Good question. First let me say, you are an adult and can make up your own mind about bringing someone with you. Except for the pets. No pets allowed in the recovery places. Sorry.

That said...

I could keep you up till all hours of the night telling you nightmare stories about patients who thought bringing someone with them was a great idea. But let me just say this, about that.

If you were MY sister, mother, friend, spouse, child, you wouldn't even think about bringing someone with you when you're going to Costa Rica to have major surgery performed under a general anesthesia. Why you ask? Because the very last thing you need is to have any distractions from the one and only job you have, which is to tune the world out and away from your mind and only concentrate on getting through the rough couple of weeks following surgery. Someone you bring with you will probably want to....

1. Talk to you 2. Laugh with you 3. Play gin rummy with you 4. Encourage you to get dressed and go out shopping or touring. 5. Not understand why the heck you have to be quiet, sleep half sitting up, not move your head and neck around at all, rest every moment that you can whenever you can, and follow Dr. Lev's post op protocols to keep you safe and also to make sure you don't do anything to compromise his beautiful work.

There have been too many times when patients have ignored Dr. Lev's orders, gotten up, gotten dressed to please their companion and go out touring or shopping and then ended up back in the OR at their own expense to repair the damage to the surgery that happened when they were out and about. At first, after the patient gets back to their room after surgery, the patient feels unable to move or feel like doing anything at all, including eating. But three or four or five days after surgery they're feeling pretty good so they figure they'll be able to easily get dressed and go out. About one hour after they leave the safety of their comfortable room, they need to sit or lie down NOW. Not five minutes from now, but NOW!!! So hopefully they'll be somewhere where there's a bench or chair. Then since their body is telling them rather loudly that they MUST lie down NOW, THIS SECOND, they first need to call a taxi or UBER and wait for them to pick them up and have them take her or him back to the comfort of the recovery place where people are there to care for them.

That sort of thing, even if it doesn't end you back in the OR, will set your recovery back to square one.

It's always sad when someone basically blows Dr. Lev's orders off, as if it's bad advice strictly meant to take away all the fun out of having major surgery.

That's the short answer by the way. If you want some stories, I've got 26 years worth and would be happy to share one or two if you'd like. Just ask me.

BOTTOM LINE: You need to ask yourself before committing to major surgery performed under a general anesthesia in another country, the following: "Am I here to take this experience seriously? Or am I here to have surgery while I'm on vacation? Or do I think that it's no biggie because after all, I've elected to do this surgery. It's ELECTIVE surgery for heaven's sake! It's not like a kidney transplant or anything. It's cosmetic surgery!

You couldn't be farther off base if you tried. This is as serious and intense as a kidney transplant or hysterectomy or any other major surgery performed under a general anesthesia for five to seven hours.

I know. This is more of a novella than a brief answer to the question. But this is one of the most important questions I will answer on this page entitled "Frequently Asked Questions". Like I said in the beginning, you are an adult and you are responsible for your own behavior after surgery.

Some people tell me that they can't possibly travel alone. They need to have their husband with them. They can't be away from their pup for 15 days. They can't be away from their children for 15 days. They just can't. Here's what I say to those patients.

"I completely understand what you're saying. Your feelings are totally legit. And you're not the only one who feels this way. That's why I'm going to recommend that you have your surgery closer to home. Or perhaps find a doctor who will be perfectly fine with doing everything you want, the way YOU want to do it. There's nothing at all wrong with you. This thing is most definitely not for everyone. It's just not. It's a huge commitment. A humongous undertaking. You shouldn't have to force yourself to do something that upsets you so much before you even get to Costa Rica. And that's where I will end this answer.

Some people seem to be under the impression that the longer you wait to have a facelift, the better. This is not necessarily the case, according to Dr. Lev. He says that the older you get the less elasticity in your skin and the thinner your skin gets. This makes surgery a more difficult procedure and the result isn't as good as it would be were the skin more supple, with greater elasticity. I was 48 when I had my first facelift with Dr. Lev and for me, that was the perfect age to have it done. When I asked Dr. Lev how a second facelift would look on me when I was 58, ten years later, he said there would be an improvement, but the overall result likely wouldn't be as good an overall result as I had the first time at age 48. I did have it done a second time and the results, fortunately, turned out well, but he was right, it wasn't quite as awesome as the first one.

