YOU on a diet - Appendix B - YOU TIPS!

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YOU TIPS! Maintain Your Holding Pattern. Before you have any kind of plastic surgery for your skin, your doctor should insist upon a healthy nutritional status-primarily so you can heal properly after surgery (that is, maintaining a diet with healthful ingredients) . You will also have much better outcomes if you actually train for surgery like you would for a road race, by exercising. You will need to be sedentary after surgery, so being strong beforehand just makes you bounce back better. Your doctor will also use diet and exercise to assess your ability to stay at your current level of weight. The doctor will want to know if your weight's been stable over the last six to twelve months. If you've been fluctuating either up or down, there's no point in having the surgery. If you're prone to gaining weight again, you'll simply stretch

it out and defeat the purpose of the surgery. And if you're still losing weight, the surgery may be a bigger waste of money than the psychic hot line, because you run the risk of sagging again after the surgery. Take a Reality Check. It all sounds more blissful than an ocean-side pina coloada: no more fat; no more loose skin, ah, the ideal body. But many people have a tough time adjusting to life in the plastic era. Why/ There are psychological reasons: Weight gain occurs slowly-and most times, with the exception of some surgical procedures, weight loss happens slowly as well. You have time to psychologically adjust to your new body, whether it's getting bigger or smaller. But when you have plastic surgery (especially with removal of your skin), the changes are fast, drastic, and, in some cases, emotionally heart-stopping. It took ten years to get and and

mentally adjust to your sense of "you," but when somebody whacks off twenty pounds of excess fat and skin and stitches you up like grandma's needlepoint, it takes a whole different mind-set to deal with the effects. Yes, losing weight and losing excess skin are what you've always wanted, but you need to be prepared for the scars, the body adjustments, for the attention you'll be given. While some people bask in the compliments they receive on their new bodies, others are embarrassed or shamed by positive feedback, because it reminds them of how noticeably overweight they once were. Lots of obese people never look in the mirror, so your new body may take some getting used to. There are also physical reasons that people are disappointed after plastic surgery. It's not like blowing your nose. Some of these surgeries are quite invasive, and there are drains, swelling, some pain, immobilization, and other discomforts that

come with them. Some patients expect to look twenty-five years old when they're done. That just isn't real. The best you can hope for is a fitter, well-rested, ten-years-younger you. Do Your Own Checkup. With some skin-altering procedures, it seems as if everybody and his mother's gardener thinks he can do them. But for any of these procedures, you need a board-certified plastic surgeon. Liposuction docs should perform more than 100 procedures a year, and those doing surgeries for massive skin reduction should be doing a minimum of one and hopefully more a month. The board-certified plastic surgeon will be equipped to handle complications (remember, in liposuction procedures, the fat gets stabbed, and one potential risk is the stabbing of vital things and things that bleed a lot residing under or in the fat). It doesn't matter whether you sign up to have surgery done in a hospital or an in-office doctor's OR; there's only one way to determine if the facility meets standards of high quality for service and cleanliness. That is, it needs to be accredited by the country's health-care do-gooder group called the Joint Commission, the patients safety champion. You can search for facilities at www.jcaho.org. It's the backup and reassurance you need when someones about to slice a few bricks' worth of skin off your belly. Just because the corner guy is offering the "latest" or "newest" or "most cutting-edge" procedure doesn't mean you should be first in line. The plastic-surgery field is full of fraud, and you don't want to be a lab rat in someone else's experiment. Make sure the tool, technique, or procedure has scientific

backing. One good place to start: Check the surgeon's website to see his results or ask for the "brag book" of sample cases like yours. Some plastic surgeons specialize in extreme weight-loss patients and can show pictures with disappearing bat wings and shots with and without skin aprons. But remember that no one shows off images of complications or poor results, so ask to see at least a dozen pictures. It helps if the surgeon is a diplomat in a plastic surgical society such as the American Society of Plastic Surgeons (ASPS),The American Society for Aesthetic Plastic Surgery, the International Society of Aesthetic Plastic Surgery (ISAPS), or the American Association of Plastic Surgeons (AAPS)- which means having to keep up with the latest and greatest. And ask for references. After all, just because the corner plastic surgeon buys a quarter-million- dollar device doesn't mean that you need to bankroll the financing. Now Stop. We've all seen pictures of them; they're people who treat cosmetic operations like massages. The more they have, the better they feel. But the truth is that these people have more plastic than an in-debt college student. Yes, it's tempting to have additional procedures, but plastic surgery can be as addictive as any drug. The sign that you're in a constant quest for-watch our fingers making quotation marks in the air-"perfection" is that you're planning your next surgery soon as you're finished with the one before it. So, yes, find your trouble spots and decide what will make you happy. Then pick an end point where you want your body to be and deal with the reality of what you're going to look like when you get there. Look in the mirror, tell yourself what changes would give you satisfaction, and then stop. If you can't stop-if you're constantly

considering lipo-ing this or tucking that-then it's not your skin you need checked; it's your head. Bottom line: Before deciding on a procedure, you have to accept the fact that you're not seeking perfection; you're seeking improvements in your body and your happiness.