Breast Lift and Implant Exchange!- Dominican Republic

Introduction:
For those potential patients who still hold on to the antiquated belief that the best doctors are In the states....And for Doctors in the states who discourage traveling overseas for body modification, outwardly touting safety as their concern and inwardly concerned with the safety of their income. Welcome to the 21st century.
There's a diamond in the heart of the Dominican Republic, so rare in so many ways I almost don't want to share him...his name is Dr. Fernandez Goico. Detailed and Intelligent descended from a lineage of physicians, And trained under among others Dr. Pitiguay of Brasil aka the father of modern-day plastic surgery, it is clear art of medicine is in his blood.
He posses Membership not only with the Society of Plastic Surgeons in his native Dominican Republic but *also* with the International Society of Plastic Surgeons. Talented as he is handsome and as classy as he is caring. His passion for his work is evident in not only in the asthetic outcome of his patients. But In the way he addresses each patient putting their safety first.
Join me this October as I travel to Santo Domingo to join the ever growing phenomenon of medical tourism. I will be receiving ethnic rhinoplasty allong with breast implant exchange and lift.
Plastimedic the facility in which Dr Goico operates from, is one of the newest (less than 5years old) and most modern facilities the country has to offer,* currently touting a 0% infection rate. *(The same cannot be said for CIPLA which house a cluster of surgeons whose reputations preceed them some for better some for worse. As a RN I urge you to do your research and study your potential surgeons accredations, affiliations and most importantly know your doctor's history a quick Google search will steer you in the right direction) *Thanks Tammy!*
Following surgery an overnight stay is required for close monitoring. Plastimedic offers a handful of semi private rooms in contrast to CIPLA 's army style thirty bed unit which offers little to no privacy. Post operatively the nurse/patient ratio was at worst approximately 1:10. In the states post op care due to the acuity of the patient should range ideally 1nurse to a maximum of 4 patients. The more patients nurses have especially in such a delicate state can lead to unintentional yet potentially devastating errors/ oversight. This alone has been a huge deterrent for many seeking the care of CIPLA Affiliated Plastic surgeons because they do not want to go through the post op overnight experience, in general patients have said they feel like they've stepped back in time...no thank you.
I will reside at a "Arelis recovery house" run by a former Nurse of Dr. Fernández Goico which is not only beautiful and spacious offering single rooms with gorgeous private bathrooms, it prides itself as being situated in one of the best residential areas Santo Domingo has to offer patients during their fragile period of recuperation.
Post operatively I will join the ranks of past and present Goico "dolls" a term used proudly by patients in DR to pay homage to whom they have had their work done by. Transportation is provided to his follow up visits as well as the airport. He and his wonderful assistant Karel are always available, The Doc makes house calls and urges you to contact him no matter the day or time and yes...he provides you with a phone if needed.
He is a class act, in a league of his own, and somehow remains humble and accessible it's absolutely charming as well as disarming. What Surgeon gives you direct access to them in the wee hours of the morning? Or let's you whatsapp them about a pill and not ....President Obama's doctor perhaps lol that's IT!
In Dr. Luis A Fernandez Goico's meticulous world. Every patient is a VIP.

