Dr. Weinfeld’s greatest professional aspiration is that his patients be happy with their results and happy in general. He believes patients can derive true value from the increase in happiness that should be part of any plastic surgery experience, whether it be for cosmetic or reconstructive purposes. Accordingly, he will do anything in his power to make his patients happy.
Dr. Weinfeld believes that if someone does not have the capacity for happiness, undergoing plastic surgery is not going to make him or her happy. Likewise, the happier someone is to start, the happier they are generally going to be with the results of surgery. For that reason, Dr. Weinfeld invests a lot of time and energy into creating conditions conducive to happiness to set the stage for happiness with the surgical experience. Furthermore, Dr. Weinfeld spends a lot of time researching happiness and how aspects outside of surgery can increase joy in the lives of his patients.
What follows are some key variables Dr. Weinfeld has found to be important.
Overall Health and a General Sense of Well-Being
Given that, at a biological level, happiness is merely a chemical state within the brain, it is important to think of our brain as an organ just like any other organ in our body. The healthier one’s body, the healthier all our organs are going to be and the better they are going to function. It follows that the healthier the brain is, the better it can create a state of happiness.
Many of the things discussed in the next several paragraphs are likely obvious. Nevertheless, the impact these things have on health, the health of our brain, and, thus, the amount of happiness experienced justify a brief overview.
How Can I Live a Healthy Life?
Sleep, diet, and exercise make up the three most important pillars of a healthy life. Without proper sleep, diet, and exercise, true health, a sense of well-being, and happiness are diminished. In this diminished state, satisfaction with surgical results is harder to achieve.
Improving one’s sleep, diet, and exercise routine should be part of everyone’s preparation for surgery. Fortunately, small changes can reap huge rewards. Of the three, sleep is likely the most important.
Why have I chosen to dedicate space in a plastic surgery website to focus on sleep? There are countless reasons, but I will focus on just a few.
Sleep truly is the fountain of youth. Sleep’s ability to make one feel and look younger should be of interest to anyone seeking plastic surgery. Sleep and health are interrelated. The quality and quantity of sleep impacts the body’s hormonal, metabolic, immune, repair, and recovery activities. Optimizing these functions is important not only for slowing down the aging process but also for maximizing recovery from plastic surgery procedures, whether cosmetic or reconstructive in nature.
How Does Sleep Affect Mood?
Sleep has a significant impact on brain processes that relate to our psychological status, general outlook, and interpersonal relationships. Together, these three contribute to what we experience as mood. Good sleep is essential for the normal function of the chemical reactions and electrical activity in our brains that create mood.
A good mood manifests as a sense of general well-being. A bad mood manifests as being unhappy and limits the ability to be made happy, even by something good in one’s life. Thus, a good mood and a general sense of well-being are important for being able to benefit psychologically from good plastic surgery results. A patient must have a good mood and the capacity to be happy in order to feel happy about plastic surgery results and for the surgery to ultimately be a success. Because of its significant positive impact on mood, sleep is a key ingredient for that success.
How Does Sleep Affect Physical Health?
A lack of quality sleep can negatively affect your body in a myriad of ways. Consistent sleep deprivation can lead to high blood pressure, heart disease, poor circulation, increased inflammation, fatigue, decreased immunity and healing, and many other harmful effects.
Your endocrine system is made of glands that produce, store, and release hormones that tell your body how to function. Among other things, these hormones affect your blood pressure, heart rate, appetite, metabolism, development, and sexual function. Poor sleep quality and duration can affect your endocrine system’s ability to regulate these hormones and their essential functions in the body.
One of these hormones is cortisol, which is the primary stress hormone (also known as the fight-or-flight hormone). When you don’t get enough sleep, your body produces an overabundance of cortisol. This can interfere with your immune system’s production of protective proteins (cytokines) that fight infections and inflammation. This has a detrimental effect on healing and decreases your immunity, making you more susceptible to infections.
This is why getting adequate quality sleep is so important for your body, especially as it relates to recovery from surgery.
How Can I Sleep Better?
It might not seem like it, but you can have a lot of control over the quality of your sleep. The following are strategies that almost everyone can undertake. Start with the knowledge that a rested brain sleeps better.
