A brief word about correspondence:  Please indicate your full name on all correspondence, as I will file it by name, and retain it for a period of 60-90 days, but will then delete it if there is no further activity. Please keep your own file of such correspondence, as you can forward it to me if you resume correspondence after your files have been deleted from my computer. Post-op patient correspondence files are kept indefinitely.

Find below a questionnaire, and pre-op recommendations.  Let me know if you have further questions.  If you plan to coordinate a consultation  with a surgery date, then sending photos will also be important.  See below:

CERTIFICATIONS:

Certified:  American Board of Plastic Surgery
Member:  American Society of Plastic Surgeons
Member:  American Society for Aesthetic Plastic Surgery

ACCREDITED AMBULATORY SURGERY CENTER:

Our onsite Ambulatory Surgery Center is accredited by: AAAASF (American Association for Accreditation of Ambulatory Surgery Facilities, Inc) 

OUT-OF-TOWN:
We try to tailor out-of-town consultations and surgeries to fall on consecutive days, and do a compressed follow-up, aiming to get patients home on the 3rd or 4th post-op day, but this leads to some logistical hurdles.  Since it may be difficult for patients to describe what I will be seeing at consultation, and since I also need this data well in advance of an out-of-town consultation, I request that patients call the office to talk to the staff about specifics of their health history, as well as habits, such as smoking, chronic medications, and homeopathics.  I also request  that you send (e-mail or post) a  set of preliminary photos (front, both sides, and 45 degree quarter views - no faces). PLEASE WRITE YOUR NAME ON EACH PHOTO BACK. This allows me to make preliminary determinations about the extent of surgery that will be necessary. Because surgical patients may require some assistance in the early hours post-op, it is most important that you have a companion to accompany you at discharge from the surgery center, or we can help you to arrange for this by placing you in touch with a local private-duty nursing agency who can provide this for you on the day of surgery.     I will see out-of-town patients in follow-up on the first and third, or first and second post-op day to be sure that they are doing well, and to address questions regarding recovery.. Fortunately complications of this surgery are uncommon, and the common ones are noted above. Though patients are welcomed to return for follow-up at 3 months, the reality of travel over great distance is that this is seldom done.  I do like to see interval photos at 6 weeks and 12 weeks to be sure that the shape is developing properly.  Also, yearly breast exam with your GYN is recommended, and yearly mammography after the age of 40, unless there is a family history of breast disease which would mandate mammograms at an earlier age.  Currently, some local hotels have favorable rates and comfortable rooms or suites, to make your stay as pleasant as possible.  There are ample activities available for visitors to Richmond, even those who are recuperating from surgery (Museums, Parks, etc).

Those traveling for surgery should have a family member, or companion, accompany them to allow for simple post-op care, transportation, etc.  If you are unaccompanied, you may hire a nurses aide from a local agency to do these things for you in the first 4-8 hours after surgery (Cost: about $15 per hour). 

Information for out of town patients can be found on this page: http://www.advanced-art.com/Guests.htm

Some maps showing where our patients have traveled from are found here:  www.advanced-art.com/Map-Demographics.htm 

About Sending Photos for Breast Reduction:     

• Please send five views, and any special views that show problems if you are inquiring about revision surgery. 
• The photos should be from the front, both sides, and both 45 degree angles. 
• The photos should be taken in good lighting, against a dark background, with arms at the sides, and framed from neck to waist in all views, so that overall body proportion and symmetry can be assessed. 
• Please shoot the photos from an aspect that is about even with the level of your nipples, so that viewing angle will allow assessment of ptosis, etc.  
• Photos taken by bouncing off of a mirror are not acceptable, as they produce too much distortion, especially with the arms lifted. 
•  If you send digital photos, please use JPEG  (.jpg) format, and simply attach them individually, rather than sending a Zip file. Digital  Photos should be 640x480 resolution so that they will not be too large to send, or to view (all digital cameras can be set to this resolution). This may necessitate sending multiple e-mails if your ISP does not allow attachments over 1MB in size.  
• Polaroids or similar types are fine by mail, also, but may delay reply somewhat.

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PRE-OP QUESTIONS:

 

]] SURGERY DATE:
]] NAME: 
]] FULL ADDRESS:
    Street:
    Apt:
    City:                State:             Zip:
]] Phone Number(s) with Area code:
    Home:  (      )
    Work:  (       )
    Cell:    (       )
    Pager: (       )
]] Preferred Stable E-mail Address:
]] Age: 
]] Date of Birth:
]] Social Security number (needed for OR posting):
]] Height:
]] Wt:
]] Current Bra size:      (for breast surgery patients only)
 
]] Do you sag with nipple at or below the level of the folds beneath your breasts?:            
]] What size do you want to achieve?:
     
]] Do you smoke?                How much and how many years?
You will be required to quit if you smoke, and will not be a candidate for
surgery if a breast reduction, major breast lift, facelift, or abdominoplasty is contemplated due the much higher complication risk in smokers.

 

]] Do you have any medical conditions such as: Diabetes, high blood pressure, or heart disease?

Are you presently under the ongoing care of a physician?            Please elaborate:

Do you have a history of previous surgery?                  Procedures:

 

]] List any medications you take regularly and dosages and their reason (include aspirin,
vitamins, Birth control, homeopathics):

 

]] Are you allergic to any medicines?

 

]] How many pregnancies if any?

FOR BREAST REDUCTION PATIENTS: (be sure to send photos from all angles)
]] Have you had any breast surgery in the past?               What?             Result

]] Have you ever had a mammogram?                Results:
If over 40 and you should have a mammogram within a year before surgery.
]] Is there a family history of breast cancer or breast disease?

 

FOR BREAST AUGMENTATION SURGERY PATIENTS:  (be sure to send photos from all angles)
]] Have you had any breast surgery in the past?               What?             Result
]] If you are planning to come for revision of an existing augmentation, when was it done?
 Incision Site:                    Implants over or under the muscle:
 What implant type (silicone or saline):                     High or Moderate Profile:       Smooth or Textured:  
 Anatomical or Round:                            Implant Manufacturer:
 Implant size:                                         Fill volume (for saline):
 Can you obtain your old operative report(s):
 Why do you want/need revision?:

 

]] Have you ever had a mammogram?                Results:
If over 40 and you should have a mammogram within a year before surgery.
]] Is there a family history of breast cancer or breast disease?

 

FOR LIPOSUCTION AND TUMMY TUCK PATIENTS:  (Be sure to send photos of all areas of concern from front, back and sides)
]]Which areas of concern do you think will benefit from liposuction?:
]]Have you had liposuction before?
}}Have you had any abdominal or leg surgery in the past?:        What?:

 

FOR EYELID SURGERY PATIENTS:
]] An eye exam report, including a test for glaucoma and examination of the retina will be needed before surgery. You will need to forward a copy of this report (within the last year) before proceeding.

 

]]]]Please send these answers back to me, and I will save them for your file.

To cut data, use the cursor to highlight it with the left mouse key depressed, and click Ctrl-C.  To paste it, place the cursor on the new document and click Ctrl-V.  Answers can now be added to the pasted document.

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