Financial responsibilities.

The cost of surgery includes various concepts for the services provided. Total costs include:

– Surgeon fees.

– Surgical medical inputs, such as implants, equipment rental or state-of-the-art technology.

– Fees for anesthesia and pre-anesthetic evaluation.

– Clinic or operating room rights where the procedure will be performed.

– Hospitalization if required.

– Surgical assistant, scrub nurse or surgical instrumentation.

– Post-operative insurance in case of complications.

– Girdles, stockings, compression clothing.

– Laboratory exams.

– Medical prescription or medications.

– Pain pumps or medical devices for pain management after surgery.

– Massages, lymphatic drainage therapies.

– Hotel or lodging for recovery after surgery.

– Transport.

In addition, potential future costs must be budgeted for additional procedures required to review, optimize, or complement the results.

Additional costs may be incurred if complications from the surgery are generated. For most plastic surgeries, some insurance must be purchased before surgery, covering complications that may occur in the first period after surgery. During the orientation appointment, you can clarify much more about this insurance coverage and its costs. Usually, these insurances are paid before surgery during the preoperative evaluation with the anesthesiologist.

There is the potential that secondary surgeries or hospitalization costs related to revision surgery will be required in the future, and it will be the responsibility of the patient to bear the fees generated.

Budget request or surgery costs.

You can get a tentative budget by contacting us; the team, assistants and surgery coordinators will talk with you, learn about your health condition and explain to you in detail about the high quality of our service provided.

Finally, you will know the actual cost of the procedure after your face-to-face or telehealth (online) appointment www.drlopezrios.com appointment with our specialist.

Payment conditions.

1. Payment in cash in Colombian pesos (COP), American dollars (USD) or Canadian dollars (CAD).

2 . Wire transfer.

3. Use a Credit or debit card.

To reserve the surgery date, an advance of 50% of the budget cost must be made, which is fully refundable when cancellations are made three weeks before the scheduled date. The total payment of the budget must be made before the surgery.

Budgets are valid for three months.

Surgery postponement policy.

If the procedure is postponed to another date, the value of the quoted price will remain in force for three months.

Surgery cancellation policy.

Surgery cancellation policies should be discussed directly with the surgeon where the procedure was scheduled.

Both Colombian insurance companies belonging to the General System of Social Security in Health and EPS or prepaid medicine, as well as foreign insurance companies,  excludes coverage for cosmetic surgeries and refuses to care for a patient with any complications that may occur after surgery, especially the first few days after the procedure. For this reason, I recommend carefully reviewing your health policy or contacting your insurance company to obtain detailed explanations of the coverage policies. Likewise, most insurance plans exclude coverage for revision or secondary surgeries.

When you schedule aesthetic plastic surgery, you must acquire a policy before the surgery that covers complications associated with the surgery. You can contact us if you want more information; we are happy to answer your questions and explain coverage and costs.

I perform cosmetic procedures such as applying botulinum toxin, facial fillers, hyaluronic acid, and chemical peeling in my office in El  Centro Ejecutivo, Poblado, Medellín, Colombia.

As a plastic surgeon, I have a license to operate in Colombian territory, and I perform surgeries in El Hospital San Vicente Fundación in Medellín, Colombia, a university care center. Likiwise, I perform aesthetic plastic surgeries at  IQ Interquirófanos  o  Quirófanos el Tesoroin El Poblado, Medellín, Colombia. The selected location depends on the availability of the operating room, equipment or patient preferences. The local and regional regulatory bodies authorize all the places where I perform surgeries; they also have extensive experience managing aesthetic plastic surgery patients, a trained and certified human team with high-quality standards and the necessary resources to perform surgery. 

The different cosmetic procedures and surgeries are performed with local or general anesthesia depending on the indication and characteristics of the procedure and the patient.

Local and general anesthesia haave risks. The potential for complications, injury, and even death exists from surgical anesthesia or sedation. For this reason, discussing these risks during the medical assessment consultation before surgery with the surgeon or with the anesthesiologist is essential in case general anesthesia is required.

In most cases, I use lidocaine or bupivacaine; if you have a history of allergy or intolerance to these drugs, it is essential to remember this during the medical consultation.

