Frequently Asked Questions
So what happens after I contact you?
The first thing I do is to quote you on the basic surgery.
Before booking your flights or accommodation, I first of all send your case study/notes up to the surgeon along with photographs that I get you to send me. Until I hear back from the surgeon as to whether you would be a likely candidate I do not book any transport or accommodation.
What is the service fee I am paying to JBTG?
Most travel agencies charge a service fee for most bookings made. This has come into effect in the last 10 years as most airlines drastically cut or eliminated commissions paid to travel agents. The revenues had to be replaced by some means or most travel agencies would cease to exist. Most people recognise that a service fee is a small price to pay to ensure that your travel is booked safely by an experienced travel agent.
I charge $250NZD for surgery clients who are travelling independently, this covers my negotiations with the surgeons, the bookings of flights and accommodation and the general “go between” involving yourself and the hospital staff. For escorted tours I charge $500 per surgery client as this fee has to cover my flight and accommodation, as gone are the days of free seats on aircraft! (Hence the minimum number of 4 for a group!)
Is my restorative surgery covered in my travel insurance?
No, in New Zealand, elective surgery is not covered. However I am working with a USA insurance company who will cover medical tourism.
Do I have to share a room with someone else on a tour?
Prices are per person based on 2 people sharing, and I endeavour to match you up with another person from the group. However accommodation is easy on the pocket in Thailand and you pay very little more (approx $400-500) for your own room.
What do I need to tell you to pass on to the hospital?
I need photos of the area where you want surgery, I need photos front on, side and at 45% angle, no jewellery and not need to show your head (unless of course its for surgery from neck up!)
Compile a list of the medications you take, if any, and dosage information. This list should include vitamin and mineral supplements and herbal products, as well as drugs or supplements you take only occasionally. Please tell me so that I may pass on to your surgeon, and the anaesthesiologist for the procedure, about every drug – over the counter, prescription or illegal – you take. This is for your own safety. The surgeon and his or her office staff must keep all information about you confidential.
You will also be asked about any allergies you have or if you have ever had a bad reaction to any medications or anaesthesia or to latex.
Make up a list of any other surgeries you have had or major illnesses and when you had them, since you will be asked about these and it can be hard to remember dates sometimes.
You might want to take to your first consultation with your surgeon some old photos of yourself to show what you looked like or photos from magazines to help you convey to your surgeon how you wish to look or what your expectations are. But remember to be realistic in your expectations. You cannot present a photo of a fashion model and say, "Make me look like that." Abdominoplasty can make your stomach look flatter, it cannot give you a "six pack".
What happens at the consultation with my surgeon in Thailand?
At the consultation, you will meet with the surgeon who will perform your surgery.
At the consultation, you may be given an informed consent form. This is a form that outlines all the possible risks of an abdominoplasty that you will have to read and sign if you decide to have the surgery. This piece of paper states that you have been fully informed about all the risks and that you completely understand them.
What happens at the Physical Examination?
The surgeon will examine you. You will be asked to remove your top and bra, and perhaps your panties, and get into an examination gown. A nurse is usually in the room during the examination. Your surgeon will examine your skin condition, type, thinness, and elasticity. He or she will also assess the amount of skin on your body/face to be removed and if muscle repair is necessary. He may pinch or tug on your skin gently to test your laxity. You may be asked to bend over slightly and relax your stomach muscles, he will also take photos. You may feel uncomfortable during this time, so prepare yourself for it.
Question you may like consider asking at your consultation:
1. How extensive will my scars be and where will they be located?
2. Do you believe my goals can be met?
3. How long will the surgery last and how long will I be under anaesthesia?
4. What are the complications for surgery?
5. What kind of anaesthesia do you use for surgery?
6. I have heard that general anaesthesia can make some patients sick to their stomach. What can you do to lessen its effect?
7. Who will administer my anaesthesia?
8. What would you do if I were to have a complication?
9. What types of medications will I be given and which pain medications do you normally prescribe?
10. What tips do you have for me to ease any discomfort and pain?
11. Must I abide by any special diet postoperatively?
12. I take (Fill in the blank – birth control, diet pills, antidepressants, whatever) Will I have any adverse reactions from the prescribed medications or anaesthesia?
