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Posts Tagged ‘postoperative instructions’

Postoperative Instructions: Testicular Implants

Saturday, August 16th, 2014

Testicle Implants Dr Barry Eppley IndianapolisThe loss or absence of a testicle in a man can have adverse psychological effects. Testicular implants (also called testicular prostheses) are a relatively simple surgical procedure that can lead to an improved body image for those men so affected. It is done through a small incision in the scrotum and takes less than one hour to perform under anesthesia. Based on Dr. Eppley’s experience, these are the most common considerations to know after testicular implant surgery.

1.  Testicular implants usually have a low amount of postoperative discomfort but the scrotum will feel a little tight. Take your pain medications as needed. Significant swelling will occur in the first few days (peaking the second day after surgery), making it more swollen than seen the first night after surgery. This is normal.

2. Apply ice packs (frozen peas or mixed vegetables work well) to the groin area over the implanted side for the first 24 hours to help with swelling. This will keep down some but not all of the swelling.

3. If your job involves deskwork or very light activity, you may return to work 2 or 3 days after surgery. Remember that it is likely that you will have some discomfort for the first few days after surgery when deciding when to go back to work.

4. You may sit and do all activities as you normally would do, short of exercise during the first week after surgery. It will be helpful to have underwear that does not fit too tight but provides good support.

5.  There will be no dressings applied. Only a layer of glue will be over the scrotal incision. The glue will fall off in several weeks after the procedure.

6.  You may shower the next day after surgery and do not worry about getting the incision wet. Do not take a bath or submerge the incision under water for ten days after surgery. (like a hot tub)

7.  All of the sutures will be dissolvable and underneath the skin. You may see a few small sutures on the outside of the incision but these also are dissolvable.

8. Numbness of the skin around the scrotum is normal after this kind of surgery. Normal feeling will return but it may take up to several months after surgery for that to occur.

9.  You may participate in any physical activity that feels comfortable, including exercise. You should avoid running or sex for one week after surgery.

10. If any redness, tenderness, or drainage develops after the first week of surgery, call Dr. Eppley and have your pharmacy number ready.

Postoperative Instructions for Lip Implants

Friday, September 27th, 2013

 

The use of implants for lip augmentation is a surgical procedure that adds permanent volume to the lips. It is done as an office procedure under local anesthesia if done alone or in the operating room under general anesthesia if it is included as part of a collection of other plastic surgery procedures. The implants are inserted through small incisions inside the corners of the mouth through the body of the lip form one corner to the other. The following is a list of after surgery care and considerations for the lip implant procedure.

1.  Lip implant surgery will cause some slight discomfort for the first 24 to 48 hours. Most patients find it can be relieved with mild pain relievers such as Alleve or Ibuprofen. The lips may be sensitive to touch and pressure (caused by activities such as drinking from a straw and kissing) for up to two weeks.

2.  There are no dressings applied after lip implant surgery. Antibiotic ointment can be applied to the corners of the mouth at the incision site to keep the area soft and supple.

3. You will experience swelling in the lips after surgery. Swelling typically takes three days to peak and then will begin to subside over the next two weeks. You may use ice packs to help reduce the swelling and provide comfort during the first day after surgery.

4. The incisions in the corners of your mouth can get wet with no concern for infection. You may shave (men), wash your face and perform oral hygiene (brushing your teeth, mouthwash) as normal.

5. The small incisions in the corners of your mouth will have sutures that need removed one week after surgery (unless you are from out of town). These sutures should be kept moist with antibiotic ointment, applied three times a day, to the corner of the mouth. If dissolvable sutures are used, it is normal for the corners of the mouth to get slightly red in color as those sutures dissolve, applying antibiotic ointment can help lessen this effect.

6. Your lips will feel a little tight when you open your mouth widely. That will take several weeks to a month to return to normal. You may stretch open your mouth and lips as much as feels comfortable. You may eat whatever you like.  Focus on liquids and soft foods for the first few days after surgery.

