Pre and Post operative advice

When it comes to submitting yourself to plastic surgery, it is important that you have a good health condition and be a psychologically stable person. A well balanced diet enriched in vitamins and proteins is also recommended.

You will need to avoid smoking two weeks prior to surgery and two weeks afterwards. Nicotine produces problems related to skin blood circulation and affects the healing process of the body. Four weeks before having surgery, you should avoid medications containing aspirin such as Motrin (Ibuprofen) or Alka Seltzer since they can increase bleeding during the operation. Tylenol and acetaminophen are allowed.

If you are younger than 40 years of age, Dr. Chavarría will make a complete blood test when you arrive at Costa Rica. If you older than 40 years of age or if you are younger than this but have a history of diabetes, hypertension, cardiac disease, reumathoid arthritis or other diseases, you must have a general health assessment by an internist or a cardiologist.

For Dr. Chavavarría have a better idea of your personal case and of the surgery you require, it is recommended for you to send photographs: front and sideways of the region of your body you want to be operated on.

When you are ready to schedule surgery, we will review our schedule to determine possible dates that will fit into your time plan. There are certain times of the year when Dr. Chavarría’s surgery schedule is very busy and this will affect how quickly you can have your surgery. Upon scheduling surgery we require a non-refundable 25% deposit to hold the date.

Dr. Chavarría performs surgery in a number of locations. Generally, aesthetic plastic surgery takes place in a Hospital (Clínica Bíblica or Clínica Católica) or in an ambulatory surgery center. The difference in the total cost is between $500 and $1000USD. These facilities meet strict health care guidelines and are equipped with the latest in surgical technology.

After surgery:

•After a Facelift Surgery
It is important for you to rest for several days, reclining with the head elevated to control the swelling. It is normal for incisions to ooze some blood and serum after the procedure and a small level of swelling is to be expected even when the above suggestion is followed. Dr. Chavarría performs a facelift that leaves minimal scars and provides excellent results. The face will usually feel numb and stiff for a time after surgery but this will fade as the days and weeks pass.

Slight discoloration of the skin is usually normal, particularly if the skin is soft. If your skin appears purple and feels hard, Dr. Chavarría should be notified. Pain is usually modest and is responsive to the oral medicine provided. Severe pain should be brought to the doctor's attention. It is often wise to alter the diet temporarily so that foods which are relatively easy to chew are chosen. Facial skin sutures will usually be removed within a week.

After a facelift, you will usually be socially presentable in 7-14 days. The majority of the swelling will also diminish in a few weeks, but patients should be aware that some months of recovery are needed to see the final outcome and fully evaluate the procedure's success.

Most of the time, Dr. Chavarría performs a neck liposuction together with the facelift. Makeup can normally be applied in about 10 days but you should consult with the doctor to see if this is best in your case as slight differences in individual healing may prompt him to ask for you to wait a bit longer. Do not use hair dye until 1 month after the operation.

• After a Neck Liposuction
You should plan to rest for a day or so after surgery, keeping your head elevated to control the swelling. If Dr. Chavarría has prescribed a compressive garment or wrap, this should be used according to his instructions. Generally, you will have to wear it ll day for 7 days and during sleep for 3 weeks. It is quite normal for the tiny incisions to leak some fluid over the first 24 hours or so. Mild to moderate bruising is not unusual and should disappear in 1-2 weeks. The swelling should be soft and relatively non-tender. About half of the post-surgical swelling will vanish within a month, but it will be 3 months before is disappears entirely and the result can be evaluated. Avoid all strenuous activity for 1 week after surgery (you may take non-strenuous walks).

Thereafter, recommencement of your usual activities should be fine. Pain is usually modest and is responsive to the oral medicine provided. Severe pain should be brought to Dr. Chavarría’s attention. When absorbable internal sutures are used in the tiny access incisions, these require no removal. If a suture or two is used externally, the doctor will remove these in about a week. Makeup can usually be used after a week or so but consult the doctor to see if this is best in your case as slight differences in individual healing may prompt him to ask you to wait a bit longer.

• After a Rhinoplasty
It is important for you to rest for several days, reclining with the head elevated to control the swelling. If a dressing has been placed over your head, this should be managed according to Dr. Chavarría’s instructions. However, if significant new pain develops beneath the dressing, it should be removed and the ear examined. Pain is usually modest and is responsive to the oral medicine provided. Severe pain should be brought to the doctor's attention. Soft swelling is usual and there may be some blunting of the shape detail within the contours of the ears. Bruising is usually mild and should be soft.

