The consultation appointment is extremely important as much of what happens during the entire surgical experience is determined at this important meeting.
Dr. Niamtu performs all consultations personally. We feel it is important to speak to the actual person whom will be performing the surgery. Our staff will assist, but Dr. Niamtu will perform the consult. If you can’t speak to your doctor, maybe you chose the wrong office!
We often get the question “who will be doing the surgery”? “Only Dr. Niamtu performs the surgery at our office. Some offices or institutions employ teaching fellows, residents, or interns. Although teaching is a great thing, it is customary for these student doctors to perform part of the surgical procedure, this is how they learn. In our office, only Dr. Niamtu performs surgeries and provides follow up for every single patient.
The consultation appointment is perhaps the most important time spent between the doctor, staff and patient. It is paramount that patients feel relaxed and be prepared to talk and listen. Some patients are nervous when it comes to talking to someone about their cosmetic concerns. Relax! This is all we do and we do it all day, all year! Please feel free to bring a spouse or friend along. It is always good to discuss the treatment at some point with a care-giver or support person.
Our interest is to find out what exactly it is that you may wish to change and to evaluate each patient specifically and present multiple options. It is your job to communicate what it is that bothers you or that you may want improved. “What do you think I need” is not the best communication. The patient must take some responsibility for communication in describing the changes they may desire. If we feel that a given procedure is beneficial we will mutually discuss it. Remember, no one “needs” cosmetic surgery, it is all entirely elective. Most of us, however, desire to look and feel as young as we can. The best way to approach the consultation is to do some homework before hand. It really helps to look in the mirror and make a list of what it is that you would like to change. Although it may seem obvious, things may be overlooked for one reason or another, so a list is useful. It also helps to vies our web site for the specific procedures that you may desire or want more information. Presenting with a list of questions is also beneficial so you don’t overlook details that you forgot to ask during your consultation.
We will address your concerns and at the same time we will evaluate your entire head and neck to discuss the comprehensive changes of aging and available options. Again, please be candid and let us know what bothers you and what you would like to improve. Dr. Niamtu will discuss your concerns and examine you. You will be asked to hold a mirror and specifically identify your concerns. We will look at pictures and show you examples of proposed procedures. We will discuss your health history and how it relates to safe surgery and anesthesia. Please be prepared to inform us of all health problems and medications that you are taking. We need to know if you smoke and how much and for how long. We need to know if you have had ever experienced any problems with surgery, anesthesia or post operative bleeding. In short, we need to know it all! The more we know, the safer you are.
There are always multiple options for rejuvenation and we will discuss various treatment options. It is fine for you to take notes since we will be discussing many things. We will provide you with a list of procedures we discussed as well as their costs. The decision to have cosmetic facial surgery may revolve around many thing including family, finances, recovery and health. In order to have successful cosmetic facial surgery the patient must consider several factors.
1. Are you doing it for the correct reasons?
Our patients tell us that they look and feel better. They often feel recharged and excited about their new look. You can see some of these comments here (Comments from Our Patients). Cosmetic surgery will not save a failing relationship or guarantee a promotion. The best patients are those who do it for the correct reasons; to look and feel better.
2. Are you healthy to undergo the proposed procedure?
Many patients with common medical problems are candidates for cosmetic facial surgery. Controlled hypertension, diabetes, moderate smoking, and other common problems do not usually prevent surgery or anesthesia. We uphold the same standards as local hospitals for preoperative screening. Depending upon your age and health history we may need a physical from your physician and minor lab work. This is specific to each patient and each procedure. Minor procedures with IV sedation usually require less work up than longer or combination procedures. If we require a physician physical or lab work, it is imperative that we receive it two weeks before your surgery so we can act on any abnormalities. Although most patients are candidates for surgery and anesthesia in our AAAHC fully accredited surgery center, Dr. Niamtu may elect to treat the patient at a hospital or outpatient surgery center. We utilize a staff of anesthesiologists and nurse anesthetists that may also meet with you before surgery for certain medical problems.
