Surgery for Out of Towners

[zado611]

how do doctors go about doing post op for someone way out of town?... I live 4 hours from my plastic surgeon

[Dr. Elliot Jacobs]

Obviously, it is more difficult to provide post-op care to a patient who lives further than one hour from the surgeon's office.  That is why I urge my out of town patients to remain in the NYC area for at least several days before they return home.  If there are any immediate problems, then I can deal with it right then.  The additional few days in New York also provide an excellent opportunity to visit and take advantage of the museums, parks, shopping, Broadway plays, etc, that New York offers.

As part of my entire surgical package, I provide comprehensive instructions and explanations for the surgery.  This includes preparation for the operation, what to expect right after surgery and also long-term care and treatment.  An educated patient will have a far smoother post-op course.

For the most part, once a few days have elapsed and there are no problems (the potential problem of most concern would be a hematoma), then they can return home.  I insist on there being frequent communication between us after that.  Communication consists of answering questions directly by email or telephone.  And, if there is a question about healing, I ask that photos be sent to me by email -- and I can usually answer by email.

The time frame between one week and several months is one in which there is extremely active healing going on under the skin -- and truly there are very few times when surgical intervention would be indicated.  Sometimes massage may be initiated -- but only at the right time.

Mother Nature plays an active part in the healing process -- and that includes the possible development of scar tissue.  This cannot be predicted ahead of time.  Sometimes scar tissue develops beneath the nipples -- and if massage and time do not help, then sometimes a kenalog injection is necessary.  This would not be done before 4-6 months have elapsed since surgery.  I would need for the patient to return to my office for this treatment.

I have done literally hundreds of patients from outside the NYC area -- many from all parts of the US and many from all parts of the globe -- including all continents (except Antarctica).  This method of providing post operative care has been quite successful for them.

Dr Jacobs

[DrBermant]

how do doctors go about doing post op for someone way out of town?... I live 4 hours from my plastic surgeon

I see many gynecomastia patients travel from around the world who prefer my techniques. It is not uncommon for us to work with patients from 3 different continents each week. Here are a few of their experiences:

• Travel from the United Kingdom . UK,
• Travel from Canada
• Travel from Hong Kong, Vietnam, and other countries in Asia
• Travel from Hong Kong and Ireland for Revision Gynecomastia Surgery

I have been doing this for many years and have evolved a system that minimizes Swelling and Bruising After Male Breast Reduction and maximizes Comfort After Gynecomastia Surgery. Refinements such as my After Male Chest Surgery Dressings enable mobility and activity after the operation.

The after surgery care starts out with before surgery education and that is why I have such an extensive website on this topic. The education then continues with my Preliminary Remote Discussion where I can evaluate patients, explain the specific recovery and after surgery issues for that individual, and set up a tentative surgery.  Patients are then examined by the day before the surgery.  The hands on education continues in this setting. They have the surgery and are then seen the next day (except for Saturday operations who are checked on that Monday.)  Many of our patients can return home after that examination. Then depending on the complexity of the problem, we have an in office dressing removal 6 days after surgery.  The other option is a telephone remote dressing removal with the patient about 10 days after surgery. 

Therefore, the minimum stay for our typical gynecomastia patients is 3 days and 7 days for more complex problems.  Those staying in Richmond usually turn their time into a vacation taking in the region Richmond Virginia / Washington D.C which offers quite a bit to do. Some of our patients travel further taking other cities such as New York or Florida as part of their visit to our country.

For our patients only 4 hours away, most travel back home the day after surgery and return for the dressing removal since the travel is not that bad. Some pick the telephone dressing removal.

We encourage our patients to call us at any time with questions. However, with all of the patient education, it seems that there are just not many after surgery questions that have not already been answered by our methodology of precision surgical sculpture and concentrating on a well informed and educated patient before the operation.

Hope this helps,

Michael Bermant, MD
Learn More About Gynecomastia and Male Breast Surgery

[George Pope, M.D.]

I see a large number of out of state and out of the country patients, and with this in mind, my office staff is geared toward providing service to these patients throughout their entire experience, both pre- and postop, in order to help things go smoothly.

Patient education is obviously important, and a well-educated patient will have a smoother postoperative experience than one who is not.  If you are coming from another city, we make sure that you know exactly what is expected of you before you leave us.  Complications from any surgery are rare; however, unexpected complications can arise.  I enroll ALL of my gynecomastia patients in an insurance plan that will cover the majority of costs related to specific complications of surgery. That helps minimize patients' out of pocket expenses should a complication arise.

Out of town/state/country patients may have to return to Orlando for complications to be managed, but that is extremely rare.  Many times a family physician or another plastic surgeon in the patient's home town can evaluate him and communicate directly with me. 

With Orlando, FL being one of the biggest tourist destinations in the world, many patients, gynecomastia and otherwise, opt to have surgery here and combine surgery with a family vacation.  Sounds odd, but it happens quite frequently and works out quite well.

Dr. Pope, MD