The Diet after Plastic Surgery

At Yager Esthetics, patients often ask me if there is a special diet they should follow after liposuction or tummy tuck surgery. While the short answer is that they can eat what they want, a sensible and healthy approach to diet and portion control is essential to maintaining the best shape.
While I do not claim to be a nutritionist or registered dietician, I thought I would pass along some healthy eating guidelines to lose or maintain your weight. I do not endorse any particular diet plan, and favor learning how to eat regular food both at home and in a restaurant so you can follow these principals forever.

To increase your body’s metabolism, you have to keep it working all day long. Skipping meals is the worst thing to do, as your body just slows down thinking it may never be fed again. I recommend eating every three to four hours in a sensible way.

In the morning you need a sensible breakfast, such as Special K with fruit, an egg white omelette with veggies, or a whole grain toast with preserves and coffee or tea. In between breakfast and lunch, have a low fat yogurt with 100 or less calories and a piece of fruit and space them out.

For lunch, I prefer a protein the size and thickness of my palm with a starch (rice, potato, etc) the size of my fist without a thumb. I can have as much veggies as I want, like a salad, but very little dressing on the side.
In between lunch and dinner, another yogurt and fruit. Dinner is the same guideline as lunch. After dinner, 2-3 hours later, I allow myself a dessert of 100 calories or less of any type. I often find it difficult to eat so much in a day. At work, sometimes frozen food are convenient if you read the labels, keep fat calories to 25% or less, and keep it under 500 calories.

Throw in a little exercise 2 to 3 times a week, and you are well on your way to a healthier new you! If you need more help, call us and we will recommend a nutritionist or weight loss doctor to help you.

Getting the Most out of Plastic Surgery

Plastic Surgery can do many positive things for you. It can reshape a nose, balance your breasts in size and shape, repair the damage after pregnancy or massive weight loss, and restore a youthful appearance to your face. Advanced laser and injectable treatments can make a big difference without surgery, as well as skincare and peels.

Patients are virtually always pleased with the changes that surgery brings, but they sometimes think that it is a substitute for exercise, diet, and a healthy lifestyle. Sorry, but it is not that easy. If you want to maintain and optimize your results, you should listen to your doctor.
After a tummytuck, or abdominoplasty, procedure you need to exercise to maintain and restore tone to the abdominal muscles. No matter how skinny you are, if you relax the stomach muscles, you will not be totally flat. The surgery reshapes the waist and returns the muscles to a tighter state, but muscle strength is important and something you have to do.

Following liposuction, you need to maintain your weight. If you continue to eat in a way that increases fat in your body, you will get bigger and possibly require more surgery. Better to watch your diet and enjoy.

You must take care of your skin, as a facelift or eyelid surgery only fixes sagging. The texture and sun damage need to be improved by proper skincare and sun avoidance. Diet and water intake are also important.

If you make the effort to undergo cosmetic plastic surgery, protect your investment. I only want you to look your best and show off my work in the best possible light. What better advertising could there be?

The Patient Escort After Plastic Surgery

Whenever a patient undergoes a surgical procedure required sedation, regional, or general anesthesia, they are required to have a patient escort over the age of 18 to leave the office. This has always been the policy of Yager Esthetics, even before we became a AAAASF Accredited Surgery Center. It is amazing that some patients are annoyed at this rule.

The purpose of the patient escort is to have someone who is not altered by the medications that are given with anesthesia, and are not subject to the physical limitations imposed by the surgery so that they may help you arrive home safely. There should also be someone with you for at least the first 24 hours in case something happens and you are unable to call for help. It is common sense.

Going home in a taxi by yourself is never acceptable. If you pass out in the cab, what happens? If you get out of the cab and fall going into your home or building, who can help you? If you become confused or fall asleep from the anesthetic effects, who knows what might happen.

I know that some people live alone, and feel that it is embarrassing to tell someone they need help getting home from cosmetic surgery. It is a private matter, and not everybody has a person that they trust. If this is the case, ask about hiring a nurse or nurse’s aide to take care of you for the first night. They can pick you up and go home with you. Your safety is definitely worth the minor expense.

Terrorism and Plastic Surgery

When we witness a senseless attack on society such as 9/11 or the bombing at the Boston Marathon, the first instincts are usually sadness and possibly fear. We reassess what we do, where we go, how we travel, and become more suspicious of people and situations around us. These are all natural responses, and it is difficult to change them.

