Abdominoplasty + Brazilian Butt Lift

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  • Dr. Brown:
    • Gown – XL, XL Length
    • Gloves – 8 Indicator glove, 7.5 Biogel gloves
  • Dr. Chandler:
    • Gown – L
    • Gloves – 5.5, 6.0 if 5.5 unavailable
  • Sean Kirby PA-C
    • Gown – XL
    • Gloves – 7.5 Indicator glove, 7 nonlatex glove
  • Pre-operative Medications
    • Night before:
      • Scopolamine patch placed behind ear
      • Shower with Hibiclens for couple days before surgery 4% topical chlorhexidine soap.
    • At Check In to Surgery Location:
      • Tylenol 975mg PO x1
      • Gabapentin 600mg PO x1
      • Celebrex 400mg PO x1
  • Intra-operative Medications
    • Ancef 2 grams IV (ok if allergic to Penicillins).   Vancomycin 1g IV (if allergic to Ancef).  Please start infusion in prep
    • Infiltration Solution for breasts (PHARMACY to prepare, in pre-op order set – NO EPI):
      • NS or LR 500 mL
      • Ropivicaine 300mg   OR  (Bupivicaine 150mg = 30mL of 0.5% Bupivicaine)
      • Clonidine 0.3mg
      • Dexamethasone 4mg
    • Tumescent solution for Liposuction
      • 1L LR or NS + 2 amps of 1:1000 epi
      • Be able to make approximately 1-5 bags of this depending on amount of fat to be sucked out.
      • Place in towel/blanket warmer
    • 1g Ancef to mix with fat before injection.
    • 1g Vancomycin to mix with fat before injection.
    • 2G Vancomycin powder for abdominal closure
  • Post-operative Medications (Prescribed pre-op)
    • Tylenol 650mg PO q6 hours scheduled
    • Methocarbamol 1500mg PO q6 hours scheduled
    • Gabapentin 300mg PO q6 hours scheduled x3 days
    • Celebrex 200mg PO BID x3 days
    • Cephalexin 500mg PO q6 hours scheduled for 4 doses starting after surgery
    • Pericolace 1 tab PO BID scheduled
    • Phenergan 25mg PO q8 hours PRN nausea
    • Oxycodone 5mg tabs, 1-3 tabs PO q4 hours PRN pain
    • Ibuprofen 600mg PO q6 hours scheduled, starting 48 hours after surgery
  • Anesthesia
    • Anesthesia choice
  • Patient Position
    • Will do liposuction of abdomen, then flip lateral, then other lateral and fat grafting into buttock.
    • Supine for the abdominoplasty, Able to sit up 90 degrees (make sure bed can do this)
  • Bed Attachments
    • Arm boards, Ulnar nerve pads
    • Straps for arms as we will be rolling
  • Patient Warming
    • Under body warming blanket as we will be rolling during liposuction
    • IV fluid warmer
  • DVT Prophylaxis
    • Bilateral SCDs in OR. ON and working BEFORE induction of anesthesia.
  • Foley Catheter
    • Yes, run tube thru strap of an SCD so it doesn’t pull on bladder when we flip lateral
  • Instrument Sets
    • Body
    • Liposuction Set
  • Surgical Packs
    • Custom Body Pack OR
    • Universal Pack + two 3/4 Drapes
  • Surgical Prep
    • Chloraprep x 8 for circumferential prep.  Put in blanket warmer to pre-warm prep sticks.
  • Irrigation Solution
    • Warmed Normal Saline
    • Sterile water in basin for washing instruments
    • Standard irrigation solution (PHARMACY TO PREPARE, IN PRE-OP ORDER SET)
      • NS 1L
      • Ancef 2g
      • Gentamicin 160mg
      • Betadine Paint (10% Povidone-Iodine) 100mL
  • Blades
    • 10 x 2
    • 11 x 2
  • Bovie
    • Short Protected ENT tip x 2
    • Long protected ENT tip x 2
    • Set at coagulate 60 fulgurate /  cut 60 pure
  • Suture
    • #1 Prolene suture on largest taper needle.
    • 3-0 Monocryl Large cutting x 6
    • 3-0 v-Loc (absorbable) Long, Large Cutting  x2
    • 2-0 PDS on Large Taper x 8
  • Drains 
    • 10F perforated flat JP drain, on trocar if availalbe, 100mL bulb suction x 2
  • Additional Supplies:
    • Marking pen, Paper Ruler
    • 18G spinal, 60cc syringe for injection of local
    • Liposuction Power Generator (Black and Black Vibrastat or MicroAire)
    • Infusion pump (tumescent in)
    • Infusion tubing (tumescent in)
    • Liposuction tubing (fat out)
    • Suction machine (fat out)
  • Dressing
    • Wide Long Steri strips and Mastisol
    • Compression garment – Dr. Brown to bring if cosmetic.
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