This is not meant to be a judgment or attack of any kind on this patient, the clinic and surgeon that attended her, the country/destination or recovery retreat or even the medical tourism company that may or may not have assisted her with this trip (although it appears that she had no such assistance). It simply is and should be a resource to show you what HAS and COULD occur as you plan and make your journey and how to perhaps avoid it happening at all. Traveling abroad for surgery should be vigorously researched before making your decision. This is also to make you aware of things you may not have even considered that could occur on this journey and give you an opportunity to analyze how you would deal with it. You do not have to come with MNB, but do take the time during your research to ask your "Medical Concierge" how perhaps some of these events would be handled or avoided!
| THE PROBLEM THAT AROSE: |
WHY THIS WON’T HAPPEN WITH MNB: |
| I contacted the clinic in Costa Rica and told them I wanted the “full” tummy tuck; meaning the anchor cut along with breast lift/augmentation. I had weight loss surgery and lost 130 lbs. |
Your individualized and medically thorough Treatment Plan will require pictures be submitted in advance to properly evaluate your unique surgical needs. The Treatment Plan as well as the list of procedures on the website will very specifically detail exactly what the definition of each surgical procedure and how much EACH procedure will cost. It is spelled out and you will know that a “tummy tuck” addresses ONLY the abdomen, the “anchor cut” is a separate and not always necessary procedure, and that a breast lift/ augmentation is also a separate procedure. Also, we do not use Clinics for procedures, especially for such a large procedure! We only operate in appropriate hospitals, preferably those that are labeled “clean procedure” hospitals that are generally never host to surgical procedures that can foster secondary (staph) infections.
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I had the big belly and the pubic protrusion. I explained that a ‘mons lift’ would not work for me, that I had to have the ‘mons resection,’ … they said “No problem,” and quoted a price of $xxxx. |
Again, if pictures are submitted and a Treatment Plan created by the surgeon based on these pictures, the patient is not left telling the surgeon what s/he “needs.” The surgeon should be telling the patient.
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| I got to Costa Rica … and at that time they told me that they didn’t know I meant the ‘full’ tummy tuck; even though I explained in writing and on the phone which procedure I was talking about…they said I would have to pay more money. |
Truly in Plastic surgery Lingo, there is no “full tummy tuck.” Again, each procedure is spelled out very clearly. She requested four different MAJOR procedures
Abdominoplasty (tummy tuck)
Vertical anchor incision (sounds like she also had a hernia repaired from her comments further below)
Mons lift/resection
Breast lift with implants
but this was not made clear by herself nor understood by the surgeon/his staff and so she was charged differently than she was expecting and the surgeon was not anticipating these surgeries:
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When they examined me…I showed them the pubic area and explain AGAIN about the mons resection. They again said, “No Problem.” |
First of all, our surgeons speak English but we understand that sometimes things can get missed when speaking another language. Secondly, you are personally accompanied to your in-person consultation with the surgeon and anesthesiologist by MNB. This person is already familiar with your Treatment Plan and is there for ANY support or clarification you or the surgeon may require. They are completely bilingual.
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I went to the clinic on May 18th for surgery…they did blood work 30 minutes before surgery. I have no idea if they got results. |
With MNB you are required to obtain surgeon indicated bloodwork and other pre-op screening tests BEFORE you get on the plane (except in VERY RARE cases!) In fact, we need to see most of our patients’ results about 6 weeks PRIOR to their surgery dates! If for some reason you cannot have these tests done in the USA, and the surgeon determines by your Health History Form, that you are a “low risk” patient, in certain circumstances you would be allowed to come to Brazil but would have to sign a waiver that if, once the results came back (yes you might have to arrive days earlier than most patients!), the surgeon saw any reason NOT to perform your surgery, he would inform you of this and you realized you were taking a chance in coming and not being pre-screened.
Now, there is a blood test that WE do within a couple hours of your arrival at the airport that tests specifically for embolism/thrombosis, a possibility after long plane rides. The results WILL be received before you are ultimately cleared for surgery, two days after your arrival date. If this test comes back as positive, you will be subjected to a dopplarRadar exam of the legs to fully rule out the possibility of embolism before your surgery.
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I went to the ‘recovery retreat’ the next morning.
