maintenance after liposuction | Dr. Forley
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Posts Tagged ‘maintenance after liposuction’


Monday, September 12th, 2011

Stress is a normal psychological and physical reaction to the ever-increasing demands of life. Juggling multiple responsibilities such as work, home life, care giving, and relationships can lead to excess stress. Stress can manifest itself in a variety of emotional, behavioral, and even physical symptoms that vary enormously among different individuals. The impact of stress on your efforts to maintain your results after body contouring surgery can be significant and needs to be understood so that it can be managed.


A variety of hormones are released by our body as it responds in a defensive manner to the external trigger of stress. Cortisol is a primary hormone associated with weight gain that gets released due to stress. An excessive amount of cortisol in your system with chronic stress can slow your metabolism. Weight gain will occur even with the same caloric intake and activity level that you had prior to the stressful period in your life. A slowed metabolism that is then paired with stress-induced cravings for less healthy food choices is a set-up for weight gain. There is also evidence that stress induced cortisol secretion increases the deposition of central, deep, stored fat within the abdomen that can be very difficult to reduce.

Common physical symptoms include sleep disturbances, muscle tension, muscle aches, headache, gastrointestinal disturbances, and fatigue. Mood changes, like irritability and depression, can be associated with stress due to alterations in your blood sugar levels. It is also known that people under stress have a greater tendency to engage in unhealthy behaviors, such as excessive use or abuse of alcohol and drugs, cigarette smoking, and poor exercise and nutritional choices. The symptoms of stress and changes in behavior need to be identified to help you implement successful stress reduction.

An important step in stress management is exercise. Since it evolved from a primitive “fight or flight” instinct, stress primes our bodies for action. Exercise on a regular basis helps to turn down the production of stress hormones and associated neurochemicals. Thus, exercise can help avoid the damage to our health that prolonged stress can cause. In fact, studies have found that exercise is a potent antidepressant that combats anxiety and aides many people in sleeping well. “Mindful” activities like yoga and Tai Chi can help you avoid the chronic, uninterrupted stress that is so harmful to your well being as well as your efforts to achieve a long lasting result from your body contouring procedure.

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Tuesday, August 30th, 2011

Now that you have committed to a healthy, low calorie diet and a regular exercise routine to maintain the results of your liposuction, you are probably wondering if there is anything to be done about your body’s metabolism. Metabolism is the process by which your body converts what you eat and drink into energy. BODY CONTOURING:  METABOLISM schemeDuring this complex biochemical process, calories in food and beverages are combined with oxygen to release the energy your body needs to function. Even when you’re at rest, your body needs energy for all its “hidden” functions, such as breathing, circulating blood, adjusting hormone levels, and renewing cells. The number of calories your body uses to carry out these basic functions is known as your basal metabolic rate (BMR).

Several factors determine your individual BMR: your body size and composition, sex, and age. The bodies of people who are larger or have more muscle burn up more calories, even at rest. Men usually have less body fat and more muscle than do women of the same age and weight and therefore burn more calories. As you get older, the amount of muscle tends to decrease and fat accounts for more of your weight, slowing down the amount of calories you burn. Energy needs for your body’s basic functions stay fairly consistent and aren’t easily changed. Your BMR accounts for about 60-75% of the calories you burn every day. In addition to your BMR, other factors determine how many calories your body burns each day: food processing, digesting, absorbing, transporting, and storing the food you consume also takes calories. This accounts for about 10% of the calories used daily. For the most part, your body’s energy requirement to process food stays relatively steady and isn’t easily changed. Physical activity and exercise accounts for the rest of the calories used by your body each day.

