• Dr. Megan Dreveskracht

MANAGING THE OUT-OF-TOWN SURGERY

In my practice, especially with my Top Surgery practice, I frequently have patients who travel from out-of-state to have surgery. Now, I’ve previously written a blog post about the pitfalls of what we call ‘medical tourism, and this is not what I’m talking about in this instance. Even in the largest of cities, you may not be able to find your perfect surgeon. This could be for the specialization required for your specific surgical goals, that you just haven't “vibed” with the consultations you have had, or maybe you have been eyeing a surgeon from afar on social media. Whatever the reasoning may be, you may find yourself in a situation where you are considering an out-of-town surgeon. If so, what are the most important factors to consider when planning your remote surgery?


TIMING

One of the most important factors to consider during your planning is ensuring you give yourself enough time after the procedure to be in close proximity in the rare but unfortunate event of a complication. At the very least, I think a couple of days after surgery is good. Most issues that need immediate attention, such as ongoing bleeding, will present in the first 72 hours after surgery. This way, it is your surgeon that will take care of you instead of some random Emergency Room doc or on-call Plastic Surgeon. This is not only the safest thing to do for you but also usually the most cost-effective. Your surgeon is the one who performed your initial surgery–not only do they know you as a patient and know any pertinent medical history you may have, but they know exactly what was done in the operating room during your initial procedure. This will make going back into surgery much easier, quicker, and potentially safer. In addition, most surgeons do not charge their own patients a fee for managing urgent complications. If you show up in your local ER, however, you better bet you will be footing the bill for whoever ends up managing your issues.

In all likelihood, no urgent or emergent issues will occur. This doesn’t mean that you shouldn’t also have an in-person check in before hitting the road. Swelling actually will increase in the days after surgery and usually peaks around day three or four. This means things will most certainly change over those first couple of days, and allowing your surgeon to follow those changes helps us to determine if things are progressing normally or abnormally. Last but not least in terms of timing is your comfort. You will be much more comfortable chilling out for a couple of days after surgery as opposed to schlepping through an airport.

HAVE A PLAN

This point cannot be overstated enough. Develop a detailed plan with your surgeon in regards to a) their expectations for follow-up and (b) the most likely complications to occur with your particular procedure. Have an idea of how and who will be managing any postoperative issues. Knowing these details will help you also to get a better understanding of the most appropriate time frame to remain in the area after surgery before returning home. Many of the most common postoperative complications such as a superficial skin infection (cellulitis) or minor wound healing issues can be safely and effectively managed from afar. Other complications however, such as a fluid collection, may warrant in-person intervention. To address these more invasive interventions, discuss with your surgeon who could potentially manage these issues once you return home. I will generally tell patients to contact their primary care provider ahead of time just to be safe. Another alternative is if your surgeon has any colleagues in your area that would be willing to see you postoperatively. This will put you in the hands of someone who is experienced, familiar with your procedure, and has the trust of your own surgeon.

THE DETAILS

It goes without saying that after surgery, you will not be feeling like your greatest self. This is why choosing the right caregiver for your postsurgical needs and the correct location for your recovery are key. You want someone who will be comforting, caring, and can take charge as your medical advocate if need be. Thinking about bringing along your best friend who you love dearly but doesn't seem to know when to stop talking? Probably not the person who is going to allow you the time you need to recover restfully.

As far as location, there are a couple key things to consider. How close is it to the surgery center and also your surgeon's office? Especially in larger cities, it’s important to remember they might not be particularly close to one another. The features of where you are staying are just as important as its location. You are going to want a comfortable place to relax that is easy to move around in. Two flights of stairs up to that Air BNB? Yeah, probably not the best idea.

BE WILLING TO RETURN

Like I keep reiterating, odds are that your surgery and postoperative course will go smoothly. However, ‘unlikely’ does not equal zero either. And it’s not all about death and dying. Some complications such as wound healing issues or fluid collections, if not managed correctly in a timely fashion, can dramatically affect the aesthetics of your long-term outcome. As a surgeon, it is incredibly challenging when an out-of-town patient can’t find the time or means to travel back to see me for an issue, yet gets frustrated when their results fall short of perfect as a consequence. Thus, if you choose a surgeon that doesn’t live locally, it must also be a possibility for you that you can return if needed.

THE BOTTOM LINE

Traveling out of your area to get plastic surgery is incredibly common practice and can be a safe and reasonable option when done right.

 

If you would like to know more about this or any other topic, please leave your comments or questions below or call 425-776-0880 to schedule your consultation today.


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