Reconstructive plastic surgery, on the other hand, is surgery which attempts to restore form or function. This may involve correction of congenital deformities or abnormalities, restoring portions of the face to a state which may have existed prior to an injury, tumor removal, a previous unsuccessful surgery, improving the function of the nasal airway or visual fields, or reanimating the paralyzed face.
Additionally, one must realize that family, friends, and acquaintances will not necessarily give approval after the surgery has been performed.
Patients should also know that while significant improvement can be seen in the first few weeks after surgery, subtle changes may also occur in the year following surgery and, in some cases, beyond.
Patients receive medicine in the preoperative period, before their arrival in the surgical suite, that will make them very sleepy. Then, in the surgical suite, they receive intravenous medications which help them “go to sleep”. A local anesthetic is used to supplement the “twilight anesthesia” to make a specific area of the patient’s body numb, so that there will be no pain.
Consultation fees are due at the time of the initial visit. Personal check, Master Card and Visa are acceptable forms of payment. Surgical fees are quoted at the end of each individual consultation. If surgery is scheduled, our policy requires all facial plastic surgery fees to be paid in full approximately three weeks prior to the surgery date, or on the day of your preoperative visit. It is customary and appropriate for surgical fees to be paid in advance of elective plastic surgery. The surgeon is then assured the patient is not undertaking elective surgery he/she cannot afford, and that the patient is sincere about proceeding with this treatment. Also, studies indicate this financial arrangement assures a better doctor-patient relationship. If you are interested, personal loans for financing the operation may be arranged with outside sources.
One must remember that all expenses, including a separate fee for the use of an operating room, the anesthesiologists’ services, the cost of prescriptions, and the cost of preoperative laboratory tests, are your responsibility as well.
Insurance companies’ policies vary, and we cannot predict how your company will handle your individual case. There are many different policies with variable allowances and coverage amounts. The staff will assist patients in getting their insurance company’s reimbursement by filling out required forms and submitted reports of the operation. However, my office cannot ethically, and will not, fill out forms in such a way as to make a procedure not appear to be done for cosmetic reasons when, in fact, it is. The patient must remember that health insurance policies are contracts between the insurance company and the patient. You, the patient, not the company, are responsible for charges incurred.
Ultimately, you, the patient, are the only one who can effectively work out any disagreements with reimbursement with your insurance company. You will be billed and expected to pay the portion of the total bill your insurance company does not pay. The only exceptions are those situations where the particular type of insurance plan has an agreement with the surgeon and/or the facility to accept their predetermined usual and customary allowance.
Because you have read the General Information section of this booklet, you are aware of the general concerns of facial plastic surgery and how the business office of my practice operates. Your personal consultation will now be addressed.
Many of the important questions about your contemplated procedure, the degree of expected improvement, and the anticipated length of recovery will be discussed in this section.
Prior to our consultation visit, my office may ask you to complete a medical history questionnaire and to mail or bring it with you. Be sure to list and describe any medical condition(s) and all surgeries you have had in the past or presently have. Please list all allergies, reactions to medicines, soaps, ointments, surgical tape adhesives, etc. In addition, carefully list any and all medications, vitamins, aspirins, or antihistamine decongestants that you take. Be sure to include all dosages of each medication and how often you take them. During your first visit, we will discuss your desires and the conditions that you wish to have corrected or improved. This is followed by an examination and analysis of each condition. I will give you an idea of what I believe can be accomplished in your particular situation. If it is appropriate, we may be able to use video imaging to illustrate what results I think you may expect in your individual case. This is especially helpful for nasal, chin, and neck surgery candidates who can actually visualize what they may look like following the procedure. The expected improvements of each procedure will be discussed, along with the limitations, risks, and alternatives. Please ask any questions that may concern you about the proposed surgical procedure.
In most cases, certain preliminary tests are required, such as blood counts and other laboratory tests. Depending on certain medical disorders, special X-rays, electrocardiograms (EKG’s) or consultations with other medical specialists may also be necessary prior to elective surgery.
Occasionally, I may ask you to return to the office at least one or more times prior to surgery to discuss the proposed surgical improvements. This may be particularly true if I have asked you to see another physician or obtain other medical consultations. An additional visit may also be helpful by allowing you to better understand the surgery you are going to have.
Also, if surgery is scheduled long after our initial consultation, I may ask you to return to the office prior to surgery and conduct the aforementioned steps so as to review and refresh your memory and answer any new questions that you may have.
