Meeeeee 😂

😂😂😂😂😂

Girl me lmao .

Me lol 😂

Surgery scheduled for the 9th jus got my lab work. According to him I’ll get a green light 😂😂

I am also having surgery May 2024 and I am traveling out of state for it, my Dr. still has not told me anything about having labs done.

Wow!! Thank you for the wonderful words. Best of luck on your recovery.

OMG, what a lovely thing to say! Thank you! That's very nice of you. Have a great day--you made mine.

I'm sorry for asking this but I have to,if someone is having a HIV aids, it's a problem If she get BBL,, hips and tummy tuck

I agreee! Me as well

Thank you. Please let me know if you have any questions I can address for you.

You are so welcome. You are a good student!! Any questions let me know.

@@DrWilliamMiamiwhat all labs are needed? Should this be mentioned to my primary physician? Does it have to be less than 90 days before surgery?

You can but the hypertension needs to be well controlled and get medical clearance from your physician.

Thank you! Best of luck with your surgery and recovery!

If the hemoglobin and platelets and white bloods cells are all within normal limits than the other values are not as important when it comes to surgery but you should always review your labs with your primary care doctor.

Yes get is as close to normal as you can before surgery and then after surgery maintain a strict diet because the higher the glucose level the greater the chance of infection.

@@DrWilliamMiami mine is 171 the ac1 is 7.8 and I’m seeing Dr William this month. Should I cancel or?

Very interesting!!!! I fell asleep myself watching it! 😂 But there was a lot of information and no good way to make it interesting other than to just try and get all the information out.

So nice of you--thank you! 🇨🇦💪🏻💪🏻

That's what it is there for! Glad you found it helpful. Here is a video about breast augmentation you may find helpful: kzfaq.info/get/bejne/pr1lrNd2ldLLYZs.html

Thanks again!

That is just so nice of you to say. Thank you. I love to educate and I am happy you are finding it helpful. It's a tough subject to try to make interesting.

@@DrWilliamMiami Your very welcome Dr. William 😊. Yes, I agree that it tough but you make it so interesting. Keep up the good work. Looking forward to another lesson 😊

Thank you! What else would you like to see? Give me a topic and I am happy to make a video on that topic.

My pleasure!

Thank you but I really only know plastic surgery at this point of my career--it has been a while since I went through all of the labs like for rheumatology patients or pregnant patients so I am not the best to discuss these types of labs. But thank you! Glad you found it helpful.

I love when things like that happen.

Thank you very much.

Glad it was helpful!

Glad it helped!

Thank you for thanking me!

I am glad you watched it! There is really no way to explain it in an interesting way!

I don't know how you could get through it twice--it is a little on the boring side! I admire your tenacity!

Happy to help!

Thank you! You are correct (although not every high white count is indicative of infection in all cases). Thanks for keeping my honest!!

If a person's thyroid labs are normal then they can have surgery.

Thank you! You're welcome. Please let me know if you have any topics you wish discussed.

Every patient gets an EKG before surgery.

We do require a preoperative urinalysis (UA). There is not supposed to be any bacteria in the urine but there are other factors on the urinalysis like leukocyte esterase and WBCs that can indicate infection so I would see your family doctor and have them review your UA to make sure you don't have an untreated urinary tract infection.

That's a good question. I don't read the EKGs myself--Anesthesia looks at the EKGs just to make sure there is not a problem. It is not common to find a problem as most of our patients are healthy but once in a blue moon something shows up that we need to involve cardiology.

There isn't a specific cut off--it really depends on the health of the patient. Health is more important in determining your candidacy for a BBL then age is.

Yes that is exactly right. The results of lipo are permanent--so where the fat cells were removed you can no longer gain fat because the cells are simply not there.

