Logo Roy Kim, MD
San Francisco Plastic Surgery

call us at 415.362.1846

220 Montgomery Street, suite 348
San Francisco CA - 94104

Why is My Surgery so Early in the Morning?


Alarm Clock Waking Teen Girl

As you probably suspect, one of the biggest reasons why I went into Plastic Surgery is to become a sadist. Not only can I inflict pain with surgery, but I can also make my patients wake up at a painfully early hour to completely disrupt circadian rhythms and generate even more torment.

On a more serious note, the reason why surgery is scheduled so early in the morning is because we’re actually quite compassionate. Generally speaking, you will need to have an empty stomach for about 6-8 hours before your procedure. This ensures that your stomach is empty of any contents for general anesthesia. This way, if you get nauseated after surgery, you can try to throw up, but nothing will come out. With no stomach contents, you won’t accidentally swallow stuff into your windpipe, or lungs.

Aspiration pneumonia is a serious complication for any surgical procedure requiring sedation or general anesthesia. If you have dry heaves, as opposed to actual stuff or vomit in your stomach, then the changes of you having anything going into your lungs is much lower. As surgeons, we take this risk so seriously that we ask patients not to eat or drink 6-8 hours before any surgery requiring some sleep or sedation medicine.

If you have your operation at 730 AM, that means that you probably have had nothing to eat or drink- you’ve been sleeping at night. If we operated at 300 PM, then you would not be allowed to eat or drink after 700 – 900 AM, and you’d be wide awake during your entire fast. You would probably be grumpy and hypoglycemic, and you would not have the advantage of being asleep during this non-eating and drinking period.

So, be thankful for your early morning surgery start time!


 Should you desire more information about my available services, or want to schedule an appointment, please contact my Patient Care Coordinator at info@drkim.com, or call our office at 415-362-1846.

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Saturday Shout Out- THE ART OF MANLINESS


Let's face it-  it's hard being ultra manly with no guidance.  This website will help you tremendously in attaining the proper masculine ideal.  This website, the Art of Manliness, should help anyone attempting to reach manly nirvana.




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When Can You Have Sex After Plastic Surgery?


Let’s face it- many people want to have plastic surgery to not only boost confidence, look more rejuvenated, appear more youthful- they want to feel more sexy. There, I said it, and I hope I didn’t offend anyone.

So, when can you “get it on” again after your procedure? My favorite answer- it depends- still works here, but some common sense applies as well.

Basically, you want to feel recovered, in little to no pain, and have your surgical incisions closed before you get back to your significant other. This assumes that you are an active participant in the, er, festivities.

Mentally and psychologically, it’s important to have plastic surgery for you, and not necessarily for others. If you’re secure and confident before surgery, then after you heal and aren’t in much pain, you should feel confident to have fun with your partner in crime as soon as possible after plastic surgery.

Plastic Surgery involves surgery, so you probably will not feel comfortable with physical intimacy until some of the swelling, bruising, and pain has gone away. Of course, this depends on the location of your surgery, number of locations, and how quickly you heal, but it’s generally safe to have sex when your body tells you that it’s not in significant pain.

If you have surgical incisions, in general you will want them to be healed and closed up before pursuing rigorous activity. You don’t want to have plastic surgery, and then have a slight separation of your scars due to over-exuberance with your partner. Allowing your incisions to heal is a good indicator of when you’ll be ready for a return to fun.

It’s always best to ask your plastic surgeon about the right time to return sex, and only he or she knows, after talking to you and examining, when the best time is for you and your body.

If you have any questions or comments on this topic, please feel free to leave a comment below.

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What is the Recovery Like After a Mommy Makeover?


38524, VENICE, ITALY - Friday March 12 2010. Angelina Jolie and Brad Pitt board a canal boat in Venice with their twins Knox and Vivienne. The Jolie-Pitt family are in Venice while Angelina films a movie called The Tourist . Photograph: PacificCoastNews.com

A Mommy Makeover is a large operation involving the abdomen and upper body. The abdomen usually undergoes a tummy tuck and some bilateral flank liposuction to reduce and eliminate the loose skin that may be associated after childbirth. The breasts often undergo a breast augmentation, breast lift or a combination breast augmentation and lift to give a more youthful and aesthetically appealing appearance to the breasts. Both operations can usually be done at the same time. In many women, a Mommy Makeover is a powerful, confidence building operation.