He won't combine a facelift with any other surgery. He also won't combine any other surgery with a body lift. You can, for instance, combine a breast surgery with a tummy tuck or arms as long as there is nothing going on with the patient that would preclude such a combination.

It, of course, would depend on the extent of the dental work. But after a facelift you won't be able to "open wide" for about 10 -12 days postop and even then, you will still have to strain a little to get your mouth open wide. Opening too wide too soon can actually compromise the facelift surgery. As I said, it all depends on the extent of the dental work. That's why it's best to get the prep work done (implants, crowns, etc) three or so days prior to your surgery. Then 11 or 12 days after the surgery you could go in to have the dental work installed…carefully.

If you have any level of facelift, breast lift/reduction, tummy tuck you need to arrive at least two days prior to surgery unless you're coming from more than a 6 hour flight, then you should come three or more days prior to surgery, and you should stay for at least 12 days after surgery. The longer you stay after surgery, the better. So stay as long as you possibly can post op. You'll be near your surgeon and that's a good thing, especially the first three weeks after surgery. Although you could go home after 2 weeks post op and be ok. People are mostly very nice in the world and if you ask for help, at least someone will help you with your luggage, especially with removing the suitcase from the conveyor belt in the baggage claim. Lifting heavy things in the first three weeks post op is not a friend to major surgery of any kind.

Dr. Lev doesn't do any dermatological procedures including laser or peels. The only peel he will allow during a facelift is the "perioral peel" which is a chemical peel performed by his colleague who comes into the OR and piggybacks onto the facelift surgery and addresses the area from the bottom of the nose to the chin all around the mouth to soften the "cigarette smoker's lines".

Yes, however should something appear in your test results that precludes you from having the surgery, Dr. Lev won't do it until the issue is resolved quickly. That's why it's better to have the tests done in your own home turf.

For the first week you will look like you and a Mack truck got into a fight and the Mack truck won.

Some speak better English than others. One or two RNs will be watching you all through the night on surgery night. You can communicate with them in English. Most nurses and doctors in Costa Rica speak English. Some more than others but everyone understands at least some English.

Dr. Lev and the anesthesiologist will stay at your side after surgery until you wake up from the anesthesia. Then the nurses take over and Dr. Lev will return the next morning to check you to make sure you're ok to be released to the recovery place and then he will release you at which time you will be picked up by the recovery place driver and brought back to the recovery place and your room where you'll need to stay in bed without moving around too much for the first few days. You can ask for your meals to be delivered to your room. The first two or three days you won't be able to chew so most of your meals should be broth or yogurt or a shake or ice cream or whatever doesn't require chewing. Plain ice cream, not Cherry Garcia, for instance ( my favorite) which requires chewing!

You can send photos of the issue and an explanation and Dr. Lev will call you or you can ZOOM with him so he can see the issue and give you advice on what to do about it. Sometimes it's just a matter of waiting, which I consider to be the hardest part of the facelift surgery. The full recovery from any major surgery (a facelift, breast lift, tummy tuck, etc are all "major" surgeries) is at least six months.

You will rest, rest and rest. And when you're finished resting you will rest some more. Remember you are NOT on vacation. If you bore easily, that's a shame because you will be bored for a while. You must not move around too much after surgery or the movement can literally compromise Dr. Lev's beautiful work. A lot of people think that because this is elective surgery it's no big deal. They couldn't be more wrong about that. (You'll hear me say this a few times because it's really important to know that this is MAJOR SURGERY performed under a general anesthesia. If you had a hysterectomy or kidney transplant you would be thinking about "what will I do today"? Tour? Shop? Play pickleball? Go to a spa? Stop it! Just come down without a companion and concentrate on getting your 6 month healing process off to a good start. If that means you'll be bored, so be it. People, don't make me nag you because I know you'll want to kill me and that doesn't make me feel very comfortable. This world scares me enough. I don't need to look over my shoulder wherever I go wondering if a patient who wants to kill me for nagging them into submission, is actually going to kill me!