13. I have heard Arnica Montana helps with the swelling and bruising if taken before and after my surgery. Do you recommend it? What about bromelain?
14. If I have an emergency the night after surgery, what should I do?
15. How long do you recommend I take off from work, school, etc. to heal properly?
16. When should I expect to look "normal" again?
17. How long after surgery will I be able to walk, exercise, run or participate in contact sports?
18. When will my sutures (stitches) be taken out?
19. Will I have surgical drains?
20. Do you recommend the use of scar gels, silicone sheeting or other remedies?
21. If I develop an infection or" abnormal asymmetry, what is your policy on a revision? Who will pay for a second surgery?
22. Typically, how long do the results of my surgery last?
If you can think of any other questions or additional information you desire to know, ask. The consultation is your time to ask. Don't hesitate to ask or express your concerns.
After the consultation you will be taken by a representative for blood tests, heart tests and any other assessment that is required
How long after the consultation do I receive surgery?
I try to make your appointment the day following your arrival into Thailand, it is usually scheduled in the morning and then surgery is performed either same day or the following day.
Will there be someone there at the hospital other than the staff and do they speak English?
Yes, we have a hospital representative for your comfort. Your surgeon will speak perfect English and most of the nursing staff speaks English as well. However you will find that some of the auxiliary staff do not speak very much English.
How do I get from/to hospital?
As part of the $250 fee to hospital they provide a driver to pick you up at the airport and take you back, and will transport you to and back from every consultation and surgery in an air conditioned vehicle.
Will it be hot in Thailand?
Yes, hot and humid!
The rainy season lasts from July to October and is dominated by the southwest monsoon, during which time rainfall in most of Thailand is at its heaviest. However, like the “cool” season, the name “rainy season” is slightly misleading. While it certainly does rain during this season it’s more likely to consist of flash-flood afternoon downpours than a continual drizzle for days. If you can bear the heat and humidity, the weather in Thailand is typically sunny throughout the rainy season, but when the rain comes, it’s fast and it’s furious.
The weather in Thailand classified as the hot season lasts from March to June when higher relative temperatures and occasional rain are the norm.
Southern Thailand receives perhaps only two or three weeks of “cool” weather in late December or early January. The southern region of Thailand really has only two seasons – “rainy” and dry, not technically experiencing “cool” weather, per se, but featuring glorious sunshine without unbearable heat, beginning in late November and continuing onto April or May.
I'm having a Tummy Tuck/ Breast lift and augmentation in a few months. What type of clothes can I wear after? Many people say that because of the swelling, my clothes won't fit. Should I buy some tracky pant dresses and maternity pants?
It is wise of you to start planning. It is true that after surgery, you will be very swollen and that your regular clothes might not fit.
Most patients prefer clothing that is comfortable and easy to get in and out of. Tops and sports bras that zip in the front are great. It will be uncomfortable for you to try to put a shirt or sweater over your head. Sweatpants work very well as you will have some swelling. Right after surgery you may need clothes that can accommodate swelling. The good news is that after the breast implants your bra size will be larger, and after tummy tuck, you will have a smaller tummy to fit in pants once the swelling resolves.
The use of a post-surgical bra following breast surgery (augmentation, lift, reduction) is for both support and compression. Providing good support is more important than excessive compression. The ‘support’ will decrease post-operative pain and discomfort, reduce early stress on the skin closures, and help reduce dependent swelling within the breast. The ‘compression’ will help reduce swelling and enhance its resolution.
In fact, any type of garment that provides breast support and compression can be utilized. Immediately after the operation, surgeon place patients in a Surgilast tube top. This is a tubular elastic dressing that has a fishnet appearance. It is easy to place and avoids the need to worry about a properly fitting bra. Some patients continue this post-op and others change to a sports or other comfortable bra. I emphasize to my patients that whatever they chose to wear should provide support and compression, but most of all be comfortable. I want my patients to actually wear the garment for its benefits, so I certainly don’t want the garment to increase post-op discomfort.
I recommend that patients wear post-op support and compression (every day, all day) for 6 weeks following surgery. During this time they prefer that they avoid an under wire bra. Patients can begin wearing an under wire bra after their swelling has subsided, the inframammary skin closures are healed and non-tender, and their implants have settled like they would expect.
