How do I prepare for surgery?

Do I need someone to stay with me?

Yes! You will need someone to drive you and pick you up from surgery. This is a very important person, because they will need to receive instructions about your safety and care immediately after surgery. They do not need to be a nurse, but they do need to be a trusted person who will follow instructions and stay with you for at least the first 24 hours, or until you are safe to drive again. In the event of any rare complication, you will need someone to help you reach emergency medical care. The start time of your surgery can change, so this person needs to be available at all times on the day of your surgery.

What types of supplies should I have on hand before surgery?

The list varies depending on the surgery you are having, but it is good to have ibuprofen, Tylenol, milk of magnesia, Vaseline, hydrogen peroxide, saline eye drops, hard candy (in case of a sore throat) and cotton tip applicators. Please fill your prescriptions prior to surgery and have your caregiver bring them when they come to pick you up at the surgery center.

What types of food should I have on hand after surgery?

Anything you like! Your activity levels will be low and we expect your appetite to be less than normal. When you do eat, focus on yummy but healthy foods in small quantities, like protein drinks. Let your appetite be your guide. Hydration and healthy snacks that are easy to prepare are the best. If you are typically the one to prepare food for your family, plan ahead and get stuff in the freezer!

How many days will I need to take off work? How long before I can take care of my children?

This depends on the surgery! For large surgeries, I tell all patients to take a week off from work and plan to do a bit of part time the following week if you need to. Arrange for alternative childcare the first week. You will find that after surgery, you will tire more easily and have greater difficulty concentrating during the main healing phase, which can last up to 6 weeks for many surgeries. 

What if I get sick prior to surgery?

RESCHEDULE.  Everyone gets sick. I know it is inconvenient FOR EVERYONE, but you will have a difficult time after surgery and the chances of complications and poor healing increase significantly if you are also fighting an illness when you have surgery. The sooner you let us know, the more options we have to rearrange our schedule.

Is it better to schedule multiple procedures at the same time?

This seems like a good idea because we are very busy and combining surgeries seems more efficient. When possible, however, I favor splitting procedures into separate sessions. For body surgery the recovery process must be taken into consideration. For surgeries where the recovery is not such a limiting safety factor, I love to combine procedures to help you get a more natural outcome. When a second stage is planned, small revisions to the original surgical area can be performed at that time, which is another big advantage of splitting procedures.

How long should I plan before returning to exercise?

I like to let patients be their own judge of activity levels after surgery. Please know this is NOT what the vast majority of plastic surgeons would say. Pain and fatigue are nature’s way of making sure you are aware of the need to rest parts of the body, which are recovering from injury.  LISTEN TO YOUR BODY. Most people feel better with small amounts of activity initially, followed by a return to full activity levels at about 3-4 weeks.

What should I do if I live out of town?

We have many out of state patients! This situation is less convenient, but the vast majority of people can be discharged home immediately after surgery with a planned follow up in 5-7 days. Depending on how far away you live, it may be best to plan to stay for a full week. You may need additional visits in the first month after surgery, so additional trips may be required. We have found that we are able to maintain good communication with our patients as long as you are willing to text/call/email with photos.

Is it OK to travel after surgery?

Yes. Depending on the surgery, it is safe to travel after the first 2-3 days. If you go out of town for a vacation, remember NO hot tubs and please consider staying in an area which has access to medical care in the event you need assistance for up to 30 days after your surgery. Where possible, it is best not to plan any important travel for 30 days after surgery in the event you need additional post operative care and attention.

Are there any financing options for surgery? 

Yes! Surgery is an investment with benefits which should last a lifetime. When financially planning for surgery, budget for the possibility of additional procedures or medical expenses. HSA accounts can in some cases be used. We offer financing through Care Credit – 6 months deferred interest or 24/36 months at 14.99/15.99%. The financing can be a great deal ONLY if you understand the terms and do not make late payments. My office is expert in these issues and are very happy to help you research this option. http://angelakeen.com/financing-options/

How do I talk to my family about surgery?

This is a great question. I typically find that patients need privacy before surgery. After surgery they are in a much better position to share their story. Family is ironically very bad at separating their interests from yours. For that reason, they often give you their feelings (which have nothing to do with your perspective) about surgery rather than the support you might be looking for. I find that only the plastic surgery patient understands the issues involved with their decision to proceed with surgery. You will need at least one very good support person. If you need suggestions on how to talk to coworkers or family, please ask! You are not alone and we are here to help!

Will insurance cover my surgery?

In my practice, we do not accept insurance. Even though our surgery offers tremendous health and wellness benefits, insurances almost universally do not cover cosmetic surgeries. In cases where your plan claims to offer coverage, the process is time consuming, uncertain and adds a level of stress and frustration, which should have no place in elective medical care. 

Will my health insurance cover medical problems after surgery?

You need to have a plan to cover additional expenses which may result from an unplanned emergency after surgery. There are some policies which may deny insurance assistance with hospitalizations related to cosmetic surgery.

Should I be at my ideal body weight before surgery?

Preferably you should be within 10 pounds of your goal weight before surgery. Being near your ideal weight is important for all types of surgery – breast, body, and face! If you are happy and stable in your weight or you are within 10 pounds of your ideal weight, you are a very good candidate for surgery.  If you have a BMI over 30 https://www.cdc.gov/healthyweight/assessing/bmi/adult_bmi/english_bmi_calculator/bmi_calculator.html, I do not advise surgery until you have met some initial weight loss goals. Gaining weight after surgery will exaggerate any areas of swelling or imperfections and stress your scars. Losing weight can cause other problems especially for breast surgery. We recommend close monitoring of weight before and after surgery. After surgeries like tummy tuck, liposuction, or breast reduction, you will have a new lower baseline weight to maintain. Significant weight gain prior to surgery may be an indication to reschedule your procedure.

I struggle with my weight. What is the best way to lose (gain) weight before surgery?

It is best to schedule surgery when you are at a stable weight. Losing weight quickly is always a stress on your system. Any nutritional deficiencies will make your healing riskier and prone to complication. A combination of fewer calories (or more if you need to gain weight) with more muscle building and cardiovascular activities is the right formula for everyone. For most people this means slowing down other parts of your life and investing more time in the planning of and enjoyment of eating and activity tailored to your own needs. This is hard, but generally what’s good for you is good for those around you! Healthy foods can cause weight gain if eaten excess and people who struggle with weight can achieve a healthy BMI. Believing you can do it and getting the right advice is something that can take a year or more. Make yourself the priority for a while, or forever?! This is the key to the best outcomes from surgery. If your BMI falls outside of the normal range, please contact our office so we can help you get started; [email protected].

Do I need medical clearance from my doctor for surgery?

If you are under the care of a physician for any medical conditions you will need an updated visit prior to surgery. Many offices are happy to help you if you say you need clearance for an elective surgery. If you have not had a general medical exam, we recommend you schedule one to review things like basic lab values, immunizations, and blood pressure check prior to your consultation. Our nurse can review your history and help you schedule the right type of consultation if needed. [email protected]

What if I need to schedule another type of surgery prior to my surgery with Dr Keen?

If you require another type of surgery, it is best to wait a full month before or after your surgery with Dr Keen. This is in case you have any special healing requirements that need to be carefully followed by your surgeon. Too many caregivers can confuse your care. Your system also needs time to recover which may be more or less than 30 days depending on the surgery you need.