The facilities where I performed the surgeries are authorized by the regulatory entities at the regional level and have high-quality anesthesiologists to provide optimal care to all my patients.

All procedures and surgeries have risks ranging from mild to severe and short or long-term. For this reason, it is essential to carry out an adequate medical assessment of Telehealth (online) or face-to-face that includes a complete clinical history and a complete physical examination to know what the surgery is about, the management alternatives, including not surgery or medical treatments, in addition to all these associated risks, understand them, clarify doubts, and sign the document known as informed consent.

General risks of any procedure or cosmetic surgery.

You must read and understand this information carefully and thoroughly.

Alternative treatments.

There are alternative forms of treatment consisting of non-surgical and surgical procedures for any medical condition. Potential complications and risks have also been associated with alternative treatment treatments.

General risks.

Every surgical procedure has a certain number of risks, and it is vital that you understand them and the possible associated complications. Additionally, each procedure has its limitations. The decision to undergo a surgical procedure is based on balancing the risks and the potential benefits. Even though most patients do not experience complications, you should discuss each with your surgeon to fully understand the possible consequences of undergoing surgery or procedure.

Bleeding.

It is possible to experience bleeding episodes during and after surgery. Intraoperative blood transfusions may be necessary. If postoperative bleeding occurs, emergency treatment may be necessary to control the bleeding or in case of hematoma or collections of blood; it will be required to drain the accumulated blood and transfuse blood. It is recommended not to take salicylic acetyl, known as aspirin or anti-inflammatory drugs, 10-14 days before surgery, as these may increase the risk of bleeding. Herbs, herbal products, multivitamins, or dietary supplements may increase the risk of bleeding. Hematoma or blood collection can occur any time after surgery, especially after trauma and even after sexual intercourse, which should be avoided for the first few weeks after surgery. If blood transfusions are required to treat blood loss or bleeding-associated anemia, there is a risk of blood-related infections such as hepatitis and HIV (AIDS). Medicines related to heparin that prevent thrombus formation in the veins can cause bleeding and decrease the platelet count. These drugs are often used after surgery when there is a high risk of deep vein thrombosis or pulmonary thromboembolism, severe conditions that can be fatal if they occur.

Infection.

Infections are rare after plastic surgery. If the infection appears, additional treatments are required, such as the consumption of oral or intravenous antibiotics, hospitalization, or surgery. According to different studies that exist in the medical literature and a study carried out by Lopez Ríos, A.A. In the company of other surgeons, where the most important complications presented in one of the centers where we perform plastic surgeries were reviewed, in three years, infections occurred in less than 1% of the operated patients.

Changes in skin sensitivity.

It is common to experience decreased or loss of skin sensation in areas that have undergone surgery. The decrease or complete loss of sensation in the skin may not be fully resolved after surgery; this is especially important for breast surgeries, where the sensitivity of the nipple-areola complex may be altered and significantly interfere with sexual life.

Irregularities of the contour of the skin.

Irregularities in contour, shape, and depression in the skin can occur after surgery. Visible or palpable wrinkles in the skin may appear after surgery. Residual skin irregularities at the end of the incisions or “dog ears” are always possible when there is excessive redundant skin. These can improve over time or can be corrected surgically.

Significant separations or opening of the wounds (dehiscence).

Wounds may separate or open after surgery. If this happens, further treatment, including surgery, may be necessary. When they are slight separations or dehiscence, they can be managed medically with dressings until they heal completely. In other cases, performing procedures to suture again with local anesthesia and even returning to the operating room to close the wound entirely is necessary.

Colour changes in the skin, edema.

Bruising and edema usually occur after surgery. The skin on or near the wound may turn light or dark. Although uncommon, swelling and discoloration of the skin can persist for long periods; this can be permanent on rare occasions. Among other recommendations, avoiding sun exposure and using sunscreen for at least six months after surgery is essential due to the risk of hyperpigmentation and existing colour changes.

Skin sensitivity.

Itching, hypersensitivity, and exaggerated response to heat or cold may occur after surgery. Usually, these resolves when the scarring matures, lasting up to a year after the operation, but it can persist chronically on rare occasions.

Sutures and stitches.

Most surgical techniques use internal sutures. You can feel these sutures after surgery. The sutures may come out through the skin spontaneously, become visible or irritate and may need to be removed after several weeks.

