Edward D. Buckingham, M.D.
Facial Plastic & Reconstructive Surgery
Preoperative Instruction Sheet
| PLEASE READ THE FOLLOWING LIST OF INSTRUCTIONS VERY CAREFULLY TO MINIMIZE ANY ADVERSE SURGICAL OUTCOMES. IF YOU SHOULD HAVE ANY QUESTIONS, PLEASE DO NOT HESITATE TO ASK US. |
Aspirin & Aspirin-Related Products
Aspirin and aspirin-related products (see following list) should not be taken either 2 weeks before or after surgery because they increase the tendency of bleeding.
For this reason, it is very important that contents of any “over-the-counter preparations” be checked carefully prior to their use.
Many headache preparations, cold remedies and “hangover cures” contain ASPIRIN. The chemical name of aspirin is acetylsalicylic acid.
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Examples of drugs containing salicylates (aspirin) are as follows:
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| Acetidine Alka-Seltzer Anacin Anahist APC Aspirin BC Bromo-Quinine Bromo-Seltzer | Bufferin Coricidin Darvon Compound Dristan Ecotrin Empirin Compound Excedrin 4-Way Cold Tablets Inhiston | Liquiprin Midol Pepto-Bismol Persistin Sal-Sayne Stanback Theracin Trigesic |
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Examples of aspirin-related products are as follows:
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| Advil Anaprox Ansaid Arthrotect Cataflem Lodine Mefenamic Acid Clinoril Daypro Diclofenac Naprosyn Etodolac Feldene | Ibuprofen Indocin Indomethacin Ketoprofen Ketorolac Tolectin Mobic Motrin Naprelan Voltaren Naproxen Nuprin | Orudis Oruvail Piroxicam Ponstel Relafen Sulindac Tolmetin Toradol Dolobid |
You can substitute TYLENOL (acetominophen) for these products if you require pain medication before surgery.
Check with your pharmacist if you are uncertain whether a medicine contains aspirin.
Herbal Medications & Nutritional Supplements
Some herbal medications and nutritional supplements may also increase bleeding or photosensitivity (i.e., sun sensitivity). Please discontinue all herbal medications and nutritional supplements 2 weeks before and 2 weeks after surgery. In particular, discontinue use of the following medications and supplements 2 weeks prior to surgery and for 2 weeks after surgery. Some of the following plant foods, such as celery, dill, fennel, may be used in moderation in your diet.
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Some herbal medications that may make you bleed:
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| Bilberry Black cohosh rhizome Kava kava Cayenne Dong quai Echinacea Feverfew Fish oil caps Garlic Ginseng Ginkgo biloba | Hawthorne Horse chestnut bark Tonka bean seeds Licorice root Ma huang (ephedra) Meadowsweet flower Melatonin Poplar bark or buds St. John’s wort Sweet birch bark Sweet clover plant | Sweet vernal grass leaves Sweet-scented bedstraw plantValerian Vanilla leaf leaves Willow bark Wintergreen leaves Woodruff plant Yohimbe |
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Some herbal medications that may make you sensitive to the sun:
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| Angelica root & fruit Celery Dill Fennel Khella fruit Lomatium root Lovage root | Cow parsnip Parsley Queen Anne’s lace Agrimony Bergamot peel Bitter orange peel Buttercup plant | Fig Goosefoot Lemon peel Psoralea seeds Rue leaves St. John’s wort Yarrow plant |
Vitamins
If you are taking a routine multi-vitamin, you may continue doing so. However, if you are taking any vitamin E pills, please stop 2 weeks before and 2 weeks after surgery, as this may increase your chance of bleeding.
Prescribed Medications
If you are taking prescription medications, e.g., for high blood pressure, please continue to do so even the morning of surgery, except:
1. If you are diabetic, please refrain from taking your diabetic pills or insulin injection the morning of surgery as you will not be eating or drinking anything that morning. Please also check your blood sugar level that morning prior to coming to the hospital. If your blood sugar is excessively low (below 80) you may take a few sips of orange juice.
2. If you are taking prescription pain medications, e.g., for arthritis, please ask us if you can safely continue these medications. Some of these medications contain aspirin or aspirin-like products that may cause you to bleed. (See the previous page for list of aspirin-related products.)
If you are asthmatic, please take your inhaler(s) the morning of surgery as well as per your routine schedule.
Diet
Do not eat or drink anything (including gum, mints, etc.) after midnight the night before surgery. On the morning of surgery, you may have a few sips of water when you take your prescription medications. Otherwise, do not eat or drink anything that morning.
Tobacco
Nicotine in any form, including cigarettes, cigars, chewing tobacco, and even transdermal patches and gum can adversely affect your wound healing. If possible, you are advised to stop all forms of tobacco 2 weeks before and after surgery, especially if Dr. Buckingham is performing a FLAP reconstruction (e.g., facelift, cancer reconstruction, etc.). There is a chance that you may compromise the success of your surgery if you should continue to take tobacco.
Alcohol
Try to abstain from any heavy drinking 2 weeks prior and after surgery. If possible, curtail even moderate social drinking the week prior and after surgery.
On the Day of Surgery…
1. Please wear a button-down shirt instead of a pull-over shirt so that you may change clothes afterwards without disturbing your wound or soil your clothing.
2. Also do not engage in any vigorous cardiovascular exercise the morning of surgery. Increasing your blood flow with exercise the morning of surgery may increase your chance of bleeding.
3. Please make sure that you have arranged to have someone transport you home after the surgery if you’re scheduled to go home afterwards. We also believe it is mandatory in many cases to have a companion or family member stay with you for the first 24 hours after surgery.
4. If you wear fingernail polish, please ensure that at least one fingernail is free of polish so that the pulse oximeter (the device that reads your oxygen levels) may properly function.
5. Please wash your face the morning of your surgery, preferably with an antibacterial soap.
Also…
Please read all your postoperative instructions very carefully now before your surgery. You should clean all your wounds with mild soap and water or Hydrogen Peroxide (sparingly), and apply Polysporin Ointment using Q-tips.
We greatly appreciate the confidence you have shown in us by allowing us to assist you in improving your appearance and health, and you may be assured of our best efforts to achieve the most satisfactory surgical result possible for your particular individual anatomy and condition.
Edward D. Buckingham, M.D.