I have had the fortune to operate patients originating from Japan, Italy, USA, Austria, England, South Africa and other countries. Because I am a female doctor, female patients from Arab countries enjoy the freedom of not having to cover parts of their body and so I am able to offer an aesthetic suggestions to help them harmonize their overall look. Special consideration is given to foreign patients because it is understandable that they are stretching their local boundaries and so we go to lengths to make sure that they are well cared for.

Three Key things to know about plastic surgery in Brazil:

1. Brazil has some of the most experienced Plastic Surgeons in the world.

This is partly due to the society having a long-term, "easy-openness" regarding the body aesthetic, which has lead women and men towards a natural desire for improving the look of their body via sculpturing surgeries. This societal tendency has provided the fertile ground for the evolution of world-class medical schools, plastic surgeons and innovative techniques.

As with any doctor that you may be choosing in your country, first make sure that the surgeon has a long history of experience with the type of surgery that you are considering. She or he should be licensed (in Brazil it is the Conselho Regional de Medicina or (CRM) and the Doctor SHOULD HAVE A TITLE AS A SPECIALIST in Plastic Surgery. Excellent resources for researching doctors are the Sociedade Brasileira de Cirurgia Plastica (Brazilian Plastic Surgery Society)[in Portuguese], International Society of Aesthetic Plastic Surgery [in English] or the Fedaración Ibero Latinoamericana de Cirugia Plastica y Reconstructiva (Latin American Federation of Plastic and Reconstructive Surgery) [in Spanish].



2. Don't come to Brazil for tourism and for Plastic Surgery.

Would you go to Los Angeles, London or Hong-Kong for plastic surgery and then go out sight-seeing? Bandaged? Risking injury to the wound? Plastic Surgery is surgery (see section titled "Tips Obtained During 23 Years of Plastic Surgery Experience") and as such requires the necessary time and rest for the correct evolution of the healing process. In certain cases you may have to be resting in bed from two to five days (longer if you have multiple large procedures). Add to that your to/from travel time and pretty soon your vacation time is all gone.

Your mind-set should be that of having a healthy experience, and a fast recuperation period, so that when you go home you are ready to go back to your daily activities in peace.  Of course, if you have allot of free time, after the recuperation period you can explore the many wonderful sites of my country, especially Bahia, where I grew-up.



3. Don't be afraid to turn-around and go back home if you are not fully confident.

The Doctor that you choose should just charge you for an initial consultation fee (I charge R$200). That fee should cover about an hour's visit within which you should be able to ask and receive clear answers regarding ALL YOUR QUESTIONS. You should see a range of photographs of similar cases as that which you are considering and the Doctor should show a long-term competency with the procedure.

Then, nothing should happen. That is, you should be able to go back to your hotel and think about the situation, for as long as you need. You should not sign any documents or be pressured into paying any deposits. ONLY WHEN YOU ARE CONFIDENT of the Doctor, and when you have a clear understand of all the events surrounding the surgery , then you can make a commitment to move forward with the operation.

If you are unsure, go home. Or go site-seeing now that you are in the country. The worst thing that you can lose is your plane-fare and a night's stay at a hotel. But be sure to understand that this is an option available for you.

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Your Arrival

This may be one of the most worrisome parts of your experience since you may be arriving tired from a flight into a country that may be unknown. The reality though is that there is little to worry about. You can arrange in advance for a limousine service to take you to your hotel. If you choose our clinic we will have a car and driver, as well as an English speaking representative greet you and help you check-in to where you'll be staying.

On the other hand, if you want to get to your hotel on your own, its easy. Right outside of the customs exist is a single taxi desk, with friendly attendants. You show them the address of the hotel, and pay one flat fee to the destination (to most hotels near the clinic this will be about $R120), then you go to one cueu of blue and white taxies, get into the next one available, give the driver the payment receipt and the address...and he or she will take you there directly, in a clean, safe car, without any detours or extra charges.

