Face Lift Pre-Op, Operation & Post-Op Procedures

  1. Do not take aspirin products, non-steroidal anti inflammatory drugs such as Advil, Ibuprophen, Motrin, Aleve and other prescription drugs, multi-vitamins, vitamin E, anti-aging medications, herbal pills, or products containing these drugs for two weeks prior to surgery and for two weeks following surgery. You should take blood pressure medication in the morning of surgery with sips of water. All other medications (cholesterol, hormones, diabetes etc.) can be skipped.
  2. Do not eat or drink anything from midnight on the day of the surgery for all anesthesia procedures (no coffee, chewing gum, saltines, etc.).
  3. Wear clothing that has a button or zipper front and avoid clothing that pulls over the head.
  4. Do not wear makeup or contact lenses.
  5. Be sure to have a family member or friend drive you home after the surgery and stay with you for the remainder of the day. If you have sedation or general anesthesia, you will not be allowed to leave alone. You must have someone accompany you. A taxi cab driver is not allowed to pick you up, unless you are accompanied by a relative/friend. We will provide you with limousine information, should you require a driver.
  6. Schedule a post-operation follow-up appointment.
  7. Fill prescriptions Dr. Byun has given to you prior to surgery. Most patients will receive IV Antibiotics during surgery. Prescription for pain medications can be used only as needed should pain increase after surgery. Tigan (big pink pill) is a rectal suppository. Use this only in the case of severe nausea.
  8. Buy a reusable ice pack from your local pharmacy (i.e. Walgreens) and a box of clean gauze. You will use them for eye and face areas. The first 48 hours makes the most difference.
  9. If you are a smoker, stop smoking two weeks prior to surgery and two weeks following surgery. Do not wear a nicotine patch or chew nicotine gum because they constrict the blood vessels and deliver less amount of oxygen to the surgery areas.
  10. If you consume alcohol, and are a “social drinker”, meaning you allow yourself one or two glasses of wine, or an occasional beer, on one or two occasions weekly, you need to stop any alcohol intake, 48 hours prior to surgery.
  11. If you are inclined to have more than “the occasional drink”, meaning your body is conditioned to alcohol intake on a daily basis, or five times, or more, weekly, you need to stop any alcohol consumption 5 days prior to surgery.
  12. You will be receiving a pre-op phone call the day prior to surgery to give you any instructions, additional information, or answer any questions you may have with regard to your scheduled procedure.
We have provided a sample copy of an Operative Report. The procedure is subject to change per the patients needs.

Rhinoplasty

NPREOPERATIVE DIAGNOSIS: Nasal Asymmetry

POSTOPERATIVE DIAGNOSIS: Nasal Asymmetry

OPERATION: Rhinoplasty, infracture of the nasal bone through a silicone augmentation and the spreader graft, the lower lateral cartilage through the intranasal closed technique.

ANESTHESIA: General

Indication: The patient is ___ year old male who once to improve the nasal features. He has a slightly bulbous tip with a low dorsum and then a wide spreading nasal bone.

OPERATIVE PROCEDURE:
After induction of local anesthesia in a supine position, the patient was prepped and draped in the usual sterile fashion. 5 ml of 1% Lidocaine with epinephrine was injected to the area and a throat pack and nasal pack were utilized. Intracartilaginous incision was made bilaterally intranasally where the subperiosteal dissection was done along the nasal bone. Using the Converse scissors, the tip of the nose was also dissected retrograde from the incision where the customized soft silicone was inserted to the dorsum of the nose. The strut was also intruduced in between the medical crura of the lower lateral cartilage where 1.5 cm with the 0.5 small strut was insterted to give him better projection. Infractures were done bilaterally using the 3 mm osteotome with the fenestrated technique and the ostectomy was performed with good hemostasis obtained. The nasal symmetry was good where the supratip and infratip break angle was acceptable with good increase in height which balances his face well and this was closer to the size that we discussed prior to the surgery. The incision was closed using 4-0 Vicryl. Good hemostasis was obtained. Aquaplast was applied to stabilize the infracture. He was extubated and transferred to the Recovery Room in good standing.

BROWLIFT / FACELIFT / NECK LIFT

Guaze packing in the nose can be removed after 24 hours by gently pulling it out, unless instructed differently by Dr. Byun. Avoid hanging your head forward. Do not remove any cast or tape on the surgical area. These will be removed by Dr. Byun at your post operative check up. Cleanse any uncovered incisions 3-4 times a day using clean gauze soaked in saline water. (found at your local pharmacy). If you do not have a cast and only bandages covering your nose then it is acceptable to get your face wet, but avoid doing so if possible. If there is a cast, do not allow the cast to get wet.