It may be tempting to blame a changed metabolism for weight gain, but your body generally balances your metabolism to meet your individual needs. There is a natural tendency to lose muscle mass as we age with additional loss of muscle from a decrease in physical activity. The body resets its metabolic rate to match the decreased demands required by the lower muscle mass. That’s part of the reason why consuming high calorie foods in your teens and twenties, with no effect on your weight, results in weight gain when the same foods are eaten in your forties and fifties. Starvation diets are generally unsuccessful because your body compensates by slowing down its bodily functions and conserving calories for survival.  As a result, a starvation diet works against your achieving a sustainable weight reduction.

To succeed at losing weight, you need to create an energy deficit by eating fewer calories, increasing the number of calories you burn through physical activity, and building muscle to increase your metabolic needs. As a general goal, include at least 30 minutes of physical activity in your daily routine. If you want to lose weight or meet specific fitness goals, you may need to increase your activity even more. Strength-training exercises, as discussed in Part 2 of this series, are important because they help counteract muscle loss associated with aging.

In the final part of this series,  Dr. Forley will talk about the role stress plays in your ability to maintain the results of your body contouring procedure.

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Tuesday, August 23rd, 2011

Along with the healthy eating habits discussed in Part 1 of this series, you need to pursue a good exercise program following your body contouring procedure. Although liposuction and tummy tuck surgery will be of great benefit to your appearance, the long term maintenance of the result requires your active participation. If you hear friends complaining that the surgical results didn’t last or fat went to other parts of their body after their liposuction procedure, it usually is an indication of a sub-optimal or non-existant program of diet and exercise. Excessive caloric intake of any kind-protein,carbs,or fats-will get deposited as body fat no matter how much prior surgery you may have undergone. The observation that the fat may get deposited in “new” areas not typical for you is because there are fewer fat cells remaining in the areas treated by liposuction. Again, this is an indication that you are not utilizing the calories that you consume in your diet and therefore they are being stored as fat.


When you actively build muscle mass, you burn calories more efficiently and regain a more youthful metabolism. The more muscle you build, the more calories you burn, and the easier it is to keep your weight under control with less obsession about diets and calorie counting. Regular exercise will not only help you lose weight but can improve your mood, prevent health problems, and promote good sleep habits. You will look better and feel better, which can boost your confidence, improve your self-esteem and prevent depression. Staying active also helps manage your blood pressure and cholesterol.

You don’t even need to set aside major chunks of time for working out. Take the stairs instead of the elevator or walk during your lunch break. Dedicated workouts are great, but physical activity you accumulate throughout the day helps you burn calories, too. Physical activity delivers oxygen and nutrients to your tissues and, as a result, your entire cardiovascular system works more efficiently. When your heart and lungs work better, you’ll have more energy to do the things you enjoy. Regular physical activity can help you fall asleep faster and deepen your sleep. A good night’s sleep can improve your concentration, productivity and mood. Physical activity doesn’t have to be drudgery- try yoga, hiking, or an at home weight lifting program. Visit for exercise resources.

To maintain ideal muscle tone, aim for at least 20-30 minutes of strength-training exercises 2-3 times a week. Remember to allow your body to rest in between workouts so your muscles have time to recover and grow. Here are a few recommendations from Wellness 360 for some quick, at-home workouts, which do not require any special equipment.

  • Squats: If you are looking to build muscle and gain strength in both your buttocks and thighs
  • One-Arm Row: To strengthen your upper/middle back and shoulders, and a great way to target those lateral muscles.
  • Push-Ups or the Modified Push-Up: A quicker way to build muscle in the chest, abdominals, shoulders, and arms
  • Shoulder Press: A good way to tone your shoulders and arms.
  • Bicep Curl: To build endurance and power in your biceps
  • Kick-Backs: To get those well-defined arms in the triceps area
  • Plank: Good for overall strengthening and toning of the body

If you’re carrying some extra pounds and having a hard time losing them, it’s tempting to blame a sluggish metabolism. But is your metabolism the only reason you can’t lose weight? And, more importantly, is there anything you can do about it?

In Part 3 of this series, Dr. Forley will discuss how your metabolism can influence your success at maintaining your new shape.