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Accommodations

Another piece of good news about São Paulo is that for the size of the city, there is a wide variety of very good hotels at excellent rates. Another good option, and perhaps better for your recuperation, is called a 'flat', which is a larger hotel room that may resemble an apartment and can include a kitchen. There are a few flats near my clinic that can be good choices for you. Flats can be a good choice for your recuperation since some allow you to keep, cook, re-heat food as you desire, without having to go out, yet they have room service available if you need something to eat without bother.

Since you may be staying from 5 to 15 days, good, safe, clean accommodations can be arranged to meet your budget needs.

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Companions

This really depends on how social you are during recuperation. Some people want to go into their cave, while others need mom or a sister around to help. Whether or not you chose to have someone accompany you may depends on your budget and their time availability.

In case that you are limited to coming alone, our clinic can provide a full-time companion to help you during the first days after returning from the hospital and for as long as you need. It is important that someone be there to help you with your medicines, your food, going to the toilet, etc., since you may be feeling discomfort when you move. Having to get out of bed at night to go to the bathroom, with bandages and soreness, may not only be a bummer but it can be harmful to you if you happen to fall.

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Getting Around

São Paulo is the second largest city in the world, only slightly smaller than Seoul, South Korea. Although it is broken down into neighborhoods, (our clinic is in Moema), because of its size, it is often difficult for tourists to get their bearings. But there are many interesting places to visit, including a large number excellent restaurants, etc. For those times that you would like to look around the city, more than likely before your surgery, or afterwards when you are well enough, our clinic can arrange for a guided tour to take you around.

We can also make arrangement for you to get around during the other times when you will need to travel.  Such as:

• To and from the airport;
• To and from your hotel to our clinic for your initial consultation;
• In the case that you need to go to a laboratory for tests, although that is discussed here;
• To and from your hotel to the hospital for your surgery;
• To and from your hotel to our clinic for post-surgery check-ups.

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Language and Culture

Even though São Paulo is big, most people here are relaxed (even in rush hour traffic) and even, friendly. The majority of "Paulistanos" come from some other place in this large country and/or have family roots from some other country in the world. It is said that São Paulo has the largest Japanese community outside of Japan. There are also many Germans, Italians, and of course, Portuguese, so we seem to empathize with a stranger and you'll probably get that feeling too.

Most persons here don't speak allot of English but they will try to help you if you are friendly and ask for assistance. A pocket dictionary with a few phrases will help you understand what is necessary to get by. If you need a translator, we can also arrange the services of friendly translators who will help you, and even teach you some Portuguese.

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Your Safety

Unfortunately, today safety is a concern for all of us in most cities around the world. And your safety is also our concern too. Be that as it may, São Paulo is a relatively safe city as long a you take the standard steps that you would take when traveling to a large city in a foreign country. A key action item is not to go out unaccompanied since you may simply get turn-around and lost. Since your primary objective is your plastic surgery and your recuperation, we believe that you'll probably keep a low profile and not do the things that dumb tourists do when traveling.

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Initial Consultation

You are encouraged to first read the section titled "Our Services" and specifically the text regarding Personalized Attention. This is so you understand that we are not a high-pressure 'you must do this surgery now' type of clinic. Our primary concern is your wellbeing, your long-term good looks and excellence in Plastic Surgery.

Our initial consultation lasts about an hour during which time I examine your condition and determine the state of your health. We serenely and honestly discuss your specific needs and you get to look at photographs of prior cases similar to yours. As I relate the options that are available, you will be able to ask any and all questions that may come to mind regarding any aspect of the procedure. At the end everything should be clear to you.

As mentioned above, in item number 3 of "Three Key Things to Know...", afterwards, if need be, you will have the opportunity to go back to your hotel or to go home in case that you decide that plastic surgery is not for you. You will not be pressured to stay, sign any papers or go through any procedure that you are not fully ready for.

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Fees and Documents

If you choose to go ahead with your surgery then you will visit with Rose, our business administrator, who will discuss the details regarding finances and documentation. Again, Rose is not there to twist your arm, she is there just to provide you with the necessary information that you need.

