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DR. FABIO FAQ
1. Are you an MD and board certified in plastic surgery, and by whom?
Yes, I’m certified by the Brazilian Society of Plastic Surgery (Sociedade Brasileira de Cirurgia Plastica/ SBCP)
2. Do you teach and/or do clinical research?
I teach for specialization courses at the university only when I’m invited, without a contract. I’m usually invited to teach about breast reconstruction after mastectomy because of cancer or about massive weight loss surgery. They invite me most to talk about reconstructive surgery, since they are doctors that are specializing in that field.
3. Are you published and where might I reference your writings?
Unfortunately I have not published. I should have done it, therefore I’ve been working too much and haven’t had any time left.
4. What are the top 5 procedures that you perform?
Lower Body Lift (LBL), inner thigh, arm lift, breast lift, facelift (including eyelids), breast reconstruction after mastectomy, hair transplantation surgery and liposuction.
5. How frequently do you have to do revisions?
It is more common to perform revisions after lipo, because there is a chance to have a small accumulation of a little perceivable fat, especially when it’s an extensive lipo. Another reason to revision is to retouching the scars. In Brazil, the incidence of scar hypertrophy is common.
6. What is your policy on revisions?
On the revisions the patients only pay the hospital expenditures. Even the anesthetist doesn’t charge for it’s honorary.
7. How many surgeries do you perform per week?
I perform ten surgeries, two per day.
8. Are your surgeries assisted? If so by whom and what are their credentials?
I have two assistants, one plastic surgeon, one general surgeon and two nurses that directly participate on the surgical act.
9. In an emergency do you have hospital privileges for admission?
Yes, I do.
10. Are emergency facilities and services available (emergency room, urgent care, ambulance, etc.)?
Yes, they are.
11. What tests are performed on donor blood (HIV, Hepatitis, etc.)?
HIV I and II, hep.B and C, Chaga’s disease (common in the north part of our country), VDRL, HB, blood type, RH factor, hemotocrit
12. How frequently do you find it necessary to administer blood, and how many units on an average are given?
If it’s an extensive surgery, I usually indicate transfusion. It’s more common in reconstructive surgery after massive weight loss surgeries. Even in these cases, I indicate the minimum, up to 5 units.
13. What preventative measures do you utilize to prevent and/or treat DVT?
I ask the patient to take Clexane; to wear an elastic sock during surgery; massage is done on the legs during surgery; compression pump on the legs after and during surgery; lymphatic draining on the immediate post op done by a physiotherapist while patient is still in the hospital.
14. What is the method for equipment sterilization?
Autoclave and ethilen oxid
15. Where is the surgery performed in a hospital or outpatient surgical center?
In the hospital
16. What type of anesthesia is used?
General anesthesia in combination with epidural anesthesia. The epidural anesthesia associated with the general have many advantages that are:
a) at the end of the surgery, the patient is still under the epidural anesthesia and this way s/he fells less pain for the first 12 hours after surgery
b) the association of the two anesthesia allows the anesthetist do a general anesthesia containing less drugs, which is better for the patient and the “coming to” is faster.
17. Who administers the anesthesia, are they board certified and by whom?
The anesthesia is administered by an anesthetist, and s/he is certified from the Brazilian Society of Anesthesiology.
18. What types of complications do you see, how are they handled and at what rate do you see complications?
The most common complication is the seroma. Some times we have to put the suction drains back and the patient returns to the States with them on, and they can be removed by a PCP (primary care physician).
19. How are post-op complications handled after returning home?
When it occurs, it’s a late seroma. It can be followed up by a general surgeon.
20. What is your rate of infections?
In 400 cases of bariatric patients operated, being 250 Brazilians and 150 Americans, I had one case of infection. The infection occurred on the late post operative time. The patient had a wound opening on the posterior part of the LBL and because the patient kept having a diarrhea, there was a contamination of the open fluid through the excrements. The treatment was very easy because the wound was already opened and there weren’t risks for the patient.
21. How often and why is the hyperbaric chamber used?
It’s usually used in smokers. Actually, I’d like to use it for all the patients, but many of them don’t like to be “locked” for two hours in the hyperbaric chamber.
22. If several rounds of surgery are needed, what is the waiting period between each round?
Two to three weeks. It depends on the patient’s recovery.
23. How frequently do you perform plastic surgery on patients with large weight loss?
Two times a week.