Kim (00:01.922)
Hi, Kylie. Welcome. I am really excited to have this conversation with you. Nutrition is something that I've always had a bit of a passion for. I actually originally was gonna go to university to become a dietician, but when I went through pelvic surgery a few years ago, I, about two and a half years ago, I really was focused on what I could be doing nutritionally and even with supplements to help.
support me through that journey and when I found you I was really intrigued by the information that you were sharing as it pertains to surgery not necessarily pelvic surgery per se but that could potentially be part of who you're who you're speaking to but I'm really excited to learn more so can you give us an introduction about who you are what got you into this world of nutrition as it pertains to surgery?
Kylie (00:38.14)
Right.
Kylie (00:52.878)
Yeah, thank you for having me on. So I am a registered dietician and I have my master's in my undergrad and my master's in nutrition. And when I graduated, I moved up to Boston. And you know, after graduation, I'm sure kind of like you, like you're given basics, but you're not really trained. So I fell upon a like post-surgical center in downtown Boston. And I just had this amazing mentor.
And she just really took me under her wing and trained me to love post-surgical nutrition. And that really took the client, the client now, patient before, is just preparing them for surgery, which I'm learning later, but in the hospital setting, you know, you're seeing where they're at, you're trying to maximize their nutrition after surgery and trying to heal their incision as quickly as possible.
And being in Boston was so amazing because they take you so seriously. And so that's what I did for close to a decade. And just really honed in on that and then took some time off. And then like several years later, camping with a plastic surgeon and just kind of asked him what was he doing and for his for his clients after he did these major, major surgeries and he just said nothing. We just send them home. And I remember being
horrified for every woman out there, but it wasn't his job. You know, it wasn't his job. So that was it. So I was like, boom, I found my calling. I'm really into equity care for elective surgeries and for surgeries in general, when they just send you home, you know, and they don't give you anything. So that's kind of where it started and that's what I'm doing now. So I'm doing elective surgeries, but of course, honing in on cosmetic and plastic surgery, but.
But I love it. I absolutely love it. So that's my history. Yeah.
Kim (02:52.003)
That's very cool. And what do you mean by equity? Like when you say equity, I forget even what the term was. You just said the word equity, so I wasn't quite sure what you meant by that.
Kylie (03:02.218)
Yeah, so actually I love that you said it because we were developing my website and we created this term and I was like, this is amazing. But literally what it is, is creating an equal balance of seriousness for all surgeries. Whether you are saying this is an elective surgery or whether you're in the hospital and you have to have surgery, we have to treat it the same, especially for women to advocate for ourselves.
But we really have to treat this as the same type of surgery, as serious as it is, and that giving the proper care before, during, and after surgery, as if it was any other type of surgery. I think that is what I've really jumped on the last, even the last few weeks of just having equity care for elective surgeries, getting as serious as you can, because the consequences are gonna be the same, whether it's elective or not, you know?
Kim (03:56.878)
Right, right. Yeah, exactly. That's such an important point. Thank you for clarifying that. So you focus on elective plastic surgeries, but kind of what you were to kind of reiterate what you just said, but surgery is surgery. And while there are different surgeries, there's principles that remain the same. There is kind of chosen trauma, if you could say that, to the body. And...
Kylie (04:01.166)
Yeah.
Kylie (04:14.709)
surgery.
Kylie (04:21.85)
Right. Mm-hmm.
Kim (04:23.938)
There are things that we can be doing, knowing that's coming up, things we could be doing to prepare and also things we can do to recover. So you focus specifically on the food piece, which I love and I don't really know very many other people like yourself talking about it. So where would you start with somebody? Well, like I guess because of what I just said, surgery is surgery, but are there...
innuendos and you can kind of make that part of your answer. Are there specific cases or types of surgery where you would make a different plan for somebody when they're starting? So let's start with the somebody who is having surgery. What would you recommend to them from a nutrition perspective in terms of preparing for that surgery?
Kylie (04:57.511)
Mm-hmm.
CREA.
Kylie (05:07.63)
Yeah, okay. So across the board, no matter what type of surgery, getting labs, but getting appropriate labs. That would be the very, very first thing. About 30% of my clients are coming to me undiagnosed pre-diabetes and elevated cholesterol across the board, whether they've lost 50 pounds or whether they haven't lost weight, no matter what, that's what is coming to me. So I would say...
Whenever you're thinking about having surgery, getting baseline labs to check pre-diabetes, inflammation, your iron levels, ferritin, those are gonna be really the basis in your albumin, the basis of how well you're gonna go into surgery. When they do studies on nourished patients going into surgery, they look at those parameters to see if this patient can go into surgery safely. So getting those labs
hands down, number one, and that way you can kind of have a foundation or a jumping off point of what your diet looks like. And a little tidbit there is, like I said, with the pre-diabetes, so I'm seeing more clients with this going into surgery. Well, after surgery, it is trauma. Your blood sugars are naturally high. Number one, research shows that totally impairs your incision care. There was a huge meta-analysis about that. And so we want to make sure that your blood sugar is stable.