What should I expect after Facelifts, Eyelifts and Rhinoplasty?
Taking care of your skin after cosmetic surgeries is more complicated than after less invasive procedures because you need to treat your wounds, manage swelling, and keep up with everyday skin care for best results.
To minimize swelling, experts recommend regular use of ice or cold compresses, especially in the first three days after your surgery. Sleeping with you head elevated above your heart will also help avoid an increase in swelling overnight.
As for bruising, ask your surgeon whether you should take Arnica montana, an herbal supplement that may help minimize bruising or discolouration. I also am a big fan of Bromelin tablets (after surgery) which comes from the core of the pineapple. I also recommend eating pineapple leading up to and after surgery.
Even though your face will be sore after cosmetic surgery, it’s important to continue to cleanse your skin regularly to help with healing and avoid build-up in your pores that might lead to breakouts. Try washing with mild astringent pads to cleanse sore areas without applying pressure. Then, be sure to apply a gentle, non-comedogenic moisturizer. Non-comedogenic moisturisers have a lighter feel than regular moisturisers, and many are oil-free, so they won't leave additional oil on your skin. Most labels will advertise if a moisturizer is non-comedogenic or oil-free. Neutrogena and Cetaphil are some of the best names in the field of hypoallergenic and non acenegnic products sold in NZ, in fact Cetaphil can be bought online shopping from Countdown supermarket!
For a face/neck lift immediately after you are in the recovery area after the surgery, your head and neck will be bandaged and probably in a compression type of garment to help reshape the new angle. The use of a compression garment (chin strap) for the first week or two following neck lift surgery helps reduce the bruising and swelling by applying pressure to the surgical area so that fluid and blood will not accumulate under the skin. Your surgeon will give you instructions on keeping your head and neck area completely still. If you need to turn to look at something, turn your entire body not just the neck. Not every surgeon will believe in using compression bandages, so make sure what your plastic surgeon's stance on this.
I have heard that I have to sleep sitting up after surgery, is this true?
Sleeping upright for the first few days after surgery will help decrease some of the swelling, but will not make the implants "drop" faster. You can sleep on your side after about a week or so but should avoid stomach sleeping for a few months. The implants will settle or "drop" naturally over time provided your surgeon created an adequate pocket or space for the implants. This whole process may take up to three months for the implants to soften and settle into their final natural position/shape. . Your plastic surgeon will give you very specific instructions on what bras to wear and exercises/activities to avoid. You should strictly follow these instructions.
The best position to sit and even sleep in after a tummy tuck is the reclined position. One good position to sleep and sit after tummy tuck surgery is to recline in the "beach chair" position with one or two pillows behind your head and one or two pillows behind your knees. It will minimize the tension on your scar while your newly stretched skin relaxes over the days following surgery. Be sure to get up and walk several times a day and exercise your ankles and feet while reclining to prevent blood clots from developing in your legs.
Recovery from a tummy tuck surgery will take some time and, occasionally, it will not be pleasant. An abdominoplasty, especially a full abdominoplasty, is serious surgery. One thing you learn during the recovery is just how often you use your abdominal muscles on any given day!
The evening after your abdominoplasty surgery, you may be groggy from the anaesthetic and/or oral medications. You actually probably won't remember much of the first day or two. You should take it easy.
Tips on Recovery from Tummy Tuck Surgery
When you wake up after tummy tuck surgery, your abdomen may be very swollen and it may be throbbing. Don't wait for pain to be unbearable before you take your pain medication. Take your pain medication on time because that stops the pain before it gets too bad. You will actually use less pain medication if you take it on time than if you wait for the pain to become severe. And pain interferes with healing. There is absolutely no reason to be tough and suffer through the pain.
As the days go on the swelling and pain will dissipate. You may have bruising, but this will go away as well. Make a mental note of this or you may be fall into a depression. Bruising and swelling are normal and only to be expected after most surgeries.
When you leave the hospital or surgical facility, you should receive a list of postoperative instructions and a general advice on the recovery from plastic surgery. This should tell you how often to change the dressings, whether you can shower or take a sponge bath, and what restrictions you have on your movement or activity. The list should also give you things to watch out for, such as an elevated temperature or bleeding from the incision and information on how to contact the surgeon.
