Plastic Surgery Guide

Oral Surgery

If you have undergone surgery inside your mouth, frequently rinse with Peridex. You should be on a liquid diet for 48 hours followed by a soft diet for an additional three days.

Medications

• Antibiotics: eat yogurt, drink acidophilus milk, or take lactobacillus capsules daily to decrease the possibility of yeast infection.
• Regular prescriptions: continue as prescribed by your physician.
• Two days following surgery: Take pain medication regularly, such as 1-2 Tylenol pills every four hours. Scientific evidence has proven that following surgery, a low but definite blood level of mild pain medication goes a long way toward controlling discomfort. Stronger pain medicine is available if you need it. Many patients find that their discomfort slightly increases late in the afternoon or evening. If you are not bothered by pain or discomfort or do not have trouble sleeping, you do not have to take pain or sleep medication.
• Menstrual cycle: Women may experience irregular, or even miss a period or two, for a month or two following surgery. This is normal. Your body will soon adjust and return to its regular cycle. Continue with your regular birth control program.

Two to Three Days after Surgery

• Visitors: Family and friends are very important during the recuperation period. However, you may want to be left alone to sleep or rest. It is important to decide how often you will have visitors, and for how long.
• Activity: You will probably feel better and eager to be up and about. Alternate periods of activity with periods of rest throughout the first several days. You can take brief walks, be sure to wear your hat, scarf, and sunglasses.
• Site swelling: As part of the healing process, your body absorbs extra fluids and nourishment during the first 24 to 48 hours after surgery. By the second day, you will notice an increase of swelling at your operative site. This is normal and will resolve over the next several days to several weeks. Elevating the area and applying icy cold compresses will help decrease swelling. Also, be sure your room is not too warm, as elevated air temperature will increase swelling.
• Oozing: Small capillaries may continue to ooze for several days, and bruising is the result. Your body absorbs this fluid over the next week to ten days. As small blood cells break down during this absorption process, you may notice residual discoloration for a few weeks. This is rare and usually quite minimal. Limit direct sun exposure while bruising, and discoloration is present, as the sun will exacerbate these conditions. You may find relaxing in a warm tub very soothing. If you still have dressings, however, be sure they are kept dry or wait until they are removed. Usually, you may shower after two days, and bathe after one week.
• Irritation to intravenous site: apply a warm moist washcloth can help to alleviate it.

Three to Five Days after Surgery

• Fever: You may continue to run a low-grade fever for a few days. It usually signifies that you need to take deeper breaths. If your temperature rises above 101 degrees, call the office.
• Constipation: Mild constipation may occur caused by pain medication, inactivity, and surgery. Continue drinking plenty of liquids–six glasses of water or juice a day--and take one or two tablespoons of Metamucil or a comparable product each morning. A glass of prune juice or an ounce of Milk of Magnesia may also help.
• Swelling: Beginning to resolve at this point. You may notice slight, shooting discomfort. This is a sign that nerves are returning to normal. Some firmness of the operative site is also normal while swelling is present. Remember that your stitches will still be tender.
• Appetite: It may still be decreased. Continue to avoid excess salt, sugar, spices, fatty dairy products, and alcohol.
• Activity: Rest as much as necessary. You may increase your level of activity each day, but stop when you feel tired. If you have had a tummy tuck, you should continue to walk with you back flexed, though every day you may stand gradually more erect.
• Intimacy: Shortly after surgery, many patients desire closeness and intimacy with the one they love. Hugging, embracing, and kissing is certainly recommended. When you feel up to it, you may resume sexual activity. Explain to your partner that you must go very slowly and gently until your soreness resolves and you are totally recovered.
• "The Blues": Almost everyone experiences symptoms of mild depression or anxiety during recovery, usually about five days postoperative. You may find yourself short-tempered or withdrawn, lashing out angrily at family and friends or crying. The depression, which occurs after cosmetic surgery, is often the psychological response to reaching your goal and the time has come to move on to the next phase in life. You CAN get through this period by reminding yourself that what you are going through is perfectly normal. Keep yourself busy and your mind off your temporary appearance. You can probably think of dozens of projects you've been putting off that will fill up your time without tiring you out. Fresh air will make you feel better. Walking can also help to decrease depression, as well as speed up the healing process.

