Pre-Operative Guidelines For Plastic Surgery Patients

1. STOP SMOKING AT LEAST 1 MONTH PRIOR TO SURGERY and at least 2 weeks AFTER surgery because smoking will interfere with healing and can lead to various post operative complications.
2. DISCONTINUE MEDICATIONS CONTAINING aspirin, ibuprofen, blood-thinners, Vitamin E, and ALL herbal supplements at least 1-2 weeks prior to and 1 weeks after surgery. These medications can cause prolonged bleeding. Tylenol is safe to take just before and after surgery, if needed.
3. FILL YOUR PRESCRIPTIONS BEFORE your day of surgery and keep them at your bedside at home along with a notepad to help keep track of the medications you have taken. Expect some forgetfulness up to 36 hours post-op and during narcotic use. Also, have food in your stomach before you take your medications to minimize any nausea. DO NOT drive or drink alcohol when taking narcotic pain medication.
4. BRING YOUR PAIN MEDICATION WITH YOU on the day of surgery, so that the nurse can verify your medications and administer, if needed.
5. IF YOU ARE PRONE TO NAUSEA OR MOTION SICKNESS let your physician know. Routine anti-nausea medications will be given through your IV in the operating room to prevent nausea as well as antibiotics, steroids for swelling, and pain medications before you wake up from surgery. If necessary, medications can also be prescribed to prevent nausea at home.
6. CONSTIPATION IS NORMAL FOLLOWING SURGERY. General anesthesia slows down the GI tract and narcotic pain medication increases the likelihood of constipation It is okay to take a stool softener (such as over-the-counter Colace) or fiber bulkers (such as Metamucil or Fibercon) following surgery. Drink lots of water and be sure to eat a well balanced diet including fruits and vegetables the days before and after surgery.
7. WOMEN MAY EXPERIENCE A CHANGE IN THEIR FIRST MENSTRUAL CYCLE following surgery. It may be lighter and shorter. Menstrual irregularity usually lasts just one cycle.
8. DO NOT EAT OR DRINK ANYTHING 8 HOURS PRIOR TO YOUR SCHEDULED SURGERY TIME. You may have clear liquids (7-up, Gatorade, apple juice or water) up to 4 hours before surgery.
9. ARRANGE FOR A RESPONSIBLE ADULT TO TAKE YOU HOME AND STAY WITH YOU FOR 24 HOURS after surgery. Although everyone heals differently and has varied pain thresholds, expect some soreness, fatigue, mood swings and some fogginess for a minimum of 1 week post-op. Swelling and bruising typically peak at day 4-5 post-op during the normal healing process. Arrange child care if possible, and plan to be off work until you are feeling better and your doctor says it is safe to resume your activities.
10. PLEASE CALL IF YOU HAVE ANY QUESTIONS. We are all here to make your surgical experience as comfortable as possible.

WARNING ABOUT BLOOD THINNING MEDICATIONS

Blood thinning products can cause excessive bleeding during and after surgery. Both prescription and over the counter medications can have blood thinning properties. If you currently take any of the medications or herbal preparations listed below discontinue use 1 to 2 weeks prior to your procedure. Remember this is only a partial list. If you have any questions, please contact your local pharmacist.

If you were told by a doctor to take a blood thinning medicine on a regular basis for stroke or heart attack prevention, severe arthritis, atrial fibrillation, or a prosthetic heart valve, ask your surgeon when this medicine should be discontinued.

Read the labels on all the medications that you take on a regular basis. Many products contain Aspirin (ASA or acetylsalicylic acid) and must be stopped 7 to 14 days prior to surgery.

Read the label on any new medications you take during the 14 days prior to your surgery. Many headache, cough, and cold remedies contain Aspirin (ASA or acetylsalicylic acid) and should not be used.

Below is a list of medications that must be stopped for the 7 to 14 days before surgery:

If you need pain, headache, cough, or cold medicine during the 7 to 14 days prior to surgery, you may take products containing Acetaminophen (Tylenol).

