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 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 specially 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 that 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 associates and 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.

   

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 patients 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

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