7. You may experience some bruising after surgery. Taking Arnica Montana tablets prior to your surgery may help to prevent bruising. In addition, topical Arnica gel may be applied after surgery to help reduce any bruising that may occur.

8. There are no physical restrictions after lip implant surgery. You may return to work and resume physical activities such as working out as soon as you feel comfortable.

9. You may begin driving again as soon as you are off pain medications, can react normally and feel comfortable doing so.

10. If any lip redness, tenderness, or drainage develops after the first week of surgery, call Dr. Eppley and have your pharmacy number ready.

Postoperative Instructions for Calf Implants

Saturday, August 17th, 2013

 

Implants for calf augmentation are surgically placed by incisions behind the knee. Very soft solid silicone implants are inserted under the fascia and on top of the gastrocnemius muscle. Either the inner half of the muscle (two implants) or both halfs of the paired gastrocnemius muscle (four implants) can be augmented.

The following are the typical instructions for calf implant augmentation:

1. On discharge from the surgery center, go home directly to bed for the night. Get up only to go to the bathroom and keep the legs elevated as much as possible.

2. Calf implants are associated with a moderate amount of pain in the first few days after surgery.  Narcotic pain medications are almost always needed and you should them as prescribed. In a few days or by a week after surgery, you may switch to Ibuprofen completely or alternate between doses with the narcotic medication.

3.  There will be ace wraps placed around the calfs after surgery. This is in place for comfort only and does not play a role in maintaining the position of the implants. You may take these off the next day and they do not need to be put back on unless they feel better if they are worn.

4.  The incisions behind the knees are covered with glued on tapes. This may be allowed to get wet while showering. They will be removed during your first postoperative visit. The sutures in the incisions are under the skin and do not need to be removed.

5. Swelling and tightness of the calfs is common and peaks by two to three days after surgery. Conversely, bruising is uncommon although possible.

6. You can’t walk around a lot nor walk up stairs at first when you have this type of implant. You MUST limit your walking or risk infection. You should also elevate your legs as much as possible for the first week and wear a type of support hose for 3 weeks. Normally, you may return to exercise and other activities after 6 weeks.

7. It may be helpful to wear hoes with 1 – 2” heels after surgery and for several weeks thereafter. This will cause the calf muscles to not be under too much stretch and the discomfort will be less.

8. Do not expose the calf or scars to the sun or tanning bed for at least 2 -3 weeks after the surgery as severe burns can occur from minimal exposure. Scars must be covered when exposed to sun or the tanning bed (so as not to hyperpigment) until all redness is gone which takes 3 to 6 months. You may use tanning creams.

9. The incision behind the knee will heal in about 10 days. However, it will remain red for up to 6 months until its color eventually fades and blends in better with the surrounding skin. A small fine-line scar will remain. The area surrounding the implants, however, will take about 6 weeks to fully heal. Therefore, you need to be careful with activities to avoid potential problems. Most complications occur in men who do not follow instructions well and insist on returning to work or the gym too early. This can result in hematoma (bleeding), excess swelling, or other problems.

10.  If any redness, tenderness, or drainage develops on the chest or from the armpit incisions after the first week of surgery, call Dr. Eppley and have your pharmacy number ready.

Postoperative Instructions for Brow Bone Reduction Surgery

Tuesday, April 9th, 2013

Most brow bone reductions need to be done through an open scalp incision. Unless the amount of brow bone reduction is very minimal (a few millimeters) the underlying frontal sinus must be factored into the operative technique. Brow bone reductioin can be done by burring, burring and infracture and removal of the brow bone with reshaping and replacement.

The following are the typical instructions for brow bone reduction:

1. Brow bone reduction is associated with a only a very moderate amount of pain in the first few days after surgery.  Narcotic pain medications are prescribed and use them if you need them. In a few days, you may switch to Tylenol or Ibuprofen or alternate between doses with the narcotic medication.

