South Coast Urogynecology

THE PROCESS (What to do if you are from out-of-state)

Once we have answered all your questions to your satisfaction and you have decided to proceed with aesthetic vaginal surgery we then try to make your experience as pleasant and stress-free as possible. We offer a concierge service that can take the worries off your shoulder. Please call us for details.

Our staff will work with you to choose a time and date that is convenient once you have decided on surgery. You will then go to our website at www.urogyn.org, click on the “Office Information” tab, click on “Patient Forms” and download the History and Physical PDF file. Print this out and fill it out to the best of your abilities and fax it back to us. This will be our initial screen on your health. If you wish, we can fax this form to you. I will review your History and Physical and call you if I have any concerns. You will also download the files called “Essential Pre-Op Instructions” and Post-Op Aesthetic Vaginal Surgery.” These are very important files that detail your preparations prior to surgery and your instructions after surgery. It helps to review these so that there will be no surprises. If you have significant incontinence or pelvic organ prolapse then you will also need to download and fill out the files called “Pelvic Pain & Urinary Frequency Scale,” “Quality of Life – Urinary Distress Inventory,” and “Intake & Voiding Diary.” Having these filled out and faxed to us ahead of time makes your office experience even more streamlined and efficient. One more thing, if you have the capability of obtaining a digital photograph of your vulvar area you can send this to me securely and we can discuss by phone or email what it is you do not like and what it is you are aiming for in terms of appearance and function.

Prior to your departure to California you must ensure that you are not pregnant. Please check a pregnancy test before you fly. We will do one also in the office to confirm you are not pregnant. We cannot do your procedure if you are pregnant. You will fly into John Wayne International Airport and will travel to the office typically by taxi, shuttle, or limousine. We can arrange your transportation. We recommend coming into our office in the morning to meet Dr. Alinsod, review your history, perform a physical examination, and be evaluated for surgery. You can then specifically tell us your wishes and desires and expectations for surgery. You can bring in a photo to show us the appearance you are looking for. You can also tell us how tight a vagina you are wanting. At this time you have the advantage of getting a full physical examination, and PAP smear if you wish, for no additional charge. This is certainly a value added service. After the examination, if you wish to proceed with surgery, this is when you will pay your fee. We accept cash, credit cards, and check. You will need to arrange for financing through Capital One if you wish. We can help you with that. It is best to arrange for financing well ahead of time. We cannot perform your surgery if financing has not been completed.

We then decide on a time for surgery in our office. We require that you have had nothing to eat or drink at least 8 hours prior to your time of surgery. One hour prior to this time you will need to place an anesthetic cream on the surgical site (EMLA Cream) to start the anesthetic process. We will also give you an anti-anxiety medication and oral pain medication. About 15 to 30 minutes prior to surgical “cut time” we will give you an injection to ease your surgical discomfort. We will go ahead and take your “Before” pictures immediately before surgery. When we are satisfied with your level of comfort we will proceed with surgery. This is when you get your local injection of Marcaine and the actual surgery starts. We monitor your vital signs, ask you to tell us of your comfort level, and allow you to nap if you wish. Surgery takes 1-2 hours. We have soothing music for you to listen to and relax as we complete your surgery.

After surgery is finished you will go to our recovery room for approximately 30-60 minutes, or longer if necessary, to recover, relax some more, view beach scenes on the TV screen until you feel fit to go leave. We will check your vital signs several times during this time period. We will examine you one more time for bleeding and release you when appropriate. Your ride will take you home or to your hotel where you will be checked in expeditiously and with privacy. If you had requested it we will arrange for a home health specialist to visit you in your suite. If you had requested it we can even arrange for a nurse to stay in an adjoining suite ready to assist you in any way. You can have room service or visit one of the fantastic restaurants if you stay at St. Regis Resort. You can be pampered to your heart’s desire at one of the five-star resorts or you can choose a less expensive hotel and let your partner pamper you! Be sure to have ice packs, Dermoplast Spray, your pain medication, antibiotics, estrogen cream, and any other medication already in hand BEFORE you go to the hotel since most hotels do not have a pharmacy. The most convenient thing to do for your prescriptions is to use the pharmacy on the first floor of our office and get your meds prior to surgery. We can even call in medications for you at the pharmacy of your choosing if you live in California. Now you can sleep. If needed, we will give you a sleep aid. You can use 50 mg of over-the-counter Benadryl to help you sleep if you have no contraindications. The next day, you will most likely check out of the hotel and visit our office for an exam prior to your departure for home. If you have no bleeding, you have good pain control, no excessive puffiness, no signs of infection then you can even skip the appointment and just fly or drive home. Again, we can help arrange your transportation. We want you to keep in close contact with us during the first couple of weeks so we will either call or email you to check on your progress. Do not evaluate the results of your surgery at this time because you will often be disappointed. This is the time when bruising, puffiness, discomfort, discharge and bleeding occurs. Read the Post-Op Aesthetic Vaginal Surgery sheet again to evaluate whether your symptoms are normal or not. Be sure to be compliant with “Pelvic Rest” in the first 6 – 8 weeks to ensure proper healing. Call or email us if you have any questions or concerns. A digital photograph may be helpful if you are able to send one securely. We usually answer our emails within a few minutes. Dr. Alinsod and staff are available 24/7.

Plan to see us 6 – 8 weeks after surgery to ensure that healing has been proper and complete. Now you can use a mirror and judge the results yourself. If you are happy and have no problems you will be released to resume normal activities including sexual intercourse. If needed, we will teach you how to perform vaginal stretching exercises to soften any scaring that may occur and to ensure an adequate sized vagina. Many who live far away will take the “After” pictures of their vulvar region and email it to me. It is important to me to receive these pictures to keep track of our cosmetic results and ensure a complete patient file. If you are happy with the results and have no other concerns then the follow-up visit is elective. We can do a phone or email follow-up. If the occasional minor revision is needed then we will do this in the office at no charge. There is no charge for any of the postoperative appointments.

In closing, be sure to take your antibiotics and use your estrogen cream. We do not want any infections and we do want rapid healing with softened tissues and skin. Outstanding service and excellent results are our goals.