After surgery patients tend to study the operated area in fine detail and their awareness of the changes made are greatly heightened. Keep in mind that the tissues may feel different than what you expected, and will change as you go through the recovery period.
Do not expect miracles overnight! Your final result will be obtained at approximately 6 weeks after surgery, and optimal results can take at least 6 months.
Prior to Surgery
- 2-3 weeks prior to surgery take 1gm of vitamin C twice daily.
- Discontinue vitamin E and other supplements on the attached list as they can cause bruising.
- Discontinue Aspirin 2 weeks prior to surgery. Check with the doctor who prescribed the Aspirin regimen to ensure this course of action is medically safe for you. Substitute Paracetamol or Panadol for aches and pains.
- Eliminate alcohol 5 days prior to surgery, and 5 days following surgery.
- Smoking should be stopped 2 weeks prior to surgery. Smoking is proven to increase the complication rate in cosmetic procedures.
- Wash your entire body, focusing on your hair and face, with Hibiclens the evening before and the morning of surgery.
- Take Arnica as directed.
What Can I Expect After Surgery?
- Expect swelling. Swelling is usually at its worst on the third day, and will start to diminish thereafter. Swelling around the chin may be noticeable for 3 to 6 months.
- Keep your head elevated above the level of your heart at all times (approx. 30 degrees). Do not lay flat. Sleep in a recliner when possible or prop your head up with at least 2 pillows.
- Ice should be used for the first 48-72 hours. You will be given a head wrap with re-usable ice packs. You may use the ice pack for 20 minutes at a time, and then remove it to give the skin time to rest from the cold. Direct placement of ice to skin for prolonged periods of time may produce a burn. Remember, your face will be numb.
- Lukewarm heat may be applied after 72 hours. However, your face may be numb and caution is required. The provided packs may be warmed in the microwave or a heating pad may be used. Judiciously evaluate the temperature prior to applying to the swollen area.
- You will be prescribed a steroid to assist with inflammation and to reduce the swelling. It is not required, but will assist with recovery and is recommended. A known side effect of this medication is a disturbance to sleep. The directions are provided on the packaging, but avoiding the bedtime dose may alleviate this disturbance.
- Minor oozing from the incisions inside the mouth should be expected during the first 72 hours. The incision is located on the inside of your lower lip at the depth of the fold.
- Notify us if a sudden or prolonged gush of bright red blood occurs.
- Dark blood clots may be coughed up or occur at the incision line. This may be normal and should not be alarming.
- Expect bruising along with swelling. The bruising should begin to dissipate as the swelling subsides. The bruising may spread in the skin as it dissipates. It will likely change colors from black/blue/purple, to green, to yellow.
- The most common sites for bruising are the corners of the mouth and the jawline. During the next 1-2 weeks the bruising will have a gravitational shirt down the neck and settle along the neckline. This is normal and will resolve in 1-3 weeks depending on the severity.
- Please notify us immediately if you develop significant bruising that feels hot to the touch, tender, and firm. This may be a localized hematoma (blood clot) at the surgical area.
- Your face and neck will feel tight, but may not necessarily look tight. There may be a feeling of numbness around the chin and lower lip for several weeks, and could last months after surgery. It will dissipate and your feeling will return to normal.
- A long lasting local anesthetic (numbing injection) will be administered during surgery. This will assist with pain relief for up to 72 hours. This will also make your chin and lower lip numb during that period.
- Please notify us if there is any persistent numbness at your follow-up appointment.
- Motor nerves are usually NOT affected, and you should have normal face and lip movement.
Diet Restrictions After Surgery
- You may have something to eat, either warm or color (NOT HOT), once you leave our office. Start with liquids and mushy foods: soup, yogurt, scrambled eggs. You should then gradually advance to a soft diet ford the rest of the week. A soft diet is anything you can cut with a form (ground meat dishes, casseroles, cooked vegetables, chicken, fish, macaroni, etc.). The only foods to avoid are popcorn, nuts, and foods with seeds or berries in them.
