Post Operative Facial Surgery Instrucions

An adult should stay with you for a least the first 24 hours after surgery. You many need help with your daily activities for 7-10 days and should be off work and have someone available to help you at all times. 

You should rest with your head elevated on at least 2 pillows for the first 48 hours after surgery. You should restrict your activity for at least a week after surgery. Avoid bending at the waist or picking up heavy objects. Typically, you can return to work 2 weeks after the surgery. You may have to wear camouflage make-up.

It is not unusual for you to have a sore throat for 24-48 hours after surgery. You pain medication should help with this discomfort. Throat lozenges may help.

Do not drink alcoholic beverages, smoke, drive a car, or sign legal documents for 24 hours after surgery.

It is best to take your pain medication before pain is experienced. It is easier to prevent pain than control it. Pain medicine can cause nausea.  It is best to try not to take pain medicine on an empty stomach.

Mild bleeding from the surgical site is not unusual. Mild pressure will control the bleeding. If bleeding persists or is heavy, contact us immediately.

Cold tends to prevent swelling. We recommend cold packs immediately after surgery and the day following the surgery. This is especially important after eyelid or browlift surgery. After 48 hours after surgery, warm (not hot) packs may be beneficial. Avoid excess heat on skin that has reduced sensation following the surgery. Cold or heat over dressings will not be helpful.

Swelling and bruising is a normal sequel to surgery and should be expected. Resolution of swelling and bruising takes time and may not be complete for several weeks to a few months depending on the type of surgery and the individual patient. Bruising can be covered up with camouflage make-up.

Exposed sutured or stapled skin incisions should be washed with soap and water three times per day. After drying, the incisions should be cleaned with 3% Hydrogen Peroxide and a Q-tip. The incisions should then be constantly covered with the antibiotic ointment dispensed to you. Incisions should not be allowed to become dry or crust over.

Some sutures may be self-absorbing and will disappear after a few days if kept moist with ointment. Other sutures must be removed. We typically remove these 5-7 days after the surgery.

Camouflage make-up may be applied to discolored areas 5 days after surgery, and to the incisions 10 days after surgery.  Do not place the make-up heavily on the incisions.

It is important to stay out of direct sunlight, as your eyes and the skin around them will be sensitive.  If you must go outdoors for whatever reason, it is advisable to wear UV blocking sunglasses for at least 6 weeks. 

Different surgical procedures require special dressings, while some require none. Do not remove dressings unless specifically instructed to do so. Some dressings are removed the day following surgery and some remain in place for a significant period of time.

Start with clear liquids, then advance to soup and crackers when able, then resume you regular diet as directed.

No driving if your vision is not adequate as well as while still taking prescription pain medication.

 

Procedure Specific Post Operative Instructions

Dressing  

Blepharoplasty – Ice cold 4×4 soaks as directed.  If eyes do not close at first due to swelling, you may need a lubricating ointment at night (eg. Refresh P.M. Lubricating eye ointment or Lacrilube). A piece of plastic dressing may be used to help eyes retain moisture as well. During the daytime you may use a natural tears formula (eg. Refresh artificial tears) as needed for dry eyes.

Facelift/Otoplasty/Liposuction – The dressing placed immediately after surgery will typically be removed by us the next day during your appointment. Starting one day after surgery, wear support strap we provide full time for the first week and at least half time for the second week. After two weeks you may want to wear the neck garment at night for another 2 weeks for additional support. 

Orthognathic Surgery / Facial Implants – Normally no dressing is required. If a tape dressing is placed, leave it in place for 48 hours.

Facial Resurfacing – You will wake up with a layer of moisturizing ointment covering all areas of resurfaced facial skin. Keep all facial resurfaced skin moist with petroleum jelly or aquafor.  You may need to apply the ointment to your face several times a day.  It is very important to keep the skin covered with ointment to prevent the skin from becoming dry.

Rhinoplasty – The splint placed on your nose is to remain in place until you surgeon removes it at the one week follow-up visit.

Sutures

Blepharoplasty – Dissolve in about 2 weeks.

Facelift/Otoplasty/Liposuction – Dissolve in about 2 – 4 weeks. Ear bolsters will be removed in 1 week.

Orthognathic Surgery / Facial Implants – Dissolve in about 2 weeks.

Facial Resurfacing – none.

Rhinoplasty – Dissolve usually in about 2 weeks.

Wound Care

Blepharoplasty – Upper blepharolplasty incisions may be cleaned with diluted peroxide and coated with recommended ointment. Apply a small amount on the incision line. Blood tears and drainage are normal, especially the first few days or with increased activity. If eyes feel dry, a natural tears formula (eg. Refresh artificial tears) may be used as needed. 

Facelift/Otoplasty/Liposuction – Your hair should be washed gently everyday beginning the day after surgery. Incisions may be cleaned twice a day using a Q-tip with diluted peroxide (50% water) followed by the application of Polysporin antibiotic ointment over all suture lines.

Orthognathic Surgery / Facial Implants –If oral incisions were used, brush your teeth gently three times a day and rinse with warm salty water. (Approx. 1 teaspoon of salt per cup of water) Be careful not to swallow any of the water. Brush your teeth gently at least two times a day to maintain good oral hygiene.

