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The following information is based on our experience with thousands
of office procedures. Its purpose is to provide you with important
informtion which will be useful to you during the operative and
post-operative period.
Surgical procedures may be performed either in the hospital
operating room, LRMC Ambulatory Surgery Center or in our office
operating room. While office surgery may save the patient several
hundred dollars, one should realize that there are some differences
when compared with hospital surgery. We have to use local anesthesia
and are unable to sedate as heavily before the operation as we
can in the hospital. Consequently, only some of the many types
of procedures are appropriate for office surgery such as those
that are of relatively short duration and which do not require
general anesthesia.
Not everyone should have office surgery. Those who are too anxious,
those who want to be asleep and those with a suspect medical
history should go to the hospital or ambulatory center surgery
center. During your initial consultation, when appropriate, the
various advantages and disadvantages of hospital surgery, ambulatory
center surgery and office surgery will be presented to you.
You will be given a time to arrive at office. Depending upon
the nature of the procedure and individual preference, a sedative
is sometimes given on arrival. The surgery will be performed
under local anesthesia and with the exception of the injection,
should be comfortable. The length of time for the surgery varies
with the complexity of the procedure but an estimate time will
be given to you during the preoperative consultation visit. After
the procedure is finished, you will be discharged to the responsible
adult who accompanies you.
- Do wear loose comfortable clothing which is easy to remove
and replace.
- Do eat a light breakfast if you are having afternoon
surgery.
- Do not have breakfast if you are having morning
surgery.
- Do have a responsible adult to accompany you and
to spend the night with you if necessary.
- Do wear flat shoes.
(Walking in high heels can be hazardous when you are sedated.)
- Do inform us if you have taken any medication on a regular
basis or have any drug allergies.
- Do not take aspirin routinely
two weeks before surgery. Avoid ibuprofen for 48 hours.
- Do
bring sunglasses if having eyelid surgery.
- Do wash your hair
the night before surgery.
- Don't plan to drive yourself home
after surgery.
- Don't drink alcoholic beverages the day of
surgery.
- Don't wear makeup to the office.
Immediately after an incision is closed the sutures provide
100% of its strength. During the next few days natural wound
healing begins and wound strength increases. In some areas, such
as eyelid where the tension is minimal, the wound is strong enough
to remove sutures at three or four days. In other areas, such
as the face, a longer time is required for the wound to become
strong enough. Some degree of redness around the individual sutures
is common and does not indicate infection. If the redness is
along the whole suture line or if the suture line is tender or
swollen, you should have the area examined. Usually, antibiotics
will quickly reverse these effects.
Do not be overly apprehensive about suture removal. The process
is usually relatively painless and brief and our personnel are
well trained and expert in their removal under our direction.
Usually, you will be able to wear makeup, wash hair, shave, etc.
following suture removal. The doctor will advise you regarding
this.
Sutures are also used beneath the skin, made of a substance
which is absorbed by the body. It is normal for several weeks
after the skin sutures are removed for small pimple-like processes
to appear in the wound. This is the body reacting and absorbing
the sutures underneath the skin. These should be left alone and
the body will take care of them.
All surgery causes some degree of swelling. This is simply a
response to injury and is temporary. In the facial area the swelling
is more apparent because it tends to distort the features. Swelling
will resolve much more quickly if the injured part is elevated.
Occasionally, ice compresses will be recommended for the first
twenty-four to thirty-six hours after facial plastic surgery.
Try to use the compresses twenty minutes at a time, then rest
twenty minuses and resume. Though comforting, the compresses
probably do no good after the swelling is present.
Discoloration is simply due to microscopic amounts of blood
which are present in the tissue. It will resolve. During the
time of absorption the color will change and move about somewhat.
The time required to fully absorb the blood varies from patient
to patient but usually requires two to three weeks. It can be
covered with makeup after the first week. You can camouflage
the discoloration to some extent by using a thick makeup. A water
base makeup, pancake by Max Factor (two shades darker than your
skin color) may be applied with a moist sponge. After it dries,
a second layer may be applied. It can be removed with water.
Merle Norman's retouch cover cream (two shades darker than your
skin color) may be used over hard to cover areas but this is
somewhat more difficult to remove.
Do not apply makeup over the incisions themselves for several
days after the sutures have been removed.
You will be instructed on the cleaning of the suture line by
the nursing staff. In general, it is necessary to clean the wound
three times daily with Q-Tips using Peroxide to initially clean
the wound and then to apply a thin layer of antibiotic ointment.
For the first day or so some bleeding is to be anticipated from
the wound. If there seems to be continuous ooze then simply apply
pressure to that area with a clean gauze for five or ten minutes
by the clock.
Discomfort following facial surgery is usually mild and usually
controlled with mild pain medication. If indicated, a prescription
for pain will be given. Severe pain occurring during the first
twenty-four hours following surgery may indicate a collection
of blood (hematoma) and should be evaluated by calling the office.
Infection is uncommon after facial plastic surgery
but does occur occasionally. Some specific procedures maintain
a higher infection risk than others. Consequently, on occasion
a prescription for an antibiotic will be given. A low-grade
temperature after the operation does not necessarily mean an
infection is present. Generally the body temperature does not
rise much above 100 degrees following surgery and is usually
due to a mildly dehydrated state because of diminished fluid
intake.
During the consultation visit, charges will be reviewed for
you by our office personnel. Every attempt is made to give an
accurate estimate of the final charges prior to surgery. However,
especially when dealing with cancer, it is impossible to know
the extent of the surgery and complexity of reconstruction until
after therapy has been initiated.
Our physicians are participating physicians with Medicare, Blue
Cross and Blue Shield, Evolutions Health Care, Capp Care/Beach
Street, BCS Emergis, Health Choice, HealthEase, CCN, and United
Health Care. In general, fees for elective facial cosmetic surgical
procedures are payable in advance. Remember, if you have any
questions about charges, insurance coverage, methods of payment,
etc., please do not hesitate to discuss them with us.
You should contact us at any time if you have a question or
if you have any difficulty. Call 352-728-2404. During regular
office hours our office staff will answer and assist you. After
hours for emergencies call this number. An answering service
will answer and in turn notify one of us who will then return
your call.
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