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Postoperative Instructions

Table of contents:

  1. Blepharoplasty
  2. Cheek and chin implants
  3. Chemical peel
  4. Dermabrasion
  5. Facelift and neck lift
  6. Facial Feminization Surgery
  7. Forehead contouring, scalp advancement and browlift
  8. Lip lift and augmentation
  9. Mandible contouring
  10. Forehead contouring, Scalp advancement, Browlift and Mandible contouring
  11. Mohs reconstruction
  12. Rhinoplasty
  13. Skin biopsy
  14. Torn earlobe repair
  15. Trach shave (Chondrolaryngoplasty)
  16. CO2 Laser Resurfacing

BLEPHAROPLASTY (“EYELID LIFT”) POST-OPERATIVE INSTRUCTIONS


These instructions should be carefully read and followed. They are designed to answer the most commonly asked questions regarding post-operative care.

Activity:

Limit your activity over the first week following surgery. You are encouraged to walk around the house on the day of surgery and thereafter. This helps to prevent blood clots from developing in the legs. Move/pump your legs frequently while lying down. This also helps in preventing blood clots from developing. When you rest or sleep, keep your head elevated with 2-3 pillows and avoid turning on your side. If you overexert yourself, bleeding or prolonged swelling may result. Keep your emotions under control. It is not unusual to feel a bit depressed for a few days after surgery. This quickly passes as you begin to look and feel better. Anger, crying or other emotional outbursts will only add to the swelling or increase the likelihood of bleeding. Avoid bending, lifting, pulling, pushing, straining and aerobic activities for 3 weeks. You may begin to return to regular exercise 3 weeks after surgery. Ease into this, gradually increasing your exercise level back to normal by 5-6 weeks from surgery. Take deep breaths often when you get home for the first 24 hours after surgery. This helps to expand the base of your lungs.

Oral intake:

Alcohol consumption should also be limited as this may raise the blood pressure and initiate bleeding. Do not drink alcohol during the first week.  Drink plenty of fluids following surgery, as dehydration can contribute to nausea. You may want to avoid foods that require much chewing, such as steak. Soft foods may be easier to eat. Small amounts of food 20 minutes before taking postoperative medications (especially pain medications and/or antibiotics) can prevent nausea. If you vomit or feel nauseated, you should delay food and pain medications until the nausea passes. Take only 2-3 ounces of clear liquids at hourly intervals until the nausea subsides. If this symptom persists, call for anti-nausea medications, as subsequent vomiting may be harmful and lead to complications.

Bathing and showering:

Following surgery you may bathe, but do not submerge your head in the water, please avoid hot water. You can gently shampoo your hair and shower 3 days after the procedure. When massaging your hair, please do so toward the incisions and not away from them to avoid widening of the incisions.

How to deal with common side effects from surgery:

It is unusual to have significant pain after a blepharoplasty procedure. If the prescribed medication does not control pain, please report this to us. Redness and swelling of the eyes may occur but should resolve within 2-3 days from surgery. Some swelling and bruising is to be expected. Bruising is treated with Arnica, an herb that will be provided by our office. Swelling and bruising is maximal at 48 hours post-surgery and gradually subsides over the following 10-14 days. Usually about 60% of the swelling subsides after day 4. Infection is also unusual. Fever, localized swelling with redness and tenderness may signify a developing infection and should be reported. Appropriate treatment will be initiated. Your final results will occur between 6-12 months.

Other common instructions after surgery:

A responsible adult must provide transportation for you after surgery (public transportation is not permissible) and remain with you until the morning following the procedure. If you are having several procedures, you may need assistance for 1-2 days following your procedure. You will need to arrange transportation for your appointment at our office on the day following surgery. Do not drive for 24 hours after surgery or anytime that you are taking pain medications. Avoid making major decisions or participating in activities requiring judgment for 24 hours after surgery. Smoking should be strictly avoided as it interferes with the blood supply to the healing tissues and slows subsequent healing. Take all medications as instructed postoperatively. Avoid excess sunlight to the incisions for at least a year. Even mild sunburn may cause prolonged swelling or irritation of the healing incisions. Use sunscreen with zinc oxide and SPF 20 or greater to help decrease the visibility of the scar. Do not compare your progress with that of other patients. Remember that everyone’s healing process is unique. Also, if you have any questions or concerns, call on us. Your family and friends may mean well, but you can receive wrong information.

Care for the incisions:

The sutures used on your incisions are absorbable and we do not need to remove them. Nevertheless, if crusting happens we can remove the sutures after postoperative day 5. Ice packs should be used within the first 48-72 hours after surgery to help with swelling. Apply ice for 15-20 minutes out of each hour while awake. Be sure they are lightweight. Never apply ice directly to the skin but wrap it in a towel. Dipping gauze pads into iced water works well. Apply Bacitracin to the incisions three times a day.

Call the office if you develop one of the following:

Fever of 101 degrees F or greater, pain not relieved with pain medication, swelling, redness, bleeding, and/or foul drainage from incision area, persistent nausea and/or vomiting, or any other concerns.

CHEEK AND CHIN IMPLANTS POST-OPERATIVE INSTRUCTIONS


These instructions should be carefully read and followed. They are designed to answer the most commonly asked questions regarding post-operative care. There are two parts to this postop instruction sheet. The first part is generic and refers to most facial plastic surgery procedures. The second part bears information specific to the procedure you will undergo.

Activity:

Limit your activity over the first week following surgery. You are encouraged to walk around the house on the day of surgery and thereafter. This helps to prevent blood clots from developing in the legs. Move/pump your legs frequently while lying down. This also helps in preventing blood clots from developing. When you rest or sleep, keep your head elevated with 2-3 pillows and avoid turning on your side. If you overexert yourself, bleeding or prolonged swelling may result. Keep your emotions under control. It is not unusual to feel a bit depressed for a few days after surgery. This quickly passes as you begin to look and feel better. Avoid bending, lifting, pulling, pushing, straining and aerobic activities for 3 weeks. You may begin to return to regular exercise 3 weeks after surgery. Ease into this, gradually increasing your exercise level back to normal by 5-6 weeks from surgery. Take deep breaths often when you get home for the first 24 hours after surgery. This helps to expand the base of your lungs.

Oral intake:

Alcohol consumption should also be limited as this may raise the blood pressure and initiate bleeding. Do not drink alcohol during the first week.  Drink plenty of fluids following surgery, as dehydration can contribute to nausea. You may want to avoid foods that require much chewing, such as steak. Soft foods may be easier to eat. Small amounts of food 20 minutes before taking postoperative medications (especially pain medications and/or antibiotics) can prevent nausea. If you vomit or feel nauseated, you should delay food and pain medications until the nausea passes. Take only 2-3 ounces of clear liquids at hourly intervals until the nausea subsides. If this symptom persists, call for anti-nausea medications, as subsequent vomiting may be harmful and lead to complications.

Bathing and showering:

You can shower on the day after your procedure.

How to deal with common side effects from surgery:

It is unusual to have significant pain after an aging face procedure. If the prescribed medication does not control pain, please report this to us. There is discomfort, of course, but remember that this will quickly pass. Some swelling and bruising is to be expected. Bruising is treated with

Arnica, an herb that will be provided by our office. Swelling and bruising is maximal at 48 hours post-surgery and gradually subsides over the following 10-14 days. Usually about 60% of the swelling subsides after day 4. Infection is also unusual. Fever, localized swelling with redness and tenderness may signify a developing infection and should be reported. Appropriate treatment will be initiated. Your final results will occur between 6-12 months.