2.  There will be a circumferential head wrap placed right after surgery. This is in place to control extreme swelling and does not play a role in maintaining the new position/shape of the brow bones. You may take it on the next day after surgery. If it should get loose or come off during the night, just leave it off. It is not a critical part of brow bone reduction surgery.

3.  The sutures in the scalp incision are dissolveable and do not need to be removed. There is no need to apply antibiotic ointment to the incisions as all it will do is make your hair greasy and be hard to shampoo out.

4. Bruising and swelling will develop around the eyes after surgery which is perfectly normal. In some patients the eyes may almost swell shut by the second day after surgery.

5. You may shower and wash your hair 48 hours after surgery. There is no harm in getting your sutures wet with soap and water.

6. Your forehead will feel stiff and may not move normally for up to a month after surgery. It will also feel numb for even longer. This is all normal and as the feeling comes back in the forehead you will experience strange sensations such as shooting pains or itching as the nerves recover.

7. You may wear any type of hat around your forehead whenever you feel comfortable doing so.

8. There are no restrictions on normal daily activities after the surgery. You may do light exercise anytime afterwards that you feel comfortable. But no strenuous exercise that involves bending over for three weeks after surgery.

9.   You may drive within several days after the procedure, provided you are off pain medication and can react normally to driving conditions.

10.  If any redness, tenderness, or increased swelling develops on the forehead or around the eyes after the first week of surgery, call Dr. Eppley and have your pharmacy number ready.

Postoperative Instructions for Pectoral Implants

Monday, April 1st, 2013

 

Male chest enlargement by soft solid pectoral implants is done by placing them under the pectoralis major muscle. The implant is placed so that it stays above the lower muscle border, creating a larger pectoralis muscle bulge.

These are the typical postoperative instructions to follow after having had pectoral implant surgery.

1. Pectoral implants in men, similarly to breast implants in women, are associated with a moderate amount of pain in the first few days after surgery.  Usually narcotic pain medications are needed and you should them as prescribed. In a few days, you may switch to Tylenol or Ibuprofen or alternate between doses with the narcotic medication.

2.  There will be a circumferential chest wrap placed right after surgery. This is in place for comfort only and does not play a role in maintaining the position of the implants. You may take it on and off based on your comfort. Most patients feel more comfortable wearing fairly continuously for the first week after surgery.

3.  The sutures in the armpit incisions are dissolveable and do not need to be removed. You may apply antibiotic ointment to the armpit incisions twice a day for the first week after surgery.

4. Bruising may develop on the chest a few days after surgery which is perfectly normal.

5. You may shower and get your chest and armpits wet. There is no harm in cleaning them with soap and water.

6. Your armpits will feel stiff and sore after surgery and your arms more so on raising them. A faster recovery will occur if you begin raising your arms up to the level of your shoulders in the first day or two after surgery. Thereafter, practice raising your arms above your head. These arm range of motion exercises will help the injured pectoralis muscle feel less stiff sooner.

7. You may wear any type of shirt or garment, including one that has to pull over your head to get it on or off.

8. There are no restrictions on normal daily activities after the surgery. You may do light exercise anytime afterwards that you feel comfortable. But no strenuous exercise of the chest muscles for three weeks after surgery.

9.   You may drive within several days after the procedure, provided you are off pain medication and can react normally to driving conditions.

10.  If any redness, tenderness, or drainage develops on the chest or from the armpit incisions after the first week of surgery, call Dr. Eppley and have your pharmacy number ready.

Postoperative Instructions for Earlobe Repair and Reconstruction

Sunday, March 17th, 2013

 

Repair of the earlobe is done for a range of conditions from a tear caused by an ear ring, stretching of the earlobe from gauging to traumatic injuries. The small size of the earlobe allows even complex repairs to be done under local anesthesia as an office procedure in most cases.