The skin on your abdomen may be numb. This is normal. Abdominoplasty involves loosening the skin from its previous attachments and re-draping it. That action, along with the incisions, means that some nerves were cut. Sensation will usually come back gradually over the course of several months. Sometimes, the first thing you will feel in areas that were numb is itchiness or tingling. There is the possibility that sensation in the skin will not come back completely.
Sleep with your head and shoulders elevated for the first week to 14 days or however long your surgeon suggests. Use two or three good fluffy pillows to keep your head up or perhaps a wedge-shaped pillow.
You will be laying down a lot because you will be sore and will have problems standing upright for a week. Sitting may be more comfortable, but still might be a bit much for you. Sleeping may not be a problem, since some pain medications can make you sleepy. The energy that your body will use in healing can also make you feel sleepy, too. Sleeping is actually good for you while you heal.
Getting up and down from a sitting position or in and out of bed will be difficult and will hurt. One trick I learned to get out of bed was to first roll on my side close to the edge of the bed. Then I would let my legs drop over the side of the bed at the same time I pushed my upper body upright with the arm that was underneath me. This way I spared my abdominal muscles a bit of strain. Remember, everything will continue to get easier as the days pass. Full recovery after tummy tuck could be several weeks.
You will have a follow-up visit with your surgeon about 3 or 4 days after your tummy tuck surgery. He or she will check your drains, examine your incision, and generally check to see how you are doing.
Your sutures may be removed 5 to 10 days after surgery, but may be left in for 2 weeks or more. Parts of your incision may heal faster than other parts, so your surgeon may take some sutures out and leaves others in a little longer. While the incision is still open, do not smoke or use nicotine patches or gums. These interfere with healing. Better yet, quit smoking.
The Importance of Post Operative Appointments
Once you have had the surgery it is like being at the half way mark in a long distance race. The recovery part of this procedure takes an enormous amount of patience and fortitude, as the healing process will be changing daily. All post operative appointments are included with your final price that you paid your surgeon. More than likely, the surgeon will lay out in the post operative instructions the appointments and time you are required to come into the office, so that he or she can check your overall status with healing.
Do I see the surgeon again for a check up?
- Your First Post Operative appointment - most plastic surgeons will want to see you after 24 hours.
- This is your first post operative appointment, and it is to gauge how you are doing and to assess your progress since the procedure.
- The Second Post Operative appointment is usually at the end of the first week.
- You will still have sutures in your incisions, so your surgeon might take this appointment to remove them. Most of the time sutures are removed anywhere from 5 - 7 days post op. Your plastic surgeon will check the incision for any unnecessary drainage, and if you have drains you might have these removed at this time.
- The Third Post Operative appointment is usually at the end of the second week.
- You will end up having a few post operative appointments with your surgeon. It is very important to keep all appointments and make sure you are doing everything he wants you to do per his post operative instructions.
Do I have to wear support garments?
Yes you must wear abdominal support garments especially for tummy tuck or breast augmentation or reduction! Your doctor may advise you to wear a support garment around your abdomen. This may be in the form of a wide binder that goes around your abdomen or a girdle-like garment that pulls on or zips up the side. Either will compress your abdomen a bit and help in healing and controlling the swelling. You may even wake up after the surgery with an abdominal binder already on.
You might want to have two or three of the binders or surgical abdominal support garments on hand while you heal, so that you can wear one while you wash the other. Some need to be line-dried and are slow to dry, so having a second or third on hand is a good thing.
Tummy Tuck Recovery Tips from Abdominoplasty Patients
- Buy a six-pack of cotton panties three sizes bigger than you usually get. Nice big old granny panties, not bikinis. A tight elastic band around your sore abdomen is not comfy! If the seams bother you, wear the panties inside out. Wash them first to get out the chemicals and soften them.
- If you have surgical drains, try wearing two pairs of panties and putting the drain bulbs in between. If the bulbs poke you, put a sanitary napkin or a gauze square dressing between the bulb and the inner panty. If that is uncomfortable, just pin the bulbs to your nightie or top or to the top of your pants.
- Ask your plastic surgeon if you can put Bacitracin, Neosporin or another antibiotic ointment on the incision. I did. I found it very soothing, and have healed beautifully. However, some surgeons do not want you to touch the incision any more than is absolutely necessary. Follow your surgeon's instructions.
