PREPARING FOR SURGERY
MEDICATIONS TO AVOID: Please stop taking any medications containing aspirin, ibuprofen, diet pills, and herbal medications (includes OTC) for at least two weeks prior to surgery. Such drugs can cause increased bleeding, interfere with anesthesia, cause cardiovascular concerns and/or increase your risk for post-operative complications. If you use hormone medications or have an implanted hormonal device, please discuss this with your pre-operative nurse. If you happen to develop a cold within weeks of your surgery, you must notify one of our nurses – do not just begin taking cold medication as this can have the same contraindications listed above.
ALCOHOL: Do not drink alcohol two weeks prior to your surgery and at least one week after surgery. Alcohol can cause increased bleeding complications.
SMOKING: Smoking reduces circulation to your skin and impedes healing. We advise stopping one month before and one month after your surgery. This includes nicotine patches, gum, chewing tobacco and electronic cigarettes.
DIET: Please start taking multivitamins and increase your protein and fiber intake. Continue to take multivitamins for one month after your surgery. This will aid in the healing process.
LABS/DIAGNOSTIC TESTS: If you have been instructed to get a diagnostic test or blood draw and haven’t done so yet, please take care of this immediately.
FILLING YOUR PRESCRIPTIONS: Please have your prescriptions filled BEFORE the day of surgery. Our nursing staff is dedicated to making this a safe and informed journey. Please do not hesitate to call upon us with any questions or concerns.
HIBECLENS: Prior to your scheduled procedure, you will need to purchase a bottle of Hibiclens. This is an antimicrobial soap that can be found at all major pharmacies. You will use this soap in the shower the night before and the morning of surgery. If you are having a facial surgery, please disregard. For facial procedures, we will provide you with recovery supplements at the time or your pre-operative appointment.
STOOL SOFTNER: You will need to purchase Colace prior to your scheduled procedure. During the post-operative phase of surgery, the combination of anesthesia, narcotic pain medication use and the surgery itself can cause patients to experience decreased intestinal mobility. This can lead to constipation. If you are experiencing constipation and taking Colace, do not take a laxative. Please contact our office for further guidance from your dedicated nursing staff.
SHAVING: Please refrain from shaving, waxing, or laser hair removal in the areas that will be operated on.
EXERCISE: Please refrain from any exercise the day prior to surgery and the morning of surgery.
FASTING: Do not eat or drink anything after 12:00 midnight the night before surgery unless directed by our nursing staff. This includes water, coffee, gum, candy and/or mints. You may brush your teeth, but do not swallow any water.
**Please report any new health conditions such as signs of cold, infection, or other illness that were not present at the time of your pre-operative appointment.**
DAY OF SURGERY
CLEANSING: Use Hibiclens anti-microbial soap to perform a 2-minute cleansing scrub of the surgical area. Please refrain from applying moisturizer, powder, deodorant, or perfume to your body or face. Using these products will add bacteria to the skin and increase the risk of infection. Also, please do not shave the surgical area. Please do not apply makeup or any products to your hair after your shower.
ATTIRE: Wear comfortable, loose-fitting clothing that does not go over your head (shirts that either zip or button up the front are best). Please do not bring valuables with you and leave all jewelry at home.
CONTACTS: If you usually wear contacts, please leave them at home the morning of surgery and wear your glasses.
CAREGIVER: You must have a responsible adult drive you home from surgery and stay with you for 24 hours who will monitor your health and support you following surgery. You will also need a caregiver to drive you to postoperative appointments until you are able to drive.
ELEVATOR ENTRANCE: Your comfort and privacy is important to us. For this reason, we have created a separate and private entry through the Surgery Center Elevator. On the day of surgery, please report to the Surgery Center Elevator in the underground parking lot. This elevator can be used for post-operative visits as well for up to the first six weeks of the healing process.
ARRIVAL TO SURGERY: When you arrive at our office, you will be escorted to your private patient suite to begin the preoperative process. You will be asked to change into surgical attire. Dr. Egrari will meet with you before you enter the operating suite. This is the time to finalize your surgical plan; it is also when we will do basic preparation or mark your skin as needed. There will be time for last-minute questions.
OPERATING AND RECOVERY ROOM: Your surgery will be performed in our fully accredited, on-site surgical suite. When your surgery is complete and your dressings are in place, you will be moved to the recovery area and rest here until safe to be discharged and go home.
POSTOPERATIVE VISITS: Due to the nature of surgical scheduling, it may not be possible for Dr. Egrari to personally attend each of your post-operative visits. Rest assured that your safety is paramount at all stages of the recovery process, and that our nursing staff will be in direct communication with Dr. Egrari regarding all aspects of your recovery. You are welcome to use the Surgery Center Elevator for a more convenient entry and exit during your early postoperative period.
BLOOD CLOTTING PROVENTION: It is extremely important that you engage in light walking every 3-4 hours for about 10 minutes. Depending on your procedure, you may be given additional medications and devices to use post-operatively. The use of these additional preventative measures will be explained during your pre-operative appointment and during the recovery period.