The after care instructions for earlobe repairs and reconstructions are as follows:

1. Earlobe repairs, whether a simple split repair or a more complete reconstruction, are associated with a minimal amount of pain in the first few days after surgery.  Usually narcotic pain medications are not needed and Tylenol or Ibuprofen are sufficient.

2.  There may be a small dressing (tape or bandaid) placed over the earlobes for the first 12 to 24 hours if the earlobe has significant reconstruction. Its purpose is to catch any oozing that may occur right after surgery. (usually there isn’t but as a precaution) It may be removed the next day. In smaller earlobe repairs there is no dressing used over the sutures.

3.  A light layer of antibiotic ointment needs to be applied to the sutures on the earlobes three times per day to keep them moisturized. This is done whether removeable or dissolveable sutures are used.

4. If permanent sutures are used, they will be removed by Dr. Eppley in 10 to 14 days after surgery.

5. You may shower, wash your face and shave (men) the next day. There is no harm is getting them wet with soap and water.

6. Do not pull on your earlobes or wear clip-on ear rings for up to one month after the procedure. Re-piercing your ears should wait at least 6 to 8 weeks after the earlobe repair.

7. You may wear eyeglasses or sunglasses after the procedure.

8. There are no activity restrictions after the surgery. You may exercise at any level at which you feel comfortable.

9.   You may drive right after the procedure. Since most earlobe repairs are performed under local anesthesia, many patients drive themselves to and from the facility.

10.  If any redness, tenderness, or drainage develops from the earlobe after the first week of surgery, call Dr. Eppley and have your pharmacy number ready.

Postoperative Instructions: Buttock Implants

Monday, March 11th, 2013

Buttock implants is an established method of permanently increasing the size of one’s buttocks. Implants are placed either into the gluteal muscles or on top of the gluteal muscle through an intergluteal incision. It is a buttock augmentation procedure that takes more recovery than the more commonly performed buttock augmentation method. Here is a list of the most important buttock implant after surgery recovery instructions.

1. Buttock implants are associated with a significant amount of pain in the first few days after surgery. Take your pain medications (narcotics) as needed. That would be 2 to 3 tablets every 3 to 4 hours as needed.

2.  You will have an above the knee compression girdle placed on right after the surgery that you will wear home. The garment is there for comfort so wear it afterwards every day if it feels better on. You may remove the garment and shower the next day after surgery.

3.  The incision between your buttocks will be covered with glued on tapes. There is no care needed for it. It is ok to get it wet and it will likely get loose in the first week after surgery.

4. The tapes on your incisions will be removed by Dr. Eppley at your first follow-up visit. Most of the sutures will be dissolvable and underneath the skin. There will be several support sutures on the outside which will be removed two or three weeks after surgery.

5. Sitting on your buttocks will be uncomfortable and should be avoided for the first few days after surgery. It will likely be more comfortable initially to lay on your stomach or back. While you can’t hurt the implants by sitting on them, it will be a few days until that feels more comfortable.

6. Wear whatever clothes feel comfortable. Initially loose clothing like sweatpants is best.

7. Numbness of the skin around the buttocks is normal after this kind of surgery. Normal feeling will return in a few weeks after surgery.

8. Avoid exercise of any kind for four weeks after surgery so breakdown (opening) of the incisions can be prevented. Too much activity too soon is the main reason why problems with healing of the incisions occurs.

9.   You may drive when you feel comfortable and can react normally and are off pain medication. It is all about how comfortable sitting on your buttocks is before you can drive.

10.  If any redness, tenderness, or drainage develops after the first week of surgery, call Dr. Eppley and have your pharmacy number ready

Postoperative Instructions: Inner Thigh Lifts

Tuesday, March 5th, 2013

 

Inner thigh lifts are done to recontour the bulging or full area between the inside of the upper legs. In some cases, it is done to correct sagging inner thigh skin after a large amount of weight loss. Through a crecent removal of skin of varying widths with the upper end in the groin crease, the sagging thigh is lifted and tightened. Liposuction of the fat in the thigh skin below the excision is often done to debulk the inner thigh area as well. The location of the incisional closure/scar is hidden as much as possible in the groin crease.

