Pre-Op Instructions
We are so excited to partner with you in this transformational journey! We are here to support you and help you every step of the way, so please, if you have any questions or need further clarification, do not hesitate to ask. We love it when our patients are prepared, and we will do our best to help you achieve that! Here is some information that you need to know in order to prepare for your surgery.
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.
The Day of Surgery
Your day has arrived! You will be excited, nervous, anxious, happy, relaxed… So many mixed feelings. Do not worry — we are here to support you every step of the way! Here are some final reminders to help the day go smoothly:
- Plan to leave all your personal belongings at home or at the hotel if you are traveling from out of town. This includes your jewelry, cell phone, watch, etc.
- Dress comfortably and with clothing that will be easy to put on and take off after your surgery. Consider:
- Slide-on shoes
- Extra pair of warm socks to wear in the post-anesthesia care unit (PACU)
- A loose dress or top that zips or buttons in the front, particularly if you are having a breast procedure
- You should shower one more time before leaving for the surgery center with the Hibiclens or Dial soap, but do not wash your hair. Do not go into surgery with wet hair. It can make your body very cold during anesthesia.
- Please do not wear any makeup or jewelry. This includes removing any piercings. Also, remove any acrylic nails and nail polish so we can safely monitor your oxygen saturation during surgery.
- If you get your period (and this happens often), please wear a pad. Do not wear a tampon.
- If you take prescribed beta blocker antihypertensives or thyroid medications, please take them the morning of surgery with a sip of water, or even better without water.
- DO NOT take an ACE Inhibitor (lisinopril, captopril, etc.) or an angiotensin receptor blocking (ARB) medication (losartan, Avapro, Benicar, etc) the morning of surgery.
- DO NOT take any diabetes medications/insulin during your fasting period.
- YOU MUST arrange for someone older than 18 years old to pick you up and stay at home with you the evening after surgery. If you do not have a responsible adult to stay with you for the first 48 hours (about 2 days) after surgery, your surgery will be canceled.
- We ask that your caregiver is prepared to receive you after surgery. They should:
- Have a light snack in the car.
- Have a water or electrolyte drink waiting for you.
- Prepare the car with chuck pads (disposable absorbent pads) to protect the car seats, particularly if you had liposuction.
- Stay within a 15-minute drive from the office so they can come and pick you up when we call them. They should not plan to stay in the office during your surgery, as we do not have enough room in the lobby for companions and patients. But there are many shops and cafés nearby (including Dadeland Mall).
- Relax! You are in good hands.
List of Supplies for Surgery
We put together this list based on feedback from patients. They have told us that these items were helpful to have during the first few weeks after surgery. Not all supplies are necessary, and some are surgery-specific. Review the list carefully and select what items you think will be most beneficial for you. The must-haves are in bold.
- Mupirocin 2% ointment – prescribed by PCP or your surgeon
- Extra Compression socks (to alternate wearing one pair and washing the other)
- Hibiclens or Dial Antibacterial Soap – start using 5 days prior to surgery
- Body wipes/baby wipes
- Loose-fitting clothing (dresses, robes, etc.)
- Shoes that are easy to put on and take off
- ABD pads
- Gauze pads
- Chucks pads for drainage (liposuction/BBL primarily)
- Thermometer
- Tylenol Extra Strength/Tylenol PM
- Advil/ibuprofen — can be taken 48 hours after surgery
- Gatorade/Pedialyte
- Pineapple juice
- Water
- Gas-X
- Colace/Miralax/docusate sodium (stool softener)
- Zyrtec or Clartin for allergies
- Arnica products
- Menstrual pads only – tampons increase the risk for infection
- Iron regimen supplements for another 2 weeks post-op
- Pampers (by preference) – some patients use this during their menstrual cycle
- Female urination device
- Shower curtain to protect mattresses or chairs (liposuction/BBL primarily)
- Old towels that may get messy from drainage
- Step stool to climb in and out of the car
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 too, 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 to include 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.
Pre-Operative Medical Clearance
Pure Plastic Surgery believes our patient’s health is our number one priority. The following tests are required for your safety. Please make sure to have these tests done 45-30 days prior to your scheduled surgery date.