You must not blow your nose for two weeks. You may gently clean just inside the nostril with a moise Q-tip and saline water. If you have to sneeze, do so with your mouth open. Bruising alone the lower eye area is expected and is normal. Do not wear eye glasses or sun glasses until after receiving permission from Dr. Byun. Failure to adhere to this precaution may result in adverse effects following surgery.

  1. MEDICATIONS
    Use the pain pills and anti-nausea we provided, as needed. You can skip if you don’t need them. If you were prescribed an antibiotic, start taking this immediately following surgery and continue until bottle is finished. Dr. Byun will usually give you a one week course. Discontinued use could make you vulnerable to infection. Do not take blood thinners, aspirin, ibuprofen, multi-vitamins, vitamin E, anti-aging medications, herbal pills, and products containing these drugs for two weeks prior to surgery and for two weeks following surgery since they increase bleeding. Continue taking any other pills for blood pressure, cholesterol, birth control and hormone pills as part of your regular routine.
  2. BANDAGES
    Leave all external bandages on for 48 hours following surgery. The term external bandages refer to bandages that are not directly applied to the skin then reapply them as instructed per surgery.
  3. SWELLING
    Post Operative swelling is normal and peaks about 48-72 hours after the surgery. The majority of the swelling will go down within the first two weeks. Swelling is a part of the healing process, so it is normal for the surgical areas to be swollen for a few months after the procedure as the body heals. You can apply re-useable ice packs to the surgical areas for the first 24-48 hours to help reduce swelling in these areas.
  4. BLEEDING
    Small amount of bleeding from incisions is part of the healing process and is normal. Expect bleeding from the incisions 24-48 hours after the procedure. If bleeding continues after this 48-hour period, apply gentle pressure to the area using clean gauze and call our office.
  5. SHOWER
    You must shower 48 hours following surgery. At this time you may also remove external bandages (ace wrap, epi-foam, and gauze) as directed by the instructions below pertaining to your particular procedure. BAndages/tape applied directly to the skin, if any, especially those covering incisionsmust not be removed. At this time it is also important to allow soapy water and shampoo to run gently through the incision areas. Baby shampoo is recommended as regular shampoo may sting your incisions. Following your shower, re-apply clean/laundered ace wraps, epi-foam, compression garments, and binders as necessary depending on your particular procedure. Fresh gauze can be placed on incision sites if they are irritated by wraps, foam or garments. For patients who have undergone a procedure to the face: when applying shampoo or conditioner be mindful of the incisions along the hairline. Massage the scalp gently taking extra care to not irritate incisions. Also try to avoid snagging suture incisions with a comb or brush.
  6. EXERCISE
    An increased heart rate and blood pressure increases swelling and compromises the healing process, so relax and take it east for the first two weeks following surgery. It is a MUST that you consult Dr. Byun before returning to regular physical activities. With each follow-up as the weeks go by, Dr. Byun will inform you on which activities are suitable for you at that time. Generally however, for the first two weeks light walking and movement is acceptable, while bending forward (as that increases blood pressure in the head and may cause bleeding), stretching the surgery area, and any activities that will raise your heart rate should be avoided.
  7. SLEEPING
    Cover your pillow with an old towel or pillowcase as there will be dripping of blood from the incision in the first 24-48 hours after surgery. This is completely normal. For two weeks, sleep using two pillows to elevate your head, neck and shoulders for face related procedures. Should you have any sleeping difficulty, Tylenol PM is the recommended sleep aid. If the problem still exists, we advise that you call our office for a prescriptive drug, after speaking with Dr. Byun.
  8. DRIVING
    Try not to drive for one week following surgery. If you must drive however, you may not while taking pain medications. Remember, your safety comes first.
  9. SMOKING/ALCOHOL
    If you smoke, do not smoke for two weeks after surgery. Do not wear a Nicotine Patch or chew Nicotine Gum as this constricts your blood vessels and inhibits healing. Do not consume alcohol for at least ten days after surgery as this also raises blood pressure and causes late bleeding. If this will be a problem Dr. Byun can prescribe a medication to help you quit smoking prior to your procedure.
  10. NAUSEA/PAIN
    Nausea is a common side effect. It is recommended by Dr. Byun to take Zofran, which was prescribed to you, as soon as you arrive home and one pill before you go to bed. Along with anesthesia, the pain medication may cause nausea. Therefore, you should stop or decrease the amount of pain medication intake. In order to decrease the nausea created by the pain medication, make sure to take it after meals.