ACTIVITY: Take it easy and try to avoid strain. For the first 2 weeks, no lifting, pushing, pulling over 10 pounds. Excessive physical activity could increase bleeding, swelling and bruising. Avoid aerobic activity for 3-4 weeks after surgery. Do not resume strenuous exercise for 4-6 weeks, this includes sexual intercourse.
SHOWER/SOAKING: You may shower 48 hours after surgery unless you have drains. If you have drains, you will be able to shower after one week. No baths, hot tub, or pool for 4 weeks.
BED POSITIONING AND POSTURE: Posture and positioning will vary depending on your specific surgery. Your pre-operative nurse will go over specifics with you.
HEAT/ICE PACKS: Use heating and/or ice packs only if instructed to do so by Dr.Egrari or our nursing staff. Ice is only appropriate for the first 24-48 hours if you have been instructed to use cold packs.
BRUISING AND SWELLING: It is normal to experience swelling and bruising. However, swelling can linger weeks after surgery. If you have any concerns, please contact our office and speak to a nurse.
DRAINS/FOLEY CATHETER(if applicable): Drains should be emptied 3 times a day. After recording the amount for each drain, squeeze the bulb and insert the cap to activate suction. The bulb should stay compressed. If necessary for your procedure a catheter may be placed. Catheters are removed the day after surgery.
DRESSINGS/GARMENTS: Keep your dressings as clean and dry as possible. Do not remove them unless instructed to do so. It is acceptable to have some oozing of fluid or blood on your dressing. Wear your garment 24 hours a day for the next 4 weeks except for showering. It should be snug, but not painful.
DIET: Your diet should start light; such as warm soups, pudding, applesauce and yogurt then progress to a normal diet as tolerated. If you have nausea, carbonated soda and dry crackers can help.
DRIVING: Do NOT drive while taking pain narcotics. You must be able to operate a vehicle safety.
MEDICATIONS: It is important that you use the medications as directed unless you experience abnormal symptoms that might be related to the medications usage. Symptoms such as itching, rash, wheezing, and tightness in the throat are probably due to an allergic reaction. Should these occur, discontinue all medications and call the office at 425-827-7878
POSTOPERATIVE BOWEL HABITS
During the post-operative phase of surgery, the combination of anesthesia, narcotic pain medication use, and the surgery itself can cause patients to experience decreased intestinal motility. This can lead to the unpleasant experience of constipation. It is imperative that patients are proactive during this period in order to avoid this consequence of surgery. Below are ways that patients can lessen this effect and increase comfort levels during recovery:
- Increase water intake to 1500 – 2000 mL (6 – 9 eight ounce cups) daily beginning at least two weeks prior to surgery, and continue 7-10 days after surgery.
- Increase intake of naturally high-fiber foods including fruits, whole grains and legumes in the pre-operative period, and continue to add these foods to diet throughout the post-operative period.
- Begin using natural laxatives such as prune juice or dried prunes.
- Ambulate as frequently as tolerated as early in the recovery period as possible. Not only does this alleviate constipation and stimulate intestinal motility, but can also prevent other serious complications such as blood clots.
- Begin using Colace (docusate sodium) immediately after surgery. Please take three 100mg capsules daily, and continue to use this medication for as long as narcotic pain medication is necessary. *This item is listed on your Pre- OperativeShopping List*
- Transition to non-narcotic pain relievers such as Extra Strength Tylenol as soon as you adequately control pain levels.
Please AVOID LAXATIVES such as Miralax (polyethylene glycol) and Citroma (magnesium citrate) throughout the Post-Operative phase of your surgery unless specifically directed by Dr. Egrari. These medications have the potential to cause complications and can increase your discomfort.
Typical Post-Operative Symptoms:
- Tightness, stiffness, swelling in surgical area
- Tingling, burning, or intermittent shooting pain
- Hypersensitivity or lack of sensitivity (should gradually resolve over time)
- Shiny or itchy feeling skin
- Sleep disruption: you normal sleep patter should return gradually
Call the office immediately if you experience any of the following:
- A high fever (anything over 101 F)
- Severe nausea and vomiting
- Bright red skin that is streaking up or down your bandages and is hot to the touch
- Severe pain that cannot be controlled by pain medication, taken as prescribed
- Excessive bleeding
EMOTIONAL AND PHYSICAL REACTIONS TO SURGERY
Surgery affects each person differently. These curves are just a basic outline. The most common reaction is to be depressed on the third or fourth day. However, some patients say, “Well, not me. I didn’t feel depressed.” But three weeks later, they may have a crying lag while driving to work.
Sometime near the end of the second week, they’ve begun to feel better. Then there will be a day in there when they realize that they look fantastic!
Patients will naturally experience feedback – both positive and negative. Some people tell me that they’re a bit irritated because people are now paying them more attention than they did before. And I say to them, “Isn’t that why you had the surgery? Because you wanted to be more attractive?” And they reply, “Yes, but why didn’t they like me the way I was?!” But eventually, people start to really enjoy the extra attention…
Anyone who has had cosmetic surgery has shown they are a person of courage and they may now demand great deeds for themselves. They have given up the excuse called: “I’d be too afraid to do that.”