Regarding Fees:

1. You will be presented with an official detailed written quotation for my surgical services and for the services of my team;
2. You will be given an estimate of the cost of the hospital. There is a range of hospitals that can accommodate both your budget as well as your comfort. We can only provide you with an estimate for the hospital because only they can provide an official quotation. ;
3. In the case of a prosthesis, metacrylates, etc., if need be you can also receive an official quote from the manufacturers representative;
4. Payment for our services must be made in full up to two days before the surgery. This payment will cover my fees, the anesthesiologist, any additional assistant doctors, my instrument assistant and any other persons involved. Again, you will have a full quotation disclosing these fees, before you make a commitment.
5. In the case of prosthesis, metacrylates, etc., it may be possible for you to negotiate and pay the manufacturers representative directly. Of course, this may add some complication to your life and so we can arrange to make the payment to them on your behalf. Payment for these items is also due at least two days before the surgery;
6. The hospital is paid directly by you. We will be glad to make a reservation on your behalf. No, we don't get any money or percentage from the hospital. You can discuss and negotiate the price directly with the hospital.
7. Other payments that you will need to consider are those for nurse care during the first few days after your surgery. Don't forget to budget for a lymphatic massage therapist. We can introduce you to established professionals and you can negotiate and pay them directly or we can intervene on your behalf. One other thing to keep in mind is that you will be asked to purchase some corsets to aid in your recuperation. We can reference you to two local manufacturers who offer good products at good prices.
8. As well, you should budget for transportation in case that you would like our clinic handles this. Hotel and meals should be paid directly to those service providers.

Regarding Documents

1. As in your country, you will receive a series of legal waivers to sign, detailing procedures and risks specific to the operation(s) that you are considering. In today's litigious society, unfortunately we must go through this step.  Since we are in Brazil, they will be in Portuguese, they will be translated for you but the originals will be signed in Portuguese. If you have any doubts, we can make available a certified official translator who can confirm any of the information that you receive.

   Again, if you are not sure about any aspect of these documents, you will have time to think it over or even desist. We would like to make sure that you are absolutely comfortable with your decision to utilize our services.

2. The first documents that you will receive are called "Protocolos". There is one that is generic for all procedures and then there is one specific for each type of procedures that you are undergoing.

   The generic document includes information that the Sociedade Brasileira de Cirurgia Plastica (Brazilian Plastic Surgery Society) believes is important for a consumer to know about undergoing plastic surgery.

   The specific document, provides information that pertains just to the surgery that you are considering. For example, the Blepharoplasty document describes, the photographs that should be taken, the ideal age for the person, duration of the hospital stay, type of anesthesia to be used, the duration of the surgery, pain, bandaging, bruising, scarring, and the final result. Then there is a section on useful recommendations, pre-operation and post-operation. Last, there is a description of the possible complications. Its very detailed.

3. The next document is a medical services contract with me, which specifies the procedures that will be done, the follow-ups, payments and terms.
4. Last is the Informed Consent agreement, where you indicate that you are satisfied with all the information that you were given regarding the procedures, the recuperation, the complications, the duration, etc. Here you authorize undergoing the procedure and its risks. You will be asked by the hospital to sign a similar type of document upon check-in.

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Lab Tests

It is possible, and much more practical, for you to undergo the required lab tests in your country and then bring the results with you. Depending on the surgery that you would like, it may be necessary for you to go through a cardio test and blood test, including HIV. With the results on hand we can schedule your surgery for a period soon after your arrival, after you've had your consultation and have agreed to the fees and documents, mentioned previously.

On the other hand, it's ok if you would like to have your lab test done here. In São Paulo there are a number of world-class laboratories that can assist you. The thing that this will do is add a few days to your stay.

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Hospital Procedures

Modern hospitals now work somewhat like hotels, you have a check-in process which gives you access to their accommodations for periods of 24 hours. A representative from the clinic will escort you to the check-in process and up to your assigned room, to make sure that you are comfortable. Most of my surgeries require an overnight stay but some may require 2 nights.