I. Labs
- Complete Blood Count (CBC)
- Comprehensive Metabolic Panel (CMP)
- Human Immunodeficiency Virus (HIV)
- Coagulation panel (PT/PTT)
- Electrocardiogram (EKG)
- Chest X-ray
- Serum HCG pregnancy testing
- All diabetic patients require a Hemoglobin A1C level (HgbA1c)
II. Medical Clearance Letter
- A medical doctor must perform a history and physical exam within 45 days of your surgery date and send us a letter that states you are a candidate for the surgical procedure you are going to undergo. The doctor must state your risk for surgery (low, moderate or high risk).
III. Breast Surgery
- Patients over the age of 40 years old require a mammogram within the year of their scheduled surgery date.
- For patients under the age of 40 years old with a family history or personal history diagnostic testing will be required.
IV. Further Testing
- Our surgeons reserve the right to require additional testing as needed based on your medical history and the results of the tests listed above. We urge you to get your tests as soon as possible to avoid any delays.
- If you have anemia (Hemoglobin less than 12) you must visit your primary care provider for specific instructions on increasing your hemoglobin levels before surgery. Our surgeons do not provide guidance on treating your anemia as this would not be appropriate.
Your doctor should fax the complete medical clearance to 786-899 2764 or email it to Info@PUREplasticsurgery.com or Yanisi@PUREplasticsurgery.com
All tests must be received by our office at least 14 days (2 Weeks) prior to surgery to avoid any cancelations.
Please do NOT purchase any plane tickets until you are fully cleared, if you do, make sure it’s a refundable ticket or that it can be rescheduled without fees. The same thing applies for your hotel or recovery home. We cannot guarantee the date of surgery if we do not have all medical clearance documents and full payment sent to us at least 14 days prior to your surgery date.
The entire team is dedicated to helping you in every way we can; if you have any questions or concerns, please feel free to contact us at 305-900-5310.
Once again thank you for choosing Pure Plastic Surgery.
MEDICATIONS TO BE AVOIDED BEFORE SURGERY
THESE MEDICATIONS MAY CAUSE BLEEDING PROBLEMS AND SHOULD BE AVOIDED 2 WEEKS PRIOR TO SURGERY
| A-B | C-E | F-M | M-O |
|---|---|---|---|
| 4-Way Cold Tablets | Cama Arthritis Pain Reliever | Feldene Caplets | McNess Pain Tabs |
| Aspirin All Forms | Carisoprodol Comp. (Soma) | Fenoprofen Tablets | Measurin Tablets |
| A.S.S. Enseals | Celebrex Capsules | Fiogen Tablets | Mecofenamate Capsules |
| A.S.A. Tablets | Clinoril | Fiorinal All Forms | Mefenamic Acid |
| Aches-N-Pain | Codoxy Tabs | Flexeril | Meclomen Caplets |
| Acoda #3 | Congesprin Chewable Tablets | Fortabs | Medipren Ibuprofen All Forms |
| Addaprin | Cope Tablets | FungiCure | Menadol –IB |
| Adlevika | Cosprin All Forms | Gaysai –S Tablets | Megaprin |
| Advil All Forms | Coricidin All Forms | Gelpirin Tablets | Mephyton Tablets (Vitamin K) |
| Aleve Tablets | Coumadin | Gemnisyn Tablets | Mepro-Analgesic #2 |
| Alka-Seltzer All Forms | CP-2 Tablets | Genacote All Forms | Meprobamate All Forms |
| Anacin Arthritis Formula | Damason-P | Genpril | Methocarbamol All Forms |
| Anaprox All Forms | Darvon All Forms | Genprin Film –Coated Tab | Micrainin Tablets |
| Anodynos Tablets | Dasin Capsules | Gensan | Midol Caplets |
| Ansaid Tablets | Daypro Caplets | Goody’s All Forms | Mobidin Tablets |
