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Cosmetic
Procedures Performed by Dr. Bowden
Below, you'll find detailed information about specific procedures.
Instructions for Nausea
Tearduct Surgery Post Op
Oculoplatic Surgery
Post Op
Chemical Peel Post Op
Hard Palate Graft Post Op
Instructions for Ice Pocket
Brow Surgery Post Op
Instructions for Pain Medication
Instructions for Warm Compress
Laser Post Op
Instructions In Case Of Nausea Or Vomiting
Following surgery you may experience a feeling of indigestion, gas, the
desire to burp and at times, nausea.
You can sip small amounts of fluid slowly after surgery. You may find
that a carbonated soda (7-Up) may get rid of the feeling of gas by
helping you to 'burp'. Sometimes it helps to walk about a little.
If you only drink clear fluids and perhaps a little toast or a plain
cracker for 3 - 4 hours after surgery your stomach will tend to get back
to normal.
If you are feeling hungry and want to have a light lunch or dinner, that
is fine.
Please follow all the other instructions you have been given.
IF YOU EXPERIENCE ANY NAUSEA THEN PLEASE REMEMBER THE FOLLOWING: You have
been given some suppositories. Please insert one as soon as you think you
feel the least bit nauseated. Please lie down and rest quietly. A cool
wet compress over your forehead is often soothing. You can expect the
suppository to make you sleepy and usually after a short nap the nausea
passes. If you really think you are nauseated it is better to use the
suppository at once rather than waiting "just in case the feeling
passes". If you wait for too long, it is much more difficult to
break the cycle of nausea and vomiting.
The suppository will not harm you.... it may make you sleepy but in
general will not cause any other problems.
Most patients do not experience any nausea following surgery, but we want
you to be prepared. We expect you may not need any of these
suppositories.
For Patients Who Have Undergone Tear Duct Surgery
Do not be surprised if your nose runs after surgery.
Try not to blow your nose as this can cause bleeding. If your nose does
bleed: -- Apply ice to nose with gentle pressure. -- Sit up straight. A
pillow may help with support. -- Spit out any fluid (blood) at the back
of your throat. -- Try not to swallow any blood. Try not to bend over as
this can occasionally start bleeding. Hot fluids have a tendency to make
your nose run more frequently. Wear a drip pad under your nose for 2-3
days after surgery to catch the material that might run down. Beginning
the day of surgery, use the following: Normal Saline nose spray--spray in the nostril on the side that had surgery. Beconase Nasal Spray-this will help control the
healing to make the best surgical outcome. Antibiotics-take these as
directed on the bottle.
Post Operative
Instructions for Oculoplastic Surgery
Please rest quietly all day following surgery. You do not have to remain
in bed. A recliner is OK. You may read if you want or watch TV. Do not
take a shower or a bath today. (Make do with a sponge bath if needed.)
You may begin showering and wash your hair on the day following surgery
unless you have a patch or head covering. You may drink water, clear
fluids, 7-Up, clear broth, or tea. You may have a light lunch or dinner
as long as you are not feeling nauseated, and you are hungry. You may
have your regular diet whenever you feel like eating it. Use the Ice
Pocket from your post-op kit to minimize swelling and reduce "black
and blue." Use the Ice Pocket for 2 full days after surgery, then switch to the Warm Pocket the next morning,
Thursday. Continue the Warm Pocket until all bruising is gone or Dr.
Bowden tells you that you may quit. Beginning on the day after surgery,
after applying the pockets, cleanse the incision gently with Q-tips or a
washcloth to remove any crusting of blood or other debris. This helps
make the nicest scar. Your post-op kit has some ointment and artificial
tears (Bion tears and Duralube
ointment) for the eye. To put the ointment or tears in the eye, pull down
gently on the lower eyelid and placing a drop or a small amount of
ointment in the space between the eye and the lid. Put the ointment in
the space just like you put toothpaste on a toothbrush. Continue this
until your post-operative appointment. You are to put ointment (Ciloxan) on the incisions following surgery. Apply a
small amount to the tip of your finger and then gently rub this on the
incision. You should do this 3-4 times daily to keep the area moist and
"glistening" and allow the least amount of scarring. Some
dissolving stitches will not dissolve without the ointment. Continue this
until your post-operative appointment. If your eye is patched, try not to
crush the patch while sleeping. You may sleep on that side. Your post operative appointment is scheduled for.
Chemical Peel to Localized Areas of the Skin
Variable concentrations of solutions will be applied to your skin. This
may sting and burn for two to five minutes.You
will be leaving shortly after the procedure is performed. You may resume
normal activities.
