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The Process

How to Prepare for Surgery

Pre-surgical instructions

Follow specific fasting requirements (typically no food or drink 6-8 hours before surgery) and avoid certain medications. These instructions ensure anesthesia safety and reduce complications.

Blood Thinners

Stop Aspirin, Ibuprofen, and Warfarin 5-10 days before surgery to minimize bleeding risks.

Herbal Supplements and Vitamins

Discontinue Fish oil, Vitamin E, Ginkgo biloba, Garlic, Ginseng, and others 1-2 weeks prior to surgery.

Steroids
Taper or adjust Prednisone if necessary to avoid affecting healing.
Antidepressants
Consult about SSRIs like Prozac or Zoloft as they can increase bleeding risk.
Diabetes Medications
Adjust Insulin or Metformin due to fasting requirements.
Anti-hypertensives
Stop ACE inhibitors or ARBs like Lisinopril on surgery day to prevent low blood pressure risks.
Oral Contraceptives

Discontinue temporarily if advised due to clotting risks.

Transportation and care arrangements
Arrange transport and ensure a responsible adult is available to assist for 24-48 hours post-surgery.
Skin preparation
Cleanse with antibacterial soap the day before surgery, and avoid lotions, creams, or makeup on the surgery day.
Lifestyle modifications
Stop alcohol and smoking at least two weeks before surgery to improve healing and reduce complications.
Clothing and personal items
Wear loose, easy-to-remove clothing. Avoid jewelry, makeup, contact lenses, and nail polish on surgery day.
Fasting guidelines
Follow fasting rules (typically from midnight before surgery) to prevent anesthesia complications like nausea.
Preoperative testing
Complete required tests (blood work, ECG, ophthalmological tests) to ensure you are fit for surgery.
Mental preparation
Ask any questions to your surgeon beforehand to ease anxiety and clarify the process.
Post-surgery home setup
Clean bed linens and comfortable setup with head elevation to reduce swelling.
Hand hygiene
Wash hands thoroughly before applying ointments or touching operated areas. Avoid touching the surgical site to promote healing. Keep essentials (medications, water, tissues) within reach for convenience during recovery.

After the Procedure and Postoperative Care Consultation

Medical history review
A detailed assessment of the patient’s health, including medications, allergies, and prior surgeries, to ensure suitability for surgery and anesthesia. Specific conditions affecting surgery, like high blood pressure or clotting issues, are addressed.
Facial and eyelid examination
Comprehensive evaluation of functional and aesthetic concerns to identify specific needs. This includes assessing eyelid drooping, excess skin, wrinkles, and symmetry.
Discussion of outcomes
The surgeon and patient align on realistic goals for the procedure. Expectations for the final appearance, healing time, and results are set, ensuring mutual understanding.
Risks and complications
The surgeon and patient align on realistic goals for the procedure. Expectations for the final appearance, healing time, and results are set, ensuring mutual understanding.
Preoperative photographs
Photos are taken to document the pre-surgical appearance for comparison and surgical planning, helping the surgeon achieve the desired result.
Medical tests
Depending on the patient’s health and age, tests like blood work or an ECG may be required to ensure fitness for surgery and anesthesia safety.
Ophthalmological eye tests
  • Schirmer’s test: Assesses tear production to detect dry eye, which is crucial for eyelid surgery planning.
  • Peripheral vision test: Measures the extent of the patient’s side vision, ensuring that any eyelid surgery does not impede visual fields.
  • Visual acuity test: Determines sharpness of vision, ensuring no pre-existing issues may be aggravated by surgery.
  • Intraocular pressure test: Helps rule out glaucoma by measuring eye pressure, a critical factor in surgery planning.
Surgical plan and consent
A detailed surgical plan is developed, covering incisions, techniques, and expected outcomes. The patient signs informed consent acknowledging understanding of the procedure, risks, and recovery.
Discussion on anesthesia
  • Local anesthesia: Suitable for minor procedures; numbs the area while keeping the patient awake. Recovery is faster with fewer risks.
  • IV sedation: Moderate sedation for more involved surgeries; keeps the patient relaxed but not fully unconscious.
  • General anesthesia: Used for extensive surgeries; patient is fully unconscious. Discussed when the complexity or duration warrants deeper sedation.
  • Patient questions: The surgeon addresses all patient concerns, ensuring clarity on the procedure, recovery, and outcomes, fostering confidence and reducing anxiety.

Surgery Day and Anesthesia

Arrival

Arrive at the clinic/hospital at the designated time, typically a few hours before surgery to allow for preoperative preparation. Bring a valid ID and any necessary paperwork. Ensure a companion is available for transport and support after the procedure.

Check-in and preparation

You’ll be checked in and escorted to a preoperative area where you will change into a gown. Pre-surgical vitals (blood pressure, heart rate) will be measured, and an IV line will be placed to administer fluids and medications. The surgical team will verify your identity, the procedure, and the surgical site, marking it as needed.

Discussion with the anesthetist

Type of anesthesia: Confirm whether local anesthesia, IV sedation, or general anesthesia will be used. This is based on the type of surgery and personal health factors.

Medical history: Review any relevant health conditions, allergies, past reactions to anesthesia, and current medications to ensure proper planning.

Fasting confirmation: Confirm you have followed fasting instructions to prevent complications such as aspiration (stomach contents entering lungs during anesthesia).

Concerns and preferences: If you have anxiety about anesthesia, discuss sedation options or ways to minimize discomfort during the procedure. Ask about the anesthetic’s expected duration and any side effects.

Types of anesthesia

Local anesthesia: Numbs the surgical area, keeping you awake but pain-free. Often used for minor procedures.

IV sedation: Provides relaxation and slight drowsiness; you may not remember parts of the procedure. Ideal for intermediate-level surgeries.

