In this episode of Carpools & Cannulas, San Diego plastic surgeon Dr. Katerina Gallus of Restore SD Plastic Surgery and Dr. Jennifer Greer of Greer Plastic Surgery in Cleveland, OH, talk about post-op care after plastic surgery. Why are compression garments so ill-fitting??? Do you really need a drain? What about lymphatic massage? Learn from these two plastic surgery experts!
Transcript
Dr. Greer: …Greer, I just said… Hi, you’re on. Hi.
Dr. Gallus: Hey.
Dr. Greer: You were, like, waiting for me. I got all set up and then realized that my kid took my running light apart to use for a lightbox, so that was awesome.
Dr. Gallus: Oh, right. There’s always a snag.
Dr. Greer: It’s right here. Yeah. It’s fine. And the screw’s missing of course. Whatever.
Dr. Gallus: Well, I need the lightbox because I did a chemical peel on Friday and my face, you can’t really tell.
Dr. Greer: Are you flaking?
Dr. Gallus: A bit close. It’s coming off. It looks really horrifying in person.
Dr. Greer: Isn’t that fun? I’m all red because I have a raging cold and I’ve blown my nose, like, 100 times today.
Dr. Gallus: Oh, perfect. Yeah.
Dr. Greer: I know. And the best is when you’re scrubbed into OR and you’re like, “My mask is full of snot. This is amazing.”
Dr. Gallus: That is hands down one of the worst experiences. So yeah.
Dr. Greer: Yeah. It’s so gross.
Dr. Gallus: Mm-hmm. So, let’s see. I have to start this off, being in San Diego, with a go Padres. Not even like crap about baseball, but…
Dr. Greer: I don’t either, but apparently the Guardians are doing okay now. I don’t know. I was out to dinner with someone on Saturday and everybody’s cheering and we’re like, “Oh, baseball. It’s this important?” I Google, I’m like, “Oh, okay. If they get through this and then the next one then they can go to the series. All right.”
Dr. Gallus: Okay. Yeah. No one thought the Padres would make it, so it’s a big deal here. And then someone was telling me that the game in Seattle Saturday night went 18 innings, which underscores why I… Right. That’s right.
Dr. Greer: Right. And then there’s gonna be another game the next day. Awesome.
Dr. Gallus: Yeah. Kill me. Anywho. So, that’s my baseball update, but we were gonna talk about post-op stuff, right?
Dr. Greer: Yeah. Kinda like swelling, compression, garments. I think we should talk about icing too because people ask me about this all the time.
Dr. Gallus: Okay. What’s your take on icing?
Dr. Greer:. I hate it. Like, everything’s numb. Don’t do it. It’s just they always wanna do it for lipo or for facelifts. The whole area’s numb. I’ve seen people give themselves frostbite. I do have people do it for Blephs.
Dr. Gallus: I wanna know who Revision Bob is.
Dr. Greer: I don’t know. I’m gonna go with rep. I’m gonna guess.
Dr. Gallus: Yeah, I don’t tell people to ice lipo. That seems weird. The only time I advocate for ice is for breast surgery, like breast augmentation because it is, you know, under the muscle and I feel like it really does hurt and it feels better to have ice packs up here.
Dr. Greer: Do you wrap them after aug? Because I always wrap with an ACE wrap and then I’m like, “Well, you’re not gonna feel the ice through the ACE anyway.”
Dr. Gallus: Oh no, I just put ’em in a bra to stop it. And honestly I feel like you can ice way longer than the immediate postop period and still get… It’s kind of like icing a sore muscle. It makes sense to me because it’s your muscle…
Dr. Greer: Right. So it’s decreasing inflammation.
Dr. Gallus: Yeah. So, I do like ice for that. I’ve only seen somebody get an ice injury once from icing too much. But it was a reconstructive case, a melanoma on the foot. He had surgery, he had a flap and then he iced it, and was a ding-dong. It worked out fine. Also risk factor was that he was a doctor, so you know how we do.
Dr. Greer: We always have complications. It’s a rule.
