Common COVID-19 Coronavirus Q and A

How long has TorontoPlasticSurgeon been in business?

TorontoPlasticSurgeon was opened by Dr Mulholland in 2020, and his protege Dr. Thomas Bell took over as head surgeon soon after. Over the past 25 years, Toronto Plastic Surgeons has become a nationally recognized brand that has always been committed to uncompromising patient safety, well-being and excellent outcomes As a result of the COVID-19 Pandemic, we have made the necessary changes to our clinic and office protocols to ensure the optimal safety for patients and staff. We have been offering safe cosmetic plastic surgery procedures in our government-approved, private surgery center, so we know a thing or two about infection prevention and control. Over the past 2 decades, Dr, Mulholland has navigated Toronto Plastic Surgeon successfully through the SARS outbreak, H1N1 and now COVID-19, and passed that attention to detail and patient care onto Dr. Bell.

What is the COVID-19 Coronavirus?

The COVID-19 is a novel coronavirus virus that attacks the upper respiratory tract most commonly and can affect the lungs, gastrointestinal tract, cardiac lining and even the lining of the brain. It is extremely contagious, more than 3 times as infective as the common flu and has a mortality that is tenfold higher than the flu as well. The vast majority of people, (over 80%-90%) who contract the virus experience mild to moderate symptoms consisting of fever, cough, sore throat, runny nose, muscle aches, fatigue, shortness of breath, loss of smell and taste. Some patients, the minority get upset stomachs, diarrhea, nausea and vomiting, while even more uncommonly, cardiac, stroke, neural, rashes and other symptoms that may be as a result of coronavirus.

It appears that many patients can be pre-symptomatic and asymptomatic carriers and amplify the spread. The vast majority of patients will mount an immune response and fight off the virus over 10-21 days.

15-20% of patients will need hospital care settings and require supplemental oxygen. 5% will require ventilation and the mortality once on a ventilator is very high.

Those who recover develop antibodies and more recent evidence suggests this will confer some immunity, meaning you can’t get re-infected, but we don’t know for you how long.

At this time, there is not therapeutic antiviral that works, nor a vaccine, so if you get sick the only treatment is supportive.

Virtual Care and COVID-19

TorontoPlasticSurgeon re-launched its new website in the month of April. The new TorontoPlasticSurgeon is rich in new and informative procedural content about our nonsurgical med spa and plastic surgery surgical services. We also transitioned our TorontoPlasticSurgeon team to dedicated Virtual Care. Using a dedicated and PIPEDA compliant GOTO platform, we now conduct Virtual consultations so you can reach out and explore your aesthetic options from the safety and comfort of your own home. Further, many of our preoperative and post-procedure care is offered virtually, decreasing the risk of travelling to and from the clinic.

Our Universkin, customized, bespoke physician strength skin care can be also managed virtually. Simply upload your photo, fill out the Univserskin questionnaire and our Artificial Intelligence and Computed Intelligence will analyze your photo and selected the optimal combination and strength of your active ingredients for truly bespoke, medical grade skin care, which is designed for the unique properties of your skin. We then compound your serums on site and ship to your home, without you ever having to come into the office.

How do we prevent contracting coronavirus?

Our only effective strategies to minimize or eliminate the risk of infection are:

• Physical distancing: stay 2.0-meters (6 feet) away from others
• Hygiene: Hand washing, sterilization and avoid touching mucous membranes
• Wear a facial covering when outside
• Wear personal protective equipment when inside the 1 foot zone.

How can I get my TorontoPlasticSurgeon Treatments Safely?

If a lot of medical aesthetic treatments are close to the face, inside a 1-foot zone and I can’t wear a mask, how can they be done safely and effectively? Dr. Mulholland and Dr. Bell would like to share with you an overview of the steps we have taken to ensure we are offering the safest possible environment for your aesthetic treatments: These COVID-19 Interventions include: Screening, patient flow, density, physical distancing, plexiglass, enhanced sanitization, PPE and the all-important SafeFilter, also known as a CareFilter for facial aesthetic treatments.

What is COVID-19 Screening?

Screening: TorontoPlasticSurgeon will be conducting email and Telephonic pre-screening for all patients prior to their scheduled appointments. The screening questions test for any COVID-19 symptoms or risks. On the day of your visit, you will also undergo another test at our Screening Center Outside the clinic and this will include a “no touch” infrared camera thermometer. You must pass the screening test to enter the clinic. All TorontoPlasticSurgeon staff also undergo screening and temperature test twice daily as well.