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Sunday, August 14th, 2011

Now that you have undergone a body contouring procedure – liposuction, tummy tuck or body lift – you will want to maintain the benefits…

Maintaining the results you have achieved after cosmetic body contouring surgery requires a long term commitment to a healthy diet and a reasonable amount of exercise. The reason is simple, if the calories you consume exceed the calories you burn, the excess will get deposited as fat. This balance can also be affected by your metabolic rate, which can vary with age. As you get older, you will have to work harder to maintain your calorie balance. Finally, stress can play a role in your life and affect your overall health. Read New York City Plastic Surgeon Dr. Bryan Forley’s advice on how to reduce its impact on your sense of well being.


Good nutrition requires a satisfactory diet. Finding a diet with the right combination of nutrients, that works with your lifestyle and that you can also enjoy is a very individual process. There are many nutrients that make up a routine diet, such as fats, carbohydrates, protein, fiber and vitamins. Below, we will give you a general idea of what each nutrient entails.

Fats are nutrients that give you energy. Fats can either be saturated or unsaturated and most foods have both types of fat. Saturated fat or “bad” fat is mostly located in animal products such as milk, cheese, and meats. If you are going to eat meat try poultry or fish as they have less saturated fat than red meats. Saturated fats are in coconut oil, palm oil, and cocoa butter, which are processed in snacks, coffee creamers, and whipped toppings. Trans fat is another type of “bad” fat that is found in shortening and partially hydrogenated oils, such as chips, crackers, cookies, some margarines, and salad dressings. There are “good” fats, and those are known as unsaturated fats, which help to lower cholesterol. The two types of unsaturated fats are monounsaturated and polyunsaturated. Monounsaturated fat is located in canola, olive, and peanut oils. Polyunsaturated is found in safflower, sunflower, sesame, soybean, and corn oils, and mainly in seafood. Omega-3 fatty acids are a type of polyunsaturated fat that can reduce the risk of heart disease. Salmon or mackerel are full of Omega-3 fatty acids and it is recommended that you should eat 3oz. twice a week. Other sources of “good” fat are flaxseeds and flaxseed oil, nuts, and seeds. It is recommended that 20-35% of your total calories each day come from fat. This includes, no trans fat, up to 10% polyunsaturated fat, up to 10% saturated fat, and 10-15% monounsaturated fat.

Processed carbohydrates such as white bread, white rice, cookies, and soft drinks are made up of simple sugars and refined-flour products, which contribute to the problems of obesity and type II diabetes. “Good” carbohydrates include whole grains, which are less processed and maintain more healthful properties. Whole grains are high in fiber, contain antioxidants and vitamins and minerals, are virtually fat-free, and are more slowly digested and absorbed than refined carbohydrates. It is recommended to eat three servings per day of whole-grain carbohydrates. If you’re looking for a whole-wheat product, the first ingredient listed on the label should be whole wheat. Whole-grain carbohydrates include brown and wild rice, barley, bulgur or cracked wheat, whole-wheat pasta, buckwheat, whole kernel corn, and popcorn. Bran cereals are also a good source as they are the highest in fiber. When choosing breads, select those with at least 3 grams of fiber per slice, and cereals with 5 grams or more per serving.