- If you have extra pillows, especially down ones, put some under your bottom sheet to make a nice soft nest to sleep on. You'll probably be sleeping on your back at first. It can help a lot if you put one or two pillows under your knees. That can help prevent some stretching on your new abdomen.
- Take your pain medications! That is what they're for. And don't forget that it gets better every day!
Will I get Tummy Tuck Scars?
Abdominoplasty is not scar-free surgery. Remember that your abdominoplasty scars will get worse before they get better. Your incision will heal, but scars go through a series of changes before they are completely healed and that can take months. Scars will look their worst at about 3 months after your abdominoplasty surgery. They tend to get very red and thick and raised. Sometimes, if you are cold, they turn a horrible gray-purple. It may take up to a year for your tummy tuck scars to flatten and fade. Most doctors take great care in placing the incisions well below the bikini lines so that they remain hidden, even when you're at the beach! Remember to protect your fresh tummy tuck scars from the sun exposure.
Ask your surgeon about silicone sheeting or other scar minimizing products. These sheets have been shown to help prevent the formation of keloids on your scars and to help flatten old scars, too. Keloids are overgrowths of scar tissue that can form in some wounds. Some people, especially people with medium to dark skin) are prone to developing keloids.
Several of the people on our message board have used silicone sheeting and swear by it. Silicone sheeting is to be used only after your wounds have closed. However, some surgeons instruct their patients to use Steri-Strips rather than silicone sheeting. These are basically medical paper tape and can help flatten and fade scars in the days right after surgery. Steri-Strips can be used on top of suture material and on incisions that are still open.
Will I suffer with depression after Surgery?
Many patients, including me, experience periods of sadness or anxiety as they recover from cosmetic surgery. We begin to second guess ourselves and wonder if we ever should have had the surgery in the first place. We begin to think we are "ugly" and that the bruising and swelling will never go away. If you are feeling like that, you are not alone. In fact, you're quite normal!
How do I have to sleep after a Face/neck lift?
Sleeping in a reclining chair is the best position with your chin up by using a U shaped airplane pillow works best in my practice. I usually suggest that my clients sleep that way for the 10 days however the amount of time to stay elevated after any head and neck surgery is dependent on the amount of bruising and swelling you may have. The main reason to stay elevated is to ensure rapid resolution of your swelling and bruising.
I took with me 2 x inflatable children’s swimming rings, (one for spare in case the first one popped!) I would put it in the hotel bed, cover it with a towel and sit on it; this alleviated any pressure on my tailbone and kept me from slipping down in the bed at night. I also had made a “V” shaped cushion that extended from the top of my spine to my hips, I had it made from quite dense foam and even used it on the plane journey there and back!
When can I get in the shower?
Ask your surgeon when you will be allowed to shower. You will probably be instructed not to take a bath and personally I would use a hand held shower so as not to get stitches wet since sitting in standing water before your incision heals is pretty much asking for an infection! (You will probably be told to avoid swimming until the incision heals, too.) Some surgeons allow you to shower 2 to 3 days after your cosmetic surgery, while others only allow sponge baths until a week afterwards. If you are allowed to shower, you may be asked to wear your support garments, or shower under just a light trickle of water, or with your back to the shower spray. Ask your surgeon for specific showering instructions. Remember, you may feel a bit dizzy or unsteady on your feet due to medications, so be careful in the shower.
When can I go back to work?
You will probably be "out of commission" for at least 2 weeks after your surgery. Your doctor will tell you when you can return to work and to regular activities. However, the more extensive your surgery, the longer the time off from work and other activities will be. Recovery time from surgery varies from person to person. You may need up 6 weeks off for proper healing if you had for example a very extensive abdominoplasty and other surgery. Another factor is what kind of work you do. If you sit at a desk all day you can probably return to your job sooner than if you are a gym teacher or a courier.
You should not resume exercising until your surgeon says you can. Usually this is at least 3 weeks or more after your abdominoplasty surgery, depending on the extent of your surgery. You may also be able to do some exercises or sports before you are allowed to do others. Listen to your body and don't push yourself. Actually, you probably will not think of exercising for at least a few weeks.
Can I walk around after surgery?
