Consultation with Dr. Hoyos / Virtual Consultation
Consultation with Dr. Hoyos. /virtual consultation - Medical History fill out form
Make a list of all the questions that you have in order to obtain a clear image of the surgery, duration, extension, alternatives and possible complications. Be honest and clear with the surgeon in the results you expect to obtain through the procedure.
Plastic surgery is not an exact science, and each individual responds differently to any surgical procedure. For this reason, it is possible that the results might be lesser than expected.
The doctor will order laboratory tests pertinent to your case. Please follow the instructions given to you and bring the results to your consultation. Follow the preoperative recommendations of your physician, and prepare accordingly.
Lab tests before your surgery
The basic lab tests are:
• BUN (ureic nitrogen)
• CBC (blood work)
• PT PTT (coagulation tests)
• These must be taken in morning hours.
In patient s over 40 years old:
Thoracic X rays: Other laboratories can be ordered according to each individual needs. After obtaining the results of the lab tests, a consultation with the anesthesiologist can be scheduled; appointments with other specialists will be scheduled as needed according to your specific health condition.
Traveling arrangements, hotel and aftercare
Consultation with the anesthesiologist
Ask about the options and risks of anesthesia, and the best choice for you, according to the type of surgery, health and duration of surgery.
Take all the lab test results with you to this appointment, as these results are important to the anesthesiologist. If you have a medical condition, please inform the anesthesiologist (previous records or summary of medical history can be of helpful). Follow the recommendations of the anesthesiologist about fasting time, special care and medications.
Recommendations before the surgery
1 week before surgery:
Remember to stop certain medications as:
• Aspirin or Aspirin-like drugs
• Ginko biloba
• Omega 3,6 acids
• Vitamin E
Any non-prescribed medications as dieting pills, skin care oral tablets, slimming tea or multivitamins.
Medications that should not be stopped:
Doctor’s prescribed medications as: Diabetes therapy (oral or insulin), antihypertensive medicines, Calcium, Vitamin D, thyroid hormone.
Oral contraceptives and hormone replacement therapy.
Please be advised that certain medicines can produce abnormal bleeding, please discuss with your doctor about your specific condition.
The previous night:
1. Take the medication prescribed by the physician.
2. Take a light supper and do not eat heavy meals, do not eat after midnight.
3. Take a shower with betadine soap in the area of the surgery, if you are having body surgery, from the neck down. Do not use common creams or soaps.
4. Remove nail polish, make up and jewelry (piercings, earrings, rings).
The day of the surgery:
1. Remember that you should be fasting unless directed by your doctor.
2. Bring companion (he/she must remain with you until the time you are discharged).
3. Use light sporty clothes, smooth jacket with central rack, closure comfortable socks, and sport shoes.
4. Remove all make-up, including nail polish, acrylic nails and detachable eyelashes.
5. Remove contact lenses; warn to the medical personnel about dental prostheses.
6. Please leave valuable objects at home, do not bring accessories or jewelry.
7. Bring objects of personal hygiene of your preference.
Recommendations after surgery and aftercare.
Facial surgery and surgery of the nose:
1. In the case of the nasal surgery, remember that you are going to use an intranasal splint, which will be removed in the first 24 hours. You will not be able to breath through your nose at this moment. After removal, please apply saline solution in each nostril every 4 hours, for the following 7 days to maintain cleansing and permeability of the air passage.
Also, In the dorsum of your nose will be a splint of soft tape and a plastic splint as well. This should be removed and/or replaced by your doctor or trained medical personnel only.
2. In eyelid surgery, please apply to 2 drops of viscotears® in each eye every 4 hours. If you feel intense pain in the eyes, please contact your surgeon. You can use ice or a cold pad over the area, always isolated from humidity. Always request advice from your doctor before using anything on your eyes.
3. In certain facial surgeries some bandages are left in the face or head (facelift, ears, browlift) please do not remove them without medical consent. These will be removed usually within 48 hrs following to the surgery.
Surgery of the breast (augmentation, lifting or reduction).
1. Please avoid lying down completely horizontal or face down, this can increase the inflammation and can alter the outcome of the surgery.
2. Use the medicated support and bandages that are provided for the surgery. Avoid using another type of breast support for 30 days or until your doctor’s approval.
3. You can have abnormal sensations in the breast after surgery, like occasional burning sensation or diminish of sensitivity. These are transitory and will disappear over time.
4. Call your surgeon if you feel: increased and progressive pain, abnormal enlargement in the breasts, or if you notice redness, augmentation of the temperature in the surgical zone or fever.
