Before and After Procedure Care
General Instructions to Follow Before and After Any Plastic Surgical Procedure
A successful procedure involves a partnership between you and Dr. Laverson. Following these instructions is essential for a safe experience and a good outcome. If you have questions about these instructions or are unable to comply, notify Dr. Laverson.
Three or more weeks before surgery: Proper skin care (hygiene, sun protection, control acne), good nutrition, regular exercise, and STOP SMOKING COMPLETELY. Avoid excessive alcohol consumption. Call Dr. Laverson’s office if unexected illness develops. Be sure underlying medical issues are under control, such as blood pressure, medication levels, etc, and that required medical clearance and/or required laboratory studies have been checked. If you use insulin, be sure the dose for day of surgery has been planned. Schedule time off of work for recovery, and help at home if needed. Be certain a responsible adult is confirmed to drive you to and from surgery, and to stay with you around the clock for at least 24 hours after your procedure.
Two to three weeks before surgery: Prepare and plan your schedule for the day before, the day of, and the first few days after your procedure. If you are having a facial procedure, schedule hair coloring/perm because this is not recommended for 4 – 6 weeks following surgery. Fill your prescriptions for pain medicine, sleeping medicine, anti-anxiety medicine, anti-nausea medicine, GI supplements, and anti-viral medicine or antibiotics if needed. Schedule your pre-surgical visit at the surgery center (North Coast Surgery Center, 760-940-0997, 3903 Waring Road, Oceanside, CA 92056 www.northcoastsurgerycenter.com, or Center for Surgery Encinitas, 760-942-8800, www.surgery477.com, 477 North El Camino Real, Suite 100, Encinitas, CA 92024). STOP taking any and all medications that can increase your chance of bleeding or delay healing. Medicines to completely avoid include, but are not limited to: ASPIRIN, IBUPROFEN, MEDICATIONS CONTAINING ACETYLSALICYLIC ACID, VITAMIN E, ST. JOHN’S WORT, GARLIC, GREEN TEA, ESTROGEN, CORTICOSTEROIDS, CHEMOTHERAPY, and others. If you regularly take these medications and/or other supplements, please inform Dr. Laverson in advance so appropriate management can be arranged.
One week before surgery: Confirm day of surgery plans, review prescription orders and instructions, and shop for necessary items. This may include surgical preparation solution (povidone-iodine or chlorhexidine gluconate with alcohol), cool compresses, gauze, ointment, extra pillows, waterproof underpads, and/or other items. Call the office at 760-753-6464 if questions arise about what you will need. Locate the most comfortable areas for you to gently recline during recovery. Arrange magazines, books, and/or other diversions during the early period of healing. RELAX.
One day before surgery: Pack your bag for the day of surgery. This should include any necessary paperwork, personal identification, all prescription medications, and warm cotton socks. If you are having facial surgery, bring large framed dark tinted sunglasses and a wide brimmed hat or light scarf. Confirm your route to and from surgery with the responsible adult who will drive you. Confirm plans with your 24-hour support person. Have Dr. Laverson’s contact number(s) available at your bedside, 760-753-6464. Anesthesia may call to review your state of health. Shower as directed with anti-bacterial soap and/or surgical prep solution. Do not use hair gel or styling products or cosmetics. Remove finger nail and toe nail polish. Do not eat or drink anything after 12 midnight the night before your procedure, with the possible exception of your usual morning medication with a small sip of water. RELAX. If you need medication to help control stress or help you get a good night’s sleep, call Dr. Laverson’s office 760-753-6464.
Day of surgery: NOTHING by mouth. Dress appropriately in comfortable, loose fitting clothing. A top that zips or buttons up the front, sweatpants or loose shorts, cotton socks, and slip on shoes are best. Do not wear cosmetics, jewelry, contact lenses, hair clips, or body piercing jewelry. If there is something you cannot remove, let the admitting nurse know right away.
Please read and understand the above instructions. Following these instructions is your responsibility. It is also your responsibility to ask Dr. Laverson and/or his staff questions related to these instructions, or about your health, healing, and/or your procedure. Further elaboration of general pre-surgical instructions HERE.
Laser Skin Resurfacing and Deep Chemical Peels
Preparation Before: Consider topical tretinoin with hydroquinone (GOLD formula) before for 4-8 weeks (optional). Schedule when you can take at least one week off of work and social events. If you have had cold sores in the past, be sure the doctor prescribes Valcyclovir or another anti-viral medication for you to take two days before and for several days following the procedure to prevent cold sores from recurring. Have Vaseline®, Aquaphor®, or other recommended topical application ready at home before your procedure. Also consider asking for a medication to help you sleep and/or relax for those several difficult days immediately after the procedure.