Fat necrosis.

Fatty tissue deep in the skin can decrease circulation, especially after liposuction. This produces tight areas within the skin. Additional surgery to remove these areas of fat necrosis may be necessary. There is the possibility of contour irregularities in the skin due to fat necrosis. Typically, this fibrosis and areas of irregularity improve over the months and resolve spontaneously.

Damage to deep structures.

There is the potential for damage to deep structures, including nerves, the central nervous system, eyeballs, blood vessels, muscles, intestine, kidneys, intrathoracic, intra-abdominal or retroperitoneal structures in any surgical procedure. The possibility for this to occur varies according to the procedure. However, this type of complication is rare. Injury to deep structures can be temporary or permanent, and sometimes complementary or emergency surgeries are required to repair the injured systems and control bleeding. For this reason, there is always the risk of requiring additional surgical incisions, with more significant scars or scars in unexpected areas and even the requirement of drains and probes as measures to control this type of complication.

Scars.

All surgeries leave scars, some more visible than others. Although good healing after a surgical procedure is expected, abnormal healing can occur within the skin or deep tissue. The scars may be unsightly and of a different colour from the surrounding skin. The scars may be unsightly and of a different colour from the surrounding skin. The scars may be asymmetrical, with a different appearance between the left and right sides of the body. There is a possibility of visible skin markings from sutures and drains. In some cases, the scars require surgical revision or medical treatment. Scars require multimodal treatment to appear pleasant when mature, even one year after surgery. Multimodal treatment includes ointments, creams, massages, infiltrations, compression therapy, silicones, infiltrations with corticosteroids or other products, lasers, and even surgeries.

Surgical anesthesia.

Local and general anesthesia haave risks. The potential for complications, injury, and even death exists from surgical anesthesia or sedation. When the scheduled surgery is under general anesthesia, an assessment with the anesthesiologist is required, with whom you can discuss these risks in greater detail, and you will need to know, understand, and sign an additional informed consent.

Asymmetry.

Symmetry in the appearance of the contour may not result after surgery. Skin tone, fat deposits, skeletal prominences, and muscle tone can contribute to normal asymmetry and body features. Many patients have differences between the right and left sides of their body before surgery. Additional surgeries may be necessary to improve asymmetries. Although the proposed surgery may claim to improve symmetry, this is not fully achieved in all cases.

Delayed healing.

Wound dehiscence, wound separation, or delayed healing may be possible. Some areas of the skin may die or become necrotic. This may require frequent dressing changes or additional surgeries to remove unhealed tissue. Smokers are at increased risk of skin and tissue necrosis and wound healing complications. For this reason, it is ideal not to smoke or stop smoking at least one month before surgery and three months after the operation.

Allergic reactions.

Local allergic reactions to tape, suture materials, glues, blood products, topical preparations, or injected agents have been reported in a few cases. Severe systemic reactions, including anaphylactic shock, can occur due to using drugs during surgery or prescribed medications. Allergic reactions may require additional treatments; you must tell us in detail about the allergic reactions you have had in your life to minimize their presence during your health care.

Shock.

In rare circumstances, your surgical procedure may develop severe trauma to your body or a generalized inflammatory response; this is called shock. Although serious complications are rare, infection or excessive fluid loss can lead to severe illness and death. If post-surgical shock occurs, hospitalization and additional treatment may be necessary.

Pain.

You may experience pain after surgery. The pain of variable intensity and duration can occur and persist after surgery. Chronic pain can occur infrequently due to nerves trapped in scar tissue after surgery. In general, the prescribed medications and postoperative care control the pain after surgery.

Unsatisfactory results.

Although good results are expected, there is no express or implied guarantee of the results that will be obtained. You may disagree with the results of the surgery performed. This may include asymmetry, visible or unsatisfactory scar location, visible deformities, wrinkling of the skin near sutures or at the end of incisions, dog ears, poor healing, dehiscence or opening of wounds and loss of sensation, and excesses of skin or tissue. Correcting or alleviating the effects of a surgical scar may not be possible. Additional surgeries may be required to improve results or minimize their appearance.

Deep vein thrombosis, cardiac or pulmonary complications.

