Dr. Robert Whitfield, a plastic surgeon in Austin, learned about nutrition from treating severely burned patients, where aggressive nutrition is lifesaving. He applies that knowledge to cosmetic surgery patients, recommending around 100 grams of protein daily to support healing. His protocol also limits opioids in favor of other pain management drugs like gabapentin and celecoxib.
Questions this video answers
June 16, 2021.
Approximately 1 gram per kilogram of body weight per day (e.g., 70 kg → 70 g).
Protein requirements go up 50% to 100% after severe burns.
About 100 grams of protein per day.
Ondansetron (Zofran) for nausea; gabapentin for nerve pain; celecoxib (Celebrex) for inflammation; plus a small amount of postoperative narcotic as needed.
Chapters
Why do plastic surgeons know about nutrition? Hi, this is Dr. Robert Whitfield. I'm a board certified plastic surgeon in private practice in Austin, Texas, where we try to achieve natural results through art, science, and innovation. I was recently asked this question from one of my great patients who travels from out of state to see me because I'm always talking to her about nutrition and gut health. And so this all really stems from my training. So as a general surgeon in training and as a plastic surgeon in training, I took care of burn patients. I don't know that most people would understand this, but there's rarely a sicker patient in a hospital environment, barring what recently happened with COVID than a very, very severely burned patient. And really without aggressive treatment, both to hydrate the patient with IV fluid resuscitation and to give them early nutritional support, usually through their intestinal tract, these patients typically will succumb to their injuries. So, okay, why the burn patient? What's the issue specifically? So the severely burned patient becomes catabolic. So they break down everything. Their hypermetabolic response is really mediated by catecholamines, which are EPI and norepi. In our system, it's responsible for flight or fight. I think I said that backwards. Fight or flight. So in any event, in addition to corticosteroids, so this is all being mediated through your adrenal glands. So everything's revved up. And these patients can be incredibly difficult to manage, especially acutely after their injuries. So does this somehow relate to what we do in cosmetic treatments? And if so, how do we, you know, bridge the gap and create an understanding of why it's important for nutritional support? So the protein requirements after a burn patient go up 50 to 100%. So, all right, what's the daily normal protein requirements? So it's really typically 1 gram per kilogram of body weight per day. I know the metric system is baffling in the United States, but normally that means a 70 kilogram or 150 pound person will need 70 grams of protein a day. So basically, if you think of that cosmetic patient like a patient who suffered this type of injuries, and they need increased protein. So just think of 100. It's a Benjamin. So I just say everybody needs at least a minimum of 100 grams of protein per day. So you already should be getting around 60 or 70. I'm ramping it up. After cosmetic treatment or surgery or what have you, you can do this after an injury, too. You'll recover better. So why? Because that's what your body needs. You can't heal without increased amounts of protein, which basically gives the amino acids to the body. So you can actually heal. So in summary, you know, the tradition of taking care of these severely burned patients led me to have a greater understanding of nutrition and proper hydration. So I've tried to convey this to all of my clients who are getting cosmetic treatments or surgeries in that we have to make sure and maintain proper hydration. We have to maintain appropriate nutrient supplementation, which I'm not going to delve into here and focus primarily for me on their dietary intake of protein, which for me, once again, I concentrate on about 100 grams a day. In addition, I use something called ERAs, Enhanced Recovery after surgery. It's a medication protocol that uses Zofran for nausea, Gabapentin for nerve pain, Celebrex for inflammation. Taken prior to a treatment the night before and then afterwards we use a small amount of narcotic. Now that may vary, you know, depending on what treatment we're doing. But this all really, really leads to what? Well, it's a enhanced recovery period. And what does that mean? Well, it's decreased, right? So everybody wants to get back to their activities, daily life sooner, their work sooner, their family sooner, their travel schedule sooner. So I'm always under pressure to figure out how to that in a very fast paced world. And this is just how I approach it. I start with what you're taking in. All right, if you want to learn more, you can hit us up on, I guess, you know, my Instagram, Dr. Robert Whitfield, Facebook, the same. And at my website, www.doctorrobertwitfield.com.