During the next three to five days, your skin may turn dark and begin to
peel. SUPPLIES NEEDED:
- 3% Hydrogen Peroxide
- Vaseline Petroleum Jelly or Crisco
- Q-tip cotton swabs
POST PEEL
INSTRUCTIONS
Twice a day, morning and evening: dip nonsterile
Q-tip swabs in hydrogen peroxide (the typical household variety) to get
them very wet. Apply the hydrogen peroxide saturated swab to the skin and
scrub lightly to remove all debris and dead skin that comes off easily.
Do not peel skin off manually. It will come off naturally. Using a Q-tip
swab, or your finger, apply a coating of Vaseline to keep skin smooth,
supple and lubricated. It must appear glistening at all times.
If during the first few days of the healing process, you experience
marked swelling of the face with noticeable heat of the skin, you are not
removing enough of the debris and dead skin. Please re-cleanse the area.
You may swim, shower, bathe, shave and have your hair done, even on the
day of the procedure.
Do not apply sunscreens for at least two weeks or until your skin is
completely healed.
You may use make-up and cover-ups when the skin is healed and pink.
You may experience one or more of the following conditions (these are
normal reactions):
Burning or itching eyes or puffiness around the eyes. If this occurs,
bathe the eyes with cool water and apply iced, wet, cold compresses for
relief. Stretching or pulling of the treated skin, causing a feeling of
tightness. This will be alleviated when the peeling begins and by keeping
the skin lubricated with Vaseline. A general feeling of fatigue or low
energy level. This will disappear after a few days. While you do have
this feeling, try to get some extra rest and/or sleep.
Hard Palate Graft instructions
These instructions are to help your mouth heal after surgery on the hard
palate.
SUPPLIES:
Benadryl Elixir - This may be obtained over the counter and is used for
the soreness in the mouth. INSTRUCTIONS: Swish 2 Tablespoons in mouth
then spit out as needed for soreness in mouth. DO NOT SWALLOW AS THIS CAN
MAKE YOU VERY SLEEPY. Mouthwash of choice - (This is used for your own
comfort) Use as needed . If bleeding in the
mouth should occur, place your thumb directly on the graft site in the
roof of the mouth and apply pressure for 10 minutes. Make sure you are
sitting up when doing this and not bending over.
Wear your plastic stent at all times. You may remove it as desired for
cleaning, but should immediately replace it in your mouth.
Avoid very hot foods as heat can cause bleeding. Avoid foods that have
rough edges such as toast or crackers.
Healing takes place in about 5 to 7 days. During this time the graft site
may be sensitive, especially when not wearing your stent, but will
eventually return to normal.
Ice Pockets
Why Cold?
After surgery, blood vessels leak. This leakage leads to swelling. In
order to minimize swelling, it helps to decrease the flow of blood to the
swollen area. The more ice you apply and the longer you apply it, the
less swelling there will be.
Ice Pockets
Your post-op kit contains the ice pocket. Just wet it, open it, and fill
it with crushed ice. Apply this to where you had surgery. It may get wet
and drip, but you can catch the fluid with towels wrapped around your
head. Leave the ice pocket on as much as you can tolerate for the first 2
days. Don't stay up and put it on during the night, since your sleep is
more important. You can, of course, go to sleep with it on your face.
Remember, the more you do the ice, the less swelling and black and blue
you will have and the sooner you can return to work.
FYI
In order to be adequately cold, something must be wet. If you reach into
a bucket of ice and grab a Coke, it is easy. But if you reach into a
garbage can filled with ice and water looking for a Coke, it is VERY
COLD. You may have to reach in three or four times to get it. The moral
of this story is that ice is not as cold as ice and water. The next moral
is-DON'T USE ANYTHING BUT THE ICE POCKET TO APPLY COLD TO THE SURGICAL
AREA.
Post Operative
Instructions For Brow Surgery
Please rest quietly all day following surgery. You do not have to remain
in bed. A recliner is OK. You may read if you want or watch TV. Do not
take a shower or a bath today. (Make do with a sponge bath if needed.)
You may begin showering and wash your hair on the day following surgery
unless you have a patch or head covering. You may drink water, clear
fluids, 7-Up, clear broth, or tea. You may have a light lunch or dinner
as long as you are not feeling nauseated, and you are hungry. You may
have your regular diet whenever you feel like eating it. Use the Ice
Pocket from your post-op kit to minimize swelling and reduce "black
and blue." Use the Ice Pocket for 2 full days after surgery, then switch to the Warm Pocket the next morning,
Thursday. Continue the Warm Pocket until all bruising is gone or Dr.
