SCHEDULING YOUR PROCEDURE AT PLASTIC SURGERY CENTER

• After a consultation with your surgeon, your surgery is scheduled by the surgeon’s office. The surgery center will be notified of the type of procedure, time required for surgery and type of anesthesia. Plastic Surgery Center will coordinate care with your surgeon.
• The surgery date and time is a planned time, but may be changed due to special circumstances.
• We will give you as much notice as possible if the surgery time must be changed.

AT THE TIME OF YOUR PRE-OPERATIVE EVALUATION WITH YOUR SURGEON YOU SHOULD:

• Discuss the procedure in detail, review and sign your Surgical Consent form.
• Discuss your medical history and any medications that you are on.
• Inquire if any laboratory testing or EKG is required?
• Discuss your after-care arrangements including your transportation.
• Discuss and learn about any drains or catheters that you may have.
• Discuss your after-care medications. It is recommended that you obtain your after-care medications prior to the day of surgery and have them ready at home.
• Make your first Post-operative appointment for follow-up.
• Discuss contact information for any questions you may have after surgery

PREPARING FOR SURGERY

Where to stay after surgery? You will need to arrange for a postoperative recovery site after leaving the Plastic Surgery Center.

The most appropriate site for postoperative care must be discussed and approved by your surgeon. Your will need an after care provider to assist you after surgery.

The options are:

• Home
• Friend or family members home
• Nurses home
• Motel-Hotel with assistance
• You will not be able to stay at the Plastic Surgery Center. Plastic Surgery Center is an Ambulatory Surgery Center and does not provide overnight stay.

Under certain circumstances, the Plastic Surgery Center and your surgeon may require you to be transferred to a hospital or recovery center for after care. If this occurs, arrangements will be made for transfer and the financial responsibility will be with the patient. It is always good to discuss your health insurance information with your surgeon’s office prior to any procedure.

Who can take care of you after surgery?

• You should have a competent adult as your post-operative care-giver. Spouse, friend or adult child are all reasonable.
• If you do not have access to a family member or friend, the Plastic Surgery Center or your surgeon’s office can help arrange for a post-op care-giver, such as a nurse or other medical professional.
• You must have a physically and emotionally competent adult who is capable of assisting you walk to the bathroom as well as observe and assess your condition.
• Please review your post-op caregiver with your surgeon prior to surgery.
• Minor children are not adequate caregivers.

Transportation

Who can drive you to your post-op recovery site?

• A licensed driver with a private car who is able and prepared to assist you.

Except under very limited circumstances, Plastic Surgery Center does not approve of taxi drivers for transportation after surgery. Such an exception would have to be arranged and authorized prior to your procedure.

When you check in to Plastic Surgery Center on your surgery day, you will be asked to provide the name and phone number of the person picking you up from the surgery center. Pick-up is usually within 1 1/2 hours after completion of surgery, but may be extended. You should be driven home in a vehicle where you can lie down or a seat that reclines. The person picking you up will be given instructions and be asked to park at the rear of the building near the wheelchair access for direct pick-up from the recovery room. Your surgery time or post-op recovery may be delayed and therefore the time for your ride home may be changed. The person providing your ride home must have a flexible schedule.

MEDICATIONS TO AVOID IN THE WEEKS PRIOR TO SURGERY

Aspirin and other NSAID pain medications

Do not take aspirin or any product that contains aspirin, Motrin, ibuprofen, Advil, Aleve, or any anti-inflammatory medications for 2 weeks prior to surgery as these products can interfere with the clotting of blood. Tylenol is permitted at any time. You should notify your surgeon weeks in advance if you are any form of blood thinning medication so appropriate arrangements can be made.

Other medications for health conditions.

At the time of your pre-operative consultation with your surgeon, you should discuss your current medications. Your surgeon will give you information on which medications to take prior to surgery. When you arrive at Plastic Surgery Center, your will be asked to list your medications. It is a good idea to have a list of your medications written out to bring with you.

Herbs and supplements.

At the time of your pre-operative evaluation with your surgeon you should review any herbs/supplements that your are taking and receive instructions on which are allowed or recommended to be discontinued prior to surgery.

OPERATIVE PROCEDURES THAT REQUIRE GENERAL ANESTHESIA

Who are the anesthesiologists?

Anesthesia care providers are either members of Associated Anesthesia Medical Group or directly on the Staff of Plastic Surgery Center. Plastic Surgery Center does not utilize Nurse Anesthetists. Only Board Certified Physician Anesthesiologists are allowed to provide general anesthesia services for our patients. Anesthesia care providers are not employed by Plastic Surgery Center and are independent practitioners.

