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SURGERY PROCEDURE


FOR EACH PROCEDURE:


MOST IMPORTANT: Discuss how to assess the pt from a physical viewpoint & decide which procedure is appropriate, which method/approach is appropriate & WHY.
Indications for procedure
Contraindications absolute/relative
Pre-op consultation & assessment
Assessment must be both general & specific
Thorough relevant medical assessment most important:


Thorough medical & surgical Hx
Relevant examination & investigations
Medications
Allergies
Response to previous anaesthetics
Psychological assessment
Brief social/personal history may be relevant


Thorough assessment from cosmetic surgery viewpoint
Determine what the pt. wants, feels, thinks balance expectations against what is cosmetically achievable
Discuss appropriate procedure of choice agreement b/w pt & surgeon
Must be doing this for themselves
Decide whether pt is appropriate for surgery ie pt selection probably the single most important part of the whole process, esp from psyche viewpoint


3 categories:
Suitable
Suitable with reservations
Unsuitable


Specific physical assessment relevant to procedure e.g. note breast asymmetry etc
If suitable, explain details of procedure and what is realistically achievable
Show photos
Discuss expected postoperative course, time off work, bruising, swelling, discomfort, usual follow up, 24 hour availability, etc
Include risks & possible complications
Know when to refer to specialist pre-op e.g. cardiol, ophthalm etc.
Make sure that the patient understands & encourage time to make informed decision
Also encourage them to ask questions both at consultation & pre-op
BEWARE CERTAIN PATIENTS (see later)
Arrange further pre-op appointment if necessary e.g. BAM sizing etc

PREOP
PHOTOS
MARKINGS
CONSENT