Dr. Gallus: Yeah. I mean, you don’t need to tell me that after 10 minutes I should probably take the ice pack off because I’ll be numb and I won’t be able to tell if I’m… Yeah. And when you do ice I do tell them, 10 minutes on, 10 minutes off at the most. Because you will go numb and then you won’t know what you’re doing.
Dr. Greer: Yeah. And then you injure your skin.
Dr. Gallus: Yeah. So, okay. Yeah, ice on your face, I don’t recommend that either.
Dr. Greer: Is that your dog growling?
Dr. Gallus: Yeah, she’s growling.
Dr. Greer: Oh, good. I was like, “Is my house…? Like, do I have a poltergeist?”
Dr. Gallus: No, she’s growling because somebody walked past our house, and we’re on the second story. So I’m not really sure what she’s accomplishing by barking at ’em from the second floor.
Dr. Greer: That’s awesome. They are already very far away. Yeah, my cat’s just sleeping in a chair today instead of trying to knock my phone over, so that’s a win.
Dr. Gallus: Oh yeah, that is. Okay. Are we done yelling at the people outside? Okay, good. Okay, so yeah, ice, what about heat? I mean, it doesn’t do anything but I feel like it sometimes makes people feel better. But again, the risk is that you can burn yourself.
Dr. Greer: Injure. Yeah. I never specifically recommend it. Sometimes if somebody has more, like, muscle spasmy stuff, but I’m trying to think when that would happen. You know the time I do recommend ice is Mondor’s, which is when you get thrombophlebitis of one of the blood vessels in the breast and it feels like a little cord. So I’ll have them do ice and Motrin.
Dr. Gallus: Yeah, that’s you should do. Yeah. Okay, so we’re off ice and heat. What about compression? How do you feel about garments?
Dr. Greer: I do like compression. Oh, there’s Elise from my office. Hi, Elise. Yay. I do like compression. I know some of our colleagues don’t use them, but when I had lipo it just felt like everything was, like, all loose and not contained. My only annoyance is that they don’t fit everyone very well. When they fit well, they’re great. When they don’t fit well, they’re just an annoyance.
Dr. Gallus: Yeah. I mean, if there weren’t already eight different companies making garments, I would design my own garments because they really do such a terrible job of, like, making garments that fit people that would really… I mean, the bras are pretty self explanatory. I put people in a light, post-surgical compression bra after surgery, but for…
Dr. Greer: But, like, the torso garments, like, some people have really long torsos and, like, they can be the shortest person.
Dr. Gallus: And some people are petit and I feel like everybody’s garment comes up to, like, here and so it stops where it needs to be and then it folds over.
Dr. Greer: And it digs in. I always send them home…for lipo, I’ll do garment with a binder over it, and then if the garment’s really uncomfortable I just have them stop that and just do the binder.
Dr. Gallus: Yeah, I know. I would do a binder, except I also feel like it’s the same problem. Either it rides up or you can’t pull it down.
Dr. Greer: Wrinkles and folds, yeah.
Dr. Gallus: Yeah. If I do liposuction to the torso, they end up in, like, almost like a girdle so it comes down below the… And you’re like, “Well you don’t need anything on your legs. We didn’t do that.” But the only alternative garment is the kind that is, like, a lower body suit, leotard. But in order to do that you have to, like, clasp it underneath in the crotch area.
Dr. Greer: So, those are actually the ones I use, and I know the patients hate the crotch snaps at first, but they loosen up after a couple of days. I spoke too soon on the cat, oh. So, when I had lipo, that’s what I had. And, like, you get pretty adept at them, but it takes about two days. So, I just tell people to leave ’em unhooked for the first couple of days.
Dr. Gallus: Oh, yeah. That’s not such a bad idea. Yeah, people just hate bending over to get to it so I just put ’em shorts.
Dr. Greer: Right. It is hard. But then the shorts are crotchless, right?
Dr. Gallus: Mm-hmm.
Dr. Greer: They have, like, the cutout?
Dr. Gallus: Mm-hmm.
Dr. Greer: See that’s weird too, and it’s probably…
Dr. Gallus: Because people do and do not like that.
Dr. Greer: Things ride up in weird ways and then just TMI, but then you go to the bathroom and you’re like, “Did I pee on it? Did I not?”