Bowden tells you that you may quit. Your post-op kit has some ointment
and artificial tears (Bion tears and Duralube ointment) for the eye. Use the tears during
the day every 2 hours and use the ointment at bedtime. To put the
ointment or tears in the eye, pull down gently on the lower eyelid and
placing a drop or a small amount of ointment in the space between the eye
and the lid. Put the ointment in the space just like you put toothpaste
on a toothbrush. Continue this until your post-operative appointment. You
should not use any ointment on the brow incision.
Special instructions for the Use of Pain Medictions
In your post-op kit you will find Tylenol 500 mg. These extra strength
caplets should control most of the pain. You may take one or two of these every 4 hours. In addition, you have been
given a prescription of
- Tylenol # 3
- Percocet
- Darvocet N-100
- Lorcet Plus 7.5 mg.
These are for pain that is not controlled by the regular tylenol caplets. You can take 1 tablet every 4 hours
as needed. You may take them in addition to the caplets, but do not take
more than 8 pills (caplets or prescription medicine) in 24 hours.
If you have any nausea discontinue the
medication and call the office.
If you are taking a product with Codeine you may experience constipation.
You may take any laxative you are accustomed to using or try some Milk of
Magnesia. If you have any questions please call the office.
Warm Pockets
Why Warm Pockets?
The third day after surgery, the blood vessels are no longer leaking.
Heat dilates the blood vessels and increases the blood flow through the
area. This carries away the black and blue and waste products.
Warm Pockets - How to Make Them
Use the ice pocket from your post-op kit. Get it wet and then heat it in
the microwave for 30 seconds to 1 minute until it gets warm, then place
it over the face. You also can get a bowl of warm water and dip the
pocket in it, wring it out, and then place it over the face. Either way,
the cloth will not remain warm very long. You must continually warm the
cloth for it to have the desired effect. THE POCKET SHOULD NOT BE SO HOT AS TO CAUSE A BURN-IT IS A WARM POCKET, NOT A
HOT POCKET. Some people put dry rice in the
pocket and heat this. This will hold the heat longer but may get too hot
and require other cloths between the pocket and the face.
Some other things to remember:
After sleeping all night, the eyelids will always be the most swollen
early in the morning. Fluid accumulates in the face by gravity. As the
day wears on, gravity allows the fluid to return to the normal
circulation and leave the eyelids and face. You will frequently be MORE
swollen on the second and third post-operative day than on the first
post-operative day. Continue using the warm compresses until all the
black and blue is gone
Laser Skin Resurfacing After-Treatment Instructions
Immediately After Treatment Areas treated should always be kept moist
with Vaseline, applied at least three times per day or so to keep the
area glistening.
Follow a daily skin care regimen three times per day as follows:
Splash the face with warm water. Clean the entire treatment area with
white vinegar and distilled water mixture (One tablespoon white vinegar
to one pint of distilled water). Apply Vaseline to the entire treatment
area. The area should remain moist to facilitate healing. Pain
Medications
Most patients experience minimal pain with this procedure and do not
require pain medication. However, to accommodate individual tolerances, a
pain medication prescription may be provided in case you should need
this.
Warning Signs
Call Dr. Bowden's office immediately if you develop fever or chills.
Antibiotics
If prescribed, complete the entire course of antibiotics
and/or Zovirax.
Crusting/Itching
Crusting that occurs is expected. Do not be alarmed. This will gradually
fall off over a seven to ten day period. Do Not remove any crusting
because this may cause bleeding or scarring. Itching is a normal sign of
healing but if it is intolerable, oral Benadryl may be used according to
manufacturer's instructions.
Red Skin Beneath the Crust
The underlying skin is healthy but will have the appearance of red
sunburned skin. Don't be alarmed. This color is normal and usually fades
after a 2-12 week period. Sun Exposure Direct sun exposure must be
avoided. When outside, use a sun screen with SPF 15 or greater. That will
further protect you from ultra violet radiation. Excessive sun exposure
in the early postoperative period could cause pigmentary
changes.
Make-Up/Moisturizer
Make-up can be applied after all of the crusting has resolved - usually
seven to ten days. The most effective approach is the use of a green
cover stick that can be complemented by a natural overlay. Your usual
moisturizer may be used after crusting has resolved. Please feel free to
ask if you have any questions.
Excess Skin Pigment
Should you notice any skin pigmentation or browning (this is usually
first noticeable 2 weeks or more after resurfacing), call Dr. Bowden's
office the next business day. Dr. Bowden may suggest that you begin using
anti-pigment liquid. This is applied twice daily for 14 days.
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