Other common instructions after surgery:

A responsible adult must provide transportation for you after surgery (public transportation is not permissible) and remain with you until the morning following the procedure. If you are having several procedures, you may need assistance for 1-2 days following your procedure. You will need to arrange transportation for your appointment at our office on the day following surgery. Do not drive for 24 hours after surgery or anytime that you are taking pain medications. Avoid making major decisions or participating in activities requiring judgment for 24 hours after surgery. Smoking should be strictly avoided as it interferes with the blood supply to the healing tissues and slows subsequent healing. Take all medications as instructed postoperatively. Avoid excess sunlight to the incisions for at least a year. Even mild sunburn may cause prolonged swelling or irritation of the healing incisions. Use sunscreen with zinc oxide and SPF 20 or greater to help decrease the visibility of the scar. Do not compare your progress with that of other patients. Remember that everyone’s healing process is unique. Also, if you have any questions or concerns, call on us. Your family and friends may mean well, but you can receive wrong information.

Care for the incisions (cheek implants):

After cheek implants placement you will have incisions in your mouth under your upper lip. Those are closed with absorbable sutures. Please do not touch or pull on the sutures as they will spontaneously reabsorb 7-10 days after the procedure. You should avoid brushing your upper teeth for 10 days and use Peridex as prescribed for your dental and gum hygiene. Due to the swelling and the trauma from surgery the cheeks may feel a little “tight” after the procedure, however this will improve rapidly with the use of ice packs. There may be some temporary numbness in the cheeks area that may take up to 3-4 weeks to resolve.

Care for the incisions (chin implant):

After chin implant placement you may have incisions in your mouth under your lower lip. It is closed with absorbable sutures. Please do not touch or pull on the sutures as they will spontaneously reabsorb 7-10 days after the procedure. You should avoid brushing your lower teeth for 10 days and use Peridex as prescribed for your dental and gum hygiene.

Alternatively, there may be a small incision in the crease just under your chin. That incision is closed with sutures that will be removed in 7 days after the procedure. If the incision is on the skin under the chin, then brushing your teeth is OK. Due to the swelling and the trauma from surgery the chin may feel a little “tight” after the procedure, however this will improve rapidly with the use of ice packs. There may be some temporary numbness in the lower lip area that may take up to 3-4 weeks to resolve.

Call the office if you develop one of the following:

Fever of 101 degrees F or greater, pain not relieved with pain medication, swelling, redness, bleeding, and/or foul drainage from incision area, persistent nausea and/or vomiting, or any other concerns.

CHEMICAL PEEL POST-OPERATIVE INSTRUCTIONS


Chemical peels are used to improve skin texture and coloration.

The doctor may prescribe a bleaching agent to prepare the skin 2 weeks prior to the procedure.

Skin may turn dark or reddish brown, depending on the strength of the peel.  The area may swell.  You will peel in 3-5 days, up to 10 days.

If you have ever had a cold sore, let us know, as you will need to be pre-medicated to prevent an outbreak.

Postoperative Care Instructions:

  1. Apply crushed ice/frozen peas to the area 20 minutes on, 20 minutes off for the first day.
  2. If needed for swelling and/or pain, take 1-2 Advil/Motrin every 4-6 hours.
  3. The area can be washed the next day with a mild soap, pat dry. Apply a light moisturizer like Eucerin Cream, Lipid Drops, etc.
  4. Wear a good sunscreen 30 or higher with UVB and UVA protection.
  5. Do not pick if you peel; this could cause scarring.

DERMABRASION POST-OPERATIVE INSTRUCTIONS


Dermabrasion is a mechanical abrasion of the skin texture.  It is done under local anesthesia and a mild sedative (if desired).

The doctor may prescribe a bleaching agent to prepare your skin 2 weeks prior to the procedure.

A special dressing is applied after the procedure.  You will be red and swollen for 1 – 3 days.  You will come to the office the next day or two for a dressing change.  The following days, as you heal we will change to an antibiotic ointment and show you how to clean the wound with water at body temperature.  When the skin heals, apply a mild moisturizer or lipid drops (occasionally, we have to adjust any of the above due to your own skin type’s reaction), then apply a good sunscreen and makeup to cover.

Skin will be pink for 2-3 weeks.  It is very important you continue using sunscreen 30 or higher UVA and UVB protection while it is pink or pigment changes could occur.

If you have ever had a cold sore, let us know, as you will need to be pre-medicated to prevent an outbreak.

Post Care Instructions:

  1. Apply crushed ice/frozen peas lightly to area 20 minutes on, 20 minutes off for the first day.
  2. Take 1-2 Advil/Motrin every 4 – 6 hours for pain.

 FACELIFT AND NECK LIFT POST-OPERATIVE INSTRUCTIONS


These instructions should be carefully read and followed. They are designed to answer the most commonly asked questions regarding post-operative care.

Activity:

Limit your activity over the first week following surgery. You are encouraged to walk around the house on the day of surgery and thereafter. This helps to prevent blood clots from develop in the legs. Move/pump your legs frequently while lying down. This also helps in preventing blood clots from developing. When you rest or sleep, keep your head elevated with 2-3 pillows and avoid turning on your side. If you overexert yourself, bleeding or prolonged swelling may result. Keep your emotions under control. It is not unusual to feel a bit depressed for a few days after surgery. This quickly passes as you begin to look and feel better. Anger, crying or other emotional outbursts will only add to the swelling or increase the likelihood of bleeding. Avoid bending, lifting, pulling, pushing, straining and aerobic activities for 3 weeks. You may begin to return to regular exercise 3 weeks after surgery. Ease into this, gradually increasing your exercise level back to normal by 5-6 weeks from surgery. Take deep breaths often when you get home for the first 24 hours after surgery. This helps to expand the base of your lungs.

Oral intake:

Alcohol consumption should also be limited as this may raise the blood pressure and initiate bleeding. Do not drink alcohol during the first week.  Drink plenty of fluids following surgery, as dehydration can contribute to nausea. You may want to avoid foods that require much chewing, such as steak. Soft foods may be easier to eat. Small amounts of food 20 minutes before taking postoperative medications (especially pain medications and/or antibiotics) can prevent nausea. If you vomit or feel nauseated, you should delay food and pain medications until the nausea passes. Take only 2-3 ounces of clear liquids at hourly intervals until the nausea subsides. If this symptom persists, call for anti-nausea medications, as subsequent vomiting may be harmful and lead to complications.

Bathing and showering:

Following surgery you may bathe, but do not submerge your head in the water, please avoid hot water. You can gently shampoo your hair and shower 3 days after the procedure. When massaging your hair, please do so toward the incisions and not away from them to avoid widening of the incisions. If you color your hair, please do that immediately prior to surgery as you may not be able to do so up to 4 weeks after the surgery. If you are using a hair dryer you should use it only on the cool setting for about 4 weeks.

How to deal with common side effects from surgery:

It is unusual to have significant pain after an aging face procedure. If the prescribed medication does not control pain, please report this to us. There is discomfort, of course, but remember that this will quickly pass. Some swelling and bruising is to be expected. Bruising is treated with Arnica, an herb that will be provided by our office. Swelling and bruising is maximal at 48 hours post-surgery and gradually subsides over the following 10-14 days. Usually about 60% of the swelling subsides after day 4. Infection is also unusual. Fever, localized swelling with redness and tenderness may signify a developing infection and should be reported. Appropriate treatment will be initiated. Your final results will occur between 6-12 months.

Other common instructions after surgery:

A responsible adult must provide transportation for you after surgery (public transportation is not permissible) and remain with you until the morning following the procedure. If you are having several procedures, you may need assistance for 1-2 days following your procedure. You will need to arrange transportation for your appointment at our office on the day following surgery. Do not drive for 24 hours after surgery or anytime that you are taking pain medications. Avoid making major decisions or participating in activities requiring judgment for 24 hours after surgery. Smoking should be strictly avoided as it interferes with the blood supply to the healing tissues and slows subsequent healing. Take all medications as instructed postoperatively. Avoid excess sunlight to the incisions for at least a year. Even mild sunburn may cause prolonged swelling or irritation of the healing incisions. Use sunscreen with zinc oxide and SPF 20 or greater to help decrease the visibility of the scar. Do not compare your progress with that of other patients. Remember that everyone’s healing process is unique. Also, if you have any questions or concerns, call on us. Your family and friends may mean well, but you can receive wrong information.