You need to find an airline that flies to San Jose, Costa Rica. The symbol for the San Jose airport is "SJO". How long the flight is depends on your departure city. From LAX to SJO the flight if you can get a nonstop, is 5-6 hours. It's about the same from NYC. Any farther away, like from Europe or Australia, the flights can be 24 hours with stops. If you can find nonstop service from your location to San Jose, Costa Rica, that is the best. Also if you're coming from Europe, Asia, Australia, you need to arrive in Costa Rica at least 4 or 5 days prior to surgery to allow your body to acclimate to the new time zone and also to decompress from the intensity of traveling such a long distance.

4-6 weeks if you've had a facelift. With other surgeries for other parts of your body, you can do it whenever you're physically ok to get yourself to a beauty salon without straining yourself.

4-6 weeks as long as you pace yourself so that you're not putting a strain on your surgery. If you've had a tummy tuck or breast lift/reduction you need to get back slowly starting with walking. Then increase the exercise load according to how you're feeling and according to what your body is telling you to do and not to do. With breasts and tummy, I wouldn't do anything strenuous for 2 months and even then I would monitor my body. See what it's saying to you. Our bodies let us know when it's ok to do or not to do one thing or another. You just have to listen to it and if you do you are more likely to have a wonderful post op journey, but remember that plastic surgery is not a perfect science and also that plastic surgery is a partnership between doctor and patient. Dr. Lev has been doing incredibly beautiful work for 35+ years, but if the patient doesn't follow Dr. Lev's post op protocols, recommendations and advice (my advice as well which is based on his advice with a shot of jewish mothering), the result and healing process will likely be The complete healing process is 6 months even though you will look amazing after just a month. When I had my first facelift with Dr.Lev, I looked fantastic after two weeks. But I was only 48. For my second facelift at 58 I looked fantastic after 3 weeks.

It's best if you go down to CR and CONCENTRATE FULLY on your surgery without looking for other things to do or to get. You can incorporate a few small procedures into your facelift, such as a perioral peel which is a chemical peel that softens the lines around your lips from the bottom of the nose to the chin. That is the ONLY peel you can have during a facelift and Dr, Lev's colleague comes in and piggybacks on Dr. Lev's facelift surgery. You can also get fillers or botox during your surgery or during your stay. You can have your earlobes trimmed during the facelift. If you come down three or four days prior to surgery you can get dental work done. We have found that many patients feel like since this is elective surgery it means it's no big deal. So they look for other things to do while they're there having the facelift or breast lift or tummy tuck. I strongly advise you to get those ideas out of your head before you even contact me initially. You need to be ready to trust that my advice is coming from a place of experience with our patients since 1998. It's also coming from a place of caring. I care about every patient I work with and give them the best advice possible. Sometimes it seems I'm too rigid in my advice and that is true. I am. Why? Because when I wasn't acting like a jewish mother to the patients in the past, insisting on one thing or another, like I do now, we had more complications. When I put my foot down and started nagging patients until they were brought to their knees, we had considerably less complications, so to be more concise, my jewish mothering isn't such a bad thing. It actually helps the patients understand the gravity of this journey.

The only way to comply with Dr. Lev's protocols and "drill" is to stay at one of the two recovery places we have worked with for years and who know what Dr. Lev wants and needs from the patients in recovery. In the recovery places they include in their daily fee, all rides to and from Dr. Lev's office, the clinic on surgery day and pick up from the clinic the next morning after Dr. Lev examines you and releases you to the driver who will take you back to your recovery place and your room where you will begin the annoying task of recovery. Being taken care of by our team will guarantee that you will have the best post op care. These two places also include taxes, three meals a day, wifi, internet, electric hospital bed, private bathroom, A/C, ceiling fan. In the more expensive place, since they were built as an independent/assisted living residence, you will have access, with the push of a button, to their 24/7 nurses station. The nurses will manage your meds and take your vitals every day. They also have an in-house chef and you can order off of a menu or ask for something special and if they have it, the chef will make it and have it delivered to your room. The more expensive place is about a 15 minute drive to Dr. Lev's office. The less expensive place is only two blocks from Dr. Lev's office which is wonderfully convenient. The clinic is also about 4 blocks away and the dental office is 4 blocks away in the other direction. Here are the two recovery places we work with.