Pre-Operative Instructions
Ten days prior to the surgery:
- If you are taking aspirin, and have NEVER had a heart attack, arrhythmia (such as atrial fibrillation), stroke/mini stroke, blood clot of any sort, stent or prosthetic heart valve placed, or any other medical condition requiring regular intake of aspirin other than general prevention, please stop aspirin to prevent bleeding risk. You may resume aspirin 3 days after the surgery.
- If you are taking aspirin and you have had a heart attack, arrhythmia (such as atrial fibrillation), stroke/mini stroke, blood clot of any sort, stent or prosthetic heart valve placed, or any other medical condition requiring regular intake of aspirin, please do not discontinue it.
- Please stop non-steroidal anti-inflammatory drugs (NSAIDs) such as Excedrin, Advil, Aleve, Alka-Seltzer, Ecotrin, ibuprofen and some cold medications, as they can make your blood thinner, which leads to a higher risk of bleeding and bruising during and after the surgery. You may still take Tylenol for any type of pain.
- Please stop Coenzyme Q10, vitamin E, fish oil, St John’s wort and/or garlic supplements, as they all have the capacity to make your blood thinner and increase the risk of bleeding and bruising during and after the surgery. This could in turn alter wound healing.
- If you are taking Coumadin or warfarin, please notify the office of your recent INR (we may ask you to have your INR checked 1 week prior to the procedure). Do not stop your blood thinner.
- If you are taking Eliquis, Pradaxa, or Xarelto, please notify the office. Do not stop your blood thinner.
- Continue all other prescription medications.
- Cancel other commitments and appointments on the day of the surgery. You will spend most of the day in the office and will want to take it easy for the next 24 hours.
- You may wish to review your personal schedule for the week or 2 following the procedure. If sutures are used, you will need to have them removed in 1 to 2 weeks. You may also have swelling or bruising that could interfere with social engagements for several weeks following the treatment.
- Ideally, you should not travel for the next 7 days after the surgery.
- If you smoke, it is imperative that you significantly reduce, or, preferably, quit smoking prior to the procedure. Smoking can severely affect wound healing. The most crucial time is two days before the procedure and one week after the surgery. Using a nicotine patch instead is a slight improvement, but not nearly as good as not smoking at all. The more you smoke, the worse your scar will look.
Seventy two hours before the surgery:
- Discontinue all alcoholic beverages, as they can make your blood thinner, which leads to a higher risk of bleeding and bruising during and after the surgery. This could in turn alter wound healing.
- You may arrange to have a friend or family member drive you to and from the appointment; however, due to the pandemic, we politely ask that they do not come inside the office.
- We require that you do not drive yourself home after the surgery. Someone should be available to pick you up once the surgery is completed. Please make sure they can be flexible with their time as we cannot be certain of your discharge time.
- You may wish to purchase the items needed for wound care at home after the surgery ahead of time. These items are listed at the end of this document.
On the day of the surgery:
- Take all of your medications (except those listed above) on the day of the surgery.
- Bring a complete list of all of your medications on the day of surgery.
- It is very important to have a complete, healthy breakfast on the day of surgery. As you may be with us well into the afternoon, please also bring a packed lunch. We strongly advise that you do not skip meals on your surgical day.
- Wash your hair the night before or morning of the surgery and use freshly laundered clothes to help reduce the chance of getting an infection. You may require to have dressings on the face that may interfere with hair washing for the first 2 days after the surgery.
- Please avoid wearing makeup if the surgery is on the face.
- Wear comfortable clothing to your appointment. Try to wear something that does not need to be pulled over your head after the surgery if you are having surgery performed on the face or neck. Please avoid wearing clothes and jewelry (earrings, necklaces) that you do not want unexpectedly stained with small droplets of blood.
- If you wear hearing aids and are having surgery around your ears, bring a container to hold them during the surgery.
- If surgery is on the face, please do not wear contact lenses. Wear glasses instead.
- If you wear dentures and surgery is to be done around the mouth area, we may need to remove them, so bring a container in which they can be stored.
- It can be helpful to bring reading materials such as a book, tablet or laptop to help pass time.
- Please be aware that physical activity will need to be restricted for a period of 2-3 weeks after the surgery to ensure proper wound healing. You will also have to avoid heavy lifting (nothing over 10 lbs) and bending over for the first 72 hours after the surgery.
Supplies to be obtained for wound care at home after the surgery:
- Salt water (1 cup of boiled, bottled or distilled water + ½ tsp. salt).
- Clean Q-tips.
- A greasy unscented ointment such as Vaseline Petroleum Jelly Original, Aquaphor (if you have used in the past and are not allergic to lanolin), Vaniply Ointment or CeraVe Healing ointment. It is important to use generous amounts to prevent the wound from drying out.
- Non stick gauze such as Telfa.
- Non-allergic paper tape such as Micropore (ideally nude in color, to better dissimulate the appearance of the dressing). Try not to use plastic or cloth tape as it may be very irritating or cause local skin allergies.
You will be given specific oral and written wound care instructions following your surgery. Exactly how you will have to take care of your wound will depend on the type of reconstruction that is ultimately performed.