Alan M. Greenberg_ MD_ FACOG P. Clay Alexander_ MD_ FACOG

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    Alan M. Greenberg, MD, FACOG                                    P. Clay Alexander, MD, FACOG

                             Liposuction and/or Lipoabdominoplasty
Liposuction and/or Lipoabdominoplasty (Tummy Tuck) Pre-operative Instructions
    Our office wants to provide you with the very best surgical care. You can help to minimize the risk of
    complications by carefully reading and following your pre-operative and post-operative instructions. Please ask
    us to clarify anything you don’t understand.

   DO NOT take ASPIRIN (Anacin, Bufferin, or Baby Aspirin) IBUPROFEN (Advil, Motrin, or Nuprin),
      NAPROXEN (Aleve) or any other non-steroidal anti-inflammatory drugs (NSAIDS) similar to these
      medications for 10 days before surgery; these will promote bleeding and bruising. It is permissible to
      take acetaminophen (Tylenol or Anacin-3). Check the labels of all you medications, even those which
      you purchase without a doctor’s prescription, to be sure you are not taking any aspirin or aspirin-like
      substances. Remove any products containing aspirin from you medicine chest so that you do not
      inadvertently take it during the week before your surgery. Consult your physician before you stop taking
      any prescribed medicines. Please inform us if you are taking any medications to treat arthritis, or any
      blood-thinning (anti-coagulant) medications. Below is a list of medications that must be stopped:

Advil                     Congesprin           Frobe                       Nalfon                     Salsalate
Aleve                     Cope                 4-way Cold Tabs             Naprosyn                   Salsitab
Alcohol                   Coricidin            Garlic Capsules Gelpirin    Naproxen                   Sine Off
Alka Seltzer Amigesic     Corticosteroids      Genpril                     Norgesic                   Sine Aid
Anacin                    Coumadin             Genprin                     Norwich Ex. Strength       Na thiosalicylate
Anaprox                   Darvon ASA           Ginko Biloba                Nuprin                     Soma Compound
Anaproxin                 Darvon Compound      Goody’s Body Pain Haltran   Ocufen                     Suindac
Ansaid                    Daypro               Halprin                     Orudis                     Synalgos DC
APC                       Depakote             Ibuprin                     Oruvail                    Tenacetum-parthenium
Argesic                   Dexamethasone        Ibuprofen                   Oxyphenbutazone            Tolectin
Arthra G                  Diclofenac           Ibuprohm                    Oxybutazone                Tolmetin
Arthropan                 Dipyridamole         Indameth                    Oxaprozin                  Toradol
A.S.A.                    Disalcid             Indocin                     Pamprin                    Trandate
Ascodeen                  Divalproex           Indomethacin                Pepto-Bismol               Rendan
Ascriptin                 Doan’s pills         Ketoprofen                  Percodan                   Tental
Aspergum                  Dolobid              Ketorolac                   Persantine                 Trigesic
Asprin                    Dristan              Lortab ASA                  Phenaphen Phenylbutazone   Trilisate
BC Powder                 Easprin              Magan                       Piroxicarn                 Tusal
Baby Aspirin              Ecorin               Mg Sallicylate              Ponstel                    Vaquish
                                               Meclofenamate                                          Vitamin E
Bayer                     Empirin              Meclofen                    Prednisone                 Voltaren
Brufen                    Emprazil             Medipren                    Quasic                     Warfarin
Bufferin                  Endodan              Mefenamic acid              Relafen                    Willow bark
Butazolidin               Excedrin             Menadob                     Rexolate                   Zactrin
Cephalgesic               Feldene              Midol                       Robasissal                 Zorprin
Cheracol Caps             Fenoprofen           Mobidin                     Roxiprin
Children’s Aspirin        Feverfew             Monogesic                   Rufin
Choline Salicylate        Fiorinal             Motrin                      Saleto
Clinoril                  Flurbiprofen         Nabumetone                  Salflex

         DO NOT drink alcohol for one week prior to surgery. This might cause excessive bleeding.
         DO NOT fast or undergo dramatic weight loss just prior to surgery. You should be on a stable,
          healthy, well-balanced diet for at least 2 weeks before surgery. Liquid diets, extreme low calorie diets,
          and rapid weight loss diets may predispose you to cardiac irregularities, surgical complications, or poor
          wound healing.
         DO NOT take decongestants such as Sudafed or Actifed for 5 days before surgery.

         DO NOT take appetitie suppressants such as phentermine (Fastin) for at least 2 weeks before
         DO NOT take Zoloft or other antidepressants and all herbal remedies, unless specifically approved
          by your surgeon, for two (2) weeks before surgery.
         DO NOT use moisturizers or soap that contains moisturizers for one week before surgery. The ink
          markers used to outline the areas on your body to be treated by liposuction will rub-off too easily if you
          have recently used a moisturizer.
         Antibiotics, such as cefadroxil (Duricef), cephalexin (Keftab) relatives of penicillin, doxycycline
          (Monodox), or ciprofloxacin (Cipro) are to be taken twice daily in order to minimize the risk of a surgical
          infection. Antibiotics should be taken with food to reduce the risk of gastric upset. Start taking you
          antibiotic the day before surgery, and continue until the entire supply is completed. If you surgery is
          scheduled to begin in the early morning (before 9:00 am), taking your antibiotic and eating should be
          postponed until after surgery.
         Lorazepam (Ativan) is a mild sedative and sleeping pill that does not make one feel “drugged.” Surgery
          is more easily tolerated if you are well rested and relaxed. We suggest that you take one Lorazepam the
          night before surgery.


