LIPOEDEMA SURGERY WAITLIST REQUEST

First Name *

Last Name *

Email Address *

Mobile *

Has Dr Somia recommended Water Assisted Liposuction? *

YesNo

Current BMI (surgical risk increases with BMI over 35 and requires additional planning) https://www.heartfoundation.org.au/bmi-calculator *

Which areas are to be treated? *

Are you required to address any other concerns before scheduling surgery? Please detail

If you take blood thinners or heart medication you will be required to seek the advice or your cardiologist and GP *

I understand the requirementsI do not understand the requirementsI do not take blood thinners or heart medication

If you take GLP-1 products ie Ozempic for Diabetes or weightloss you will be required to follow a 24 hour clear fluid diet prior to the usual 6 hour surgery fasting time *

I understand the requirementsI do not understand the requirementsI do not take GLP-1 antagonist products

If you use nicotine or vaping products you will be required to cease 12 weeks before and after surgery *

I understand the requirementsI do not understand the requirementsI do not use nicotine or vaping products

If you take a contraception pill you will be required to cease this 2 weeks before surgery to avoid clotting issues *

I understand the requirementsI do not understand the requirementsI do not take a contraception pill

I understand the waitlist is currently approximately 12 months? *

YesNo

I agree to update Dr Somia's office if my plans change or I no longer wish to proceed? This helps to keep our waiting list current and enables other patients to have surgery sooner. *

YesNo

I understand the need for a 2nd consultation with Dr Somia before a surgery date is confirmed and that if my first consultation was virtual that I need to attend in person? *

YesNo

I understand that I must have a current GP referral for consults and surgery and that a referral from a specialist of GP who performs cosmetic services does not qualify? *

YesNo

I agree to limit requests for updates on the list. (Note you will receive a confirmation email of this request). If you do not receive a checkin link via sms after 6 months please get in contact with us. *

YesNo

I understand that any fee estimates given at this time are a guide and will need to be updated closer to the date of surgery. It is not possible to give an exact fee so far in advance. *

YesNo

I understand private health insurance and medicare will not cover this surgery as it is not yet recognised by medicare. Private health insurance may be used for rehabilitation provided I have adequate cover (no specific item number just rehab cover on policy). Arm Brachioplasty does attract medicare/fund cover provided criteria is met. *

YesNo

Pre-surgery process

WHAT HAPPENS NOW:

1. Periodic SMS checkin links to update us on your readiness for surgery. If your BMI is over 35 we will contact you to discuss options. BMI's over 35 increase surgical risk and need to be planned carefully.

2. A date for surgery will be offered. Full date information via email and an sms to alert you it has been sent. We require a response within 7 days. If you are not ready for the date offered you can postpone without consequence. Let us know when you would like to have surgery and you will be placed into that time frame. Whilst we cannot guarantee specific requests for dates we wiill try to work with you. You will not have to restart the waiting process.

3. Once a surgery date is confirmed a $1050 non refundable deposit is due within 1 week and applications for superannuation can commence. You will be given information on joining our Surgical App to assist you in getting ready for surgery including pumps, garments etc. If surgery is cancelled within one month of the surgery date 30% of Dr Somia's fee is due.

4. You will see Dr Somia again to discuss the procedure and review your planned areas for surgery. Pre-operative blood tests and ecg will be arranged to ensure you are otherwise healthy. In some cases additional clearance may be needed from specialists such as haematologist, cardiologist or pain specialist. Consultations fee is $250.

I understand a $1050 non refundable deposit is due 2 weeks after a date for surgery is confirmed and that 30% of Dr Somia's fee is payable if the surgery is cancelled within one month of the surgery date. *

YesNo

Rest assured we are doing our very best to fit everyone in as soon as possible. We only have one surgeon and the demand for surgery is very high. On the positive side, this is an opportunity to really focus on conservative treatment to be in the best possible condition to undergo surgery and make the most of it. Patient Care Team - Tahlia, Jane and Juanita