If an ear turns purple and hard, Dr. Chavarría should be informed. Showering is fine once dressings are off, but cleansing should be limited to allowing water to run over the ears. Incisions may be gently cleansed with half-strength hydrogren peroxide solution if there is any dried blood or serum on the surface of the skin. Avoid all strenuous activity for 2 weeks after surgery. After period post-operative period, gradual resumption of non-contact exercise is fine.

Sutures can usually be removed in about a week and the ears will often be presentable at this time. Most of the swelling disappears within a few weeks. If the doctor has asked you to do so, use a headband over the ears when sleeping until instructed to discontinue its use (approximately 3 weeks).

• After Eyelidplasty
It is important for you to rest for several days, reclining with the head elevated to control the swelling. Intermittent use of cool compresses on the eyelids for a day or two will also help with swelling. The eyelids should be treated quite gently, however, as the skin is thin and fragile. Tearing is normal in the early post-op days and you should use eye drops or ointments as recommended by Dr. Chavarría. If the lining of the eye becomes very irritated or if there is a sensation of "something in the eye" that causes pain, the doctor should be notified. Pain is usually modest and is responsive to the oral medicine provided. Severe pain should be brought to the doctor's attention. It is normal for incisions to ooze some blood and serum after the procedure and soft swelling is to be expected even when the above suggestions are followed. Avoid all strenuous activity for 2 weeks after surgery.

After these 2 weeks, you may begin a gradual resumption of exercise. In many cases there will be bruising ("black and blue") which will vanish over a period of 7 to 14 days. The use of sunglasses while stepping outside is a good idea during this time, both to hide the swelling and to protect the eyes from strain.

Upper eyelid sutures can usually be removed in a few days with lowers removed soon thereafter. The doctor may alter this routine somewhat based upon swelling and the tension observed in the wounds. Most patients will be socially presentable within a week or so. Swelling should completely disappear within two to three weeks. Use of makeup in women can typically be resumed in about 10 days, but consult the doctor to see if this is best in your case.

• After Browlift Surgery
It is important for you to rest for several days, reclining with the head elevated to control the swelling. Avoid all strenuous athletic activity for 2 weeks after surgery; after this, you can gradually recommence exercise. Pain is usually modest and is responsive to the oral medicine provided by Dr. Chavarría. Severe pain should be brought to the doctor's attention. It is normal for incisions to ooze some blood and serum after the procedure and this may dry on the scalp and in the hair. The hair may be gently washed after 24 hours, but one should not scrub the scalp. Water may be allowed to run through the hair during the first days and shampoo may be added thereafter. Absorbable scalp sutures usually require no removal.

When clips of non-absorbable sutures are used, they will usually remain for 10-14 days. Swelling naturally follows surgery and the forehead may look tight and shiny on its surface. You will be presentable in just a few days, but must remember that some weeks will be needed for the swelling to vanish completely.

• After a Breast Augmentation
Right after a breast augmentation surgery, the breasts will be sore and feel quite tight. There is a good deal more pain when the implants have been placed beneath the chest muscle. Oral pain medicine will not remove all soreness, but should make the discomfort quite bearable if used as directed.

Resting and sleeping face up may make you more comfortable. Although lying on one's side is acceptable if you find it comfy; you should not lie on your chest for the first few weeks. If drains were placed by Dr. Chavarría, these will be removed in 3 to 7 days. You will be instructed on how to care for them and in how to empty and measure their output. Keep a record for the doctor so that he can accurately judge when to remove them. Once the drains are removed, you may shower (without scrubbing over the wounds) and pat yourself dry thereafter. It is a good idea to dry the areas of the incisions with cool forced air from a blow dryer to dry the tapes left on the skin. Be careful to test the temperature with your hand before using the dryer. For the first week or two it is preferred that you wear no bra, but simply a loose fitting top. Dr. Chavarría will give you a special bra for the first few weeks for you to us.

After two weeks you can begin to wear a jog bra that is not too tight. By 4 to 6 weeks afterwards, it is fine to invest in some new brassieres. Wounds are closed with internal "absorbable" sutures which require no removal. These will usually be reinforced on the skin surface with tapes. Avoid all strenuous activity for 2 weeks after surgery. After 2 to 4 weeks subsequent to surgery, you can recommence lower body exercises; nonetheless, exercise involving the use of your chest muscles should be postponed until 4 weeks after the operation. You should use some light gauze over your incisions to protect them from your clothes for a week; this way you can avoid any allergic reaction or irritation from dyes or detergents in the cloth. If the gauze becomes lightly stained with a yellow or pinkish fluid, change it as needed.