Below is a link to a video that is talking about Iron Deficiency Anemia and it explains how to raise iron levels. Iron Deficiency Anemia is the most common cause of anemia in the US and about 1/3 of women of child bearing age are iron deficient. This is what I tell my patients: I suggest they see their family doctor and check their iron level which is called a Ferritin level. If it is low than they can take iron along with Vitamin C to increase their iron levels which will fix the anemia. They should do this under the guidance of their family physician. If their ferritin level is normal and they have anemia I recommend discussing with their family doctor ways to potentially decrease the loss of Iron from their body which usually entails an OCP or IUD and making sure they don't have endometriosis or fibroids which their OB/GYN can help with. Essentially they look at ways to slow the loss of iron from their body (as above: IUD etc) and ways to increase the iron in their body (iron supplemntation). If none of those things are the problem then I suggest seeing a Hematologist (a specialist in the blood) as there are many other causes of anemia that are not related to iron deficiency and they can look at their blood and potentially bone marrow along with a host of other labs and determine the cause of anemia. Here is the link: kzfaq.info/get/bejne/mbmqqrZ008-wdmw.html

Either one works fine.

It depends how low. If it is 0.2 below the normal value that's fine, but if it is significantly low than the patient needs to see a hematologist to find out the cause of their low white blood cell count before having surgery. It is not very common to find a patient with a very low white count when getting labs for surgery because it has usually been picked up already or patients have had problems with infections.

@@DrWilliamMiami ok thank you! I am scheduled with you on May 9th. The coordinator called me and everything was fine except my wbc was 2.8 and its never been low before. I am scheduled to see a hematologists just to see why but i have not had any problems.

​@user-lb8bm7rb9t hey. Did you see the specialist? Mines is at 3.78. I just submitted my labs today, so I am assuming I'll hear back from someone soon.

Please let me know what the surgical coordinator says because I’m having the same problem but usually never get sick

@Nico-yy8xw Mia accepted mines. Mines was only. 3.78. I just had my BBL 2 weeks ago. I guess depending on the company and DR they will determine if it's okay or not.

Thank you. Glad you enjoyed it.

I suggest the Folate, Vitamin C and Iron for my patients. Here is a video explaining it better: kzfaq.info/get/bejne/b55zZJll09evgH0.html

When patients have a medical problem, such as Raynauds for example, surgeons usually require patients to gain medical clearance from their specialist to ensure it is safe for them to have surgery. There is usually no problem with Raynauds and surgery but it is always good to have clearance to ensure the patient is safe before surgery. Patients with anti-phospholipid syndrome are at risk for developing blood clots so plastic surgeons typically don't operate on patients with that disorder or any other disorder like Factor V Leiden etc which cause blood clots. We don't want to take the risk a patient will develop a blood clot which can be fatal (PE, Stroke, Heart Attack) or have serious consequences (clot in the liver, kidney or spleen) for an elective procedure. Safety is always priority number one.

Thank you for your answer. Keep up the excellent work!!

I don't use CRP (C-reactive protein) as a plastic surgeon. I never order it for my patients. It is a test that came out when I was in medical school and it was thought at that time to be a big break through, but it is quite non-specific--meaning it doesn't mean if you have an elevated CRP than you have this problem. It is elevated under a lot of very different circumstances so it doesn't reflect just one thing. It is a general marker of inflammation but one could have inflammation from an infection or from the liver which are two totally different things so I have never really found it that useful. I would speak to your primary care doctor about it.

I would speak with your primary care doctor to determine the cause. Sometimes we see an elevated AST from alcohol consumption, but there are several other causes so I would talk with your family doctor to rule out any other causes.

You would have to email me at drwilliammiami@icloud.com to discuss. I can't discuss here in an open forum.

Ok sorry about this thank you

Yes it can. A high PT indicates the blood doesn't clot as well as it should and that can lead to more bleeding after a BBL. I only operate on patients with normal PT values. I refer patients to a hematologist if they have a high PT.

I send mine 3 weeks ago spend thousand of dollars to hear im not clear and they were so rude about it my surgery is supposed to be tuesday i always thought hes my best doctor i couldnt trust noone else with my surgery but how the md was on the phone i literally cried

I would see a cardiologist to get their clearance.

No it wouldn't. If you had it checked again I am sure it would be fine. These very, tiny minor lab abnormalities are within lab error.

I would ask the ordering physician to review the EKG with you. Hard to answer it here.

