Forms/Post Op Instructions
The following forms should be filled out by all new patients. Click to download (.pdf):
Click to download consent forms (.pdf):
- Botox/Dysport Consent
- Fillers (Juvederm/Restylane/Perlane) Consent
- Latisse Consent
- Sculptra Aesthetic Consent
Click below for our post-op patient instructions:
• Blepharoplasty Post-Op Instructions
• Face Lift Post-Op Instructions
• Rhinoplasty Post-Op Instructions
• Otoplasty Post-Op Instructions
• Septoplasty Post-Op Instructions
Blepharoplasty Post-Op Instructions
ANY SUDDEN DECREASE IN VISION OR PAIN UNRELIEVED BY MEDICINE OR LARGE SWELLING, ESPECIALLY IF ONLY ON ONE SIDE, SHOULD BE REPORTED TO THE OFFICE IMMEDIATELY.
SWELLING
Every operation, no matter how minor, is accompanied by swelling of the surrounding tissues. The amount varies from person to person. The swelling itself is not serious and is to be expected after your surgery. The main thing to remember is that swelling eventually subsides. You can help decrease the swelling in the following ways:
1. Sleep with your head elevated at least 15 degrees for one week after surgery. Use an additional pillow or two under the mattress if necessary.
2. Apply iced compresses made of face towels - not an ice bag - to your eyelids for twenty minute periods every two hours for the first three days after your surgery. You can also soak gauze 4X4's in ice water, wring them out, and apply these over the eyes in place of compresses.
3. Avoid bending over or lifting heavy things for one week. Besides aggravating the swelling, this may raise your blood pressure and cause bleeding.
4. Avoid straining from constipation, since this will also raise your blood pressure. If you feel the need for a laxative, get Correctol or another mild laxative from your pharmacist. No prescription is required.
5. Avoid hitting or bumping your face and eyes. It is wise not to pick up small children. You should sleep alone for one or two weeks after your operation to avoid any accidental bumps.
6. Avoid sun exposure to the face during the first month after your operation. Your incisions are more susceptible to the sun's rays, and they can darken and become more noticeable with sun exposure. After they have healed sufficiently (about 10 days), you can apply SPF 15 or higher sunblock over the incisions for protection.
7. Do not tweeze your eyebrows for two weeks.
8. You may have your hair washed at a salon or wash it gently yourself twenty-four hours after surgery. Do not use a regular blow dryer near your face, since this may irritate your eyes. You can use a cap dryer instead.
9. You may take a shower or bath the day after surgery. Do not get your eyes wet. Your face may be gently cleaned with cotton squares.
DISCOLORATION
It is expected to have varying amounts of discoloration about the eyes. Like swelling, this is temporary and varies from person to person.
You can camouflage the discoloration to some extent with makeup, and we will tell you at your office visits when cosmetics can be applied. Do not apply makeup until all your sutures have been removed, and you have been given approval by the nurse or doctor.
DISCOMFORT
If you have discomfort after your surgery, the application of iced compresses should be effective. You will be given a prescription for a pain medication which you should take according to the instructions on the label. If this does not relieve your discomfort, or if the pain is greater on one side than on the other, please notify the office. If the office is closed for the night, the answer¬ing service will get in touch with the doctor.
TEMPERATURE
Generally, the body temperature does not rise much above 100 degrees following eyelid surgery. This slight rise is usually due to dehydration caused by insufficient fluid intake. It is not uncommon to feel warm to the touch when you actually do not have a fever. To be sure, use a thermometer to measure your temperature. Report any persistent temperature above 101 degrees to the office.
THE HEALING PHASE
1. Swelling may persist somewhat longer than you may have anticipated. Take heart; we have never encountered a case yet where it did not ultimately subside. The same is true for discoloration.
2. If you have nasal allergies or sinus trouble, you should take antihistamines to decongest your nose. Nasal congestion can contribute to the swelling and discoloration.
3. On rare occasions, the whites of one or both eyes may become partially discolored. This is painless. It will not harm your vision, and it will eventually clear without medical treatment.
4. Occasionally, the swelling will cause the lower lid to become separated from the eyeball proper. This condition is usually reversed as the swelling goes down. It can be prolonged, however, if face powder granules or other makeup become deposited in the area when cosmetics are being applied. Massage is sometimes advised by the doctor.