What we should do is support the victims, seek out the people who committed the crimes, bring them to justice, and figure out how to prevent it from happening in the future. With the Marathon incident, I believe that is where we are right now.

What does this have to do with Plastic Surgery? I feel that Cosmetic Plastic Surgery is the epitome of the American way of life. We do not apologize for success and the ability to invest our hard earned money in our own happiness. Whether it is a new pair of shoes, a fancy car, or a little liposuction, it is our right to enjoy.

I am well aware that there are more important things in life then your appearance, and for some Plastic Surgery is frivolous. I am not suggesting that Plastic Surgery is a way to protest terrorism. What I suggest is that we be vigilant, but not change what it means to be an American, and enjoy the freedoms our ancestors have fought so hard for.

Beauty Pageants and Plastic Surgery

I was recently interviewed on Levantate on Telemundo to discuss beauty pageant contestants and plastic surgery. Is it ok for them to undergo a procedure to enhance their beauty, or is it cheating? It is an interesting topic to discuss.

No one has a problems with makeup for pageants, even though it can cover flaws and make you appear more beautiful than you actually are. It is accepted as a part of the normal routine. False eyelashes, high heels, and even hair weaves all seem to be ok as well. Even some form shaping undergarments are used.
I think you need to be very careful with cosmetic plastic surgery. While it is available to all, it is a surgery and has risks. It can potentially improve your beauty which may be against contest rules. If not, I think certain operations are more understandable than others.

If you are super slender, but have a small pocket of exercise resistant fat, it may be impossible to safely remove it with diet and exercise. To become anorexic or be forced to keep your body fat at an absurdly unhealthy level may be dangerous to these women. I would much prefer a selective liposuction.
What if a woman is born with a deformed nose, or has an accident resulting in a crooked nose? Should she be barred from competition? How about a cleft lip? The slope becomes very slippery.

My opinion is that if it is allowed by the rules of the pageant, and if it will help a woman in her future career, more power to her. Just be safe and do it for the right reasons.


I am sure by now many of you have heard of the tragic case of the woman who went to a Plastic Surgeon in Brooklyn for a discount liposuction and died. The important parts of the story are that she had previously undergone a heart transplant, and that after she died, her Plastic Surgeon allegedly changed her medical record to hide that fact.

While it is horrible when anyone dies after an elective cosmetic surgery, it is one of the very infrequent but possible risks of any procedure. Even if the surgeon does everything perfectly, this can certainly happen. Pulmonary emboli, fat emboli, cardiac events and strokes can occur in the perioperative period regardless of the type of surgery. The problems with this case are the fact that she was a transplant patient, had an office procedure, and her doctor changed her chart after.

I have operated on patients after liver transplant and kidney transplants for all types of procedures. I always contact the primary care and transplant team prior to accepting the patient to determine if it is safe and where the best place to perform the operation would be. Medication management around the procedure is also key. I do not believe this happened here.

Changing a medical record is against regulations and law. The chart is a record of patient care meant to tell the story to whoever needs to know what occurred. It is never 100% perfect, as you cannot transcribe every single word exchanged between you and your patient and all of your staff. It should be accurate, though.
Please be careful when you select a Plastic Surgeon for your procedure, and make sure he/she is doing the right thing for you, not for their financial benefit. If something feels off, do not bargain hunt. You only have one life.

The Weather and Plastic Surgery

As I write this, it is about 20 degrees Farenheit outside in New York City. Just to walk from my car to Yager Esthetics is brutally cold. The wind off the water that rises from 165th Street is mercilessly frozen as it stings your skin. It is still January, and so people are still not thinking about the beach and summer activities.

As I have been in practice here for 16 years now, my surgery schedule is the same as ever. I am grateful for being given the opportunity to help so many people achieve their esthetic goals. No matter how cold, even if it snows, patients find a way to make it here for surgery.

Being a busy plastic surgeon, patients have to wait for appointments to consult with me. That is why it is so frustrating when patients cancel or fail to show up for appointments because it is too cold. I try to respect my patients’ time by not double booking appointment slots, and my office calls to confirm the night before as well. This helps to insure an efficient process for both of us. It is a sign of honor.