Dr. Gallus: Yeah, “Did I pee everywhere?”
Dr. Greer: Yeah, it’s great. The cat’s in the room with me and he’s like, “What are you talking about?”
Dr. Gallus: Oh. Crotchless garments, what?
Dr. Greer: Yep. Crotchless garments. This is what we talk about professionally.
Dr. Gallus: Funny fact though, I was at the conference in San Diego one year and a friend of mine, or actually like…anyway she was an acquaintance but she’s a GI doctor, and the GI people were having their conference in the convention center at the other end. And so I met her for lunch because she lives in, like, Minnesota and she’s like, “I heard that your exhibit hall is crazy.” I’m like, “It is?” And she’s like, “Yeah. I heard there were women running around in their underwear. There’s women in their underwear.” And I was like, “What? No. Oh, the garment overalls.”
Dr. Greer: Oh, that’s funny.
Dr. Gallus: Because they had, like, marina models that year on pedestals wearing garments, and they had these crazy wigs and it was this whole to-do, and I was like…
Dr. Greer: Oh, that is a little weird.
Dr. Gallus: I was like, “Come on in. We’ll go scope it out. You can see the…” You couldn’t pay me enough to wear those. I don’t care how cute you think you are.
Dr. Greer: That’s funny.
Dr. Gallus: Yeah. “Here’s the crotchless garment that I have to wear, but I’m gonna wear a…”
Dr. Greer: With some underwear under it.
Dr. Gallus: A blue wig. Maybe no one will notice.
Dr. Greer: Nice. That sounds fantastic. Yeah, they probably got paid really well, I hope.
Dr. Gallus: I don’t think so.
Dr. Greer: Yeah, so I mean I always found it more comfortable wearing a garment. Like, I liked wearing the garment because otherwise it just felt really unsupported and really uncomfortable. But I know other people don’t use them at all, so I’m not too worried about it if somebody’s like, “It’s really uncomfortable.” I’m like, “Fine, take it off. We don’t want chafing. We don’t want irritation or just do the binder or go get some spanks.”
Dr. Gallus: Yeah, I do tell people spanks is an option if they hate it. It’s hard though because I feel like it does get the swelling down faster, so if you just did liposuction and let them walk out the door, they’re gonna go, poof. So it is really nice that I tell people to try and stay in compression around the clock for two weeks. Except for when you shower and/or you’re washing said garment.
Dr. Greer: Oh, you’re nicer than I am. I tell ’em four weeks.
Dr. Gallus: Ooh. And then I tell ’em it’s good idea to continue to wear it but I need that two weeks, and then after that some people really, like, like wearing it for a long time because it provides support.
Dr. Greer: Oh yeah. Wear it to work out. Well, that’s where I’m more easy going if it’s irritating or annoying them. I’m like, “Fine take it off. Don’t worry about it.”
Dr. Gallus: Right. Yeah, I get about not using one but I do understand from the surgeon’s perspective it gets away the headache of like, “Does it fit right? Is it bothering them? Are they getting chafing?”
Dr. Greer: Right, and I always measure for mine so when they don’t fit them, I’m like, “Oh, that jerk who measured.” And people always ask, like, how did they end up in their garment? Like, we put it on you while you’re asleep. We’re really good at dressing unconscious people. You’re welcome. As long as it’s got, like, hook and eye closures and zip-up on the side, then we can do that.
Dr. Gallus: You have to start your side first. That’s really…
Dr. Greer: Yeah. I mean, my team is like so smooth at the garments now. Like, they lay a towel. So we have to roll you over, tuck your garment under, roll you over on the other side. If you’ve ever seen people make a bed under an unconscious person, this is how we do it. But, like, my nurses work with me all the time now and I realized my circulator, Megan one day I’m like, “Wait, you’re rolling up the towel so I can tuck it from my side regardless of what side of the bed I’m on.” She’s like “Yeah.” Yeah, so it always goes on the same way, and then if I’m on the wrong side, like, the hook and eye closure is suddenly very hard.
Dr. Gallus: Yeah. Because you get used to your system, I know. When I was in training I worked with a nurse who could, like, you pulled the bra over because there’s, like, six clasps and she could, like, get ’em all.