Facial Resurfacing – Starting the day after surgery, wash your face three times a day with Cetaphil Cleanser (can be obtained at Wal-Mart or Med-X), gently using fingertips. Do not wipe face dry with a towel. Instead, pat dry with a clean paper towel. This also promotes exfoliation of the top layer of skin, which you may see come off on the paper towel. After washing your face, completely moisten all treated areas with a thin layer of moisturizing ointment such as petroleum jelly or aquafor.  Between washings, you can use a mist bottle filled with distilled water help keep your skin moist and comfortable. It is critical to keep the resurfaced areas moist during the first several days of healing.  Do not pick at the face if crusting or scabbing occurs.

Rhinoplasty – Starting the first day after surgery, using a cotton Q-tip, swab out the nose

twice a day with diluted peroxide (50% water). After cleaning the nose apply a thin

layer of Bacitracin or Polysporin with a Q-tip.

Activity

Blepharoplasty – Elevate the head off the bed 30 degrees. Use ice the first 24 to 48 hours for swelling. Increase activity as tolerated with no heavy exercise for two weeks. Avoid driving while still taking prescription pain medication.

Facelift – Elevate head off of bed at least 30-45 degrees. Use ice or frozen green pea packs over the surgical areas for the first 24-48 hours as often as tolerated to help decrease swelling and bruising. Limited neck turning for up to six weeks (avoid rapid movement when turning your head). Increase activity as tolerated with no heavy exercise or lifting for at least two weeks. Eat a soft diet for the first few days. Avoid driving while still taking prescription pain medication.

All Surgeries – Elevate head off of bed 30 degrees. Use ice for 24 to 48 hours. Increase activity as tolerated with no heavy exercise or lifting for at least two weeks. Follow a soft diet for the first few days. No heavy exercise or lifting for at least two weeks. Vigorous chewing or talking should be kept to a minimum the first 48 to 72 hours after surgery. Try to avoid lying directly on either side of your face for at least the first week. We prefer you to lie only on your back. Avoid driving while still taking prescription pain medication.

Special Instructions

All Surgeries -. Swelling, bruising and some bloody drainage is normal. However, if one side is swollen and bruised more than the other or it is much more painful, please call and notify us.

Blepharoplasty – Contacts may be worn after about one week. Swelling and bruising is normal. Eyes may feel dry and scratchy.  Blurred vision can persist for an extended period.  If you feel you have vision loss, call us immediately.

Facelift – Signs of Hematoma – A hematoma is a painful extreme hardness often accompanied by bruising, usually unilateral causing asymmetry. Call us immediately if you have these symptoms. As numbness subsides, it is common to feel tingling or sharp sensations. These sensations will eventually go away, however it may take weeks to resolve.

Facial Resurfacing – The treated areas will have associated mild stinging and burning for the first several days that should be controlled with the prescription pain medication you were given. Treated areas may remain reddened or pink for up to three months. Protect sensitive skin from sun exposure for at least the first year with a sun block at least SPF 30 UVA and UVB. Occasionally viral fever blisters erupt. Therefore, you should begin taking the prescribed antiviral medication the day of surgery to prevent this from occurring. If you have a tendency to develop fever blisters or believe are developing some during the healing phase, please let us know so that we can adjust your medications. Peeling and crusting of the skin usually stops in 7-10 days. Make-up can be worn after the crusting stand your surgeon approves you to do so. We recommend using Physicians Formula Self Defense® Color Corrective Moisturizing Lotion (SPF 15) and Concealer 101® Perfecting Concealer Duo. These products will help cover the redness after surgery. They are hypoallergenic and will not irritate sensitive skin during the healing process.  These products can be found at Walmart.

Rhinoplasty & Otoplasty – Protect the sensitive skin from sun exposure with sun block for at least six weeks. Avoid pressure on the surgical site. (i.e. tape glasses off of for up to six weeks. It is normal for the nose to be stuffy the first couple of weeks.  Using a saline nasal spray (eg. Simply Saline®) can be helpful for relief. Afrin nasal spray can be used for no more than 3 days to decrease bleeding and congestion. If Afrin is used for more than 3 days you can become addicted to it and have worsening of your nasal congestion. Swelling, bruising and some bloody drainage is normal. If bleeding persists or is heavy, keep your head elevated, apply icepacks and decrease your activity.

Supply List

                             All Surgeries         All External Incisions(will be provided)          Facial Resurfacing

                    Prescription Medication                Antibiotic Ointment                         Petroleum Jelly / Aquafor

                Frozen Green Peas, Ice Packs            Tip Cotton Swabs                                 Cetaphil Cleanser

                 Nutritional Snacks (i.e. Ensure)                 Peroxide                          Paper Towels/ Misting Bottle

                                Gauze                                                Sun Block UVA

 

We greatly appreciate the confidence you have shown by allowing our staff to assist you in improving your appearance and health.  Our very best efforts will be given to achieve the most satisfactory surgical results possible for your individual anatomy and desires.

                 If you have any emergent questions Dr. Caldemeyer can be reached on his cell form at (931) 510 – 0206