One strategy to jumpstart the process of sleeping better is to plan and follow through with a long night’s sleep. This is simple — go to bed early and do not set an alarm. This is best done on a weekend. Aim to go to sleep by 8 p.m. This might seem really early to some, but 8 p.m. is actually the time that most adults first feel tired enough to go to sleep. Most people just ignore the urge and stay up two to three more hours, missing the opportunity for amazing sleep.
Set an Early Bedtime
Starting your sleep early is the best method to give yourself the opportunity to get enough sleep. Plan your time to sleep. When you do this, respect the fact that your body’s sleep pattern follows a natural timing of body events called the circadian rhythm. When we match our sleep with the rhythm, we maximize our sleep potential. Setting and following a consistent bedtime is a good way to achieve this.
Remember, the natural time your body is ready to go to sleep is likely hours before you usually go to bed. Over the next several evenings, pay attention to when you feel tired, and you will likely find that it is generally at 8 or 9 p.m. If you pay attention to it and are honest with yourself, you will also recognize that you are probably not achieving anything productive after that time. So when it boils down to it, you have very little to lose and a lot to gain by going to bed early.
Take a Hot Shower and Keep Your Bedroom Cold
We fall asleep faster and the quality of our sleep is improved when our body temperature is lower than our daytime waking body temperature. We can influence our bedtime temperature with one simple trick: taking a hot shower or bath immediately before going to sleep. While this may seem like a paradox, it isn’t. It is completely biological and scientific.
When we take a hot shower, the blood vessels in our skin expand. This allows blood to rush the surface of our skin to bring heat to the surface to cool off. Our body literally radiates heat into the air when we emerge from the hot water. As we lose heat to the environment, our core temperature drops rapidly, setting the conditions for falling asleep. To maximize this effect, we need to cool our room temperature to keep us cool for the duration of the night to achieve a full night of good sleep.
Avoid Exercise Before Bedtime
While exercise is important for good health and even good sleep, it should be avoided for at least two hours before going to sleep. Exercise releases numerous stimulatory brain chemicals called neurotransmitters that excite the brain instead of relaxing it. This can make it harder to fall asleep and diminish the quality of sleep. The stimulatory effect of exercise can be used strategically instead of caffeine to wake up when feeling tired. Avoiding caffeine later in the day will also have positive effects on sleep.
Stick to a Regular Sleep Schedule
Going to sleep at about the same time every night and waking up around the same time each morning improves the quality of sleep in the long run. This regular pattern will “train” the brain to prepare for and engage in good sleep. In addition, the routine of the same sleep and wake cycle will parallel and reinforce the natural sleep signals our brain is getting from the circadian rhythm.
Get 30 Minutes of Sunlight
The circadian rhythm is a natural sequence of activities in our body and brains that regulates many functions including sleep. Getting at least 30 minutes of sun exposure each day maintains the integrity of our circadian rhythm and improves sleep.
Avoid Bright Lights Before Bedtime and Sleep in a Dark Room
Bright lights stimulate the brain in a variety of ways. One of the ways has to do with confusing the circadian rhythm and its effect on the needed release of melatonin. Avoiding bright lights prior to going to sleep will help you wind down and fall asleep quicker. Sleeping in a dark environment will improve the quality of your sleep. Blackout window shades, sleep masks that cover the eyes, and limiting the lights from electronics in the room all help.
Avoid Screen Time Before Bedtime
Screen time is essentially an issue of light exposure. The reason screen time deserves a separate mention is because it has a powerful negative effect on our sleep. Modern device screens emit a spectrum that is skewed toward blue light. The wavelength of blue light has the most negative impact on our sleep.
Avoid looking at screens for two hours prior to going to sleep. That is easier said than done in the modern era. There are simple things you can do to limit the negative effect of the blue light from screens on your sleep. Most smartphones have setting functions for nighttime mode with reduced blue light. Set your phone to start this mode at 7 p.m., and give yourself a bedtime target of 9 or 10 p.m. Another strategy is to wear amber glasses. These are easy to find in many stores and online. Amber glasses reduce the intensity of the blue wavelength in the light, including the light from device screens.