Care for the incisions:

Keep your initial dressings dry. We will remove your dressing on the first day after surgery. You will be instructed about caring for your incisions at your preoperative visit. Ice packs should be used within the first 48-72 hours after surgery to help with swelling. Apply ice for 15-20 minutes out of each hour while awake. Be sure they are lightweight. Never apply ice directly to the skin but wrap it in a towel. Dipping gauze pads into iced water works well. Apply Bacitracin to the incisions three times a day for 7 days.

Call the office if you develop one of the following:

Fever of 101 degrees F or greater, pain not relieved with pain medication, swelling, redness, bleeding, and/or foul drainage from incision area, persistent nausea and/or vomiting, or any other concerns.

FACIAL FEMINIZATION SURGERY POST-OPERATIVE INSTRUCTIONS


These instructions should be carefully read and followed. They are designed to answer the most commonly asked questions regarding post-operative care. There are two parts to this postop instruction sheet. The first part is generic and refers to most facial plastic surgery procedures. The second part bears information specific to the FFS procedure you will undergo.

Activity:

Limit your activity over the first week following surgery. You are encouraged to walk around the house on the day of surgery and thereafter. This helps to prevent blood clots from developing in the legs. Move/pump your legs frequently while lying down. This also helps in preventing blood clots from developing. When you rest or sleep, keep your head elevated with 2-3 pillows and avoid turning on your side. If you overexert yourself, bleeding or prolonged swelling may result. Keep your emotions under control. It is not unusual to feel a bit depressed for a few days after surgery. This quickly passes as you begin to look and feel better. Anger, crying or other emotional outbursts will only add to the swelling or increase the likelihood of bleeding. Avoid bending, lifting, pulling, pushing, straining and aerobic activities for 3 weeks. You may begin to return to regular exercise 3 weeks after surgery. Ease into this, gradually increasing your exercise level back to normal by 5-6 weeks from surgery. Take deep breaths often when you get home for the first 24 hours after surgery. This helps to expand the base of your lungs.

Oral intake:

Alcohol consumption should also be limited as this may raise the blood pressure and initiate bleeding. Do not drink alcohol during the first week.  Drink plenty of fluids following surgery, as dehydration can contribute to nausea. You may want to avoid foods that require much chewing, such as steak. Soft foods may be easier to eat. Small amounts of food 20 minutes before taking postoperative medications (especially pain medications and/or antibiotics) can prevent nausea. If you vomit or feel nauseated, you should delay food and pain medications until the nausea passes. Take only 2-3 ounces of clear liquids at hourly intervals until the nausea subsides. If this symptom persists, call for anti-nausea medications, as subsequent vomiting may be harmful and lead to complications.

Bathing and showering:

Following surgery you may bathe, but do not submerge your head in the water, please avoid hot water. You can gently shampoo your hair and shower 3 days after the procedure. When massaging your hair, please do so toward the incisions and not away from them to avoid widening of the incisions. If you color your hair, please do that immediately prior to surgery as you may not be able to do so up to 4 weeks after the surgery. If you are using a hair dryer you should use it only on the cool setting for about 4 weeks.

How to deal with common side effects from surgery:

It is unusual to have significant pain after an aging face procedure. If the prescribed medication does not control pain, please report this to us. There is discomfort, of course, but remember that  this will quickly pass. Some swelling and bruising is to be expected. Bruising is treated with Arnica, an herb that will be provided by our office. Swelling and bruising is maximal at 48 hours post-surgery and gradually subsides over the following 10-14 days. Usually about 60% of the swelling subsides after day 4. Infection is also unusual. Fever, localized swelling with redness and tenderness may signify a developing infection and should be reported. Appropriate treatment will be initiated. Your final results will occur between 6-12 months.

Other common instructions after surgery:

A responsible adult must provide transportation for you after surgery (public transportation is not permissible) and remain with you until the morning following the procedure. If you are having several procedures, you may need assistance for 1-2 days following your procedure. You will need to arrange transportation for your appointment at our office on the day following surgery. Do not drive for 24 hours after surgery or anytime that you are taking pain medications. Avoid making major decisions or participating in activities requiring judgment for 24 hours after surgery. Smoking should be strictly avoided as it interferes with the blood supply to the healing tissues and slows subsequent healing. Take all medications as instructed postoperatively. Avoid excess sunlight to the incisions for at least a year. Even mild sunburn may cause prolonged swelling or irritation of the healing incisions. Use sunscreen with zinc oxide and SPF 20 or greater to help decrease the visibility of the scar. Do not compare your progress with that of other patients. Remember that everyone’s healing process is unique. Also, if you have any questions or concerns, call on us. Your family and friends may mean well, but you can receive wrong information.

Care for the incisions:

Keep your initial dressings dry. We will remove your dressing on the first day after surgery. You will be instructed about caring for your incisions at your preoperative visit. Ice packs should be used within the first 48-72 hours after surgery to help with swelling. Apply ice for 15-20 minutes out of each hour while awake. Be sure they are lightweight. Never apply ice directly to the skin but wrap it in a towel. Dipping gauze pads into iced water works well. Apply Bacitracin to the incisions three times a day for 7 days..

Call the office if you develop one of the following:

Fever of 101 degrees F or greater, pain not relieved with pain medication, swelling, redness, bleeding, and/or foul drainage from incision area, persistent nausea and/or vomiting, or any other concerns.

Forehead contouring, Scalp advancement and Browlift

  • Ice should be applied every 2 hrs during the first 4 days, and then three times a day for the following 3 days.
  • On the day after the surgery the initial compressive dressing will be changed with an elastic bandage (aka Ace-wrap).
  • The elastic bandage has to be worn day and night for 7 days followed by 7 days when the bandage should be worn only at night. This bandage helps limit the amount of swelling.
  • Showering can start on postoperative day 3-4. Care should be taken to gently massage the hair in a direction toward the incisions and not away from them. The Ace wrap can be reapplied after the shower.
  • Your scalp will be numb for approximately 2-3 months after the surgery.
  • Do not use hairdryer at the “hot” setting as the sensation over the head and the scalp may be gone or decreased – thus the hairdryer may overheat the scalp and possibly cause sores or burns. The hair dryer may be used only at the “cool” setting.
  • Do not drink through a straw and sneeze with your mouth opened for the 14 days after the surgery.
  • Headache or discomfort may occur for a few days.
  • Many patients can go back to work within ten days following surgery.
  • Avoid physical activity that causes sweating or a rise blood pressure for eight days.
  • Sutures and surgical clips are generally removed within 9-10 days.

Mandible Contouring

  • Do not brush your teeth for 10 days after the surgery. The teeth and mouth must be cleaned with a mouth wash solution (like Peridex) twice a day for the first 14 days.
  • Soft diet is recommended for the next 48-72 hours.
  • One night hospital or recovery facility stay may be required.
  • On the day after the surgery the initial compressive dressing will be changed with an elastic bandage (aka Ace-wrap).
  • The elastic bandage has to be worn day and night for 7 days followed by 7 days when the bandage should be worn only at night. This bandage helps limit the amount of swelling.
  • Showering is OK on the day after the surgery. The Ace-wrap can be reapplied after the shower.
  • The lower face will become moderately swollen and may also bruise. Ice should be applied every 2 hrs during the first postoperative day and every 4 hrs thereafter for the following 3 days. Swelling is worse typically 2-3 days after the surgery.
  • Return to usual activities in approximately one week.
  • The mouth sutures dissolve spontaneously 5-10 days after the procedure.
  • It may take four to six weeks before the improved contour becomes obvious.
  • Some swelling will persist up to 3-6 months after the procedure.