Most of the facial surgical procedures can be performed on an outpatient basis at the Fedok Plastic Surgery or at South Baldwin Regional Medical Center. I will give you my opinion as to whether the surgical procedure should be completed at these facilities or as a hospital inpatient if your particular insurance dictates such. In either case, you should be prepared to remain in the surgical facility until I believe it is safe for you to return home or to a clinic villa. If you are returning to your home, you must arrange to have someone accompany you home upon discharge, stay with you through the first night and bring you back to the office in the morning. Our staff is able to assist you with arranging villa stays and nursing care.
Certain procedures may be considered by the surgeon to be best performed as an inpatient or hospital outpatient. Patients are hospitalized at South Baldwin Regional Medical Center or at the University of South Alabama Medical Center. The cost generally depends on the type of surgical procedure being completed and the amount of time in the operating room. Costs usually include the operating and recovery room expenses, medications and supplies.
Check with your insurance company to see if your policy will cover any of the above-mentioned incurred expenses at that particular facility.
There are certain medications, vitamins, etc., that I ask you not to take for at least two weeks prior to your surgery. These include Vitamin E (over and above what is already in a multi-vitamin); aspirin and any drugs containing aspirin or aspirin-like ingredients; and most anti-arthritic medicines. These medicines and this vitamin seem to prolong bleeding and increase postoperative bruising. However, medicines that contain acetaminophen can be used safely in place of aspirin for pain. They are available without prescription. Depending on your procedure, you may be able to take any of the non-steroidal anti-inflammatory medicines, such as ibuprofen, up to forty-eight hours prior to surgery. Ask Dr. Fedok or his staff if you have to take such medicines.
I recommend that patients take 500 milligrams of Vitamin C twice a day and one extra-strength multi-vitamin one week prior to surgery, as well as for a minimum of two weeks during the postoperative healing period. While a multi-vitamin may contain Vitamin E, the amount is not so significant as to cause an increase in bleeding.
It is very important that patients follow my instructions. Smoking is not allowed after midnight. I highly suggest that you do not smoke for at least two to three weeks prior to surgery. If you are having a facelift, do not smoke at all until healing has progressed satisfactorily. Smoking has a direct adverse effect on healing because the nicotine diminishes blood blow to the tissues. Also, most patients will not be allowed to eat or drink anything after midnight.
I do require that men shave closely the morning of surgery. Men with beards or mustaches do not have to shave these areas unless they are having a facelift or chin augmentation.
Upon your arrival at the surgery facility, you will receive medications which will make you very sleepy and help relieve any anxieties. Normally, once you arrive in the operating room, you will have an intravenous line in place so that further medicines can be given to assure that you will be “asleep”. Then, a local anesthetic will be given to the area to be operated on which will provide complete anesthesia. Patients who undergo this type of anesthesia may have amnesia regarding the entire surgical experience. This type of anesthesia is used for your comfort and safety. Please, do not worry, you will not “know” what is going on during the course of your surgery, nor will you experience any pain.
During the first morning check, you will be given instructions on how to take care of the surgical area, as well as instructions on taking any medication during the healing period. A return appointment will also be scheduled at that time, usually one full week after surgery. Occasionally, it is necessary to examine some patients more often during the first week, and those appointments will be scheduled accordingly. Appointments will be scheduled during regular office hours.
It is my policy that patients are not charged for visits during the first year, unless there is a new concern that we are focusing on, when they have paid their full surgical fee in advance. Thereafter, the charges are determined on a case-by-case basis.
My goal is to make your entire surgical experience a pleasant and convenient one while striving to achieve a natural appearance for you. As it is very important to me that you thoroughly understand your potential surgery and the policies of my office, please read all the materials and ask any questions you have regarding the procedure you are contemplating during our visits. I believe that an informed, prepared patient has a much better surgical experience than one who is not well-prepared or still has misconceptions about the surgery. Please remember all the information presented in the materials as general, and that there may be exceptions depending on your particular case. I will do my best to inform you about your surgery and its postoperative course, which will often require several visits so that I may monitor the healing process and your progress. These follow-up visits are essential for obtaining the best possible result. Again, please feel free to discuss any special problems with me or the office staff, and we will do our best to help solve them.
I look forward to meeting with you during your upcoming visit. I trust the online brochure will assist you in making the most of your valuable time.