Don’t Eat Too Much Before Bedtime
While some find it hard to go to sleep hungry, eating too much prior to going to sleep can be detrimental. A large meal can lead to digestive issues and experiences that interfere with sleep. Small snacks are generally okay. Drinking too much fluid prior to going to sleep can lead to waking in the night to use the bathroom, which also diminishes sleep quality.
Alcohol has a negative impact on your quality of sleep. The more alcohol consumed and the closer to bedtime it is consumed, the greater the drawbacks. Thus, it is best to avoid alcohol in the evening and, if you do drink alcohol, consume it in moderation.
People often wonder why alcohol is bad for sleep. It’s a depressant, which is the opposite of stimulants that limit sleep. Furthermore, those who drink alcohol know that it can make you sleepy. So why shouldn’t you drink before going to bed? The reason alcohol is detrimental to your sleep quality is complex, but it has to do with the depressant property of it as a “drug.”
Alcohol depresses (decreases) the activity in the centers in our brain that are responsible for sleep. Sleep is not a passive brain activity but, rather, an active one. We have locations in our brain responsible for generating sleep. Alcohol slows the activity of those locations and, thus, reduces the quality of the sleep they produce. Specifically, alcohol has the greatest negative effect on our REM sleep.
Caffeine is a stimulant found in many beverages such as coffee, tea, soft drinks, and energy drinks. It is also present in some foods such as chocolate. Consuming caffeine too close to bedtime can make it difficult to fall asleep and can decrease the quality of sleep. The half-life of caffeine in the human body is 6 hours, and it can take up to 10 hours to completely clear it from your system. Because of caffeine’s prolonged action in the body, it is best to stop consuming it after 12 noon to maximize your sleep quality. You will find the better you sleep, the less you will rely on caffeine to be alert and have energy during the day.
Tracking Your Sleep
Everyone has different physiology (biological functions), so the impact of the strategies listed above will be slightly different for each person. The key to achieving good, healthy, happiness-inducing sleep is figuring out which are most important for you so you can maximize their impact. Data is central to this process. Thus, if you are serious about sleeping better, you should track and analyze your sleep.
Subjective Sleep Data
One important data point is subjective (your experience), which includes how you feel in the morning and how much energy you have during the day. In order to track trends, that information should be recorded in a notebook or a digital format dedicated to your personal sleep data. Simply labeling how you feel in the morning and the energy you have during the day as “Great,” “Good,” or “Poor” is enough to get started.
Objective Sleep Data
The other important data set is objective, which includes number data about the quality of your sleep from an external device. There are a variety of sleep tracking devices that range from simple to complex and inexpensive to expensive that can be used for this purpose.
The Apple Watch, Oura Ring, and Fitbit are some popular wearable sleep-tracking devices. I have no true or direct financial ties to any of the listed devices. I have found the Fitbit Charge devices to be reliable and easy to use with easy-to-interpret data. The Fitbit monitors your nighttime movements and heart rate to gather information about your sleep and pairs with your smartphone to present the sleep data. The most useful information provided is sleep duration, which is broken into awake, light sleep, deep sleep, and REM sleep.
The overall duration of your sleep is important. For an adult, eight hours should be a goal, and seven hours should be an absolute minimum. Within that total sleep duration, the more deep sleep and REM sleep you get, the better and more rested you will feel, and thus, the greater your capacity for happiness.
Of note, I don’t believe the data from these sleep-tracking devices is 100 percent accurate and scientific the way data derived from a polysomnogram (formal sleep test in a sleep lab) would be, but it is a good start and provides some trackable data.
Track Your Successes
Once you start to track both the subjective and objective quality of your sleep, you will naturally start to correlate it to variables you can control (i.e., the better-sleep strategies already discussed). Crucial to this process is to also record and note the success you had in implementing the sleep strategies. Figuring out the cause and effect relationship between the better-sleep strategies on one hand and the subjective and objective sleep data on the other will allow you to fine tune your approach to getting more and better-quality sleep.
The better your sleep, the happier you will be. The happier you are, the more benefit you will derive from cosmetic or reconstructive plastic surgery. I want my patients to derive the most benefit from the procedures I perform, and I can’t emphasize the role of sleep enough.
What if I Have Sleep Apnea?
