GENERAL QUESTIONS 1. What is the best age for a plastic surgery? The best scenario for a plastic surgery is after completing the full grow and development, usually alter 18 years of age. Certain surgeries are designated to be done to correct the effect of time or childbirth. There is an exception to the rule: it is the otoplasty, can be done since the 7 years of age, due to the prompt development of the eras compared to the rest of the body. 2. Can anyone be suitable for a plastic surgery? Any person in good health or with a general condition that is controlled with adequate treatment (as hypertension, hypothyroidism) is a potential candidate for a plastic surgery. 3. Can a person be changed to resemble a movie star, a model, an actress, or to change the identity? A plastic surgery can refine and change some of the physical landmarks of a person, making a younger or more appealing profile, but the basic morphology cannot be changed, hence it is not possible to look identical to your favorite star. 4. How safe is a plastic surgery? The risks of a surgery are related to four factors: a good surgeon (certified by the appropriate board as the American Society of Aesthetic Surgery (ASAPS), Colombian Society of Plastic Surgery SCCP), a certified anesthesiologist, a clinic with suitable equipment that fulfills the basic norms of security and asepsis (registered by the appropriate Health association), and of course, a healthy patient. These factors constitute the golden rule for a safe surgery. The questions that must become when a specialist consults, are who, how and where is going to be performed. Ask for the credentials and references of the professionals who are going to treat you, to contribute to your peace of mind. 5. Is anesthesia safe? The anesthesia in one of the medical specialties with greater technological advances nowadays. In our country all the anesthesiologists must be certificated, and is the only regulated specialty legislatively to add safety to the patients. Anesthetic agents are more and more exact, achieving less collateral effects, as pain, nausea, etc. Specialized treatments exist to control the postoperative pain, making the anesthesia more comfortable. Remember to request an appointment with the Anesthesiologist before the surgery, so he/she can do a physical and lab tests revision to assure that all is in order. Make a list of the questions that are related to the anesthesia prone to be answered in the consultation. Remember that the greatest fear of the patient is indeed to the anesthesia, solving doubts can reduce the anxiety and increase the security. 6. If I live overseas, how much time do I need to schedule the surgery, how much time I must remain in the city and how soon can I travel back home? The patient who live overseas is a special case, require a fast evaluation and programming, special adjustments of accommodation and special care. When in contact with the surgeon, it is necessary to do the lab tests in the place of origin for the preoperative evaluation. It is important that the patient send by fax or electronic mail the results of these examinations, as well as antecedents of clinical relevance to make an initial approach phase of the possibilities of carrying out the surgery. Virtual consultation can be done to assess the patient and surgical options. The patient must know clearly that nothing replaces the personal evaluation with the surgeon and the anesthesiologist, and often can change the surgical and anesthetic conduct. A special recommendation for the patients is to arrive at least 72hrs prior to the surgery so the body can adapt to the new atmospheric conditions. The surgery is scheduled with priority, and the recovery period varies from 8 to 12 days. In the recovery special accommodation and care by domiciliary nurse is provided 24 hours a day. In addition, the patient must assist to physical therapy sessions during the postoperative time. 7. How can I be prepared before the surgery? They point is to have completed the preoperative process successfully: It consists of the appointment with the surgeon and anesthesiologist and the lab tests. Please follow the instructions of the anesthesiologist about medications (some must be suspended). Do not smoke, drink alcohol or consume medications without prescription the night previous to the surgery, and take a light supper until midnight . Try to rest and to go to sleep early 8. What should I do the day of the surgery? Wear comfortable clothing and footwear. Take out jewelry and make up. Bring companion so someone can take care of you after the surgery. 9. What should I do after the surgery? Rest properly; be sure to be attended at all times. Take light meals in the first 48hrs; follow the recommendations and medications instructed by your surgeon. 