5. During the first several days following surgery, the incisions will be hard to see. Next, they go through a period of slight swelling and will possibly redden. Later this subsides and they become virtually imperceptible. This is the way scars normally mature. Any unevenness of the edges of the incisions or lumpiness of the scars is usually temporary, and will subside with time. Cosmetics or cortisone creams may be used to minimize the visibility of your incisions during this process. If an incision was made inside the eyelid, the scar will not be visible.
6. Occasionally, small cysts which resemble ordinary whiteheads will appear beside the upper lid incisions. Like whiteheads, they will disappear when their contents are expressed in the office. They may occur in the lower eyelids as well, although this is rare.
7. Patients often experience some blurring of vision for two or three days after the operation. This is generally due to the swelling and/or the ointments being used to lubricate your eyes, and will clear up spontaneously.
POSTOPERATIVE CARE
Following your surgery, we will want to see you in the office at regularly scheduled intervals to monitor your progress.
RESUMING NORMAL ACTIVITIES
1. You may begin wearing glasses or sunglasses the day following your surgery. Do not wear contact lenses for at least 4 to 6 weeks after your surgery. Wrap-around sunglasses are preferable, since they protect the incisions from the sun's rays.
2. Do not swim, dive, water ski, or participate in strenuous athletic activity for at least one month after surgery.
3. Plan to return to work no sooner than four or five days after your surgery. A full week of recuperation would be ideal. Even after one week, you may feel more comfortable wearing large framed sunglasses when you are out in the public eye, if you are at all self conscious about your bruising.
4. False eyelashes should not be worn for ten days following your operation.
5. You may wear a wig or a hairpiece as soon as you desire.
6. Do not apply hair coloring until three weeks have elapsed since your surgery.
REMEMBER
If you have any questions that are not answered here, please call us. No question is too insignificant, and your calls are not an inconvenience to us. You can call us at (804) 378-7443.
Face Lift Post-Op Instructions
The following instructions are based on experience with many facelift operations. They will answer many questions that may arise after your surgery. You and your caregiver should read them several times so that you become familiar with them. Please follow these instructions faithfully; those who do so have the smoothest postoperative course and more satisfactory results.
***For the first 72 hours after surgery you should not be alone. Please arrange for a family member, friend, or caregiver to be available during this time.
SWELLING
Any operation is accompanied by swelling of the surrounding tissues. The amount varies from person to person, but it always seems more prominent in the face. Swelling may be more noticeable after the first postoperative day. It may be more pronounced along the jaw line, and is generally most noticeable in the morning after you first wake up. This swelling is normal. It is not serious, and is to be expected after your surgery.
The main thing to remember is that swelling eventually subsides. You can help decrease the swelling in the following ways:
1. Sit, stand, and walk as much as you can after you leave the hospital. Staying in an upright position can decrease the tendency for swelling.
2. When you need to look from side to side, move your shoulders and head as one unit, as though you had a stiff neck. The healing process of the tiny sutures (or stitches) will be sufficient after two weeks for you to move your head normally again. Do not move your neck from side to side.
3. It is always a good idea not to use your back when lifting heavy objects. For at least a week after surgery, bend at your knees, not at your waist, to lift light objects that are below waist level. If an object is in the least bit heavy, ask a family member to lift and carry it for you.
4. For your own comfort and to aid the healing process, be especially careful not to bump your face and neck. Sleeping alone for one week after surgery will help insure that you rest comfortably.
5. Sleep with the head of your bed elevated for one week after your surgery. To accomplish this, place two or three pillows under the head of the mattress. For the first three days after surgery, do not put a pillow under your head, but put your head flat on the mattress, with the mattress plumped up by the pillows underneath it. Sleeping on your face tends to tear down the supporting stitches used under the skin. Therefore, it is necessary to sleep on your back for 3-4 weeks. Some patients find a reclining chair placed at a 45 degree angle to be more comfortable.
6. Supporting the face and chin with a chin sling aids healing and protects the face and ears from undue stress. Wear the chin sling constantly for one week after your operation. After this, the sling should be worn at night until 30 days after your surgery. It is also beneficial to wear the sling during the day when you are alone during this 30 day period.
7. You can continue to use ice compresses in the exposed areas of your face such as you were using at the hospital. They may help with the discoloration and swelling, as well as minor discomfort, for a few days after you leave the hospital.
8. Avoid straining during bowel movements. If you need a laxative, your pharmacist can suggest an over the counter preparation.
9. Protect your face from the sun with a sunscreen for at least one month; it is always a good idea to wear sunscreen to keep harmful rays from intensifying the aging process.
