Since 1986           Tel.: (506)2220 0224   Fax: (506)2290 2014  Email: pinosurgery@aol.com     San José, Costa Rica

Going through you surgery Process

The following are some frequently asked questions by our patients:

 

What procedure will be better for mi needs?

When looking for a better appearance you are very aware of your problem areas. But, you might no be so conscious of the approach for achieving the best results.

In order to recommend the best way to address your desires, Dr. Pino has to analyze your case. Photos sent by email or a first consultation are very important tools to help Dr. Pino evaluate your needs.

In your first contacts with us, try to be very explicit in your desires and expectations. That way Dr. Pino will be able to give you all the information you need to make a better surgical decision.

When can I have my procedure done?

Once you decide details on the type of surgery, is time to schedule the procedure. It is very important to know how long you should stay in San Jose after surgery. Recovery time usually is from 7 to 15 days in San Jose, after the surgery. Following that period of time, you may travel back home.

Are there any requirements before the surgery?

Some tests are required in order to assure your safety during the surgery. These tests vary depending on your age and health status.

You must have the following tests done:

A- Patients under 50 years old non-smokers with no chronic diseases:

- Complete Blood count with platelets (CBC)
– Prothrombine Time (PT)
– Partial Thromboplastine Time (PTT)
– HIV
– Hepatitis B and C.

B- Patients all ages with chronic diseases (High Blood Pressure, Diabetes, Asthma, etc)

– All Smokers (more than 10 cigarettes per day)
– Currently non smoker who did smoke for more then 10 years in the past.
– All patients over 50 years old.

- Complete Blood count with platelets (CBC)
– Prothrombine Time (PT)
– Partial Thromboplastine Time (PTT)
– HIV
– Hepatitis B and C.
– BUN (Blood Urea Nitrogen)
– Creatinine
– FSB (Fasting Blood Sugar)

- Thorax X Ray’s, AP and Lateral
– EKG (Electrocardiogram)
– Medical Clearance by a Cardiologist or an Internal Medicine MD.

You should send the tests results to our office as soon as you have them. Our personnel will contact you and advice if everything is clear for surgery. It is important to be in good physical condition and clear before you schedule your surgery.

In order to hold your reservation on the Operating Room, we request a $500 deposit 3 weeks before the scheduled surgery date.

The day before surgery

As soon as your requirements are satisfied and the surgery scheduled we will set a pre operative appointment. The appointment is usually the day before the scheduled procedure. During the consultation we will provide you with instructions to prepare yourself for surgery.

Part of the instructions include the following items:

No food after 10 pm the day before surgery.
No Vitamin E or Aspirin (ASA) one week before and two weeks after.
No smoking one week before and after the surgery.
No Alcoholic beverages 48 hrs before surgery.
Prescriptions of the medications you will need after surgery.
How you should clean the surgical area prior to surgery.
What to expect from your recovery.
What will the outcome be?
At what time you have to be in the clinic the day of your surgery.

Try to clear all your doubts and questions during this consultation because on the day of surgery you may not be able to do so.

Full payment should be done at this point to the receptionist in front desk after your consultation.

The day of surgery

You have to arrange for someone to drive you to and from the clinic. Under the pre operative medication, you will be drowsy and sleepy. You cannot drive by yourself to the Clinic.

Upon your arrival to the Clinic one of our nurses will take you to the pre-operative room and prepare you for surgery.

A surgical gown will be provided and the nurse will give you sedatives that will help you relax and induce sedation. The nurse will get your weight and vital signs and Dr. Pino will take your pre-op pictures and perform surgical markings if necessary.

Once you are properly prepared, we will walk you into the Operation Room. There you will lie on the Operation table. The OR personnel will make you feel comfortable, place you the monitoring devices and an IV solution.

During the Surgery, you will not have any conscience of what is happening nor feel any pain. You will wake up in recovery room.

In recovery room, a nurse will be with you all the time guaranteeing your safety and well-being.

Dr. Pino will visit you constantly and will decide when you are ready to be discharge from the clinic.

We will provide you with postoperative instructions that will help you to take better care of yourself after surgery. A follow up appointment will be scheduled within the first week.

Dr. Pino or his personnel will be available after you are discharged from our facility to respond questions and help you if you need anything surgery related.

Some Remarks by Dr. Ronald Pino

The following remarks concerning your expectations will establish a greater understanding between us.

- The aim of Aesthetic surgery is to make you look as good as possible. It cannot do more than that. If you are expecting a transforming miracle, you will unquestionably be disappointed.

- Surgical results from aesthetic surgery depend on a number of determining factors. Which include (but are not limited to) the physical condition of the skin, the presence or absence of fat, the relative age of the skin, the number and types of wrinkles present, the underlying bone structure, heredity and hormonal influences. Another factor involved in the final result, the healing process, is not entirely within the control of either surgeon or patient.

- Surgery intended to improve sagging tissues, wrinkles or fat necessarily leaves scars. Despite what you may have heard, all surgical scars are permanent and cannot be erased. The plastic surgeon’s job is to place the scars in natural lines or in places where they are least notice-able and more easily camouflaged by make-up.

- Plastic surgery is a combination of art and science but no surgery is an exact science. It is not possible to guarantee a perfect final result.

- In the post-operative period, before you see the improvement in your appearance, you will probably go through a typical period where you can look somewhat battered, uneven and bruised followed by another temporary period when you will look “strange” to yourself. Some patients may experience a temporary period of slight emotional depression right after surgery.
This will be at a time when the patient looks the worst. It is not easy to look swollen and bruised especially when natural expectations are toward an improved appearance. Such feelings are very normal; fortunately, they pass by quickly.

- Each individual varies considerably. Most patients are able to appear in public around three weeks after surgery, although some camouflaging may be needed. You should get aside about three weeks until you become “sociably acceptable”.

- If you have questions about your surgery, be sure to have them answered in advance, either by my office staff or me. Well-meaning friends are not good source of information. Many of my staff has been with me for years. All of them are thoroughly informed, trained and able to answer most questions, which may occur to you. Find out everything you want to know from us. A well-informed happy patient is our ultimate goal.

- Actually, I perform all surgeries on my patients. My trained personnel will assist me. I and my expert team of assistants, who are continually in touch with me, will do the post-operative care and follow-ups. It is not possible for me to see you on all of your post-operative visits or answer all your phone calls. If I am not available, my well-trained staff will carry out your care.

- Perioperative smoking results in significantly higher complication rates (specifically, wound healing complications) that are unrelated to the number of cigarettes smoked. Our experience has shown that we cannot turn a smoker into a nonsmoker. Our experience, however, suggest that extreme discretion should be exercised when offering plastic surgery procedures to smokers. Smokers must know about their possible higher risk for wound healing problems. As we perform the operation we try to be more conservative, mobilize less, remove less tissue, and immobilize the patient in the critical first 3 days to prevent them from smoking. With reference to our anecdotal evidence, we have since noticed a significant reduction in the incidence of wound healing problems.

- The techniques I perform are a compilation of personal experience, ideas gathered over the years from attendance at meetings throughout the world, observation of other surgeons, and by simply keeping my eyes and ears open to my patient’s suggestions. In addition to techniques that are safe and facile, an organized care regimen will be provided from pre to postoperative status in order to obtain consistent, predictable, and aesthetically pleasing results.

Ronald Pino, MD
Certified Plastic Surgeon
Member: American Society Plastic Surgeons
ASPS #7735