the doctor’s personality and practice before deciding if he or she is the right provider for you.

## **Book More Than One Consultation**
As with most decisions in life, you’ll want to get more than one opinion. You should plan to consult with at least two doctors before moving ahead with your surgery or procedure. When deciding on who to book a plastic surgery consultation with, it is important to first consider the following: 

- What is the provider’s board certification(s)?
- Does he or she have hospital privileges?
- Is he or she recommended by someone you trust?

While referrals aren’t mandatory, [researching a doctor’s board certification(s)](https://aedit.com/aedition/medical-board-certification-in-plastic-surgery-cosmetic-dermatology) and hospital privileges (yes, even if you’re interested in an outpatient procedure) are musts. Tools like the [AEDIT provider network](https://aedit.com/providers) can help you find qualified doctors in your area.

Once you narrow down your search and schedule consultations with the providers you want to meet, there are a couple of things to keep in mind about the process. While it is standard to consult with multiple doctors before settling on ‘the one,’ it is best to not reveal the names of the other doctors you are considering. Similarly, do not share the proposals you receive from one provider with another, for it may influence what they recommend for you.

## **Questions to Ask During a Cosmetic Surgery Consultation** 
*What should you discuss in the consultation room? From reviewing before-and-after photos to learning about the pre-op and post-op care, below is a guide to the most important questions to ask during a cosmetic surgery consultation to ensure you feel empowered to make the best decision.*

### **Aesthetic & Expertise** 
**1. What procedure(s) do you recommend for me?** 
You may have your heart set on a certain procedure or treatment, but you should plan to have a conversation with your doctor during your consultation about what he or she sees as the best course of action for you and your concerns. The decision is ultimately up to you, but the plastic surgeon will be able to take a more holistic look at the situation and potentially offer [a series of options](https://aedit.com/aedition/plastic-surgery-results-are-about-proportion-not-perfection) that you are a good candidate for.

**2. How often do you perform this procedure?**
While there are exceptions, it would make sense that the more frequently a provider performs a treatment or procedure, the more time they’ve had to refine their technique and specialize in it. Asking how often they perform the procedure they are recommending or the one you are interested in will help give you a better sense of their expertise.

**3. Are there before and after photos available?**
You’ll be hard pressed to find a plastic surgeon who doesn’t readily offer a look at their previous work in the form of before-and-after photos, but don’t be shy in asking for them. In addition to seeing how the results turned out for different types of patients, you’ll also get a better sense of the doctor’s aesthetic. 

**4. Would you be willing to put me in touch with previous patients?**
If the provider you’re consulting with didn’t come recommended from a friend or colleague, asking to speak with an existing patient (preferably one who underwent the same procedure you are interested in) can be a good way to learn more about the doctor, practice, and overall experience.

### **Cost & Pre-Op Care**
**5. What is the cost breakdown of this procedure?**
Because most cosmetic procedures are considered elective, they are not typically covered by insurance. They are also not cheap. Prices can vary dramatically from practice to practice, as can the way the cost is presented. To avoid hidden fees or surprises, ask for a comprehensive overview that includes pre-op and post-op care. While it is impossible to foresee complications, getting a sense of any additional expenses that may pop up (from recovery essentials to additional procedures) will allow you to budget accordingly. With that said, certain cases of rhinoplasty, eyelid procedures, and breast surgeries (to name a few) may be fully or partially subsidized by insurance, so be sure to check with your insurance provider before booking.

**6. How many pre-op appointments will be needed?**
If you’re interested in a surgical procedure, you’ve likely already considered the recovery time that may be required. But what about the time involved with pre-op prep? From bloodwork to imaging, there are tests to be run and assets to be secured prior to going under the knife or needle. Get a sense of what the timeline looks like from the day you book your procedure until your last follow-up appointment to ensure you are able to make the commitment.

**7. Is there anything I need to do prior to getting the procedure?**
Whether you need to [lose weight before scheduling a body contouring procedure](https://aedit.com/aedition/why-you-should-lose-weight-before-plastic-surgery) or press pause on your skincare routine in the days leading up to a treatment, you’ll want to have the provider give you a sense of any pre-operative instructions or guidelines. That way, you can consider how they may impact your daily life.

