Pre-op for Lipedema Surgery

Thank you for scheduling your surgery with Atlantic Surgical Associates, Dr. Boris Volshteyn. Here is what to do and what to expect prior to your surgery.

Surgical Facilities

Dr Volshteyn performs all Lipedema procedures at accredited facilities only and specifically at CentraState Medical Center in Freehold NJ or Middletown Specialty Surgery Center in Red Bank NJ.

The Short Stay Department and anesthesia will give you a call the night before regarding what time to arrive and where to go.

Medications

  1. Lyrica (Gabapentin) to decrease nerve pain if needed
  2. Mobic (Meloxicam) is a ling acting anti-inflammatory and non-narcotic pain medication
  3. Scopolamine patch will be placed in the hospital
  4. Keflex (cephalexin) is antibiotic
  5. Valium to reduce muscle cramps after surgery if needed
  6. Percocet pain medications
  7. Zofran is anti-nausea medication if needed
  8. Xarelto is to prevent blood clots and other potential complications related to blood clotting

You will be provided with above listed medications prior to surgery. We can mail your prescriptions to you and you can get them filled at your local pharmacy or we can send them to you electronically.

If you are traveling from other areas, we can also send prescriptions to local CVS Pharmacy at
610 WEST MAIN ST. FREEHOLD, NJ, 07728 located across the street from the hospital for
your convenience.

Do not start taking them before surgery. Just have them ready.

Supplement to be taken before and after surgery

  1. You may start taking Arnica Montana 30c two day prior to surgery. This helps with stiffness, healing and reduces swelling and bruising. Arnica can be found at any health food store or pharmacy. Take 5 pellets 5 times daily and continue after surgery until you finish the tube. Amazon.com: Trader Joe’s Papaya & Pineapple Enzymes : Health & Household

  2. Bromelain is an enzyme found in pineapple juice used for reducing swelling. You may start this as directed 2 days after surgery. Amazon.com: Life Extension Specially-Coated Bromelain – Bromelain Proteolytic Enzyme Extract From Pineapple Supplement For Joint Health – Gluten-Free, Non-GMO, Vegetarian – 60 Enteric-Coated Tablets : Health & Household

  3. Papaya and Pineapple enzymes can also be helpful in reducing swelling and inflammation after surgery. Amazon.com: Trader Joe’s Papaya & Pineapple Enzymes : Health & Household

Hygiene before and after surgery

  1. Shower with basic soap the night prior and on the morning of surgery. Use Hibiclens antibacterial soap, which can be found at any pharmacy, on the areas where surgery is to be performed.

  2. For example, if you have legs done, wash from waist down to you feet with Hibiclense. If arms are to be treated wash from armpit to fingertips.

  3. Do not use it on the face or chest as it will be too drying.

  4. Amazon.com: Hibiclens – Antimicrobial, Antiseptic Soap and Skin Cleanser – 8oz – for Home and Hospital – 4% CHG : Health & Household

  5. Do not use any lotions or moisturizers.

  6. Use Summers Eve or other Boris Acid containing feminine cleansing product the evening before surgery and on the morning of your surgery to clean your private parts.

  7. Amazon.com: Summer’s Eve: WashAmazon.com: pH-D Feminine Health – Boric Acid Foam Wash – pH-Balanced, Paraben-Free, and Plant-based (Sensitive, 6 Fl Oz (Pack of 1)) : Health & HouseholdAmazon.com: Monistat Maintain Feminine Wash with Boric Acid, Fragrance Free, 10 Fl Oz : Everything Else

Diet modifications

  1. Refrain from any blood thinners, Vitamin E, Vitamin A, Aspirin, Advil, Ibuprofen, wine, Alcohol, ginger and garlic starting from 10 days prior to surgery. You may take Tylenol but not Exedrine, for pain or headaches.

  2. Do not drink or eat anything past midnight prior to your surgery date.

laboratory testing before surgery

  1. Your preoperative appointment will be scheduled with the hospital prior to your surgery and all preop tests can be done there.

  2. If you are traveling from far away and need to have tests done locally, you will need to have the following tests: 
a. Laboratory: CBC, BMP, PT, PTT, INR, COVID PCR Antigen (not quick antibody and no home tests) within 6 days from surgery 
b. If you have following conditions, you will need additional tests: Diabetes – HbA1c, Thyroid issues – TSH. 3. Chest X ray, Electrocardiogram.

  3. You will need a preoperative clearance from your primary care physician if you have one.

  4. If you have any major medical conditions, such as heart or lung issues, or clotting problems, make sure that you have in writing clearance from your specialist – Cardiologist, Pulmonologist, hematologist, etc.

  5. Failure to do that will result in cancellation of your surgical procedure.

Other Planning

  1. Please be sure to have a driver with you to pick you up after your surgery.

  2. Wear loose easy to put on and take off clothing to the hospital

Garments

Bring with you for surgery brand new compression garment with you to be placed on you after surgery by Operating room staff. Use the same size as you wear now. The most commonly used brands are SZSalus, Marena and Flexi

After Lipedema Liposuction treatment of arms we recommend
Marena Arm Compression Vest
Brabic Arm Compression
Isavela Arm Compression 

After lipedema Liposuction treatment of lower extremities we recommend
High Waist Compression Girdle | Medical Compression Girdle – The Marena Group, LLC crotch-less garments below ankle with side zippers

Supplies

You will need additional supplies after the surgery. Prior to discharge from the hospital, regardless if you stay for a night or not, you will need the absorbent pads, ace wraps with Velcro. Links below are provided for your convenience but you do not have to buy from these specific suppliers:

  1. https://www.amazon.com/42502000-Abdominal-McKesson-Cellulose-Rectangle/dp/B07K318J93ref=sr_1_8crid=377T3BD3U3FGL&keywords=abd%2Bpads%2Bfor%2Bwounds&qid=1681227647&sprefix=abd%2Bpads%2Caps%2C71&sr=8-8&th=1

  2. https://www.amazon.com/REMEDIES-Disposable-Underpads-36×36-Inches/dp/B07ZQQJCFD/ref=sr_1_2_sspacrid=1RL3U7UP9BT2H&keywords=chucks+for+bed&qid=1681227693&sprefix=chucks+for+bed%2Caps%2C68&sr=8-2-spons&psc=1&spLa=ZW5jcnlwdGVkUXVhbGlmaWVyPUEzUjJGMkFMUjg3UzhZJmVuY3J5cHRlZElkPUEwOTQ4ODQzQTM5MFRRWlpDWkxVJmVuY3J5cHRlZEFkSWQ9QTA1MjU0NTRYRkgzN1ZCUFo2OTgmd2lkZ2V0TmFtZT1zcF9hdGYmYWN0aW9uPWNsaWNrUmVkaXJlY3QmZG9Ob3RMb2dDbGljaz10cnVl

  3. https://www.amazon.com/Self-Closure-Athletic-Compression-Stretched-Customized/dp/B08YP9M6VXref=sr_1_3crid=33J364DNH58AK&keywords=8%2Binch%2Bace%2Bwrap%2Bwith%2Bvelcro%2Bclosure&qid=1681228143&sprefix=8%2Binch%2Bace%2Bwrap%2Caps%2C102&sr=8-3&th=1

We appreciate your business. If you have any questions, please do not hesitate to contact our office at 732-402-8191 ext 2. 

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“The nightmare is finally over.
My stomach looks absolutely wonderful... I will see you next fall for my face and I promise to quit smoking."
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