No discussion of sleep would be complete without a mention of sleep apnea. Sleep apnea is a condition where a person stops breathing while asleep. Central sleep apnea refers to a lack of normal signals to the body’s breathing mechanisms while sleep. Obstructive sleep apnea refers to a temporary but repetitive blockage of the airway while asleep. Both types are dangerous and can lead to life-threatening changes in the cardiovascular system and other body systems.
If you suspect you have sleep apnea (i.e., you always feel tired even if you have engaged in better-sleep strategies), a formal sleep study in a sleep lab by a sleep medicine doctor may be in order. Obviously, I cannot not provide medical advice about sleep apnea to non-patients. Thus, the preceding comments should not be construed as medical advice. But, if you are local and have concerns about sleep apnea, my office can provide you information about expert doctors in the field of sleep medicine.
Sleep Guru — Matthew Walker, PhD
Much of what I know about sleep I learned from experts in the field of sleep science. The research and thoughts of Matthew Walker, PhD, a neuroscientist at University of California, Berkeley, who studies sleep, have been particularly helpful. They have broadened my appreciation for the importance of sleep in every aspect of our lives, including the experience of happiness. If you are interested in learning more about sleep, Dr. Walker’s book “Why We Sleep, Unlocking the Power of Sleep and Dreams” is a good place to start. Also, a simple search for the terms “matthew walker sleep” will lead you to videos and podcasts about the topic of sleep.
Back to a previous theme — a healthy brain. Think of the brain as the organ that generates and experiences happiness. The healthier the brain, the better it can generate and experience happiness. Exercise is a crucial ingredient for maintaining a healthy body and healthy brain.
Regular exercise has a multitude of health benefits, including increasing one’s chance of living longer, increasing muscle and bone strength, reducing risks of certain types of cancer, and regulating normal blood sugar and insulin levels. These benefits are extremely important for overall health, but there is another set of benefits that relate directly to brain health and increasing happiness.
The Happiness Benefits of Exercise Include the Following:
- A direct positive effect on mental health and mood
- Improved thinking, memory, learning, and judgment skills
- Better control of weight and appetite
- Improved sexual health
- Longer duration and quality of sleep (but avoid exercising in the 2 hours before bedtime)
- Increased energy and decreased pain
Exercise and Sleep
The relationship between exercise and sleep is worth repeating. Exercise improves sleep quality, but strenuous exercise should be avoided two hours prior to bedtime to avoid sleep disturbance. So, while exercise is important, one needs to be strategic about when to engage in it. The principle of being strategic as it relates to when to engage in exercise also related to the timing relationship between exercise and surgery.
Exercise and Plastic Surgery
Regular and strenuous exercise is beneficial prior to and immediately leading up to surgery. However, for most surgeries, a period of rest from strenuous cardiovascular exercise and resistance training (e.g., weight lifting) should be enacted. The duration of the appropriate length of exercise abstinence varies in accordance with each surgery type. Thus, as we hope to be your surgical team, when you meet with us to discuss surgery, please make sure you get all your questions regarding this topic answered.
Cessation from strenuous exercise does not mean stopping all activity. Walking is a physical activity that is healthy and encouraged soon after almost all surgeries so long as safety precautions are implemented.
How Much Exercise Do I Need?
Experts generally recommend at least 30 minutes of moderate cardiovascular exercise 6 times a week or 30 minutes of vigorous exercise 3 times a week.
The definitions of moderate and vigorous exercise are worth investigating online on one’s own, but as a guideline, moderate exercise will noticeably raise the heart rate such as a brisk walk. Vigorous exercise raises the heart rate and results in perspiration.
An example of vigorous exercise is a fast-paced run or bike ride. Many of the wearable devices I mentioned in the section about objective sleep data can also provide real-time feedback as to the level of exercise being achieved. Furthermore, strength training or resistance training (e.g., weight lifting) adds further health benefits when added to a weekly exercise program.
The health and mood benefits of exercise is a vast topic. For the purposes of describing its role in successful plastic surgery, the relationship between regular exercise and happiness should not be underestimated. If one wants to prepare for a safe surgical experience and, at the same time, significantly increase the potential of being truly happy with the results, exercise is an ingredient to the recipe for success that should not be forgotten.