The recovery retreat, “XxxXxxx” is 12 miles up a mountain from the clinic. They have no phones which was a shock when we got there. |
Firstly, after such EXTENSIVE surgeries, the surgeon would absolutely NOT be discharging you the next morning after surgery. You generally remain in the hospital (NOT a clinic!) for 48 hours where we can monitor you, control your pain better and be able to help you immediately in the most crucial 24-48 hr post op period where the chance of avoidable complications can be minimized.
I have personally been to this and other “recovery retreats” in CR and the road up is bumpy and the property has roaming farm animals, steep slopes, stairs and small rooms. It is quaint and picturesque but definitely not medically appropriate accommodations for a recovering plastic surgery patient! MNB has recognized from the beginning that only accommodations in established 3, 4, and 5 star apart-hotels (all-suite properties with separate bedroom and living area whenever possible) would adequately accommodate our patients, especially those that stay such a long period of time and spend most of the time IN the hotel recovering. Our indicated hotels work with us in accommodating our patients properly (for example, we use more linens and towels, need high speed internet connections for our laptops, kitchen amenities due to our long stays, American TV stations, etc). We need elevators, as stairs and “mountain slopes” only give an opportunity for an incision to become stressed and open, giving an outlet to
infection, slow healing and can ruin final scarring results! Even the bumpy ride by van, up the mountain severely compromises new internal and external stitches and just HURTS. We need air-conditioning and sometimes twice daily linen changes to keep the incisions as clean as possible as we spend so much time in bed recuperating… who wants to lay on soiled bed sheets?
The hotels should also be centrally located and literally within MINUTES of not only the surgeon’s office and hospital, but also close to needed amenities and conveniences such as a grocery store, pharmacy, maybe a mall, etc.
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The TT was extremely crooked and there was a little red triangle where the TT met the mons lift and hernia repair. I thought that didn’t look normal but was assured it was. |
The “little red triangle” at the “T” sounds like the incision was already opening. Not that this is uncommon at a “T” point like this, there is a lot of stress on the skin. As far as the sloppiness of the scar placement, MedNetBrazil’s surgeons are extremely aesthetically conscious. Remember that they are used to pleasing an extremely vain culture where string bikinis are the garment of choice for several months out of the year! Scar placement and outcome (being as invisible as possible!) is paramount to a surgeon having a good reputation in Brazil! Our surgeons also recognize the uniqueness of the post WLS patient and does NOT feel they should be satisfied with less than perfect scarring or scar placement just because they used to be heavy! Our surgeons are perfectionists in the total aesthetics of their work.
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they didn’t do the mons resection. They said they did what all plastic surgeons do in that area. I was shocked! This is something that should have been said before surgery…because many plastic surgeons and general surgeons know of the resection for WLS patients |
Again, in the end, this is not about the money. This is a huge investment anyways, in time, money, emotions, expectations… it should be done right the first time! Go to the BEST place that has the MOST experience for what YOU need! Look at the overall costs yes, but, realize that all tummy tucks are not created equal!! Do not assume that the same results will be had and all plastic surgeons use and are proficient in the same techniques! There are HUGE differences in techniques and skill levels that ultimately can DRAMATICALLY impact what can safely be done during your surgery/visit, how you heal, how fast you recover, if you suffer complications unnecessarily and ultimately your results and satisfaction with your decision. Although Brazil is famous for plastic surgery and many innovative techniques start there, it does not mean that all Brazilian plastic surgeons are experienced and as aesthetically minded either! Bottom line…. do not ASSUME anything and do NOT settle or make your final decision based solely on price. MNB is committed to PATIENT ADVOCACY and we want you to go where is BEST for you. That is why we do NOT work exclusively with one or two surgeons.
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Now I do smoke..I did not realize that smoking could cause such bad things…now I do…however … they knew I smoked and went ahead with surgery…after telling me about complications that could possibly result. |
Smoking is a HUGE contra-indication to plastics and can lead to serious post op complications in healing. When you fill out the MNB Health History Form (again, WELL in advance of your arrival in Brazil) and the surgeon reviews it and sees you have ANYTHING noted (assuming you fill out the form honestly) that could affect your surgery or healing, we can either address it in advance and have it impact as little as possible, your surgery, or tell you if it feasible at all. We also again, are used to treating “compromised” patients in the “higher risk” category with various healing issues and have collaborated with doctors of other specialties (hematologists, hyperbaric doctors, etc) that can offer our patients supplemental treatments in the post op period that have proven to be extremely effective in lessening such types of post op complications and help our patients heal better and faster with as few complications as possible.