General anesthesia: You will be fully unconscious during the procedure, used for more complex surgeries. Recovery may take longer, with grogginess post-surgery.

Monitoring during surgery

The anesthetist will monitor your vital signs (heart rate, blood pressure, oxygen levels) throughout the procedure to ensure safety and adjust medications as needed.

Post-anesthesia care

After surgery, you’ll be moved to a recovery area where your vitals will continue to be monitored as you wake up from anesthesia. You may feel groggy or disoriented; this is normal. Pain relief medication will be provided as needed. The anesthetist will check on your comfort level and provide instructions for managing any nausea or discomfort.

Immediate Postoperative Recovery

After the surgery, you will be taken to a recovery ward where nurses and the surgical team will monitor your vital signs (heart rate, blood pressure, oxygen levels) as the anesthesia wears off. Depending on the type of anesthesia used, you may feel groggy, disoriented, or slightly nauseous—this is normal. Pain management will begin immediately, with medications provided to control discomfort. *Your surgeon may include specific instructions.

Waking Up from Anesthesia

If you had general anesthesia, you may feel groggy or confused for a few hours as it wears off. The anesthetist will check your comfort level and manage any side effects, like nausea or dizziness. For IV sedation or local anesthesia, you may feel more alert but still drowsy. You will be allowed to wake up gradually before moving to the next stage of recovery. Your surgical area may feel tight, swollen, or numb, which is expected and will be closely monitored. Your surgeon may include specific instructions.

Pain and Medicationry

Pain relief is typically managed with prescribed medications, either orally or through an IV. The surgical team will ensure you are comfortable and provide clear instructions on managing pain at home. You may also receive antibiotics to prevent infection, as well as anti-nausea medication if needed. Your surgeon may include specific instructions.

Post-Surgical Monitoring

You will remain in the recovery ward until your vitals stabilize and you are alert enough to be discharged. This process may take a couple of hours, depending on the complexity of the surgery and the type of anesthesia used. For more invasive surgeries, you may need to stay longer for observation or be admitted for an overnight stay. Your surgeon may include specific instructions.

Discharge Instructions

Depending on the procedure, your discharge will either be to home or to a recovery retreat as per the surgeon’s recommendation. Once you are ready for discharge, the medical team will provide detailed instructions, which include:

Wound care: Instructions on how to clean the surgical site, apply ointments, and care for any stitches or dressings.
Medications: A list of prescribed medications (painkillers, antibiotics) and the correct dosage schedule.
Activity restrictions: Guidelines on when to resume light activities, avoid strenuous exercise, and how to elevate your head to reduce swelling.
Diet: You may be advised to start with light, easy-to-digest foods and hydrate well, especially if you’ve had anesthesia.
Follow-up appointments: A scheduled date for your follow-up visit to assess healing, remove stitches (if necessary), and review progress. Your surgeon may include specific instructions.

Pain Management at Home

Continue taking prescribed pain medications as instructed. Over-the-counter painkillers like acetaminophen may also be recommended for mild discomfort. Avoid excessive use of medications not prescribed by your doctor, as they may interfere with the healing process. *Your surgeon may include specific instructions.

Swelling and Bruising

Swelling and bruising around the surgical site are common, especially with facial or oculoplastic procedures. Apply ice packs as directed (usually in 10-15 minute intervals) to minimize swelling. Keep your head elevated, even when sleeping, to reduce fluid buildup. Swelling typically peaks 2-3 days post-surgery and then gradually subsides at different rates, depending on factors like sex, age, and the extent of the procedure. *Your surgeon may include specific instructions.

Wound Care

Follow your surgeon’s specific instructions on keeping the wound clean and dry. Use any prescribed ointments or dressings as directed. Avoid excessive touching or rubbing of the surgical area to prevent infection and promote healing. Stitches may be dissolvable, but if not, you will have a follow-up appointment to have them removed. Your surgeon may include specific instructions.

Activity and Movement Restrictions

For the first 48-72 hours, rest as much as possible and avoid strenuous activities. Avoid bending, lifting heavy objects, or strenuous exercises that may increase blood pressure and risk bleeding at the surgical site. Gradually resume light activities as recommended by your surgeon, typically after 1-2 weeks. Your surgeon may include specific instructions.

Bathing and Showering

You may need to avoid showering for the first 24-48 hours, depending on the surgery. Follow your surgeon’s instructions regarding when and how to shower without getting the surgical area wet. Sponge baths may be recommended during the initial recovery phase. Your surgeon may include specific instructions.

Signs of Complications

Watch for signs of infection, such as excessive redness, warmth, swelling, or drainage from the incision site. Fever, increased pain, or difficulty breathing should be reported to your surgeon immediately. Other signs of concern include excessive bleeding, persistent nausea, or swelling that worsens instead of improving. Your surgeon may include specific instructions.

Follow-up Care

Your first follow-up visit is typically scheduled within a week post-surgery to assess healing and remove any stitches or dressings. Additional follow-up appointments may be required depending on the type of surgery and individual recovery progress. Adhere to all follow-up appointments for optimal recovery and to address any concerns with your surgeon. Your surgeon may include specific instructions.

Returning to Normal Activities

The timeline for resuming work, exercise, and other normal activities will vary based on your specific procedure and recovery. Light activities such as walking can often be resumed after 1-2 days, while more strenuous activities may take 2-4 weeks or longer. Always follow your surgeon’s specific guidelines on returning to exercise, driving, or performing heavy lifting. Your surgeon may include specific instructions.

Long-term Care

Continue protecting the surgical area from the sun with sunscreen or protective clothing, as sun exposure can impact healing and cause scarring. Use scar treatments or ointments as recommended by your surgeon to promote proper healing. Your surgeon may include specific instructions.