But also, the common treatment after surgery is, you know, pound juice, drink tons of pineapple juice, which is really affecting your healing. So knowing where you're at before surgery is hands down. The second thing is I don't talk about it enough. I need to talk about it more, but I created this little easy thing called a 2.0 formula. And it's called 2.0 because women were saying that, you know, after cosmetic surgery, it's like them.
2.0, like their name, but 2.0, and so I just developed this formula. But it's just, it's 2.0, so it's 20 grams of protein every meal, two cups of produce, lunch and dinner, and then two days of resistance training, you know, getting that core and your back strong for your surgery, no matter really what type of surgery. And the reason I just did this simple formula is because...
Kim (07:03.97)
I'm going to go to bed.
Kylie (07:28.754)
People are not consciously thinking about what they're eating on a day-to-day basis. And so that is the one thing. So just kind of being more conscious of the protein and quality protein, I have to say. Not collagen. We're not taking, I mean, collagen's great. I take collagen. But for, you know, not as your protein source. So having quality protein, looking at our fruits and vegetables, not just because it's fruits and vegetables, because we're transforming our gut while we're doing this, which is important as well.
giving us our antioxidants to help lower oxidative stress, which pushes at risk after surgery as well. So that's two, the labs and then the 2.0 formula. And then number three is, I call it training your palate. So the majority of us, and then even if we're eating healthy, we are eating a lot of salt, a lot of sodium, and a lot of sugar. And after surgery, sodium shows up so fast on your body.
And so it's really training your palate because it's not something temporary that you have to do low sodium after surgery. No matter what kind of surgery, lower sodium you will swell after surgery if you don't have a low sodium diet. Most really like any kind of healthy diet, but training your palate before surgery to start incorporating foods that are going to be naturally low in sodium and expanding your palate to different flavorings, spicy, hot.
acidic, things like that, so that after surgery, you're not trying to do everything at once, because it's hard. So those would be my three things, yeah.
Kim (09:06.05)
Interesting. So I have a couple of points I want to ask, kind of expand upon there. When you're talking about a lot of people coming in with high cholesterol and pre-diabetes, is your, the population that you work with, are they closer to menopause or post-menopause on average?
Kylie (09:30.851)
They are, nope, they're younger. So they're like around 35 to 40. So I say pre-menopause, right? Pre-menopause. But it's about, the majority of my clients are between 35 and 40.
Kim (09:40.822)
Yep. Yeah.
Kim (09:49.038)
Okay, interesting. As you're talking, I'm thinking, you know, I'm post-menopause now and I do a lot of, I'm doing a practitioner support certification, so learning a lot about menopause and knowing that we are at increased risk of diabetes, our cholesterol is typically higher post-menopause, so I was just wondering if that was the case for your population, but also then good to know for people who are going into surgery during that time of life, if they are post-menopause, knowing that
based on what you just said, we are typically more elevated in those two categories as well.
Kylie (10:21.69)
Yeah, for sure, and I think they're being taught, we're being taught that it's inflammation, but I will check inflammation markers for my clients and they're normal. And I don't know the strong research behind inflammation, but I'll just check that marker and it'll be normal, but the blood sugar and the cholesterol will still be there. And those are markers that your surgeon will not recommend.
just to FYI, most surgeries are not gonna recommend those labs, but it's just important to do it because otherwise you're not gonna realize it until you go to your next PCP appointment a year later. You know?
Kim (11:03.99)
And that sort of segues into my other question with regards to checking inflammation. Is it CRP that you're checking or is there another one that you like?
Kylie (11:09.282)
Mm-hmm. Yes, I usually check a CRP. And I really, that was one of the most common questions that I got when I first started, was what do we eat for inflammation? What do we do for inflammation? And so I did my research, and I tried to really, I tried to really teach about it. And then every single person that I would check, it was normal. Every single person that was concerned about it. And like I said, I haven't done a lot of
recent research, but I was just finding that it was all normal. And so I just kind of had to draw back the curtain a little bit and say, we need to just go back to the basics and let's just focus on this basics because inflammation, let's not worry about that because according to your blood work, I'm not seeing that. I'm not seeing that. Now there may be underlying inflammation going on because of your diabetes, because of cholesterol, which is what we hear as well, but it doesn't matter, right? What doesn't matter is...
how you treat it is going to be the same. So I go about it like that.
Kim (12:09.55)
Right, right.
And then, and so to, I guess, being another person who's asking that question, do you recommend then a low inflammatory food diet pre and potentially even post, we haven't gone to the post yet, but still focusing on the pre surgery is like, I think about low FODMAP, the AIP diet, there is low inflammation food. So is that something that you would have people focus on, even if their markers said it's not something that you would need to worry about?