### **Safety** 
**8. Where will this procedure be performed?**
Whether your procedure is being performed in a [hospital or an outpatient surgery center](https://aedit.com/aedition/unexpected-things-to-know-about-the-plastic-surgery-operating-room), you’ll want to ensure the facility is accredited. Both are evaluated for safety by [The Joint Commission](https://www.qualitycheck.org/), though outpatient surgical facilities may also be accredited (voluntarily) by the [Accreditation Association for Ambulatory Health Care (AAAHC)](https://www.aaahc.org/). If you’re undergoing an outpatient procedure, be sure your doctor has hospital privileges to avoid possible risks in case of an emergency.

**9. Does this procedure require anesthesia?**
In addition to learning whether or not your procedure requires [sedation or anesthesia](https://aedit.com/aedition/everything-you-need-to-know-about-anesthesia), you’ll also want to know who will be administering it. Be sure there will be a board certified anesthesiologist or certified registered nurse anesthetist on hand to administer and monitor throughout the procedure. Knowing the type of anesthesia required will also inform whether or not you will need someone to give you a ride home and care for you post-op.

**10. What is the protocol if there are serious complications during the procedure?**
Statistically, even the most qualified doctors performing the most routine procedures can run into complications. One of the reasons it is important to establish that your provider has hospital privileges is in the event there is an emergency during an outpatient procedure. Confirming what processes are in place to deal with unexpected events in the operating room can provide peace of mind.

### **Recovery & Results**
**11. What is the downtime associated with this procedure?**
While there are plenty of minimally invasive procedures that you can schedule during your lunch break, most surgical procedures will require at least a couple days of recuperation. Ask the doctor to break down the recovery period, including how long it will be before you can resume certain levels of activity (from returning to work to exercising) and the side effects (think: pain, swelling, and bruising) you can expect to experience during each phase.

**12. Will I receive written post-op instructions?**
Sure, you may be able to wing the assembly of your IKEA furniture, but recovering from a cosmetic procedure that you just invested a lot of money in is not something you want to do blindly. Most doctors will have written post-operative instructions available for patients that detail everything from pain med and icing schedules to when you can resume basic day-to-day activities (think: showering, laying down, etc.). As simple as it may seem, you want to be sure that you will have something to refer back to when it comes time to navigate the recovery process.

**13. Is there a medical professional on call to answer post-op questions?**
No matter how much research you do beforehand and how thorough the written post-op instructions may be, you can pretty much guarantee that a question (or many!) will arise during the recovery process and require immediate assistance. In addition to good ol’ fashion phone calls, many practices now offer live chats on their websites that allow patients to speak with doctors, physician assistants, and/or nurses in real time. Check with the provider to see what types of services would be available to you.

**14. How many follow-up appointments will be necessary?**
While the exact number of post-op appointments varies by procedure, at least one follow-up is usually needed within the first week. That may be the only check-in needed for, say, an injectable treatment, but surgical patients can expect to meet with their cosmetic surgeon several times in the months following their procedure. Like pre-op care, it is important to have a sense of the timeline prior to booking.

**15. How long will it be before I see results?**
Any doctor will tell you that the healing process, like the procedure itself, depends on the patient, but there are general timelines that can shed some light on when you will start seeing the effects of the procedure and when you can expect a final result. While the results of some procedures are immediate, others can take a year (or more) to fully reveal themselves, so you’ll want to be sure your expectations and patience-level are managed beforehand. 

## **Additional Factors to Consider Before Choosing a Provider**  
*While qualifications and expertise are certainly key components of the decision-making process, there are intangibles related to a provider’s personality, bedside manner, and practice that cannot be underestimated. Even if the provider checks all the boxes above, be sure to also consider the following before choosing who to book your procedure with.*

### **Do you feel comfortable with the doctor?**
The doctor doesn’t need to be your best friend, but he or she should put you at ease. In addition to (hopefully) answering all of your questions, consider how you feel when speaking with the provider. Undergoing any procedure (even an elective one) is a big decision, and you should feel respected and empowered throughout the process.  

### **Are you comfortable with the practice and facilities?**
Did you wait long in the office before seeing the doctor for your consultation? Did the appointment feel rushed? How was the vibe in the waiting area and patient rooms? Taking notice of how you feel about these kinds of details should play a role in how you go about choosing a provider.

### **Is the provider's staff professional and courteous?**
Truth be told, you’ll probably be interacting more with the practice staff than you will with the doctor. From the receptionist to the nurses, pay attention to your interactions with the entire team and notice how they communicate with the provider. All of this will give you insight into what kind of care you can expect before, during, and after your procedure.