Decisions...Decisions...game plan revisions...
Rhinoplasty is a go I took the ex rays (per Dr. Goico's request) and decided to inform/prepare those who knew me for the upcoming change ( bruising/swelling) they may see in the next 6weeks. Then I experienced a strange phenomenon EVERY ONE was against it. Someone reccomend removable nose shapers, (which i tried for 3days,) I wore them till I bled. And when I took them out each night my heart dropped....when I considered forgoing rhinoplasty altogether and using a less painful size my heart dropped further. Being born of a higher melanin content doesn't mean you are supposed to automatically love your nose...but on this journey I've learned many still hold on to this antiquated way of thinking. Normally passive I've become the spokesperson for ethnic rhinoplasty. My #1 question "What if you look like Michael Jackson?!"
My reply: he looked D@MN good circa "Thriller" the problem wasn't that he had his nose done it was his mindset (body dysmorphia) not knowing when enough was enough. In having to fiercely defend my decision, I've had to admit to myself... rhinoplasty is something I want deep....within my heart of hearts ever since I was a preteen, I've envisioned it and now I can't think of anything I want more. With the talented hands of Dr. Goico I'm ready to get my beautiful nose and move on with my life...dedicate my neuronal activity to achieving a new dream. For that, ability...that freedom I am ready and willing to Travel to a place I've never been and make a 20year dream a reality.
It was heartbreaking telling my father whom I'm nearly identical to. But at 32 I'm done making decisions for others happiness. There comes great pleasure in coming out of whatever closet you're in. Initially, facing the opinions of my coworkers, friends and family was Overwhelmingly oppositional (99.99998% of them attempting to stop me)
*still there*
In conjunction with my rhino I'm also considering BBL + general liposuction instead of my initially planned breast lift with a (10/15% larger) implant exchange. Ultimately, of course I want it ALL but.
For safety which Dr Goico is stellar in emsuring, He, Doesn't reccomend doing all three and I wholeheartedly agree.....but the issue is which two? The decision changes on a daily basis.
The rationaile:
Most docs don't recommend having procedures which require different healing positions. Prone (face down) is contraindicated for rhino. And supine/dorsal (lying on back) even with a million donut pillows compromises the fat transfers, reabsorption, adds unnecessary pressure (I've read up to 400 per square inch on the glutes) undboutedly compromising fragile circulation that is trying to be established. Is created when a patient spends most of their time in supine Yet I've seen docs do both or all three! Ive seen a judicious few who wouldnt dare compromise the overall outcome knowing that the healing position is the second only to the surgery itself!
And as an RN I want a conservative whose looking out for my optimal outcome asthetically. Most doctors want you off of your buns for 3 weeks. There are even devices geared to assist you in this process.
So it sounds as if the answer would be simple right? Rhino, breast lift & implant exchange! Supine position (slightly elevated) required for both....but that's where things get complicated. Goico told me months ago...something I took far too lightly "be as close to your goal weight as possible before your lift" because if you lose afterwards the sagging will (albiet to a lesser degree perhaps) return *so I'm passing this gem of knowledge to you*
With 44 days till showtime the problem is I'm 40 lbs away from where I want to be. I'm juicing (avoiding plants Rich in k closer to the big day) but SWEET BABY JESUS it's hard. And now I'm mentally creating the most creative positions that can give me the ability to have rino and BBL. So far I've come up with laying on my stomache but placing a wedge pillow from my torso to my chin (perhaps even cutting a divit in the area where my chin will rest so that my with the help of a neck pillow (positioned backwards with the opening towards my back) my head will remain upright...it's exhausting but invigorating. I'm ready for change.

I'm Going to what's app Goico about my concerns I'm sure we will come to a conclusion. He was a realist from day one im the one who had to slowly realize what he said about a breast lift in haste before meeting a comfortable weight maintenance range made perfect sense. That's why he's wonderful. He's available, knowledgable, and honest.

FYI
* tomatoes, certain greens rich in vit K , supplemental vit K, vit E and Fish oil, birth control (ex. Nuvaring) are in most cases contraindicated min 2weeks prior to surgery due to their interference with the bloods natural clotting ability. going super green before my first surgery almost prevented it from happening. My clotting factor time was horrendous* in fact my Australian, doctor (who ultimately performed the breast aug 11years ago) exclaimed "if you had been in an accideeent you would haeeve bleed ouut before the ambulance arrived!"
This time around, although I'm juicing, I intend on withholding certain veggies closer to the big day.

That's basically what I was advised by the good doc! My advice: use it as a general blueprint, a guideline to make sure you and your doc are on the same page. I'll still have the refined tip and raised bridge, I'll also have alarpasty to reduce my nostril size. Dr. Goico understands vision and i love and trust his work when it comes to rhinoplasty that's the most important part of picking the right surgeon I wouldn't trust anyone else in DR with my face, hands down he reigns supreme!
I am worried about possible keloid scarring when he harvests the cartilage from my ears...but it's something we'll discuss