Patient Resources

STARTING NOW: Two Weeks Prior to Surgery

Take Multivitamins: Start taking a brand name (ex. One-A-Day) multivitamin daily to improve your general health once you have scheduled your surgery.

Take Vitamin C: Start taking 1000 mg of Vitamin C daily to promote healing.

Do not take aspirin or ibuprofen: Stop taking medications containing aspirin or ibuprofen. Review the list of drugs containing aspirin and ibuprofen carefully. Such drugs can cause bleeding problems during and after surgery. Instead, use medications containing acetaminophen (such as Tylenol).

No vitamin E: No supplemental Vitamin E. Vitamin E contained in a brand name multivitamin is acceptable.

Fill your prescriptions: You will be given prescriptions for medications. Please have them filled BEFORE the day of surgery and bring them with you.

THE DAY BEFORE SURGERY:

Confirm surgery time: We will call you to confirm the time of your surgery. If you are not going to be at home or at your office, please call us to confirm at (210) 495-5771.

Prescriptions: Make sure that you have filled the prescriptions you were given.

Cleansing: The night before surgery, shower and wash the surgical areas with Cetaphil cleanser. Remove all make-up and mascara from your eyes.

Eating and drinking: Do not eat or drink anything 8 hours prior to surgery – including water.

THE DAY OF SURGERY:

Special information: Do not eat or drink anything if you are having your surgery at the surgery center! If you are having surgery at the office have a light breakfast or lunch but do not have coffee. If you take a daily medication, you may take it with a sip of water in the early morning.

Oral hygiene: You may brush your teeth but do not swallow the water.

Cleansing: Shower and wash the surgical areas again with a mild cleanser such as the Obagi cleanser or Cetaphil.

Make-up: Please do not wear moisturizers, creams, lotions, or makeup.

Clothing: Wear only comfortable, loose-fitting clothing that does not go over your head. Remove hairpins, wigs, and jewelry. Please do not bring valuables with you.

You should plan to arrive 90 minutes earlier than your scheduled surgery time to the surgery center. For in-office surgery you should arrive at your scheduled time. Patients less than 18 years old must be accompanied by a parent or legal guardian.

VITAMINS/HERBAL SUPPLEMENTS: The vitamins and herbal supplements can cause abnormal bleeding problems and can affect your cardiovascular system. Below is a list of herbal supplements/vitamins that may affect surgical outcome and safety. These vitamins/herbal supplements should be avoided for at least four weeks prior to surgery.

Dong Quai
Gingko Biloba
St. John’s Wort (all types)
Echinacea
Ginseng
Valerian
Ephedra
Glucosamine
Feverfew
Goldenseal
Vitamin E (more than 400 IU daily)
Fish Oils (Omega‐3 Fatty acids)
Kava
Garlic
Licorice

DIET PILLS: Patients having surgery must discontinue any diet pills for at least 2 weeks prior to surgery. This includes but is not limited to Phentermine, Reduze, Ephedra (any type), and both Prescription and Over‐the‐counter Non‐Prescription Diet Pills. Please let Dr. Lopez know if you have any questions about this policy, but the unknown risks of these substances (however small they may be) are simply not worth it when having an elective procedure.

NICOTINE PRODUCTS: Nicotine reduces the blood flow to the skin any may impair healing. Quitting smoking drastically improves the body’s response to surgery. In order to be scheduled for an elective procedure, Dr. Lopez requires cessation of all nicotine products listed below for six before surgery and six weeks after surgery.

Nicotine Gum
Cigarettes/Cigar
Patches

YOUR FIRST 24 HOURS: If you are going home, a family member or friend must drive you because you have been sedated. Someone should stay overnight with you.

DRESSINGS: Keep your dressings as clean and dry as possible. Do not remove them unless instructed to do so.

ACTIVITY: Take it easy and pamper yourself. Try to avoid any straining. You may go to the bathroom, sit and watch TV, etc., but NO MATTER HOW GOOD YOU FEEL, DO NOT CLEAN THE HOUSE, REARRANGE THE ATTIC, ETC.! We do not want you to bleed and cause any more swelling and bruising than is unavoidable.

ICE PACKS: Cold or ice packs help to reduce swelling, bruising, and pain. Use frozen peas in the package or crush ice cubes and put the ice into a zip-lock bag. This should help, not hurt. If the ice feels too uncomfortable, place a thin barrier between the ice and the skin. Dr. Lopez recommends placing the cold packs on the surgical site every twenty minutes while awake.