10. Remember - report any sudden increase in swelling to us.
11. Please have a family member or friend with you the first day and night home from the hospital. Report any confusion or altered mental status immediately to us.
12. On your first day home from the hospital be sure to keep hydrated, drink at least one 16oz Gatorade bottle in addition to additional fluids.
DISCOLORATION
It is not unusual to have varying amounts of discoloration about the face. Like swelling, it may become more pronounced, especially in the neck, after the first day or so. Remember, this is temporary. It usually lasts no more than two weeks, and it decreases in intensity all the time.
The instructions given for decreasing swelling will also help the discoloration; however, there is no medication that will cause it to disappear rapidly. You can camouflage the discoloration to some extent by using makeup, and a concealer used around the eyes can help cover bruises. DO NOT APPLY MAKEUP OVER THE INCISIONS UNTIL SEVERAL DAYS AFTER THE SUTURES HAVE BEEN REMOVED. You can apply makeup within 1/4" of the incision lines, however.
DISCOMFORT
You can take the pain medication which we will have prescribed for you. Under NO circumstances should you take any medicines containing aspirin or salicylates. Be sure to check the labels of any pain medication you have, or that you purchase from the drug store.
If you have a sudden onset of pain or a feeling of tightness around the incisions, especially if it is particularly strong on one side, call the office.
OOZING
If you notice bright red oozing coming through the bandages, go to bed, elevate your head, apply ice compresses to your face and neck, and call the office. We will give you further instructions when you call.
TEMPERATURE
Generally, your temperature will not rise very much above 100 degrees after your facelift; this rise is due to the healing process. It is common to feel that your temperature is increased after surgery, but this is usually not the case. To be sure, you should measure your temperature by mouth. Report any persistent temperature above 100 degrees to the office.
WEAKNESS
It is not unusual after you have had an anesthetic or any type of operation to feel weak, have palpitations, break out in "cold sweats", or feel dizzy. This gradually clears up after a few days without medication.
INSOMNIA
We will have prescribed a sedative for you in case you have difficulty sleeping after your operation. It is important to remember that such drugs can make some people feel light headed and weak. You should only take this if you need it.
DEPRESSION
It is not unusual for you to go through a period of mild depression after cosmetic surgery. No matter how much you wanted the operation, the postoperative swelling and bruising can be disappointing. Be patient. The bruising and swelling will subside quickly, and your surgical result will be evident.
NUMBNESS
Parts of the face, neck, and ears will sometimes feel weak/numb after a facelift. This is temporary, and will gradually go away.
TIGHTNESS OF THE FACE
The skin of your face may feel tight, and you may feel that it interferes with your smile. This will disappear within a few weeks.
INJURIES TO YOUR FACE
You may have some kind of accidental blow to your face during the early postoperative phase. This actually does happen to many people. You don't need to be too concerned, unless the blow is hard, or if you have hemorrhaging or swelling afterwards. If you do have these symptoms, call the office. Otherwise, just mention it to us at your next visit.
THINNING OF THE HAIR
You may temporary experience some thinning of the hair in some areas by the suture lines in the temple and behind the ear.
MEDICATIONS
As we mentioned before, a prescription for pain and one for sleep have been ordered for you. Take these only if you feel you need them. Take ALL of your antibiotics until you run out.
After we remove your dressing, you should clean the incisions with hydrogen peroxide two or three times a day. You should then apply the antibiotic ointment we prescribed for you with a Q-tip to the incisions. Keep the incisions thoroughly covered with the ointment until we tell you to stop using it.
INCISIONS
After all your stitches have been removed, the incisions will be a deep pink. There will be varying amounts of swelling in and around the incisions themselves. With time, the pink will become white, and the firmness of the scars will soften, making them less noticeable. Everyone heals at a different rate, but it takes approximately one year for all the changes to occur.
THE POSTOPERATIVE PERIOD
When you come out of the anesthesia after your surgery, you will have a large, bulky dressing. This will remain in place for about 24 hours after your surgery. If your dressing begins to feel very tight or uncomfortable, report it to us. You may also have a plastic drain behind each ear. If you do have drains, they will be removed the evening after your surgery, or at your first postoperative visit to the office the day after your surgery. Call us if one of the drain reservoirs fully fills with blood. You should be as quiet as possible during this time. A great deal of talking and having too many visitors is discouraged.
At your first postoperative visit, we will remove your dressing, remove drains if you have them, change your bandages, clean your incisions, and apply ointment. You will probably feel much better after this visit. At no time should you try to remove any sutures or disturb any crusting yourself. If you are bothered by something after your surgery, call us or tell us about it at one of your postop visits.