5. In some cases drainages are left in the inferior part of the breast. These will be removed from 2 to 8 days; nevertheless they need special care like the change of the dressing every 24 hrs. Consult to the nurse about your specific case.
6. Use moisturizing cream in the skin around the surgical area. Do not use it on the surgical wounds.
POST-OP INSTRUCTIONS FOR BODY CONTOURING PATIENTS: LIPOSELECTION, VASER HI DEFINITION , TUMMY TUCK, MINI TUMMY TUCK
1. INCISIONS: Incisions can appear several different ways:
-It may be closed with a small stitch, which will be removed about one week after surgery.
-It may have a drain inserted into the site and sutured into place (refer to DRAIN section).
-It may be left open in order for the fluid to drain out on its own.
One should expect a large volume of blood-tinged anesthetic solution to drain from the incision sites during the first 24 hours. This will vary from patient to patient. In general, the more drainage there is, the less bruising and the swelling there will be. You may have a few incisions drain for up to a week. Even though the fluid is red, it is only about 1% blood with the remainder being local anesthetic and saline. Maxi-pads are recommended for bandages over your drainage sites and an adult diaper for more coverage. These pads must be changed every 4-6 hours to prevent infection. Many patients have found it helpful to utilize a shower curtain or other protective pad on their mattress, underneath the sheets for the first several days after Body contouring procedures.
2. DRAINS: You may have small plastic drains exiting numerous incision sites. These drains are sutured into place and will be pulled after your drainage stops. Typically this is in about 4-7 days, but could be up to two weeks. These drains are there to minimize the chance of seroma complications and to speed up your recovery.
You will need to monitor the amount of fluid that collects in the drains by recording it on the “drain record” form that you received at your pre-operative appointment.
When a drain becomes fairly full, release the small cap at the top and re-close. Take a measurement only after you have released the air and re-closed it. Write down the measurement of fluid. Then proceed to un-cap the bulb again and dump the fluid out into the toilet.
Once you have emptied the bulb, squeeze the bulb to get all of the air out, and re-cap it while you are still squeezing it. This will create suction and allow more fluid to drain.
Repeat this procedure with all other drains.
It is important that you keep track of the drainage from each drain site. Your doctor will need to know this information before he can remove the drain/s.
3. CARE GIVER: You must have someone stay with you for 24 hours after surgery. It is normal for patients to become light headed when rising from a seated or lying position. It is helpful to have someone there to assist you in getting up and around, record your medication intake, and encourage you to eat and drink.
4. SHOWER: You may shower 24 hours after your surgery. If you have drains, put a long shoe lace or pantyhose around your neck and safety pin the drains to that.
5. MEDICATIONS: Post-op medications have been prescribed. If given a sample of Celebrex, take 2 pills the morning before surgery and 1 pill the evening before surgery. Continue taking after surgery. Everything else you will begin after your surgery. Cephalexin (antibiotic) begin taking immediately following your surgery. Percocet or Vicodin/Hydrocodone should be taken as needed for pain. You may switch to Tylenol for pain control at your discretion. Do not combine Tylenol with Percocet or Vicodin. Phenergan can be taken if you experience nausea. If you do experience nausea or vomiting it is probably from to the medication. Please try to take medication with food. If it persists, please contact our office. Lunesta is a sleeping pill and may be taken at night for a full 8 hours sleep. You may experience a metallic taste in your mouth from Lunesta.
If you are unable to take any of these medications, please contact our office so we can arrange for other medications.
6. COMMON SIDE EFFECTS:
-A collection of fluid may develop under the skin and have a “waterbed” appearance. It may make you feel more uncomfortable and swollen. If this occurs, please call us. It is something we can easily address in the office.
-If you have surgery on your lower extremities, you may experience additional swelling in your lower legs, calves and ankles. To minimize the swelling, keep your legs elevated as much as possible for the first 2 weeks.
-Menstrual irregularities with premature or delayed onset of monthly menstruation are a common side effect of any significant surgery.
-Flushing of the face, neck and upper chest may occur after liposuction and may last for a day or two.
-Slight temperature elevation during the first 48 hours after surgery is a natural consequence of the body’s reaction to surgical trauma.
-Bruising varies between each patient. The more extensive the LipoSelection, the more bruising one can expect.
-If you experience constipation it is probably due to the medication. Please try to increase your intake of prunes, fiber, and clear fluids. If it persists, please contact the office.
-Males and females may experience significant swelling in the pubic region after lower abdominal liposuction. Males may need to purchase an Athletic Support Garment for significant genital swelling and elevation of the scrotum is recommended.