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2 days before I was to go home….I had a fever…they called the doc and he said he was ‘unconcerned’… I didn’t know what to do….so I changed the airline tickets and came home. |
MNB’s Medical Concierge Service doesn’t only provide your medical transport and airport p/u but most importantly, 24/7 HOTLINE SUPPORT with our Medical Concierge Staff. You can and should call us at 2 a.m. for these kind of problems! This is a dedicated phone line and dispatching desk. Your weekly “Concierge” fee you pay affords you 24/7 contact with US not the hotel’s Front Desk staff! You will also be seen DAILY by a real nurse that will help you change the dressings and bandages and help insure that only STERILE techniques are used to avoid the possibility of a post op infection. They assess you and your progress and healing and she updates the surgeon daily on your progress between his visits with you. Having a specially trained wound care nurse greatly limits the risk of infections such as she experienced. They will come with sterile surgical dressing changes and know what to look for and would have caught the propensity to infection before a fever developed AND most importantly, contacted the surgeon as soon as it was noticed.
Also, you must be assessed and cleared for travel by the surgeon. MNB facilitates all calls to the airlines for you on your behalf when your travel plans are changed due to your surgery. We ARE concerned, an infection can be serious. WE absolutely strive to send you home as healthy and healed as possible.
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| When I got home…that little red triangle opened up and poured blood and pus all over. The docs put me in the hospital right away on IV antibiotics and said I had an infection at the TT site and on my right breast. |
I don’t know how many days post op she was when this happened or when she decided to fly home. I am sure that the hospital was right to put her on IV antibiotics. I also do not know if she was given antibiotics (at least a five day course) immediately post op which generally helps to stave off most chance of infection. It seems evident she did not have the post op nursing care to help
minimize the chance of infection and timely follow up with the surgeon to treat the infection. This is why we have our unique Medical Concierge System in place, why you really need to examine exactly what you get for the money and why MedNetBrazil’s world-class and dedicated surgeons would have their patients cared for in nothing less than this manner.
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| My major complaint with Costa Rica is the fraud of getting me there and then wanting more money to do the procedure we spoke of….and not telling me before surgery that they didn’t know how to do the procedure I requested. |
I do not know if she went through a “Medical Tourism” company but it sounds like she attempted conversation directly with the surgeon and/or his staff. Quite frankly the initial confusion over the prices and procedures requested and agreed upon could have simply been a lack of understanding due to the language barrier and not “fraud” as it felt the way it happened. This is another important reason to choose a reputable BILINGUAL/ BICULTURAL Medical Tourism company to help you and why the surgeon should INSIST on referring you to one he trusts if you inquire directly with him. A simple and innocent misunderstanding can cause a lot of grief. A responsible and ethical surgeon or clinic recognizes this need and is more than happy to let the Concierge company handle this interaction just as his own Front Desk staff handles his domestic patients.
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The infection is from a medical facility….smoking makes a person more susceptible…for this I accept responsibility. |
Generally infections at the wound site are not caused “from a medical facility” like for example, “staph infections” that you hear of people contracting in USA hospitals just sitting in the ER for example! Infection at the wound site is most often due to improper wound care and lack of sterile cleaning techniques which is again why we do not leave this all-important detail to you the patient to handle alone but have wound care nurses to provide this to you. Yes, smoking can
make you more prone to infection because oxygen-rich blood flow is compromised in smokers. In addition to the hyperbaric chamber treatments we probably would have prescribed for her post op, she would have had Lymphatic Drainage massages to help encourage blood flow to the incision sites, minimize and channel post op swelling (also a reason for a wound to open) through the lymphatic system and help avoid the buildup of fluid (seromas) which can also cause infections.
As you can see, proper medical aftercare is absolutely essential. It is just as important, if not more in some cases, as the technique of the surgery itself and skill of the surgeon. Neither MNB or the surgeon leave this most important part of your surgical experience to anyone less than REAL wound-care trained nurses.
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