On the fourth or fifth postoperative day, we may begin to remove some sutures.
On the seventh or eighth postoperative day, we will remove the sutures around your ears and some of the staples in the scalp. You may want to wear makeup at this time, but remember not to apply it directly on the incisions.
Between your tenth and twelfth postoperative days, we will remove the rest of the staples. After this visit, you can wash your hair, but avoid straining your neck. Please do not visit your hairdresser or color your hair for three weeks after your surgery.
We will see you again for a three week visit. By this time, you will already be somewhat familiar with the "new you". After this visit, you can see your hairdresser for a professional styling.
Two months after your surgery, we will take photographs and monitor your healing. We will also be doing this at intervals during the following months.
POSTOPERATIVE CARE
Following your surgery, we will want to see you in the office at regularly scheduled intervals to monitor your progress.
RESUMING ACTIVITIES
1. GLASSES AND CONTACT LENSES - Eye glasses may be worn as soon as bandages are removed. Contact lenses may be inserted the day after surgery.
2. HAIR AND BODY CARE - We will wash your hair in the office five days after your surgery. The antibiotic ointment will eventually wash out, we assure you.
- You can use cotton balls to wash your face gently after the first week. Use a mild soap and wash with a gentle, upward motion.
- You can take a shower by the fourth postoperative day, but NEVER take one on a day after you have sutures removed.
- Do NOT tweeze eyebrows for one week after your surgery.
3. HOUSEHOLD ACTIVITIES - You can be up and around with your usual activities, except for lifting heavy objects.
4. CLOTHING - For two weeks after surgery, wear clothing that doesn't have to be pulled over your head.
5. ATHLETICS - For six weeks after your surgery, do not swim, perform any kind of strenuous athletic activity, or perform any exercises that involve turning the head.
6. KEEPING A STIFF FACE AND BACK - Move your face and neck as little as possible after your surgery to help your skin heal faster to the underlying tissues. To help achieve this, you should do the following.
7. Avoid excessive smiling.
8. Do NOT bend your head forward or backward for two weeks.
9. Avoid gum and foods that are hard to chew. Easily chewed foods such as soup, mashed potatoes, stewed chicken, and hamburger are allowed. Stay away from steaks, French bread and other hard to chew foods for at least one week.
10. Avoid yawning with your mouth opened widely for at least one week.
11. Turn your head with your neck and shoulders as one unit. For two weeks, move your head as though you had a crick in your neck.
12. DRIVING - Do not drive a car for at least 2 weeks after surgery, because you should not be in a situation where you have to turn your head.
13. RETURNING TO WORK AND RESUMING SOCIAL ACTIVITIES - When you return to work depends upon the amount of physical activity and public contact your job involves, and also the amount of swelling and discoloration you develop. Many patients return to work and go out socially two or three weeks after their surgery. As soon as you are comfortable with your new appearance, let others enjoy it too.
FINALLY
Remember the things you were told before your operation:
When your bandages are first removed, your face will be swollen, and you will have some amount of discoloration. The swelling will be mostly gone within two weeks; however, it will take six to eight weeks for all of the swelling to disappear.
The discoloration will gradually disappear over a period of ten to fourteen days in most cases.
Report any of the following to the office:
- Temperature elevation
- Sudden swelling or discoloration
- Excessive bleeding
- Yellowish discharge from the wound
- Development of any drug reaction
- Increased pain or feeling of tightness
- Confusion
Most of all, be PATIENT during the healing process. The results will be worth the wait. If you have any further questions, we urge you to call us at (804) 378-7443.
Nasal Surgery Post-Op Instructions
The following instructions have been designed to answer practically every question that might arise regarding the "do's" and "don'ts" after surgery. You and your family should read these several times to become familiar with them. Follow them faithfully, because those who do generally have the smoothest postoperative course.
SWELLING
Every operation, no matter how minor, is accompanied by swelling of the surrounding tissues. The amount varies from person to person. The swelling itself is not serious and is to be expected after your surgery. It sometimes is worse on the second postoperative day than it was on the first, and in the mornings.
Remember is that swelling will always subside eventually. You can help decrease the swelling in the following ways:
1. Sleep with your head elevated until all of the dressings have been removed from the nose. Use an additional pillow or two under the mattress, if necessary.
2. Stay up (sitting, standing, walking about) as much as possible after your return home. THIS IS IMPORTANT. Of course, you should rest when you tire.
