CSTAR PATIENT POLICIES & GUIDELINES

At CSTAR International our main goal is to provide superior results with a top level of service and enjoyment for our patients. Please read our policies carefully to understand the plastic surgery process with CSTAR International.

CSTAR INTERNATIONAL PATIENT SURGICAL PROCESS

1. Arrival at your local vicinity airport. For your trip, please list the name of the airport below:

2. Pick up at the airport. A car service will pick you up upon arrival and bring you to your place of accommodation. The driver will be holding a sign with your name on it.
3. Pre-operative Appointments with your plastic surgeon and anesthesiologist. Our staff will be with you every step of the way to provide support and make sure you are ready for surgery.
4. Surgery.
5. Recovery: Our plastic surgeons, nurses, aestheticians, and recovery house staff will provide a five-star recovery experience.
6. Transport Includes airport pick up, drop off, labs, surgery day and doctor’s appointments
7. Follow up. We will follow up with you regularly to monitor the healing process over the months following surgery.

SCHEDULING YOUR SURGERY
By booking a day for surgery you are confirming that you agree to our policies. Once you have set a date for your procedure with our Patient Coordinators, we will need from you the following:

✓ Deposit payment. A nonrefundable USD $600 is required to schedule a date for surgery and book operating room time. This is deducted from your surgery total.

✓ Copy of your passport. It is mandatory for clinics to have the patient name, identification number, nationality, and date of birth in the medical record. This information must be supported with a copy of the patient’s passport, which is the valid document used to enter the country.

✓ Flight Itinerary. We need this to schedule your pickup service upon your arrival and to build your Patient Itinerary, which will indicate your appointments from the moment you arrive until surgery. Post-operative appointments are scheduled in advance. Patients from the American continent must arrive in their receiving country at least 72 hours before surgery. Patients coming from other continents must arrive in the country at least 5 days prior to surgery.

✓ Results of Presurgical Laboratory Exams. Prior to surgery, you are required to send us copies of your laboratory results and medical clearance when indicated. These must be current within 6-8 weeks of your date of surgery.

BLOOD WORK EXAMS
The exams that will need to be done before surgery are:
✓ Complete Blood Count (CBC)
✓ Prothrombin Time (PT)
✓ Partial Thromboplastin Time (PTT)

Hemoglobin requirements: Hemoglobin levels must be at least 12 g/dL for patients to be accepted for surgery. We recommend that patients get labs early so that low hemoglobin levels are detected, and treatment started to get the level above 12 g/dL. If patients do not reach these levels, we will be obliged to postpone the procedure and reschedule for another time. This may entail additional costs that must be covered by the patient.

Please keep in mind that during anesthesia evaluation these exams will be reviewed by the anesthesiologist who may request additional exams. These are NOT included in the costs. It is the anesthesiologist who will have the final decision to clear a patient for surgery.

✓ Accommodation Choice. Estimates include highly recommended accommodation options for patients to choose from. A quiet, quality and clean environment with easy access is very important to support recovery from surgery. We work with patients to stay at a place that serves their tastes and budget and wants to protect them from making a bad choice regarding accommodation as it can be stressful on arrival. Please stay only at a certified recovery house or one of the hotels on the list provided by CSTAR International.

YOUR SURGICAL ESTIMATE
Estimates for surgical plans developed through phone consultations will be confirmed after an examination of your Patient Medical Form by the plastic surgeon. There may be changes to the plan after the in-person consultation with the surgeon that may lead to extra charges if additional operative time is required.

Services Included in the Surgical Estimate
✓ Surgical Package

• Round trip transport to and from the airport (DR only)
• Round trip transport to and from the clinic the day of surgery
• Personal accompaniment (depending on the surgical package you selected) by our staff or your recovery house throughout the process of care. You will always be with someone during your medical appointments, anesthesia evaluation, buying medications, and garments
• Personalized follow-up during your recovery time. Recovery House nurses are available to assist patients throughout the process of care. Private nurses are available as needed for an additional charge.
• Follow up visits
• Insurance policy for postoperative complications. The policy is provided for all plastic surgery patients and covers expenses related to medical, emergency room, hospital, and surgical services in the Dominican Republic for 30 days after surgery. After the evaluation of anesthesia, the medical record and other related documents are evaluated by the insurance company who verifies the insurability of the surgery. Patients with hemoglobin of less than 12, BMI greater than 35, or other abnormalities in their pre-surgical exams will not be insured.

