Edward D. Buckingham, M.D.

Facial Plastic & Reconstructive Surgery

Postoperative Instruction Sheet

Postoperative Anesthesia

After anesthesia, you may feel nauseated and may even experience vomiting for the first 24 hours.  You may take anti-nausea medication if prescribed to alleviate your symptoms.  If your vomiting persists despite medication, please contact us immediately.  You should feel much better by the next day.  If you are still suffering nausea and vomiting after the first 2 days, please let us know.  If you were sedated or underwent general anesthesia, do not drive or operate any machinery as you may injure yourself or others.  Sometimes, the narcotic pain medications you are taking may also cause some upset stomach and/or nausea.  Try taking these medications with food, or abstain from taking them if they cause undue nausea and vomiting.  It is also natural for you to feel a bit of fatigue for the first 2 to 3 days after surgery as your body recovers from the combined effects of surgery and anesthesia.

Items needed for post-operative care: Hydrogen Peroxide, Polysporin Ointment, Q-tips, Ice Pack

Showering and Water Exposure

Please do not get your wound area wet until all bandages have been removed.  (If you are having nasal plastic surgery, please follow the bathing directions on that sheet.)  If you do not have bandages, please do not shower or get your wound wet for the first 24 hours.  After this period of time and after your bandages are off, you may shower and gently dry your wounds.  After the first day, you may gently wash your face with mild soap and water.  Try to avoid any vigorous cleaning of the suture line.

Wound Care

1. The suture line should be cleaned 2 to 3 times daily with mild soap and water.  If crusting persists use a q-tip or cotton balls soaked in hydrogen peroxide to remove.  (Be careful near the hairline if you have dark hair to avoid bleaching the hair.)  Again, care should be taken as the sutures are delicate and can be broken if vigorously cleaned.  Blot dry and apply polysporin (generic- double anti-biotic ointment), to the wound edges with a clean q-tip so that a crust (scab) does not have a chance to form.  If you develop a red, itchy, blistery area after you apply the antibiotic ointment, stop applying the ointment as a small percentage of patients may develop an allergic reaction to it.  Also you may refrain from applying any ointment at night so as not to soil your bed sheets.  Try to use a q-tip instead of your fingers when applying ointment, because your fingers may be dirty and cause an infection in your suture line.

2. Apply ice packs over the wound, except in cases of pedicled flaps (small attachment of skin with blood supply), for the first 24 to 48 hours as it will significantly reduce your postoperative swelling and cut down on your recovery time. You may do so every 20 minutes to one hour as it is convenient.  After the first 2 days, ice packing will not lessen any swelling.

3. Sleeping at night with your head elevated with a couple of pillows will also help reduce the amount of swelling and reduce your recovery time. Sleep on your back or side only.

4. Avoid any hot packs to your face as you may burn yourself unknowingly.  After your surgery, your wound area will be numb for several weeks, and you may burn yourself if you apply too hot an object (such as a curling iron to your hair or even if you blow dry your hair) near or on your operated skin.

5. If you routinely wear make-up, please refrain from doing so for at least the first week after surgery.  Make-up may cause significant irritation to the skin and also adversely affect your wound healing.  Further, perfumes and colognes may irritate your wounds, so try to minimize or abstain from using these kinds of products near your wounds during the first week as well. If you had a brow lift or facelift, or any surgery near the hairline, please postpone any planned permanent waves or hair coloring for four weeks following surgery.

6. Your stitches will be removed 1 week after surgery.  Continue using Polysporin for 2 days after the stitches are removed. After 2 days you are encouraged to begin using sunscreen SPF 15-30.

7. Avoid any excessive rubbing or scratching of the wound area as this may disrupt the suture line or cause darkening of your skin.  If you should have severe itchiness around the wound area, contact us immediately so that we may prescribe a medication to alleviate your symptoms.

Antibiotics

If we prescribed antibiotics, please take them as directed.  It is recommended that you take your antibiotics with food to minimize any chance of an upset stomach.  If you are nauseated, please wait until the nausea has subsided before resuming your antibiotics.  If you develop diarrhea, please stop taking your antibiotics.  If your diarrhea should persist, please contact us regarding this matter.  If you should develop a fever (> 100.5) after the first 2 days, please let us know as well.

Pain Management

If you have significant pain after surgery, please take the prescribed pain medication.  Please be sure to take your pain medication not more frequently than prescribed.  Also, as this medication is a narcotic, you are advised against driving or operating any machinery while taking your pain medication.   Further, you should not partake of any alcohol when using narcotic pain medications.  If you have only mild pain, you may take plain Tylenol to alleviate your symptoms.  However, if you take plain Tylenol you should wait four hours before resuming your other pain medications as they frequently already have Tylenol in them, and you do not want to overdose on Tylenol.  You should also avoid taking any other pain medications, especially aspirin or aspirin-related products (See the Preoperative Instruction Sheet for a partial list of aspirin and aspirin-related medications).  If you develop any unexplained pain, you should report this to us immediately.

Bruising and Swelling

It is normal that you have moderate bruising and swelling after surgery for the first 2 weeks.  You will notice every day that the bruising and swelling are diminishing.  However, if you develop any new-onset swelling, especially in the first 2 to 3 days, please let us know immediately.

Sun Exposure

Excessive exposure to sun in the first 3 weeks after surgery may result in prolonged facial swelling and injury to the skin.   Also, excessive sun exposure to your wound area may cause your wound to darken (hyperpigment) in relation to the surrounding skin.  If you must go into the sunlight, wear a wide-brimmed hat and apply one of the SPF 30 sun-block preparations, preferably with titanium dioxide or zinc oxide, available at your pharmacy. We offer a post-operative SPF 30 sun block for faces with both of these ingredients.

Exercise & Activity

For the first 2 weeks, please refrain from bending over or straining very hard.  If you are constipated, please inform us so that we may prescribe you a laxative.  It is acceptable to begin light walking 24 hours after surgery.  Jogging and light non-contact exercise should not be resumed until 2 weeks, whereas strenuous sports require 6 weeks of healing before being safely resumed.  If you feel that you are too weak to perform a given activity, then you should listen to your body and rest appropriately.

Other Things to Avoid

Please reread the Preoperative Instruction Sheet carefully and review all the medications, vitamins, and herbal supplements that you should avoid before and after surgery, including the advice about smoking and drinking.  If you should have any questions about your surgery or about any of the instructions written above, please do not hesitate to contact us at 512-401-2500 or 866-451-2500.