3. Avoid bending over or lifting heavy things for one week. Besides aggravating the swelling, this may raise your blood pressure and start a hemorrhage.
4. Avoid hitting or bumping your new nose. It is wise not to pick up small children.
5. Avoid excessive sunning of the face during the first month after your operation. A sunscreen is always advisable, but a total sunblock is suggested for the first month.
6. Do not tweeze your eyebrows for one week.
7. Avoid "sniffing", that is, constantly attempting to pull air through the nose as some people do when their nose feels blocked. This will not relieve the sensation of blockage - it will only aggravate it because the suction created on the inside will cause more swelling.
8. Avoid rubbing the nostrils and the base of the nose with Kleenex or a handkerchief. Not only will this aggravate the swelling, but also it may cause infection, bleeding, or the accumulation of scar tissue inside the nose. Use the "moustache" gauze dressing instead if discharge is excessive.
DISCOLORATION
It is not unusual to have varying amounts of discoloration about the face. Like swelling, the discoloration may become more pronounced after you have been discharged. It usually lasts not more than a week or two, all the while decreasing in intensity. If the nasal bones were not reshaped, there is usually very little bruising. The measures which will help your swelling subside will also be working to decrease the amount of discoloration. You can camouflage the discoloration to some extent by using a thick makeup base.
NUMBNESS
After surgery you will notice that the tip of your nose feels firm, and it is not uncommon for the nose to feel numb for a short time. If you have incisions inside your nose, you may be able to feel minor irregularities in its surface until all swelling disappears.
NASAL PACKING AND BLEEDING
For the first twenty-four hours, your nose will be lightly packed to decrease the oozing. Nevertheless, it is not uncommon to soak several gauze pads (your moustache dressing) during the first several hours after surgery. The frequency with which these are changed should decrease. If it does not, go to bed, apply ice compresses about the face, and report it to the office by telephone. You may be told to return to the office or hospital.
You will be seen in the office or hospital the day after surgery for removal of the packing. Some ooze immediately afterwards is to be expected.
Change the drip pad as needed using 4x4 gauze and tape.
Whenever the nasal passages are blocked, such as when you have a cold or an allergy, the nasal glands produce more mucous than normal. Your nose is blocked from the postoperative swelling, so you can expect an increase in mucous drainage for several days. It will be blood tinged and should cause you no concern unless the drainage looks like pure blood and flows freely, as when you cut a finger. If this happens, please call the office immediately.
DO NOT attempt to remove blood clots or anything else from the nostrils.
If a turbinate resection was part of your nasal procedure, bleeding can occur from this area for up to six weeks after your surgery. Be diligent in using the nasal drops and ointment. This helps the healing process and the dissolving of the crusts that form on the turbinates.
Your exercise regimen will be curtailed at least to some extent for the first few weeks following surgery. Upper body exercise is especially prohibited, as it is more likely to cause turbinate bleeding.
PAIN
There is usually little actual pain following nasal surgery, but you may experience a deep bruised sensation as a result of the postoperative swelling that occurs. As is usually the case with such things, this seems worse at night and when one becomes nervous.
The usually prescribed drugs which minimize pain often cause sensations of light-headedness, particularly in the immediate postoperative period. This may seem to make your recovery more tedious. Please take the pain medicine as needed. Do not try to "tough it out" if you are uncomfortable. DO NOT take aspirin, ibuprofen, or any other NSAIDs (Non-Steroidal Anti-Inflammatory Drugs).
NAUSEA
Sometimes the anesthesia, the pain pills, or swallowed blood will make you nauseated. If this occurs, a suppository can be ordered to make you more comfortable.
DEPRESSION
It is not unusual for an individual to go through a period of mild depression twelve to thirty-six hours after surgery. Even though you very much want this surgery, and even though we have tried to tell you what to expect postoperatively, you may be somewhat shocked at seeing your own face swollen and bruised.
This is a very temporary condition which will subside shortly. The best "treatment" is to busy yourself with the details of your postoperative care and try to remember that the recovery period will soon be over.
INSOMNIA
You may experience some difficulty falling asleep. For this we have prescribed a sleeping pill. If you must take one, remember that such drugs make some people feel light-headed and weak.
NOSE DROPS
Salt water nose drops and an antibiotic ointment are prescribed to keep the nose moist and open. This will prevent any crusts from forming.
KEEPING A STIFF UPPER LIP
The upper lip is important in nasal surgery, as much work is done in this area. To keep the healing tissues from being disturbed, do not move your upper lip for as long as the bandage is in place.