“Tracheal Shave” or Chondrolaryngoplasty

  • During the first 24-48 hours swelling may occur.
  • All patients will spend one night in the hospital following the surgery, to make sure that there is no change in breathing.
  • Mild voice weakness or hoarseness may occur in the first few days after surgery, but should not be long term.
  • There may a slight soreness of the neck especially with swallowing. This may last 2-3 days after the procedure.
  • Showering is OK on the day after the surgery
  • Usually there are no limitations to speaking.
  • Ice pack applied to the treated area for a couple of days is always recommended.
  • If surgical glue was used to close the skin, avoid using moisturizers or ointments as they may dissolve the surgical glue.

FOREHEAD CONTOURING, SCALP ADVANCEMENT AND BROWLIFT


POST-OPERATIVE INSTRUCTIONS

These instructions should be carefully read and followed. They are designed to answer the most commonly asked questions regarding post-operative care. There are two parts to this postop instruction sheet. The first part is generic and refers to most facial plastic surgery procedures. The second part bears information specific to the FFS procedure you will undergo.

Activity:

Limit your activity over the first week following surgery. You are encouraged to walk around the house on the day of surgery and thereafter. This helps to prevent blood clots from developing in the legs. Move/pump your legs frequently while lying down. This also helps in preventing blood clots from developing. When you rest or sleep, keep your head elevated with 2-3 pillows and avoid turning on your side. If you overexert yourself, bleeding or prolonged swelling may result. Keep your emotions under control. It is not unusual to feel a bit depressed for a few days after surgery. This quickly passes as you begin to look and feel better. Anger, crying or other emotional outbursts will only add to the swelling or increase the likelihood of bleeding. Avoid bending, lifting, pulling, pushing, straining and aerobic activities for 3 weeks. You may begin to return to regular exercise 3 weeks after surgery. Ease into this, gradually increasing your exercise level back to normal by 5-6 weeks from surgery. Take deep breaths often when you get home for the first 24 hours after surgery. This helps to expand the base of your lungs.

Oral intake:

Alcohol consumption should also be limited as this may raise the blood pressure and initiate bleeding. Do not drink alcohol during the first week.  Drink plenty of fluids following surgery, as dehydration can contribute to nausea. You may want to avoid foods that require much chewing, such as steak. Soft foods may be easier to eat. Small amounts of food 20 minutes before taking postoperative medications (especially pain medications and/or antibiotics) can prevent nausea. If you vomit or feel nauseated, you should delay food and pain medications until the nausea passes. Take only 2-3 ounces of clear liquids at hourly intervals until the nausea subsides. If this symptom persists, call for anti-nausea medications, as subsequent vomiting may be harmful and lead to complications.

Bathing and showering:

Following surgery you may bathe, but do not submerge your head in the water, please avoid hot water. You can gently shampoo your hair and shower 3 days after the procedure. When massaging your hair, please do so toward the incisions and not away from them to avoid widening of the incisions. If you color your hair, please do that immediately prior to surgery as you may not be able to do so up to 4 weeks after the surgery. If you are using a hair dryer you should use it only on the cool setting for about 4 weeks.

How to deal with common side effects from surgery:

It is unusual to have significant pain after an aging face procedure. If the prescribed medication does not control pain, please report this to us. There is discomfort, of course, but remember that

this will quickly pass. Some swelling and bruising is to be expected. Bruising is treated with Arnica, an herb that will be provided by our office. Swelling and bruising is maximal at 48 hours post-surgery and gradually subsides over the following 10-14 days. Usually about 60% of the swelling subsides after day 4. Infection is also unusual. Fever, localized swelling with redness and tenderness may signify a developing infection and should be reported. Appropriate treatment will be initiated. Your final results will occur between 6-12 months.

Other common instructions after surgery:

A responsible adult must provide transportation for you after surgery (public transportation is not permissible) and remain with you until the morning following the procedure. If you are having several procedures, you may need assistance for 1-2 days following your procedure. You will need to arrange transportation for your appointment at our office on the day following surgery. Do not drive for 24 hours after surgery or anytime that you are taking pain medications. Avoid making major decisions or participating in activities requiring judgment for 24 hours after surgery. Smoking should be strictly avoided as it interferes with the blood supply to the healing tissues and slows subsequent healing. Take all medications as instructed postoperatively. Avoid excess sunlight to the incisions for at least a year. Even mild sunburn may cause prolonged swelling or irritation of the healing incisions. Use sunscreen with zinc oxide and SPF 20 or greater to help decrease the visibility of the scar. Do not compare your progress with that of other patients. Remember that everyone’s healing process is unique. Also, if you have any questions or concerns, call on us. Your family and friends may mean well, but you can receive wrong information.

Care for the incisions:

Keep your initial dressings dry. We will remove your dressing on the first day after surgery. You will be instructed about caring for your incisions at your preoperative visit. Ice packs should be used within the first 48-72 hours after surgery to help with swelling. Apply ice for 15-20 minutes out of each hour while awake. Be sure they are lightweight. Never apply ice directly to the skin but wrap it in a towel. Dipping gauze pads into iced water works well. Apply Bacitracin to the incisions three times a day for 7 days..

Call the office if you develop one of the following:

Fever of 101 degrees F or greater, pain not relieved with pain medication, swelling, redness, bleeding, and/or foul drainage from incision area, persistent nausea and/or vomiting, or any other concerns.

Forehead contouring, scalp advancement and browlift

  • Ice should be applied every 2 hrs during the first 4 days, and then three times a day for the following 3 days.
  • On the day after the surgery the initial compressive dressing will be changed with an elastic bandage (aka Ace-wrap).
  • The elastic bandage has to be worn day and night for 7 days followed by 7 days when the bandage should be worn only at night. This bandage helps limit the amount of swelling.
  • Showering can start on postoperative day 3-4. Care should be taken to gently massage the hair in a direction toward the incisions and not away from them. The Ace wrap can be reapplied after the shower.
  • Your scalp will be numb for approximately 2-3 months after the surgery.
  • Do not use hairdryer at the “hot” setting as the sensation over the head and the scalp may be gone or decreased – thus the hairdryer may overheat the scalp and possibly cause sores or burns. The hairdryer may be used only at the “cool” setting.
  • Do not drink through a straw and sneeze with your mouth ? for the 14 days after the surgery.
  • Headache or discomfort may occur for a few days.
  • Many patients can go back to work within ten days following surgery.
  • Avoid physical activity that causes sweating or a rise blood pressure for eight days.
  • Sutures and surgical clips are generally removed within 9-10 days.

LIP LIFT AND AUGMENTATION POST-OPERATIVE INSTRUCTIONS


We greatly appreciate the confidence you have shown in us by allowing us to assist you in improving your appearance and health. You may be assured of our strong commitment to helping you achieve the best surgical result possible. We urge you to follow the advice below very carefully in order to maximize the benefit of your surgical outcome and recuperate as quickly as possible with the least amount of difficulty.

INSTRUCTIONS

  1. Take the medicine(s) Dr. Mardirossian has prescribed, to prevent infection, help alleviate pain and diminish swelling. Please call our office as soon as possible if you have multiple episodes of nausea, heaving and/or vomiting.
  2. You may take Tylenol® if you need to for pain or fever. Avoid any fever relieving agents that contain aspirin or have anti-inflammatory properties like Aleve®, Advil® or Motrin®; these may cause more bleeding.
  3. Avoid rubbing the skin under your nose and your nose as much as possible for the upcoming month.
  4. Normally, a lip lift does not cause severe pain. If you develop or have constant pain, especially if it does not seem to go away or it intensifies over time, and/or significant swelling with bruising or black and blue, please call our office immediately.
  5. Do not brush your upper teeth but use a mouth rinse instead for the first two weeks.
  6. If any bandages were placed (Steri-Strips™), leave these on until the doctor sees you again. They may fall off by themselves regularly.
  7. The stitches (sutures) may cause some discomfort. The sutures will be removed around day 7 or 8 after the procedure. Our team will inform you exactly when these will be removed. After the sutures are removed some redness may persist in the area for up to 2 months after the procedure. This should steadily improve though. Any sutures placed on the lips directly are self-resorbing and usually do not need to be removed.
  8. You may shower or wash your face the evening following the day of surgery (i.e. 24 hrs. after). You can shampoo your hair. Please avoid the lip incisions. Do not rub the wounds, place make-up or pull on the stitches. Pat dry your lips.
  9. The wound(s) may ooze for the first 24 – 48 hours after surgery. The oozing fluid may have a blood tinge to it; this is normal. Keep the incisions as clean as possible.
  10. Apply a thick layer of Bacitracin or Polysporin for the first two weeks to improve the healing process.
  11. Absolutely no smoking. Avoid extreme physical activity, straining, exercises, or exertion for at least three (3) days. Rest more than you usually do.
  12. Do not apply excess tension or strain on the incision line for at least 3 weeks to avoid the possibility of wound healing with a wide scar.
  13. Avoid excessive exposure to sun (including tanning salons) in the first three (3) weeks. If you are planning on being out in the sun you should always protect the nose-lip area with a strong sunscreen (e.g. SPF30 or greater.)