Protein can help you shed those unwanted pounds and keep your belly full. Quality protein also helps you sustain muscle during weight loss, improve muscle fitness, improve immunity and antioxidant function, build HDL cholesterol, and enhance insulin and leptin function – all of which contribute toward optimal weight management efforts over time. But it’s important to eat the right amount and the right kind of protein to get the health benefits. Seafood is one of the best sources of protein because it’s usually low in fat. Fish such as salmon is a little higher in fat but it is the heart-healthy kind, filled with Omega-3 fatty acids. White meat of poultry is good for excellent, lean protein rather than dark meat, which is higher in fat. Milk, cheese, and yogurt are not only dairy foods but are excellent sources of protein, containing valuable calcium. Choose skim or low fat dairy to keep bones and teeth strong, prevent osteoporosis, and enhance weight loss. Eggs are one of the least expensive forms of protein. The American Heart Association says normal healthy adults can safely enjoy an egg a day. One-half cup of beans contains as much protein as three ounces of broiled steak and they are loaded with fiber to keep you feeling full for hours. Pork tenderloin is great and this versatile white meat is 31% leaner than 20 years ago. The intake of soy protein daily can help lower cholesterol and reduce the risk of heart disease. Combine soy protein foods like tofu with a healthy low fat diet. Lean beef has only one more gram of saturated fat than a skinless chicken breast. Lean beef is also an excellent source of zinc, iron, and vitamin B12. If you are looking for protein on the go, grab a meal replacement drink, cereal or energy bar. Check the label to be sure the product contains at least six grams of protein, and is low in sugar and fat. To get the potential weight loss benefit, experts advise aiming for around 120 grams of protein a day. If you want to increase your protein intake, do it slowly over the course of a week.

Eating a higher-fiber diet has been shown to lower blood cholesterol levels, improve and prevent constipation, and slow digestion. The American Dietetic Association recommends the intake of 20 to 35 grams of fiber a day. There are two types of fiber, insoluble and soluble. Though both have health benefits, there’s a difference between the insoluble type of fiber found in whole grains, carrots, tomatoes, and lettuce, and the softer, water-soluble type found in oatmeal, pears, strawberries, and apples.

Insoluble fiber doesn’t dissolve in water. It helps keep bowel movements regular, and may reduce the risk of colon problems. It may also reduce the risk of hemorrhoids, varicose veins, and obesity (by making us feel full). Insoluble fiber is in: Whole-wheat grain and wheat bran, brown rice, bulgur, seeds, and vegetables (carrots, cucumbers, zucchini, celery, and tomatoes).

Soluble or viscous fiber is the softer type that dissolves in water. When digested, it helps prevent cholesterol from being absorbed in the intestines. This type of fiber is also thought to help minimize the rise in blood sugar levels after a meal, which is particularly helpful for people with diabetes. This type of fiber comes from: beans, oatmeal and oat bran, some fruits (apples, mangoes, plums, kiwi, pears, blackberries, strawberries, raspberries, peaches, citrus fruits, dried apricots, prunes, and figs), and some vegetables (dried peas, beans, and lentils).

Vitamins are essential nutrients that contribute to a healthy life. There are many good reasons to consider taking vitamin supplements. Your body uses vitamins for a variety of biological processes, including growth, digestion, and nerve function. There are 13 vitamins that the body absolutely needs: vitamins A, C, D, E, K, and the B vitamins (thiamine, riboflavin, niacin, pantothenic acid, biotin, vitamin B-6, vitamin B-12 and folate).

There are two types of vitamins, water-soluble and fat-soluble. Water-soluble vitamins are easily absorbed by the body, which doesn’t store large amounts. The kidneys remove those vitamins that are not needed. Fat-soluble vitamins are absorbed into the body with the use of bile acids, which are fluids used to absorb fat. The body stores these for use as needed.

Dr. Forley recommends VitaMedica as a supplemental vitamin program. The morning and evening packets make it easy and convenient to stick with a daily routine. The program provides a combination of vitamins and nutritional supplements, filled with minerals, organic flax seed oil, and antioxidants. It is formulated with nutrients that support glowing skin, hard nails & lustrous hair; strong bones and flexible joints; and a vital cardiovascular system.

If the concept of healthy eating seems challenging, begin by slowly incorporating these recommendations into your diet. Drastic changes are more difficult to maintain long term.

Follow these links to help you with your calorie intake:

NEXT BLOG POST BY NEW YORK PLASTIC SURGEON DR. BRYAN G. FORLEY: The best exercises to maintain your new body shape

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