Typically, Plastic Surgery Center will make arrangements for you for your anesthesia care provider. Special requests are permitted and can be made through your surgeon’s office. The anesthesiologists make great effort to honor special requests, but they are not always possible. If you have any concerns, you should discuss this with your surgeon’s office to make special arrangements.

Phone call on the night before Surgery

Generally, you will receive a phone call from the anesthesiologist the evening prior to surgery to discuss your anesthesia, medications or any questions you may have about the anesthesia. If you are not available the night before, the discussions will occur when you arrive at the Plastic Surgery Center.

Anesthesia fee payment

The fee for anesthesia services is an amount based on the surgeons decisions about the time required for surgery and is determined in quarter hour increments. Payment for Anesthesia services is to be made separately to AAMG (Associated Anesthesia Medical Group) or can be made to your surgeon who will be responsible for AAMG fees. Your surgeon’s office will coordinate that with you. If your surgery is covered by insurance as described above, your insurance carrier will be billed directly by the anesthesia care provider.

LABORATORY AND OTHER TESTS

Blood tests are not routinely required. Some health condition or family history may be an indication for blood tests; this is determined by your surgeon and the anesthesiologist prior to your surgery. This should be discussed with your surgeon at your pre-op visit. If tests are necessary it must be completed no later than 7 days before surgery and in a printed report. Lab work is not done at the Plastic Surgery Center

EKG (electrocardiogram): Required for male patients over 60 year of age and female patient over 65 years of age and to have been done within the year prior to surgery or at the recommendation of your surgeon or the anesthesiologist due to health concerns.

THE NIGHT BEFORE AND THE MORNING OF SURGERY

Generally, you will receive a phone call from the anesthesiologist the evening prior to the procedure for general anesthesia procedures. Please make sure that you have provided the correct phone numbers to your surgeon’s office and have access to your phone the evening prior to the procedure.

Have a light early dinner. Eating light the day prior to surgery can reduce post-operative nausea.

Do not eat or drink anything after 10PM the evening prior to your procedure, except for water and clear liquids which can be taken up until 4 hours prior to your procedure. No alcohol after 10 PM.

Clear Liquids include: Water, carbonated soft drinks, tea or coffee (no milk or creamer), non-pulp fruit juices, Gatorade.

Do not take sleep medicines unless discussed and authorized by your surgeon and anesthesiologist.

At the time of your pre-operative exam you should discuss your medications with your surgeon. You should be instructed on which medications to take or withhold. Discuss which of your normal medicines you can or should not take the night before and morning of surgery. If you are diabetic or have other medical problems the anesthesiologist may give you additional instructions the evening prior to surgery.

No smoking at least 12 hours before surgery. Smoking increases risks associated with surgery. Ideally, cut down or stop smoking as soon as possible prior to the day of surgery. Some surgeries may not be scheduled if you are a smoker.

If you suspect that you are developing or have an illness such as a cold, cough, sore throat, stomach or bowel upset. Notify your surgeon as soon as possible. Your surgery may be cancelled for your safety. Call the PSC front desk at 650-322-6291.

DRESS AND BODY CARE

You should wear your normal under-clothing. Casual, easily removable, front zippered or front button loose fitting tops are preferable. Wear loose easily removable pants, like sweat pants or skirts. Low-heeled slip-on shoes or slippers are preferred. You will be discharged through a private exit.

Blood staining can occur so don’t wear expensive clothing. You should not wear clothes that must be put on over the head. Jewelry and valuables should be left at home. Do not wear any jewelry to the surgery center. Do not wear make-up the day of surgery.

You should shower or bathe the night before or morning of surgery. Do not shave surgical areas the day of surgery. Do not apply creams, moisturizers or perfumes to the skin. Do not apply nail polish.

WHAT TO EXPECT THE DAY OF SURGERY

Please arrive one hour before the scheduled time for surgery. When you arrive, go to the greeting window at Suite A where the receptionist or nurse will meet you. Bring an ID card with you. If your procedure is covered by insurance, please bring your insurance card with you. Feel free to have a friend or family member with you.

You will be walked to the preoperative area.

The Nurse will:

• Escort you to the changing room where you can put on a surgical gown and lock your clothing.
• You will wait in a private preoperative waiting area where you can lie comfortably on a gurney (a small moveable bed).
• The nurse will ask some routine questions about your health, medications, transportation and postoperative arrangements.
• The nurse will put in an intravenous if you are having a local anesthetic.
• A friend or family member can wait with you in the pre-op area.

