Most Commonly Performed Procedures

Orthopedic

Spine

Cosmetic Surgery

Breast Augmentation (Augmentation Mammoplasty)	Breast Reduction (Reduction Mammaplasty)
Buttocks Augmentation	Buttocks Lift
Chemical Peel (Skin Refinishing - May require mulitple sessions)	Chin Augmentation(Mentoplasty)
Dermabrasion (Skin Refinishing - May require multiple sessions)	Ear Surgery (Pinnaplasty)
Face Lift (Rhytidectomy)	Eyelids (Blepharoplasty)
Facial Implants (Chin, Cheek & Jaw Surgery)	Facial Line Filling
Liposuction (Lipoplasty)	Nose Surgery (Rhinoplasty)
Tummy Tuck (Abdominoplasty)	Upper Arm Lift (Brachioplasty)
These links are provided just as informational material

Carpal Tunnel Release

Summary

Carpal tunnel release is a surgery that is designed to treat individuals with carpal tunnel syndrome. This surgery is done on an outpatient basis. During the surgery patients are awake, but given anesthesia to block pain and encourage relaxation.

Carpal tunnel syndrome is caused by narrowing of the carpal tunnel passage. The narrowing of the passage leads to compression or pinching of the nerve. This causes pain and weakness in the hand and wrist. Carpal tunnel release is usually performed on patients who have achieved little to no relief after being treated with non-surgical methods. A test called an EMG is done to diagnose carpal tunnel syndrome. Once diagnosis is confirmed, surgery should be scheduled promptly to prevent nerve damage.

Length of the procedure: 1 hour or less.

Hospital Stay: This is an outpatient procedure.

Recovering before traveling home: Patients seeking carpal tunnel release through medical tourism can return home within 24 hours in most cases.

Procedure Details

Your surgery begins with the administration of anesthesia to block pain and promote relaxation. The area will be prepped with a sterile antiseptic liquid. Then, an incision usually about an inch in length is made on the palm of the hand.

After the initial incision is made the surgeon will carefully expose the carpal tunnel by making an incision through the connective tissue immediately below the skin�s surface. When they have the carpal tunnel in sight they will release it by cutting it with a scalpel or scissors.

To finish the procedure the surgeon will stitch the skin together. The carpal tunnel is left divided. However, the two ends of the carpal tunnel will fill in with scar tissue over time.

After the Procedure

After the procedure your wrist will be wrapped in bandages and a splint. The splint and bandages will need to remain in place for about a week�s time. You may have some discomfort, but you will be given a prescription for pain medication to help relieve any discomfort.

One week after your carpal tunnel release surgery you will need to start performing motion exercises to promote healing and ensure returned function. Your doctor will recommend certain motion exercises or they may prescribe professional physical therapy. Depending on the extent of your carpal tunnel syndrome it can take a few weeks to an entire year to completely recover from the procedure.

Results

The prognosis for carpal tunnel release is very good. This procedure can effectively get rid of the pain, tingling, numbness and muscle weakness caused by carpal tunnel syndrome. In fact, nearly 85% of patients who have this surgery experience relief from their symptoms. Many also experience increased strength and restored function.

Risks and Complications

As is with any surgery there are risks associated with carpal tunnel release. However, this is considered a low risk and safe procedure. The following is a list of the most common risks and complications:

� Infection

� Pain

� Incision pain

� Scar sensitivity

� Arterial damage

� Inflammation

� Stiffness

� Hand or wrist weakness

� Injury to the median nerve

� Nerve damage

� Need for repeat repair caused by improper healing

� Scar tissue formation

Any concerns you have regarding these risks before or after the procedure should be discussed with your surgeon promptly.

Contact your physician if:

� Swelling increases

� Pain increases

� Pain is not relieved by medication

� Bleeding is excessive or uncontrolled

� Bright red bleeding comes from incision

� The incision feels warm or has a warm sensation

� The incision or surrounding are becomes red

� Discharge accompanied by an odor comes from the incision

� Nausea or vomiting develops

� Fever is uncontrolled with Tylenol or ibuprofen

� Dizziness develops

� Headache develops

� Muscle aches accompanied with chills

Bunionectomy

Summary

A bunionectomy is a procedure that excises or removes bunions. Bunions form between the joint at the base of the big toe. They occur as a result of inflammation that is typically caused by shoes that are too tight or fit poorly, combined with the joint being overly mobile.

