Cosmetic Surgery Safety: Lifestyle Factors Play an Important Role

NEW YORK, NY (Oct. 19, 2004) — Some individuals seeking cosmetic surgery are considered poor candidates because of specific lifestyle factors that can seriously impact their safety in the operating room and during recovery. A new patient education initiative by the American Society for Aesthetic Plastic Surgery (ASAPS), the nation's most prestigious organization of board-certified plastic surgeons specializing in cosmetic surgery, encourages patients to adopt daily habits that promote good health -- both in preparation for and following cosmetic surgery. "As plastic surgeons and physicians, our professional interest is to help patients achieve a better quality of life by improving both the way they look and the way they feel," says Los Angeles plastic surgeon and ASAPS President Peter Fodor, MD.

Serious medical conditions make cosmetic surgery unadvisable for a small number of patients. However, overweight individuals or smokers also may be told "no" or "not yet" when seeking cosmetic surgery from a board-certified plastic surgeon. "If a patient is overweight or obese, the potential risks associated with surgery and anesthesia are likely to be greater," says Charlotte, N.C. plastic surgeon Felmont Eaves, MD, chair of the ASAPS Patient Safety Steering Committee. "In some cases, a surgeon may recommend postponing surgery until the patient has reduced his or her weight." Smoking, as well as chronic exposure to secondhand smoke, can make someone a poor candidate for cosmetic surgery. "Smoking decreases the blood supply to the skin and deeper tissues so that wound healing following surgery may be impaired," says Dallas plastic surgeon Fred Hackney, MD, chair of the ASAPS Practice Relations Committee, which has developed a new patient information brochure, Cosmetic Surgery and Your Lifestyle . "It also increases the risks associated with sedation and general anesthesia." Most patients are advised to quit smoking for a period before and after surgery. "Naturally, plastic surgeons would like to see their patients who smoke give up the habit entirely and often may refer patients to smoking cessation programs," adds Dr. Hackney.

Physician education and public information on patient safety in cosmetic surgery are a major focus of Dr. Fodor's platform as ASAPS President, an office he assumed last April at the ASAPS Annual Meeting in Vancouver, British Columbia. He says that while doctors must use good judgment when evaluating patients for surgery, patients must assume responsibility for following pre- and post-surgical instructions designed to increase safety and avoid complications.

Dr. Fodor also believes that patients must carefully select their plastic surgeon on the basis of appropriate plastic surgery training and American Board of Plastic Surgery certification. "Board-certified plastic surgeons are committed to patient safety and to helping patients adopt healthier lifestyles. There are many members of the American Society for Aesthetic Plastic Surgery who have incorporated 'wellness' education into their cosmetic surgery practices," he says. "Some even have nutritionists and weight management specialists on staff in their offices. Others spend time talking with patients about their daily habits and then refer them to other specialists in the community for help in making positive lifestyle modifications."

Some of the lifestyle factors that may be discussed during the plastic surgery consultation include:

• Current weight and history of weight fluctuations



• Nutrition and vitamin supplements



• Exercise frequency and type (aerobic/non-aerobic)



• Smoking habits and exposure to secondhand smoke



• Alcohol consumption



• Sun exposure



• Sleep patterns



• Stress level and coping mechanisms

"Lifestyle factors are not only a consideration in terms of whether a patient can safely undergo cosmetic surgery, but they often determine the quality and longevity of surgical results," says Michael McGuire, MD, a plastic surgeon in Santa Monica, Calif., who heads the ASAPS Public Education Committee. "For example, if patients have not learned to control their weight before undergoing liposuction, the odds are they won't maintain the full benefits of the procedure. In the case of patients who have undergone facial rejuvenation, it's essential that they learn proper techniques of sun protection to avoid accelerating the skin's aging process and undoing the positive results of surgery."

"What we, as plastic surgeons, are increasingly advocating for our patients is an 'anti-aging' lifestyle," says Dr. Fodor. "Maintaining a healthy diet and weight, stopping smoking, moderating alcohol consumption, getting plenty of sleep, avoiding excessive sun exposure, and reducing stress all have been shown to improve health and, in many cases, lengthen life."

Chicago-area plastic surgeon Laurie Casas, MD, who chairs the ASAPS Communications Commission, says a large portion of those who come to her for cosmetic surgery already are very health-conscious. "Many of my patients see cosmetic surgery as just another aspect of self-maintenance," she says. "My goal is to encourage all my patients

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