Gen Preperative Instructions

Updated General Preoperative Instructions for All Procedures

Medical Clearance and Screening

1. Medical Clearance:

• All patients must complete a medical clearance no later than one month before surgery, including:

• Blood work to evaluate overall health.

• EKG required for all patients, regardless of age, to assess baseline cardiac function.

• Details for Clearing Physician:

• Information regarding the type of procedure, estimated duration, and typical amount of lidocaine and epinephrine will be provided to the clearing physician to ensure a thorough evaluation.

2. Specialist Clearance:

• Some patients may require additional clearance based on their health and risk factors:

• Diabetes: Clearance from an endocrinologist; Hemoglobin A1c must be below 7.

• Sleep Apnea: Clearance from a pulmonologist, including an evaluation of CPAP use and suitability for the procedure.

• Cardiovascular Risk Factors: Patients with a history of high blood pressure, cardiovascular disease, family history, high cholesterol, or physical inactivity may need a stress test to ensure cardiac readiness.

• Obesity or High BMI: Weight loss may be required to reduce visceral fat, upper abdominal subcutaneous fat, or overall BMI to make the procedure safer and technically feasible while reducing surgical morbidity.

• Immunological Disorders: Clearance from an immunologist or rheumatologist for autoimmune conditions.

• Mental Health Conditions: Clearance from a psychiatrist or psychologist for patients with ongoing treatment or psychological conditions.

3. Breast Surgery Patients:

• Mammogram is required for patients over 35 years old or with a family history of breast cancer.

• Patients with Prior Silicone Implants:

• MRI may be required to evaluate for implant leakage or rupture.

4. Patients with History of MRSA:

• Patients with a history of MRSA infection, colonization, or healthcare workers with potential exposure must undergo:

• Nasal Swab Test to evaluate for MRSA colonization.

• Prophylactic Treatment:

• Mupirocin (Bactroban) applied inside the nose twice daily for two weeks.

• Chlorhexidine Showers or Betadine Body Wash for two weeks.

• Retesting is required before surgery to confirm clearance.

5. Facial Surgery Patients:

• Patients undergoing laser or facial surgery should inform the surgeon if they have a history of cold sores or Herpes Simplex. Prophylactic Valtrex will be prescribed to prevent reactivation.

Lifestyle and Smoking Cessation

1. Nicotine Abstinence:

• For surgeries involving flaps (e.g., tummy tuck, breast lift, facelift): Stop all nicotine products 2 months before and 1 month after surgery.

• For other procedures: Stop smoking 1 month before and after surgery (2 months preferred).

2. Alcohol: Avoid alcohol for at least 1–2 weeks before surgery.

3. Weight Loss Requirements:

• Patients with high BMI or excess visceral fat may need to lose weight prior to surgery to:

• Reduce surgical risk.

• Improve safety and technical feasibility of the procedure.

Medications and Supplements

1. Medications to Avoid:

• Stop aspirin, NSAIDs, Vitamin E, and herbal supplements 2 weeks before surgery to reduce bleeding risk.

2. Required Medications:

• Continue essential medications (e.g., blood pressure medications) with a small sip of water on the morning of surgery.

Supplies to Obtain or Consider

Some of these items may be provided by our office; others should be purchased in advance.

1. Personal Care Items:

• Body Wash:

• Chlorhexidine, Cloroxine, or Betadine body wash.

• Antibacterial soap (e.g., Dial) for all surgeries.

• Cetaphil soap, Cetaphil lotion, and Aquaphor.

• Vinegar, distilled water, and a spray bottle (for CO2 laser resurfacing of the face).

• Rubbing alcohol and hand sanitizer.

• Soft pillows (including one for under the knees to avoid sliding).

• Hats with large brims or side covers (for facial procedures to avoid sun exposure).

2. Medical Monitoring and Devices:

• Blood pressure machine.

• Thermometer.

• Recliner for ease of movement, especially for abdominal or large surgeries.

3. Clothing:

• Gowns with front zippers for ease of dressing.

• Cotton bras with front closure and no underwire (for breast surgery).

• Compression garments, liposuction boards, and tummy tuck binders.