What is Patient Flow and how can it help with COVID-19?

Patient Flow, Volume and Density: To minimize congregation and aggregation, we have reduced patient volume and individualized flow, ensure we can perform the necessary sterilization between each treatment and thoroughly clean each room and all devices. But to also minimize patient bottle necks and exposure to other patients and staff, you must be punctual and on time. If you are late for your appointment by more than 5 minutes late, we may need to reschedule the appointment to avoid distancing violations.

What does Physical Distancing do and how do you do this in the Clinic?

Distancing: No more crowded TorontoPlasticSurgeon Waiting Rooms. We will be enforcing 2.0 meter (6 feet distancing). You must wear a mask and bring gloves to your appointment and have the mask or facial covering your nose and mouth at the screening center. You must come alone to the screening center, as no one can accompany you into the office building. Your ride or companion must wait in the car or neighborhood for you to call them when you have exited the clinic after your treatment

Plexiglass:  We have erected a large network of Physical Distancing Plexiglass barriers to ensure your safety in areas where you would contact TorontoPlasticSurgeon Administration staff.

How do I avoid close contact with other patients and staff at TorontoPlasticSurgeon ?

Concierge service. Once you have passed your Screening Test you will be checked in by our TorontoPlasticSurgeon Client service representatives who will be equipped with Personal Protective Equipment and will be behind the Plexiglas barrier. Quickly after check-in, you will be met by your treatment provider, who will be respecting distancing and will have full Personal Protective Barrier Equipment. She will take you right to your treatment room. Staff will be wearing distancing alert pagers to ensure they stay 6 feet apart from each other.

Will there be Hand Sanitizers available for me at the Clinic?

Increased Sanitation: You will come to the clinic with a mask and gloves. There are also multiple sanitization stations throughout the clinic and COVID-19 hand washing instructions at each sink. There are enhanced sanitization and cleaning protocols of all clinic surfaces hourly and, in the treatment rooms, after each patient encounter. Deep cleaning by a bonded health care cleaning service is also performed nightly

What exactly is Personal Protective Equipment and how does that help in COVID-19 Infection?

Personal Protective Equipment or PPE: PPE is medical barrier equipment that separates the staff’s expired virus and surfaces from the patient and the patients expired virus from the medical staff. Think of it as Physical distancing inside 1.0-foot face-face encounters like during Botox, fillers and energy based facial treatments, such as lasers, fractional RF treatment, IPL Photofacials and peels.

All TorontoPlasticSurgeon staff will have PPE. The Treatment staff who must necessarily get inside the 1.0-foot zone, will have the full and enhanced PPE including:

• A full face shield
• Wrap around goggles
• N95 mask
• Bouffant surgical cap
• Protective Gown

What else can keep me safe from COVID-19 when I am getting Injectable Botox, fillers, laser, RF treatments, micro needling, microdermabrasion and peels close to my face?

The SAFEMASK – FULL VIRAL FILTER

The SAFEMask revolutionizes the safety of cosmetic enhancement facial treatments, including “up-close” Botox, fillers, lasers and facial energy devices.

In close facial treatments include Botox, fillers, facial lasers, RF devices, micro needling, microdermabrasion, peels and other energy-based devices. TorontoPlasticSurgeon patients will be using a “SAFEMASK”, which Dr. Mulholland helped bring to market with Care Stream USA (CareFilter), the makers of nitrous oxide, laughing gas. The SafeFilter is easy to breathe through and filters 99.999% of all viral particles from inspiratory air (protecting you) and expiratory gases (protecting the treatment professionals and technicians). You can breathe in and out easily through this, with your nose plugged during your injectable  Botox, filler and facial energy based treatment.

                                             The SAFEMASK Filter

 

The SafeMask is easy to inspire and expire through and filters 99.999% of all viral particles from inspiratory air (protecting you) and expiratory gases (protecting the treatment professionals and technicians). You will be breathing through this and expiring through this easily, with your nose plugged during our Botox, filler and facial energy-based treatments and peels.  This virtually eliminates your risk of breathing in the novel coronavirus while being treated, or exhaling virus if you are pre-symptomatic or a symptomatic carrier.

What about pain control and the SafeMask?

The SAFEMASK can easily be connected to Nitrous Oxide, also known as laughing gas, so not only are you COVID-19 protected but the nitrous oxide will induce a natural surge of serotonin and dopamine in your brain, which are the neurotransmitters of well-being.  You will have significant pain reduction, anxiety control and an intense sense of euphoria. COVID-19 has left patients nervous enough about in-close medical care and the SafeFilter connected to Pronox means relaxation, safety and comfort.