When these two factors combine a lump develops on the side of the joint. Overtime, this causes the big toe to push towards the second toe. This may also lead to new bone growth or a bone spur. The bunion is made up of soft tissue, and sometimes a bone spur.

You may consider a bunionectomy if:

� Conservative treatment has failed to correct the problem

� Your bunion has caused a foot deformity

� Intense pain has led to difficulty walking or performing other activities

� Your bunion has caused you to become unstable when walking

Length of the procedure: 1 hour

Hospital Stay: Depending on the method of surgery used and the severity of your problem you will be hospitalized for a maximum of 24 hours following the procedure, if at all.

Recovery before traveling home: Patients seeking a bunionectomy through medical tourism can return home within 24 to 48 hours in most cases.

Procedure Details

Your surgery will begin with the administration of anesthesia. Depending on what type of surgical method your doctor has chosen you will be given an ankle block, general anesthesia or a spinal block. Then, the area will be prepped with an antiseptic liquid.

During the surgery an incision will be made directly on the swollen area of your foot. The surgeon will remove the lump. They may also need to reposition the big toe. If this is necessary another incision may be required. If damage to the joint is present the surgeon may attach the bones of the foot with screws, wires or a metal plate. In some cases the joint may need to be replaced with an artificial joint.

After the Procedure

After the procedure your incisions will be closed with sutures or tape. The surgical wound will be wrapped in a compression dressing. The compression dressing will help maintain proper alignment of the bones and reduce swelling.

After the anesthesia has worn off in most cases you will be released from care. You will need to elevate your foot for at least 24 hours following the procedure. It will be at least 6 to 8 weeks before you can return to normal activity. Your surgeon may require you to wear a special orthopedic shoe or boot during this time. These orthopedic devices will help accommodate healing and provide you stability during the healing process.

Results

About 85% to 95% of patients consider their bunionectomy procedure successful. However, results depend largely upon a number of factors including age, severity of deformity, and the patients adherence to their surgical recovery instructions. Many patients also use orthotics after they heal from the procedure to keep their feet properly aligned and to prevent another bunion from forming.

Risks and Complications

As is with any surgery there are certain risks associated with a bunionectomy procedure. However, it is important to note that complications arise in less than 10% of bunionectomy patients. The following is a list of the most common risks and complications:

� Infection

� Pain

� Nerve damage

� Reoccurring bunion

� Reaction to anesthesia

Contact your physician if:

� Fever of 100.5 or above occurs and is uncontrolled by Tylenol or ibuprofen

� You have chills

� Pain is constant or increases

� There is redness of warmth in the surgical area

� Swelling develops in the calf

� Water or moisture causes the surgical dressing to come off

� The surgical dressing becomes bloody

Shoulder Joint Replacement

Summary

Shoulder joint replacement is used to relieve joint pain and immobility. However, it is done at a fraction of the rate of other joint replacement surgeries. There are a number of conditions that this surgery is used to treat including:

� Osteoarthritis

� Rheumatoid arthritis

� Post-traumatic arthritis

� Failed shoulder replacement

� Avascular necrosis

� Rotator cuff tear arthropathy

The shoulder is a ball and socket joint. A healthy joint has protective cartilage between the ball and socket. A damaged joint has reduced cartilage and the ball and socket rub together. Shoulder joint replacement surgery removes the damaged ball and socket and replaces them with artificial parts.

Length of the procedure: The entire procedure takes 2 hours.

Hospital Stay: The average hospital stay for patients undergoing a shoulder joint replacement procedure is 2 to 4 days.

Recovery before traveling home: Patients seeking shoulder joint replacement through medical tourism can usually return home within 3 to 4 days of their surgery.

Travel Tip: The hospital stay for this medical tourism procedure can fluctuate, and there is no definitive way to guarantee whether you will need to stay 4 days or less. For this reason, it is best to travel on a flexible schedule or give yourself a buffer in your travel dates.

Procedure Details

Your surgery will begin with the administration of either a regional or anesthetic block and general anesthesia. The surgical area will be prepped with an antiseptic liquid and sterile draping. Then, the surgeon will make an incision so they have access to the shoulder joint.