DIET: If you have any postoperative nausea, carbonated sodas and dry crackers may settle the stomach. If nausea is severe, take the Phenergan that was prescribed. If you feel normal, start with liquids and bland foods, and if those are well tolerated, progress to a regular diet.

SMOKING: Smoking reduces capillary flow in your skin. We advise you not to smoke at all during the first 6 weeks after surgery.

ALCOHOL: Alcohol dilates the blood vessels and could increase postoperative bleeding. Please do not drink until you have stopped taking the prescription pain pills, as the combination of pain pills and alcohol can be dangerous.

DRIVING: Please don’t drive for at least 2 days after general anesthesia or intravenous sedation or while taking prescription pain pills.

POST OPERATIVE APPOINTMENTS: It is very important that you follow the schedule of appointments we establish after surgery.

In general, the least serious problems occur more often and the more serious problems occur rarely. If a complication does arise, you, Dr. Lopez or Dr. Perro and their staff will need to cooperate in order to resolve the problem. Most complications involve an extension of the recovery period rather than any permanent effect on your final result.

Normal symptoms swelling and bruising: Moderate swelling and bruising are normal after any surgery. Severe swelling and bruising may indicate bleeding or possible infection.

Discomfort and pain: Mild to moderate discomfort or pain is normal after any surgery. If the pain becomes severe and is not relieved by pain medication, please call us at (210) 495-5771.

Crusting along the incision lines: Not uncommon and is treated with antibiotic ointment generously applied.

Numbness: Small sensory nerves to the skin surface are occasionally cut when the incision is made or interrupted by undermining of the skin during surgery. The sensation in those areas gradually returns–usually within 2 or 3 months up to 1 year as the nerve endings heal spontaneously.

Itching: Itching and occasional small shooting electrical sensations within the skin frequently occur as the nerve endings heal. Ice, skin moisturizers, and massages are frequently helpful. These symptoms are common during the recovery period.

Redness of scars: All new scars are red, dark pink, or purple. Scars on the face usually fade within 3 to 6 months.

Hematoma: Small collections of blood under the skin are usually allowed to absorb spontaneously. Larger hematomas may require aspiration, drainage, or even surgical removal to achieve the best result.

Inflammation and infection: A superficial infection may require antibiotic ointment. Deeper infections are treated with antibiotics. Development of an abscess usually requires drainage.

Thick, wide, or depressed scars: Abnormal scars may occur even though we have used the most modern plastic surgery techniques. Injection of steroids into the scars, placement of silicone sheeting onto the scars, or further surgery to correct the scars is occasionally necessary. Some areas on the body scar more than others and some people scar more than others do. Your own history of scarring should give you some indication of what you can expect.

Wound separation or delayed healing: Any incision, during the healing phase, may separate or heal unusually slow for a number of reasons. These include inflammation, infection, wound tension, decreased circulation, smoking or excess external pressure. If delayed healing occurs, the final outcome is usually not significantly affected, but secondary revision of the scar may be indicated.

Sensitivity or allergy to dressings or tape: Occasionally, allergic or sensitivity reactions may occur from soaps, ointments, tape or sutures used during or after surgery. Such problems are unusual and are usually mild and easily treated. In extremely rare circumstances, allergic reactions can be severe and require aggressive treatment or even hospitalization.

Increased risks for smokers: Smokers have a greater chance of skin loss and poor healing because of decreased skin circulation.

Injury to deeper structures: Blood vessels, nerves and muscles may be injured during surgery. The incidence of such injuries is extremely rare.

Medical complications: Pulmonary embolism, severe allergic reactions to medications, cardiac arrhythmias, heart attack, and hyperthermia are rare but serious and life-threatening problems. Failure to disclose all pertinent medical data before surgery may cause serious problems for you and for the medical team during surgery.)

UNSATISFACTORY RESULT & NEED FOR REVISIONAL SURGERY
All Facial Plastic Surgery treatments and operations are performed to improve a condition, a problem or appearance. While the procedures are performed with a very high probability of success, disappointments occur and results are not always acceptable to patients or the surgeon. Secondary procedures or treatments may be indicated. Rarely, problems may occur that are permanent.

POOR RESULTS: Asymmetry, unhappiness with the result, poor healing, etc. may occur. Minimal differences are usually acceptable. Larger differences may require revision surgery.