4. Dietary and Hydration Needs:

• Water and electrolyte solutions (e.g., Gatorade).

• Easy-to-digest food items, such as:

• Toasted white bread.

• Mashed potatoes.

• Plain baked chips (e.g., Lay’s).

• Crackers.

5. Medications for Comfort:

• Over-the-counter Tylenol.

• Colace (stool softener) for constipation.

• Gas-X for belching or abdominal gas.

6. Mobility Aids:

• Stepstool for getting in and out of vehicles or higher beds.

• Slippers with non-slip soles.

Preoperative Hygiene

1. Body Wash:

• Use Chlorhexidine, Cloroxine, or Betadine body wash for 2 days prior to surgery.

• Pay special attention to areas like the belly button.

2. Shaving and Trimming:

• Avoid shaving within 48 hours before surgery to reduce infection risk.

3. Day of Surgery:

• Avoid lotions, makeup, hairspray, and jewelry.

• Wear loose-fitting, front-zipper clothing for ease of dressing and undressing.

Dietary Restrictions

1. Day Before Surgery:

• Stick to a clear liquid diet for abdominal surgeries to reduce intestinal inflammation.

2. Night Before Surgery:

• No food or drink after midnight unless otherwise specified.

Logistics and Caregiver Responsibilities

1. Transportation:

• Arrange transportation with a low vehicle or stepstool for easy access.

2. Caregiver:

• A responsible caregiver must accompany the patient to the preoperative appointment and during recovery.

3. Household Preparation:

• Arrange for a recliner or pillows for a 30-degree angle if required for recovery.

• Ensure clean linens, thermometers, and blood pressure machines are available.

Important Notes and Warnings

1. Pregnancy:

• Avoid unprotected sex 2 weeks before surgery; a pregnancy test will be conducted.

2. Crowded Areas:

• Avoid crowded places 2 weeks before surgery to minimize infection risk.

3. Realistic Expectations:

• Patients must fully understand the risks and benefits of their procedure and have realistic goals.

Specific Preoperative Instructions for Individual Procedures

Each procedure has unique requirements. Please consult the specific instructions provided for your surgery.

Less Commonly Prescribed Medications and Supplements

1. Methylprednisolone Dose Pack (Medrol)

• Indication: Used for swelling or allergic reactions.

• Potential Side Effects: Increased appetite, mood changes, difficulty sleeping, and elevated blood sugar levels.

2. Prednisone (10 mg or 40 mg daily for 3–10 days)

• Indication: Prescribed for inflammation or allergic reactions.

• Potential Side Effects: Stomach upset, insomnia, mood swings, increased blood sugar, or fluid retention.

3. Allegra (Fexofenadine) 24-Hour, 1 Tablet Daily

• Indication: Used to treat allergic reactions.

• Potential Side Effects: Dry mouth, dizziness, or headache.

4. Hydrocortisone Cream 1%

• Indication: Applied to affected areas to reduce inflammation from allergic reactions.

• Potential Side Effects: Skin irritation, dryness, or thinning with prolonged use.

5. Hydrochlorothiazide (25 mg Daily)

• Indication: Occasionally used for excessive swelling (edema).

• Special Instructions: Monitor blood pressure closely and have assistance when standing up to prevent dizziness.

• Potential Side Effects: Dehydration, electrolyte imbalances, and lightheadedness.

6. Nitro Paste

• Indication: Applied to improve blood flow and address venous congestion.

• Application: Apply a thin layer every 2–6 hours with a sterile instrument.

• Potential Side Effects: Headache, dizziness, or low blood pressure.

7. Bromelain (500 mg Twice Daily)

• Indication: Used to reduce swelling and bruising.

• Potential Side Effects: Stomach upset or allergic reactions, especially in patients with pineapple allergies.

8. Arnica Montana

• 12C (5 Pellets, 3x Daily): Used for facial procedures.

• 30C (5 Pellets, 3x Daily): Used to reduce bruising and swelling.

• Potential Side Effects: Rare allergic reactions or mild digestive upset.

9. Zofran (Ondansetron)

• Dose: 4 mg–8 mg orally or rectally every 6–8 hours as needed for nausea and vomiting.