Avoid excessive smiling.
Avoid pursing the lips such as in kissing for ten days.
Do not pull the upper lip down as women do when applying lipstick. Apply lipstick with a brush.
The upper teeth should be cleaned with toothpaste on a face cloth. The lower teeth may be brushed as usual.
Avoid gum or foods that are hard to chew. Soups, mashed potatoes, stewed chicken, hamburger steak, or any easily chewed food is permissible.
After the first few days, if you have chosen to continue wearing a moustache dressing because of the excessive mucous drainage, do not change it more than twice daily. Changing the dressing has a tendency to move the upper lip and the base of the nose. The fact that these dressings have become soiled does not hurt anything except, perhaps, one's sensibilities. You should be able to put up with this for a few days in a good cause. Incidentally, if the dressing becomes stuck, it may be loosened with a few drops of peroxide, however do not use peroxide in the inside of the nose. Also, the best type of adhesive tape to use is Micropore paper tape, because it is less irritating to the skin. It is readily available in most drug stores.
CLEANING THE NOSE
Don't blow the nose at all for ten days. After that, blow through both sides at once. Do not compress one side.
You may clean the outside of the nose and the upper lip with cotton tipped applicators (Q-tips) moistened with warm water. You can do this as soon as you return from the hospital, but do not rub the nose very hard.
After the packing is removed, which is usually on the first postoperative day, the outside and near inside of the nostrils may need to be cleaned with a Q-tip moistened with warm water or saline solution if crusting is present. One of the antibiotic ointments that you will be given, usually Bacitracin, should be applied to the inside of the nose with a Q-tip. Twist the Q-tip around inside gently; you can go in about an inch or until you feel any resistance. This will help prevent crusting and help you to breathe better. This should be done at least 3 to 4 times a day. You were also given a saline spray. Lie on the bed, hang your head over the side, and drop in 6-10 drops in each side. Do this before you put the ointment in 3 to 4 times a day.
Soon after the bandage has been removed, the skin on the nose should be cleaned gently in your usual manner twice a day, to remove the oily material that is produced by the skin glands. This will also assist in the reduction of swelling.
DRYNESS OF THE LIPS
If your lips become dry from breathing through your mouth, coat them with Vaseline or lipstick. A vaporizer with plain water by the bedside at night might be a helpful addition.
TEMPERATURE
Generally, the body temperature does not rise much above 100 degrees following nasal surgery. This rise usually occurs if the patient becomes slightly dehydrated because he does not drink enough water. Take your temperature either rectally or in the armpit. The rectal temperature is one degree above the oral temperature, and the armpit temperature is one degree below the oral temperature. Report any persistent temperature above 100 degrees.
WEAKNESS
It is not unusual for a person who has had an anesthetic or any type of operation to feel weak, have palpitations, break out in "cold sweats", or get dizzy. This gradually clears up in a few days without medication.
MEDICATION
Our office will usually give you all of your prescriptions the day before or the day of your surgery. Almost all patients will be given an antibiotic to be taken after surgery. Obtain explicit instructions about this medicine from the nurse. Multivitamins with vitamin C are suggested for the pre- and postoperative periods, and can be obtained by you without a prescription.
We strongly discourage you from taking any Vitamin E preparations prior to or after surgery. These may increase the probability of bleeding. If you develop a rash or other reaction while you are taking one of the medicines, this could mean that you are developing an allergy to the medicine. If this occurs, please stop taking your medications and call the office immediately.
YOUR FIRST POSTOPERATIVE OFFICE VISIT
The appointment for your first postop visit should be made prior to surgery. This appointment will most probably be for the day after surgery, particularly if your surgery was performed on an outpatient basis. It is generally on the first postoperative day that the minimal nasal packing that was placed is removed. It is normal to have a small amount of bloody oozing after this. It is important that you try to eat or drink something before coming into the office the day after surgery. Ideally, this should be high in calories and protein, such as milk and cookies. If you don't feel up to this, at least a soft drink with high sugar content is advisable.
POSTOPERATIVE CARE
Following your surgery, we will want to see you in the office at regularly scheduled intervals to monitor your progress.
RESUMING ACTIVITIES
The head of your bed will no longer need to be elevated after the splint has been removed.
While the bandage is in place, don't wear any pull over clothing.
NO STRENUOUS ATHLETIC ACTIVITY FOR ONE MONTH, including swimming, jogging, aerobics, etc. No diving or water skiing for two months. No contact sports for four months.
