Download Pre-operative Instructions for Blepharoplasty

THE PRE-OPERATIVE SESSION™
PRE-OPERATIVE INSTRUCTIONS FOR BLEPHAROPLASTY/
ENDOSCOPIC FOREHEAD LIFT / MIDFACE LIFT
THREEWEEKSBEFORESURGERY:
• Laboratorytests,EKGandeyeexaminationsmustbedoneandthewrittenresultsofthistesting
mustarriveatourofficeonefullweekbeforesurgery(ourfaxnumberis585-271-4786).
• SURGERYWILLNEEDTOBERESCHEDULEDIFTHEREISANYCHANCEYOUAREPREGNANT.
• Ifyouareplanningtohaveahaircutbeforesurgery,pleasedosothreeweeksbeforesurgery.
• Allfeesaredue,includingsurgical,facilityandanesthesia.
TWOWEEKSBEFORESURGERY:
• Donottakeproductscontainingaspirin,ibuprofen(eg.Advil,Motrin),orVitaminE.Checkwith
yourpharmacistwhentakinganyover-the-countermedications.Manypainrelievers;coldand
sinusmedicationscontainaspirinoribuprofen.TylenolisOK.
• Refrainfromallnicotineproducts,includingcigarettes,pipetobacco,chewor“thepatch.”
Nicotineinterfereswithhealthycirculationandmayaffecttheresultofyoursurgery.Italso
placesyouathigherriskofcomplicationwhenreceivinganesthesia.
• Starttaking1000mgofVitaminCthreetimesperday.VitaminChelpswithhealing.
• Ifyourdestinationaftersurgeryismorethan30minutesfromtheoffice,youmustmake
arrangementstostayinahotelonthenightfollowingsurgery.
ONEWEEKBEFORESURGERY:
• Donotdrinkalcoholfor1weekbeforeandaftersurgery.
• Ifyoupermorcoloryourhair;itshouldbedone1weekbeforeand/or5weeksaftersurgery.
DAYBEFORESURGERY:
• TheSurgeryCenterwillcallyouafterNOONtoinformyouofyourarrivaltimeforsurgery.
• DONOTEATORDRINKANYTHINGAFTERMIDNIGHT(includingwaterandgumchewing).
SURGERYMAYBECANCELLEDIFTHISISNOTFOLLOWED.Afastingstateisrequiredinorderto
receivesedationforsurgery.Theonlyexceptionismedication,whichwewillinstructyoutotake
thedayofsurgerywithasipofwater.
DAYOFSURGERY:
• Gotodesignatedsurgicallocation:973EastAvenue,Suite101.
•
•
•
•
Youmayshowerandshampoothemorningofsurgery.Donotwearmakeup,hairspraysorgels,
ornailpolish.Youmayleaveacrylicnailson.
Avoidclothingthatmustbepulledoverthehead.Pleasewearloosefittingclothing.
Donotwearjewelryofanysortorbringvaluablestosurgery.
Dentures,ifworn,shouldbeleftinplace.
POST-OPERATIVE INSTRUCTIONS BLEPHAROPLASTY/ENDOSCOPIC
FOREHEAD LIFT
ACTIVITY:
• Limityouractivitysharplyoverthefirstweekfollowingsurgery.
• Youareencouragedtowalkaroundthehouseonthedayofsurgeryandthereafter.Thishelpsto
preventbloodclotsfromdevelopinthelegs.Move/pumpyourlegsfrequentlywhilelyingdown.
Thisalsohelpsinpreventingbloodclotsfromdeveloping.
• Whenyourestorsleep,keepyourheadelevated2-3pillowsandavoidturningofyourside.Ifyou
overexertyourself,bleedingorprolongedswellingmayresult.
• Keepyouremotionsundercontrol.Itisnotunusualtofeelabitdepressedforafewdaysafter
surgery.Thisquicklypassesasyoubegintolookandfeelbetter.Anger,cryingorotheremotional
outburstswillonlyaddtotheswellingorincreasethelikelihoodofbleeding.
• Avoidbending,lifting,pulling,pushing,strainingandaerobicactivitiesfor3weeks.
• Youmaybegintoreturntoregularexercise3weeksaftersurgery.Easeintothis,gradually
increasingyourexerciselevelbacktonormalby5-6weeksfromsurgery.