✓ Post-Operative Therapy (when appropriate)
– Certified aestheticians perform specialized postoperative therapy sessions to optimize post-operative recovery after liposuction and tummy tuck procedures.
– We recommend one session daily. Each session is 45 min long and helps to enhance lymphatic drainage, reduce swelling, soften tissues, and speed recovery. Patients generally begin the day after surgery and continue throughout their stay.
– Double sessions are also available upon the patient’s request.
✓ Garments
– The estimate itemizes the cost for 1 set of postoperative garments and/or bras appropriate to the procedure(s). Someone from our team will go with you to the garment store to purchase these.
– Additional garments required by the patient will incur additional costs.

✓ Medications – Standard medications appropriate to the procedure(s) will depend on the Doctor’s recommendation
– Additional medications required by the patient will incur additional costs.

Services Not Included in the Surgical Estimate
✓ Blood work and Medical clearances. Safety is our highest priority. You need to get any blood work or additional exams done at home and send us results before traveling for us to make sure everything is ok for surgery. These must be within 6-8 weeks of your date for surgery. Medical clearances may be requested by your specialist. Please have in mind that during anesthesia evaluation these exams will be reviewed by the anesthesiologist who may request additional exams. These are NOT included in the costs. It is the anesthesiologist who will have the final decision to clear a patient for surgery.
✓ Airfare. Airfare is not included in the fees. CSTAR can work with you to include airfare in your package deal if desired.

PATHOLOGY SPECIMENS
Occasionally our surgeons remove tissue and send it to Pathology for microscopic examination. Typically, these are skin lesions, masses, breast tissue, or breast capsule(s). In these cases, additional fees may be required to pay for the Pathology fees.

PAYMENT

Payment Options
-Debit or credit cards: Visa, MasterCard, AMEX and ZELLE
-Wire transfers or direct deposits to our US bank account.
-Cash.

Once you indicate your preference, we will send further instructions on making payments.

Prepayment Program
Our Prepayment Program facilitates the payment of your procedure by making installments to gradually pay the balance before surgery. This can be done with any form of payment. All fees must be paid in full before surgery.

PAYMENT INFORMATION AND CANCELLATION POLICIES

• A non-refundable deposit of USD 600 is required to hold a date and schedule surgery. Deposits are good for 6 months.
• Before arrival at your medical travel destination, at least 100% of the total costs must be paid through CSTAR International.-The remaining balance MUST be paid at least 30 days before surgery. Noncompliance may lead to surgery rescheduling or cancellation.-In case of bank deposits or transfers, please keep in mind that each bank has its own policies and transactions may take up to 5 business days.
• To avoid any delays or inconveniences, please make sure to notify your bank that you will be traveling and using your card in the country you will be traveling to. It is also important to notify your bank of the approximate amount of the anticipated purchase to avoid the transaction being flagged or denied.
• Patients are responsible for all debit/credit card and wire transaction fees such as foreign transaction fees.
• In case of a medical issue that prevents you from having surgery after arrival, you are entitled to a full refund from the recovery house, and 85% of surgery costs not including the deposit. (Subject to individual doctor regulations. All monies will be returned by the doctor and recovery houses, NOT CSTAR International.)
• In case of cancellation of surgery before departure, you are entitled to a refund minus the non-refundable deposit. Please allow 7-30 days for a refund to be reflected in your account.
• Any debit/credit card or bank fees already implemented or required will be deducted from all refunds.
• If you leave the recovery house before your contracted discharge date, there is NO refund of unused days. (Subject to individual recovery house regulations)

PRE-OPERATIVE INSTRUCTIONS

At CSTAR International your safety is of utmost importance to us. For this reason, you may be asked to stop taking certain medications, vitamins, and supplements, before surgery. Please have the following in mind while getting ready for your procedure:

Two months before surgery

• No smoking or nicotine-containing products (cigarettes, e-cigarettes, patches, gums, etc.)
• Stop recreational drugs.
• Please notify us if you become sick with any virus, sore throat, fever, or cough.
• Make sure you have submitted your laboratory results.
• Three weeks before surgery
• No Aspirin, aspirin-containing medications, and anti-inflammatory agents.
• No vitamin supplements that contain Vitamin E or Omega.
• Stop all Herbal or Dietary Supplements. This includes vitamins, and antioxidant supplements, as well as consumption of any form of Green Tea. If there are any doubts, please ask us and we will guide you.
• Make sure at least 50% of your payment for surgery has been submitted. To avoid any delays or inconveniences, please make sure to notify your bank that you will be traveling and using your card in the country you will be traveling to.

