RPS | Post-Operative Instructions

R P S | R O S I N G P L A S T I C S U R G E RY, I N C .
P O S T- O P E R AT I V E I N S T RU C T I O N S
General:
For patients undergoing general anesthesia, it is normal to feel dizzy and sleepy for several hours
after your operation. Therefore, you should not drive, operate any equipment, sign any important
papers or make any significant decisions until the next day. Once you are home after your procedure,
it is important to rest. Sitting in a recliner with your head & chest elevated is helpful for swelling.
You should rest and avoid lifting anything more than 5-10 lbs. However, you should be getting up
and walking to the bathroom and around the house as to not remain sedentary for too long.
Remaining sedentary will increase your chances of developing a blood clot in your legs (venous
thrombus). Blood clots in the legs will usually result in unilateral (one side) leg swelling and pain.
If this clot dislodges, it can travel to the lungs and cause a pulmonary embolus, which can be life
threatening. Pulmonary embolus presents as chest pain and shortness of breath. This is why it is
critical to avoid remaining sedentary for too long in the first few days after surgery.
Diet:
Let your appetite dictate your diet after surgery. In general, you should start with clear liquids and
progress to a normal diet as tolerated. You may have received narcotic pain medication that may
make you nauseated, if taken on an empty stomach. Soups and foods that are easy to digest are best
tolerated as you begin to eat (avoid spicy and fatty food). Drink plenty of fluids. Do not drink
alcoholic beverages for 24 hours. Usually after anesthesia, the BRAT diet is recommended: bananas,
rice, apple sauce, toast. Coﬀee or tea are acceptable. Yogurt is suggested as it will help prevent
complications involving the colon that can arise from antibiotics.
Restrictions after your surgery:
-
Do not bend over or lift objects heavier than 5-10 lbs. for one week
No strenuous activity for two weeks. Generally, 25% of strength first week, 50% second week,
75% third week, 100% fourth week. Yoga, elliptical, running - after 2 weeks
No swimming for 3 weeks.
Avoid direct sun exposure to surgical wounds as this can influence the scar appearance.
Avoid excessive alcohol intake and all smoking for 1 week after surgery.
Abstain from sexual activity for 2 weeks.
If you experience bleeding, take some clean tissue/paper towel and press directly on the bleeding
site with one finger for 10 minutes (do not remove your finger, watch television to distract
yourself.) If the wound is still bleeding, apply pressure for another 10 minutes. If this does not
stop the bleeding, call the oﬃce.
Temperature:
Please report any temperature over 101 degrees to our oﬃce.
**If there is an emergency, please call the oﬃce or go to the emergency room. If you feel there is a
life-threatening emergency, call 911.
R P S | R O S I N G P L A S T I C S U R G E RY, I N C .
P O S T- O P E R AT I V E I N S T RU C T I O N S
Medication:
The standard prescription after surgery is as follows:
1.
Percocet 5/325mg 1-2 PO Q6 hours PRN pain # 30, no refills (pain)
2.
Doxycycline 100mg PO BID x 3 days #6 (prophylactic antibiotic)
3.
Scopolamine Transdermal Patch to apply night before procedure and
remove after procedure #1, no refill (for nausea after anesthesia)
If prescribed an antibiotic, begin taking the antibiotic at night after the procedure. Do not take
antibiotics before the procedure. You may take the pain medication as needed according to the
instructions, 1-2 pills every 6 hours as needed. Start by taking one and see if this is enough to cover
your pain. If not, you can take another pain pill 30 minutes after the first. Remember to have something
in your stomach before taking narcotic pain medication to avoid nausea (soup, toast). If you are going to take
tylenol instead of the narcotic pain medication (which has tylenol in it), do not exceed the 24 hour
limit of 4000mg (MAX twelve Norco pills with 325mg of tylenol). The scopolamine patch is a
motion sickness medication that may help to prevent post-operative nausea and vomiting. Apply
the patch the night before surgery behind your ear or if having a facelift, above your clavicle.
Remove the transdermal patch the day after surgery. Unless specifically instructed, aspirin products
such as Bayer, Buﬀerin, Anacin, Excedrin, etc. should be avoided for at least 5 days after surgery.
This also includes Advil, Nuprin, Motrin, and Ibuprofen. Herbal supplements such as fish oil, garlic,
ginger, ginkgo biloba, ginseng, goldenseal, kava kava, melatonin, St. John’s wort should be avoided 5
days after surgery.
Sutures:
Face & eyelid sutures are removed 1 week after surgery. Abdominoplasty patients have internal
sutures that will absorb after several weeks. Liposuction sutures are removed 1 week after surgery.