The Day Of Your Surgery

1. PLAN TO WEAR LOOSE FITTING CLOTHING (such as a jogging suit) and easy on/off shoes. A top with front zipper closure or buttons works well if you are having upper body surgery. Pants with an elastic waistband also work well, as you will be drowsy following surgery.
2. DO NOT WEAR ANY MAKE-UP, JEWELRY, OR BRING VALUABLES on the day of surgery, except your ID and insurance card. You may wear socks in the operating room and wear underwear IF it does not interfere with your surgical site and your physician approves. Please remove all JEWELRY prior to your surgery, including, but not limited to rings, watches, earrings, nose piercings, tongue piercings, and naval piercings. If this is not possible, you must discuss with your surgeon.
3. BRING YOUR PAIN MEDICATION WITH YOU on the day of surgery, so that the nurse can verify your medications and administer, if needed.
4. YOU WILL BE ASKED TO CHANGE INTO A GOWN. Your surgeon will mark the surgical site and your anesthesiologist will have you sign a consent for anesthesia. You will have the opportunity to ask any last minute requests.
5. AN IV WILL BE STARTED IN YOUR HAND OR FOREARM in the pre-op area and a nurse will accompany you in the operating room throughout your surgery.
6. ONCE YOU’RE IN THE OPERATING ROOM you will be asked to lie on the table. The anesthesiologist will give you medication through your I.V. to relax you as soon as you are lying down. These medications also help you to forget being in the operating room.
7. MONITORS AND EQUIPMENT will be applied to your body. This may include a blood pressure cuff on your arm, a pulse oximeter on your finger, 3 EKG pads on your torso, SCD pressure stockings to your calves (to reduce blood clots), and a grounding pad to your thigh (for surgical electro-cautery machine).
8. YOU WILL DRIFT OFF TO SLEEP VERY COMFORTABLY. A tube will be placed in your throat AFTER you are asleep and will be removed BEFORE you wake up. The only awareness you may have of the tube could be a sore, scratchy throat following surgery.  If your surgery is planned for more than 3 hours you may also have a FOLEY CATHETER in your bladder. This will also be inserted AFTER you are asleep and removed before you wake up. If you are staying overnight, the catheter will be removed in the morning. You should be able to urinate normally after its removal.
9. YOU WILL BE TRANSFERRED TO THE RECOVERY ROOM ON A BED and can expect to stay for another 1-1.5 hours. Most patients are fully awake with 15-60 minutes after surgery, but may not remember much due to the anesthetic drugs. You will be released when your vital signs are stable and your nausea, bleeding, and pain are minimal. A nurse will be with you while you are recovering.
10. YOU AND A RESPONSIBLE ADULT WILL BE GIVEN SPECIFIC DISCHARGE INSTRUCTIONS, necessary supplies, and a 1 week post-op appointment. Ask questions anytime.
11. MOST IMPORTANTLY, REMEMBER TO LISTEN TO YOUR BODY…Rest when you feel pain or fatigue. BE PATIENT with the healing process, and remember you may have good and bad days.

Post-Operative Guidelines For Plastic Surgery Patients

1. TAKE YOUR MEDICATIONS AS DIRECTED. Pain tolerance varies from one person to the next. Stay on top of your pain by taking your medication regularly for the first few days. Take your medications with food to decrease the chances of nausea.
2. REST FOR THE FIRST 24 HOURS following surgery. DO NOT drive or drink alcohol while taking narcotic pain medication. You may walk and climb stairs slowly. No heavy lifting or any exercising for a minimum of 2+ weeks. LISTEN TO YOUR BODY! Everyone heals at different rates.
3. YOU MAY SHOWER 24-48 HOURS after surgery. Keep your incisions clean and dry. Your surgeon may remove your dressings and/or some stitches at your post-op visit. You may use hydrogen peroxide to clean the incisions. DO NOT submerge in a bath or swimming pool for a minimum of 3 weeks.
4. CALL IF YOU EXPERIENCE excessive pain, bleeding, swelling, discoloration at the incision site, or fever over 101 degrees F. Remember, scars take a year to fully mature. Wear sunscreen (SPF 30) over your scars after they heal.
5. WHEN CALLING THE OFFICE TO SPEAK WITH A NURSE please be aware the nurse will return your calls based on her availability. If you have an emergency, please make this known. When you call, please have the following information available**:
   • name / date of birth
   • date of most recent surgery
   • type of most recent surgery
   • name and phone number for pharmacy
   • drug allergies
   • symptoms and onset / temperature
     **NOTE: Oxycodone and Dilaudid cannot be called in for a refill. These prescriptions require a new written prescription each time.
6. SPECIAL CONSIDERATIONS AS INDICATED:
   • GARMENTS/BINDERS: Garments (bras or girdles) help to reduce swelling and promote tissue retraction following certain surgeries. Wear it for about 3-4 weeks, around the clock, under clothing. The garment may be removed for bathing, or you may shower in the garment and blow it dry. The garment may also be loosened or adjusted as needed. Hand wash your garment and DO NOT dry it in the dryer. (Bring your second garment to your post-op visit.) Keep any dressings or steri-strips on as instructed.
   • DRAINS: Drains may be inserted to reduce blood/fluid accumulation at the surgical site. They should be emptied about 4 times per day, and more often if necessary. The bulb should be compressed when emptied, then closed. The tubing can be massaged as needed to maintain potency. Expect some oozing at the tubing insertion site. Gauze can be used to reinforce the site. The drain bulbs can be placed in the pockets of your jacket or safety pinned to your clothing. Drains are typically removed 1-2 weeks post-op. A drain record should be kept to record the amount of daily output.