Dr. Greer: Oh, all six?
Dr. Gallus: It was so amazing. I’ve never been able to replicate that.
Dr. Greer: I feel like we should try that at ASPS. Yeah, you’re going this year. We should just bring a bra and practice. Well, you have to fold it. Like, you have to fold the under part because otherwise…
Dr. Gallus: Yeah. Get it outta the way. Yeah. It was impressive.
Dr. Greer: Oh, Amanda says it’ll be me next Monday. Girl, we’re gonna have fun.
Dr. Gallus: Get you in that garment.
Dr. Greer: I always wonder if people have weird memories of us dressing them as they’re waking up.
Dr. Gallus: I think people are just the next day when I see them, they’re like, “How’d you get me in this?” I’m like, “Mmh.”
Dr. Greer: Magic. I mean, we’re, like, rolling ’em around. We’re, like, lifting ’em up.
Dr. Gallus: Magic. “You’re asleep.” My oldest daughter dances and she’s been in The Nutcracker every Christmas, and it’s a production with the company ballet, so the city ballet. So, I’ve helped backstage and there’s quick changes, and then sometimes you’re just hanging out just trying to be helpful and the actual company ballet dancers come back and they literally have seconds to, like, change. And I’ll just be there and I’m like, “Oh I got this.” And it’s dark, you can’t see. It’s, like, a whole other different challenge of getting those hook and eye closures. Except it’s usually some sweaty, very well toned, you know, gay man.
Dr. Greer: I mean that sounds fabulous. I can’t think of anything more fabulous than putting a gay man in a leotard in the dark.
Dr. Gallus: Yeah, it’s their, like, coats and stuff for… Yeah. It’s funny. But it’s the same nonsense, and they’ll be back there with like a little iPhone light so that we can see what they’re doing. And the thing is, at the same time they’re not just standing there letting you dress ’em. They’re, like, trying to switch their socks, or their shoes, or whatever.
Dr. Greer: Oh, my gosh. Crazy. Hey Amanda, how are you? We’re getting lots of hi’s today from all the patients.
Dr. Gallus: Yeah. So, I feel like those skills translate into more than one setting.
Dr. Greer: I always tell people like, if you need help, like, dressing a dead body, call a plastic surgeon.
Dr. Gallus: Like, for real.
Dr. Greer: We’re really good at it. And then I’m always afraid somebody I know will turn up murdered with a change of clothes, and they’ll be like, “You know who mentioned this on Instagram last week? It was Dr. Greer.”
Dr. Gallus: Yes. Yeah. “We just need to put this outfit on.”
Dr. Greer: Yep, that’s fine. Very helpful.
Dr. Gallus: That’s awesome. All right, so that’s compression. How do you feel about foam? Do you use lipo foam?
Dr. Greer: I was gonna ask you. I do like Topifoam. I do. I don’t use it on everything, but I’ll use it on my tummy tucks and, like, where I lipo. And, you know, when I started using it, when I stopped using drains on breast reduction and I switched to doing superomedial pedicles, and I do aggressive lipo in the lateral chest, I started putting Topifoam in the lateral chest, like, wrapping it with an ACE wrap because I had a couple seromas, boom.
Dr. Gallus: Oh, that’s a good idea. I haven’t had a seroma issue but I always tell them, “If you liposuction here and right in here, which everybody likes to have done, there’s not a great way to get compression on that area.” And so, like, the bra sits there, but then everything bulges up and…
Dr. Greer: The foam definitely helps.
Dr. Gallus: The foam definitely helps.
Dr. Greer: Oh, and Dana said it makes it more comfortable. So yeah, I do like it.
Dr. Gallus: Oh, I might add that in.
Dr. Greer: I like it because it kind of, pads, like, the chafing areas. I keep some in my office too, and then if people have seromas I’ll put it under. Okay, good to know, Dana. Thanks. I’ll make sure I liberally apply Topifoam more often.
Dr. Gallus: So, do you put Topifoam on for your tummy tucks too, or no?
Dr. Greer: I do. I’ll just put one sheet right on the front. I just feel like it adds a little extra padding. And then if I do, like, on the waist I’ll put another full sheet on each side.