Surgeries, especially long ones, more than two hours, may be associated with the formation or increase of clots in the venous system. Pulmonary complications may occur secondary to clots or pulmonary emboli, fatty deposits, fatty emboli, and partial lung collapses after general anesthesia. Pulmonary emboli can be life-threatening and, in some circumstances, fatal. Inactivity, lack of mobility or staying in bed for long periods, in addition to other medical conditions such as some autoimmune and coagulation diseases, can increase the incidence of blood clots that travel to the lungs, producing a giant blood clot which can make death. It is essential to discuss with your doctor any history of blood clots, edema or swelling in the lower limbs, autoimmune diseases or coagulation disorders, or the use of estrogens or oral contraceptives which may contribute to the worsening of these conditions. Cardiac complications are a risk with surgery and anesthesia, even in asymptomatic patients. If you experience shortness of breath, chest pain, or unusual heart palpitations, seek medical attention immediately. If any of these complications occur, you require hospitalization and further treatment.

In the medical evaluation before surgery, risk factors are identified that can be controlled or reduced to avoid venous thrombosis and pulmonary thromboembolism. Likewise, during surgery and in the postoperative period, measures are initiated to reduce these complications, such as using heparin according to the Caprini scale, intermittent pneumatic compression in the lower limbs, and stimulating early mobility after surgery.

Additional notices.

Smoking, secondhand smoke, and nicotine products (patch, gum, or nasal spray).

Patients who currently smoke and use tobacco or nicotine products, patches, gum, or nasal sprays have an increased risk of surgical complications such as skin necrosis, delayed healing, and unsightly scarring. Individuals exposed to or second-hand smokers are also at increased risk of similar complications attributed to nicotine exposure. Additionally, smoking harms anesthesia and anesthetic recovery with increased coughing and the possibility of increased bleeding. Individuals not exposed to tobacco smoke or nicotine-containing products have a significantly lower risk of developing these complications.

It is essential to stop smoking at least six weeks before the surgical procedure and until your doctor indicates that it is safer to resume smoking.

Long-term results.

Alterations in the appearance of your body may occur due to age, sun exposure, weight loss, weight gain, pregnancy, menopause, or other circumstances unrelated to your surgery.

Female patient information.

It is important to tell your surgeon if you use oral contraceptives, estrogen replacement therapy, or if you think you are pregnant. Many medications, including antibiotics, can neutralize the effect of oral contraceptives allowing pregnancy.

Sexual relations after surgery.

Surgery requires coagulation of blood vessels. Increased activity can open these vessels leading to bleeding or bruising. Activities that increase your pulse or heart rate can cause additional bruising or bruising, edema and the need for re-surgery to control bleeding. It is essential to abstain from sexual activity until it is deemed safe by your surgeon, usually the first three weeks after surgery.

Mental illnesses and elective surgery.

All patients seeking elective surgery must have realistic expectations focusing on improvement rather than perfection. Complications or less-than-expected results are sometimes unavoidable, sometimes requiring additional stressful surgeries. Discuss extensively with your surgeon, before surgery, any history of depression or mental illness. Even though many individuals can psychologically benefit from plastic surgery results, the effects on mental health cannot be adequately predicted, and follow-up by a multidisciplinary group that includes psychiatry and psychology and additional therapies is required before, during and after surgery.

Medicines.

Many adverse reactions can occur from over-the-counter drugs, herbs, or prescription drugs. You should be sure to review with your surgeon any drug interactions with your medications. If you have an adverse effect, stop the medication immediately and call your surgeon for further instructions. If the reaction is severe, consult the emergency department immediately and contact me directly to inform me about these symptoms. When taking prescription pain medications after surgery, you should know they can alter thought processes. You do not drive or operate complex equipment, do not make important decisions, and do not drink alcohol while on these medications. Be sure to take your medications as prescribed.

Prostheses or implants.

They are supplied by the manufacturing or distributing companies, their selection is made by the patient based on the information provided during the consultation, and they are based on existing recognition in the market and compliance with national INVIMA and international standards such as the FDA (Food Drug Administration) of the United States. The marketing company or manufacturer guarantees the prostheses and is not the direct responsibility of the surgeon.