Kylie (12:42.754)
Well, I don't but I do. So instead of confusing them and saying we need to do inflammation for most people it's just too much information to handle because they're prepping for surgery because your brain is in a Thousand directions because you're preparing for your own surgery right because it's elective So what I say is in general what I am offering is a low inflammatory diet, right? But I'm not teaching that I'm teaching the protein and the two cups of produce
and that's naturally anti-inflammatory, but at the end of the day, research doesn't show it's going to be inflammation that's going to prevent them from healing. The research shows, are they nourished before surgery? Do they have protein stores before surgery? Do they have all their micronutrients? So I focus on that, and then naturally, it's going to be an anti-inflammatory diet. But I don't bring that word into the vocabulary because I feel like it's gonna confuse my client.
Kim (13:41.026)
Yeah, totally makes sense. And then on the protein piece for my last kind of piece to expand upon here, there's a lot of talks, specifically now with the population that I work with, kind of perimenopause and postmenopause about upping our protein and how very few people are actually getting the adequate amounts of protein. And this was something that I really focused on more so post, but thinking now, I probably should have done it beforehand too, but I wasn't necessarily thinking in that way. But...
Kylie (13:58.683)
Right?
Kim (14:10.306)
Protein-wise, why is protein important and what do you recommend? Is it in line with what the recommendations are for protein or do you go even higher than that as you're preparing for surgery?
Kylie (14:20.946)
So, well, yes, so as prepared for surgery, I don't go higher. I just make sure that they're more conscious of it and that they're knowledgeable of protein. Across the board, they're just not eating enough. I think there's a stat out that says only 30% of us, middle age, are actually eating enough protein. And of course you get different people with different versions of how much protein. But I do about 0.8 to one gram per kilogram.
but really it's about are you eating an adequate protein every single meal. But then after surgery, really depending upon how many surgeries they're having, because a lot of women are doubling up on their surgeries, then I give them a lot more protein after surgery. Did that answer your question?
Kim (15:07.542)
Yeah, and so what's like, what is protein doing? How is it helping us?
Kylie (15:10.55)
Oh, oh yeah, okay. So protein is really, of course, as we know, it's a made up of all the amino acids. And after surgery, your body needs certain amino acids and they make them on their own. But after surgery, some of the amino acids become what's called conditionally essential, which means that your body has to eat them in order to make them because it's going through a traumatic stage. And so, you know, some of those amino acids are something like arginine, okay, or glutamine.
So we have to eat those in food form in order to meet those amino acids. Those amino acids are going to go to your muscle, the tissue that was broken, and they're literally going to build the muscle again, stack by stack, as if they're a building block. And so that is what protein does. Now, the amino acids all have functions for surgery. So for instance, we recommend whey protein, which is a derivative of milk.
because whey protein is super high in the amino acid leucine. And leucine has been found to, studies have shown it's one of the best amino acids to help rebuild muscle tissue. So at the end of the day, it helps rebuild the muscle that's been broken from surgery and help it put it back together.
Kim (16:30.422)
sense. And now on collagen. So you pointed out that like collagen is something that I take, I recommend many people take. I think it's something that again some people probably are deficient in especially as we're aging. But I hear a lot of people talking about protein isn't necessarily counted in your total protein count for the day. So it's kind of its own separate category even though it's listed under protein.
Kylie (16:57.199)
Mm-hmm.
Kim (16:57.206)
So why is that? Why is it not? Is it because of the amino acid? It doesn't contain the amino acids we need?
Kylie (17:02.03)
Yes, yes. So I take collagen and I think it's a great protein to add in, but I just tell my clients, during, I have a term that's called for the sake of surgery. So for the sake of surgery, we are not counting this towards your protein needs because it's missing three amino acids, I believe it's methionine and tryptophan. I'm not quite sure, but I think there's, I know there's three. It's missing, completely deficient of three amino acids, which does not make this what's called a complete protein.
It does not supply all the amino acids for your body to make it, to break it down and to rebuild the tissue. So we do not count that towards our protein needs after surgery. But I mean, I take it, I like it, you know? But for the sake of surgery, it's just not something, it's not a protein supplement that I recommend.
Kim (17:53.802)
Is there anything that the collagen would be doing for the sake of surgery?
Kylie (17:58.406)
Well, there's research and probably the brand that most people are using, there's a patented collagen out that has been shown to actually help with cellulite. So that's why I pay attention to it, because of my niche, to help with skin trigger and to help with cellulite. So it's still, I mean, it's still, you know, it's still a great additive to your diet. Yeah.
Kim (18:25.91)
Right, right. And are there any, like staying on the pre-preparation, are there any foods we should avoid? So you'd mentioned protein, you'd mentioned antioxidant, you talked about your 2.0 with the vegetables. So that's kind of the general guideline, I guess. And then are there foods that we should make sure are not on our list or as part of our daily diet?
Kylie (18:32.242)
Okay.
Kylie (18:53.158)
Yeah. I wouldn't say on the daily diet, but I say that week before surgery is when you have to just look at your diet even more. Your surgeon, of course, is gonna give you a huge list. But something that I added on recently was adding to eliminate foods that have SGA, which is a glycolyde, and it basically prevents anesthesia from leaving your body. So there's a study out.