The surgeon will remove the humeral head or the ball of the joint first. They will also clear away any bones spurs by filing them off the socket. They will examine the glenoid socket. If it is severely damaged it will be removed or replaced, otherwise it will be repaired and left in place.

The artificial parts used in a shoulder joint replacement are made from metal and plastic. Surgeons use bone cement to secure the artificial parts in their desired positions. Once everything has been placed tendons are reattached to the bones and the surgical incision is closed.

After the Procedure

After the procedure you will be moved to recovery first. You will be monitored carefully until you recover from your anesthesia. Then, you will be moved to a regular hospital room for the remainder of your stay.

You will be given IV pain medication for the first 24 hours following your procedure. A drain will be placed in your shoulder, but removed within 24 hours. Your arm will be in a sling and your shoulder will wrapped in bandages.

During the first few days of your hospital stay a continuous motion device will be used to apply gentle movement to the shoulder joint. A physical therapist will prescribe you some flexibility and strength exercises to do during your recovery.

Upon leaving the hospital the following precautions should be taken:

� Keep the incision dry

� Check incision for swelling or drainage

� Avoid use of deodorant

� Avoid lifting heavy objects

� Follow discharge instructions

Results

Most patients achieve a full recovery within 1 year of their shoulder joint replacement surgery. The majority of patients experience reduced pain and improved motion, strength and function following this procedure. However, adherence to the rehabilitation process is crucial to a successful outcome. An artificial shoulder joint can last up to 20 years.

Risks and Complications

As is with any surgery there are certain risks associated with shoulder joint replacement. The following is a list of the most common risks and complications:

� Infection

� Loosening of the artificial joint

� Dislocation

� Arterial damage

� Nerve Damage

� Stiffness

� Pain

Any concerns you have regarding these risks and complications before or after your procedure should be discussed with your physician.

Contact your physician if:

� Blood soaks through the surgical dressing and is not affected by pressure

� Pain is not alleviated by pain medication

� Swelling in the arm occurs

� Redness, pain or swelling of the surgical wound develops

� Discharge from the surgical wound is yellowish or foul smelling

� Temperature rises above 101

Meniscal Repair

Summary

Meniscus repair surgery is done arthroscopically or through open surgery. It is done when the meniscus becomes torn or injured. The meniscus is the cartilage that stabilizes and cushions the knee joint.

The meniscus repair surgery is performed in an attempt to save cartilage. When successful, it enables patients to have a healthier knee for a longer span of time. However, it is not as common as some of the other related surgeries.

There are many factors taken into consideration when deciding to perform a meniscus repair surgery. However, the tear pattern and location are the two deciding factors for most surgeons. Certain tears cannot be repaired including a horizontal, long-standing, degenerative or flap tear.

Length of the procedure: 1 to 2 hours

Hospital Stay: Generally, this surgery is done on an outpatient basis.

Recovery before traveling home: Patients seeking meniscus repair through medical tourism can return home within 24 hours in most cases.

Procedure Details

Your surgery begins with the administration of anesthesia either general or spinal block. The area will be prepped with an antiseptic liquid. Then, the surgeon will begin by evaluating the structures within the knee joint for damage.

When your surgeon isolates the areas of meniscus that need to be repaired they will use small sutures or absorbable tacks to rejoin the pieces. To finish the repair they will reevaluate the meniscus to ensure the repair is sufficient. Then, they will close the incisions with sutures or tape and dress the wound with bandages.

After the Procedure

After the procedure you will spend an hour or two in recovery. Once the anesthesia has worn off you will released. You will be wearing a knee brace or an immobilizer and be given crutches to use for several weeks following the procedure.

To adequately heal after meniscus repair you need a significant amount of non-weight bearing time. It is important to remember the meniscus is essentially the shock absorber of the knee. Any weight placed on the leg can pull apart the repaired meniscus.

In addition to the non-weight bearing time, your surgeon will also recommend some physical therapy. The physical therapy will help you regain your range of motion, balance, strength and endurance. Generally, it takes between 2 to 3 months to fully recover from meniscus repair surgery.

Results

Meniscus repair surgery is successful for most patients. In fact, about 95% of patients who have meniscus repair surgery have a successful outcome. Patients who have meniscus repair report that they have less pain and increased mobility after healing from the procedure.