Recovery after a Mommy Makeover is variable, but typically takes about 10-14 days. The more procedures you have, the longer recovery time may be required. For example, if you need just a tummy tuck, your recovery will be faster than if you have a tummy tuck and liposuction. Another example would be if you had just a breast augmentation, you should have a slightly faster recovery compared to a breast augmentation with a breast lift.

A Mommy Makeover is typically done in a surgery center or hospital setting. Depending on your overall health and the amount of surgery you need, you may have to stay overnight in a hospital. After you go home, you will still need someone to help take care of you for 1-5 days afterwards.

After your procedure, drinking plenty of fluid and walking around a little will help mobilize your fluids and help with recovery. Hopefully your surgeon uses a pain pump, which dispenses numbing medicine automatically to the areas of surgery. This will reduce your pain levels and increase mobility as well.

If you have children, you should make sure that you have extra help taking care of them right after your Mommy Makeover. You should be able to walk around gently several days after your procedure, but everyone is different, and having extra help at home will psychologically give you a little less stress.

Returning to work will take 10-14 days, and you should be able to return to an office job sooner than if you have a more active job. Driving should also be possible within 2 weeks, but you should be off of pain pills before you drive.


Should you desire more information about my available services, or want to schedule an appointment, please contact my Patient Care Coordinator at info@drkim.com, or call our office at 415-362-1846.

Do you have any questions about Mommy Makeovers? Have any comments? Please feel free to leave some below.

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What is the Recovery Time for Liposuction?


Nurse with Patient Using Cell Phone

Recovery after liposuction is very dependent on your overall health, how many areas of liposuction you had, the locations of liposuction, and how much fat was removed. In general, you should expect to take 3-10 days after your liposuction procedure to recover. Your length of recovery is highly individualized and variable.

Common sense dictates that the younger and healthier you are, the quicker your recovery will be. There are also post-liposuction instructions your plastic surgeon will go over with you, including drinking plenty of fluids, wearing your compression garments, walking around after your surgery, and other things which will aid in your recovery.

The more areas of liposuction you have, the longer your recovery will be. Most patients choose to have several areas done, but some patients may want their arms, upper body, and lower body to undergo liposuction. You will be more sore if you have more areas of liposuction done, and you may need more time off of work to fully recover.


Certain areas of the body are more painful than others after liposuction. The areas of the body with more movement, especially the core areas of the body, will have more soreness and pain compared to parts of the body that don’t move as much, such as the hip areas. The more you use your body parts that had liposuction, the more sore you will be as well.


The more fat removed with liposuction may cause more soreness as well. More fat removal implies more body areas of surgery, which may result in more soreness, bruising, and stiffness after surgery.


 Should you desire more information about my available services, or want to schedule an appointment, please contact my Patient Care Coordinator at info@drkim.com, or call our office at 415-362-1846.

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Do you have any other questions about liposuction?  Please feel free to comment below.

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Who Should Inject Your Botox and Juvederm?


Botox, Juvederm, Dysport, Restylane, Radiesse, and others- there are many products that are pretty easy to inject in an office setting to help reduce wrinkles, make deep folds look better, and improve your overall appearance, all without a trip to the operating room. With all of the products available, you may wonder- who should you trust to inject all of this stuff?

It depends on what state in the US, and what country you may live in, but many injectables are given by nurses and doctors. Even among doctors, there are many different specialties. However, it is my opinion that you should get an injection from someone you trust, who can also deal with the complications arising from these injectables.

In the US, there are the core 4 specialties that have educational, formal training during the post-medical school years. These specialties are Plastic Surgery, Facial Plastic Surgery, Dermatology, and Oculoplastic Surgery. Even if these specialists choose not to do aesthetic surgery, they still undergo training as part of their overall medical education to perform cosmetic procedures. Also, CME/ continuing medical education requirements are still in place, meaning that continued training, seminars, conferences, and lectures are required to maintain board certification in these 4 specialties.

In the US, if you’re a doctor of a different specialty, you won’t get this training in your post- medical school training. You will be forced to take a weekend course, a week long course, or some other alternative education, to learn about cosmetic injectables.

Nurses are allowed to perform cosmetic injectables under the supervision of a doctor. This supervision varies widely, and can mean anything from the doctor being physically present, to the doctor being nearby, to the doctor being available by phone, to whatever the nurse and doctor agree upon. This would explain why some nurses seem to be able to perform injectables with no doctor visible or present during the procedure.