It's a relatively old study, but I have incorporated it because I felt no harm, no foul. It's something that could actually really help you. But the SGA's prevent the enzyme from breaking down and having anesthesia detox from your body. And so things like tomatoes is something that I no longer recommend. Potatoes, something I no longer recommend, like that week before surgery. And also before surgery, we...
I actually Googled this one time just to see what other surgeons are saying. It's all over the place. It's absolutely all over the place. But the one thing I tell my clients is we are not doing beef. We're not doing anything that's going to sit in our stomach. Different surgeons say different things, but I do recommend super high fiber foods that are easily going to go through your body the week before.
as well as, I think you said a void, but we do wanna have, I recommend a lot of apple juice, electrolyte water, I recommend all of that before surgery as well.
Kim (20:28.206)
Okay. And I'm assuming things like you've talked about, you know, obviously avoiding the sugars, the salts, so processed food, that type of thing. So making sure we have nice good whole foods. And can you explain again what does SGA stand for? Oh, sorry. Okay. So is it an additive or what? Like, how would we know if a food has it in there?
Kylie (20:45.29)
Oh, I don't know.
Kylie (20:50.358)
No, it's just a compound that's natural. It serves as a natural insecticide in plants as like a protective measure, but it inhibits like enzymatic properties in our body for anesthesia. And so, yeah, it is, it's very interesting. So that's why I don't recommend it. But yeah, I think the salt thing is something that's super important too, just for the sake of just...
Kim (20:59.216)
Okay.
Kim (21:04.007)
Oh, okay, interesting.
Kylie (21:18.526)
expanding our palate to get used to the food that's going to come after surgery.
Kim (21:20.478)
Right. Yeah. And I like so tomatoes and potatoes, I'm thinking of that they fall under the nightshade category. And a lot of people can experience joint pains and inflammation with nightshade. So I'm, I'm going to look into that and just see if maybe all of the nightshades have this SGA. Yeah. Interesting. Cool. Okay. What about then before we move on to the post side, because we're kind of going to cover the similar questions there, but
Kylie (21:28.326)
Mm-hmm.
Kylie (21:37.006)
It probably does. I'm almost certain it does. Mm-hmm. Yeah.
Kim (21:48.086)
What about supplementation? So we're, most dietitians and nutrition people that I follow are always kind of taking a food first approach, but are there any supplements that you would say could play a role or are absolutely essential that we consider? So collagen, I guess some people could argue that is a supplement, but what about things like vitamin C or fish oils or vitamin D, that type of thing?
Kylie (21:58.162)
Thank you very much.
Kylie (22:06.951)
Right?
Kylie (22:11.11)
Right, so I love that question because oftentimes what's being taught is we say we need vitamin A, we need vitamin C, we need vitamin D, but what's happening is people start vitamin stacking and then they start missing out on micronutrients. So while I'm a food first dietician for the sake of surgery, I don't mess around, right, because we just simply can't get everything in unless we are, we really know what we're doing.
So absolutely supplementation before surgery, hands down. And so what I recommend is you need to get on a good quality, clean protein powder, which is what I always recommend like an organic way that has nothing in it because all these protein powders have all these additives or a plant-based protein, which would either be like a soy or a pea protein or like a mix, but it needs to be a complete protein. So hands down, starting that.
adding in. And then in terms of supplementation, it should be, there's surgery supplements, there's brands. Really the only one right now that's out that I do recommend is Vitametica. It's one of the oldest ones. There's others out there, but I'm not really crazy about the companies themselves and kind of how they run their business. So I really like Vitametica,
multi-vitamin because the majority of Americans are going into surgery with micronutrient deficiency which you know which are like some of the B vitamins, the thymins, things like that and those are critical nutrients in order to heal after surgery. Like you need those in stage one and two of the healing process and so we have to we don't take chances so we have to have a good supplementation before surgery and I recommend
that the minute that you decide that you're going to have surgery is the minute that you're getting on a multivitamin with minerals. And if you don't know what that is, you know, go into a natural food store because they usually have good quality supplements and asking them, you know, what is good. But I like brands like Solare, Garden of Life, they got bought out by Nestle, so they're so-so. But yeah, so, you know, there's just lots of good brands out there.
Kim (24:29.014)
Yeah.
Kylie (24:33.754)
But definitely, I never recommend individual supplements. I always recommend a well-rounded multivitamin because it can cause toxicity more than anything else if we're not careful.
Kim (24:46.362)
Okay. And then I didn't send you this question ahead of time, but no, it's just on the flip side of that is like, are there, because I know that the doctors will often say, make sure you, anything that could thin the blood, anything that could interfere with, so are there supplements that we should make sure are not in our vitamin stack? And as you're saying, we don't want to do a vitamin stack, but are there things that we should make sure we're not taking as we prepare for surgery?
Kylie (24:50.726)
Uh oh, uh oh, uh oh.
Kylie (24:59.855)
All right.