Risks and Complications

As is with any surgery there are risks associated with meniscus repair surgery. However, it is important to note that the risks are relatively uncommon. The following is a list of the most common risks and complications:

� Infection

� Nerve damage

� Arterial damage

� Blood clots

� Pulmonary Embolism

� Reaction to anesthesia

� Insufficient Repair

� Inadequate Healing

Contact your physician if:

� Bleeding of surgical wound increases

� Pain increases and is uncontrolled by pain medication

� Temperature rises about 101.5 and is uncontrolled by Tylenol or ibuprofen

� Circulation seems to decrease

� Tingling sensation or numbness occurs in legs feet or surgical area

� Rash develops

� Discharge from surgical wound occurs and is accompanied by foul odor

� Surgical wound feels warm to touch or has warm sensation

� Fever is accompanied by sweating or chills

� Pain or swelling in the calf develops

� Shortness of breath or breathing difficulty occurs

Rotator Cuff Repair

Summary

The rotator cuff is part of the shoulder. When functional, the rotator cuff is what enables you to rotate, raise and lower your arm. When the rotator cuff becomes injured or damage the strength and mobility of the shoulder and arm can be limited significantly.

Then non-surgical treatment fails to restore strength and mobility surgical rotator cuff repair is merited. Rotator cuff repair can be done in one of three ways, open, mini-open or arthroscopic. These methods are all done in an operating room using either general anesthesia or a nerve block.

You may qualify for a rotator cuff repair if:

� Your injury has failed to heal after 3-6 months of physical therapy

� You are young and need full shoulder function and strength

� You are in optimal health, giving you the ability to heal properly and commit to rehabilitation

Length of the procedure: 1 to 3 hours

Hospital Stay: Depending on the method used you will be hospitalized 0 to 3 days after rotator cuff repair.

Recovery before traveling home: Patients seeking rotator cuff repair through medical tourism can return home within 24 to 72 hours in most cases.

Procedure Details

Your surgery begins with the administration of anesthesia, either general or nerve block. Then, you shoulder is prepped with a sterile antiseptic wash. Before the surgeon begins operating he or she will examine the shoulder for stability and range of motion.

The surgeon will begin operating by making the necessary incisions. They will examine the damage to the rotator cuff before making any repairs. Then, they will repair the rotator cuff by reattaching the muscle that has detached from the bone. This is done with screws or stitches. They may need to remove bone fragments or spurs, shave bone repair tendons or shave bone down to repair the rotator cuff.

After the Procedure

After the procedure you will be taken to recovery. You will monitored for about 2 hours and either released or admitted to a room after that time. You will be given pain medication to ease discomfort and prescribed physical therapy to ensure optimal healing.

Physical therapy may include:

� Extensions of the wrist, elbow and hand

� Flexing the wrist, elbow and hand

� Stretches of the arm and shoulder

� Strength Building exercise

Things to expect during postoperative healing:

� One month recovery

� Immobility of arm and shoulder

� Use of an arm sling

Results

The prognosis for rotator cuff repair is good and the surgery can restore normal function in most cases. Generally, it is best to have rotator cuff repair done relatively soon after injury or damage occurs. The greater the damage or tear to the rotator cuff the less likely it will be successfully repaired.

Risks and Complications

As is with any surgery there are risks associated with rotator cuff repair. The following is a list of the most common risks and complications:

� Infection

� Pain

� Blood clots

� Arterial damage

� Inflammation

� Stiffness

� Weakness

� Damage of the deltoid tendon

� Damage of the deltoid muscle

� Nerve damage

� Need for repeat repair caused by improper healing

� Reflex sympathetic dystrophy

Any concerns you have regarding these risks before or after the procedure should be discussed with your surgeon promptly.

Contact your physician if:

� Swelling increases

� Pain increases

� Bleeding is excessive or uncontrolled

� Drainage from incision occurs

� Nausea or vomiting develops

� Fever is uncontrolled with Tylenol or ibuprofen

� Dizziness develops

� Headache occurs

� Muscle aches are severe

ACLS

Summary

Anterior Cruciate Ligament Repair or ACL repairs or reconnects the torn ACL ligament. The ACL is one of the four ligaments that stabilize the knee. The ACL is the most common of the four knee ligaments to become damaged or torn.