Dr. Gallus: Okay, nice.
Dr. Greer: Yeah. You just gotta be careful that there’s no ridges. I one time had, like, a little space in the center and this person got a ridge of swelling, which drove us both bonkers for a while.
Dr. Gallus: Yes. Because it takes a while to go down. I do like the foam because I do, like, with the sacral area, like a little dome right there.
Dr. Greer: Yeah.
Dr. Gallus: That’s nice because that area swells up. And then do you use the foam with the adhesive or no adhesive? Because I…
Dr. Greer: I use the adhesive.
Dr. Gallus: Okay. You’re in the Midwest, so I feel like I had somebody with… I used Topifoam at one place a couple years ago and they’re like, “Oh here’s a sticky foam.” And I was like, “Oh, this is awesome. It sticks where you put it.” And then, like, two days later or a day later I peel it off and she had, like, hyperpigmentation from the adhesive.
Dr. Greer: Oh really? Oh.
Dr. Gallus: I mean, it eventually goes away but it was a drag. So I’m like…
Dr. Greer: Yeah, I’ve not seen that.
Dr. Gallus: I get a lot of ethnic skin. You know, it’s not straight fits too, so people have a little bit of color and everything you… I have people who have, like, the drain has to feed up and out of the garment and you just the imprint of the drain.
Dr. Greer: They get a line from the drain? Wow.
Dr. Gallus: Mm-hmm. Yeah. I don’t know why. Maybe we just tan too much in San Diego. Maybe that’s the problem.
Dr. Greer: I mean, we don’t have sun in Cleveland so I think that really helps.
Dr. Gallus: It’s not an issue.
Dr. Greer: There’s none. It’s just cloudy all the time.
Dr. Gallus: Yeah. And it’s funny because I used to put Dermabond on everything and now I tend not to use it as much too. Also southern California, maybe we’re just all really sensitive, you know. We’re gluten free down here.
Dr. Greer: Yeah. Very delicate flowers, no gluten, probably vegan. I don’t even know. I’m in the Midwest. Like, we eat a lot of bacon and beer.
Dr. Gallus: Because you can’t resist things like adhesive and Dermabond.
Dr. Greer: Which I put pretty on everyone. It’s great. Actually I Dermabond my blephs. We talked about this I think during the bleph one. Yeah.
Dr. Gallus: Yeah. No, I have a very sensitive skin population and it sucks. When you have an allergic reaction to something its…
Dr. Greer: Oh, it’s annoying. I mean, I do get allergic reactions. It’s usually Neosporin. Somebody’s slathering that on. People don’t use Neosporin, don’t use triple ointment, don’t use Polymycin. They all have Neomycin and people are allergic to it. And then you get a big itchy rash and then you get annoyed.
Dr. Gallus: Yes. I feel like I was in a Facebook group where somebody asked about something related to putting Neosporin on it. And someone was like, “I just came here for the comments from plastics and derm.” That they are gonna go crazy.
Dr. Greer: They have, like, a little popcorn eating emoji and they’re like, “Here we go.”
Dr. Gallus: Yeah. Waiting for plastics and derm to weigh in about how much they hate Neosporin. I was like…
Dr. Greer: Love it. Well, I have a funny contact or potato story. So, you know, I got my nose pierced in June and then I got, like, the little piercing bump. So I’m like, “Oh I’ll go on Amazon and get something to settle that down.” And of course it was, like, some potato called Colangulate, whatever. So I put it on, it gets a contact dermatitis. So I’m like digging through my cupboard and I find, like, a post-procedure cream which has hydrocortisone in it. I’m like, “Cool, I’ll slather that on.” Then I got a contact dermatitis to that so it just was, like, a bigger area.
Dr. Gallus: Oh, No. To hydrocortisone?
Dr. Greer: It was probably whatever the carrier of the cream was. Or, like, one of the scents or whatever. And it was probably, like, hyper-irritated from the first step, so then I finally called myself in, like, Triamcinolone ointment. I was like, “Screw this. I’m getting a prescription steroid cream.”