MANDIBLE CONTOURING POST-OPERATIVE INSTRUCTIONS


These instructions should be carefully read and followed. They are designed to answer the most commonly asked questions regarding post-operative care. There are two parts to this postop instruction sheet. The first part is generic and refers to most facial plastic surgery procedures. The second part bears information specific to the FFS procedure you will undergo.

Activity:

Limit your activity over the first week following surgery. You are encouraged to walk around the house on the day of surgery and thereafter. This helps to prevent blood clots from developing in the legs. Move/pump your legs frequently while lying down. This also helps in preventing blood clots from developing. When you rest or sleep, keep your head elevated with 2-3 pillows and avoid turning on your side. If you overexert yourself, bleeding or prolonged swelling may result. Keep your emotions under control. It is not unusual to feel a bit depressed for a few days after surgery. This quickly passes as you begin to look and feel better. Anger, crying or other emotional outbursts will only add to the swelling or increase the likelihood of bleeding. Avoid bending, lifting, pulling, pushing, straining and aerobic activities for 3 weeks. You may begin to return to regular exercise 3 weeks after surgery. Ease into this, gradually increasing your exercise level back to normal by 5-6 weeks from surgery. Take deep breaths often when you get home for the first 24 hours after surgery. This helps to expand the base of your lungs.

Oral intake:

Alcohol consumption should also be limited as this may raise the blood pressure and initiate bleeding. Do not drink alcohol during the first week.  Drink plenty of fluids following surgery, as dehydration can contribute to nausea. You may want to avoid foods that require much chewing, such as steak. Soft foods may be easier to eat. Small amounts of food 20 minutes before taking postoperative medications (especially pain medications and/or antibiotics) can prevent nausea. If you vomit or feel nauseated, you should delay food and pain medications until the nausea passes. Take only 2-3 ounces of clear liquids at hourly intervals until the nausea subsides. If this symptom persists, call for anti-nausea medications, as subsequent vomiting may be harmful and lead to complications.

Bathing and showering:

Taking a shower is OK on the day after the procedure.

How to deal with common side effects from surgery:

It is unusual to have significant pain after an aging face procedure. If the prescribed medication does not control pain, please report this to us. There is discomfort, of course, but remember that this will quickly pass. Some swelling and bruising is to be expected. Bruising is treated with Arnica, an herb that will be provided by our office. Swelling and bruising is maximal at 48 hours post-surgery and gradually subsides over the following 10-14 days. Usually about 60% of the swelling subsides after day 4. Infection is also unusual. Fever, localized swelling with redness and tenderness may signify a developing infection and should be reported. Appropriate treatment will be initiated. Your final results will occur between 6-12 months.

Other common instructions after surgery:

A responsible adult must provide transportation for you after surgery (public transportation is not permissible) and remain with you until the morning following the procedure. If you are having several procedures, you may need assistance for 1-2 days following your procedure. You will need to arrange transportation for your appointment at our office on the day following surgery. Do not drive for 24 hours after surgery or anytime that you are taking pain medications. Avoid making major decisions or participating in activities requiring judgment for 24 hours after surgery. Smoking should be strictly avoided as it interferes with the blood supply to the healing tissues and slows subsequent healing. Take all medications as instructed postoperatively. Avoid excess sunlight to the incisions for at least a year. Even mild sunburn may cause prolonged swelling or irritation of the healing incisions. Use sunscreen with zinc oxide and SPF 20 or greater to help decrease the visibility of the scar. Do not compare your progress with that of other patients. Remember that everyone’s healing process is unique. Also, if you have any questions or concerns, call on us. Your family and friends may mean well, but you can receive wrong information.

Care for the incisions:

Keep your initial dressings dry. We will remove your dressing on the first day after surgery. You will be instructed about caring for your incisions at your preoperative visit. Ice packs should be used within the first 48-72 hours after surgery to help with swelling. Apply ice for 15-20 minutes out of each hour while awake. Be sure they are lightweight. Never apply ice directly to the skin but wrap it in a towel. Dipping gauze pads into iced water works well.

Call the office if you develop one of the following:

Fever of 101 degrees F or greater, pain not relieved with pain medication, swelling, redness, bleeding, and/or foul drainage from incision area, persistent nausea and/or vomiting, or any other concerns.

Mandible contouring

  • Do not brush your teeth for 10 days after the surgery. The teeth and mouth must be cleaned with mouth wash solution (like Peridex) twice a day for the first 14 days.
  • Soft diet is recommended for the next 48-72 hours.
  • One night hospital or recovery facility stay may be required.
  • On the day after the surgery the initial compressive dressing will be changed with an elastic bandage (aka Ace-wrap).
  • The elastic bandage has to be worn day and night for 7 days followed by 7 days when the bandage should be worn only at night. This bandage helps limit the amount of swelling.
  • Showering is OK on the day after the surgery. The Ace wrap can be reapplied after the shower.
  • The lower face will become moderately swollen and may also bruise. Ice should be applied every 2 hrs during the first postoperative day and every 4 hrs thereafter for the following 3 days. Swelling is worse typically 2-3 days after the surgery.
  • Return to usual activities in approximately one week.
  • The mouth sutures dissolve spontaneously 5-10 days after the procedure.
  • It may take four to six weeks before the improved contour becomes obvious.
  • Some swelling will persist up to 3-6 months after the procedure.

FOREHEAD CONTOURING, SCALP ADVANCEMENT, BROWLIFT AND MANDIBLE CONTOURING POST-OPERATIVE INSTRUCTIONS


These instructions should be carefully read and followed. They are designed to answer the most commonly asked questions regarding post-operative care. There are two parts to this postop instruction sheet. The first part is generic and refers to most facial plastic surgery procedures. The second part bears information specific to the FFS procedure you will undergo.

Activity:

Limit your activity over the first week following surgery. You are encouraged to walk around the house on the day of surgery and thereafter. This helps to prevent blood clots from developing in the legs. Move/pump your legs frequently while lying down. This also helps in preventing blood clots from developing. When you rest or sleep, keep your head elevated with 2-3 pillows and avoid turning on your side. If you overexert yourself, bleeding or prolonged swelling may result. Keep your emotions under control. It is not unusual to feel a bit depressed for a few days after surgery. This quickly passes as you begin to look and feel better. Anger, crying or other emotional outbursts will only add to the swelling or increase the likelihood of bleeding. Avoid bending, lifting, pulling, pushing, straining and aerobic activities for 3 weeks. You may begin to return to regular exercise 3 weeks after surgery. Ease into this, gradually increasing your exercise level back to normal by 5-6 weeks from surgery. Take deep breaths often when you get home for the first 24 hours after surgery. This helps to expand the base of your lungs.

Oral intake:

Alcohol consumption should also be limited as this may raise the blood pressure and initiate bleeding. Do not drink alcohol during the first week.  Drink plenty of fluids following surgery, as dehydration can contribute to nausea. You may want to avoid foods that require much chewing, such as steak. Soft foods may be easier to eat. Small amounts of food 20 minutes before taking postoperative medications (especially pain medications and/or antibiotics) can prevent nausea. If you vomit or feel nauseated, you should delay food and pain medications until the nausea passes. Take only 2-3 ounces of clear liquids at hourly intervals until the nausea subsides. If this symptom persists, call for anti-nausea medications, as subsequent vomiting may be harmful and lead to complications.