The anterior cruciate ligament restrains forward motion of the shin bone. In other words, it prevents the shin from going past the knee. Without it the shin and knee are unstable. In actuality, the ACL needs to be replaced rather than repaired if it is torn.

Reasons to choose ACL repair:

� You have a complete or partial tear of the ACL

� You completed rehabilitation and your knee is still unstable

� You are active in sports or work and your knee is unstable

� Chronic ACL deficiency has become life altering

Length of the procedure: 1 to 2 hours

Hospital Stay: ACL repair is done arthroscopically and does not require a hospital stay.

Recovery before traveling home: Patients seeking and anterior cruciate ligament repair through medical tourism can return home within 24 to 48 hours in most cases.

Procedure Details

When your procedure begins you will be given general anesthesia or a spinal block. The surgeon will make 2 to 3 small incisions around the knee. Saline solution is pumped in one of the incisions to expand the area and make the structures of the knee more visible. A tiny camera is inserted in another so an image of the underlying structures can be transmitted for the surgeons viewing.

The surgeon will drill small holes in the surrounding bones of the upper and lower leg. These holes will be used to anchor the ligament graft that will repair/replace the damaged ACL. The graft ligament is pulled through two of the anchor holes and secured with screws or staples. The incisions are closed with sutures or tape.

After the Procedure

When the surgery is complete you will be moved to a recovery area to be monitored. Once you have recovered from the anesthesia you were given you will be released from care. It is best to take part in some type of professional physical therapy to ensure proper healing and full restoration of mobility. It takes between 6 to 12 weeks to return to sports and normal activities following the procedure.

Results

Anterior cruciate ligament repair is chosen because it enables injured individuals to return to normal activity. It stabilizes the knee and prevents further injury from occurring. Studies show that close to 90% of individuals who have their ACL repair achieve favorable results.

Risks and Complications

ACL surgery is generally a safe procedure, but as with any medical procedure there are some risks. The following are the most common risks associated with ACL repair:

� Allergy to anesthesia

� Breathing problems from anesthesia

� Numbness in scar

� Infection

� Knee structure damage

� Nerve damage

� Arterial damage

� Blood clots

� Loosening of the graft tendon

� Limited mobility

� Bleeding

� Weakness in the knee

� Pain

� Chronic pain

� Swelling

� Chronic inflammation

� Repeat Injury

Any concerns you have before or after your ACL repair procedure regarding these risks and complications should be discussed with your surgeon.

Contact your physician if:

Bleeding is soaking through your bandages and pressure applied to the area does not control the bleeding

Pain does not subside with pain medication

Swelling or pain in the calf develops

Your toes or feet are cool to the touch and or darker than normal in color

Redness of the incision develops

Swelling of the incision develops

The incision is throbbing or has localized pain

The incision begins to ooze or has a yellowish discharge

Your temperature is above 101 degrees and does not reduce when you take Tylenol or ibuprofen

Total Knee Replacement

Total Knee Replacement Summary

Total knee replacement or TKR is a procedure that replaces a severely damaged knee joint with an artificial knee joint. During the procedure the knee will be resurfaced and cartilage and bone will be replaced with metal and plastic. This procedure is performed by an orthopedic surgeon under general anesthesia or epidural anesthesia.

The knee joint is like a hinge that helps facilitate motion in the leg. Knees become damaged for a number of reasons; including arthritis and injury. Total knee replacement is in order when a patient�s knee has been damaged beyond repair. This damage may cause continuous pain, stiffness and it usually impairs normal function.

Length of the procedure: 1 to 3 hours

Hospital Stay: If you seek a total knee replacement through a medical tourism program you will stay 7 to 10 days depending on how well you heal after the procedure. Your surgeon will expect that you meet certain criteria before they release you:

� Bend your knee at a 90 degree angle

� Get out of your bed on your own

� Extend your knee straight out

� Walk using crutches or a walker

� Complete on rep of your prescribed home exercises

Recovery before traveling home: Patients should expect to fly home within 10 days of their procedure.

Procedure Details

Before surgery can begin either general anesthesia or epidural anesthesia must be administered. Once the anesthesia has taken effect the knee will be prepped for surgery. It will be scrubbed with an antiseptic liquid.

During the procedure the knee is flexed at a 90 degree angle using a special device that holds the lower leg and foot in place. The surgeon will make an incision. The damaged bone and cartilage will be removed first.

