Guidelines to Healing (Post Surgery)

1. Schedule elective surgery when you're healthy. This will optimize your immune system and improve your chances for a speedy recovery.
   
2. Consume sufficient calories and protein. Two of the most important elements for healing are calories and protein. Extra protein is needed to build new tissue and blood vessels, repair injured tissue and increase production of cells to repair the wound.
   
3. Stay well hydrated by drinking water. It is important to drink at least 6-8 glasses of water each day and especially the day prior to surgery to help cleanse and hydrate the body. Water is especially important prior to surgery as fluid intake is reduced the day of surgery.
   
4. Do not take aspirin or aspirin-containing products for ten days prior to surgery. Aspirin is not recommended prior to surgery because it is an anti-coagulant (blood thinner) and can promote bleeding during surgery.
   
5. Do not drink alcohol one week prior to surgery. Alcohol suppresses the immune system and should be avoid around the time of surgery.
   
6. Do not smoke one month prior/after your surgery. Smoke inhibits wound healing because less oxygen is supplied to the operative site. In addition, smoking increases the risk of various complications during surgery. If you smoke, use your surgical procedure as an opportunity to quit.

Smart Sun Habits

Cincinnati summers are full of outdoor activities – golf, swimming, tennis, biking, hiking, kayaking. You name it, we’ve got it! Though each outdoor activity requires its own special equipment, one item is common to them all – sunscreen. Most people remember to apply sunscreen for a day at the beach or the pool, but participants in outdoor sports and other activities are much more likely to forget to apply sunscreen and run the risk of being burned. Did you know that even one blistering sunburn in childhood doubles the risk of getting melanoma later in life?
People most at risk for developing skin cancer are those that burn easily in the sun, have fair skin, light-colored hair, green or blue eyes and freckle easily. BUT, skin cancer can occur in people with darker skin tones including those of Hispanic and African American backgrounds. More teenagers and young adults are being diagnosed with skin cancer than ever before. This includes a rise in the deadliest form of skin cancer - melanoma.

Yearly skin examinations are recommended to identify precancerous and cancerous lesions prior to significant growth. So what do we look for? The most common precancerous skin lesion is an actinic keratosis, which usually appears as a red, scaly patch of skin. The most common locations for actinic keratoses are the face, ears, scalp, arms, hands, upper back, and upper chest. These lesions are usually treated with various topical therapies.

Basal cell carcinoma is the most common form of skin cancer. 800,000 Americans are diagnosed each year. Basal cell carcinomas most commonly present as pearly, raised papules with a central ulceration. Treatment of these cancers is usually complete surgical excision.
Approximately 250,000 new cases of squamous cell carcinoma, the second most common skin cancer, are diagnosed in the US each year. These cancers usually present as crusted, scaly patches with a red, inflamed base. Treatment is usually surgical excision. If left untreated, these lesions can spread throughout the body.

The most deadly form of skin cancer is melanoma. Melanoma is diagnosed in approximately 53,000 people in the US each year. Melanoma usually arises from an existing mole. To identify melanomas use the ABCD’s. A stands for asymmetry, B stands for border irregularity, C for color variegation and D for diameter greater than 6mm. Asymmetry, border irregularity, and color variegation are all associated with melanoma lesions whose diameter are more than 6 mm. If you discover an abnormal mole, be sure to show your doctor.

Even if you have tanned or been burned before, it’s never too late to protect your skin. Sunscreens protect your skin from UV rays and are classified according to the Sun Protection Factor (SPF). The higher the SPF number the greater the protection level. Specifically, an SPF sunscreen rating of 30 means if you use the sunscreen properly you can stay in the sun 30 times longer than without the sunscreen and get the same level of sunburn. Unfortunately, most people don't put on the right thickness of sunscreen and they don't reapply it frequently enough. As a result, many people who use sunscreen actually end up with sunburn. One ounce, enough to fill a shot glass, is considered the amount needed to cover the exposed areas of the body properly.

What else can we do?

• Apply sunscreen with an SPF of 30 or greater.• Apply sunscreen every day, all year long, for maximum protection and to prevent sun-related aging.
• Apply sunscreen 60 minutes before going outside to allow time to bond with your skin.
• When possible, avoid outdoor activities between 10 AM and 4 PM, when the sun’s rays are the strongest.
• Be sure to reapply sunscreen frequently, every two hours, and after swimming, perspiring heavily or drying off with a towel.
• Wear a hat with a 4-inch brim all around to protects areas often exposed to the sun, such as the neck, ears, eyes, forehead, nose and scalp.
• Wear clothing to protect as much skin as possible. A tightly woven fabric provides greater protection than loosely woven fabric.
• To protect your eyes from sun damage, wear sunglasses that block 99 to 100 percent of UVA and UVB radiation.
• Swimmers should remember to regularly reapply sunscreen. UV rays reflect off water and sand, increasing the intensity of UV radiation and making sun protection especially important.

Allison M. Holzapfel, MD, FACSFacial Plastic and Reconstructive SurgeonMangat-Kuy-Holzapfel Plastic SurgeryBoard Certified, Facial Plastic and Reconstructive SurgeryBoard Certified, Otolaryngology – Head and Neck SurgerySpecializes in cosmetic and reconstructive surgery of the face and neck. She specifically performs multiple skin cancer reconstructions on the face and neck each week.