10. What is the postoperative care of a plastic surgery? The process of recovery cares surrounds a suitable personal care, relative rest, and specialized treatment of physical therapy and body lymphatic drainage. Remember to follow the instructions of your surgeon, to use the garment and the bandages according to the type of surgery, for the recommended time. 11. Do I have to follow a special diet? The first 48 hrs avoid dairy, acid products. Later, a dietary guide with a suitable direction by a nutritionist can make the effects of the surgery long-lasting. 12. How long is the recovery?, When are the stitches and drains going to be removed? Most of the symptoms like pain and discomfort yield in average 8 days, time in which the stitches and drains are removed. Limited physical activity is recommended before 1 week. Begin the daily activities of progressive form. 13. How long I have to use the garment? The time of use of the postoperative garment depends on the surgery that has been performed: in a lipoplasty 1 to 3 months, in abdominoplasty can extend up to 6 months, according to the individual case. 14. When I can go back to work? The time of return to work depends on two factors: the first one is the type of surgery performed: in facial surgeries and lipoplasty 8 days, in bigger surgeries, like a full facelift or abdominoplasty, 15 days. The other factor is the type of work that the patient does: office activities sooner than the ones who work outdoors or with important physical activity. 15. When can I do exercise? The exercise can start around the third week, slight and progressive. It also depends on the type of surgery; please follow the specific recommendations of the surgeon in this particular subject. 16. When I can have sex? The commencement of sexual activity depends on each person, in some patients symptoms cease at 2 weeks. The ideal is to wait enough time so that the sexual activity doesn't become uncomfortable. 17. When I can dress normally? According to each surgeon, it is possible to be used an postoperative garment, sometimes with a medicated foam band to accelerate the healing process, which causes that the patient look like "stuffed". The time use is approximately 1 month, later regular clothes can be used underneath the garment, until the time for complete healing is achieved. 18. I can go out at night? The exposure to cold or adverse environmental conditions can exacerbate pain and tenderness, especially in nose job or body contouring surgeries. It is recommended to use warm clothing to avoid unpleasant symptoms at least for the first month. 19. When I have sun exposure? The time for sun exposure is variable, swelling and bruises must be gone. This period is at least 1 month 20. When can I travel? Many patients travel from overseas to have surgery. Usually they have a limit of time, which gives a narrow window of recovery. The ideal time is as much as possible, but the recovery critical periods yield approximately at 8 days. This time depends on the intervention; the surgery that more incapacity generates is abdominoplasty with 14 days. Facial surgeries: nose, face, eyelids, face and neck lift usually require 8 days.

FACIAL SURGERY 21. How long is the surgery? The operating time of the procedure can vary from 1 to 2 hours in a nose job or eyelid surgery, to 5 to 6 hours in a facelift. 22. The changes are subtle or dramatic? Is my family going to recognize me at home? Am I going to recognize myself in the mirror? The ideal result is the most natural possible; the patient must see a younger person in the mirror, preserving the foremost facial characteristics. In the beginning, due to the swelling, it is a little difficult to observe the results, but this diminishes with time, observing the results from 3 to 6 months. 23. What are the Russian threads and what are their uses? The Russian threads are polypropylene threads (in US available as Contour threads ® ) that can be implanted in various parts of the body to make a lift of facial structures like the eyebrow tail. It must be considered that this method should be used in particular patients without excessive wrinkles who require a slight to moderate facelift. 24. What are the endoscopic surgery and SMA? What are their advantages? The endoscopic surgery consists of inserting an endoscope with a camera to avoid big incisions or dissections; the Surgery of Minimum Access (SMA) does the equivalent without a magnified ground visual aid, like the camera. Their main advantages are the reduction of the scars, the access to difficult places and the decrease of the swelling producing a faster recovery. 25. Does it hurt after the surgery? How much? Facial surgery is not generally very painful, but the bandages and the inflammation can be uncomfortable. The pain can be easily controlled by the use of oral analgesics. 