• In the case of breast implants, if you can feel the ribs with your finger, under the breast or on the side of your chest, you can feel the edge of the implant under your breast and on the side of your chest.
• Currently manufactured implants strive for durability from the outer shell, which has been designed much thicker to prolong the life of your implant. A thicker cover may be more straightforward for it to sit on.
• If you think that feeling or seeing an edge of the implant shell might be a problem, breast augmentation with implants is not recommended.
• We cannot change the quality or thickness of the fabrics. You will be more likely to feel the implant if you are thin or have very little breast tissue.
• The larger the size of your implant, the more noticeable the changes in your breast will be over time. A large implant will stretch the tissues over time and may cause thinning and sagging. Your tissues do not improve with age; on the contrary, they will have less capacity to support the weight of any implant, especially a large implant.
• Any implant is filled correctly to avoid collapse and possible folding of the outer shell when standing up, which will feel firmer than a normal breast. If the external cover folds, it may fail early and require a new surgery and replacement of the implant.
• Deflation of the implant: This can occur with saline implants since they have a mechanical valve that can fail.
• If you want a completely natural chest, it is not advisable to have a breast augmentation with implants.
• Breast implants are safe, but they can sometimes have side effects. These can be simple and unusual, such as fibrous capsular contracture, or complex and very rare, such as chronic seroma and Anaplastic Large Cell Lymphoma (ALCL), a pathology that still needs further investigation to associate with breast implants correctly.
• Patients who present these side effects must be examined by their surgeon; they require study, treatment, and follow-up.
• Anaplastic large cell lymphoma (ALCL) is an infrequent complication that can occur. Still, generally in the early stages, it can be adequately treated by removing the implants and their capsule, thus leading to their remission. In the world, there are almost 11 million patients with breast implants, and there are few cases of ALCL reported in the world literature; the estimated incidence is approximately 1:16,018.
• Implant dislocation: it is the wrong location of the implant, which can occur spontaneously due to excessive flaccidity of the breast tissues; it may require surgical treatment for its correction.
• Implant Rupture (Gel Filled): Although rare, the implant can rupture spontaneously, usually several years after placement, due to expected wear of the silicone coating or a rare manufacturing defect. This rupture can also happen after direct trauma to the breasts. Implant manufacturing companies recommend changing them ten years after placement when an increase in spontaneous rupture rate, not related to trauma, has been observed. The rupture releases the silicone gel filler. The rupture can cause a flattening, softening and sensitization of the breast and the appearance of palpable masses. The gel may remain lodged within the tissue capsule around the implant or migrate into the breast, underarm lymph nodes, and other body parts. Rupture of the implant requires removal of the implant and the gel, although definitive removal of all the gel may not be possible.
• Wrinkles and folds in the skin: Folds or undulations (“Rippling”) of the implant surface can be visualized and palpated more frequently in patients with saline implants or lean builds with thin breast tissue.
• Implant extrusion: Lack of adequate tissue coverage or infection can result in exposure and extrusion of the implant. If tissue rupture occurs and the prosthesis is exposed, removal is necessary.
• Breast disease: including breast cancer, can appear independently of prosthetic surgery. The current medical literature does not demonstrate an increased risk of breast disease or breast cancer in women who wear breast prostheses for cosmetic or reconstructive reasons.
• Decreased lactation: although most patients can breastfeed after surgery, this may be reduced for reasons directly related to the section performed on the breast tissue in surgeries with or without implants.
• Encapsulation and calcification are the infrequent hardening of the capsule that surrounds a breast implant, causing pain, increased consistency of the breast, and, when more severe, deformity. Treatment is conservative in the early stages and surgery may be required at an advanced stage to correct the problem.
• Asymmetries: may occur in the final shape and volume of the operated breasts, especially if they are pre-existing.

Need for additional surgeries.

Complications can occur and additional surgeries or other treatments may be necessary. Secondary surgeries may be required to obtain optimal results. Although risks and complications occur infrequently, the risks mentioned have been associated with any surgery. Other complications and risks can occur but are very rare. The practice of medicine and surgery is not an exact science. Although good results are expected, there is no express or implicit guarantee of the results that will be obtained. With surgery, it may not be possible to achieve the optimal result with a single surgical procedure. Multiple surgical procedures may be required to achieve the result.