| Aqua Mephyton Amps (Vitamin K derivative) | Diflunisal Tablets | Halfprin | Mobigesic Tablets |
| Argesic Tablets | Dinol Tablets | Haltron Tab | Mobisylcreme |
| Arthralgen Tablets | Dimetapp Sinus Caps | Hep-Lock | Momentum Muscular Backache Formula |
| Arthritis Pain Formula Tablets | Disalcid Tablets/Capsules | Heparin | Motrin All Forms |
| Arthritis Strength Bufferin All Forms | Doan’s Pills | Ibufen-200 | Myofluxcreme |
| Arthropan Liquid & Tablet | Dolobid Tablets | Ibuprin | Nabumetone (Relafen) |
| Ascriptin All Forms | Double-A Tablets | IBU-TAB Ibuprofen Tablets | Nalfon Caplets/Capsules |
| Asperbuf Tablets | Dristan Sinus Caplets | Ibuprofen Tablets | Nalfon Tablets |
| Aspergum | Dristan Menthol | Idenal Tab | Naprelan Tablets |
| Aspercreme | Duoprin All Forms | Indocin Supp./Oral Suspension/SR Capsules | Naprosyn All Forms |
| Axotal Tablets | Duradyne Tablets | Indomethacin Caplets | Neocylate Tablets |
| Azdone Tablets | Easprin Tablets | Isollyl Improved Capsules | Norgesic Forte Tablets |
| Back-Quell | EC- Naprosyn Delayed Release Tablets | Ketoprofen | Norwich Aspirin Tab |
| Bayer All Forms | Ecotrin All Forms | Lanorinal Tablets | Nuprin |
| BC Powder All Forms | Efficin Tablets | Listerine | Naproxen Tablets |
| BC Tablets All Forms | Eldepryl | Lodine All Forms | Norgesic All Forms |
| Buf-Tabs | Emagrin Tablets | Lortabl ASA Tablets | Norwich Extra Strength Aspirin |
| Buff-A Comp All Forms | Empirin All Forms | Magan Tablets | Nuprin Ibuprofen/Analgesic Tablets & Caplets |
| Buffasal | Enteric Coated ASA | Magnaprin Arthritis Strength Tab | Orudis |
| Bufferin All Forms | Equagesic Tablets | Magsal Tablets | Os-Cal-Gesic Tablets |
| Buffets II Tablets | Equazine –M Tabs | Marnal Capsules | Orphengesic |
| Buffinol Tablets | Excedrin All Forms | Maximum Bayer Aspirin | Oruvail Capsules |
| Butalbital Compound Tabs | Maximum Strength Arthritis Pain Formula (Anacin) | ||
| Butazolidin All Forms | Maxiprin –15 | ||
| P-Y | |||
| Pabalate -SF Tablets | St. Joseph Aspirin for Children | ||
| P-A-C Revised Formula | Salflex Tablets | ||
| Pamprin Max. Pain Relief Caplets | St. Joseph’s Adult Chewable Aspirin Caps | ||
| Pepto-Bismol Tablets and Suspension | Sulindac | ||
| Persistin Tablets | Supac All Forms | ||
| Ponstel Kapseals | Synalgos Capsules | ||
| Propoxyphene Compound –65 | Stanback Tablets and Powder | ||
| Pabalate | Surasal Tablets | ||
| Pain Reliever Tabs | Synalgos –DC Capsules | ||
| PediaProfen Suspension | Talwin All Forms | ||
| Percodan And Percodan –Demi Tablets | Tenstan Tablets | ||
| Phenylbutazone | Ticlid | ||
| Propoxyphene HCI/Aspirin Formula | Tolectin All Forms | ||
| Regular Strength Ascriptin Tablets | Tolmetin All Forms | ||
| Rowasa (5-ASA) | Torado All Forms | ||
| Rufen Tablets | Triaminicin Tablets | ||
| Relafen Tablets | Tricosal | ||
| Robaxisal Tablets | Tri-gesic | ||
| Roxiprin Tablets | Trilisate Tablets/Liquid | ||
| S-A-C Tablets | Uracel -5 | ||
| Salicysal | Ultraprin | ||
| Sine-Off Sinus Medicine Tablets-Aspirin | Uvsinus Inlay Tabs | ||
| Sloprin | Valprin | ||
| Saleto Tablets | Vanquish Caplets | ||
| Salocol Tablets | Verin | ||
| Soma Compound with Codeine Tablets | Voltaren Opthalmic Sol. | ||
| St. Joseph Cold Tablets for Children | Voltaren Tablets/X-R Tablets | ||
| SK-65 Compound Capsules | Vioxx | ||
| Soma Compound Tablets | Yutopar Tablets | ||
| **ANY over-the-counter cold medication |