Kylie (25:12.294)
So really the biggest vitamin that has most research is vitamin E. That's one of the biggest ones. What's come out recently, and I hope that I make sense when I say this, is they say no omegas because they say it thins the blood. And I'm actually going to work with my team to get the research behind that, because in the hospital, they give omegas right before surgery, in two feeds, right? So they're giving it to them before, during, and after surgery. I don't know how it entered.
the layman, I don't know how it entered the cosmetic surgery space, but basically, the biggest ones are vitamin E, that's one of the big things, and your surgeon will likely say omegas as well. And those are the two biggest ones, and then the other ones that they also say in terms of food would just be ginger, garlic. Those are the two biggest ones. Yeah.
Kim (26:04.75)
Okay, so now we're gonna go, well actually one more question here because this is also gonna be something I ask on the post side, but what about, what role does hydration play in the pre and then we'll talk about post after, but should we be, I think we should always be well hydrated, but should we be extra well hydrated before we go into surgery?
Kylie (26:11.386)
Okay.
Kylie (26:24.314)
Yeah, so, I mean, they're gonna give you a ton of IV fluids during surgery. However, that week before, especially, I usually recommend, you're doing a minimum of 75 to 100 ounces. You're trying to hit that on a daily basis. But hydration is really what's going, that's the majority of your blood composition. And so when you have, if you ever remember getting your blood drawn and they can't draw blood because you're dehydrated, I don't know if it's ever happened to you, but it's happened to me.
That's just a reason of having hydration means that you're hydrating your blood. If your blood is hydrated, your blood can move to your incision. And if blood carries the nutrients and it can carry well because it's hydrated, then your incision can receive nutrients in order to heal, right? So that's the important part of hydration. On the pre-op, it's important, first of all, to just do it for constipation purposes, right? We've got to prep our bodies as well.
And for the myriad of reasons that we all know about, fatigue and how we think and things like that. But before surgery, I really like to tell people to not only do water, but I do recommend electrolyte water before surgery, I think that's super important. It's almost like getting an IV before surgery, if you do it right. And then also fluids that contain sugars. So they have research about glycogen loading before surgery and so things...
that are like apple juice, even diluted Gatorade, things like that before surgery are helpful. And then of course, after surgery, you know, that's gonna play the natural part into healing and also to prevent constipation.
Kim (28:05.596)
And then like usually in surgery, you're not allowed, like they say, nothing but water by mouth. But if you have electrolytes, that's typically allowed.
Kylie (28:14.07)
I don't know, you know, every surgeon is different. I usually just tell them stick to water, you know, don't play around. You know, you don't want to get your surgery canceled because you drink, you know, a Gatorade, you know?
Kim (28:24.03)
Right. Yeah. So these are kind of guidelines for that, like the week before, as you mentioned, and then that 12 hours or whatever the guidelines are provided with your surgeon and then just water.
Kylie (28:33.05)
It's usually right and every surgeon's different. But the guidelines are changing and it's a good thing because the guidelines are really changing that you can have instead of this NPO after midnight, the guidelines are changing to no food six hours before your surgery and you can have, you can ask them to drink up until two hours before your surgery. And they've actually found that the client, that the patients have better results by doing that instead of a long fasting.
And that's what's happening in a lot of hospitals around the world, but the US is a little bit slow on that. So for the most part, surgeries here in the United States is like, you know, NPO, nothing by mouth after midnight. Which would, which include water as well. Yeah.
Kim (29:14.158)
Got it. Okay. Right. Okay. So then now switching to the post side. So here we are now, we've followed your pre-plan, we've had our procedure, and now we're on the recovery phase. And I always am a little alarmed by food in hospitals, if you can call it food. And...
Kylie (29:37.52)
Oh yeah.
Kim (29:43.094)
So sometimes some people may be released on the day and can go home and have their own meals. And I'm assuming you would make a recommendation of prepare some of those meals ahead of time, or have people that can help you. But some people may have to stay in hospital, which is not, I don't think, super ideal from a nutrition perspective. But let's talk a little bit about, first, what are the important kind of pillars to focus on?
from a recovery perspective as it pertains to nutrition.
Kylie (30:16.498)
Well, it's completely different. I'm talking about in general, whether you're at home or in the hospital or in general. Okay, so the first thing first is to get the gut moving after any type of surgery. Any type of surgery you want to stimulate the gut because you don't want a post-op ileus, which is kind of like a twisting of the bowel. So you can do something very small, like even chewing on gum that can...
Kim (30:21.142)
Yeah, in general, and then we'll focus a little bit on the, yeah.
Kim (30:40.558)
Sorry, I just wanna interrupt. What would cause a post-op ileus?
Kylie (30:45.91)
I don't even know if they even know what causes it. I think it can just happen after surgery, but it can be prevented by stimulating the gut to move after surgery. I think it's probably because of the anesthesia and the medications and the gut can stop because basically that's what it's doing and then it can twist and can have a blockage. So you wanna stimulate the gut. So that would be.
what's an old school way, what's called sham eating, sham feeding, and that is chewing gum, and that can actually stimulate the gut. So that would be hands down number one. And number two is you do wanna start nutrition. The research shows that the better recovery is you want nutrition starting as soon as possible. So drinking even like, I even recommend, make your liquids even nutrition. So unsalted bone broth, unsalted bone broth.
even if it's dairy free, like a soy milk or something like that. Starting nutrition hydration as soon as possible. Those would be, I think, the two biggest things. Yeah, and then if you're going home, I am super vigilant about constipation. I said you do whatever you can to prevent constipation because constipation and pain will prevent eating.