Bone will be removed from other areas to ensure proper fit of the artificial knee. The front and back of the femur will be removed. The top surface of the tibia will be removed along with the back of the knee cap.

To complete the procedure the surgeon will repair the attached muscles and ligaments. They will close the wound with sutures and wrap the knee in a sterile bandage. A tube may be placed to the wound to drain properly.

Artificial Knee Components

The artificial knee is made of metal and plastic. Metal meets the end of the tibia and femur and a plastic spacer acts as buffer between them. The implant for the knee cap is made of plastic.

The artificial knee can come in a number of designs. Many artificial knees are designed with pegs that require small holes be drilled into the bone surface for placement. Other implant styles would include implants that are secured with central stems or screws.

After the Procedure

Many patients feel dizzy, sick or tired immediately following their procedure. This is perfectly normal and is a result of the anesthesia. Hospital staff will closely monitor the patient for complications during this time.

Results

The total knee replacement is life altering for many patients. Once healed most patients are able to participate in activities they were unable to prior to their procedure. Knee replacement has a life span of 10 to 15 years on average.

Risks and Complications

Hip Replacement

Summary

THR or total hip replacement is a common surgical procedure. The procedure rebuilds a deteriorated or damaged hip joint to make it more functional. During the procedure the damaged joint is replaced with an artificial prosthesis.

Signs that a hip replacement may benefit you:

Hip pain is limiting your daily activities including walking and bending.

Hip pain persists when you are resting during the day or night.

Stiffness in the hip has reduced your ability to move or lift your leg.

Anti-inflammatory drugs or glucosamine sulfate do not provide relief.

Hip medications are causing harmful or unpleasant side effects.

Treatments like physical therapy or using a cane do not relieve your pain.

Length of the procedure: 1 to 3 hours

Hospital Stay: 4 to 10 days

Recovery before traveling home: When seeking a total hip replacement via medical tourism you can expect to travel in 7 to 10 days.

Procedure Details:

When you arrive for your procedure you will be prepped for surgery and administered anesthesia. During the procedure your surgeon will remove diseased cartilage and bone first. They will also remove the ball and socket of the hip.

The ball and socket of the hip is then replaced with a metal ball and stem that is positioned inside the femur. Cement is used to attach this prosthesis to the femur. In some cases the prosthesis is placed without cement. This prosthesis has microscopic pores that connect to the femur bone over time.

After the Procedure

When the procedure is complete you will be in recovery for about 2 hours. You will be bandaged for about 24-48 hours. IV antibiotics will be administered to prevent infection, along with pain medication to ensure your comfort level. Blood thinners will be given to prevent clot formation.

Dislocation is common after total hip replacement. Certain measures will be taken to prevent this for the first 6 to 8 weeks after the procedure. These Measures include:

� placing one pillows between your legs

� avoiding crossing your legs

� not bending forward 90 degrees

� using a higher toilet seat

� not letting your knees and/or toes turn in

You will start physical therapy shortly after your procedure and continue with it for several weeks. Exercise will be prescribed for you to do independently and with a physical therapist. You will also use crutches or a walker for several weeks.

Orthopedic

Spine

Carpal Tunnel Release

Summary

Procedure Details

After the Procedure

Results

Risks and Complications

Bunionectomy

Summary

Procedure Details

After the Procedure

Results

Risks and Complications

Shoulder Joint Replacement

Summary

Procedure Details

After the Procedure

Results

Risks and Complications

Meniscal Repair

Summary

Procedure Details

After the Procedure

Results

Risks and Complications

Rotator Cuff Repair

Summary

Procedure Details

After the Procedure

Results

Risks and Complications

ACLS

Summary

Procedure Details

After the Procedure

Results

Risks and Complications

Total Knee Replacement

Total Knee Replacement Summary

Procedure Details

Artificial Knee Components

After the Procedure

Results

Risks and Complications

Hip Replacement

Summary

Procedure Details:

After the Procedure

Results

Risks and Complications

Disk Replacement

Summary

Procedure Details

After the Procedure

Results

Risks and Complications

Laminectomy

Summary

Procedure Details

After the Procedure

Results

Risks and Complications

Spinal fusion

Summary

Procedure Details

After the Procedure

Results

Risks and Complications