• Potential Side Effects: Constipation, headache, or drowsiness.

10. Celebrex (Celecoxib, 100 mg–200 mg Daily or Twice Daily)

• Indication: For inflammation and pain relief.

• Potential Side Effects: Stomach upset, heartburn, or increased risk of cardiovascular events with long-term use.

11. Mupirocin Ointment (Bactroban)

• Indication: Applied to prevent colonization of MRSA in patients with a history or risk factors for MRSA.

• Special Instructions: Use twice daily on affected areas as part of pre-procedure prophylaxis.

• Potential Side Effects: Skin irritation or itching at the application site.

12. Chlorhexidine Wash

• Indication: Used for whole-body cleansing prior to surgery to reduce bacterial colonization.

• Potential Side Effects: Dry skin, irritation, or allergic reactions.

13. Viviscal

• Indication: A dietary supplement for promoting hair growth and reducing hair thinning, particularly for stress-related or post-surgical hair loss.

• Dosage: One tablet twice daily (morning and evening) with water after food.

• Potential Side Effects: Generally well-tolerated but not suitable for individuals with shellfish allergies due to marine content.

Note for Patients:

These medications and supplements are rarely prescribed and are used on a case-by-case basis. Please follow all instructions carefully and notify your surgeon if you experience any unusual side effects or symptoms. Always discuss any concerns about your medications with your provider.

Post-Surgery Showering Guidelines

General Overview

Showering after surgery requires careful preparation and specific precautions to ensure safety and proper healing. Follow these instructions to minimize risks and maintain hygiene.

Showering After a Tummy Tuck

1. Timing and Assistance:

• Wait until your surgeon allows you to shower.

• Have a caregiver present to assist you during your first shower.

• If you have a second compression garment, use it for easy switching.

2. Shower Preparation:

• Disinfect the shower thoroughly using appropriate cleaning agents.

• Use new antibacterial soap and avoid previously used shower supplies.

• A showerhead with a handheld option is highly recommended.

• Place a shower chair inside the shower in case you need to sit down.

3. Safety Precautions:

• Be cautious of dizziness when first removing your garment. This is common due to vasovagal reactions or changes in blood pressure.

• If dizziness occurs, sit down immediately or have your caregiver assist you in elevating your legs.

4. Showering Technique:

• Ensure the water is neither too hot nor too cold.

• Wash nonsurgical areas first.

• Let soapy water run over surgical sites; do not scrub.

• Use the handheld showerhead to rinse gently.

5. Post-Shower Care:

• Dry surgical sites with sterile pads or dressings—do not use towels or reusable items.

• Lie down on clean sheets after the shower.

• Your caregiver should reapply dressings while wearing gloves, ensuring they do not touch the side of the dressing that contacts the incision.

Showering After Liposuction

• Follow the same principles as above.

• Use a handheld showerhead to rinse areas with minimal disturbance.

• Ensure compression garments are clean and ready to wear after the shower.

Showering After Breast Augmentation

• Avoid scrubbing the surgical area.

• Let soapy water run gently over incisions and rinse with a handheld showerhead.

• Dry incisions with sterile dressings, and ensure a caregiver handles dressings with gloves.

Important Notes for All Procedures

• Do not shower if drains are still in place unless explicitly instructed by your surgeon.

• Keep the shower brief and focus on maintaining a clean environment.

• Avoid touching or contaminating surgical areas with non-sterile items.

• Always use clean, freshly laundered towels and sheets after showering.

Contact Information

• Dr. Babak Farzaneh

• Direct Communication: Call or text Dr. Farzaneh directly on his cell phone.

• Virtual Assistance: Utilize Dr. Farzaneh’s virtual clone on our website for immediate answers.

• Office Locations:

• Chino Hills: 4511 Chino Hills Parkway, Suite C, Chino Hills, CA 91709

• Irvine: 2967 Michelson Dr., Suite S, Irvine, CA 92618

Post-Treatment Instructions for JP Drain Management

General Overview

JP (Jackson-Pratt) drains are placed to remove excess fluid from the surgical site and reduce the risk of complications. Proper drain management is essential for ensuring a smooth recovery. Please follow these instructions carefully to avoid complications and maximize healing.