If tapes left on the skin ("Steri-strips") become loose or fall off, dry the skin and replace them with those provided by the doctor. Sexual intercourse can be resumed after 3 to 4 weeks. When full activities have been resumed, wear good support for your breasts in the form of a well-fitted bra.

• After Breast Lift Mastopexy
A breast lift is often associated with mild/moderate discomfort during the early days after surgery and there may be a bit of a "stinging" sensation in the incisions. The modest pain is responsive to the oral medicine provided but severe pain should be brought to the doctor's attention. There may be some numbness in certain areas of the breast skin, but this will ordinarily resolve over time. You should keep your breasts dry during the first few days, using a bath tub instead of a shower. Once you resume showering (without scrubbing over the wounds), pat yourself dry thereafter. It is a good idea to dry the areas of the incisions with cool forced air from a blow dryer to dry the tapes left on the skin. Be careful to test the temperature with your hand before using the dryer.

For the first week or two, it is preferred for you to wear the surgical bra provided by Dr. Chavarría. After two weeks you can begin to wear a jog bra that is not too tight. You can invest in some new brassieres around 4 to 6 afterwards. Sutures used are of the internal "absorbable" variety and, in general, do not require removal. However, their presence immediately below the skin surface may lead to the exposure of some (called "extrusion" or "spitting"), and these will be removed for you by the doctor.

Avoid all strenuous activity for 2 weeks after surgery. Around 2 to 4 weeks after the surgery, lower body exercise can be recommenced but exercise involving the use of your chest muscles should be postponed until 4 weeks after surgery. Sexual intercourse can be resumed after 3 to 4 weeks. You should use some light gauze over your incisions to protect them from your clothes for a week; this way you can avoid any allergic reaction or irritation from dyes or detergents in the cloth. If the gauze becomes lightly stained with a yellow or pinkish fluid, change it as needed. If tapes left on the skin ("Steri-strips") become loose or fall off, dry the skin and replace them with those provided by Dr. Chavarría. When full activities have been resumed, wear good support for your breasts in the form of a well-fitted bra.

• After Breast Reduction
Breast reduction is often associated with mild/moderate discomfort in the early days, and there may be a bit of "stinging" sensation in the incisions. The usually modest pain is responsive to the oral medicine provided, but severe pain should be brought to Dr. Chavarría’s attention. There may be some numbness in certain areas of the breast skin, but this will ordinarily disappear over time. If a significant reduction has been done, there can be permanent loss of sensation in the nipples. However, some sensation may return over a period of many months. Keep your breasts dry during the first few days, using a tub bath instead of a shower. Once you resume showering (without scrubbing over the wounds), pat yourself dry thereafter. It is a good idea to dry the areas of the incisions with cool forced air from a blow dryer to make the tapes left on the skin dry.

For the first week or two it is preferred that you wear no bra, but simply a loose fitting top. After two weeks you can begin to wear a jog bra that is not too tight. You can invest in some new brassieres around 4 to 6 afterwards. Sutures used are of the internal "absorbable" variety and, in general, do not require removal. However, their presence immediately below the skin surface may lead to the exposure of some (called "extrusion" or "spitting"), and these will be removed for you by the doctor.

Avoid all strenuous activity for 2 weeks after surgery. Around 2 to 4 weeks after the surgery, lower body exercise can be recommenced but exercise involving the use of your chest muscles should be postponed until 4 weeks after surgery. Sexual intercourse can be resumed after 3 to 4 weeks. You should use some light gauze over your incisions to protect them from your clothes for a week; this way you can avoid any allergic reaction or irritation from dyes or detergents in the cloth. If the gauze becomes lightly stained with a yellow or pinkish fluid, change it as needed.

If tapes left on the skin ("Steri-strips") become loose or fall off, dry the skin and replace them with those provided by the doctor. When full activities have been resumed, wear good support for your breasts in the form of a well-fitted bra.

•After a Gynecomastia Surgery
Some soreness and a sense of numbness over the chest is normal after surgery. You need to wear the provided compression garment for two weeks, removing it only for showers. Pain is usually modest and is responsive to the oral medicine provided. Severe pain should be brought to the doctor's attention. If drains were placed by Dr. Chavarría, these will be removed in 3 to 7 days. You will be instructed on how to care for them and in how to empty and measure their output. Keep a record for the doctor so that he can accurately judge when to remove them. Once the drains are removed, you may shower (without scrubbing over the wounds) and pat yourself dry thereafter. It is a good idea to dry the areas of the incisions with cool forced air from a blow dryer to make the tapes left on the skin dry.