    DO NOT wear unnecessary jewelry, perfume, and minimize use of cosmetics. You may use deodorant.

    DO NOT drive home. Arrange to have someone drive you home after the surgery.

    Diet: You should eat a light, low fat meal, such as toast and juice, fruit, dry cereal and/or non-fat milk no less
    than two hours prior to surgery. Avoid whole milk, cream, butter, cheese and other foods that are high in fat
    content as dietary fat slows digestion and delays stomach emptying. Minimize caffeine intake the day of
    surgery. You will be given a snack as soon as surgery is completed.

    Wear loose clothing. There is usually quite a lot of drainage of slightly blood-tinged anesthetic solution after
    surgery. Since this drainage might stain clothing, choose your clothing with this in mind. Because we will
    apply elastic support garments on top of some bulky absorbent gauze padding, your clothing should be very
    loose and comfortable.

    Women: Wear a comfortable bra that you would not mind getting stained from the blue ink that is used to
    mark the surgical areas. Do no wear an exercise sports bra if you are having liposuction on your abdomen or

    Men: Speedo-type swim trunks are the easiest type of garment to wear into the operating room for surgery.
    Jockey-type underpants are acceptable. Boxer-type underpants are less convenient, and may prevent optimal
    results. Bring extra underpants to wear after surgery.

    Bring warm socks to help keep you feet warm during surgery. If you tend to get cold hands, you are welcome
    to bring clean mittens (no leather gloves) to wear during the surgery. The operating room is kept relatively
    warm at 71 – 74o F.

    Towels & Plastic Sheets. Plan ahead to avoid staining the car seat with blood-tinges anesthetic solution: Bring
    a towel and a plastic sheet (such as a trash can liner) to cover the car seat during your ride home. Prior to
    surgery pad you bed at home and your living room chair with towels and plastic. Be careful to avoid allowing
    drainage to stain carpets.

    Music to relax by: Patients usually enjoy listening to soothing quiet music during surgery. If you have an
    MP3 player or IPOD, you are welcome to bring it with you.

What to Expect on the Day of your Combined Liposuction/Tummy Tuck Procedure

    If you arrive during regular office hours, please check-in at the reception desk in the waiting area. If you
    arrive before office hours, please take a seat in the waiting area until the staff member greets you.

    Upon arriving at Dr. Greenberg’s reception area, you will be greeted and asked to sign your surgical consent
    forms if you have not already done so. You will then be escorted to the operating room. After one last trip to
    the bathroom, pre-operative photographs will be taken and, finally, the areas on your body that are to be treated
    with liposuction are marked with a felt-tip pen. It usually takes about 30 to 45 minutes after arrival before the
    surgery begins. You will take a sedative by mouth after Dr. Greenberg has marked your abdomen.

    For safety purposes we may place an intravenous (IV) access catheter in your arm; it consists of a small plastic
    IV tube with a rubber stopper on the outside through which medications can be injected if needed. A blood
    pressure cuff place on your arm and pulse monitor is placed on your finger.

    Next, a large volume of anesthetic solution is carefully and gently injected into the targeted fat. Once an area of
    fat has been well infiltrated with the anesthetic solutions, the fat is usually completely numb. The infiltration of
    the local anesthetic is a slow, careful process that can take as long to complete as the liposuction itself.

    Following the completion of the liposuction phase of the surgery (usually upper/lower abdomen, flanks and
    hips) the marking of the skin incision for the tummy tuck procedure is performed while standing up.

    Next, you will lie down on the surgical table, the surgical site is scrubbed and the surgical drapes are placed.
    The tummy tuck surgery is then carried out. At the completion of the surgery, absorbent pads are placed over
    the incision. Surgical drains are used when necessary.

    Finally, after the IV-line is discontinued and the post-liposuction compression garment is applied, you are ready
    to go home. Because some of the local anesthetic remains in the area that was treated, you may not feel any
    significant soreness until several hours after the procedure is done. Although you will feel well enough after
    surgery to drive yourself home, you must not do so because large amounts of local anesthetic may cause some

    The Tumescent technique that we use minimizes post-operative discomfort. Because the residual local
    anesthesia lasts for 18 to 36 hours, regular Tylenol is often sufficient to treat post-operative discomfort. You
    will have been given a stronger narcotic prescription in case you need something stronger to control your pain.
    With the Tumescent technique there is usually no post-surgical nausea, nor the unpleasant feeling of a
    “hangover” usually associated with general anesthesia.


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