Welcome to our practice. This document contains important information about what we offer and how we work.

Communicating with the Office

In order to schedule surgery and provide care, we use email and videoconferencing (but no text messages). Despite reasonable efforts to protect the privacy and security of electronic communication, it is not possible to completely secure the information. 

While we will attempt to review and respond in a timely fashion to your electronic communication, we cannot guarantee that all electronic communications will be reviewed and responded to within any specific period of time. These services should not be used for medical emergencies or time sensitive matters.

Medical Information

To make decisions about surgery, we require a thorough and up to date knowledge of your medical history. Please be prepared to share this information at the time of your initial consultation. Please also update the office with any changes to your health, medications, situation or preferences as soon as they occur. We may need to request medical records from other offices or hospitals.

If you have Sleep Apnea (OSA) please let us know. Severe OSA may preclude you from having surgery. For surgeries that require sedation or general anesthesia, you may need to provide an updated Sleep Study and you should expect to provide a Compliance Report that demonstrates one month of consistent treatment. 

For all procedures, it is important that High Blood Pressure and Diabetes are adequately controlled. Consider making an appointment to see your Family Physician or Internist if you think the treatment could be optimized. 

Decisions About Surgery

The decision to offer or proceed with surgery requires that your surgeon has judged that a reliable surgical option is available and that the expected benefits outweigh the potential risks associated with that procedure.

In addition, patients who are planning to have surgery under general anaesthetic or sedation will need to be approved by the anaesthesiologist. A consultation with this physician may be required and for private cases the applicable fees will be the responsibility of the patient. This assessment is usually not completed until after a booking package has been submitted to the hospital or surgical facility. Although it is late in the process, it is possible that you would find out at this point that you are not a candidate for surgery. We cannot be responsible for any financial expenditures (consult fees, deposit fees, etc) or loss that a patient incurs up to that point.

We have a shared responsibility to make sure that you are informed and actively participating in decisions about care. Through the consultation process, you should develop an understanding of:

a) your condition

b) the recommended treatment option and the alternatives

c) the expected outcome

d) the typical recovery, and

e) the potential risks

We will make a reasonable effort to inform all patients, but there will be occasions when our regular consultation process is inadequate. It is difficult for us to check your level of understanding, so please ask questions if you are unclear about any of the Surgical Risks listed below. If you decide to proceed with surgery you will be asked to sign a Consent Form. Signing this form gives your surgeon permission to carry out a specific surgical procedure and it indicates that you feel adequately informed and that your questions have been answered. This contract is for the performance of a procedure and not a guaranteed result. 

Medical (MSP) Coverage and Financial Responsibility

MSP coverage is available for a specified list of procedures that aim to treat medical conditions. The treatment of some conditions, such as breast asymmetry, requires an application to the Medical Services Plan. The treatment of benign lesions is not a benefit. Cosmetic surgery is not covered by MSP. Significant weight loss does not qualify an individual for MSP coverage or body contouring procedures. 

Revisions and secondary procedures are rarely covered by MSP. This holds true even for procedures that are initially provided by MSP. Fees, loss of income and any other expenses associated with secondary procedures will be the responsibility of the patient unless otherwise specified.  

Scheduling

To schedule surgery, a 'booking package' must be completed. Patients may be asked to fill out forms and return them to the office. Incomplete forms or delays in this process may result in the postponement or cancellation of your procedure.

A component of our practice involves caring for those with urgent medical problems such as cancer and trauma. In order to meet the needs of those patients, we may have to cancel your surgery or appointment on short notice. We cannot be responsible for any financial loss or any other inconvenience caused by this change in schedule. We understand that this has the potential to be extremely disruptive and, therefore, try to avoid this whenever possible.

Preoperative Instructions

Anyone who will be having a surgical procedure under general anaesthetic or sedation, must arrange to be picked up by an adult who can drive them home. 

The safe administration of general anaesthetia and sedation requires a period of fasting to ensure the stomach is empty at the time of the procedure. Specific instructions will be provided. If you do not follow the instructions your procedure may be delayed or cancelled. 

Scar Care & Compression Garments

Some patients will benefit from advanced scar care products. On the other hand, other patients will form a very acceptable scar without any special treatment. We will provide advice and recommend products that promote good scar formation. Individual responses may vary and a minority of patients will develop skin irritation from these products. For patients who develop a problematic scar or for those who want the best possible aesthetic outcome, we encourage you to engage a Dermatologist who has expertise in this area. Patients are responsible for all fees and expenses related to scar care and Dermatology appointments. 

Compression garments help to control the normal swelling that occurs after surgery. We will provide guidance about how and when to use compression. While we can make recommendations about what type of garment is required, we cannot order them for you and guarantee a proper fit. We can provide some information and resources, but patients will be responsible for the ordering of garments and for the expenses. You may be asked to bring a garment on the day of surgery.  

Availability of Your Surgeon

Your surgeon is in surgery 3-4 days a week which restricts the amount of time that they are available for office visits. As a result, it is difficult to be flexible with office appointment times. At times when your surgeon is unavailable, we may make arrangements for you to be seen by a colleague or a staff member. This individual will have access to your medical records.

In the unlikely event of an urgent or emergent post-operative concern, please call the office at 604-273-1034. If this occurs outside of office hours, there will be an option to reach the Plastic Surgeon on call. It may be necessary to go to your local emergency department. If this is not the Richmond or Delta Hospital, your surgeon will not be able to attend to you or provide care. 

Surgical Assistants and Students

Surgical assistants are regularly present in the operating room. This individual will either be another plastic surgeon or a physician with operating room experience. They often assist with the suturing (stitching, wound closure) but they will not be 'doing the operation' or working without your surgeon’s supervision.

It is rare for us to have a student or trainee. When it does happen, it is a privilege and our responsibility to provide an educational experience. Students and trainees will only be allowed to participate in your care to the extent that they are capable and in such a way that it will not impact your care. They will be supervised at all times.  

Out of Town Patients

Our surgeons are unable to provide care at hospitals other than those in Richmond and Ladner. It is difficult to arrange care near to home for our out of town patients. Your local physicians often do not have the will or expertise to take over or even to assist with care. Therefore, patients who are from out of town may be required to make unscheduled trips to see us for postoperative care. Out of town patients should be prepared to bear the financial cost of such trips including transportation, accommodation, lost wages, and any other expenses that may be necessary.

Smoking and Recreational Drugs

Reliable wound healing cannot be expected in smokers who are having certain surgical procedures. Therefore, these procedures will not be offered to smokers. Our surgeons may judge other procedures to be safe, in which case it would be necessary to discontinue smoking for 4 weeks before and after surgery. Recreational drugs can interfere with general anaesthetics and these interactions can be life-threatening. Therefore, it is imperative that you are up front about what you are using. Abstinence for up to 6 weeks before surgery will be required.

Opioids

The use of Methadone, Metadol or high dose narcotics is a contraindication for treatment at non-hospital surgical facilities and, therefore, to any private / cosmetic surgery.

Triplicate prescriptions for narcotic ‘pain killers’ need to be filled at the pharmacy within 5 days. A replacement will not be provided until the day of surgery and only if the original prescription is returned to your surgeon.