I have written several blog posts about reducing pain during Botox injection, reversing Botox and Juvederm, and there are other tips and tweaks that aid in cosmetic injectables. These are not necessarily trade secrets, but rather, being educated by experts and reading original articles from peer-reviewed, internationally recognized journals. It’s my opinion that many casual injectors outside of the “core 4” specialties are unaware of these methods and ways to avoid complications, reduce risk, and increase patient satisfaction and comfort.

There are subtle procedures within the realm of Botox and Juvederm, such as injecting into the eyebrow areas to achieve an arch, reducing neck muscle strength, getting just the right spot to reduce migraine headache pain, and other more rare and difficult procedures that I believe require more expertise and knowledge to deliver correctly and efficiently.

There’s always the issue of price. Yes, I am probably going to charge more than a nurse for the same cosmetic injectable, because I’m a board-certified Plastic Surgeon. I’m sure my colleagues do the same. You’re not necessarily paying just for the supplies and the cost of the cosmetic injectable- you’re paying for expertise and for the knowledge of how to fix things if they’re not quite perfect. I think that working with a doctor who is well-versed in cosmetic injectables may be more rewarding for you, as the person who has to live with the results.

And of course, there’s the old saying- You Get What You Pay For.

If you have any comments, please feel free to type away below this blog post!


Should you desire more information about my available services, or want to schedule an appointment, please contact my Patient Care Coordinator at info@drkim.com, or call our office at 415-362-1846.

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Where Can You Inject Botox?


Botox is used in many other areas of the face, but most of these uses are off-label. Although a doctor has discretion to use Botox in different areas, these applications or injections may not be FDA approved. The more common areas include the forehead, to reduce forehead wrinkles, and in the sides of the eyelid areas, to reduce crow’s feet.


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Vote Early, and Vote Often


Assortment of 'vote' badges

Today is Election Day in the US. Please consider voting early, and voting often.

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Congratulatons to the San Francisco Giants!


San Francisco Giants fans celebrate their 3-1 victory over the Texas Rangers in game 5 of the World Series at Rangers Ballpark in Arlington, Texas on November 1, 2010. The Giants won series 4-1.  UPI/Ian Halperin Photo via Newscom

San Francisco Giants pitcher Brian Wilson (R) reacts to the final out against the Texas Rangers as catcher Buster Posey (L) celebrates after Game 5 of Major League Baseball's World Series in Arlington, Texas, November 1, 2010. REUTERS/Tim Sharp (UNITED STATES - Tags: SPORT BASEBALL)

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Can You Get Liposuction if You Are Overweight?


Doctor weighing overweight man

The short answer- It depends.

Liposuction is a procedure that removes fat on a permanent basis. The fat is removed through tiny incisions, and generally only in areas that have external fat. You will go over the exact areas with your plastic surgeon, but in general, fat is removed from localized areas of the body that are your problem areas.

If you’re overweight, fat can obviously be removed through liposuction. To be the best candidate for liposuction, you should have only isolated problem areas of fat, and not have fat all of your body.

Sometime being big is not an indication of being overweight. Having a big frame, or being committed to lifting weights, may increase your body size but may not result in having an excessive amount of fat.

A BMI calculation, or body mass index calculation, is a rough estimate for being overweight. Typically at BMI of 30 or higher is an indication of being overweight. However, if you have a larger bony structure, or have a lot of muscle, then you may have a higher BMI yet still have lower body fat and be a good candidate for liposuction. A good BMI calculator can be found here- www.nhlbisupport.com/bmi/bmicalc.htm

If you have problem areas, then usually liposuction is a good alternative. However, if you’re overweight with internal fat in your abdominal cavity, which is visceral fat, then you are probably not a good candidate for liposuction. If you think that you need to lose more than 20-30 pounds, then you may be asked by your plastic surgeon to lose weight before undergoing a liposuction procedure. Finally, if you’re under the age of 21, then diet and exercise may be strongly recommended before liposuction, since young men and women are usually very successful in losing weight safely and quickly due to excellent body metabolism.


Should you desire more information about my available services, or want to schedule an appointment, please contact my Patient Care Coordinator at info@drkim.com, or call our office at 415-362-1846.

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  • American Board of Plastic Surgery
  • American Aesthetic Society of Plastic Surgery
  • American Society of Plastic Surgeons
  • Real Self