TREND REPORT: Dr. Michelle Eagan Talks Round-The-Clock Recovery With RNs

Many agree that recovering from a cosmetic plastic surgery procedure is not always easy, but is the current trend of doctors turning to overnight nursing care to help their patients recover, also ultimately benefitting the surgeon as well as the patient?  The answer is Yes! San Francisco Cosmetic Plastic Surgeon, Michelle M. Eagan, MD, says that for many of her patients sending them home with a 24 hour round-the-clock RN is often necessary. Dr. Eagan says it can dramatically reduce many of the minor problems that could rapidly snowball into a significant medical crisis, and ultimately impact the patient’s surgical result. Dr. Eagan, a highly-qualified aesthetic plastic surgeon, is the developer of the 3-D Mommy Makeover and the Secret Makeover which includes feminine rejuvenation.  In this interview with Aesthetic Insider™ Dr. Eagan discusses top tips to faster recovery from surgery, and how to determine when it’s necessary to send a qualified nurse home with a patient. To learn more, visit www.eaganplasticsurgery.com.

Dr. Michelle Eagan

In what surgical instance do you feel it is imperative that a patient recover overnight with a qualified caregiver or Registered Nurse?
There are so many different types of cosmetic procedures and the ones that are more complex tend to have the larger transformation For those type of surgeries, such as the 3-D Mommy Makeover or Brazilian butt lifts and even facelifts, how you take care of the body after surgery can really improve the patient results and their experience. For my Mommy Makeovers, tummy tucks, facelifts or surgeries that include multiple procedures, I often have patients go home with a Registered Nurse or qualified caregiver, rather than a friend or family member.

When it comes to post-operative care, what can an RN or qualified caregiver do do that a friend or family member cannot?
It’s not that friends or family can’t recover a patient; it’s just that qualified experts know how to help a patient have a better recovery. A qualified expert is not only equipped to handle any possible emergencies, but also understands how to best comfort the patient through this stage of their recovery. The goal is to have the patient recover in as healthy a way as possible while decreasing any potential risks including blood clots to the legs or the lungs which are the number one risk that we prevent in major operations. Experienced caregivers make it easier for the patient to get around, including going to the bathroom, helping them get their meals prepared, and taking their medications at the correct times. The patients don’t have to worry about doing any of these things on their own, teaching someone how to help them or troubling their friends or family. A qualified caregiver really can enhance the surgical experience and the amazing transformation that the patient has decided to undergo.

Do you prefer that your plastic surgery patients recover at home or in more of a hospital setting?
It really depends on the patient. I would say that the majority of my cosmetic surgery patients are very healthy and recovering at home is more pleasant, in the sense that they know their surroundings, they have everything they need and they don’t have to pack a lot of things. Also it is often more cost-effective too, which matters to everyone. Every opportunity we can cut costs we try to do that as long as it’s safe. Compared to a hospital, there are other reasons I prefer them staying at home: they don’t have to be concerned with parking, waiting for discharge, etc. The way my patients recover at home with expert care is a more personalized experience especially since these are post-operative caregivers that help me. Sometimes the hospital experience can feel cold and impersonal, whereas for overnight RN nurses it is their job to ensure a safe, enjoyable and completely private recovery for my patients, one at a time.

Is it your preference to use a Registered Nurse for at home recovery?
Yes. It’s really important that the person taking care of my patients has specific experience with surgical procedures.  I want the person taking care of my patient to know the nature of the surgical case involved, how to customize care for the patient based on their procedure, what to look for to keep the patient safe , and to know when to call me if something does not seem right. A non-qualified person really does not understand what is normal with our more invasive surgeries. Rather than take the risk, I think it’s safer for all involved to have an expert RN or caregiver with the patient for the first 24 hours following a major invasive procedure.   Plus patients are used to complying when a nurse tells them they have to get out of bed to walk so they can increase circulation and reduce blood clots. So yes, my preference is to have a qualified nurse or someone who’s very experienced with surgical patients and knows how to take vital signs, check surgical sites, wound care, as well as safely and comfortably assist the patient to the bathroom or walk around without causing strain to the patient. These experts are used to working long hours, are scheduled to check vital signs, make sure the patient has settled in and are taking their pain medications as directed. Having such care does make a big difference in a patient’s post-op recovery experience. I can also worry less knowing that the patient is in good hands.

Which cosmetic surgery procedures require the most post-operative care?
Every patient is different. Sometimes it’s based on the length of the surgery, extent of procedures performed, or even a patient’s age and current health condition. Mommy Makeovers, which may include several procedures during one operation, are good examples where the patient needs expert after-care for two or three days following surgery. Other procedures such as certain Brazilian Butt procedures, tummy tucks and facelifts may require extra post-op care too. My general rule of thumb is that we have post-op care for a minimum of 24 hours following any major cosmetic surgery procedure. Plus for my patients that go home with post-operative care, the nurse or assistant will come and pick them up from the surgery center, bring them to where they’re staying, help them get in and out of the car, help them get situated at home or at the hotel, then call me to ensure everything is OK and ask for further directives if any. They also send me vital signs every few hours, take care of the patient through the night and bring them back to see me the following day for their post-op appointment.