When I have to turn patients away for visits because my schedule is full, I feel awful when I have a gap caused by the temperature. I urge you to dress in layers, bundle up, and honor your obligation to come for your appointment, whether it is a new consult or post operative visit. You can be sure I will be there.

Art, Children, and Plastic Surgery

At first glance, any two of these things go together well, with an easily seen connection. Plastic Surgery can be very much an artistic field where creativity and esthetic vision are of primary importance, and so it would be a natural fit with art. Children and art are also a natural pairing, as those of you with children know. Even Children and Plastic Surgery can be connected by birth defects, cleft lip correction and even pinning back the ears.

When I expanded Yager Esthetics for the second time, I had a dedicated free art space for Hispanic artists created within the offices. It was a great way to expose the works to the Latin community, which makes up about 95% of my patients. Through our In House Artist Program, we have hosted several events each year for the artists to explain their works, and have sold pieces at every show to date.

Our motto is “In the Community, For the Community”, and so I thought that to further help the Hispanic population, I could reach out to the children. Growing up, I always loved art. It was a way to express myself, and exploring in that medium helped all of my studies and thought processes. I was saddened to hear that art programs were being cut in the school system. The result of my brainstorming became Pequenos Picassos.

Through Pequenos Picassos, young children from single parent low income families are invited to participate in art classes with our In House Artist. They not only learn about technique, but are exposed to a Hispanic role model. Scholarship money is awarded, and money is also donated to their schools to help restore art programs. It has been incredibly rewarding for me and the participants. The response from the community has been wonderful.

Art, children, and Plastic Surgery. Now that is a combination that works well together.

Christmas and Plastic Surgery

As tomorrow will be Christmas for most of the world, I thought I would take a minute to reflect on what the spirit of this holiday season means, and how it relates to plastic surgery.

The Christmas spirit to me means going that extra mile to be a little more patient, kind, and courteous to your fellow man. Holding open the door for someone, an extra smile and wish for a nice day to a total stranger, giving to those less fortunate than yourself. Basically, the way you should behave all of the time when life doesn’t get in the way.

So what does this have to do with Plastic Surgery? While cosmetic plastic surgery is certainly about looking better, it is also a way to transform how you feel about yourself. When you look better, you feel better. When you feel better, you are more likely to be in a good mood and helpful and pleasant to others.

From my perspective, it is a time to be grateful for the opportunity to serve the Hispanic community, and to be thankful for the gifts and abilities I have been blessed with to make others more cheerful. No matter how hard I work, or if I have a difficult day, I never forget that it is a privilege, not my right, to be trusted by my patients.

Have a wonderful holiday, and try to be beautiful inside and out this season and always.

BMI and Plastic Surgery

There are some patients who seek out plastic surgery as a desperate attempt to look better without having to address the fact that they need to lose weight. While I do not believe that you need to be at your ideal weight for a cosmetic procedure, you do need to be reasonably close to it.

Not everyone wants to be skinny, and in fact the height and weight charts that are out there are often unrealistic and difficult to apply to everyone. Some people are naturally thicker, and look well at higher weights. My general rule of thumb is that if you are within 20lbs of your desired weight, it is reasonable to consider plastic surgery. There are, however, limits.

The BMI, or Body Mass Index, is a quick calculation based upon your height and weight ((weight in pounds / height in inches x height in inches)x 703). In my office, we do not offer surgery if your BMI is over 35. This is due to an increased risk of complications from surgery at this higher number, as well as a less than optimal cosmetic result.
Patients are often disappointed when I tell them to lose weight before plastic surgery. When I explain to them that it is for their own safety and long term cosmetic benefit, some of them realize that I am trying to help. I obviously do not make money by saying no. Unfortunately, some doctors here, and many overseas, do not care about your weight and will do whatever you like if you have the money. I urge you to not let this happen. Please ask them if your weight adds any additional risk, or if losing weight after surgery will alter your result. If they say no, run.

If you are convinced that you want to have this surgery then you need to take into account your fitness and weight levels. If your weight is high and you need to lose some to accomplish the optimum size for surgery like this, there are ways this can be achieved. More and more people are turning to such things as fitness trackers like Fitbit’s to help them monitor their progress. You can go onto sites such as Mobile Mob and see offers on accessories for your Fitbit to make it work for you, and to make you feel positive about getting this done, so you can go into your surgery knowing you did your best.