• Takedeepbreathsoftenwhenyougethomeforthefirst24hoursaftersurgery.Thishelpsto
expandthebaseofyourlungs.
ORALINTAKE:
• Alcoholconsumptionshouldalsobelimitedasthismayraisethebloodpressureandinitiate
bleeding.Donotdrinkalcoholduringthefirstweek.
• Drinkplentyoffluidsfollowingsurgery,asdehydrationcancontributetonausea.
• Youmaywanttoavoidfoodsthatrequiremuchchewing,suchassteak.Softfoodsmaybeeasier
toeat.
• Smallamountsoffood20minutesbeforetakingpostoperativemedications(especiallypain
medicationsand/orantibiotics)canpreventnausea.
• Ifyouvomitorfeelnauseated,youshoulddelayfoodandpainmedicationsuntilthenausea
passes.Takeonly2-3ouncesofclearliquidsathourlyintervalsuntilthenauseasubsides.Ifthis
symptompersists,callforanti-nauseamedications,assubsequentvomitingmaybeharmfuland
leadtocomplications.
PAIN,SWELLING,BRUISING,INFECTION:
• Itisunusualtohavesignificantpainafteragingfaceprocedure.Iftheprescribedmedicationdoes
notcontrolpain,pleasereportthistous.Thereisdiscomfort,ofcourse,butrememberthatthis
willquicklypass.
• Someswellingandbruisingistobeexpected.BruisingistreatedwithArnica,anherbthatwillbe
providedbyouroffice.Swellingandbruisingismaximalat48hourspost-surgeryandgradually
subsidesoverthefollowing10-14days.
• Infectionisalsounusual.Fever,localizedswellingwithrednessandtendernessmaysignifya
developinginfectionandshouldbereported.Appropriatetreatmentwillbeinitiated.
• Yourfinalresultswilloccurbetween6-12months.
BATHING:
• Followingsurgeryyoumaybathe,butdonotsubmergeyourheadinthewater.
• Youshouldtakecaretopreventgettingyoursutureswet.
OTHERCOMMONINSTRUCTIONSAFTERSURGERY
• Aresponsibleadultmustprovidetransportationforyouaftersurgery(publictransportationisnot
permissible)andremainwithyouuntilthemorningfollowingtheprocedure.Ifyouarehaving
severalprocedures,youmayneedassistancefor1-2daysfollowingyourprocedure.
• Youwillneedtoarrangetransportationforyourappointmentatourofficeonboththeday
followingsurgeryaswellasdaythedayyoursuturesareremoved.Donotdrivefor5-7daysafter
surgeryoranytimethatyouaretakingpainmedications.
• Avoidmakingmajordecisionsorparticipatinginactivitiesrequiringjudgmentfor24hours.
• Smokingshouldbestrictlyavoidedasitinterfereswiththebloodsupplytothehealingtissuesand
slowssubsequenthealing.
• Takeallmedicationsasinstructedpostoperatively.
• Avoidexcesssunlighttotheincisionsforatleastayear.Evenmildsunburnmaycauseprolonged
swellingorirritationofthehealingincisions.UsesunscreenwithzincoxideandSPF20orgreater
tohelpdecreasethevisibilityofthescar.
• Donotcompareyourprogresswiththatofotherpatients.Rememberthateveryone’shealing
processisunique.Also,ifyouhaveanyquestionsorconcerns,callonus.Yourfamilyandfriends
maymeanwell,butyoucanreceivewronginformation.
INCISIONALCAREFORBLEPHAROPLASTY:
• Icepacksshouldbeusedwithinthefirst48hoursaftersurgerytohelpwithswelling.Applyicefor
15-20minutesoutofeachhourwhileawake.Besuretheyarelightweight.Neverapplyice
directlytotheskin.Dippinggauzepadsintoicedwaterworkswell.
• Applyophthalmicointmenttoeyelidsuturestwicedailyandintoyoureyesatbedtime.
• Eyelidsutureswillberemoved3-4daysafteryourprocedure.
INCISIONALCAREFORENDOSCOPICFOREHEAD/MIDFACELIFT:
• Icepacksmaybeusedwithinthefirst48hoursaftersurgerytohelpwithswelling.Besurethey
arelightweight.Apply15minutesatatime.Neverapplyicedirectlytotheskin.