Drain Management Guidelines

1. Emptying the Drain

• Only empty the drain when it is half full to ensure accurate measurement and minimize contamination risks.

• Do not open the drain to check the fluid level; visually estimate while the drain is holding suction.

• Empty the fluid into a measuring cup to record the output accurately. Always compress the bulb and reapply suction after emptying.

• Use a sterile technique when handling the drain and bulb.

2. Recording Drain Output

• Document the output volume every time you empty the drain and estimate the 24-hour total output.

• If possible, take a picture of the log and send it to our office for review or bring the log to your follow-up appointment.

• Sudden changes in the color or quantity of drainage should be reported immediately:

• Light Pink → Dark Red: May indicate bleeding.

• Sudden Stop in Drainage: Could indicate a blockage or kink in the tube. Check for kinks and straighten the tube gently.

3. Milking the Drain

• Milking the drain prevents clots and blockages in the tubing, especially important post-liposuction or abdominoplasty:

• Timing: Milk the drain every two hours initially, particularly in the first few days after surgery.

• Technique:

• Hold the tubing near the skin with one hand to stabilize it.

• Use the palm of your fingers (not nails or sharp objects) on your other hand to gently squeeze and glide along the tubing toward the bulb.

• You may use an antibacterial lotion or lubricant to help with a smooth gliding motion.

• Goal: The purpose of milking the drain is not to clear the tube entirely (there will always be some fluid inside) but to maintain flow and prevent clogging.

4. Loss of Suction

• If the bulb suddenly loses suction:

• Check the tubing for any visible holes, tears, or disconnections.

• If you find a hole in the tubing, you may temporarily seal it with scotch tape or a small amount of glue. Inform your doctor immediately for further evaluation.

• Loss of suction could also indicate that the drain has been partially pulled out of the skin. If this occurs, the drain may need to be repositioned or removed by your doctor. Contact our office promptly.

5. Protein Intake

• To support healing and reduce fluid production, increase protein intake by 60 grams per day through protein shakes or supplements.

• Why Shakes? It is often challenging to meet this requirement through food alone, especially during the postoperative period.

• Look for high-quality protein powders with minimal additives. Popular options include whey protein isolate, plant-based protein, or collagen peptides.

6. Compression

• Ensure you wear your compression garment as directed. Proper compression helps reduce fluid accumulation and drain output by applying gentle pressure to the surgical area.

• In some cases, additional compression techniques may be recommended to reduce space for fluid accumulation.

7. Antibiotics

• Continue taking antibiotics as prescribed until all drains are removed to reduce the risk of infection at the drain site.

8. Antibiotic Ointment

• Apply a generous amount of antibiotic ointment around the drain exit site when changing dressings. This helps keep the site clean and reduces the risk of infection.

• Use sterile dressings and change them as directed, either by yourself or a caregiver.

Showering Instructions

• Drains in Place:

• Do not shower until the drains are removed unless otherwise specified. If drains are located in the face area, body showering may be permitted.

• After Drain Removal:

• You may shower two days after drain removal unless otherwise instructed.

Handling Drains

• Secure the drain bulb:

• Use pockets in your gown or a safety pin to prevent accidental pulling or tugging of the drain.

• Ensure the bulb remains compressed to maintain suction.

Signs to Watch For

• Increased Drainage:

• Sudden increase in output or change in drainage color (e.g., dark red or bright red blood).

• Sudden Stop in Drainage:

• Check for visible kinks in the tubing or clots. If no improvement, contact the office.

• Loss of Suction:

• Look for holes, tears, or dislodgement. Temporarily seal holes with scotch tape or glue and inform the doctor. If the drain is partially pulled out, it may need repositioning or removal.

• Pain or Redness:

• Signs of infection, such as redness, swelling, warmth, or tenderness around the drain site.

• Foul Odor or Discharge:

• Report unusual smells or cloudy drainage immediately.

• Dislodged Drain:

• If the drain becomes loose or falls out, contact our office promptly.

Follow-Up

• Bring your drain log, or provide an estimation of 24-hour drainage totals at your follow-up appointment.