When absorbable internal sutures are used in the incisions, these require no removal. If sutures have been used externally, Dr. Chavarría will remove these in about a week. Avoid all strenuous activity for 2 weeks after surgery. Around 2 to 4 weeks after the surgery, lower body exercise can be recommenced but exercise involving the use of your chest muscles should be postponed until 4 weeks after surgery. You should use some light gauze over your incisions to protect them from your clothes for a week; this way you can avoid any allergic reaction or irritation from dyes or detergents in the cloth. If the gauze becomes lightly stained with a yellow or pinkish fluid, change it as needed. If tapes left on the skin ("Steri-strips") become loose or fall off, dry the skin and replace them with those provided by the doctor.

With resumption of chest exercise you will likely feel some tightness and mild discomfort in the chest. Be careful to return to weight-lifting and other heavy exercise gradually so as not to irritate the recovering chest muscles.

• After a Liposuction
You can expect some discomfort after surgery, particularly in the abdomen or lateral thighs if these areas have been treated. Modest pain is responsive to the oral medicine provided by Dr. Chavarría. Severe pain should be brought to his attention immediately. It is quite normal for the tiny incisions to leak a significant amount of fluid over the first 24 hours or so. This is some of the fluid which the doctor infused into the fat at the time of surgery. Be prepared for your clothes to be stained with this and be careful of where you sit or lie down during the first day after surgery to avoid staining. Since your compression garment is likely to become stained with this fluid early on, change it for the second clean garment provided by the doctor and launder the first. After 24 hours you may shower (without scrubbing over the wounds) and pat yourself dry thereafter.

Wear the supplied compression garment at all times for 4 weeks, removing it only to use the toilet or to shower. Mild to moderate bruising is not unusual and should vanish in 2 to 4 weeks. Swelling should be soft and relatively non-tender. About half of the post-surgical swelling will disappear within a month, but it will be 3 months before the whole of the swelling is gone and the results of the operation can be evaluated. When absorbable internal sutures are used in the tiny access incisions, these require no removal. If a suture or two is used externally, the doctor will remove it in about a week.

Avoid all strenuous activity for 2 weeks after surgery (you may take non-strenuous walks). From 2 to 4 weeks after the operation, you can being a slow resumption of your usual activities.

• After a Abdominoplasty Surgery
Abdominoplasty often requires several weeks for full recovery. Early after surgery, the belly feels quite tight and standing up fully straight is often not possible. The need for this "stooped" posture will disappear within 7 to 10 days in most cases. You will initially be most comfortable resting and sleeping by having your back slightly elevated and your knees bent (a "beach chair" position). Soreness is normal and changes with your position; it will produce pain in the early days. Oral pain medicine will not remove all soreness, but should make the discomfort quite bearable if used as directed. The main abdominal wound is closed with internal "absorbable" sutures which require no removal. These will usually be reinforced on the skin surface with tapes. Umbilical sutures may be non-absorbable and will be removed in about two weeks. Ordinarily, drains are left under the skin for removal of serum during the first week after surgery.

You will be instructed on how to care for them and in how to empty and measure their output. Keep a record for the doctor so that he can accurately judge when to remove them. Once the drains are removed, you may shower (without scrubbing over the wounds) and pat yourself dry thereafter. It is a good idea to dry the areas of the incisions with cool forced air from a blow dryer to make the tapes left on the skin dry. Be careful to test the temperature with your hand before using this on your abdomen since the sensation has been diminished in your belly skin and you will want to avoid an inadvertent burn from a hot blow dryer.

You should use some light gauze over your incisions to protect them from your clothes for a week; this way you can avoid any allergic reaction or irritation from dyes or detergents in the cloth. If the gauze becomes lightly stained with a yellow or pinkish fluid, change it as needed. If tapes left on the skin ("Steri-strips") become loose or fall off, dry the skin and replace them with those provided by Dr. Chavarría. During early post-op time, you should assume a balanced diet that is easily digested. Foods that you know to be "gas inducers" for you are best avoided early on since they can add to the uncomfortable tightness in your belly.

If constipation becomes a problem, natural remedies like fruit fiber (e.g. from prunes) or Metamucil are the best first choices. If these fail, a mild laxative such as milk of magnesia may suffice. Consult Dr. Chavarría before taking any stronger medication. Resumption of mild athletic activity that does not stress the abdomen may be initiated two weeks after surgery. Exercises that put a great strain on the abdominal area (like sit ups or crunches) should be put off for 2 to 3 months, so as not to place any muscle tightening at risk.