Dr. Gallus: Oh, my gosh. That’s always fun when you get something. I had a back spasm probably, like, two years ago or so. It must have been pre Covid. And I was dying and my chiropractor’s like, “Oh I know somebody will come to your house and do a massage.” So she does the massage, and then I ended up having an allergic reaction to the…
Dr. Greer: To the massage oil. Oh.
Dr. Gallus: Oil, which I’m not allergic to anything, but that was true misery. Because I showered after and I started to not feel very good… Or no, I took a bath, whatever. And then I went to bed and then I woke up at, like, 2:00 in the morning and realized what it was. I felt awful. And then like, “Ugh.” I was like, “Maybe there’s a remnant on me.” And so I got up in the middle of the night to try and shower and get any residual oil off of me. And I, like, fell. Like, I was a mess. And then my husband’s like, “What are you doing? It’s 3:00 in the morning.” And I’m like, “I just had an allergic reaction”. It was like Hitch, you know, my face was, like, puffing out.
Dr. Greer: Oh, my gosh. It’s like when you get a full body sunburn and you just feel sick like you have the flu.
Dr. Gallus: And by that time my lips were big, my tongue was swollen and like, “Oh, my God.”
Dr. Greer: You’re like, “I need to get one of those packs, stat.”
Dr. Gallus: I was like, “Man, now my back still hurts and I have a new problem.” That’s why allergic reactions suck, because they’re, like, usually in response to something that you’re trying to fix. So, no-go. So yeah, I mean, I think that’s kind of all the post-op care, like the ideas to make your recovery better but…
Dr. Greer: Not more miserable.
Dr. Gallus: Start to dodge things that are miserable. But, you know, drains. Sometimes a necessary evil, right?
Dr. Greer: Sometimes.
Dr. Gallus: If you have to use ’em. Try not to use ’em because of that. But it’s better than nothing, huh?
Dr. Greer: Yeah.
Dr. Gallus: Yeah. All the things that come with post-op.
Dr. Greer: Although I feel like things have really changed a lot. I mean, even in the 10 years I’ve been out in practice, you know, I send everybody home now. I used to keep tummy tucks overnight. I used to keep breast reductions overnight in residency, we did. And, like, every breast reduction got a drain in residency. I stomped that out and, like, people do great. It’s much easier without it.
Dr. Gallus: Yeah, absolutely. Yeah. I used to, when I started as staff, they… You’re too young to know that they had this pizza board thing. Have you ever seen that? Where they…
Dr. Greer: Oh, that they put on the abdomen?
Dr. Gallus: No, they put the patient on this metal board and then they ACE wrapped their chest and then they slide it out.
Dr. Greer: We still have one at the hospital. There was another doctor who liked it and they’re like, “Do you want the board?” I’m like, “God, no. Why don’t we…?” And they’re, like, throwing talcum powder on there.
Dr. Gallus: I was like, “Yeah, they invented this thing called a bra. Why are we…?”
Dr. Greer: Well, I mean, so I still wrap, which I started wrapping for the seromas with my reductions.
Dr. Gallus: ACE wrap?
Dr. Greer: Yeah. So I do a bra and then I put a 6 inch wide, double length ACE wrap over.
Dr. Gallus: Over the bra.
Dr. Greer: Over the bra. And I start doing that…
Dr. Gallus: Well, then so how do you…?
Dr. Greer: How do we get ’em up? So, I just have one nurse on each side, and they lift their arm and head behind their shoulder. Like, they just put a hand behind their shoulder and that way you only have to lift them up a tiny bit, because that board you’re, like, sitting them up. So my nurses just lift them a little. Although it’s funny, I have this one anesthetist, Sarah. And if it’s a bigger patient, she’ll like put her head to the patient’s back to hold it with her head and I laugh.
Dr. Gallus: Then you just get it wrapped what, like twice or something?
Dr. Greer: On the smaller people it’s, like, four times. But I think it does help a little bit, especially with that armpit swelling from augs, because it tucks right up under there. So, I just do all my breast cases because it’s simple and nobody has to think that hard then.
Dr. Gallus: And then you take the ACE wrap off when?
Dr. Greer: Day two, when they shower. So they take the ACE off and then they just do the bra.