## **The Takeaway**
Choosing to undergo a cosmetic surgery procedure is an important decision in and of itself, but finding the right surgeon or doctor for your needs is key to achieving the outcome you desire. Scheduling initial consultations with at least two providers and arriving armed with a list of questions that covers everything from aesthetics and safety to cost and recovery can help you compare and contrast as you narrow down your search.

From reviewing before-and-after photos to learning about the pre-op and post-op care, here is a guide to the most important questions to ask during a cosmetic surgery consultation.

Questions To Ask Your Doctor During A Plastic Surgery Consultation 

15 Questions To Ask Your Doctor During A Plastic Surgery Consultation 

shutterstock 553740730 copy (2)

Of course your doctor is going to give you the low-down on how best to prepare for your cosmetic procedure at the all-important pre-op appointment. And we bet you’ve done your research on what to expect post-procedure, too. But there are still a few things that may catch you by surprise when you arrive in the operating room on surgery day. 

“For me, it was not knowing just how cold the OR can get,” says Christina*, who underwent a breast surgery several years ago. “I was already nervous, and when I was wheeled into a super cold operating room, it just added to my anxiety.”

According to a [study in the Journal of Clinical Nursing](https://www.ncbi.nlm.nih.gov/pubmed/19583663), surgery is often associated with increased stress and anxiety, which can have an adverse effect on patient outcomes. Of those surveyed, 23 percent of patients reported anxiety while being wheeled into the operating room, while 35 percent were anxious during the induction of anesthesia. All the while, 12 percent reported feeling anxious before the sedation kicked in. 

But perhaps the most interesting finding was how the figures changed once patients received a bit more intel. Pre-op preparedness and education about what to expect in the operating room reduced anxiety levels in 49 percent of patients. 

The bottom line? The more you know about what to expect in the OR, the better equipped you are to deal with it. The AEDITION spoke to board certified plastic surgeons and patients about how to tackle the unknowns of the operating room, so you can ace your cosmetic procedure like a pro.

## **1. Start with a clean slate**
While your doctor is definitely going to let you know that you need to keep your precious jewels at home and skip out on your morning makeup and skincare routine before your procedure, patients may not be aware that you also should stay away from lotions, creams, deodorants, and talcum powder. “It’s a sterile procedure and you want to be as clean as possible,” says board certified facial plastic and reconstructive surgeon [Jason Bloom, MD](https://aedit.com/provider/jason-bloom-md-2248), founder of Bloom Facial Plastic Surgery in Bryn Mawr, Pennsylvania.

Another thing to nix? Your next trip to the nail salon. He recommends patients forgo their weekly manicure, so they have bare nails in the OR. Your doctor and nurse will be monitoring the nails to check your health during the surgery and in the post-anesthesia care unit. The color of the skin and nail beds is an important indicator of blood circulation and, therefore, need to be kept as clean as possible.

## **2. Yes, it’s going to be bright and chilly in the OR**
It’s generally assumed that the temperature in operating rooms is lower to prevent the spread of bacteria, but that's only part of the equation. Most surgeons and nurses will be wearing sterile gowns and standing under bright lights for a long period of time, which can increase their body temperature. A cool room helps keep them comfortable and better focused.

From a patient’s perspective, it’s okay to request a warm blanket or ask that the room be kept at a reasonable temperature. “Once I let my doctor know that the cold was really bothering me, he was very patient and understanding and got the temperature to a comfortable number,” says Christina.

Something else that you should account for: the bright overhead lights that can no doubt be intimidating. “I have had a lot of patients comment on how bright the operating room is,” says board certified facial plastic and reconstructive surgeon [Jonathan Cabin, MD](https://aedit.com/provider/jonathan-cabin-md-956), of the Center for Advanced Facial Plastic Surgery in Beverly Hills. “But keep in mind that the right surgical lighting is critical for patient safety.” 

If you’re still concerned about bright lights or a cold room, simply remember that you’ll be induced in a matter of minutes and those worries will fade away faster than you can count to 10.

## **3. There may be music — and essential oils**
While multiple studies in the past have shown that music helps both patients and doctors relax before a surgical procedure, a [2015 study from the University of Texas Medical Branch at Galveston](https://www.ncbi.nlm.nih.gov/pubmed/26163311) went one step further. According to the study, when plastic surgeons listen to music they enjoy, their surgical technique and efficiency when closing incisions are improved. “I always have music on during surgery,” says Denver-based board certified plastic surgeon [Gregory Buford, MD](https://aedit.com/provider/gregory-buford-md-1015), of Beauty by Buford. “But recently I also started including essential oils.” 