Activity:
You may gradually increase your activity after 48 hours from surgery. It is essential that you remain
mobile and walk frequently during the day. You should walk around your house at least twice the
day of surgery. Remember:
- Do not bend over or lift objects heavier than 5-10 lbs. for one week.
- No strenuous activity for two weeks. Generally, 25% of strength first week, 50% second week,
75% third week, 100% fourth week. Yoga, elliptical, running - after 2 weeks
- No swimming for 3 weeks.
R P S | R O S I N G P L A S T I C S U R G E RY, I N C .
P O S T- O P E R AT I V E I N S T RU C T I O N S
Face & Neck Procedures:
After a face lift or neck lift procedure, I place a compressive head dressing to help reduce the chance
of a hematoma. This dressing may impact your ability to hear. If too tight at the neck, you may use
two thumbs to stretch the dressing for relief. The head dressing will come oﬀ in the morning at your
post operative visit. Usually, drains are removed the day after surgery as well. While the drains are
in place, use safety pins to keep the drains attached to your shirt or to the head dressing itself. This
will prevent them from tugging. If necessary, empty and record the drain output (see Drain Care
Instructions below)*. Usually, the drains will not fill up and therefore will not need to be emptied.
Sometimes the drains will not hold suction and will remain in a grenade shape. This is ok
and the drain will still function. Sleep with your head elevated on 2-3 pillows for the first week. This
will help with swelling. It is not uncommon to have one side of the face more swollen or bruised
than the other. This results from gravity when sleeping as the face is tilted towards one side or the
other. This will resolve with time. A neck elastic garment should be worn after the head dressing is
removed to compress the cheek flaps and neck and to provide support. The neck elastic should be
worn during day and night for the first week and at night only for the second week. After this, there
is no need for the neck strap. You can shower 3 days after surgery or 72 hours and wash your
hair. So, if your procedure was done on Wednesday, you may shower on Sunday. If your procedure
is on Monday, you may shower on Friday. Sutures and/or staples will be removed at the 1 week post
operative visit.
R P S | R O S I N G P L A S T I C S U R G E RY, I N C .
P O S T- O P E R AT I V E I N S T RU C T I O N S
Eyelid Procedures:
After surgery, place gentle ice compresses (A bag of frozen peas with a damp washcloth works best)
over your eyelid(s) for 20 minutes every hour, until bedtime, for the first 2 days after your surgery.
Then use the ice compresses for 4 times a day. Never place ice or frozen bags directly on the skin.
Starting the day after surgery you may gently cleanse the surgical area(s) with cotton balls or Q-tips
moistened with lukewarm water and hydrogen peroxide. This can help remove dried blood and
clean the wounds. Place a small amount of antibiotic ointment on the skin incision area 1-2 times a
day for one weeks. You can apply the ointment with a Q-tip. If your eyes feel irritated or dry, use
Refresh or Visine drops (Rite Aid, Wallgreens). Sleep with your head slightly elevated (on 2-3
pillows) for 2-3 days after surgery. If desired, you may wash your hair the morning after your surgery,
although try to avoid direct water contact (i.e. stand with shower head to your back) for the first
week. Please do not be alarmed by your appearance. Redness, bruising, and/or swelling of the
upper and lower eyelids, face, and cheeks occurs to a lesser or greater extent in all patients. Expect
your eyelids to be more swollen on the second postoperative day than on the first. Your eyelids will
be more swollen in the mornings than later in the day. Usually, there is some degree of asymmetry
with one side being more swollen and bruised than the other. Please note that some oozing or
drainage is common following a surgical procedure. Occasional bleeding into the white of the eye
may occur; this may take four to six weeks to completely resolve. Please be patient. Things will
return to normal in several weeks.
Continue your regular preoperative medications unless
specifically instructed otherwise. Your vision will be mildly blurry from the antibiotic ointment in
your eyes. If you experience a significant change in your vision, severe pain, high fever, sudden red
swelling or pus, call the oﬃce immediately.
R P S | R O S I N G P L A S T I C S U R G E RY, I N C .
P O S T- O P E R AT I V E I N S T RU C T I O N S
Breast Procedures:
You may remove the dressing the day after surgery. Wear a front zipping sports bra after the
dressing is removed for comfort and compression. It is advised to wear this for 2 weeks after surgery,
after which you may use whichever bra you choose. You can shower 3 days after surgery or 72
hours and wash your hair. So, if your procedure was done on Wednesday, you may shower on
Sunday. If your procedure is on Monday, you may shower on Friday. No Jacuzzi, bath, ocean or pool
swimming until two weeks postoperative.
I do not advocate any implant massage techniques as there is no solid data to support this practice
alters your long-term result in any way. If you have had breast augmentation, I recommend you
begin arm exercises of placing your hand on the wall and gradually walking your hand up the wall
above your head. Another exercise is to slowly raise both arms like you are doing a jumping jack.