Dr. Gallus: Okay. Yeah. So that was the thing, like, you’re putting people in a couple of ACE wraps, then they come in a couple days later, so you take it off. Like, are they gonna re-ACE wrap? Like, then they’re having to… No, not your patients. I’m just saying…
Dr. Greer: Right. But, like, are they supposed to? Yeah. No. So I don’t have a re-ACE wrap. But you know, somebody I trained with in residency when I was a resident, they were attending. Do you remember, like, the big, fluffy cotton that goes under cast, like, the bulky…?
Dr. Gallus: Yeah. Yeah.
Dr. Greer: He wrapped that around them. Then he’d put in Ace. It’s St. Louis, it’s 110 degrees out. It looked like the itchiest thing to me, but, I mean, he would’ve gotten a million calls so it must’ve been fine. But it was just like…
Dr. Gallus: It’s a plaster, like plaster…
Dr. Greer: It was, like, they had this, they had on-cue pumps, they were all wrapped up. I don’t know if he still does that, but it’s pretty funny. It was just a lot of fluffiness.
Dr. Gallus: That’s crazy. The ACE wrap’s a good idea though. I guess if you got a lot of aggressive lipo on it.
Dr. Greer: Yeah. I mean, like I said, it helped with the seromas and now I just do it on the breast because then it’s easy. I like to keep things as consistent across cases as I can, so it’s easy for the team and it’s easy for me.
Dr. Gallus: Right. They don’t have to be like, “Is this the breast where we do this? Is this breast where we don’t do it?” Yeah. No, for sure.
Dr. Greer: Exactly.
Dr. Gallus: I hear ya. Cool. Oh, well, we have a few minutes left. But what about lymphatic massage?
Dr. Greer: I knew you’re gonna bring that up. I think it’s great. I think it’s helpful. There’s not a ton of people in my area who do it, but we’ve got a couple people we refer patients to starting at, like, a week. And there are, like, “A week?” And, like, they’re brushing your skin. It’s very gentle. It’s not aggressive at all.
Dr. Gallus: I honestly didn’t realize that but it makes total sense. So, there’s someone we refer in our community. Well, there’s a couple people we refer to but she stopped by and was like, “Let me just have you come over to my office so you can see it and you can get a massage,” blah, blah, blah. I was like, “I won’t turn down a massage. Yes.” And Kathleen’s another person in our community. And I was like, “Oh. Well, it makes sense because you’re not massaging muscle, you’re trying to get the lymphatics.” The lymphatics are superficial, so it is a very gentle…
Dr. Greer: Light.
Dr. Gallus: Eight to 10 days is completely reasonable after a procedure. I do routinely recommend it after liposuction, maybe some tummy tucks. But we had a discussion about how it can be helpful for after a facelift. I mean, there’s no reason why you shouldn’t do it after any procedure, honestly.
Dr. Greer: There’s lymphatics everywhere, yeah. Especially when people are really bothered by the swelling. I’m like, “Go get a lymphatic massage it will help.
Dr. Gallus: It really does help, yeah. I know, I feel like… I think Kathleen and I were on, like, some sort of clubhouse and that was a thing for five minutes.
Dr. Greer: Oh yeah. I forgot about clubhouse.
Dr. Gallus: Yeah. And then Dr. Karen Horton was like, “It doesn’t work.” Like just a matter of fact and I was like, “I mean, you might wanna couch that with a, like, “In my opinion,” or, “Not for everybody.” Maybe equivocate a little bit. Because I feel like, “How could it not help? Like, you do it for, like, a facial or…” You know what I mean?
Dr. Greer: Yeah. So you know what I actually learned about it, I got a lot of hand swelling with all three pregnancies, and then I would get carpal tunnel, and then I’d have, like, my little sausage fingers and operating was hard. So, one of my employees would do, like, lymphatic massage on my hands for me so I could operate.
Dr. Gallus: Nice. Yeah.
Dr. Greer: Oh, Dr. Rorick.
Dr. Gallus: Dr. Rorick uses it. Absolutely. So yeah, I mean, I think it’s helpful. It makes sense. The lymphatic system can use all the help it can get, honestly. And compression helps with that. We know that from arms…
Dr. Greer: It doesn’t give the…
Dr. Gallus: Arms need compression.