Your surgeon will:

• Visit with you about 15-30 minutes before your surgery to discuss any questions you may have.
• If required, the surgeon will ink mark the surgical area.

For cases that require an Anesthesiologist, the Anesthesiologist will:

• Visit you about 15-30 minutes before the surgery time
• Discuss and review of the anesthesia plan
• Check your physical condition
• Start an intravenous line
• Answer any questions that you may have

You will then be taken to the operating room.

• The nurses and doctors will attach electronic monitoring devices, compressions boots on your legs to massage you legs during surgery and then the anesthesia and surgery will begin.

AFTER SURGERY

• You will awaken following your surgery in the recovery room with the nurse at your side
• If you are having pain or nausea the anesthesiologist will provide medications
• You will slowly become more alert and after variable time period be ready for discharge.
• You may have a drain tube or urinary catheter. If so, you will be given instruction on how to manage this from your surgeon and discharge nurse.
• Just before discharge your surgeon may visit and check your condition.
• Most patients have poor memory immediately after surgery so you may not remember these events
• You will be given written discharge instructions.
• When at home walking at least 100 feet 3 times per day helps reduce the risk of blood clots. While in bed you should flex and extend your feet at least 10 times every 30 minutes.

Post-surgical problems or questions

• The Plastic Surgery Center does not provide postsurgical care or specific advice regarding you postoperative surgery care.
• You will need to contact your surgeon or the doctor on-call for your surgeon for any post-discharge questions.
• In case of extreme emergency proceed to the nearest emergency room.
• The Plastic Surgery Center will have a nurse give you a routine call the day after surgery.
• At the time of Discharge, you will be given a survey card. We greatly appreciate feed-back on our facility and your care. Your advice only helps improve the care we will provide to others. It is greatly appreciated that you take the time to complete the survey and provide us fee-back.
• Most of all, we hope you will have a pleasant and fulfilling experience at Plastic Surgery Center.

PLASTIC SURGERY CENTER FEES

• Plastic Surgery Center performs both cosmetic surgery procedures as well as reconstructive surgery procedures. Cosmetic surgery is not considered medically necessary by your insurance carrier and therefore, not covered by your insurance. Plastic Surgery Center has a discounted Cosmetic Surgery fee schedule for pre paid cosmetic surgery. In certain conditions, some of your procedure may be considered medically necessary and insurance coverage would apply.
• The Cosmetic Surgery fee is based on the time required in the operating room. The time is in quarter hour increments. This fee is based on the surgical time requirements and any special equipment requested by your surgeon’s office. Your surgeon’s office will determine the time required and notify you of the fee.
• Elective cosmetic surgeries are not covered by insurance and the fee must be paid 2 weeks in advance.
• Plastic Surgery Center accepts the following forms of payment.
  • Check, made out to Plastic Surgery Center, LLC
  • Credit Card
  • Cash

• Plastic Surgery Center does not participate with financing companies or Care Credit. You should contact your surgeon’s office for any questions regarding financing.

INSURANCE COVERAGE FOR RECONSTRUCTIVE SURGERY

Plastic Surgery Center performs reconstructive surgery considered medically necessary by your insurance carrier. Some surgery may be partially or completely covered by your insurance company. This determination will be made through your surgeon’s office in consultation with Plastic Surgery Center.

Some examples of surgeries that may have insurance coverage are:

• Upper eyelid surgery due to visual impairment
• Nasal surgery for breathing problems
• Breast biopsies
• Breast reconstruction after cancer or biopsies
• Breast implant deformity or pain due to capsule contracture.
• Biopsy of any potential tumor of the skin and subcutaneous tissues.
• Breast reduction.
• Repair of birth defects
• Repair of post-traumatic deformities
• Hernia repair
• Scar revisions

If you believe that your surgery is eligible for insurance coverage, talk with your surgeon and office staff. This must be handled by your surgeon’s office several weeks prior to surgery. Prior authorization is usually required for insurance covered procedures.

Steps that will be required:

• A letter with pertinent information and coding from your surgeon to the insurance company.
• Confirmation from the Plastic Surgery Center that your insurance coverage qualifies for the procedure.
• A letter from the insurance company confirming the preauthorization.

HIPPA

Plastic Surgery Center is a private and HIPPA compliant facility. The Plastic Surgery Center HIPPA policy is attached.