And if you're not eating, you're not healing. So regimen, medication regimen is a must, is an absolute must. And a lot of people forget about that, or their caregiver doesn't give that to them, and then it just can create a snowball of difficult healing afterwards.
Kim (32:30.122)
Yeah, yeah. Yeah, I remember my doctor saying, don't try to be a hero, even if you aren't necessarily feeling discomfort, stay on this plan because it's harder to kind of catch up if you aren't. And I was really grateful for that advice and also for the medication that I had. And it's funny because I talk with a lot of people who go through surgery and some of them are just given, you know, kind of just say like,
Kylie (32:40.486)
Mm-hmm. Catch that.
Kylie (32:58.618)
stool sophomores.
Kim (33:00.226)
Well, stool softeners is one thing, but for pain management, they're often just given Tylenol, which I think is not necessarily enough. And then I think they're impeding their recovery because they're dealing with, they don't have enough pain management to help them.
Kylie (33:04.774)
Yeah.
Kylie (33:11.462)
Mm-hmm. Yes, absolutely. Yeah, I completely agree. There's a medication that's coming into the plastic surgery called expiril, and it's basically, they don't have pain for three days after their surgery. And it's expensive, and it's an additional cost. So most surgeons don't include it, so the patients have to pay for it, so not everybody does it, but I am like, do it. I mean, if you can do...
three days of post-op and not have pain, this is not the time to be a hero, right? We're not, this is the time to control everything you can medicinally, because we have to heal you, and that's number one. Yeah.
Kim (33:53.206)
Yep. Yeah, I agree. And totally agree on the constipation piece as well too. And especially in my world, as it pertains to pelvic surgeries, the first post-op poop can be really scary because some people may be having surgery for erectocele where pooping has historically been very challenging and constipation could be a contributor to what they had been dealing with. So it's like the first postpartum poop, right? You're just thinking, oh, like it's...
Kylie (34:02.694)
Right.
Kylie (34:14.079)
Yeah.
Kim (34:22.25)
you're afraid and when you're afraid you're tense and that's going to impede the success of having a bowel movement. So I always agree with you so much. I always prioritize getting the gut going and getting poop optimized. Yeah.
Kylie (34:23.795)
Right.
Kylie (34:29.275)
Right.
Kylie (34:34.562)
Right? And surgeons, they often just give, as well as just Tylenol, sometimes they'll just give a stool softener. And I used to go with it, and then now I'm like, no, we are not gonna give a stool softener because you are up against hardcore narcotics and you're filled with anesthesia. There's no way that your body is gonna work well with just stool softeners. I mean, maybe one out of 10 of my clients are okay with it, but the majority, it's like, no, we have to do something more aggressive.
for sure.
Kim (35:04.438)
Yep, yep. Okay, so from an actual food perspective and nutrient perspective, what are we wanting to focus on from a post-op recovery perspective?
Kylie (35:16.55)
So after surgery, it's not, I don't say, so I'm developing meal plans for specific surgeries right now. And so I'll give you an example so you can kind of explain it. So for instance, if you're, so for your surgery or something, I maybe would do more of a high fiber diet right, like coming out of the gate with surgery. So every, so the more that I'm into this, the more specific foods I'm dealing with after surgery.
So say for instance, I'm dealing with just a mommy makeover tummy tuck, which would be, you're really dealing with big incisions and you want to deal with high fiber foods. So for that one, it's, I'm doing, you're getting in not just fibrous foods, but you're getting in nitric oxide foods, foods that produce nitric oxide, which also help relax blood vessels and let the nutrition go. So I put a lot of pomegranates, you know, in...
in the food. I don't do a lot of vegetables after surgery. I actually do a lot of fruits. That's probably important for your listeners. Go the fruit route the first two weeks. It's just easier on your body. You're going to get more of the fiber. You're going to get more of the water. And so I deal with that. That's my biggest ones. And then I also focus on enzymatic foods. So I add in lots of figs as well.
And then just foods that are easy for your body. You know, we do no added salt, bone broth, chickpea noodles. We just do easy to digest foods. Some people can handle dairy, non-dairy. So we, you know, we deal with that. But so for instance, you know, right now on, I think on one of them, post-op day one, we have like a chia seed.
Chia seed is delicious, like a chia seed pudding for breakfast. And so that's going to get your bowels moving. It's also going to give you hydration. It's going to give you fiber. So that's for breakfast. And then for lunch, it's more of like we're doing nuts, seeds, figs. We're doing the enzymatic foods as well. And then for dinner is more of like we're doing the chickpea noodles. I mean just something that your body...
