Microsoft word - re rhinoplasty care document 070502.doc

RE PLASTIC SURGERY - MR. LOK HUEI YAP FRCS (PLASTIC SURGERY) 1. AVOID ASPIRIN OR ASPIRIN-CONTAINING MEDICATIONS for a period of 7-10 days before surgery, unless there is a strong medical reason for taking Aspirin. Aspirin makes the blood less effective at clotting and may increase bleeding and bruising, as do many other medications with names ending in ‘-phen’ or ‘-fen’. Please review the enclosed list of medications that may contain aspirin. For mild to moderate pain, Paracetomol is preferred. 2. Stop smoking for at least six weeks before surgery, and ideally discontinue smoking permanently after surgery, as cigarette smoke contains substances including nicotine which act to reduce blood supply in tissues, increasing the risk of wound failure and skin death. Nicotine patches should also be 3. Please report any sign of a cough, cold, boils or skin eruptions appearing within one week of surgery. For your own safety, if you have a cough or a cold, the operation will probably be postponed to avoid infective or airways complications. 4. Reduce your alcohol intake in the pre- and post-operative period, as alcohol can have an effect on 5. Most dietary supplements should be discontinued a month before surgery, particularly Vitamin E preparations which can cause increased bleeding and bruising. Vitamin C preparations can be taken after the operation and may help wound healing. 6. Discontinue the oral contraceptive pill for six weeks before surgery and use alternate methods of contraception, to minimize the risks of DVT (deep venous thrombosis). 7. Arrange for someone to drive you home after surgery. 1. NOTHING TO EAT OR DRINK AFTER MIDNIGHT. 2. Wash your hair as you will need to wear a head bandage for approximately 7 days after surgery. 2. Do not take medications, herbal remedies, or supplements, unless they have been prescribed for you. 3. Wear loose-fitting, comfortable clothes that do not have to be pulled over your head. 4. Storage space will be provided for your personal effects, but do not bring valuables with you to the Lok Huei Yap FRCS(Plast) 2007 All Rights Reserved 1. You will have had some nasal packs (soft, non-adherent material) placed in the nostrils to help reduce swelling and to provide internal support. You will also have a splint support on the dorsum of the nose, particularly if there has been bony surgery. 2. Arrange for someone you can rely on, to drive you home and spend the first two days with you. Additional instructions and advice can be given to the person looking after you. 3. You will have some mild to moderate discomfort after the procedure and should take regular pain relieving medication (Paracetomol) for the first week after surgery. More significant pain can be 4. There may be some small amount of bleeding or dripping from the wounds. This is quite normal, and the bleeding should gradually stop. You can change the gauze underneath the wound if necessary. 5. Avoid using reading glasses for about 3 weeks or resting any spectacles frame on top of the nose. 6. DO NOT TAKE ASPIRIN, ASPIRIN-CONTAINING PRODUCTS OR OTHER ANTI- INFLAMMATORY MEDICATIONS (e.g. Ibuprofen, Brufen, Nurofen, Alleve) for two weeks after surgery, as this may cause prolonged bleeding or additional bruising during the early post-operative period. 7. Make sure you have adequate rest for the first few days. Avoid excessive head movement for the first few days. Do try to keep your head elevated and sleep with two to three pillows for the first two 8. Do take your medications as prescribed, particularly your oral antibiotics unless you experience a gastrointestinal disturbance or skin rash. If you are constipated, do take some over-the-counter laxatives. Straining at stool should be avoided, as this may cause an increased risk of bleeding in the wounds. 9. Avoid activities that will increase your blood pressure, such as vigorous exercise, bending over, straining or lifting heavy objects – these increase your risk of having a significant bleed within the wounds. 10. You will be able to have a sponge bath, but avoid soap and water getting into your nasal wounds, the splint or any nasal packing. Please avoid getting the wound wet for the first week. 11. You may find that your eyes feel dry, gritty or puffy. This is quite normal especially if the surgery has involved the regions around the eyes. Do make sure that you keep your eyes well lubricated with the eyedrops provided. 12. If you find any crusting or dried blood on the margin of the incisions, you could help the cleaning process by using a cotton bud with some saline (salt-water), to help loosen up the crusts. 13. Please call the Practice to arrange a follow-up appointment for approximately one week after surgery. At this appointment, your wounds will be inspected, and if well-healed you can resume bathing. 14. Please avoid blowing your nose for the next 2 weeks. 15. Use mouthwash for cleaning the oral area after surgery. 16. Avoid alcohol or cigarette smoking for at least 3 weeks after surgery, and avoid using contact lenses for 17. Mr. Yap will assess your scar and the need for scar therapy. This will start at 2 – 3 weeks post-surgery, if needed, and you will be advised regarding the appropriate scar creams. Lok Huei Yap FRCS(Plast) 2007 All Rights Reserved 18. Do not expose your scars to direct sunlight for 12 months after surgery. Use sunblock with a minimum 19. Do commence a regular programme of walking around your home, avoiding complete inactivity. Gentle movements and exercises can be commenced a week after surgery. 20. Gym activity or strenuous physical activity should be re-commenced not earlier than 4 weeks after surgery. This return to exercise should be gradual. 21. You should not drive for at least 72 hours after surgery, and even then only if you are confident that you are capable of carrying out an emergency stop. 22. Your level of activity at work will influence when you return to work. Most patients will be able to return to work within 2 weeks if their job is not physically demanding. If you have a more physical occupation, you will require a longer recovery time, typically 4 weeks, before returning to work. IF ONE OR MORE OF THE FOLLOWING OCCUR, PLEASE CALL THE PRACTICE IMMEDIATELY: a) Fresh bleeding from the wound, more than a simple ooze b) Rapid enlargement at the wound site, associated with pain and bruising c) Significant pain not relieved by simple painkillers d) Wound discharge after 48 – 72 hours 1. You will have some bruising and swelling around the eyes and the root of the nose after the procedure. 2. You will notice some ‘stuffiness’ in breathing through the nose for the first 1 – 2 weeks after surgery. 3. The sutures inside your nose are absorbable and do not need to be removed. There may be some small sutures in the front of the nose which are non-dissolving and will be removed at a week’s time. 4. The scars will be healed by about two weeks after surgery but final settling and resolution of the scars 5. There will be swelling of the face, nose and eyes which will largely resolve by 7 – 10 days. Bruising may occur but should disappear over a period of 1 – 2 weeks. Lok Huei Yap FRCS(Plast) 2007 All Rights Reserved

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