26. Will I have Swelling and bruises? For how long? Swelling and the bruises are like in any area of the body, the issue is that the face is an uncovered area, which causes that the patient feels uncomfortable, and that must be protected from the sun all the time. 27. What must I do after the surgery? Is it ambulatory? Depending on the surgical time and the type of surgery, this one can be ambulatory or to require a day of hospitalization. This is seen more often in patients with medical history of importance like hypertension. At all times, facial surgeries require rest in a sited down position and physical measures as a protected ice packs or topical medications to reduce swelling. 28. What is the postoperative treatment of the surgery? Directed to reduce to the pain and the inflammation, in surgeries of face and/or eyelids is necessary to do physical therapy to improve the mobility that can be lost by the surgery. This therapy improves also bruises and swelling. 29. How long is the recovery? The recovery is variable, in 1 or 2 weeks a person can do normal but sedentary activities, in 3 to 6 months a full recovery can be observed. 30. How soon can I see the results, are they long lasting? The results are seen when the inflammation has yielded, without observed sequels from 3 - 6 months. The results are permanent in time, like in the surgery of the nose. In anti-aging surgeries like facelift the extent is considered in 10 years, even though the continuous process of aging, anyway the results show a person younger than the chronological age. CORPORAL SURGERY Body Contouring surgeries: lipoplasty, minilipectomy, abdominoplasty, Breast reduction. 31. Is lipoplasty safe? Lipoplasty is the most common aesthetic surgery around the world. As any surgical procedure, have intrinsic risk factors. The risks are associated with the patient condition, the medical history, a skilled surgeon and meticulous anesthesiologist. It is considered by statistics that a serious complication happens in 1 of 20,000 cases, which makes a procedure very safe. 32. What is the difference between liposuclpture, lipoplasty, liposuction and lipoclasy? The terms liposculpture, lipoplasty and liposuction are similar to the procedure of extraction of the fat by means of small incisions, with cylindrical cannulas of diverse sizes and forms. The liposculpture, in a stricter sense, includes, aside from the fat extraction, injecting the fat in sites where it is needed, like the buttocks. The term lipoclasy talks about to the nonsurgical injection of substances that "dissolve" the fat, but with doubtful results. 33. What is the difference between the lipoplasty assisted by LASER, VASER or Power assisted? Which of these is better? The use of additional technology to liposuction facilitate the extraction of the fat, reduces the inflammation and improves the long term results. The use of LASER makes the implosion of the fat cells by heat generation, nevertheless, the use is limited to use a very thin cannulae, it does not penetrate in fibrous tissues, like in secondary surgeries. The ultrasound of 1ª and 2ª generation makes implosion of the fat cells but they have the disadvantage of the heat generation that can cause burns. The ultrasound of 3ª generation, VASER generates ultrasonic waves at resonance, which are selective to the fat cells, it does not release heat reducing the potential of complications. The power assisted lipoplasty uses a vibratile cannula that facilitates the extraction, although does not add a physical element. The best one, is the one than the surgeon of your confidence uses. 34. What are the differences between lipoplasty, mini-abdominoplasty and lipectomy (tummy tuck)? The lipoplasty is the fat extraction without removing skin, the mini-lipectomy or mini-abdominoplasty can remove small amounts of redundant skin without modifying the navel (with or without closing the abdominal muscles), the lipectomy or abdominoplasty (tummy tuck) closes abdominal muscles and removes the redundant skin from the navel to pubis, reason why it needs umbilical reconstruction. 35. How long is the surgery? The time is addressed according to the procedure: in lipoplasty 1 to 3 hours, depending on the amount of fat to be extracted; mini-lipectomy and abdominoplasty from 2 to 4 hours according to the extension of the skin removal and the adjunct procedures. 36. When bruises and inflammation go away? Bruises and inflammation will be reduced by the use of garment and the postoperative therapy. Esteem that the bruises go away from 2-4 weeks and the inflammation from 3 - 6 months. 