explantCOSTA RICA
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Post-op information

What to expect and how to care for yourself after your explant surgery.

01

Pain control

Dr. Urzola does his best to control pain, but this is not a pain-free surgery. Expect moderate pain for a few days, then it tapers off over a few weeks.

Narcotics in Costa RicaNarcotics are administered differently here, they are available but expensive and come pre-packed, so you cannot be prescribed fewer than 30 pills.
02

Post-op garments

After surgery you will be fitted into a surgical garment that provides adequate compression. Wear it for 30 days, 24 hours a day except when showering. It helps reduce edema, bruising and pain.

03

Drains

Dr. Urzola determines if you need drains based on several technical factors. The Jackson-Pratt system has a soft bulb and a catheter near your incision; when compressed it creates gentle suction to draw out fluid. Keep the bulb compressed at all times except when emptying.

Recording drainageDrains are usually removed when output is 30 mL or less over 24 hours. Record drainage twice daily (morning and evening) and bring the log to your follow-up appointments.
04

Follow-up appointments

You will see Dr. Urzola several times during your visit, the first around 2 to 3 days after surgery and the last the day before you depart. Should you need follow-up after departure, you can set up a Skype or in-person appointment.

05

If you have complications after departing Costa Rica

Dr. Urzola does not abandon his patients after their departure. He is committed to your full recovery, and should you run into complications after departure he will see you through them.

06

Massages & hyperbaric chamber

Post-op lymphatic massages are not required for explant, but if you desire one they begin 2 to 3 days after surgery at Dr. Urzola's office. Do not massage the breasts.

HBOT (hyperbaric oxygen therapy) is also not required. If you choose it, the first session is scheduled the morning after surgery, with the rest on the 2nd and 3rd day for most benefit. It aids wound healing, stimulates new blood vessels and speeds recovery.

07

Post-op medications

These are subject to change; each patient may have allergies and medications are prescribed individually.

AntibioticZamur 500 mg every 12 hours for 5 days, to prevent infection.
Blood thinnerBadiket (Bemiparin Sodium) 3500 UI subcutaneous, then every 24 hours for 10 days.
PainBerifen 100 mg/24h · Enantyum 25 mg/8h · Tramacet every 12h, for 7 days.
NauseaDislep 25 mg every 12 hours for 5 days.
Gastric protectionZoltum 40 mg before breakfast for 7 days.
08

General instructions

Activity

  • No driving, sexual activity or exercise for 1 month; no high-impact exercise for 3 months.
  • Avoid lifting objects heavier than 4 lbs for 1 month; no bending with shoulders down for 15 days.

Diet & wound care

  • No alcohol for 4 weeks; drink plenty of liquids; eat a healthy, high-protein diet.
  • Do not submerge in water (pools, hot tubs, lakes) until 1 month after surgery.
  • Apply scar cream 1 month after surgery; protect incisions from the sun.
Do not smokeDo not smoke or inhale secondhand smoke for 3 months, smoking increases complications by up to 30%.
09

When to call the office

Call right away if you notice any of these
  • Increased swelling, redness or pain not relieved by medication
  • An oral temperature over 100.4°F
  • Yellow or green drainage, or a foul odor
  • Nausea, vomiting, rash or shortness of breath
  • One leg swollen or painful

Contacts: +1 646 363 6923 · +506 2241 5686 · +506 2208 8851.