Kylie (37:37.646)
is you're not gonna throw it up, you're not going, something that's easy on your body, but it's very, very nutrient dense. Those are the things that I really focus on. Things for your incision, things for your bowels, and then of course if you're doing something like lipo, I'm dealing a lot more with foods super high in antioxidants to reduce any oxidative stress after surgery. So I think it depends on the surgery as well, but in general, that's really what I try to do. I think the one thing I wanna say is
Oftentimes I've seen clients try to do it on their own and they hit high calorie, but they can't hit high protein. Or they'll do something high fiber, but they can't do the high protein. So really understanding that every meal is high fiber, high protein, high calorie, every meal. And that takes a lot of thinking, which is why before surgery, really sitting down and creating a meal plan, even if it's something simple.
to get you through that first week. That's probably the most important because if you don't think about all three of those, then you're gonna be, you know, you may be in trouble at the end of the week.
Kim (38:46.474)
Yeah. So a couple of things I just want to clarify. You said, I like we've talked about protein, so it's, it's helping rebuild and heal and, and we've got that. What does enzymatic, what are enzymatic foods and why would we want to pay attention to those?
Kylie (38:49.252)
W H A T
Kylie (38:54.426)
Okay.
Kylie (39:01.146)
Yeah, so enzymatic foods are foods that can naturally break down protein. So that's why people are really big into bromelain, right? Because it has an enzyme called papain, and papain can't, oh, I'm sorry, pineapple, and they has the enzyme bromelain, but then there's also papain, which is also an enzyme as well. And so when we have enzymes to help us break down protein, we can break down protein a little bit easier, and that way we can absorb the protein a little bit easier.
So having functional foods like foods that have a purpose, I like to incorporate those because those are natural foods that can help you digest your protein a little bit easier. So they just kind of work like enzyme. It just, an enzyme is the basically the term for it is just a catalyst. It helps speed up the breakdown of say protein and the absorption into your body. Yeah.
Kim (39:51.266)
it. Okay. And so would digestive enzymes be something that would be beneficial at this time to help make sure even if we are including enzymatic foods or should that or even just drinking apple cider vinegar ahead of our meals, would that help break things down better?
Kylie (40:09.89)
Well, I would not recommend apple cider that first couple weeks because you don't know if you're going to vomit So I always think about that like let's think about if we're going to you know, if you're gonna get sick So anything that's going to cause any kind of nausea I say no to so probably no on the vinegar But I think the in the enzymes and I mean, yeah, I mean that's what bromelain is It's a pill form of an enzyme and so there's lots of research out about that. I don't recommend it, but it definitely won't
wouldn't hurt at all and probably it would help. I just, I usually don't add it after that because they're taking so many pills. It's really a matter of like practicality, but yeah, I think it'd be great.
Kim (40:44.098)
Right, yep.
And you alluded to something when we were talking about the pre, you said this would be important for stage one and two recovery. So what are the different stages of recovery and how does our nutrition, what role does the nutrition play at each of those stages?
Kylie (40:59.343)
You know.
Well, it's hard. Well, the first thing is there's three to four stages. It's like there's a proliferation stage, the mature stage. I don't know how to, their maturation. I'm like the emphasis on the syllable always messes me up. I've been in the South for too long, so now I'm like switching my syllables. But there's three stages. And
Kim (41:12.522)
Yes.
Kim (41:16.738)
Ready?
Kylie (41:26.402)
All the nutrients are different. So for instance, when you, the first stage would be like more of the B vitamins, a vitamin A and energy, and then it kind of moves on to protein, vitamin A. But the, but the rule is we don't know when it goes into each stage. We just don't know. So there's, so I remember when I was practicing, I was trying to give supplementation at a time when I was thinking, okay, during this stage.
like during this first seven days, it needs this nutrient, and I try to supplement with just that nutrient. But the reality is that we don't know what nutrients the body needs at what stage, because we don't really know what stage it's in. When I say stage, I don't mean a wound healing stage, you know, like it's stage three and then stage four. I'm talking about just the healing process. We don't know. So really it's just, that's where that comes into having that.
that micronutrient, macronutrient before and during and after surgery, because then no matter what stage your body's in, your body's gonna have those B vitamins, that vitamin A, that vitamin C.
Kim (42:39.438)
And another point I just want to clarify, when you were talking about fiber and protein and calorie, and you want to make sure we have high on all of those, why is it important to have high calorie?
Kylie (42:50.355)
I love that. I love that question and that's probably the one thing that I teach the most now because people are not because it's been taught for so long that it's just protein. So I love this question. So the reason being is because your body and there's research it actually had the book that even talks about it which is fabulous but your body has to have energy to heal.
and then it needs protein to repair. So if it does not have the energy to heal, the body will start using protein for energy. And it's a hard way for your body to use energy, but your body wants to feel safe as possible, which means that if it's not getting the energy, it takes up protein and uses it for energy, and it's not gonna give it to your incision or to your wound.
it's gonna protect the organs, right? Because you went through trauma. You went through a trauma, right? And so hitting, so it's protein, and what I see all the time are people hitting the 150 gram proteins, but they're not hitting their calories and their healing is slowed because their body is not getting the calories, it's using it for energy. Does that make sense? Am I explaining it correctly? So that is why.
