Universal Preoperative Instructions
See Specific Instructions for Laser Procedures
Illness
Please notify our office if you develop an infection, cold or flu prior to surgery so we can give you appropriate instructions. Inform us as soon as possible in case we need to postpone your surgery.
Smoking
You should stop smoking at least two (2) weeks prior to surgery. Nicotine reduces circulation and can prolong healing and cause scaring and other complications.
Medications
Do not take aspirin, garlic pills, ginseng, ginko biloba, vitamin E, fish oil pills or anti-inflammatory drugs for 1-2 weeks prior to surgery. These products prolong blood clotting, and therefore, may cause excessive bleeding and bruising.
The following is a list of common medications which should be avoided:
Common Herbal Products: How They Can Affect Your Surgery
Name
Possible Clinical Significance
Before Surgery
Alfalfa
May interfere with Coumadin, and steroids.May lower blood sugar levels. Possible allergic reactions.Vomiting if taken with Flagyl.
Reduce use or stop for
7 days
Bilberry
Interferes with blood clotting, may cause excessive bleeding.May lower blood sugar levels and cause diarrhea.
Stop 7 days before
Black Cohosh
May increase the effect of blood pressure medications, and interfere with blood clotting.
Stop 7 days before
Black Tea
Can interact with other prescribed drugs. May cause insomnia, increased blood sugar.
Reduce use or stop for 7 days
Coenzyme Q10
May cause dizziness, flu-like symptoms. May lower blood sugar and/or blood pressure.
Reduce use or stop for 7 days
Cranberry
Excessive use can result in increased bleeding, diarrhea, and kidney stones.
Reduce use or stop for 7 days
Echinacea
Patients with a history of liver disease should use with caution. Contraindicated in patients with autoimmune conditions. Interferes with anti-HIV medications.
Reduce use or stop for 7 days
Ephedra
(Ma Huang)
Banned by FDA. Ephedrine and pseudoephedrine-containing products are still sold. Many side effects. Discontinue use 1 week before surgery.
Stop 7 days before
Evening Primrose
GI side effects. Contraindicated for patients taking anticonvulsants.
Reduce use or stop for 7 days
Fish Oil
May cause excessive bleeding.Stop 7 days before surgery.
Stop 7 days before
Garlic
Mild reduction of blood pressure. Interferes with blood clotting.
Stop 7 days before
Ginger
Few problems with low dosages. At higher dosages may cause cardiac arrhythmias, and interfere with blood clotting.
Stop 7 days before
Ginkgo biloba
May interfere with blood clotting and interact with anticoagulants and NSAIDs (potential for increased surgical bleeding). May lower blood sugar. Discontinue 7-14 days before extensive surgery. Seeds may be toxic.
Stop 7 days before
Ginseng
May interfere with blood clotting and interfere with anticoagulants (possibly causing excessive bleeding at surgery). May decrease blood sugar. May increase blood pressure.
Stop 7 days before
Green Tea
GI upset, insomnia, irritability, possible cardiac palpitations and headaches.
Reduce use or stop for 7 days
Horse Chestnut
Possible excessive bleeding at surgery. GI upset and decreased kidney function possible.
Stop 7 days before
Kava (Kava-Kava)
Possible dizziness, depression, headaches. May prolong effects ofanesthetic drugs. Interferes with blood clotting.
Stop 7 days before
Lavender
Drowsiness possible. May enhance sedative drugs like Valium. May increase bleeding problems.
Stop 7 days before
Licorice
May increase absorption of prescription drugs. Possible toxicity if used with digoxin. May lower potassium levels in patients taking diuretics. Increased bleeding risk in patients taking anticoagulant drugs.
Stop 7 days before
Pycnogenol
Possible increased bleeding risk, cardiovascular effects, and drug interactions (especially anti-hypertensive drugs). May lower blood sugar.
Stop 7 days before
St. John’s Wort
May reduce the effectiveness of many drugs including antibiotics, ibuprofen, Valium, sedatives, cardiac drugs, antidepressants, anti-HIV drugs, contraceptives, and many others.Prolongs the effect of narcotics. Stop use 7 days before surgery.
Stop 7 days before
Valerian
May increase the effect of sedative medications.
Reduce use or stop for 7 days
Vitamin E
Long-term use in high does may increase risk of death from all causes. No significant problems from short-term use, lower doses. Doses >400 IU/day may increase bleeding and delay wound healing.
Stop 7 days before
Diet
Do not attempt to lose weight prior to or after surgery. Eat a balanced diet, as nutrition is important for healing.
Escort
Arrange for someone to accompany you to our office. We will review the postoperative instructions with them based on your needs.
Someone should remain with you during the first 12-24 hours to assist you with medications, suture care, ice applications and bathroom needs. That person should read and be familiar with the postoperative instruction information given to you at your presurgical office visit.
Please purchase all recommended items: (found at most drug stores and supermarkets)
Q-tips (upper eyelids, rhinoplasty, to apply ointment)
4"X4" Gauze pads (rhinoplasty)
1/2" paper tape, small roll (rhinoplasty)
Cotton Squares or Rounds (laser resurfacing)
Frozen peas or corn to use as ice packs (rhinoplasty, eyelids)
Note: a zip-lock bag with water and a few ice cubes also works very well
Read Home Care Instruction Brochure
Read the home care instructions pamphlet several times prior to your surgery. The more familiar you are with your home care needs, the easier your recovery will be.
Night Before Surgery
Do not have anything to eat or drink (including water) after midnight on the night before surgery. You may take necessary medications with a very small amount of water.
Remove all remnants of makeup and take a shower and wash your your face, hair and other surgical sites with antibacterial soap before you go to bed on the evening before surgery. Reduction of skin bacteria will decrease the risk of infection.
Day of Surgery
Again, remove all remnants of makeup and shower again and wash your face, hair and surgical sites with antibacterial soap on the morning of surgery.
Wear loose fitting clothing. Your top should button or zip up the front. Do not wear a pullover top, it may be difficult to put on after surgery. Slip-on shoes are more convenient and comfortable.