Dr. Greer: Skin room to distend. Especially those patients where you’re doing high volume liposuction, there’s a lot of dead space to fill back up with fluid.
Dr. Gallus: Right. Yeah. It’s one of my favorite things to recommend. And then people who I do lower extremity stuff to, like thigh lipo or thigh lifts, I have them do legs up the wall too, which I assume everyone does, but no. So you just, like, lay on the ground.
Dr. Greer: And put your legs up on the wall.
Dr. Gallus: Yeah. Your butt on the wall, your legs up. It’s really, everyone should do it at the end of the day, but who has time for that?
Dr. Greer: Feels good on your lower back, yeah.
Dr. Gallus: Yeah. It’s great for your lower back, it’s great for your circulation, etc., etc. It’s just, you know, one more thing. But if you had surgery it does definitely, definitely helps.
Dr. Greer: Yeah. Wow. You know where we’re gonna be in two weeks? We’re gonna be in Boston.
Dr. Gallus: Boston. Are you going to that Witches of The Blade dinner on Friday night? Okay.
Dr. Greer: I am. And then there’s the Gala Flex Dinner I think on Saturday too. Oh, you’re going to that.
Dr. Gallus: Oh, yeah. I’m going to that.
Dr. Greer: Because Cindy set it up with Dr. McCord. I’m so excited to actually meet her in person.
Dr. Gallus: Yes. That’s gonna be great. Cool.
Dr. Greer: Yeah.
Dr. Gallus: Yeah. And I’m filming some stuff on for… What day do you get there, Friday?
Dr. Greer: No, I’m coming in Wednesday night, because I’m moderating a panel Thursday afternoon and I’m afraid flights will be crazy, so I’m coming in early. Yeah, I’ll be there all day Thursday.
Dr. Gallus: I’ll be there. I fly in a red-eye so I get there Thursday morning, because I have a Women Plastic Surgeon steering committee committee at 12:00, so I will be there so that I can go to that.
Dr. Greer: Oh yeah. I wonder if I RSVPed yes for that.
Dr. Gallus: You should go.
Dr. Greer: Thanks. You know what, I’m gonna go. I know I RSVPed for the luncheon.
Dr. Gallus: Oh yeah. That sold out, so that’s good.
Dr. Greer: Who’s your keynote this year? It was so good with Dr. Wendy Chen last year. She’s amazing.
Dr. Gallus: Yeah. I think it’s Allison Nada.
Dr. Greer: Okay.
Dr. Gallus: Yay. She’s supposed to be good too. I think it’ll be awesome.
Dr. Greer: Awesome. I’m excited. It’s always great women.
Dr. Gallus: Yeah. So I will see you in a couple weeks then.
Dr. Greer: I know. I’m so excited.
Dr. Gallus: Maybe we can talk about things we learned at the annual meeting.
Dr. Greer: That would be fun. I always learn good stuff.
Dr. Gallus: Cool. Bye.
Dr. Greer: All right. Thanks for joining.
Dr. Gallus: Have a good night.
Dr. Greer: You too. Bye
About Restore SD & Dr. Katerina Gallus
As the Director of Restore SD Plastic Surgery, board certified female plastic surgeon Dr. Katerina Gallus has over 15 years of experience helping San Diego patients enjoy head to toe rejuvenation with face, breast and body procedures. After a successful career as a Navy plastic surgeon, Dr. Gallus founded Restore SD Plastic Surgery with the intention of creating a welcoming space for anyone seeking cosmetic enhancement.
Restore SD Plastic Surgery offers popular facial rejuvenation procedures like facelift & neck lift, facial fat grafting, and eyelid lift; breast augmentation with implants, breast lifts or breast reduction; body contouring procedures such as tummy tuck, liposuction, mommy makeover, and Brazilian butt lift (BBL), as well as aesthetician services, BOTOX, injectable fillers, and laser treatments.
Dr. Gallus and her highly-experienced aesthetics team are here to help you look and feel your best! To schedule a personal consultation, please contact us online or call our San Diego office at (858) 224-2281 today.