Avoid sneezing until the bandage is removed. If you must sneeze, let it come out like a cough - through the mouth. If it becomes a real problem, we will prescribe medication to alleviate the condition.
Eyeglasses may be worn as long as the metal splint remains on the nose. After the splint is removed, glasses must be suspended from the forehead for a period of about six weeks. If this is not done, the pressure of your glasses may change the contour of your nose. Your glasses can be suspended from the nose after your splint is removed in three ways. One way is to use a piece of tape to hold the glasses on your forehead so that the weight is off your nose. Another alternative is a "noseguard". You can also have prescription lenses made for special frames that fit comfortably around your head. This is the most costly option, and involves seeing an optometrist. We can provide you with further information about any of these alternatives, and our nurses will be happy to discuss these with you to help you choose the option that best fits your needs.
Contact lenses may be worn the day after surgery.
RETURNING TO WORK OR SCHOOL
The average patient is able to return to school the day after the bandage is removed. That will be about five to six days after your surgery. Some hardy souls have returned earlier.
Returning to work depends on several factors: the amount of physical activity involved in your position, the amount of public contact your job requires, and the amount of swelling and discoloration that you may develop. On the average, you may return to work on the 8th to 10th postoperative day.
INJURY TO THE NOSE
Some individuals sustain accidents during the early postoperative period. You need not be too concerned unless the blow is hard enough to cause significant bleeding, swelling or pain. If a blow is sustained while the metal splint is still on, this should help protect the nose. However, for the first five weeks after the nasal splint is removed, more attention should be paid to any injury to the nose. Blows to the nose can cause the nasal bones to become deviated. Please report any accident to the office immediately if you feel it was a significant bump. Otherwise, let us know about it at your next visit.
FINALLY
Remember the things you were told before your operation:
When the bandage is first removed, your nose will appear fat and turned up too much. This is caused by the operative swelling over the nose and in the upper lip. The swelling will subside to a great extent during the next week. However, remember that it will take up to one or two years for all the swelling to disappear and for your nose to reach its final contour. The discoloration will gradually disappear over a period of seven to ten days, in most cases. The thicker and oilier the skin, the longer it takes for the swelling to subside.
The upper lip may seem stiff for some time after surgery, and you may feel that this interferes with your smile. Be patient. This will disappear within a few weeks.
The tip of the nose sometimes feels numb after nasal surgery. This will eventually disappear. Occasionally, the upper teeth will have tingling if extensive septal work was necessary. This, too, will resolve with time.
If you have any questions, please call us at (804) 378-7443. We are always happy to answer your questions, and if you should have a problem, this number is answered 24 hours a day.
Otoplasty Post-Op Instructions
These instructions are given to patients and family members to answer as many questions as possible about the healing phase after otoplasty.
Immediately after surgery the head is wrapped in a large soft bandage for at least 24 hours. The patient is seen in the office on the first postoperative day where the bandage is removed and the ears are cleaned with hydrogen peroxide on a Q-tip and then antibiotic ointment is applied. Swelling of the ears is perfectly normal, as is some bruising. A lighter dressing is then applied. The patient is typically seen again on the third day following surgery. At approximately 1 week postoperatively the bandage is exchanged for a stretch head band that is worn over the ears. This headband is worn for 2 weeks, 24 hours a day, and then at night for approximately another 2 weeks. Postoperative visits are scheduled regularly for three weeks after surgery. Follow-up visits are also scheduled at 6 weeks and 2 months after surgery.
MEDICATIONS
Otoplasty patients receive prescriptions for pain medication and antibiotic. The antibiotic is continued for one week. Discomfort following surgery is controlled with oral medication. Antibiotic ointment, such as polysporin, can be bought without a prescription at any pharmacy.
ACTIVITY
The average patient can return to work or school approximately 1 week after surgery. No strenuous activity is recommended for 4 weeks after surgery. Contact sports should be avoided for 6 weeks or until the doctor gives the OK. Swimming is not recommended for 4 weeks after surgery. If you have any questions about whether or not an activity should be resumed please ask the medical staff.
SLEEPING
The position of the ears during the healing phase is of the utmost importance. If possible, sleeping on the back with the head elevated is recommended to avoid pulling the ear forward and for minimal swelling. Wearing the headband at night until the ears are healed is extremely important to avoid injury.
CLOTHING
Wear clothing that doesn’t have to be pulled over the head for two weeks.