37. What I must do after the surgery? Is it day-surgery? Classically lipoplasty is day - surgery. But according to the extension of the procedure, short term hospitalization can be required, like in high volume lipoplasty, mini-abdominoplasty, or tummy tuck. 38. What is the postoperative handling of the surgery? In body contouring surgeries the pillar of recovery is the use of physical therapy with lymphatic drainage, external ultrasound, presotherapy, diathermia, etc. and the use of foam band and garment that make the surgery more comfortable and the return of the patient to her/his activities in shorter time. 39. Do I have to follow a special diet? One of the important aspects (and more neglected) is the nutritional handling and the adaptation of the patient to a new dietary style that allows preserving the good results. A handling of a professional in this field as an advisor is desirable. 40. How long is the recovery? The time is variable, considered between 8 to 15 days according to the procedure. The time to full activity and exercise can be from 1 to 3 months. 41. How are the umbilical changes in mini-lipectomy vs. lipectomy? Umbilical change is seen in lipectomy or abdominoplasty since the stretching of the skin make it mandatory. Mini-lipectomy does not affect the umbilical button. 42. Do I have to use drains, for how long? The use of drains is more often seen in the surgeries that require skin lifting, but their use and duration depend on the surgeon. 43. How soon can I see the results? Body contouring surgeries have the advantage of to be covered areas that can tolerate the use of garments for prolonged periods of time. The results are usually observed from 3 – 6 months. SURGERY THAT REQUIRES IMPLANTS 44. Can an implant produce cancer? What should I do if there is family history of cancer o autoimmune diseases? Big studies have discarded the connection between implants and cancer formation, but implants can exacerbate symptoms of autoimmune diseases. Even so, it is necessary to do breast examination periodically, and a close follow-up of autoimmune diseases. Please discuss with your surgeon about familiar or personal history of diseases like breast cancer, fibroadenomatous disease or any autoimmune disease. 45. How long implants last? Is it necessary to change them? When? The technology in implant materials is very outstanding, but recommended time by manufacturers is more than10 to 15 years. Solid implants (like facial ones) are designed to be in place for a lifetime. The change of an implant becomes when this period of time is passed, or if anything abnormal appears. Generally, the most frequent reasons for implant exchange is the desire of changing the size of implants. 46. What are implants made of? Breast and buttocks implants are made with diverse covers, like silicone, polyurethane, or titanium (still non available), and the filling can be of silicone, hidrogel or saline solution. In the filling those of silicone are preferred, since the other two diminish their content with time. In theory, the best material for cover is the titanium, but it is not commercially available yet. Solid implants are made of silicone, or porous materials like Medpor ® that can be more biocompatible. 47. Are breast/buttocks implants safe for diving, airplane travel? They are very safe for diving and airplane travel, the compression generated by these situations is inferior to the one necessary to break a standard implant. The stories of ruptured implants in airplanes are not more than urban legends. (If that was true the international beauty contests could not exist). 48. Should breast implants go above or underneath the muscle? Depending of the eye of the surgeon some factors can influence the position of an implant. A patient with normal amount of mammary gland, a high muscular pectoral development, or the presence of ptosis (dropped breast), make preferable to put them underneath the gland (above the muscle). In patients with almost absent breast gland, family or personal history of breast cancer the preference is underneath the muscle. 49. It is necessary to do physical therapy after surgery? Postoperative physical therapy can reduce the time of inflammation and pain, offering in the long run a more harmonious and natural result. It is important to teach the patient to do a self- massage after surgery to improve the shape and sensation. The use of brassiere all along can diminish the pain and the effect of the gravity. 50. It is dangerous to get pregnant with breast implants? Are they safe for breast feeding? Pregnancy and breast feeding are not contraindicated by implants. Nevertheless it is necessary to keep in mind the use of permanent brassiere and the frequent milk extraction to avoid the inherent pain and complications of breastfeeding. The amount of silicone in milk that can be extracted from a woman with implants is far more inferior to the amount obtained in brand baby formulas.