Dr. Bosshardt's Blog

What should I do to prepare for surgery?

plastic surgery Florida Patients often ask me what they can do to prepare themselves for an upcoming surgical procedure. I love this. It means the patient is invested in the surgery and actively working with me to get the best result. 

I believe the single most significant factor under a patients control is to avoid tobacco in all its forms. Smoking is, I feel, the single biggest lifestyle factor that can adversely affect surgery. In addition to being one of the worst habits anyone can engage in- I semi-seriously tell patients they would be better off shooting heroin than smoking- smoking puts patients at greater risk of surgical complications. Nicotine containing products, such as patches or gum should also be stopped. Nicotine is a potent vasoconstrictor; it causes blood vessels to clamp down for up to 24 hours. This reduces blood flow to areas, especially skin, and, combined with surgical manipulation, can reduce blood flow below a critical level where skin and other soft tissues will die. Smoking's ill effects are so serious that I will not perform certain elective operations unless the patient stops for a minimum of four weeks before surgery and does not resume for three to four weeks afterward. These include facelifts, breast lifts and reductions, tummy tucks, and any operation where the skin will be lifted and tightened. The risks just aren't worth it. 

Patients often ask about drinking alcohol before surgery. I have no problem with patients having a glass of wine, beer, or a single mixed drink on the evening before surgery. I don't feel this has any clinically significant effect on bleeding. I don't want patients inebriated the night before surgery or drinking heavily in the weeks leading up to surgery. Excessive alcohol intake creates enough problems of its own without adding this to the lead to surgery. Alcohol, like other sedatives, can affect a patient’s ability to metabolize and respond appropriately to many drugs used for anesthesia. Alcohol in excess damages the liver and this organ is crucial to the metabolism of a large spectrum of drugs as well as producing factors necessary for blood clotting. 


Breast implants- what does your future hold?

Young women seeking breast implants often ignore a critical aspect of this surgery: they will have these implants in their breasts for years, even decades. What happens to them over time? This is an aspect of breast implant surgery that I feel many surgeons gloss over. What are the long term consequences of having breast implants?



Surgery After Skin Cancer

skin cancer surgeryIf you are diagnosed with skin cancer, your doctor may recommend surgery to remove the cancer and prevent it from spreading. Depending on the type of skin cancer you are diagnosed with and the amount of skin and tissue around the cancer that must be removed, your Oncologist may recommend that you have reconstructive surgery to replace skin and tissue and minimize scarring.

Our plastic surgeons are highly trained in the reconstruction necessary following skin cancer removal. They possess extensive knowledge in the latest and most effective surgical techniques. Our plastic surgeons have performed a wide range of skin grafts and tissue transfer procedures.

They are fully skilled at the superior restoration of the skin cancer site so that it matches the remaining skin. Because they closely work with other experts in the field, they can call on any other type of medical expert needed right at our facility, including pathologists, oncologists, and dermatologists.


Your Hands & Plastic Surgery

It may surprise many people that many plastic surgeons perform a lot of hand surgery. Both orthopedic and plastic surgeons receive extensive training in hand surgery during their residency programs, and hand surgery is an integral part of plastic surgery. Some surgeons go on to do additional training to specialize in hand surgery.

hand surgeon floridaYou may be referred to plastic surgery for a broad range of hand problems. We do lots of trauma care involving hand injuries. These include such things as tendon repair, repair of hand fractures, and repair of complex soft tissue injuries of the hands and fingers. In the area of elective surgery, you may be sent to a plastic surgeon for removal of tumors or skin cancers of the hands; for problems related to Dupuytren's contracture, an unusual condition in which fibrous bands in the palms gradually cause the fingers to bend and remain bent; for carpal tunnel surgery to relieve pressure on nerves in the wrist than can affect hand function and sensation, for trigger fingers; and for ganglions of the fingers and wrist.

Some plastic surgeons that specialize in hand surgery can offer highly technical and complex care such as microsurgery, joint replacement, major hand reconstruction, tendon transfers, nerve and blood vessel repairs, and more.


Does liposuction help with weight loss?

liposuction weight lossThe short answer is no. The more comprehensive answer is, it depends. It depends on what type of liposuction you are discussing. There are two general categories of liposuction: large volume and small volume. 

Large volume liposuction is performed in patients who are overweight or obese and seeking removal of a large amount of fat. Most plastic surgeons agree that this would be 5 liters of fat or more at one time, about one and a quarter gallons for the non-metric types. Large volume liposuction is not a cosmetic procedure although it may produce cosmetic benefits. It is major surgery and should be done in a hospital setting with overnight monitoring because of the potential for major effects on such things as blood pressure and heart, kidney, and lung function. Deaths from liposuction have been primarily in patients undergoing large volume liposuction. In some patients who are obese and have diabetes, large volume liposuction has been shown to provide some improve in blood sugar control. 

Most liposuction done today removes much less than 5 liters and is done for body contouring. In many cases, the benefit may be seen more in how your clothes fit and how you look, than what you scales show. If you are stable in your weight and have specific areas of concern, then liposuction can help you work towards your goal. 


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Phone: (352) 742-0079

Fax: (352) 742-0059

1879 Nightingale Lane, Suite A-2
Tavares, FL
West of Waterman Hospital, just off US 441

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