• Incisionsarebehindthehairlineanddonotrequireanycare.
• Yourforeheadandtopofyourheadwillbenumbpostoperatively.Thiswillgraduallyresolveover
manyweeks/months.
• Uselowheatwhenusinghairdryersandcurlingirons
• Suture/staples/screwswillberemovedin7days.
• Adrainagetubewillbeplacedthroughoneofthehairlineincisions.Thisistopreventthe
accumulationoffluidintheforehead.Thiswillberemovedatyourfirstpostoperative
appointment.
• Wearyouracewrapatalltimesfor5days,thenwearatnightforanother7days.Washyourhair
beforeyourpostoperativeappointmentonday4/5.Ifyourappointmentisduringtheweek,
arrangementsmaybemadetohavethisdoneattheLindsayHouse.
CALLTHEOFFICEIFYOUDEVELOPANYOFTHEFOLLOWING:
• Feverof101degreesForgreater.
• Painnotrelievedwithpainmedication.
• Swelling,redness,bleeding,and/orfouldrainagefromincisionarea.
• Persistentnauseaand/orvomiting.
• Anyotherconcerns.
OfficeTelephone:585-244-1000
Physicianpagernumber:585-258-4851
Ihavereviewedandunderstandtheinstructionsprovidedformyprocedure.
PatientName(print):______________________________Date:____________
PatientSignature:_________________________________
WitnessSignature:________________________________Date:_____________
Yoursurgerywillbeperformedsafelyandwithcareinordertoobtainthebestpossibleresults.
Youhavetherighttobeinformedthatthesurgerymayinvolverisksofunsuccessfulresults,
complications,orinjuryfrombothknownandunforeseencauses.Becauseindividualsvaryinskin
textures,tissue,circulation,andthehealingprocess,aswellasanestheticreactions,therecanbeno
guaranteemadeastotheresultsorpotentialcomplications.
Thefollowingcomplicationshavebeenreportedinmedicalliterature.Theyarelistedhereforyour
informationnottofrightenyou,buttomakeyouawareandmoreknowledgeableconcerningthis
surgicalprocedure.Theywillbediscussedagainatyourpreoperativeappointment.
RHYTIDECTOMY
(facelift/endoscopicforeheadlift/mid-faceliftprocedures)
Theoverallcomplicationrateforrhytidectomyis12%
Hematoma:Aswellingormassofblood(usuallyclotted)causedbyabreakinabloodvessel.
Females0.7%.Males7%.Thisformofhematomarequirestreatmentanddrainage.
Infection:Lessthan1%.Thisisextremelyraredespitetheproximityofhairaroundthewound
HairLoss:Lossofhairinthetemplearea,behindtheearis2.3%.Thisisusuallytemporarywith
normalregrowthinseveralmonths.Malepatientsshouldbeawarethatthehairlessareain
frontoftheearwillbenarrowedandthebeardpatternwillchangepossiblynecessitating
shavingbehindtheear.
Pigmentation:(discoloration&bruising).Eithernormalorpathologicalcoloringoftheskinortissue
byadepositofpigmentationthatcancausecolorchanges.Normalbruisingresolvesin2-3
weeks.Occasionallyextensivebruisingcanrequiremanyweeksormonthstoresolve.These
problemscanbemostcommoninpatientswiththin,hypo-pigmented,transparentskin.
Patientswithdarkercomplexionsshouldbeawareofthepossibilityofresidualbrown
pigmentation.
Edema:(swelling).Thisisnormalfollowingfaceliftsurgeryandusuallylasts2-3weeks.Prolonged
edemaisunusualandmayrequireendocrine,allergyorothermedicalevaluationto
determinethecause.
NerveInjury:Injurytothenerve(s)causingaweaknessoftheeyebrow(s)orofthemouthisabout
1%.Theyoftenreturntonormalinamatterofweekstomonths,butcanpersist.
Pain/Numbness:Usuallyaroundtheearlobesorearsisabout2.5%.Significantpainpostoperatively
isunusual.Ifitexistsandespeciallyifitisunilateral,itshouldbeinvestigated.
KeloidScarring:Poorhealingwithvisibleandsensitivescarringalongincisionlines.