You will be encouraged to do a bit of walking every day in the first week and more as the weeks pass. Do it. Walking around helps prevent blood clot formation and eases swelling.
Pain medications (among other drugs) can cause constipation and other digestive problems and can back everything up. You may feel bloated and sometimes even have some intestinal cramps.
Drink plenty of water! This is a big help in keeping you regular and in helping with bloating and other distress. I cannot stress this enough. Some surgeons suggest a mild stool softener a high-fibre cereal after you are finished with your medications. This helps with getting your digestive tract in working order again and helps flush out residual medications and whatnot from the "pipes."
What about Make-up After Cosmetic Surgery?
If your skin is intact and you have no open wounds, you can resume using makeup just a few days after your procedure. After deep chemical peels or ablative laser procedures, however, it’s essential to wait until your epidermis (the top layer of your skin) has fully reformed. Be sure to check with your doctor about makeup use after any cosmetic surgery.
When you do get the go-ahead to use makeup, remember the following tips:
- Go for mineral. Many makeup manufacturers now make mineral-based lines that are gentler on your skin and provide excellent coverage.
- Combat red with green. If you have red skin or purple bruising after cosmetic surgery, a green base will help balance out those colours and give you a more natural-looking skin tone. Top this base with a powder about one shade darker than you usually wear for best results.
I have told you get a bit emotional after surgery, is this true?
I actually got a bit “weepy” after a few days, apparently this is due to the anaesthetic in the system and is quite normal and only lasted a day or so, much like the “baby blues”.
Feelings of sadness after plastic surgery are normal. If you are feeling sad or depressed after surgery, print out this list and read it to yourself. Read it aloud if necessary. What you are feeling is a normal part of healing and recovering from your surgery.
I realise that feelings of sadness do not happen to all people, but that it may happen to me. I know I need to be patient and think positively. Positive thinking promotes better healing and better relaxation. I know I need to wait out my healing period before I pass judgment on how I look. I know I need to follow my surgeon's instructions to increase my chances of having a great result. I know that stress and anxiety can only make matters worse and I will try my best to not let it affect me.
I will be:
• unable to sleep at times
During healing, my body may:
• be asymmetrical
• be lopsided
• be swollen
• be bruised
• be tender to the touch
• be firm or hard
• break out with acne
• experience irritation from the tape or anaesthetic
• have a tingling sensation
• be numb
I also realise that the subtle changes or flaws that I may see in the mirror may not be visible to others because I am my own worst critic. I realise that once I heal, my changes can be seen with the help of before-and-after photos. I realise that if I do not like the end result many months from now, after I am fully healed, I can approach my surgeon about my dissatisfaction.
I know I must not take out my insecurities or anger on my significant other, family, or friends but that sometimes I do need to vent my frustration or sadness. I know I need to keep my chin up and let my body and mind heal because surgery can trigger many emotions. I know that I can always get support from my loved ones and friends.
I know that my state of disarray and my unsure feelings are only temporary. Today, I will smile and remain patient because tomorrow is another day and will bring me one day closer to being fully healed.
Is there anything I can do prior to surgery?
Begin increasing protein intake a few weeks before surgery to build up both your strength and your tissues. Eat high quality proteins such as fish, poultry, eggs, nuts and seeds. High-fibre foods (whole grains, vegetables, fruits and legumes), calcium-rich foods (nuts, fruits, some leafy greens, molasses and small amounts of dairy products), and foods containing essential fatty acids (some nuts, seeds, or vegetable oils) are also helpful. I was told to eat lots of pineapple which I am sure helped me heal quickly.
Try to avoid a lot of dairy products, sweets, and baked goods as well as high saturated fatty foods such as fried foods, heavy meats, and cured meats. Your diet can usually be a little lighter a few days before surgery, emphasising more fruits, vegetables, and liquids. This will help ease the stress on your digestive system. Avoid stimulants such as coffee and sedatives such as alcohol prior to elective surgery.
Your surgeon will want you to avoid alcohol, stop smoking for at least one month and avoid aspirin and ibuprofen for several days before and after surgery. Alcohol, aspirin, and ibuprofen can thin your blood and cause excessive bleeding from the surgical site. Only take the pain medication prescribed by your surgeon, until he tells you otherwise.
Click here for Medications to Avoid Before Surgery