PROCEDURES
INTRODUCTION
 Thank you for visiting our web site and welcome to our world of plastic surgery! Juris Bunkis, MD is an innovative plastic surgeon who specializes in aesthetic surgery. Our practice specializes in the newest techniques for face and forehead lifts, including the mid face and short scar face lifts, blepharoplasty (eyelid surgery), rhinoplasty (nasal surgery) liposuction, abdominoplasty (tummy tuck), breast reduction / uplift through the short scar techniques, and augmentation mammoplasty (breast enlargement). We also specialize in Botox and collagen injections, laser skin resurfacing and laser hair removal. Dr. Bunkis is one of the handful of plastic surgeons to perform pectoral, buttocks and calf implant surgery.
This information has been assembled to familiarize you with the facts regarding plastic surgery. You are requested to read the information regarding any procedure(s) you are interested in thoroughly and to discuss any questions, which might arise with our doctors before you proceed with the surgical procedure(s). You may print this information as a reference during your pre/post-operative period or copies will be provided to you.
GENERAL INFORMATION
Two weeks before surgery
Avoid Vitamin E (the small amount contained in most multi-vitamin preparations is not
harmful), Ibuprofen (Advil) and all aspirin-containing products (these tend to prolong
bleeding and increase bruising) for two or more weeks prior to surgery. Tylenol may be
taken safely.
Other prescribed drugs may be taken, but please make sure that your surgeon and the
anesthesiologist are aware of any medications you take.
Prior to operations such as suction lipectomy (fat suctioning), breast reductions, thigh or buttock lifts, or abdominoplasty (tummy tuck), you will be requested to take iron tablets
(ferrous sulfate or ferrous gluconate) twice daily for two weeks before surgery and two
weeks after surgery. These are non-prescription medications that may be obtained at any
pharmacy.
Make arrangements to have someone bring you to the office on the day of your surgery, to
take you home afterward and to spend the first 48 to 72 hours after the operation with you.
To insure that your body's healing mechanisms are working at their best, it is suggested that
smoking be stopped at least four weeks before any surgical procedure, and that you refrain
from smoking for at least three weeks after surgery as well.
One week before surgery
1. In compliance with suggestions adopted by the American Society of Plastic Surgeons, it is customary for the patient to pay all fees for cosmetic surgery prior to the desired operation. This assures that the patient is sincere in his/her motivation and can afford the surgery, thus creating a better patient /physician relationship.
All fees must be paid prior to surgery, no later than the day of the preoperative visit. Otherwise, it may regrettably be necessary to release your scheduled operative time to another patient who is ready for surgery and to reschedule your procedure.
Additional fees will also be required for laboratory, surgical facility or hospital costs as well as for anesthesiologist's fees or for possible subsequent surgical procedures. It is important that you understand that the patient will be responsible for all costs associated with secondary surgical procedures.
Please note that if a functional component exists (a deformity resulting from an accident or resection of a cancer, etc.), a portion of the fee may be covered by your insurance carrier. Rarely does an insurance carrier cover the entire fee for an operation.
While our staff will assist you by filling out insurance forms, payment of all fees is the patient's responsibility; recovery of any insurance benefits is between you and your insurance company.
2. Be certain to ask your surgeon or the office staff any questions you might still have during your final preoperative visit. Necessary pre-operative laboratory tests may be performed at this visit or, if you prefer, at a local hospital or outside laboratory.
Day before surgery
No restrictions of activity.
Shower and shampoo before going to bed.
Normal diet.
Nothing to eat or drink after midnight or other time as directed by the anesthesiologist; this
includes water and other fluids, but you should take all medications prescribed by your
physician and approved by your surgeon.
Day of surgery
Shower before leaving home in the morning. Do not apply any makeup (including
moisturizers) prior to facial operations, including eye and nose procedures.
Wear clothing that is easy to put on and take off, such as a sweat suit (preferably with a
zipper up the front of the top) or a robe. Do not wear any pullover type garments. Bring
slippers or flat shoes, and do not wear pantyhose or nylons.
Take all medications prescribed by your surgeon or your personal physician, even if
undergoing a general anesthetic; use a very small amount of water to ingest the pill(s) if
necessary. Ordinarily, your anesthesiologist will call you the night before surgery to discuss
your anesthesia care.
No food or liquids may be taken after midnight prior to surgery, unless you have
specifically been instructed otherwise by the anesthesiologist.
Bring a credit card or check for the anesthesiologist and surgery center, but do not bring any
other money, jewelry, watches or other valuables to the surgical facility. Do bring any post
surgical garments, which you have been instructed to purchase.
Arrangements should have been made for someone to bring you to the office for the
surgery. A number must be left where the individual can be called to pick you up after the
operation. If such arrangements have not been made, it will be necessary to cancel your
procedure.
Depending on the procedure to be performed, your surgeon may recommend using either a local hospital or outpatient surgical facility.
Someone must be with you at home during the first 48 to 72 hours after surgery. If you
cannot arrange for a relative or friend to be with you for this period, please discuss this with the office staff at least one month before surgery and they will attempt to help you arrange
for a home health aide. A costlier alternative would be to spend the first night at the Surgery
Center.
Additional instructions for specific operations such as for breast augmentations, facelifts,
etc., should be followed.
After Surgery
Follow procedure specific instructions as given.
Take pain medication and antibiotics on a full stomach, such as milk and crackers to prevent
stomach upset. Avoid alcoholic beverages while taking pain medication or other sedatives.
To avoid unnecessary swelling or bleeding, do not bend over, strain, exercise or do any
other activities such as strenuous lifting that could increase pressure in the surgical areas for
the first week or longer if bruises and swelling are present. A good rule of thumb is to avoid
all activity that causes pain and enjoy those that do not.
Take all other medications prescribed by your personal physician.
Smoking significantly decreases blood flow to the operated area. Stopping smoking a month
before surgery and for the first month after your operations will improve your healing
ability and minimize the possibility of developing a complication. If you can do that for
two months, why not consider stopping completely to better your overall health?
You may resume driving 48 hours after your last pain pill but only if you feel comfortable
and physically able to do so.
It is possible that a patient's condition may warrant a transfer from the surgery center to a
hospital in order to provide specialized care. In this unlikely event, patients must understand
that they will be responsible for any additional costs associated with such a transfer.
Further instructions will be given at the time of the first post-operative office visit.
IF YOU HAVE ANY QUESTIONS, DO NOT HESITATE TO CALL THE OFFICE AT ANY TIME (949/ 888-9700).
Juris Bunkis, MD, FACS
email:bunkis@ocps.com
Orange County Plastic Surgery
30212 Tomas, Suite 275
Rancho Santa Margarita, CA 92688
Phone: (866) 457-1293
Fax: (949) 888-9724
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