WoundSeparation:Occursalongthesuturelineafterthesutureshavebeenremoved.
SubmentalDepression:Removaloffatintheareaunderthechinmayresultinsomeirregularareas
ofdepression.
“DogEar”:Mostallareasofexcesstissuealongscarsresolvewithtime.Iftheydonotresolvewith
healing,theymaybeexcisedatalaterprocedure.
SkinSlough:Poorhealingcausingscartissueformationoftenassociatedwithhematomaor
infection.
Anytouch-upsurgerythatmaybenecessaryisnotdoneforatleast6months.Thisisusuallyasmall
officeprocedureandnophysician’sfeeischarged.Thereishowever,anominalchargeforthe
facility,supplies,andanesthesiaifsedationisrequired.
Ihavereadthecomplicationlistandamawarethatanyoftheabovemayoccur.
PatientName(print):______________________________Date:____________
PatientSignature:_________________________________
WitnessSignature:________________________________Date:_____________
Yoursurgerywillbeperformedsafelyandwithcareinordertoobtainthebestpossibleresults.
Youhavetherighttobeinformedthatthesurgerymayinvolverisksofunsuccessfulresults,
complications,orinjuryfrombothknownandunforeseencauses.Becauseindividualsvaryinskin
textures,tissue,circulation,andthehealingprocess,aswellasanestheticreactions,therecanbeno
guaranteemadeastotheresultsorpotentialcomplications.
Thefollowingcomplicationshavebeenreportedinmedicalliterature.Theyarelistedhereforyour
informationnottofrightenyou,buttomakeyouawareandmoreknowledgeableconcerningthis
surgicalprocedure.Theywillbediscussedagainatyourpreoperativeappointment.
BLEPHAROPLASTY
(upper/lowereyelidsurgery)
Woundseparation:Theincisionlineseparatesafterthesuturesareremoved.
Infection:Exceedinglyuncommon,butmayoccur.
Epiphora:Excessivetearingdownthecheekduetoexcesssecretionoftearsortoobstructionofthe
lacrimalduct.
Cornealinjury:Eitherbytraumadirectlyorduetoglobeexposure.Usuallycanbeprevented,but
mayrequireophthalmologicconsultation,asmightanyothereyecompliant.
Telangiectasis:(Superficialvisiblesmallbloodvessels).Pre-existinglesionsarelikelytobeintensified
insizeandnumberintheeyelid.
Scarring:Keloidscarsareextremelyrarebuthealingmayresultinavisiblescar.
Pigmentation:Occasionally,patientswithdarkskinwillexperiencedarkeningofskinsecondaryto
bruisingforextendedperiodsoftime,whichmaybewellbeyondnormalhealingperiods.
Inclusioncysts:Small,whitecystsinorneartheincisionline.
Postoperativewrinkling
Hematoma:Accumulationofbloodbehindtheeyeballorundertheskin.
Asymmetryofeyelids:Usuallyunmaskingapreviousasymmetry.
Lagophthalmos:Difficultyinclosingtheeyelid.Commonimmediatelypostoperatively,butmay
persist.
Lossofeyelashes
Ptosis:Aparalyticdroopingoftheuppereyelid.
Alterationofvision:Usuallytemporary,butcanbepermanent.Exceedinglyrare.
Enophthalmops:Recessionofeyeballsintotheorbitmayappear,especiallyinpatientswithdeep-set
eyes.
Keratoconjunctivitissicca:Dryeyes.
Ectropinorscleralshow:Apullingdownwardorchangeofshapeoftheeye.
Skinslough:Veryrare.Usuallyhealswithouttheneedforskingraft,althoughthismaybenecessary.
Secondaryblepharoplasty:Occasionallyrequiredtomodifyunder-correctionorover-correction.
Anytouch-upsurgerythatmaybenecessaryisnotdoneforatleast6months.Thisisusuallyasmall
officeprocedureandnophysician’sfeeischarged.Thereishowever,anominalchargeforthe
facility,supplies,andanesthesiaifsedationisrequired.
Ihavereadthecomplicationlistandamawarethatanyoftheabovemayoccur.
PatientName(print):______________________________Date:____________
PatientSignature:_________________________________
WitnessSignature:________________________________Date:_____________