What happens after my treatment?

No more crowding in billing room. Following your treatment, any necessary plastic baggies wrapped ice packs can be applied (no more air blowers, as they can aerosolize the virus). All payments and post treatment instructions will be provided in the safety of your treatment room. You will be asked to sanitize your hands prior to exiting and then your treatment professional will check to ensure there is no one else in the hallway and will escort you from the clinic. You will be wearing your mask at all times.

What about my Post Treatment SpaMeica Follow-ups?

Virtual Care:

We will be following up on your treatment the next day, at 7 day and 14 days to ask how you are doing and how your treatment recovery is progressing as well as, to answer any questions and administer the COVID -19 screening test again. Any concerns regarding treatment we will convert from Telephonic to a Virtual follow-up on our “GoTo” online video platform, which is compliant with all federal health care privacy laws.

What if someone Drives me to the clinic, can they come in?

No, those days are gone. For physical distancing, the Ministry of Health has mandated measures and no one else can accompany you inside the building to any appointments.  Anyone who accompanies you should wait in the car and you will call them when you have left the clinic.

Can I use my cell phone?

No cell phones in the clinic. Cell phones are a significant source of viruses and other microorganisms and you might unwittingly be brining COIVD-19 into the clinic on you cell phones. Neither staff NOR patients are allowed cell phones inside the clinic. THIS is strictly enforced.

What is if I want plastic surgery and not just Botox, fillers, peels and energy devices?

We are also open for elective plastic surgery procedures and the degree of COVID-19 infection control is even more rigorous.

Do I need a COVID-19 nasal swab RNA test before my TorontoPlasticSurgeon Plastic Surgery?

If you are a cosmetic plastic surgery patient (not MedSpa clients) and have surgery, then YES, we will ensure you get a preop test. If you were to get a COVID-19 infection following surgery, it could compromise the recovery from an otherwise routine procedure and, the procedure has the risk of making your COVID-19 infection worse. To minimize this risk, we insist on all TorontoPlasticSurgeonPlastic Surgery and Hair Transplantation patients having a COVID-19 test 10 days prior to your operation and then physically distancing and wearing a mask during the time after the test and leading up to your surgery. Patients of the medical spa and undergoing non-surgical treatments DO NOT NEED TO UNDERGO COVID-19 testing.

How am I protected during the actual surgical operation?

Your surgeon and all the TorontoPlasticSurgeon OR and recovery team are wearing the most rigorous full PPE including googles, shield, mask and gown. We have been very successful in the business of surgical Infection control for over 2 decades, so you are in good hands.

How do I avoid infection during follow up appointments?

After a surgery, you should shelter at home and distance from others interacting with the outside world as much as possible A lot of your routine follow up care will be virtual. Those few live, ‘in-person” appointments will be with staff in full, enhanced PPE and you will also be coming with a mask and gloves.

Can I still undergo a General Anesthetic?

Many of the plastic surgery procedures can be done under local anesthesia and twilight sedation. Larger procedures do require a General Anesthetic, which is very safe if you are medically well, avoid synchronous COIVD-19 infection risks and the operation is modest in length.

Who performs the General Anesthetic and am I safe from them?

General Anesthetics are administered by the TorontoPlasticSurgeon Anesthesiologist, a specialist doctor in Anesthetic medicine. TorontoPlasticSurgeon uses some of the best Anesthesiologists in Toronto, like the group from Toronto General Hospital who are specialists in cardiac by-pass and transplant procedures, giving them the best possible skills for a plastic surgery patient. Each anesthesiologist has full PPE and your anesthetic will deploy viral minimization techniques. YOU must also have a negative COVID-19 test in the days leading up to your surgery.

What if my preop COVID-19 test is positive?

If your preop COVID-19 test is positive, your procedure will be postponed, and you must recovery fully prior to your surgery is performed. Typically, this may be 6-12 weeks. Of course, there will be no financial penalty in these situations.

Dr. Mulholland and Dr. Bell built TorontoPlasticSurgeon into Canada’s most renown and reputable plastic surgery and medical spa clinic. For 25 years, TorontoPlasticSurgeon has been synonymous with excellence, safety and quality. TPS has successfully navigated through SARS, H1N1 and Dr. Mulholland’s Toronto Plastic Surgeon Infection Control Policy and Procedure Manual is used around the world.