Pre-Op Care
Instructions

Before your surgery

Get your medical clearance on time. You MUST undergo a full pre-operative medical clearance within 45 days of your surgery date. Your results must be sent to our office 3 weeks prior to your surgery date. Please submit entire lab order results, appropriate imaging results, medical clearance letter, and specialist clearance letter, if applicable, no later than 3 weeks prior to your surgery date. The lab order specific to you is provided after your pre-operative phone call, which will occur 45 to 60 days (about 2 months) before surgery. A member of our pre-op department will contact you then to go over your medical history, determine your lab order, and review all instructions to prepare for surgery. Be ready with questions, take notes and make sure you are not distracted during the call so you can best prepare for your surgery.

Important timelines to keep in mind:

• 60-45 days (about 1 and a half months) before surgery: Schedule your pre-operative phone call with our team. We will call you to schedule it. We just ask that you are in a quiet place, ready to take notes and ask questions.
• 45-30 days (about 4 weeks) before surgery: Have your appointment for your medical clearance. Your lab order will be sent to you after your pre-op phone call.
• 30 days (about 4 weeks) before surgery: Start preparing for surgery. This is when your preparation really kicks into high gear. Below are the dos and don’ts.

Pre-Surgery Dos & Don’ts

First the Don’ts:

• DO NOT take Excedrin, Alka-Seltzer, Goody’s Powder, aspirin, naproxen (Aleve), Midol, ibuprofen (Advil, Motrin) or any nonsteroidal anti-inflammatory drugs (NSAIDs). These medications can cause bleeding, which leads to complications during and after surgery. If you need any pain medication, acetaminophen (Tylenol) is best.
• DO NOT take vitamin E or any other “natural” vitamins, medications or even any herbal supplements. Some examples include: Ginkgo biloba, St. John’s Wort, ginseng, Herbalife products or any herbal teas! These medications cause bleeding and must be avoided.
• DO NOT take any stimulant-type medications or any “workout” or “pre-workout” supplements. Examples include pre-workout stimulant drinks, creatine powders, ephedrine, Hydroxycut or any other “energy drinks.”
• Stop any form of estrogen 30 days (about 4 weeks) before surgery. This includes estradiol, estrogen pills, estrogen patches, estrogen injections, removing NuvaRing, etc. This means that if you are sexually active, you could become pregnant, so please use other forms of birth control during this time. If you are pregnant at the time of surgery, your surgery will be canceled, and fees will apply.
• Do not take any amphetamines 30 days (about 4 weeks) before surgery. These include: Adderall, phentermine, dextroamphetamine, Ritalin, etc.

If you are taking any weight loss medications:

• Stop taking semaglutide (GLP-1 antagonists), Ozempic, Wegovy, etc. at least 30 days (about 4 weeks) before surgery. These medications cause delayed gastric emptying and can cause complications when under general anesthesia.
• Stop taking phentermine 30 days (about 4 weeks) before surgery. This supplement will show on the drug screening on the day of surgery, forcing the cancellation of your surgery.

If you smoke, stop immediately.

• Smoking or the use of nicotine will jeopardize the results of your operation. Nicotine can cause wounds to separate, resulting in widened and thickened scars, skin necrosis, fat cell death, blood clots and other complications.
• To ensure there is no nicotine in your system, you must stop using nicotine products for 6 weeks (about 1 and a half months) before surgery and 6 weeks (about 1 and a half months) afterward. This includes, but is not limited to: hookah, nicotine vapes or pens, tobacco rolling paper for marijuana, nicotine gum, nicotine patches, and even secondhand smoke from bars/clubs or family members in the home or car.
• Please note that if the nicotine test shows positive at the drug screening on the day of surgery, your surgery will be canceled, and you will have to pay a $1500 rescheduling fee to get back on the surgery schedule.

Now the Do’s:

Start your iron regimen ASAP, but at a minimum of 30 days (about 4 weeks) before surgery. Take the following supplements to increase the hemoglobin in your blood. These can be found at your local pharmacy:

• Vitamin C: 1000 mg daily
• Folic Acid: 400 mcg daily
• Hema-Plex: As directed on the label
• Floradix: As directed on the label

Make sure you have someone to take care of you after surgery. YOU MUST arrange to have a responsible adult over the age of 18 drive you home after surgery and stay with you for the first 48 hours (about 2 days) after your surgery. Please let us know who that person is at your pre-op appointment. If you do not have someone, we can help you find a paid caretaker. You cannot take a taxi or an Uber/Lyft after your surgery. If you do not have someone to pick you up, we will not be able to perform your surgery and cancellation fees will apply.

• We have recently put together a post-op care package that includes a hotel stay and post-op care at the hotel. If you are interested in this package, please contact your coordinator.

YOU MUST send us your lab work and medical clearance(s) 3 weeks before your surgery. If you do not provide us with the medical clearance in a timely fashion, your surgery may be canceled.