Bathing and showering:

Following surgery you may bathe, but do not submerge your head in the water, please avoid hot water. You can gently shampoo your hair and shower 3 days after the procedure. When massaging your hair, please do so toward the incisions and not away from them to avoid widening of the incisions. If you color your hair, please do that immediately prior to surgery as you may not be able to do so up to 4 weeks after the surgery. If you are using a hair dryer you should use it only on the cool setting for about 4 weeks.

How to deal with common side effects from surgery:

It is unusual to have significant pain after an aging face procedure. If the prescribed medication does not control pain, please report this to us. There is discomfort, of course, but remember that this will quickly pass. Some swelling and bruising is to be expected. Bruising is treated with Arnica, an herb that will be provided by our office. Swelling and bruising is maximal at 48 hours post-surgery and gradually subsides over the following 10-14 days. Usually about 60% of the swelling subsides after day 4. Infection is also unusual. Fever, localized swelling with redness and tenderness may signify a developing infection and should be reported. Appropriate treatment will be initiated. Your final results will occur between 6-12 months.

Other common instructions after surgery:

A responsible adult must provide transportation for you after surgery (public transportation is not permissible) and remain with you until the morning following the procedure. If you are having several procedures, you may need assistance for 1-2 days following your procedure. You will need to arrange transportation for your appointment at our office on the day following surgery. Do not drive for 24 hours after surgery or anytime that you are taking pain medications. Avoid making major decisions or participating in activities requiring judgment for 24 hours after surgery. Smoking should be strictly avoided as it interferes with the blood supply to the healing tissues and slows subsequent healing. Take all medications as instructed postoperatively. Avoid excess sunlight to the incisions for at least a year. Even mild sunburn may cause prolonged swelling or irritation of the healing incisions. Use sunscreen with zinc oxide and SPF 20 or greater to help decrease the visibility of the scar. Do not compare your progress with that of other patients. Remember that everyone’s healing process is unique. Also, if you have any questions or concerns, call on us. Your family and friends may mean well, but you can receive wrong information.

Care for the incisions:

Keep your initial dressings dry. We will remove your dressing on the first day after surgery. You will be instructed about caring for your incisions at your preoperative visit. Ice packs should be used within the first 48-72 hours after surgery to help with swelling. Apply ice for 15-20 minutes out of each hour while awake. Be sure they are lightweight. Never apply ice directly to the skin but wrap it in a towel. Dipping gauze pads into iced water works well. Apply Bacitracin to the incisions three times a day for 7 days.

Call the office if you develop one of the following:

Fever of 101 degrees F or greater, pain not relieved with pain medication, swelling, redness, bleeding, and/or foul drainage from incision area, persistent nausea and/or vomiting, or any other concerns.

Forehead contouring, Scalp advancement and Browlift

  • Most patients will spend one night in the hospital or at a recovery facility following the surgery.
  • Ice should be applied every 2 hrs during the first 4 days, and then three times a day for the following 3 days.
  • On the day after the surgery the initial compressive dressing will be changed with an elastic bandage (aka Ace-wrap).
  • The elastic bandage has to be worn day and night for 7 days followed by 7 days when the bandage should be worn only at night. This bandage helps limit the amount of swelling.
  • Showering can start on postoperative day 3-4. Care should be taken to gently massage the hair in a direction toward the incisions and not away from them. The Ace wrap can be reapplied after the shower.
  • Your scalp will be numb for approximately 2-3 months after the surgery.
  • Do not use hairdryer at the “hot” setting as the sensation over the head and the scalp may be gone or decreased – thus the hairdryer may overheat the scalp and possibly cause sores or burns. The hairdryer may be used only at the “cool” setting.
  • Do not drink through a straw and sneeze with your mouth opened for the 14 days after the surgery.
  • Headache or discomfort may occur for a few days.
  • Many patients can go back to work within ten days following surgery.
  • Avoid physical activity that causes sweating or a rise blood pressure for eight days.
  • Sutures and surgical clips are generally removed within 9-10 days.

Mandible Contouring

  • Do not brush your teeth for 10 days after the surgery. The teeth and mouth must be cleaned with mouth wash solution (like Peridex) twice a day for the first 14 days.
  • Soft diet is recommended for the next 48-72 hours.
  • One night hospital or recovery facility stay may be required.
  • On the day after the surgery the initial compressive dressing will be changed with an elastic bandage (aka Ace-wrap).
  • The elastic bandage has to be worn day and night for 7 days followed by 7 days when the bandage should be worn only at night. This bandage helps limit the amount of swelling.
  • Showering is OK on the day after the surgery. The Ace wrap can be reapplied after the shower.
  • The lower face will become moderately swollen and may also bruise. Ice should be applied every 2 hrs during the first postoperative day and every 4 hrs thereafter for the following 3 days. Swelling is worse typically 2-3 days after the surgery.
  • Return to usual activities in approximately one week.
  • The mouth sutures dissolve spontaneously 5-10 days after the procedure.
  • It may take four to six weeks before the improved contour becomes obvious.
  • Some swelling will persist up to 3-6 months after the procedure.

MOHS SURGERY RECONSTRUCTION POST-OPERATIVE INSTRUCTIONS

  • If you have a bandage, keep it onovernight
  • Until the wound is healed, cleanse the area gently with soap and water daily.
  • Apply a thin layer of Polysporin, Bacitracin or Aquaphor ointment to the area, twice a day until it is healed (about 1 week).
  • There may be mild discomfort associated with the procedure. About an hour after the procedure, the anesthetic will wear off.  If you have pain, you may take Tylenol (acetaminophen).
  • If any bleeding occurs, use a cotton ball or gauze and press firmly over the site for 10-15 minutes. Do not remove the pressure before 10 minutes.  If the bleeding does not stop after this is repeated 2-3 times, please contact our office @ 561-624-0900.
  • It is normal for the wound to be pink/red and a little tender while it is healing. If you develop pain, pus or fever, please call our office.  Increasing pain after 3-4 days may be a sign of infection.
  • It is not advisable to swim in the ocean or pools until the site has completely healed. It is an open wound and inadvertent contaminants in the water may lead to infection.
  • After a week or so, the area should be healed, leaving a shiny, pink skin. This will slowly pale so that the final cosmetic result may not be apparent for several months.
  • If any signs of infection occur; redness, swelling, heat, increased pain or yellow discharge – please contact the office immediately @ 561-624-0900.

RHINOPLASTY POST-OPERATIVE INSTRUCTIONS


You have just had a “rhinoplasty” or surgery on your nose. There are incisions inside your nose, and in some instances a small incision in the skin between your nostrils. The incisions inside the nose were closed with dissolvable sutures while the one on the skin were closed with sutures that have to be removed in 7-8 days from the day of the surgery. The cartilage in your nose, and often the bones, have been carved apart, then reshaped and repositioned. There is usually no packing in your nose. You have delicate tape and possibly a molded plastic “cast” glued to the outside of your nose. The purpose of the tape and cast is to hold your cartilage and bone in their new position while they heal together, to minimize the swelling that you will have, and to protect your new nose.

This guide is written to provide you with instructions for the care of your new nose and to answer questions that you inevitably will have as your healing progresses. Please keep these instructions on hand for at least the next month as a reference source. And don’t hesitate to call our office   if you have questions that are not answered here in print.

Activities

Sleeping, resting and taking a shower

For tonight and tomorrow night, please sleep on your back with your head elevated on two pillows. Sleeping in a recliner chair is ideal. If you sleep on your side your nose will swell closed on the “down” side. Continuing to sleep on your back with your head slightly elevated for the next week is preferred. You may walk as much as you like. For a week please do not run or do any aerobic exercises. Taking a shower is OK two days after the surgery but please do not get the nasal cast wet as this may dissolve the glue that keeps it in place and the cast may then fall off. If the cast falls off, please let us know immediately as it may have to be replaced in our Office.