Care after treatment: Healing is gradual, your face is an open wound that will heal, but needs gentle care. Moisture is important, and an emollient such as Aquaphor® or Vaseline® several times daily helps maintain a moist environment for skin cells to proliferate, migrate, and resurface your face. Shower the face, daily, but avoid a strong stream of water directly on the face. Soft irrigation of the face is best. Elevate your face on several pillows at night to minimize swelling. Medication to help you relax and/or sleep may be helpful to avoid touching the face. Cool compresses (bag of frozen peas or corn) may help. Avoid direct sun exposure. Find pursuits (movies, books, paperwork, creative projects) to keep your mind off of your face during the few days immediately following your procedure. Rest as needed, allowing your body to allocate available energy to healing. Call Dr. Laverson if questions 760-753-6464.
Eyelid procedure(s) (Blepharoplasty)
Plan for someone else to drive you home from Dr. Laverson’s office , and at least several days (five or more) off work following your procedure. You may not be able to drive for several days following the procedure. Blurry vision and difficulty closing and/or opening the eyelids is common. Have shaded glasses to protect and conceal the eyes for two to three weeks. Eyelid skin is the thinnest in the body, very delicate, and prone to swelling. Additionally, there are glands, muscles, and nerves in the eyelids. All of these structures are temporarily disrupted by cosmetic surgery of the eyelids. Dry eye is common after eyelid surgery. Eyedrops and ophthalmic ointment can help maintain necessary moisture of cornea and conjunctiva, delicate membranes that cover the eyeball. Dr. Laverson supplies these products for you to use as needed following your procedure. Application of cool compresses may offer relief, as well as analgesics (medication for pain) that Dr. Laverson will prescribe. Pick this medication up at the pharmacy, and have it available at home following the procedure. Upper eyelids heal faster than lower eyelids. If you have only the upper eyelids done, recovery is brief and uncomplicated. Lower eyelid surgery, in Dr. Laverson’s hands, rejuvenate the entire middle portion of the face. The results are generally much more dramatic, but recovery is commensurately longer. Questions or problems should be referred directly to Dr. Laverson at 760-753-6464.
No special preparation. Be prepared to breathe through your mouth for one week following the procedure. External and internal splints are removed six to nine days after surgery. Your appearance and nasal breathing improve rapidly after this. For the first one to three days after your nose surgery, a moustache dressing to absorb nasal drainage may be required. Avoid bending down, nose blowing, or sneezing. Take medication for pain as needed. Sleep on several pillows; Head elevation controls swelling. Do NOT remove your splints, and do NOT use nose drops. Neosporin, Bacitracin, or Polysporin ointment can be applied once or twice daily to sutures near your nostrils. Swelling diminishes rapidly during the first two weeks, then more slowly for many months.
There is no special preparation required for these procedures. Operations to enhance shape of the lips may involve sutures on the inside or outside of the lips. Bacitracin, Polysporin, or Neosporin ointment should be applied daily or twice daily to skin sutures. Chlorhexidine gluconate 0.12% or another oral antiseptic rinse should be swished inside the mouth between teeth and lips three to four times daily to cleanse sutures on the inside of the lips. If sutures are inside the lips, stay on a liquid or soft foods only diet for one week after your procedure. Lip swelling for two to four weeks can be expected. After this, your appearance improves, and scars generally fade to imperceptibility.
Prepare for several days of inactivity at home immediately following your procedure. Consider covering mirrors, because you will look worse before looking better. Color hair before, because the use of strong colorants is not advised for several weeks after. You will need to sleep with head elevated to minimize post-procedure swelling. Bulb reservoirs should be emptied twice daily, the volume of drainage recorded, and suction restored. These drains typically are removed 3-6 days after necklift. If laser skin treatment and/or eyelids are done as part of the procedure, the above recommendations for those procedures apply. Your neck will be stiff, and driving is not recommended for at least one week, usually longer before you can see well enough and move your neck to look in different directions. The misery lasts for about one week; By then, most see almost daily improvement as swelling resolves, and the beautiful result becomes apparent. The best approach is slow, cautious resumption of activity as able.
Any lump or mass in the breast must be examined (by mammography and your physician) before getting implants. Augmentation is generally not advised until at least several months after breast feeding/breast milk is finished, and breasts have been stable in size for two months. Shower with povidone-iodine or another surgical skin disinfectant the evening before or morning of your procedure. The point is not to scrub skin of the breasts, but SOAK the breasts including area around the nipples and beneath the breasts, under your arms, and all of the skin on your chest from the neck down to and including belly button. Have analgesics (pain medicine) at home before the procedure, because you will need it immediately after. Dr. Laverson will apply a bra at the completion of your procedure. Adjust it for comfort, but wear until at least your first post-surgical appointment. Expect swelling around the implants, most significantly for two weeks following implant placement, then gradually resolving for several months. Report any significant size and/or pain difference between right and left sides to Dr. Laverson immediately.