Kim (44:11.746)
Yeah. Yep.
Kylie (44:15.778)
we add in all the proteins. So say we're gonna have, you know, I don't know, a drink or meal, and we're gonna hit that protein. But then we're gonna have all the extra calories. So we're gonna have, we're gonna get it for some, from some of it's gonna be the fat, it's gonna be from say our Farro or quinoa or something like that after surgery, because our body has to have enough energy. It's just like running a race, like a marathon, you know? We have to have enough energy to go through this trauma.
So that's why we have to hit all three of those. Yeah.
Kim (44:46.754)
So interesting. And then to kind of wrap up and talk about the last few points that we talked about on the pre side, the hydration piece is important. And well, before we go to hydration from a supplement, you said basically stay on that same all encompassing, get your vitamins and mineral supplement, no extra supplements that we need at this time. Is that right?
Kylie (45:11.462)
So it depends, it depends. So I like to recommend, like after surgery, it kind of depends on how well you're healing. If you're doing a fat transfer, I like to recommend a vitamin D. But I also recommend always a probiotic. That's probably not one thing that I recommend. So like a probiotic before, during, and after surgery, hands down, those are the main things that I'm dealing with. And then if you're a fat transfer, then it's vitamin D.
If you're having any incision healing problems, any at all, then you're supplementing with a little bit more vitamin C and zinc. And I like to add in selenium because it's just such a potent antioxidant. And I like to add in those three. If you're seeing that you're not healing adequately, those are the three that I recommend. Yeah.
Kim (46:04.463)
What's the importance of the vitamin D part?
Kylie (46:07.014)
So there's some research that shows that fat transfer cells, so the fat transfer really, they're taking fat from one place and putting it on a next. And these are not just cosmetic procedures. I have a client who has an autoimmune disorder and she actually lost fat from, I think right actually on her forehead. And so they took the fat from her thighs and put it on her forehead, as well as breast cancer.
patients, they're doing a lot of the fat transfer. Instead of having the implants, they're doing fat transfer. So there are, there's several research, they're not, they're in vitro, they're not human, because it's just nearly impossible to do this type of research on humans, but it just shows that the fat cells can be retained better in the newly transplanted fat with vitamin D. And so I just started, for my fat transfer patients, I started recommending like a vitamin D, just while they're...
while they're healing. Yeah, yeah.
Kim (47:06.95)
Interesting. And hydration, same sort of make sure you're very hydrated. What's what would be the reason? Like I think of it as just making sure we're flushing out all of the stuff that came through us through our body while we were under anesthetic. Any other reasons?
Kylie (47:21.03)
Yeah, so, no, I mean, that would be one of the biggest reasons. And of course, it helps the blood flow to the incision. But with that, though, is I really recommend getting a lot of your water also from your fruits and vegetables, from your fruits, because it's also going to have the fiber to help you carry out as well. And then also, the common thinking is chug your Gatorade, chug your juice.
and chug your beet juice. I mean, just crazy stuff in the surgery world. And no, we're not, no, we're not doing that. No, no, we're not doing that. We don't need that and you're not doing that. Because for so many reasons, we're not doing that. So if we're doing anything that has like sugar beverage, then we're having it either diluted or we're doing it with like a protein drink in order to make sure that blood sugar is stable after surgery.
that's what I see the biggest thing. So hydration, yes, but it's going to be diluted drinks. I usually don't recommend carbonated drinks. I usually just recommend electrolyte waters. Coconut water is fantastic as well at this time. And then you're hydrating plants. So for mobility, for blood flow, for everything.
Kim (48:35.31)
So interesting. How can people find out more if they would like to work with you or dive more into your content? How can people find you?
Kylie (48:36.334)
Yeah!
Kylie (48:45.442)
Yeah, so my majority of my content is on Instagram. So it's nutrition.plasticsurgery. And from there, you'll probably find everything. My new website is coming out, and the domain should be sulinu.com, S-U-L-I-N-U, or Plastic Surgery Nutrition. I scored that domain. Super excited about that. So, but usually Instagram ones.
Kim (49:10.676)
Totally.
Kylie (49:14.97)
is the biggest thing. So, yeah. Great, great. It's so great.
Kim (49:16.246)
Awesome. And we'll have that in the show notes below. But thank you so much, Kylie, for sharing your wisdom. That was super, super interesting. And I know everybody will really enjoy that. So thank you so much.
Kylie (49:24.731)
Yeah.
Kylie (49:28.57)
Well, I love your content too. I've been bingeing it the last few weeks, and I'm like, this is fascinating. This is so, because I'm like, I have, I need to interview you because I have so many questions. I'm like, I have so many more problems that I didn't know were realized in my pelvic floor.
Kim (49:45.07)
I hear that often. Yeah, yeah, yeah. All righty. Well, thank you so much.
Kylie (49:46.538)
Yes. Oh, goodness. All right, Kim. Thank you so much. I appreciate you. All right. Bye-bye.