• Drains are removed as soon as medically appropriate, usually when output is consistently low and the surgical site is healing well.

Contact Information

• Dr. Babak Farzaneh

• Direct Communication: Call or text Dr. Farzaneh directly on his cell phone.

• Virtual Assistance: Utilize Dr. Farzaneh’s virtual clone on our website for immediate answers.

• Office Locations:

• Chino Hills: 4511 Chino Hills Parkway, Suite C, Chino Hills, CA 91709

• Irvine: 2967 Michelson Dr., Suite S, Irvine, CA 92618

We’re Here for You

Drains may feel uncomfortable, but they provide valuable insights into your healing process. If you experience any issues or have concerns, please do not hesitate to contact us. Thank you for trusting TrueCare Cosmetic Surgery & Med Spa.

Post-Treatment Instructions for GLP-1/GIP Peptide Therapy

General Overview

GLP-1 (Glucagon-Like Peptide-1) and GIP (Gastric Inhibitory Polypeptide) peptide therapies are emerging treatments aimed at enhancing metabolic health and supporting weight loss. Adhering to the following guidelines will help ensure your safety and optimize the benefits of the treatment.

Post-Treatment Guidelines

1. Protein Intake

• Consume 1 gram of protein per pound of your ideal body weight daily.

• Formula to Calculate Ideal Body Weight:

• For Men: 50 kg + (2.3 kg × inches over 5 feet).

• For Women: 45.5 kg + (2.3 kg × inches over 5 feet).

• Example: A woman who is 5’5” (65 inches): 45.5 kg + (2.3 kg × 5) = 57 kg (approximately 125.7 lbs).

2. Hydration

• Maintain adequate hydration by drinking plenty of water throughout the day to support metabolic processes and prevent dehydration.

3. Exercise

• Engage in regular resistance exercises to promote muscle mass retention and overall metabolic health.

4. Body Composition Monitoring

• A DEXA scan is recommended to accurately assess your body composition and track progress.

5. Coordination with Primary Care

• Inform your primary care provider about your participation in this therapy to ensure comprehensive care.

Potential Side Effects and Complications

Common Side Effects

• Gastrointestinal Issues: Nausea, vomiting, diarrhea, constipation, and abdominal pain are common. Notify your provider if symptoms persist.

• Mood Changes: Be attentive to any changes in mood, including feelings of depression or anxiety. Report these changes to your healthcare provider.

Serious Risks

• Pancreatitis: Be alert for signs such as severe abdominal pain that may radiate to the back, nausea, and vomiting. Seek immediate medical attention if these occur.

• Gallstones: Watch for pain in the upper right abdomen, nausea, and back pain between the shoulder blades.

• Kidney Problems: Monitor for changes in urination, swelling in the legs or ankles, and fatigue.

• Vision Changes: Report any changes in vision to an eye specialist to rule out conditions like retinopathy.

• Thyroid Concerns: If you have thyroid disease or nodules, an ultrasound and endocrinologist clearance may be required.

Weight Maintenance After Treatment

• It is important to note that there is no guarantee that weight loss achieved during therapy will be maintained after stopping the medication.

• Weight regain may occur even with continued exercise and a healthy diet.

• Maintaining a balanced, active lifestyle and adhering to follow-up recommendations can help minimize the potential for weight regain.

When to Seek Medical Attention

• Severe or persistent abdominal pain, especially if accompanied by nausea or vomiting.

• Persistent gastrointestinal symptoms such as ongoing nausea, vomiting, diarrhea, or constipation.

• Signs of dehydration, including dizziness, decreased urination, or dark-colored urine.

• Sudden or worsening vision problems.

• Symptoms of gallstones, such as sudden abdominal pain after eating fatty foods.

• Signs of kidney issues, including changes in urination, swelling, or fatigue.

• Mood changes, including feelings of depression or anxiety.

Contact Information

• Dr. Babak Farzaneh

• Direct Communication: Call or text Dr. Farzaneh directly on his cell phone.

• Virtual Assistance: Utilize Dr. Farzaneh’s virtual clone on our website for immediate answers.