The relationship between diet and health goes without saying. The relationship between diet and brain health (and therefore mood and happiness) should seem nearly as obvious. Unfortunately, the link is not paid as much attention as it deserves, but the connection between a good diet and happiness is real.
To really benefit from both cosmetic and reconstructive plastic surgery, a good diet is essential. This is true because a good diet contributes to proper healing and a decreased risk of complications. Furthermore, a good diet is essential for a state of happiness. The happier a person is in general, the happier that person is going to be with the results of surgery.
The challenge in discussing the relationship between a good diet and health and happiness and, thus, successful surgery is that there are many valid yet varying opinions regarding what makes a “good” diet. Our society is obsessed with diets, and there are many making the rounds right now. Plant based (vegan), ketogenic, whole 30, intermittent fasting, paleo, and Mediterranean diets are all examples. Each one of these has its expert evangelists, and there is scientific data supporting each one of these.
I don’t have the expertise to tell you that one diet is better than another. Truth be told, humans are not all the same. Different people’s internal biochemistry responds differently to different diets. For that reason, I will not make any conclusive statements about diets. Instead, I will point to a few examples of the effects and benefits of specific foods on health and happiness. I will also reference a couple of books I have found useful. Ultimately, it will be up to you to explore and evaluate what works for you, your body, and your brain.
What Foods Are Beneficial for Happiness?
What follows are several examples of the impact diet can have on happiness. You can use this information to modify your eating practices right now with positive results.
Omega-3 Fatty Acids
Omega-3 fatty acids include DHA and EPA, and they fall under the food group we know as fats and oils. This specific group of fats and oils reduce inflammation throughout the body, including the brain, and improve mood. In addition to improving mood, they may protect the brain from psychological disorders such as depression by increasing the production of a brain chemical called serotonin that contributes to the mood states.
Omega-3 fatty acids are found in high concentrations in salmon and small fish such as anchovies and sardines. Grass-fed beef, lamb, and eggs from pasture-raised hens are other good sources.
Tomatoes contain at least three substances that contribute to happiness. The first is lycopene. Among other functions, lycopene limits the pro-inflammatory compound interleukin-6, which is associated with depression. Tomatoes are also rich in folate and magnesium. These are two common food nutrients known to have positive influences on psychological health. The mechanism for the impact of folate and magnesium on mood is complex. It ultimately relates to their contribution to the production of the neurotransmitters serotonin and dopamine, both of which are important for your brain’s mood function.
Hot peppers or chilis such as the serrano, jalapeno, and habanero are good for your mood. These hot peppers contain capsaicin, which is the chemical responsible for the burn that is felt when they are eaten. Capsaicin is fat soluble and, in this form, enters the blood and is carried throughout the body, including into the brain. The cells of our brains happen to be rich in chemical receptors that bind capsaicin. When these receptors are triggered, endorphins are released, leading to a natural feeling of calm and well-being.
Garlic belongs to a class of vegetables called alliums, which also includes onions and leeks. Alliums are known to promote healthy blood flow by relaxing blood vessels and reducing blood pressure. This effect is good for the brain and, thus, mood in the long run by decreasing microvascular strokes that result and dementia and dementia-associated depression.
Find What Works for You
I present these three examples of the link between foods and mood not to suggest that you eat a diet of salmon in spicy garlic tomato sauce. Rather, I chose these examples of common foods to make evident the important effect diet has on our brain health and happiness. These examples are not even the tip of the iceberg. There is so much more. As I said in the beginning of this section, what works for some might not work for others when it comes to diet.
Diet Book Resources
I will finish by listing a few books that I found helpful in shaping what I know about what foods work for me. Perhaps you will find them useful too.
“Food: What the Heck Should I Eat? The No-Nonsense Guide to Achieving Optimal Weight and Lifelong Health.” By Mark Hyman, MD. 2018.
“The Happiness Diet.” By Tyler Graham and Drew Ramsey, MD. 2012.
“The Paleo Solution. The Original Human Diet.” By Robb Wolf. 2010.
“This is Your Brain on Food. An Indispensable Guide to the Surprising Foods that Fight Depression, Anxiety, PTSD, OCD, ADHD and More.” Uma Naidoo, MD. 2020
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