Preparing For The Procedure
Endoscopic Midface | Browlift | Lower Eyelid
wo to three weeks off of work is recommended to recover from surgery.
On the business day prior to the operation we ask you to call to confirm your arrival time for surgery.
Do not bring valuables (cash, credit cards, watches, jewelry, etc.) on the day of surgery. Remove all makeup and nail polish before arriving for your procedure.
It is essential that someone be available to drive you home, and that person is able to spend the evening of surgery with you. It is California law that every patient be monitored for a period of twenty-four hours following surgery. This person does not have to have any nursing experience, just an interest in your welfare. While you spend the day at rest, your helper will fix soft food for your lunch and dinner, assist in applying the cold compresses to your eyes, walk you to the bathroom and just be near if you should require anything.
You may not eat or drink after midnight the evening before the browlift procedure unless instructed otherwise. This includes all food, liquids, water, candy, mints or gum.
Clothing- A scarf can be worn to camouflage a soft bandage that surrounds the cheeks, ears and upper face. Wear a loose dress, or slacks and a blouse. You must not wear anything that pulls over the head or face.
It is imperative to refrain from tobacco products for one week prior and three weeks following surgery. If smoking is continued during these periods there is a significant risk of skin necrosis and sloughing.
It is recommended that you purchase thick cover-up make-up prior to your procedure. In some instances this may be useful to camouflage bruising or redness after surgery.
Medications
At your preoperative appointment you will provided with all of the instructions for you to follow before and after surgery. During this appointment you will also be given all of the prescriptions necessary for the recovery period. You should fill these prescriptions prior to the date of surgery. We will also ask you to obtain an antibiotic ointment and saline water for use following surgery.
Please avoid any aspirin, aspirin-containing products, or ibuprofen (Advil, Aleve, etc.) for one week prior to and two weeks following your surgery. See our “Medication List” for products to avoid prior to and immediately following surgery. If you are on any medications that affect bleeding (such as coumadin or warfarin) please notify the office immediately.
Please avoid herbal supplements for 10 days prior to surgery, including and especially fish oil, ginseng and garlic.
We ask that you remain on your daily medications unless instructed otherwise. At the preoperative appointment, you will be told which daily medications to take with just a sip of water on the morning of surgery.
Post operative midface lift medication checklist
1. Antibiotic (Keflex, Clindamycin) : prescription
2. Pain reliever (vicodin, percocet) : prescription
3. Medrol Dose Pack: prescription
4. Saline water: purchased over the counter
5. Erythromycin ophthalmic ointment: prescription
6. Artificial / Rewetting tears: purchased over the counter
7. Antibiotic ointment: purchased over the counter
8. Arnica (a natural herb that significantly decreases bruising): purchased over the counter
When you wake up from surgery you will notice a soft, bulky head wrap dressing. Attached to your head dressing are two small drains. These drains collect excess fluids and help prevent infection.
Saline eye pads are placed over your eyes. These help to minimize swelling and bruising. Your vision will be blurry due to the eye ointment that was placed in your eyes after eyelid lift surgery. You may also notice that tears run down your cheeks, which is due to swelling and will subside during the first week following surgery.
Following your procedure, the nurses will ask you to meet the discharge criteria: to drink liquids, walk with a steady gait, void, manage your discomfort, and monitor and empty the drains.
You will be asked to come to our office the following day after surgery for a dressing change and drain removal. Sutures are removed from the eyelids 3-4 days after surgery; the remainder of the sutures are removed 7-8 days after surgery. You may then begin wearing make-up to camouflage any residual bruising or redness.
Make-up
Bruising can be camouflaged at one week postoperatively with make-up. It is recommended that you purchase thick cover-up make-up prior to your procedure. In some instances this may be useful to camouflage bruising or redness after surgery. A scarf can be worn around the head to hide the incisions.
Eyelid Exercises
Dr. Kolstad will instruct you on when (usually two weeks after surgery) and the type of eyelid exercises that are appropriate for your surgery. Depending on the procedures, there are three different types of exercises (see video upper lid, lower lid, and midface lid exercises).
What To Expect During Healing
Above the eyebrows, the forehead and part of the scalp there is a moderate numbness to the touch. This is always a part of the browlift procedure.
This numbness begins to disappear in a couple weeks, moving from front to back. It may take three months for sensation to return to this area.
In very rare instances some numbness may persist.
Sun Exposure
Always protect your face from the sun. At this point, a hat and sunglasses are a good idea. Following surgery, our staff will tell you when it is ok to apply sunscreen, cosmetics or facial creams. Avoid unprotected prolonged sun exposure for three months following surgery to prevent pigmentation of incision lines.
Please Remember!
Swelling, bruising and disrupted sleep are very normal postoperative browlift symptoms and will decrease as the healing process occurs. Assistance with daily activities the first two to three days after surgery is strongly recommended.