Heavy lifting

For the first week, do not lift anything over 10 pounds (including a child), do not bend forward with your head down, and do not strain in any way. For this first week, sexual activities should be very limited. After a week, you may return to all your normal activities. Please ask our staff if you have concerns regarding any specific activity.

Wearing glasses

You may wear your glasses lightly resting on your nasal cast or taped to your forehead. Our staff will show you how to manage this. Please wear the lightest weight pair of glasses that you have. You may insert your contact lenses two days after surgery. After removal of your nasal splint at a week you should limit the time that you wear your glasses and continue to wear light-weight glasses. Do not wear plastic framed glasses that rest all the way over the top of your nose. If you have very small “feet” on your glasses resting on your nose, you may wish to ask your optician to install larger, softer “feet.” You may expect some tenderness or discomfort on the sides of your nose after you’ve worn your glasses for a length of time. This is perfectly normal and may last for 3-4 months. When your nose becomes tender, remove your glasses for an hour or two. Once again, please contact our staff if you have any questions regarding your glasses or contact lenses.

Driving

Please do not drive for 24 hours after your surgery. Until that time, you will still be affected by the drugs you were given during your surgery, and it is not safe for you to drive. After a day you may drive limited amounts, however do not drive after you have taken narcotic pain medications.

Icing

Please keep ice packs above the plastic cast on your nose and both of your eyes until you go to sleep. The night after the surgery and on the 2 days after. This is to prevent bruising of your eyes, minimize swelling of your nose and face, and to generally make you more comfortable.

Care for the nose

Your nose will drain some mucus and a bit of blood for the first day or two after your surgery. This is perfectly normal. We will send you home with a drip pad of gauze under your nose to absorb this drainage. Please change the gauze as needed. We will clean out your nose at the first postoperative visit. Don’t blow your nose for a week, but you may use the nasal saline spray we will give you.

Diet

You may eat a normal diet after your surgery. You may find that swallowing solid foods is a bit difficult while your nose is stuffy. Your sense of smell may be reduced for the first week but will soon return to even better than before. Please do drink lots of liquids to help your body recover from your anesthesia and your surgery.

Medications

You will be given pain medications to take only if you need them. Do not take them more often than instructed, and do not take them if you do not feel pain. These pills contain a mild narcotic and may make you light-headed or even nauseated. You will be given antibiotic pills to take. If you are given these, please take the medication as instructed, as it is important for proper healing. Take the antibiotics until they are completely gone. You may be given a packet of Arnica Montana pills to take to help prevent bruising. Please take them exactly as instructed on the package. Please resume taking all of your normal medications the day after surgery. It is wise to take a daily multivitamin pill during the month after surgery.

Wound Care

You may sniff backwards through your nose or use a saline nasal spray at any time. But please don’t blow your nose for a week after your surgery. You will be asked to start using saline spray in your nose the day after surgery. You can purchase saline spray over the counter in your drugstore. Any brand will be acceptable; Ayr and Ocean Spray are common brands. You should use two squirts in each nostril at least four times a day. The saline reverses the drying effect that the surgery has had on your nasal lining and should be used for at least the next three months. Do not use any other sprays in your nose unless you’ve been given specific instructions to do so by our office. Please do contact us if you have any questions in this regard. If you do have a small incision in the tissue between your nostrils, we will give you an ointment to apply there. You should apply the ointment gently three times a day with a Q-tip. Continue to apply the ointment three times a day until the sutures are removed – at about a week.

You may have had some cartilage borrowed from your ear to put into your nose. If so, the incision on your ear has been closed with the same dissolving sutures used in your nose. Apply the ointment to your ear sutures (these might be on the front or back of the ear) three times a day with a Q-tip and continue to do so until all the sutures wipe away in about a week. You might also have a dressing on the front of your ear, and one on the back.

The plastic cast on the outside of your nose will be removed by us at about a week after surgery. You may wash your face and shampoo the day following surgery. Please do not get the nasal cast wet as the glue that keeps it in place may dissolve and it may fall off.

Visits to Our Office

You will  be asked to return to our Office the day after surgery. At this time, your nose will be gently cleaned out, and you will be started on nasal saline spray. One week after your surgery we will see you in our office. At this time, your outside nasal cast will be removed and your nose will be gently cleaned out. Your next visit will typically be at one month after your surgery. Normally, we will then see you at 3, 6, and 12 months after the surgery. You may have postoperative pictures taken at these visits.

Long-term Care

Recovery

Swelling of your nose and the surrounding areas of your cheek and upper lip is the normal result of your nasal surgery. The swelling will gradually resolve over varying time periods. Swelling at the upper part of your nose between your eyes that is present when your plastic mold is removed should be gone by the end of the second week. The same is true for the minor swelling of your cheeks at the sides of your nose. You may have some swelling in your upper lip (and even under your upper lip above your teeth) at the bottom of your nose. The mild tenderness and swelling here, too, will be gone within two weeks. There may well be minor swelling and a feeling of stiffness in the tip of your nose that persists well beyond the two-week period. In many cases, the tip may not be as delicate-appearing as we want it to be for up to six months after surgery. In some cases, we may inject a small amount of a form of cortisone into the tip to help in resolving this swelling.

Bruising around your nose in your cheeks and lower eyelids is very common after rhinoplasty surgery. It should be completely resolved by two weeks after surgery. If this bruising presents a problem in your return to work, we can provide you with some cover-up makeup.

Numbness over your nose is also quite normal following surgery. You will gradually regain sensation

over the top of your nose. You can expect the tip to be slightly numb and “stiff” feeling for up to three months after surgery. Breathing through your nose will gradually improve after we clean your nose out the day after surgery. By a week after surgery your breathing should be much improved. It is vital in returning to normal breathing that you spray the inside of your nose frequently with saline spray.

Nasal massage

You may be instructed in performing a nasal massage. These exercises are intended to keep your nose narrowed and straight as the nasal bones heal back to the facial bones. If you are instructed in using these exercises, please be diligent in using them for 2-3 months after your surgery. In most cases they are not needed beyond that time.

Sun exposure

You must protect your new nose from the sun for three months after surgery. Sun exposure may cause swelling in the nose and will slow down the healing process. The skin of your nose will actually be very likely to burn from sun exposure. Good protection for this three-month period means both a brimmed hat and a sun block of at least SPF 15.

SKIN BIOPSY POST-OPERATIVE INSTRUCTIONS


A skin biopsy is the removal of a small sample of growth on the skin.  The sample is then sent to the pathologist, a doctor who examines this sample under a microscope and renders a diagnosis regarding the type or growth or disease present.

Dr. Mardirossian and/or his associates review the pathologist’s findings and coordinate the treatment for your condition.  Knowing the type of growth or disease helps Dr. Mardirossian and/or his associates determine the best possible way to treat you.

There are charges from two places when a biopsy is performed:

  • The doctor for removal of the tissue to be examined, and
  • The pathologist for the preparation and evaluation of the tissue under the microscope.

It takes approximately one week for your biopsy results to be reviewed.  Our office will contact you as soon as we have the results.  (If you do not hear from us, please call the office.)

Care of Biopsy Site (twice daily for one week/beginning day after procedure)

  • Wash your hands with soap and water.
  • Cleanse the biopsy site with soap and water, then gently pat dry.
  • Apply antibiotic ointment (over the counter bacitracin ointment) to biopsy site.
  • Place a small dressing or Band-Aid over the wound until it is healed (Approximately one week). Studies show that wounds heal better when covered with ointment and a dressing.
  • Call the office at 624-0900 if signs of infection occur: redness, swelling, heat, increased pain or yellow discharge.