Much like music, essential oils are another favored practice for keeping patients calm. According to a [recent study published in Laryngoscope Investigative Otolaryngology](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5743169/), aromatherapy helps combat preoperative anxiety that can have a negative impact on patient satisfaction and outcomes. “I don’t know if it’s a placebo effect, but it’s very pleasant and soothing,” says Dr. Buford. “So far, I have only gotten positive feedback.” 

While he has taken to dabbing a bit of lavender essential oil on the inside of the patient’s mask, he also recommends using some post-surgery. Just ensure that you pick natural, plant-based essential oils that don’t irritate your wounds or interfere with your medication.

## **4. It could be a full house**
From your very first consultation, you’ll be dealing with your board certified plastic surgeon and maybe a nurse or two, so it’s only natural to assume that these will be the only people with you in the operating room. While this may be true for quick, non-invasive procedures (think: [Botox®](https://aedit.com/procedure/botox-facial), [fillers](https://aedit.com/procedure/temporary-lip-fillers), and the like), most surgical procedures ([breast implants](https://aedit.com/procedure/breast-augmentation-with-implants), [facelifts](https://aedit.com/procedure/midfacelift), etc.) will have an operating room bustling with a number of medical professionals. 

In addition to your surgeon, there will be one or two registered nurses, a scrub or surgical technician (to ensure that the surgeon has all the necessary tools), an assistant to the surgeon, and an anesthesiologist (i.e. the person who administers the anesthesia and monitors your breathing throughout the procedure).

“If I am going to have a fellow, resident, or medical student observing the procedure, I make sure to let the patient know beforehand,” says Dr. Bloom. For many doctors and surgeons, it’s a regular practice to allow fellows and residents to observe procedures as part of their training process — but they should give you an adequate heads-up. If it’s something you’re uncomfortable with, just let your doctor beforehand.

## **5. It’s normal to have a sore throat when you wake up**
If you’re undergoing general anesthesia, keep in mind that you’ll likely be waking up with a sore and irritated throat. Once you’re sedated, you’ll be intubated and placed on a ventilator. And, while the breathing tube is resting in your mouth, it also extends into your throat and windpipe, which makes your mouth, teeth, and gums very dry. 

The remedy to tackling a sore throat is rather simple:

- Drink plenty of fluids post-procedure
- Invest in some throat lozenges ahead of time
- Be sure your oral care routine includes brushing your teeth and tongue

“The recovery time is a maximum of three or four days,” says Dr. Cabin. “And, generally, the discomfort passes quickly.” But if it does last longer than the suggested time period, check in with your doctor.

## **6. Stay away from herbal remedies**
Most patients know that alcohol and caffeine should be strictly avoided before and after a procedure, but even some natural alternatives (like ginseng, fish oil, milk thistle, ashwagandha, ginkgo biloba, St. John's wort, and kava) may be off-limits as well. “We recommend that patients stay off herbal remedies for two weeks before and post-procedure as a cautionary measure,” says Dr. Cabin. “Not only can they interfere with medicines used during anesthesia, but they also increase your blood pressure and risk of bleeding.” 

Instead, both Dr. Bloom and Dr. Buford recommend supplements, like [MEND](https://mend.me/), to help optimize the body in preparation for surgery and facilitate faster healing post-op.

## **7. Prepare for any allergies** 
Your doctor is going to have you tested for just about any kind of allergy to make sure that everything goes smoothly on the day of the procedure, but, as a patient, it’s also your job to help them cover all the bases. 

Make sure you ask for a list of any medications they may be using and check that against any other medications you’re currently taking to ensure they can be used together. Also, ask your doctor for recommendations on how to combat allergies should they suddenly occur post-procedure. 

In rare cases, some patients can develop a reaction to medical adhesives, like Mastisol, that are used to secure wound dressings. In such instances, it’s essential you immediately reach out to your doctor, so he or she can prescribe medication or offer alternatives to combat the allergy. 

Some patients, meanwhile, can be moderately to severely allergic to latex products, which manifests as lip or tongue swelling, rashes, or unusual sensitivity. In this situation, doctors can use non-latex products during the procedure and suggest other options for post-op products as well. 

*Patient’s name has been changed

Heading in for a cosmetic procedure but don’t know what to expect in the operating room? Fret not, The AEDITION is here to help you tackle the unknown with #ProTips from surgeons and patients alike.