Try to do either or both of these exercises 3 times per day after surgery for the first week. This will
assist keeping your shoulders flexible.
R P S | R O S I N G P L A S T I C S U R G E RY, I N C .
P O S T- O P E R AT I V E I N S T RU C T I O N S
Body Contouring Procedures (Abdominoplasty, Brachioplasty (arms), Body Lift, Thigh Lift):
You may remove the dressing and/or abdominal binder 2 days after surgery. For abdominoplasty, the
steri-strips should remain in place. These will eventually peel oﬀ. For arm surgery, you can remove
the ACE bandages 2 days after the procedure as well. You can shower 3 days after surgery or 72
hours and wash your hair. So, if your procedure was done on Wednesday, you may shower on
Sunday. If your procedure is on Monday, you may shower on Friday. No Jacuzzi, bath, ocean or pool
swimming until two weeks postoperative. You may remove the abdominal binder for showering.
Please replace the binder to keep your abdomen compressed. It is OK to wash the binder if you
desire. The abdominal binder should be worn for 1-2 weeks after surgery to compress the abdominal
flap and prevent seroma (body fluid) formation. The goal is for the abdominal skin to stick down to
the muscle and heal. Compression helps the healing process. You may gradually increase your
activity as tolerated after surgery. Keep the elastic support binder on during the day while
ambulating or the ACE bandages on the arms for arm procedures. It is essential that you remain
mobile and walk frequently during the day. You should walk around your house at least twice the
day of surgery. When walking, bend slightly at the waist so as not to put tension on your incision. If
you need to cough, hold a firm pillow over your abdomen with some pressure to lessen the
discomfort.
R P S | R O S I N G P L A S T I C S U R G E RY, I N C .
P O S T- O P E R AT I V E I N S T RU C T I O N S
Liposuction:
You may remove the compression garments/binders/dressings the day after your procedure to
shower. Typically, patients will need to wear the garments for 1 week. Some patients, especially after
a large amount of liposuction, will have blood-tinged drainage from the access incisions. This is
normal and expected for the first 2-3 days. For the first 24 to 48 hours, bulky super-absorbent pads
can be worn overlying the treated areas, and under the compression garments. If foam was placed at
the time of surgery, keep the foam and re-apply it after showering. The foam and compression
garments help the skin heal and ‘stick down’ to the underlying soft tissue. The goal is to create a
smooth surface of compression for 1 week after liposuction. Many patients choose to wear the
garments for a greater duration simply because of the comfort the garments provide. Wearing the
post-op garment for more than the minimal number of days provides no significant advantage in
terms of the ultimate cosmetic results. Patients may experience a brief sensation of dizziness the
morning after surgery, when the garments are first removed in order to take a shower. Feeling
lightheaded is similar to what you might experience when standing-up too quickly. It is the result of
rapid decompression of the legs after the post-op garments are removed. Should dizziness occur,
simply sit or lie down until it passes. You can shower 2 days after surgery or 48 hours. So, if your
procedure was done on Wednesday, you may shower on Saturday. If your procedure is on Monday,
you may shower on Thursday.
No Jacuzzi, bath, ocean or pool swimming until two weeks
postoperative. You can expect bruising and swelling in the areas of liposuction for 1-2 weeks after
surgery. Most of the time, patients will be a few pounds heavier immediately after the procedure as a
result of fluid from the procedure. It can take up to 6 weeks for all the swelling to resolve and see
the final result. If sutures were placed, they will be removed 1 week after surgery.
R P S | R O S I N G P L A S T I C S U R G E RY, I N C .
*DRAIN CARE
1. The bulb should remain compressed. This creates negative pressure causing suction. If it is
not compressed, then some drainage will still occur through capillary action, though it is
better to be compressed.
2. Record the output of the drain daily by opening the valve and allowing the drain bulb to
expand. This will allow you to read the calibrations properly. Once recorded, empty the
contents and discard them. Re-compress the bulb.
3. Bring this record to the oﬃce on each post-operative visit.
4. Do NOT disconnect, kink, or puncture the tubing that is attached to the suction bulb.
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DRAIN
Day 1: ' '
24 hr:' '
Amount'
L _________'
R _________ '
Day 2: ' '
24 hr:' '
Amount'
L _________'
R _________'
Day 3: ' '
24 hr:' '
Amount'
L _________'
R _________ '
Day 4: ''
24 hr:' '
Amount'
L _________'
R _________
Day 5: ' '
24 hr:' '
Amount'
L _________'
R _________ '
Day 6: ''
24 hr:' '
Amount'
L _________'
R _________
Day 7: ' '
24 hr:' '
Amount'
L _________'
R _________ '

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