If you develop any signs of an infection within the two weeks prior to your surgery, please call the office. Symptoms can include: burning on urination or urinary hesitancy/urgency/frequency (signs of UTI); any coughing, sneezing, runny nose, chest congestion or sinus/ear pressure (signs of an upper respiratory infection); any diarrhea, nausea, vomiting or abdominal pain (gastroenteritis symptoms).

Eat healthy, balanced meals. Good nutrition is important to make sure you are prepared for surgery and to help you recover after surgery. Weight gain will increase your risk of surgical complications and can cause an unfavorable aesthetic result. If you gain more than 5 pounds between the time the surgeon evaluates you and the day of your actual surgery, the procedure may be canceled unless you were asked by the surgeon to gain weight for your procedure. Please pay close attention to your surgeon’s BMI limit and be careful not to go over the maximum BMI per your surgeon’s guidelines. Use a BMI calculator online to calculate your BMI and make sure you are under 30 BMI for surgery with Dr. Earle, under 33.5 for surgery with Dr. Vidal and under 34 for surgery with Dr. Wegerif.

The week before your surgery:

• Hydrate: drink at least 8-10 glasses of water a day during the week leading up to your surgery. This will improve your hydration and improve your recovery after surgery.
• Use Hibiclens (chlorhexidine) soap or Dial antibacterial soap to wash yourself daily for 5 days prior to surgery and on the morning of surgery. You can purchase these soaps at any pharmacy. This will reduce your chances of an infection after surgery.
• Start using Mupirocin 2% ointment twice a day on your nostrils. You can start this 5 days before your surgery. This will reduce your risk of an infection, as bacteria accumulate in the inner nostrils. Ask your primary care physician (PCP) to prescribe it for you. If you can’t get a prescription from your PCP, please send your pharmacy name and address for our medical staff to send the ointment to your local pharmacy.
• The night before your surgery, you will get a message with the time of your surgery and the final instructions. Please pay close attention to this message and follow all instructions. Remember, do not eat or drink for at least 8 hours before your surgery.

After Surgery

1. PLEASE START WALKING IMMEDIATELY upon arrival to your home the afternoon /evening of surgery. You must start to get out of bed and walk immediately to reduce the chances of developing a blood clot in your legs that can travel to your heart/lungs and be potentially fatal.

2. Please resume your blood pressure medication after surgery and take it as usual.

3. DO NOT travel outside of Miami, FL for 5-7 days after surgery. Doing so will put you at an unnecessarily increased risk of developing a blood clot that can travel to your heart/lungs and be potentially fatal.

a. When you go back home after waiting the full 5 days after surgery you MUST stand and walk once every hour while on ANY form of transportation. That means if you are driving you must stop the car and walk every hour on the ride home.

b. If you decide to travel before the 5 days of surgery your operation will be canceled.

c. If you travel before the 5 days without the knowledge of the surgeon you are assuming all risks which can include but are not limited to, blood clots, stroke, heart attack and possible death.

4. NO lifting of any objects > 5 pounds for the first 6 weeks after surgery.

5. NO bending at the waist or performing chores at home including emptying the dishwasher, bending over to fold laundry, using a mop/vacuum/broom, straining to reach an object overhead in a cabinet, etc…Please use common sense and do not perform any vigorous movement or activity for 6 weeks. After the 6 weeks, you can be cleared for activity after discussion with your surgeon’s office.

6. DO NOT shower or wet any of your wounds for 24 hours after your operation. Once 24 hours have passed you can gently shower your wounds and clean them with warm soap and water ONLY.

a. DO NOT rub your wounds aggressively and do not remove any steri strips (if they were used for your particular surgery).

7. DO NOT apply any creams, antibacterial products/ointments, scar creams, or any natural remedies (ex: arnica) on your wounds until the surgeon has allowed you to do so and has examined all of your wounds.

8. DO NOT soak your wounds in any body of water to include: pool, bathtub, ocean/beach, jacuzzi, hot tub, or even expose yourself to a sauna for 6 weeks after surgery!!!

9. Wear comfortable and loose-fitting clothes that do not require lifting your arms above your head to put on clothing. This will decrease the chances of stretching and disrupting your healing wounds.

a. Liposuction patients ALL require compression garments to be worn for at minimum one month but preferably 6 weeks after surgery 23 hours a day (we will let you know more details during your follow-up visits). After 6 weeks, you can use the compression garments for 12 hours a day for another 6 more weeks. After that, use the garment as needed.

b. Drainage and lymphatic massages are encouraged. At a minimum 10 massages are recommended during the first 3 weeks post-op for all liposuction surgery patients. Then continue as needed to decrease inflammation and prevent fibrosis.

10. For face procedures: NO makeup, eyeliner, eyeshadow, mascara, lipstick, etc for 4 weeks after surgery.

a. Facelift patients must avoid placing any jewelry on their neck or ears until having seen the surgeon.

b. You must avoid any and all sun exposure until cleared by the surgeon.