FINALLY
Remember that surgery of any kind causes swelling. The ears will be swollen when the bandages are removed and some swelling will remain for several weeks. Bruising also occurs, but fades as well.
You will be instructed in cleaning the incision with peroxide and applying antibiotic ointment. This is extremely important and must be done diligently.
Please come for the follow-up appointments as scheduled. If you have questions between appointments, do not hesitate to call us 24 hours a day at (804) 378-7443.
Septoplasty Post-Op Instructions
Nasal airway obstruction can be alleviated through an operative procedure that straightens the septum and reduces the size of the inferior turbinates. The septum is the internal structure of the nose that divides one nostril from the other and can become crooked or deviated, causing airway obstruction. Inferior turbinates are structures inside the nose that warm and humidify the air. They can become enlarged due to nasal allergies, and therefore impinge upon the airway. There are three sets of turbinates that make up part of the airway, but the inferior turbinates are the ones that are most commonly obstructive.
SWELLING
Every operation, no matter how minor, is accompanied by swelling of the surrounding tissues. The degree of swelling varies from person to person, and with the amount of surgery required.
Staying upright (sitting, standing, walking around) as much as possible is important after you leave the hospital. Avoid bending over or lifting heavy objects for at least one week as it may aggravate swelling or cause bleeding.
Avoid hitting or bumping your nose.
Sleep with the head of the bed elevated for approximately 3-5 days. You may place an additional pillow under your head to accomplish this.
Avoid “sniffing,” that is, forcibly attempting to pull air through the nose. This will not relieve the sensation of blockage. As the swelling of tissues decreases, your airway will improve.
Avoid rubbing the nostrils and base of the nose as this may cause infection or bleeding. Use the “moustache” gauze dressing if discharge is excessive. The moustache gauze dressing may have to be changed as often as every thirty minutes. This is not abnormal and will significantly lessen in the next twelve hour period. You will usually have clear plastic tape on your cheeks with the moustache dressing taped over it. Leave the clear tape in place until you do not need the moustache dressing anymore (usually 24-48 hours). This avoids irritating the skin from frequent moustache dressing changes.
NASAL PACKING AND BLEEDING
For the first 24 hours, your nose will be lightly packed to decrease oozing. We will remove the small packing the first postoperative day. Please be aware that during the postoperative time, you may have some minimal bleeding. Often blood stained mucus coming from the nose will be seen, and this is not unusual. Nevertheless, if you should find that you are actively bleeding from either nostril, it is important to contact the office as soon as possible.
PAIN
This is very little actual pain, and what pain you have can be alleviated with the prescribed medication. Please do not take aspirin or any aspirin containing medication.
MEDICATIONS
You will usually be prescribed pain medication, antibiotics, ointment, and nasal saline. Nasal saline can be obtained over the counter. Sealed, pressurized saline spray, such as Simply Saline or Nasamist, is preferred (see below). Any antibiotic ointment, such as bacitracin or polysporin, can be used.
CLEANING THE NOSE
The day after your surgery, much or all of the packing will be removed in our office. After this is done, the saline solution and ointment should be used to clean the nose and keep crusting to a minimum. The saline solution should be used every few hours during the day. The ointment should be placed at least 3 times a day. Avoid blowing your nose for at least 2 weeks.
RESUMING ACTIVITIES
Your exercise regimen must be lessened to some extent for the first few weeks following surgery. Upper body exercise is especially prohibited, as it is more likely to cause turbinate bleeding. Walking is always permissible. PLEASE CHECK WITH THE OFFICE BFORE RESUMING ANY OTHER EXERCISE OR ATHLETIC ACTIVITY.
YOUR FIRST POSTOPERATIVE OFFICE VISIT
The appointment for your first postoperative visit should be made prior to your surgery, and will most probably be the day after surgery. At that time, most of your packing will be removed. Please eat something nourishing and caloric prior to this visit.
RETURN TO WORK OR SCHOOL
The average patient is able to return to school or work three to five days following the surgery. Physical activity will be curtailed, as discussed above.
LONG-TERM CARE
Please realize that the turbinates may require six full weeks for complete healing. Often there will be crusting at the healing sites that will need to be removed by the doctor. This may require multiple visits for the first six weeks. This is normal and should not be cause for alarm. The crusts may interfere with proper breathing, so it is important to keep these visits. Continued use of saline irrigations will aid in reducing the amount of crusting.
If you have any questions, please call us at (804) 378-7443. We are always happy to answer your questions, and if you should have a problem, this number is answered 24 hours a day.