3. Can you take adequate time away from work or play?
Every procedure carries some recovery whether it is overnight or ten days. You cannot rush healing! Most patients are correcting 40-70 years of aging and you cannot rush your recovery. In this respect, the patient is as important as the surgeon for maximum outcome. Complications are higher in patients that do not obey recommended recovery instructions. We can tailor your procedure to match your recovery. If you only have several days to recover we may recommend more conservative or mini procedures. Some surgical procedures require one week to two weeks to return to work. Every patient heals at a different rate. Some patients go back to work earlier and some later. If time off is a big problem, it may be desirable to have your surgery on a Thursday or Friday. That way you can miss one weekend, a five day work week and another weekend. This gives you ten days off with only missing five work days.
4. What is your budget?
Again, this is different for every patient. Some patients desire a significant makeover and may perform multiple procedures at a single surgery. Others may undergo a single procedure due to finances and perform other procedures at a latter time. We have financing programs available. Our general financial arrangement is for the patient to pay a $500 non refundable deposit to reserve a surgery date. The remaining balance is due at the preoperative appointment which is usually about 2 weeks before the surgery date.
5. A second look
Sometimes a single consultation is not enough! Again, these appointments are very important. A well informed patient is our prime goal. There is no doubt that the entire process is easier for those patients that have all their questions answered and understand what and what not to do. If you need to come back in and talk to us again, or ten times, it is that important to us.
6. Time to Schedule
After consultation you may choose to proceed with your surgery. Our office will do our best to accommodate your desire for a certain date. You can schedule your surgery appointment as soon as you are sure you wish to proceed. Once your surgery appointment is scheduled, you will be asked to return to the office one more time for a pre-op appointment. At this appointment we will once again go over the proposed surgery and anesthesia as well as your medical history, physical and labs if appropriate. We will write the necessary prescriptions and provide detailed post operative instructions. We will also review the necessary paperwork, sign surgery consents and finalize fees for surgery and anesthesia. It may be helpful to have a spouse or care giver present for this appointment. By the end of this appointment you should feel pretty confident about your upcoming surgery.
7. The Day of Your Surgery
You will be asked to arrive at a given time for your surgery. Please be prompt as much scheduling has gone into this surgery. Your ride may leave and pick you up after surgery. It is helpful to have a cell phone number to contact your ride. Some patients may desire to spend the night and will not need a ride. We ask you to bathe and wash your hair the night before and the morning of your surgery with an antibacterial soap such as Dial Antibacterial, Lever 2000, etc. . Please do not wear any jewelry, makeup, nail polish or hair spray on the day of your surgery. Please wear loose fitting clothing such as a work out suit or even pajamas. Please wear a top that is button up and not a pull over and slippers or shoes that can be easily removed and put on.
It is not unusual to be apprehensive about your surgery on the day of surgery. This is very common and virtually every patient is anxious. Please rest assured that we have your health and welfare as our primary concern and although we treat thousands of patients, you are the only one in our mind at this time.
8. Immediately after your surgery
When your surgery is completed, your hair will be washed and light bandages are sometimes used. You will be transferred to the recovery room and rest comfortably while attended by a nurse and connected to vital sign monitors. As you begin to wake up, we will bring your ride or care giver to your bedside and go over the immediate post operative instructions. In addition all patients will receive Dr. Niamtu’s home and cell numbers. The patients remains in recovery until they desire and are stable to go home.
9. Post Operative Visits
There is never a charge for post operative visits. These visits vary according to the procedure. Some patients need to be seen 24 hours after surgery and others may not need to return for a week or several weeks. It is important for us to follow our patients to make sure there are no problems and healing is proceeding well. Failure to comply with post operative visits can compromise surgical care and outcomes. We will do out part, please do yours.
10. The final result
Depending upon the procedure, final healing can be days to months. As stated earlier, you can’t rush healing. Patients will see most results immediately but it may take several weeks or months for larger procedures to settle into the final healing stage. Dr. Niamtu will monitor this photographically over the course of your healing.
Occasionally touch up or revision procedures may be required. It is important to view cosmetic surgery as a sculpting procedure and sometimes it is better and safer to be more conservative. It is never a problem to do a small tissue trim or tuck after a procedure, but conversely it is a big problem if you had overly aggressively surgery and need reconstruction. 1-2% of cases may require small adjustments that can usually be done under local anesthesia. This is usually included in the surgery fee for the first post operative year. A minor materials fee may be charged depending on the revision.
Thank you for taking time to read this important information and we want to make your visits and surgery as easy and enjoyable as possible.
Joe Niamtu, III DMD