Nasal Appearance
At the time of nasal splint removal, you will have your chance to see the new nose. It will appear quite swollen but, in most cases, even in this swollen condition, the improvement can be appreciated. It takes time for the skin and soft tissue to adhere to the new framework. During your postoperative visits Dr. Kolstad may use medicines to help contour the shape of your nose.
Final results following rhinoplasty are not apparent for one full year following surgery. After three months, the changes are ever so subtle, although still important. Being perfectionists about our work, you may tell us you are pleased long before the one year anniversary. However, we request that you follow-up with us at that time for postoperative rhinoplasty photographs and so that we can enjoy your final result.
Nasal Exercises
In most cases you will be requested to begin nasal exercises after the rhinoplasty cast is removed. These exercises help reduce the swelling in your nose and should be continued for three weeks after surgery. You will be instructed on how to perform these during your visit. Nasal exercises should be performed two to three times daily for two minutes at a time. Please remember to alternate using your right and left hands. See video to the right.
Activity
Sleep with head of the bed elevated or use two to three pillows for three weeks after surgery. Three weeks after surgery you may resume full activity without medical restrictions. It is advised that you resume your work-out regimen slowly, as your body may fatigue a little easier than usual.
Wearing Glasses
You should not wear glasses for at least one month. If glasses must be worn, taping the central bridge of the glasses to the forehead will allow as little pressure as possible on the nasal bones.
Sun Exposure
Your skin should be protected from sun exposure for at least six months after surgery. A sunburn will cause the nose to swell dramatically and delay the final result. Sun avoidance or protection with a hat is preferred. You may begin wearing sun block three weeks after surgery. Factor 25 sun block with both UVA and UVB protection.
Before Surgery Checklist
Preparing for the Procedure:
1. Call to confirm your arrival time for surgery.
2. Do not bring valuables on the day of surgery.
3. Arrange a friend / family member to observe you for 24 hours after surgery.
4. You may not eat or drink after midnight the evening before the procedure.
5. No smoking for 1 week before and 3 weeks after surgery.
6. Purchase thick cover-up make-up prior to your procedure.
7. Medications: avoid (aspirin, Motrin, ibuprofen, Alieve) unless advised to continue by your doctor. Inform office if you are on coumadin / warfarin, plavix, or other blood thinner.
8. Medications: confirm which of your daily medications to continue the morning of surgery.
9. Medications: fill your prescriptions before the day of surgery. Typical medications are found below.
10. Over the counter items: arnica, saline water, Qtips, ice packs.
General Postoperative Medication Checklist
1. Antibiotic (Keflex, Clindamycin): prescription
2. Pain reliever (vicodin, percocet): prescription
3. Medrol Dose Pack: prescription
4. Saline water: purchased over the counter
5. Antibiotic ointment: purchased over the counter
6. Arnica (a natural herb that significantly decreases bruising): purchased over the counter
After Surgery Checklist
Immediately after the procedure
1. You must meet nursing criteria for discharge home; walking, voiding, talking.
2. Receive instructions dressing and drain management.
3. Confirm your appointment with the office, always on the morning after surgery.
The First 24 Hours
1. Wound care: cleaning the sutures with a Q-tip dipped in saline water and then apply the antibiotic ointment (polysporin/bacitracin) twice a day.
2. Wear the ace bandage 24 hours a day until instructed to wear it only at night
3. Activity: sleep with head of the bed elevated or use two to three pillows. No strenuous activity / aerobics / yoga / heavy lifting for 3 weeks after surgery.
4. Bathing is ok as long as you don’t get your incisions/hair wet for a minimum of four days after surgery.
5. Advance diet from liquids to soft food to your regular diet as tolerated.
6. Cold compresses are used continuously over the forehead to minimize swelling and control bruising (30 minutes on, 15 minutes off) for the first 48 hours after surgery.
7. Medications: use pain medication as necessary. You can have a maximum of 8 tablets of vicodin + Tylenol in a 24 hour period (6 vicodin + 2 Tylenol = 8, ect).
8. Medications: Start antibiotic (Keflex/Cephalexin) when you arrive home and feeling ok to take medicine.
9. Medications: Start Medrol Dosepak/methyl prednisolone when you arrive home and feeling ok to take medicine.
One Week After Surgery
1. Make-up can be started 1 week after surgery to camouflage any bruising or redness.
2. Avoid sun exposure for three weeks after surgery, then use sun block.
3. The brow and scalp will be always be numb to touch following surgery. This will improve in the first few weeks to months after surgery.
4. Swelling, bruising and disrupted sleep are very normal postoperative symptoms and will decrease as the healing process occurs.
5. Differential swelling may asymmetries of the right and left sides of your face. As the swelling goes away, so will these asymmetries. Please be patient.