Day before surgery

• Nothing by mouth after midnight (no food, medications, or liquids) unless instructed differently.
• Take out all body jewelry, contact lenses, and make-up.
• Remove nail polish, acrylic, or gel nails.
• Shower and wash surgical site(s) the night before and the morning of surgery.

On the day of surgery

• Shower and wash surgical site(s) the night before and the morning of surgery.
• Bring your post-operative garments.
• Be ready approximately 1.5 hours before surgery. Someone from our team will pick you up to take you to the hospital.
• Wear comfortable clothing and shoes
• Items to bring underwear, sanitary pads, dress, pajamas, slippers, wipes, deodorant, toothbrush, and paste.

ADDITIONAL ITEMS

Please have in mind you will need to buy several additional items before surgery. We recommend that you purchase these items for your convenience.

• Insect Repellent
• Adult diapers
• Baby Wipes
• Arnica Gel
• Hand Sanitizer
• Socks
• Sun cream SPF 45 or more
• Antibiotic Ointment
• Maxi pads

Shaving Surgical Areas
Please shave your surgical areas 2 days before your surgery date as follows:

• Tummy Tuck: Pubic Area
• Thigh Lift: Pubic and Groin Area
• Arm Lift: Arm Pit Area
• Gynecomastia Correction: Periareolar area

Clothing
Depending on the season and the country you are traveling to we advise checking the weather. Regardless of where you are traveling please bring comfortable clothes such as light dresses (easy on front closure dress), shorts, or loose clothes such as yoga pants. Shoes with no heel, sandals, or flip flops. For tropical countries you will need sunblock and most likely a hat, you can bring these with you or buy them here. You can use a small bag for your drains (when applicable), and nurses are experts hiding these so feel free to wear the clothes you want.

POST-OPERATIVE CARE

Following surgery

• BE AWARE – After surgery, you will wake up in the clinic’s recovery area. You will most likely experience shivering and cold. You should not take any food after surgery until instructed – generally around 4 hours after.
• Once you have been instructed to take any food, you should start with soups, broths, juices, jellies, and /or purees to avoid nausea after the anesthesia.
• We recommend you follow a diet low in carbohydrates and rich in protein and mixed vegetables for the first couple of days after surgery. Fruits such as papaya and pineapple are also recommended.
• You should plan to get plenty of rest after surgery, though we make sure to get everyone up and moving soon and often. You will receive recommendations on how to gradually increase activity specific to your case.
• Wounds should be kept covered, clean, and dry until instructed by your plastic surgeon.
• Day 1 after surgery for body procedures generally involves a sponge bath. Please make sure not to wet the surgical tapes until cleared by the plastic surgeon.
• We ask our patients who need garments to wear them as much as possible for 2 months. You will get specific instructions from your plastic surgeon before leaving.
• Your follow-up appointments will be scheduled between you and our medical staff after surgery.
• Smoking is prohibited for at least 4 weeks after surgery as it drastically increases wound healing complications.
• Make sure to continue taking the prescribed medication as instructed by your plastic surgeon.

Incision Care

• Gently clean your incisions with soap and water, using a soft soap.
• During the first month, apply any ointment 0r medication recommended by your physician.
• If there are any open areas, clean daily with soap and water and gently pat dry. Apply antibiotic cream and gauze to cover incisions and keep them isolated from the environment. Continue this until incisions are closed.
• One month after surgery start to apply silicone gel (Xeragel) twice a day with gentle massage of incisions. This is to help flatten, soften, and fade incisions to result in very fine line scars.
• Sunlight can cause scars to darken. Avoid sun exposure to your wounds for the next 6 months. Use SPF 50 sunscreen on all incisions for at least one year.