Patient compliance.

Following the medical instructions carefully is essential to obtain the expected results. The surgical incision mustn’t be subjected to excessive forces of tension, swelling, abrasion, or movement during the healing time. Personal or vocational activities must be restricted. Protective dressings and drains should not be removed unless directed by your surgeon. Postoperative outcome and function depend on surgery and postoperative care. Physical activity that increases your pulse or heart rate can cause bruising or ecchymosis, edema or fluid accumulation and the need to return to the operating room. It is essential to refrain from intimate physical activities after surgery until deemed safe by your surgeon, usually for three weeks. You must participate in the postoperative period, attend the follow-up appointment, and promote your recovery after surgery.

Medical insurance.

Most insurance companies exclude coverage for cosmetic surgery or any complications that may occur after surgery. Carefully review your health policy or contact your insurance company for detailed explanations of coverage policies. Most insurance plans exclude coverage for revision or secondary surgeries.

Financial responsibilities.

The cost of surgery includes various items for different services. The total costs include the surgeon’s fees, medical-surgical supplies, anesthesia, laboratory tests and possible extra-hospital expenses depending on where the surgery is performed. The costs generated by these procedures do not include potential future fees for additional procedures that you electively require to review, optimize, or complement the results. Additional costs may be incurred if complications from the surgery are generated. Secondary surgeries or hospitalization costs related to revision surgery will also be your responsibility.

Disclaimer.

The informed consent document is used to communicate information about the proposed surgical treatment and the disease or condition to be treated while explaining the risks and alternative forms of treatment, including not having surgery. The informed consent process defines the main risks most patients could have in most circumstances.

However, informed consent should not be considered an all-inclusive document when defining other treatment methods or related risks. Your surgeon may explain additional or different information to you based on the particular facts of your case and the current state of medical knowledge.

Informed consent documents are not intended to define or serve as standards of medical care. Standards of medical care are determined based on all the facts related to each case and are subject to changes in medical knowledge, technological advances, and related practice patterns.

You must carefully read the above information and resolve all questions generated before signing the consent.

CONSENT FOR SURGERY/PROCEDURE OR TREATMENT.

1. The patient hereby authorizes me as a plastic surgeon and the assistants selected to perform the scheduled procedure or treatment.
2. The patient acknowledges that unforeseen conditions may require procedures other than those mentioned during surgery, medical treatment, or anesthesia. Therefore, I (the patient) authorize the surgeon, assistants, or designees to perform such other procedures as part of the necessary or desirable professional practice. The authorization granted in this paragraph may include all conditions that required treatment and were not known to my physician when the surgical procedure began.
3. The patient authorizes me to administer the necessary or recommended anesthetics. The patient understands that all forms of anesthesia have risks and potential for complications, injury, and in some cases, death.
4. The patient understands that no guarantee has been given to me of the results that may be obtained.
5. The patient authorizes to be photographed or recorded before, during and after the surgery(s) or procedure(s), including appropriate portions of their body for medical or scientific education, marketing, publicity, social networks, and web pages. Your identity will not be revealed in the photographs.
6. For advanced medical education, the patient consented to the attendance of observers in the operating room.
7. The patient authorizes the disposal of any tissue, medical equipment or body parts that are removed.
8. The patient authorizes the use of blood products if necessary by my surgeon or the medical team. The patient is aware of potential risks to my health with its use.
9. The patient agrees that medical fees are separate from anesthesia and hospital costs. If a secondary procedure is necessary, additional expenses will be required.
10. The patient understands that not having the surgery or procedure is a management option.
11. IT WAS EXPLAINED TO ME IN A WAY THAT I UNDERSTANDED.
12. THE MENTIONED TREATMENT WILL BE CARRIED OUT.
13. THAT THERE ARE ALTERNATIVE METHODS OR TREATMENTS.
14. THERE ARE RISKS TO THE PROPOSED PROCEDURE OR TREATMENT.

Finally, the patient AUTHORIZES TO PERFORM THE TREATMENT mentioned above OR PROCEDURE, AND I UNDERSTAND THE LISTED ITEMS. The patient IS SATISFIED WITH THE EXPLANATIONS.

This information is attached to each patient’s medical history and is signed by the patient and his companion or witness, if any.