Breast Lift (Mastopexy) and Breast Reduction
Breast Lift and breast reduction are similar, so preparation and post-operative care and instructions are identical. During both procedures, breasts are lifted on the chest and skin envelope of the breasts is tightened to correct sagging and project nipples upward and forward. Some discomfort involved, so have prescription for pain medicine (analgesics) filled before procedure. Medication should be available when you arrive home. Dr. Laverson purchases and applies the highest quality Marena post-surgical support bra available. You will awaken from anesthesia wearing this supportive bra. Adjust elastic shoulder and chest straps as needed for comfort and fit (easy hook and eye fasteners, opens in front). Dr. Laverson will remove bra and bandages at your first office appointment after the procedure. Until then, keep bandages clean and dry, and do not remove the bra. Walk around home, but avoid strenuous or painful activity. Resume your normal medications, and consume a regular diet. Do not take pain medicine (analgesics) on an empty stomach to avoid nausea. Call Dr. Laverson with questions, problems, or if anything occurs that you believe may be unusual. At the first post-surgical office appointment, you will likely receive supplies for continued care of your lifted (and perhaps reduced) breasts. The quality of your final scar is an important feature of your result. This scar develops for months following the procedure. For eight to twelve weeks, Dr. Laverson may apply, and instruct you in the application of, Hypafix® tape across your skin closure to prevent scar widening by providing additional breast support. Solid support bra recommended for at least twelve weeks after breast lift or breast reduction.
Tummy Tuck (Abdominoplasty)
Because you will be inactive for one to two weeks following tummy tuck, make arrangements for child care, and reschedule all physically demanding obligations. Have pain medicine (analgesics), and if needed, muscle relaxer and/or sleeping medication available. After tummy tuck, walking several times daily around the home and deep breathing are advised, and encouraged. You will awake from anesthesia with soft padding covering your abdomen, and a snugly applied, high quality, latex-free Dale abdominal binder securing these bandages in place, and suppoting your abdominal transformation. Adjust tension of your abdominal binder by gently unfastening the velcro, repositioning the binder snugly, but comfortably, low around hips and encompassing your waist also. Refasten binder and drain reservoirs. These bulb reservoirs should be emptied two to three times daily into a small measuring cup, and the time of emptying and volume of drainage recorded. After emptying bulb, collapse it completely and re-cap to restore suction. Secure reservoir to binder with safety pin or velcro. Bring written record of drainage to follow up appointment so Dr. Laverson can evaluate best time for removal of each drain. If you went home from the surgery center with an indwelling urine catheter, it may be removed when you are able to comfortably get up from bed or chair to restroom. Do not remove bandages or shower after tummy tuck until you have seen Dr. Laverson in the office following your procedure, and then only if he has indicated you may shower. Until your first office appointment following tummy tuck, sponge bathe only (no shower or bath), and keep bandages clean and dry. Excessive blood on bandages, bleeding, or drainage from the surgical area are unusual, and should be reported to Dr. Laverson at 760-753-6464. Dr. Laverson will supply a large roll of clean padding to take home and apply beneath your Dale abdominal binder after each shower. He will also apply, and instruct you in the application of, Hypafix® tape across your lower abdominal closure for two to three months following tummy tuck to produce the best possible (least visible) scar.
Vulvo-Vaginal (Labiaplasty) and Perineal
Genital soft tissue is erectile, and prone to excessive swelling. Don’t be alarmed during the first week after your procedure when your labia and surrounding skin is bruised and disproportionately swollen with a deformed appearance. PROTECT with padding. We supply surgical padding for you to go home with, and menstrual padding works well also. Limit your activity to avoid unnecessary perineal trauma. Genital skin is delicate and sensitive. Sex, bicycle, and horseback riding are out for minimum four weeks, and should be resumed only when you can do so without pain. For PAIN CONTROL, we supply anesthetic cream for direct application to your labia as needed, and narcotic analgesic tablets (usually Vicodin, Norco, or Percocet) as prescribed. We often supply a gel pack which doubles as a warm compress (heat in microwave) or cold compress (refrigerator or freezer). Use of the gel pack is optional, but many patients find it comforting. Gentle showering and bathing daily are recommended for HYGIENE. We also supply cotton tipped applicators to moisten and gently clean between folds of skin. Any abnormal findings, significant asymmetry between right and left sides, bleeding, wound breakdown, infection, or other problem should be reported to Dr. Laverson immediately at 760-753-6464.