NIGHT OF SURGERY
- Movement is Important: Make sure you are up and walking around immediately after your surgery. When lying down in bed or on the couch, make sure you are moving your legs and ankles. Take deep breaths frequently to keep your lungs clear.
- Sleep: Sleep on your back with your head elevated about 30-40 degrees (2-3 pillows). Do not sleep on your side. Keeping your body more upright will minimize swelling. Continue this for one to two weeks.
- Talking: Avoid excessive talking, laughing, and chewing as this will cause more swelling and discomfort.
- Antibiotic: Start your antibiotic tablet the night of surgery and take all tablets as prescribed and until finished.
- Pain: You will be prescribed a pain medication for post-operative pain control. If your discomfort after surgery is not strong you are welcomed to take Tylenol in place of the prescribed medication. Do not take Tylenol with the pain medication, often the medication you are prescribed will have Tylenol in it. Do not exceed 4,000 mg of Tylenol in any 24-hour period. Take medication with food to minimize risk of nausea.
- Nausea: A common side effect after general anesthesia and strong medications. If you are experiencing nausea, we advise that you take your nausea medication.
- Constipation: You will experience constipation if taking narcotic pain relievers. MiraLAX or other over the counter laxatives are recommended. Do not wait to take until you are constipated. Begin treatment with narcotic use.
- Medications to Avoid: Take only those medications approved or prescribed by your surgeon. Avoid medications containing aspirin or ibuprofen (Advil, Motrin, Naproxen, others) for two weeks before and after surgery. These medications may increase bleeding.
- Substances to Avoid: Avoid alcohol, nicotine, and caffeine, for these will dramatically slow the healing process.
- Diet: Eat foods that are soft and require minimal chewing for one week. Do not eat salads, tough meats, or chew gum. Chewing can cause an increase in pain and swelling.
- Hydration: Stay hydrated by drinking 8-10 glasses of water a day. Try to use straws when drinking fluids. Avoid alcohol while you are still taking pain medications.
- Showering: You may wash your hair and face the next day after your surgery. Do not cleanse eye area and avoid submerging your face in water.
- Hot Tubs/Baths/Swimming Pools: No tub baths or Jacuzzi until your incisions have healed, and approved by your surgeon, which is usually around 2 weeks. It is best to wait one month for hot tubs as they tend to have more bacteria than regular chlorinated swimming pools.
HOW TO TAKE CARE OF YOUR INCISIONS
- Eating: AVOID opening your mouth more than 1 inch wide to prevent incision site separation (opening) for 1 week.
- Cleaning your incisions: In the event of crusting around incision site, clean incisions with a wet cotton swab that is dipped in diluted hydrogen peroxide (¼ hydrogen peroxide, ¾ water). Then reapply antibiotic ointment.
- Sutures: At your first post-op office visit Dr. Kulak will remove all necessary sutures. All remaining sutures will be dissolvable. Sutures are usually removed 5-7 days after your procedure.
- Sun Exposure: Avoid and minimize sun exposure. Use an SPF 30 or greater when outdoors. Even a mild sunburn can worsen swelling, irritate an incision that is healing, and cause permanent scar discoloration.
- Scar gel: Each individual has a different healing process, but it takes approximately a year for these changes to occur and the scars to look their best. After your incisions have completely healed and when your doctor has told you it is safe, you can begin to use silicone-based gel on your scars to improve healing.
WHAT TO EXCEPT
- Swelling and Discoloration: It is completely normal to experience some swelling and discoloration from bruising around the surgical incision site.
- Mild Bleeding: Some mild bleeding is not unusual at the incision sites the first few days after surgery. If you try to do strenuous activity, increase your blood pressure by straining on the toilet, sneezing, heavy lifting or bending forward you will aggravate the bleeding and swelling.
- Pain and Itching: It is normal to experience tightness, pressure, mild to moderate pain, itchiness, and soreness around the surgical site.
- Sensory Changes in Skin: You may feel reduced or heightened sensation in the upper lip and surrounding area which is normal. You can expect return of normal sensation after a few weeks to months.
- Lip Movement: Avoid any stretching of the upper lip that could put strain on the incision below the nose or cause incision site opening.
- Physical Activity: It is important to get up, walk around, and not remain on complete bed rest while your body recovers. Normal daily activity may be resumed a few days after surgery. No bending over, straining, or lifting more than 5lbs for the first week after surgery.
- Exercise: Light physical activity may be resumed 2-3 weeks after surgery. Remember to start easy and build back up to your previous exercise levels. Just know that swelling may transiently be worse with exercise.
- Driving: Do NOT operate a vehicle or make important decisions until you have been off narcotic pain medications for 24 hours. Use good judgment.
- Return to work: Most patients require approximately 5-7days off work depending on their job responsibilities and amount of face-to-face interaction.
- Cold Compress: Use cool/moist compresses or ice wrapped in a small towel for 24-48 hours to reduce swelling. You may apply a compress for 20 minutes at a time and take a break every so often. No Direct Ice!
EMERGENCY SITUATIONS – WHEN TO CALL THE OFFICE (703-481-0002) OR GO TO THE HOSPITAL
- Signs of Infection: Spreading redness, worsening swelling, increased drainage or drainage of pus, worsening pain, warmth at incision site and temperature over 101 degrees Fahrenheit.
- Excessive Bleeding: If the incisions appear to be oozing blood excessively.
- Other Emergency Situations: Shortness of breath or difficulty breathing, chest pain, lightheadedness that does not quickly resolve, severe vomiting, pain, or asymmetric swelling in your legs.