It is worthy to note that you must make a cash or credit card deposit to the hospital during this check-in. Before you leave, you will be presented with an itemized bill that indicates all the items used during your surgery and your stay. We can help you review the bill to make sure that there are no overcharges. As mentioned previously, you will be asked by the hospital to sign a contract and an Informed Consent Agreement.

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Recuperation

Of all the information available about Plastic Surgery on the Internet, recuperation is often the most down-played, yet it is of the highest importance for the long-term success of your final result. There are two key elements to a speedy recuperation: 1) rest; 2) following the instructions regarding medicines and procedures...TO THE LETTER.

The problem is that you are probably an active, independent person and will be eager to go out and show-off your new look. Staying in-doors, and worse yet, staying in bed or sitting down all day goes against your nature. But that is what you will have to set your mind to do this during a number of days, depending on type of surgery. This will be a good time for you to read those good books that you've never had time for. Knit a scarf. Start writing your biography. Whatever. Just be sure to rest, take your medicine, eat properly to nourish your body (you may notice that you feel hungrier, that is your body trying to gain energy to heal), and follow all instructions that we provide. Keep remembering that each day you are one day closer to that nice look that you've desired for yourself all these years.

If you don't, there may be consequences. Two important consequences are: 1) The lengthening and/or widening of your scars. My team and I take great effort to make sure that the sutures are made as small and discreet as is technically possible, but like any stitch, if you pull on it, it will stretch and look ugly. 2) The rupturing of stitches. This is even worse since it may mean that you will have to go back to the hospital for additional work, lengthening your healing and perhaps lengthening your stay.

Lymphatic massages are a great way to speed-up your recuperation. We can introduce you to professional massage therapists who have experience with lymphatic draining for post-surgery patients. I feel that it is important that the person be knowledgeable of what to do around wounds so that they don't push or pull where not appropriate.

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Complications

Because of the safe approach that we take to Plastic Surgery, complications don't happen very often, but we must always discuss contingency plans in case that they do happen. Everything in your Plastic Surgery experience, with me or with any other Surgeon, should be designed to lower the possibility of complications. We seldom have them because I take the time to personally and closely follow your case from beginning to end.  Because of my experience, I become aware of any early indications that may lead to complications and take actions to steer away from problems.

Whatever complication may arise after your surgery will be attended by me or under my supervision, if the case relates to something outside of my specialty.

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Follow-up's

The fee that you pay me, as indicated in the contract, includes all necessary post-operative follow-up visits as may be necessary. There are no additional charges. These visits include the changing of bandages by me or by my assistant. As mentioned in the previous section, in order to avoid complications, more than likely I will be changing your bandages since this is an opportunity to review the progress of your healing.

Since you will be returning home at some point, we may not be able to have all the of follow-up visits throughout the year after your surgery. Never-the-less, we can communicate via Email or Webcam, at which time I can receive photographs or see images of your healing process. As time goes by and questions arise, I will still be available to provide you with answers to your concerns.

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Going Home

Returning to your country will depend on the speed of your healing. We will estimate a return date based on you following all my instructions, but we'll leave some padding in case that I think you need to be looked after a bit longer. We can estimate pretty closely but your cooperation greatly helps in determining the final return date.

Finally, I have to say that it will probably be a sad day when you go because we will have gotten to know each other personally. Because of my profession I have allot of girlfriends in different countries and throughout Brazil. Sometimes, like today when I'm writing this, I get invited to their wedding because we have kept touch throughout the years. After 25 years as a Plastic Surgeon I have begun to see the grown-up children of my patients or patients that I treated as children and who have grown-up. You can read some of their stories in the testimonial section. The bottom line is that I will be so glad to think of you and your beauty walking around confidently and serenely somewhere in another country. You and I will have something in common, we will be happy to be BEAUTIFUL WOMEN.

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