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Plastic & Reconstructive Surgery

Plastic & Reconstructive Surgery


Elliot at River's Edge
New Hampshire Plastic Surgery 185 Queen City Avenue
Manchester, NH 03101

Phone: 603-314-6450
Fax: 603-314-6459


Post-Operative Instructions


Post-Op Care Instructions after Plastic Surgery:

These instructions are based on the average healing process after surgery. Your instructions may be adjusted by our office depending on your particular medical history, surgical procedure, and healing progress.

Watch out for infection, which can show up as redness, increasing pain, increasing swelling, and yellow drainage. Fever is uncommon for a minor infection but may be present. Please call the office if you think you have an infection.

Watch out for bleeding under the stitches, which shows up as rapid swelling with or without oozing from between the stitches. If you notice this, elevate the area and hold firm pressure on the area for 5 minutes without peeking. This usually controls the problem. If it does not work, please call the office.


Safety:

If you had general anesthesia:
* Do not drive any vehicle for 24 hours and/or while taking prescription pain medications
* Do not operate machinery for 24 hours or use potentially dangerous household equipment.
* Have someone at home with you until the day after surgery.
* Avoid use of all alcohol and sedatives for 24 hours.
* Do not make important decisions or sign important papers for 24hrs.
If you have facial surgery and use a CPAP machine, you may need to modify or have an alternative for 1-3 weeks after surgery.

You may apply cold compresses to the area as needed if it is soothing. Soak a paper towel in ice water then wring it out and hold it on the site for approximately five minutes. (Facial Surgery Only) 


Activity:

  1. General Activity Regimen

For the first week, we recommend: avoid bending at the hips. No exercising. Do not do anything that increases your heart rate or increases your blood pressure.

    1. Lifting: Do not lift more than 5lbs/a gallon of milk, for the first week.
    2. Activity restrictions will be addressed and modified at each follow up visit.
  1. Sleeping:  Do not sleep on your stomach or sides for the first 3 weeks after surgery. This protects the incisions on your breasts. Consider sleeping in a recliner or with a few pillows stacked behind you to prop your upper body higher.  To help keep you from rolling over, consider a pillow or two under your knees for 1 week after surgery.
  2. If you have had surgery on your nose, no nose blowing. If there is drainage, you can dab gently with a tissue or gauze.
  3. If you have had surgery on your mouth/lip, avoid large open exaggerated mouth movements (eating sandwiches, etc.). Avoid pursing/puckering your lips. We recommend sipping from a straw, on the opposite of the suture line and clamping it in between your lips, like a pipe.
  4. If you have surgery on a limb, elevate it and keep it still as much as possible for the first few weeks.
  5. If you have breast or abdomen surgery, avoid twisting of the trunk and keep your arms in front of you and avoid reaching.
  6. Expect bruising and swelling, which may travel down or across the surgical site.
  7. No driving while you are on medications that can cause drowsiness.  Return to driving, when you feel awake, alert, and able to handle the vehicle.
  8. Do not plan any flights or travel for at least 3 weeks after surgery, please discuss any tentative plans that fall within 6 weeks of your surgery with our surgical team.
  9. Avoid all nicotine products, including cigarettes, cigars, second hand smoke vaping, gums, and patches. Be honest with your surgical team regarding any use or exposure, so we may take better care of you.

Dressings/wound care:

  1. We may recommend that you apply Vaseline to incision line 2-3x/day for the two days.
  2. If you have a bolster dressing sewn to the surgical site after surgery, do not get this wet (No shower)
  3. If the incision line involves the scalp, you may have staples in place which may remain intact for up to 3 (three) weeks.
  4. Avoid shaving over the surgical site
  5. For nose, lip, and eyelid surgeries, expect some oozing and bleeding; do not hold pressure, as it may cause problems with wound healing. We recommend gentle dabbing of the bleeding site.
  6. For individuals who have had ear surgery, you may be given an earshell (Glasscock splint) to wear for protection, while sleeping or otherwise.
  7. We will make modifications and recommendations based on your progression at your weekly visits.

Bathing/showering and swimming:

  1. Most times we will recommend that you keep the area dry for 48 hours, in all other instances you are asked to refrain from getting the surgical site wet, until seen in our office. If you are allowed to get the area wet after 48 hours, you may shower or wash the area gently with your usual soap or cleanser. Let the soapy water run down over the area. Do not scrub or rub the surgical site. Gently pat dry.  AVOID direct water pressure to the surgical site.
  2. No baths, jacuzzis, steams, swimming, or submerging the incisions until 3 weeks after the incisions have completely healed.

Medications and Pain Control:

Ibuprofen and Tylenol can be taken at the same time because they work better together than they do apart.  Ibuprofen and Tylenol should be taken every 6 hours for the first 2-3 days after surgery to keep pain under control and then start to reduce the dose to find what you need to stay comfortable. Ibuprofen should be taken with a small snack to avoid upsetting your stomach.

You may have been given Exparel® , which is a long acting numbing medication (local anesthesia). This is designed to be released over 4 days (96 hours), allowing for a smoother transition during the first week after your surgery. You will know this medication was given, if you are wearing a Teal/turquoise bracelet on your wrist.

Please inform any healthcare provider of your Exparel® bracelet, during the 4 day (96 hour) period. DO NOT use any lidocaine gel or patches during this 4 day/96 hour period.


Pain

You may be prescribed a narcotic medication such as Dilaudid, Oxycodone, or Tramadol, as part of your pain management plan. 

Please review your Discharge Paperwork for specific instructions and recommendations.


Over-the-Counter Constipation Treatments

Surgery, anesthesia and pain medications may cause constipation. You may use the following over the counter medications as needed. They are listed in order of the effectiveness, starting with the lowest potency. These may be purchased at your local pharmacy or super market.

  1. Docusate-Senna (PeriColace, Colace with Senna, Senna Plus) take as directed on the label
  2. Polyethylene glycol (Miralax) take as directed on the label
  3. Bisacodyl USP 10mg suppository (Dulcolax) take as directed on the label
  4. Milk of Magnesia take as directed on the label
  5. Magnesium Citrate take as directed on the label (stay home and close to a toilet if you take this)

Return to work:

Depending on the requirements of your job, we will discuss physical activity restrictions that may require time off from work.


Follow up/post-op visits:

Most patients are seen weekly for the first 3-4 weeks.  Depending on your needs, additional weekly visits may be necessary. We schedule the next follow up appointment at the end of each visit.

Please note, a co-pay is not required for office visits that occur within the first 90 days, after your surgery. Subsequent visits, after 90 days, will require a specialist co-pay.