• STOP SMOKING: Smoking reduces circulation to the skin and impedes healing. It is best to avoid smoking, second hand smoke and cigarette replacements, such as nicotine patches or gum, in the perioperative period.  While you should ideally stop smoking for 4 weeks before and after your surgical procedure, please tell our surgeon of any smoking history well in advance of surgery.
• TAKE MULTIVITAMINS: Start taking multivitamins twice daily to improve your general health once you have scheduled your surgery.
• TAKE VITAMIN C: Start taking 500 mg of Vitamin C twice daily to promote healing.
• START TAKING AN IRON SUPPLEMENT: A good iron supplement, such as Feosol Spansules, is required starting one week before surgery and four weeks following surgery. Bowel movements may appear darker than usual as a result. Feosol is available without prescription.
• DO NOT TAKE ASPIRIN OR IBUPROFEN: Stop taking medications containing aspirin or ibuprofen. Review the list of drugs containing aspirin and ibuprofen carefully. Such drugs can cause bleeding problems during and after surgery. Instead, use medications containing acetaminophen (such as Tylenol).
• LIMIT VITAMIN E: Limit your intake of Vitamin E to less than 400 mg per day.
• FILL YOUR PRESCRIPTIONS: You will be given prescriptions for medications. Please have them filled BEFORE the day of surgery and bring them with you.
• CONFIRM SURGERY TIME: We will call you to confirm the time of your surgery. If you are not going to be at home or at your office, please call us to confirm at +1 (619) 598 – 2517.
• PRESCRIPTIONS: Make sure that you have filled the prescriptions you were given and set the medications out to bring with you tomorrow. Make sure to have the number for your pharmacy ready so that if Dr. Hughes and associates need to call in any special medications for you on your day of surgery they will have that information readily available.
• CLEANSING: The night before surgery, shower and wash the surgical areas with an antibacterial soap.
• EATING AND DRINKING: Do not eat or drink anything after 12:00 midnight except for a small amount of water to rinse your mouth while brushing your teeth.
• SPECIAL INFORMATION: Do not eat or drink anything! If you take a daily medication, you may take it with a sip of water in the early morning.
• ORAL HYGIENE: You may brush your teeth but do not swallow the water.
• MAKE-UP: Please do not wear moisturizers, creams, lotions, or makeup.
• CLOTHING: Wear only comfortable, loose-fitting clothing that does not go over your head. NO TIGHT PANTS. Remove hairpins, wigs, and jewelry. Please do not bring valuables with you.  TAKE OUT ALL PIERCINGS and REMOVE ALL ARTIFICIAL FINGERNAILS prior to surgery
• CHECK IN/PREPARATION: You should plan to arrive earlier than your scheduled surgery time. DO NOT BE LATE.  Patients less than 18 years old must be accompanied by a parent or legal guardian.
• CARETAKER: Someone must spend the first night after surgery with you.

ACTIVITY

1. The first week you will need to rest frequently. You need to walk around the house as tolerated. Avoid stairs if possible.
2. For the first six weeks post-op sleep on your stomach (unless our surgeon advises you otherwise, particularly when multiple surgeries are performed at the same time).
   
3. Avoid picking anything up greater than 5 lbs the first 4 to 6 weeks.
4. No exercise for 4 to 6 weeks.
5. No sitting for greater than 30 minutes for the first 6 weeks. Take a short break of standing after 30 minutes of sitting, and then you may resume sitting.
6. When you are sitting, place a pillow under your thighs to elevate the buttocks and eliminate pressure on the buttocks.
7. You may not drive the first week or while you are taking pain medication. After that it will depend on your ability to handle a car without causing any discomfort. You should wear your seatbelt at all times.
8. Do not engage in sexual activity at least 4-6 weeks after your surgery.
9. No smoking. This will interfere with your healing and the fat may not live.

DIET

1. Eat light the first 24 hours, clear liquids advancing to a regular diet as tolerated.
2. Patients are instructed to eat 100 grams of protein each day.  If there is a doubt as the consumption, please obtain the necessary protein from protein shakes.  Premier Protein shakes contain 30 grams of protein and only 160 calories.  3 shakes a day with balanced meals should be sufficient to meet these requirements.  Protein intake is essential to prevent healing complications like incisions opening and you must follow these instructions.
3. If you have persistent nausea stick to a bland diet until it subsides.
4. Avoid foods that can cause a lot of gas. This can cause abdominal distention and undue discomfort. Small frequent meals are best.
5. The pain medicine may cause constipation. Drink plenty of fluids. You may take any over the counter laxatives or stool softeners as needed.

DRESSINGS

1. You will have abdominal binder over your abdominal dressings. Change dressings as needed. YOU SHOULD WEAR THE BINDER 24-7 FOR 6 WEEKS, ONLY REMOVE FOR SHOWERING.
2. It is normal to have numbness over the surgical sites for several weeks or months.
3. Do not use a heating pad or ice around the surgical sites. It could cause a burn.
4. You may place new dressings if they become saturated and put on the same garment as instructed, making sure to have the garment covering pubic area.
5. It is normal to see lots of drainage on abdominal dressings. Our surgeon inserts several liters of fluid, and this fluid must either drain out or be absorbed.  It will have blood within it and will be red or pink, but this is not dangerous or a cause for concern.
   
6. When drainage has stopped, you may replace the dressings with a cotton T-shirt and place the garment other the T-shirt as previously instructed.
7. Dr. Camacho-Melo will advise you about showering.  It is essential that fluid not get into any of your incisions as the bacteria on your skin can migrate into the areas of fat transfer and cause an infection.  This occurs in about 3 out of 100 patients.  Our surgeon recommends cleansing the skin around the incisions (sponge baths, bird baths) for at least the first 2 weeks.  Also, patients should be in air-conditioned dwellings so that patients are not sweating either (for similar reasons).

MEDICATIONS

1. Take your antibiotic until it is completed.
2. If the pain medication is a narcotic it should be taken as prescribed. Do not take any Tylenol while on pain medication. The medication we prescribe may already have Tylenol in it.
3. Do not drink alcohol or drive a car while taking pain medication.
4. The pain medication may cause nausea and should be taken with food or protein shake at each dose.
5. You may resume your regular medication after your surgery except for Vitamin E, Ibuprofen (Motrin, Advil), Fish oil and Aspirin (wait at least 2 weeks post-op).
6. If you take aspirin or coumadin check with the doctor to see when you may resume them.

CALL THE OFFICE IF YOU HAVE:

1. A temperature greater than 101.5 degrees.
2. A sudden increase in pain.
3. If you have persistent vomiting.