TORN EARLOBE REPAIR POST-OPERATIVE INSTRUCTIONS


We greatly appreciate the confidence you have shown in us by allowing us to assist you in improving your appearance and health. You may be assured of our strong commitment to helping you achieve the best surgical result possible. We urge you to follow the advice below very carefully in order to maximize the benefit of your surgical outcome and recuperate as quickly as possible with the least amount of difficulty.

INSTRUCTIONS

  1. Take the medicine(s) Dr. Mardirossian has prescribed, if any; these are to prevent infection, help alleviate pain and diminish swelling. Please call our office as soon as possible if you have multiple episodes of nausea, heaving and/or vomiting.
  2. You may take Tylenol® if you need to for pain or fever. Avoid any fever relieving agents that contain aspirin or have anti-inflammatory properties like Aleve®, Advil® or Motrin®; these may cause more bleeding.
  3. Avoid rubbing your ears as much as possible with the pillow while you sleep.
  4. Normally, earlobe repairs do not cause severe pain. If you develop or have constant pain, especially it does not seem to go away or it intensifies over time, and/or significant swelling with bruising or black and blue, please call our office immediately.
  5. If any bandages were placed (Steri-Strips™), leave these on around your earlobes until the doctor sees you again. They may fall off by themselves regularly.
  6. The stitches (sutures) may cause some discomfort. The sutures will be removed around day 7 or 8 after the procedure. The doctor will inform you exactly when these will be removed.
  7. You may shower the evening following the day of surgery (i.e. 24 hrs. after). You can shampoo your hair and gently clean your ears. Please avoid the earlobes. Do not rub the wounds, place makeup or pull on the stitches. Pat dry your earlobes.
  8. The wound(s) may ooze for the first 24 – 48 hours after surgery. The oozing fluid may have a blood tinge to it; this is normal. Keep the earlobes as clean as possible.
  9. Dr Mardirossian will re-pierce your earlobes a month after the repair in the position that you wish. Please bring a pair of gold or silver earrings with stubs at the time of the re-piercing.
  10. Absolutely no smoking. Avoid extreme physical activity, straining, exercises, or exertion for at least three (3) days. Rest more than you usually do.
  11. Do not wear heavy or tight earrings for six (6) weeks to avoid pain, infection or the possibility of wound(s) opening.
  12. Avoid excessive exposure to sun (including tanning salons) in the first three (3) weeks. If you are planning on being out in the sun you should always protect the ear-lobes with a strong sunscreen (e.g. SPF30 or greater.)

CHONDROLARYNGOPLASTY (aka TRACHEAL SHAVE) POST-OPERATIVE INSTRUCTIONS


These instructions should be carefully read and followed. They are designed to answer the most commonly asked questions regarding post-operative care. There are two parts to this postop instruction sheet. The first part is generic and refers to most facial plastic surgery procedures. The second part bears information specific to the procedure you will undergo.

Activity:

Limit your activity over the first week following surgery. You are encouraged to walk around the house on the day of surgery and thereafter. This helps to prevent blood clots from developing in the legs. Move/pump your legs frequently while lying down. This also helps in preventing blood clots from developing. When you rest or sleep, keep your head elevated with 2-3 pillows and avoid turning on your side. If you overexert yourself, bleeding or prolonged swelling may result. Keep your emotions under control. It is not unusual to feel a bit depressed for a few days after surgery. This quickly passes as you begin to look and feel better. Anger, crying or other emotional outbursts will only add to the swelling or increase the likelihood of bleeding. Avoid bending, lifting, pulling, pushing, straining and aerobic activities for 3 weeks. You may begin to return to regular exercise 3 weeks after surgery. Ease into this, gradually increasing your exercise level back to normal by 5-6 weeks from surgery. Take deep breaths often when you get home for the first 24 hours after surgery. This helps to expand the base of your lungs.

Oral intake:

Alcohol consumption should also be limited as this may raise the blood pressure and initiate bleeding. Do not drink alcohol during the first week.  Drink plenty of fluids following surgery, as dehydration can contribute to nausea. You may want to avoid foods that require much chewing, such as steak. Soft foods may be easier to eat. Small amounts of food 20 minutes before taking postoperative medications (especially pain medications and/or antibiotics) can prevent nausea. If you vomit or feel nauseated, you should delay food and pain medications until the nausea passes. Take only 2-3 ounces of clear liquids at hourly intervals until the nausea subsides. If this symptom persists, call for anti-nausea medications, as subsequent vomiting may be harmful and lead to complications.

Bathing and showering:

Following surgery you may bathe, but do not submerge your head in the water, please avoid hot water. You can gently shampoo your hair and shower 3 days after the procedure. When massaging your hair, please do so toward the incisions and not away from them to avoid widening of the incisions.

How to deal with common side effects from surgery:

It is unusual to have significant pain after an aging face procedure. If the prescribed medication does not control pain, please report this to us. There is discomfort, of course, but remember that

this will quickly pass. Some swelling and bruising is to be expected. Bruising is treated with Arnica, an herb that will be provided by our office. Swelling and bruising is maximal at 48 hours post-surgery and gradually subsides over the following 10-14 days. Usually about 60% of the swelling subsides after day 4. Infection is also unusual. Fever, localized swelling with redness and tenderness may signify a developing infection and should be reported. Appropriate treatment will be initiated. Your final results will occur between 6-12 months.

Other common instructions after surgery:

A responsible adult must provide transportation for you after surgery (public transportation is not permissible) and remain with you until the morning following the procedure. If you are having several procedures, you may need assistance for 1-2 days following your procedure. You will need to arrange transportation for your appointment at our office on the day following surgery. Do not drive for 24 hours after surgery or anytime that you are taking pain medications. Avoid making major decisions or participating in activities requiring judgment for 24 hours after surgery. Smoking should be strictly avoided as it interferes with the blood supply to the healing tissues and slows subsequent healing. Take all medications as instructed postoperatively. Avoid excess sunlight to the incisions for at least a year. Even mild sunburn may cause prolonged swelling or irritation of the healing incisions. Use sunscreen with zinc oxide and SPF 20 or greater to help decrease the visibility of the scar. Do not compare your progress with that of other patients. Remember that everyone’s healing process is unique. Also, if you have any questions or concerns, call on us. Your family and friends may mean well, but you can receive wrong information.

Care for the incisions:

Keep your initial dressings dry. We will remove your dressing on the first day after surgery. You will be instructed about caring for your incisions at your preoperative visit. Ice packs should be used within the first 48-72 hours after surgery to help with swelling. Apply ice for 15-20 minutes out of each hour while awake. Be sure they are lightweight. Never apply ice directly to the skin but wrap it in a towel. Dipping gauze pads into iced water works well.

Call the office if you develop one of the following:

Fever of 101 degrees F or greater, pain not relieved with pain medication, swelling, redness, bleeding, and/or foul drainage from incision area, persistent nausea and/or vomiting, or any other concerns.

Tracheal shave

  • During the first 24-48 hours swelling may occur.
  • All patients will spend one night in the hospital following the surgery, to make sure that there is no change in breathing.
  • Mild voice weakness or hoarseness may occur in the first few days after surgery, but should not be long term.
  • There may a slight soreness of the neck especially with swallowing. This may last 2-3 days after the procedure.
  • Showering is OK on the day after the surgery
  • Usually there are no limitations to speaking.
  • Ice pack applied to the treated area for a couple of days is always recommended.
  • If surgical glue was used to close the skin, avoid using moisturizers or ointments as they may dissolve the surgical glue.

CO2 LASER RESURFACING


  1. Plan to go home following the procedure. You will be wearing a dressing to speed up the healing process of your skin. This dressing will be removed on the first follow-up visit.
  2. Rinse the treated area with a mixture of white vinegar and water (1 tea-spoonful of white vinegar to 2 cups of water) at least three times a day and then reapply the Aquaphor. This can be refrigerated and applied to the treated area with moist gauze. In this way, the skin surface is cleaned at least three times a day.
  3. Apply Crisco lard or Aquaphor 3 times a day to prevent crusting. This should be continued for 7 days.

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