- Hydration is key in recovery, and we recommend 8-10 glasses of liquid a day during the recovery process.
Activity Level After Surgery
- Avoid any strenuous physical activity for one week.
- You may return to school or light duty work (non-physical labor) between 1-2 weeks after surgery or as tolerated per your symptoms.
- Although you just had surgery, we recommend you do not stay in bed while awake to minimize the chances of blood clots in your legs.
- Try to transfer to a chair and walk throughout the house. Try to be as active as possible.
- Physician work/school generic excuse notes are available upon request.
- You may shower and wash your hair and face following the surgical procedure.
- Begin using the prescribed mouth rinse Peridex (Chlorhexidine) the first evening of the surgery. Begin rinsing with ½ ounce (line notated within the mouth rinse cap) for 30 seconds. Only use twice daily after brushing for one week. Use a baby sized, soft bristled toothbrush to clean the teeth. Keeping the mouth clean will also prevent a wound infection.
- The sutures should start to dissolve in the first week as the gum tissue starts to heal. You may rinse with warm salt water often to help soothe the wounds. Avoid mouth rinses with alcohol (a majority of the commercial OTC mouth rinses contain alcohol) as they may burn and irritate the healing wounds.
- Avoid smoking as it will slow or prevent healing and may result in an infection.
- Avoid directing water picks to the incision wounds in the first 1-2 weeks following surgery as the fluid may become trapped in the wound.
- Pain Medication – You have been given a prescription for pain pills (i.e. Percocet/Oxycodone). This is a strong pain medication and does, on occasion, make some people feel tired or somewhat nauseous (Zofran, an anti nausea medication, may be prescribed to treat nausea). Consequently, the following pain regimen has been found by our office to give our patients superior pain control and minimize the side effects found with narcotics. Take 600mg of Ibuprofen (3 tablets of Advil, Motrin, or generic Ibuprofen) every 6 hours. If you find the Ibuprofen alone is inadequate for pain control, you may take 1-2 of the stronger pain pills (Percocet/Oxycodone) every 4 hours. This regimen of medication should provide superior pain control, more than if you were taking the narcotic medication alone. The Ibuprofen has the added advantage of reducing inflammation and swelling, and may help the surgical site heal. If you have questions regarding your pain control, please contact our office. The narcotic pain medication (Percocet/Oxycodone) may cause constipation. Over the counter stool softeners are recommended. The narcotic may be substituted based on personal health history and individual needs.
- Antibiotic – You may have been given an antibiotic. Please take it as directed until it is gone.
- Peridex (Chlorhexidine) Mouth Rinse – GENTLY rinse with ½ ounce twice daily after brushing your teeth in the nonsurgical sites. Please note that a light brown/green stain may develop on the teeth and tongue. The stain can easily be polished off and should not worry you. The antibacterial effects of the mouthwash are significant and play a very important role in helping to prevent postoperative infection.
- There will be an adhesive dressing over your chin that ideally will stay in place for 5-7 days.
- A head wrap will be in place that will help facilitate holding the cold packs. This may be removed when not utilizing the cold packs.
What Follow-Up Care Will I Receive?
- You should have scheduled a follow-up appointment to monitor your healing progress, which usually occurs one week following surgery. Typically the remaining dissolving sutures will be removed at this appointment.
- Please call at any time during your recovery if you have any questions or concerns.
When Should I Call My Doctor?
- If you have difficulty breathing.
- If you have a sudden onset of new or increased swelling or bleeding.
- If you have a foul odor or taste in your mouth.
- If drainage or discharge occurs at the surgical incision.
- If you are unable to urinate.
- If you have severe pain that is not relieved by medications.
- If you experience a rash, nausea, vomiting, severe headache, severe constipation, or other unexpected reactions.
- If you have an oral temperature over 100.5 degrees.
- If you have a question or concern that must be addressed prior to the follow-up visit.
Who Should I Call if I Have Questions?
Call our office at Dallas Surgical Arts Phone Number 972-566-4900, Monday – Friday during business hours. After business hours, call the office number and an answering service will be able to connect you with the doctor.