Personally I do not operate on patients with Lupus, but there is a completely different set of labs for patients with other diseases. This lab panel is just the very basic you would get for a physical exam, or if you visited the emergency room for example. However, for diagnosis of other types of diseases there are many, many more specialty labs. Many.

is there any providers you recommend that will take patient with Lupus that's been in remission. because my blood work has been normal for over 6 years now, and I've recently been taking off some of my medication. Just trying to see if there is any alternatives because although I've been diagnosed with Lupus I still would like to have a nice body @@DrWilliamMiami

Not exactly. D-dimers is a break down product of a blood clot so it can mean you have a blood clot and the body is dissolving it.

For me those would not be exclusionary results, but I would confirm with your surgeon. It takes more than a trace of bacteria to diagnose a UTI. Symptoms and urinalysis finding such as leukocyte esterase and WBCs and significant bacteria are also required.

As long as a patient is taking iron and vitamin c and folate they can typically raise their hemoglobin in a couple of months. I always think it is a good idea for a person with anemia to discuss it with their primary care physician to see if they might be a candidate to see a hematologist.

yes

Not with me but I would ask other surgeons if they feel comfortable with patients who have Thalassemia.

Hi doc! Please respond 😭

Unfortunately I can't give direct medical advice here. I would ask your primary doctor that question. They should review the labs with you.

@@DrWilliamMiami okay so they have the final say?

Your primary doctor will give you an explanation for the labs, but the surgeon will always have the final say because it is the surgeon who takes responsibility for the patient once the patient has surgery. But we rely on family physicians, as well as cardiologists and internists to help us make sure everything is safe before surgery. But it is the final say of the surgeon as to the decision for surgery.

My RBC was 5.33 but the assistant say I cleared for surgery ,you have already done your operation or not yet

All labs have different values so you have to use the normal reference values for your lab. I would ask your physician why your ALT is high.

It is up to each surgeon what labs they prefer. For me personally I like to check the PT/PTT because it tells me if a patient's blood clots normally as I don't want a patient with weak blood clotting to have surgery as they could have excess bleeding.

@@DrWilliamMiami Thank you. I was concerned that this test looks for the opposite, i.e. blood clots, dvt.

There are tests for hypercoagulability that can find genetic mutations like Factor V Leiden for example, but there are many clotting disorders like Protein C deficiency, and it is best to see a hematologist for these tests and counseling.

I would discuss with your primary care physician and determine if a referral to a cardiologist.

Technically if you follow the American Anesthesia Guideline for preop screening they don't suggest getting labs in young, healthy patients undergoing cosmetic surgery. I do order labs routinely because I have seen patients who I thought would be fine, but they had a surprisingly low hemoglobin. So I order them on all my patients, but not every plastic surgeon does and they are not wrong. Surgery centers do because ironically Anesthesia always wants them!

I do but it depends on the problem. I would have to see photos to say. You can always email me at drwilliammiami@icloud.com

Please email me directly at drwilliammiami@icloud.com and I will get someone to reach out to you.

All labs have different range values depending on the lab so check with your doctor to make sure that your 11.8 is within the normal limits. It most likely will be because most lower cut offs are in the low 11's but check with your physician to make sure.

No it doesn't.

Elevated liver function tests should be looked at with your family doctor to see if there is any workup needed before having surgery.

Did you get cleared

@@quiarasoto Hello. My surgery is in May but I checked my labs to see what my numbers are prior to taking labs for my surgery. I should receive the surgery lab paperwork in mid April.

I would discuss any lab result that is not within the normal lab ranges with your family physician.

The level is different with each laboratory but as long as it is within the normal limits for that laboratory it is fine. Occasionally the upper limit will be 10.2 but in that case 10.3 would be fine but if it is significantly outside the range than it would be a problem and a normal value would be needed to proceed with surgery.

That should not be a problem.

Yes, that's great!

what if* also the rest of blood results are normal its just the ptt at 38. am i at risk?

I can't really advise patients on youtube specifically. I can only speak in general terms so I would have that discussion about your labs with your family doctor.

It's best to email me directly at drwilliammiami@icloud.com

Thank you. I would see a hematologist and find out why your hemoglobin is low and have it treated. You have to have a normal hemoglobin which usually means above 11.5 in most laboratories.

There will always be differences from lab to lab in their normal values and ranges etc. The main point is with an A1C over 7 you are not fit for surgery and need to get it down below 7, in fact, as close to normal as possible, because over 7 all the risks of surgery are increased especially infection.