Is privacy also a consideration for your patients?
Privacy is definitely a consideration for many of my patients. San Francisco is a highly conservative city, and being so close to the elite Silicon Valley entrepreneurs’ who want to keep their youthful looks, makes privacy a big concern. Some of them want to recover in the privacy of their own home with round the clock care, while others prefer to stay in a hotel and hire a nurse for a week to take absolute care of them. They are able to still work from their laptops, and recover in luxury at the same time. Many of the hotels allow our patients to use back entrances too so you never see who’s coming or going.

What is the 3-D Mommy Makeover and the Secret Makeover?
The 3-D Mommy Makeover is actually a new twist on an existing procedure that focuses on both the internal and external features of a woman that often change due to or after pregnancy. Many of the changes to a woman’s body that are accelerated by having children affect the breasts,  abdomen and buttocks and those areas can be rejuvenated with external cosmetic surgery procedures. Another area that is not talked about as often is the vagina which can begin to experience urinary leaking (incontinence), looseness of the vaginal wall and loss of lubrication (dryness). Therefore, the 3-D Mommy Makeover is a comprehensive approach to helping women transform themselves back to being more rejuvenated, more lifted. It helps them to feel like themselves again. Also, as these changes begin to happen to the body, many women feel a loss of confidence and feel uncomfortable in a bathing suit, or even in the bedroom. With the 3-D Mommy Makeover we can now help them reshape their bodies, both inside and out, restoring their confidence and enhancing their quality of life.

What about non-Moms?
Funny you should say that. In San Francisco not everyone is a mom and, as a matter of fact in San Francisco, the majority of people don’t have a large family, but they still want to be rejuvenated and keep up their appearances. So, I created the Secret Makeover as a way for them to rejuvenate their body in a very secret way with no large visible scarring and we can tighten and tone different areas including the breast, abdomen, vaginal area, thighs and arms, and all without leaving hardly any visible scars. Even the face and neck can be lifted and tightened without having a facelift in some patients so I try to look at person’s aging condition and offer surgical solutions that best suit their lifestyle.

What other post-recovery tips do you suggest?

  1. Drink lots of water
  2. Walk around at least four times a day, including the night of your surgery
  3. Take deep breaths multiple times each hour to help increase oxygen to your lungs and reexpand them after a long surgery
  4. Taking vitamins, eating high fiber high protein diets help improve healing. Do not eat lots of salty, high carb foods to reduce swelling and bloating
  5. Consider taking good probiotics for a healthy colon
  6. Review pain medications and be prepared before surgery as some of the pain medications can cause constipation which can lead to discomfort. Therefore, stool softeners might be applicable. Wean off narcotic medications as soon as possible
  7. Proper wound care is vital to recovery. Know what to look for when changing dressings. No stress is to be put on the surgical site. Always call the doctor if there is any question of what is normal
  8. Ask when you can and cannot shower, wash hair, etc.
  9. Have everything at your bedside ready in advance –iPod, phone and charger, books, reading glasses, water, medications, easy to digest foods, ice packs, gauze, disposable padded liners to protect your furniture and car, loose fitting clothe that can get dirty
  10. Support garments – order in advance if required

Do you use a particular service when it comes to sending a nurse home with the patient?
Here in San Francisco we have oveRNightRN which is a great service. The person who created it, Amanda Richey, is a Registered Nurse herself and has handpicked their nursing team and as she is a very experienced OR nurse. I completely trust her company. What is also great about oveRNightRN is that their nurses are all unique, as are my patients, so we can often match up personalities that really click and the patients end up really bonding with their nurse which is of course great for recovery.

Is the use of RNs for at-home recovery a new trend? If so, do you see it as being a long-lasting trend?
For me it is mandatory, so it will always be my trend. For others it’s hard to say. Outside of Beverly Hills and Hollywood, plastic surgery is still such a secretive and private decision. In San Francisco many people do admit to having botox and fillers. If you have the luxury of recovering at home or in a hotel, this offers the additional luxury, safety-first type of recovery. So I do see it becoming a popular trend in the SF Bay Area. With this option offering a personalized experience and expert care while costing less than a hospital stay, it just makes sense that a patient would choose an oveRNightRN or hired caregivers over anything else to give them the best post-surgery recovery they can have in the luxury of their own home or hotel.

Michelle Eagan, MD, is a Board Certified Plastic Surgeon with offices in Santa Rosa and San Francisco, CA. She can be reached at www.eaganplasticsurgery.com.  To learn more about post-operative RN care, visit www.overnightrn.com.

To listen to Dr. Eagan’s interview at Aesthetic Insider Radio, CLICK HERE!