Exercise

• Light exercise, such as walking, is allowed the first three weeks after surgery, increasing time and distance gradually.
• Light cardio, such as jogging, biking, elliptical, etc., can be gradually resumed. If you experience pain during an activity, slow down, and do not stress yourself unnecessarily.
• If you have had a tummy tuck, no lifting more than 10 lbs. and no straining for 2months after surgery.
• At two months after surgery, you may resume unrestricted activity.

Long-Lasting Results

• Remember that your results depend on you. We recommend that you maintain a healthy diet and regular exercise after surgery.
• Our nursing team has plenty of great recommendations to help you with a lifestyle post-op that will help to optimize your results.

Compression

• For liposuction, tummy tuck, and Brazilian butt lift patients it is very important to continue the compression garments for at least two months.
• As your swelling resolves your form will improve gradually. Please decrease the size of your garment when you don’t feel there is good compression.
• You can buy smaller garments or have garments tailored into a smaller size.

TOUCH-UPS AND REVISIONS

All procedures are performed to improve a condition, a problem, or appearance. While the procedures are performed with a very high probability of success, we cannot promise perfection and at times a touch-up or revision is desired. Our surgeons and entire team work hard to make patients happy and thus improve their lives, and we will work with patients to achieve these goals.

Patients are responsible for any costs associated with the procedure(s) including operating room fees, anesthesia fees, insurance, medications, etc. Depending upon the procedure defined with your surgeon, a surgeon’s fee may be required.

EXTENDED STAY

Occasionally, a patient must extend their stay due to unforeseen circumstances such as the continued need for drains, wound healing issues, or need for more recovery time. Under these circumstances, our top priority is always to optimize patient recovery and outcome, and we work with patients to continue care with us while trying to minimize the burdens and expenses involved.

For your airline ticket(s), please consider purchasing travel insurance in the unlikely event that you need to change your flight for a date other than the one scheduled. The cost is generally 4-10% of the purchase price of the ticket, which can be very helpful in the unlikely event that you need to extend your stay.

TIPPING

All our services are included in your package, and gratuity is not necessary. If you feel that you have received excellent service and would like to show your appreciation to our staff, may we suggest that you contribute to the staff gratuity fund through one of our coordinators. We divide and distribute the monies equally among service staff, aestheticians, and nurses that provide post-operative care for patients.

I acknowledge that I have read and understood the above policies and procedures in their entirety and agree to abide by them.

CODE OF CONDUCT FOR PATIENTS

In an effort to provide a safe and healthy environment for staff, visitors, patients and their families, CSTAR International expects visitors, patients, and accompanying family members to refrain from unacceptable behaviors that are disruptive or pose a threat to the rights or safety of other patients and staff.

The following behaviors are prohibited:
• Possession of firearms or any weapon
• Physical assault, arson, or inflicting bodily harm
• Throwing objects
• Climbing on furniture
• Making verbal threats to harm another individual or destroy property
• Intentionally damaging equipment or property
• Making menacing gestures
• Attempting to intimidate or harass other individuals
• Making harassing, offensive, or intimidating statements, or threats of violence through phone calls, letters, voicemail, email, or other forms of written, verbal, or electronic communication
• Racial or cultural slurs or other derogatory remarks associated with, but not limited to, race, language, or sexuality

PLEASE BE COURTEOUS WITH THE USE OF CELL PHONES AND OTHER ELECTRONIC DEVICES. WE RESPECTFULLY ASK THAT YOU PUT YOUR DEVICES AWAY WHILE INTERACTING WITH THE STAFF, NURSES, AND PHYSICIANS.

IF YOU ARE SUBJECTED TO ANY OF THESE BEHAVIORS OR WITNESS INAPPROPRIATE BEHAVIOR, PLEASE REPORT TO ANY STAFF MEMBER. VIOLATORS ARE SUBJECT TO REMOVAL FROM THE FACILITY AND/OR DISCHARGE FROM THE PRACTICE.

BE AWARE THAT A PENALTY MAY BE CHARGED If YOU ARE DISCHARGED FROM A FACILITY FOR ANY OF THE ABOVE VIOLATIONS, FURTHERMORE, CSTAR INTERNATIONAL IS NOT RESPONSIBLE FOR ANY MONETARY REIMBURSEMENT FOR ANY HARDSHIP THAT MAY BE INCURRED BY YOUR OWN ACTIONS.

I agree to the CSTAR International “Code of Conduct for Patients, Parents, and Visitors”