Five to Seven Days after Surgery

• Stitches: During your first few visits, Dr. Sayah will change your dressings and give you helpful hints. Remember that wounds often heal with slight crustiness or swelling. Once your stitches have been removed, you will have regular postoperative follow-up appointments. Also, if after a few weeks you notice a few small absorbable surface stitches still left they are easily removed or often fall out on their own.
• Makeup: If you have had facial surgery, you can use a standard cover-up makeup to hide black and blue areas. DO NOT put any makeup directly on any incision line.
• Bruising: Your soreness and swelling are resolving, and your bruises are changing color as they, too, resolve. If the healing process seems to "plateau" for a few days, don't worry. Soon you'll notice your bruises fading again.
• Activity: Your energy reserves may be very limited, and you may find that you still need to rest a great deal. Many patients go through a period of frustration because they don't look as good or feel as well as they would like. Be patient! Your body needs good 4-6 weeks to recover from the trauma of surgery. Gradually, you will feel better and require fewer and shorter rest periods.
• Diet: Continue drinking plenty of juices. There is evidence that pineapple juice and tomatoes decrease bruising at this stage, so you might want to include these when planning your daily meals.
• Constipation: If it continues, a daily ounce of Milk of Magnesia should help. If you are taking vitamins, particularly those with added iron, your stools may be dark.
• Driving: Go out for a test-drive with a friend before setting out on your own. If you've had facial surgery, continue to use a sunblock on any exposed incision site.
• Returning to work: Be careful not to overdo it. Your body will let you know if you try to do too much. If possible, begin by scheduling a shorter workday than usual, or take more breaks during the day. Try to postpone any meetings or projects that may be especially stressful.

Two Weeks after Surgery

• Diet: You may resume Vitamin E supplements, Asian foods, papaya juice, meat tenderizers, and any other food associated with increased bruising. You may also take aspirin or aspirin-related products. As long as you are not taking any medications, you may drink light alcoholic beverages. You should still avoid excess salt and spices, as these cause your body to retain fluids and prevent the resolution of swelling.
• Activity: Light exercise. Moderate to fast walking, stretching, and light lower extremity exercises should be started slowly. Do a bit more each day. Don't be discouraged if you are stiff and somewhat slow at first. The increase of body fluids during the past two weeks may result in temporary weakness and some muscle stiffness. If you have had a tummy tuck, you may walk perfectly erect at this point. Avoid rotation of your torso as this may stir up bleeding or oozing.
• You will be instructed on self-breast massage if you have had a breast augmentation.
• You should switch to warm compress at this point to minimize any further swelling or bruising.

Three Weeks after Surgery

• Appearance: You are probably back to work now or, if you are a student, back in the swing of things at school. You may find yourself at a plateau stage where most of the swelling is resolved, and now you see little difference from day to day. You will be happier with your appearance every day.

Six Weeks to Six Months after Surgery

• Activity: Jogging, nautilus training, light aerobics and swimming in a pool is permitted. Continue to protect your skin from the sun by wearing hats, scarves, sunglasses or sunblocks. Avoid electrolysis or waxing around your operative sites for at least 10-12 weeks.
• Emotionally: Patients feel they are back to normal–emotionally as well as physically. Whatever soreness remains at your surgical site is rapidly resolving and should be minor at this point. Keep in mind that it will take three months or longer before all swelling and asymmetry resolve.
• Office Appointments: Dr. Sayah will closely check your progress throughout this period.

Personal Incision Care Program

• A scar is part of the healing process, the idea of scarring is frightening to the patient. We attempt to compromise by treating your incisions in a way that allows proper healing while camouflaging the incision sites and minimizing scarring as much as possible. Most plastic surgery scars are very inconspicuous. Your incision lines heal in four phases, as follows:
• This program will improve the contour and final appearance of your incision lines.
• Please DO NOT independently use any creams, treatments or vitamins on your incision lines without first checking with our office. Many of these treatments may actually worsen your scars.
• Day 1-14: Characterized by slight oozing and crusting; bruising and soreness resolve in seven to ten days; ice compresses are helpful. See care instructions below.
• You may shower after 48 hours when your incision line is sealed and bandages and surgical tape are removed.
• Apply prescribed cream or ointment lightly twice daily until the area is completely healed.
• Six weeks to six months: scars lose their redness, itchiness and tenderness gradually subside; areas flatten and begin to blend.
• For six months, your incision line must be totally protected from sun exposure. Brown camouflage Micropore tape (available at our office) can be used over the area as protection while improving scar thickness.
• Always test new products on a small area of your incision line overnight to ensure that you don't develop a rash or irritation.
• If you have a genetic tendency toward hypertrophic scarring or keloids, the following treatments may be instituted:
  
  • Silicone sheeting over your incisions (available at our office)
  • Topical cortisone, such as hydrocortisone 2'/2%, applied twice per day for 2-4 weeks.
  • Small injections of Kenalog, two to four treatments, two to four weeks apart.
• In rare cases where permanent excessive scarring is still present after one year, surgical revision and/or radiation treatments can be used.

We Want to Hear from You

Frequently, during the administration of medical care, patients remain too quiet regarding their needs, recommendations, questions, and concerns. We encourage and desire your comments and are always open to ways we might better meet your needs. We would appreciate your telling us if you had a good experience. We also want to know if your experience was less than you expected. Dr. Sayah wants you to continue looking great your whole life. In addition to successful plastic surgery, many factors contribute to an attractive, youthful appearance.