7. SORENESS: Post-operative discomfort usually takes the form of deep muscle soreness and usually improves over 2-7days. It is normal to have a pulling or pinching sensation for weeks and sometimes months following surgery. The surgical area may feel numb and you may start to feel lumps or bands of collagen. This is part of the healing process. Stretching is strongly advised and helpful. While stretching, you may feel a ripping sensation. This is normal and you should continue with the stretch and work through it.
8. MASSAGE: Therapeutic massage is very helpful to speed the healing process. Massage may be done as often as every day and as hard as you can tolerate. The lymphatic drainage therapy begins 48 hrs after surgery; schedule the appointment in the aesthetic department according to availability.
9. Whirl-pools and hot tubs are permitted only after your incision sites have closed. This is usually at least one week after surgery.
10. EMOTIONAL RESPONSE: You may experience mild depression the first week after surgery. After this time your mood will improve after you see the swelling and bruising fade.
11. NO SMOKING!!!
12. EXPOSURE TO SUNLIGHT: Scars take at least one year to fade. During this time, you must protect them from the sun. Even through a bathing suit, a good deal of sunlight can reach the skin and cause damage. Wear sunscreen with a SPF of at least 15 at all times when in the sunshine. Be extremely careful if you have areas of reduced sensitivity. The same rules apply for tanning beds.
13. ICE & HEAT: DO NOT apply ice or heat to the surgical areas.
14. GARMENT: Use the garment and the foam vest 24 hrs a day. Only remove them for personal hygiene and for the post op therapy. Please have someone assist you when taking it on and off for the first couple of days because you may become lightheaded. If the neck area was treated and you were given a garment, you must wear it 24 hours a day for 30 days. DO NOT REMOVE IT FOR ANY REASON.
15. DIET: Immediate postoperative period (first 48 hours): Drink plenty of clear fluids. We recommend 8 glasses of water a day. After anesthesia the digestive tract can be slowed down, take only light meals; avoid raw food, raw fish (sushi), spicy and dairy products.
Early recovery period (from day 3 to 14): you will notice an increase in the appetite. Your body is asking for the necessary nutrients for repairing the body after surgery. Have a high protein diet (fish, meat, poultry) and limit the amount of carbs, eat light meals but more often (6 meals a day).
Late recovery period: seek nutritional advice for your individual case. Keep limited ingestion of carbs, start balancing your food including fruits and vegetables in your diet.
16. ACTIVITY: Rest for the first 24 hours. You may resume your normal activities as tolerated. If you experience more than mild swelling or discomfort you may be over doing it. This will not however affect the results of your surgery. 1 week after surgery: walking is acceptable and encouraged. 2 weeks after surgery: start isotonic exercise: jogging, spinning, yoga, stretching exercises. 3 weeks after surgery: isotonic and start isometric exercise: strength and weight lifting.
SPECIAL RECOMMENDATIONS AFTER TUMMY TUCK, MINI-TUMMY TUCK
1. You will remain in the clinic overnight. Bring articles of personal hygiene of your preference. The day of discharge you may choose special transportation service to your residence.
2. Lifting of the abdominal skin is performed to remove the striae (stretch marks) and/or the redundant skin, You must be partially-seated and/or with the knees bended most of the time, do not to walk completely straight within the first 8 days. This assures that the skin does not suffer by the tension.
Supplies to have on hand:
• Shower curtains to be placed over your car seat and mattress
• Depend diapers to help capture most of your drainage
• Maxi pads to place directly on wound site inside of diaper
• Wet-Ones to clean up bathroom
• Old set of sheets & blankets
FYI: Prepare car seat, bed and pathway to restroom to protect areas from drainage.
How to preserve your results
Remember that VHD is only the first step for a life change experience. The two ingredients for success in the long run are Exercise and proper diet.
1. EXERCISE: Rest for the first 24 hours after surgery. You may resume your normal activities as tolerated. If you experience more than mild swelling or discomfort you may be over doing it. This will not however affect the results of your surgery.
1 week after surgery: walking is acceptable and encouraged.
2 weeks after surgery: start isotonic exercise: jogging, spinning, yoga, stretching exercises.
3 weeks after surgery: isotonic and start isometric exercise: strength and weight lifting.
2. Diet: BE AWARE OF THE SCALE NOT THE MIRROR:
After VHD you will notice a big difference in your body image. Also, the way the fat in going to be stored in your body will change: you can increase as much as 20 pounds (10 kilograms) without a significant change in your shape. Remember that your waistline and other key areas will not alter easily with weight gain, so the measuring tape is not an alternative. Be aware of the scale and seek dietary advice for a balanced diet.