• Office Locations:

• Chino Hills: 4511 Chino Hills Parkway, Suite C, Chino Hills, CA 91709

• Irvine: 2967 Michelson Dr., Suite S, Irvine, CA 92618

Important Disclaimer

• Compounded Medication: This therapy involves a compounded medication obtained from a 503A FDA-regulated pharmacy in California.

• Off-Label Use: This is an off-label treatment. While we do not make claims regarding the indications for this product, compounds similar to this have demonstrated potential benefits in weight loss, metabolic health, and cardiovascular improvements in semi-controlled studies.

• This therapy should be used as a supplement and not as a replacement for medically necessary treatments or management plans. Consult your primary care provider for further advice.

We’re Here for You

Your health and satisfaction are our top priorities. If you have any concerns or questions following your treatment, please contact us. Thank you for choosing TrueCare Cosmetic Surgery & Med Spa.

IV/IM Supplement Post-Op Instructions

General Disclaimer

All treatments in this category, including NAD+ therapy, IV/IM vitamins, and supplements, are supplemental and do not have absolute FDA approval for specific medical indications. They are intended to support overall wellness and should not replace prescribed medical treatments. Please follow these instructions to ensure safety and optimal results.

General Post-Treatment Guidelines

1. Hydration:

• Drink plenty of water post-treatment to support recovery and detoxification.

2. Observation Period:

• Remain at the facility for a mandatory 15-minute observation period after IV or IM administration to monitor for adverse reactions.

3. Dietary Support:

• Consume a nutrient-rich, balanced diet to complement the benefits of your therapy.

Therapy-Specific Instructions

IV NAD+ Therapy

1. Common Reactions:

• Nausea, lightheadedness, and mild chest tightness may occur during or after treatment. These usually resolve quickly.

2. Post-Treatment:

• Avoid strenuous activities for 24 hours. Rest to allow your body to adjust.

3. Hydration:

• Ensure adequate hydration to assist in toxin elimination.

IV Glutathione

1. Benefits:

• Supports skin health, detoxification, and overall cellular repair.

2. Post-Treatment:

• Mild headache or nausea may occur but should resolve within hours.

3. Additional Notes:

• Avoid alcohol for 24 hours post-treatment to maximize benefits.

IM Vitamin B12

1. Benefits:

• Boosts energy levels, supports brain health, and improves red blood cell production.

2. Post-Treatment:

• Expect mild tenderness or redness at the injection site, which usually resolves within 1–2 days.

3. Special Notes:

• This therapy is typically well-tolerated. Contact us if you experience persistent symptoms.

IV Vitamin C

1. Benefits:

• Promotes immune function, reduces inflammation, and supports skin health.

2. Special Considerations:

• High doses may cause mild discomfort or bloating during infusion; this is normal.

3. Post-Treatment:

• Avoid strenuous activity for 12–24 hours.

IV Myers’ Solution

1. Components:

• A combination of vitamins and minerals, including magnesium, calcium, B-complex, and Vitamin C.

2. Post-Treatment:

• Mild fatigue or a feeling of warmth may occur; this typically resolves within a few hours.

3. Hydration:

• Drink water to support electrolyte balance and maximize benefits.

When to Contact Us

• Signs of Adverse Reactions:

• Persistent nausea, vomiting, dizziness, or unusual discomfort.

• Signs of an allergic reaction, such as difficulty breathing, hives, or swelling.

• Injection Site Concerns:

• Persistent redness, warmth, or tenderness around the injection site.

Contact Information

• Dr. Babak Farzaneh

• Direct Communication: Call or text Dr. Farzaneh directly on his cell phone.

• Virtual Assistance: Utilize Dr. Farzaneh’s virtual clone on our website for immediate answers.

• Office Locations:

• Chino Hills: 4511 Chino Hills Parkway, Suite C, Chino Hills, CA 91709

• Irvine: 2967 Michelson Dr., Suite S, Irvine, CA 92618

We’re Here for You

Your health and satisfaction are our top priorities. Please do not hesitate to reach out if you have any concerns or questions following your treatment. Thank you for choosing TrueCare Cosmetic Surgery & Med Spa.