The postoperative instructions for inner thigh lifts are as follows:

1.  Thigh lifts usually have a minimal amount of postoperative discomfort but they will feel very tight. There will be some swelling of the thighs and groins after this kind of surgery. This will go away within a few weeks.

2.  There are no dressings or garments to cover the incisions but they will be heavily taped. The tapes are to be left in place to serve both as a dressing and reinforcement of the incisions.

3.  After 48 hours, take a shower and do not worry about getting the tapes wet.  Do not take a bath or submerge the incisions under water for three weeks after surgery.

4.   The tapes on your incisions will be removed by Dr. Eppley at your first follow-up visit. Most of the sutures will be dissolvable and underneath the skin. There may be several support sutures on the outside which will be removed two weeks after surgery.

5.   Numbness of the skin around the groin and inner thigh is normal after this kind of surgery. Normal feeling will return but it may take up to three months after surgery for that to occur.

6.   Avoid exercise of any kind for four weeks after surgery so breakdown (opening) of the incisions can be prevented. Too much activity too soon is the main reason why problems with healing of the incisions occurs.

7. Squatting places the greatest stress on the inner thigh incisions and should be avoided as much as possible until the incisions are well healed.

8. You may drive when you feel comfortable and can react normally and are off pain medication.

9. The inner thigh scars will initially be red and ropey feeling. This will take months to settle down.

10.   If any redness, tenderness, or drainage develops after the first week of surgery, call Dr. Eppley and have your pharmacy number ready.

Postoperative Instructions: Migraine Surgery

Sunday, March 3rd, 2013

 

Migraine surgery can be done in the properly selected patient through decompression of what is known as peripheral triggers. These are various locations of large sensory nerves that may be entrapped by muscle and other tissues as they exit the skull bone. Three such peripheral triggers have been identified including the supraorbital nerves for forehead or frontal migraines, the zygomaticotemporal nerve for temporal migraines and the greater occipital nerve for back of the head migraines. Through small scalp incisions the tissue around the nerve is cleared (decompression) removing any pinching effect on it.

The typical postoperative instructions for migraine surgery are as follows:

1. Most cranial nerve decompression procedures have only modest pain after surgery. Patients usually only feel the need to use Tylenol or Ibuprofen for just a few days after the procedure, some patients may need stronger pain medication for a few days. In rare cases the surgery may actually trigger a migraine and you may use your regular migraine medications as needed.

2. You may sleep in any position that feels comfortable. Most find the best comfort to sleep sitting up for the first few days after surgery.

3. There may be a circumferential wrap placed around the head right after surgery. This will be worn overnight and you may remove it the next morning. It does not need to be replaced.

4. You may shower and wash your hair the next day. There is no harm in getting the scalp sutures wet.

5. The sutures used in the scalp incisions will dissolve on their own. There is NO need for suture removal.

6. You may treat any eye bruising with ice or neck stiffness with a warm pad in the first few days after surgery.

7. There will usually be some temporary scalp numbness or periodic itching in the first few weeks after surgery. This is due to the scalp manipulation and will resolve on its own with healing.

8. There are no limitations to any physical activities after migraine surgery. You may feel free to run, workout and do any non-contact sporting activity as soon as you feel comfortable. Wearing of hats or head bands is based on scalp tenderness.

9.There are no restrictions on what you can eat or drink after surgery.

10. If any incisional or scalp redness, increased tenderness or swelling, or drainage develops after the first week of surgery, call Dr. Eppley and have your pharmacy number ready.

Postoperative Instructions for Tracheal Shave (Adam’s Apple Reduction) Surgery

Wednesday, February 20th, 2013

 

A tracheal shave or Adam’s Apple reduction is the removal of the protruding portions of the paired thyroid cartilages that cover the larynx. This is done through a small horizontal neck incision directly over them in a natural neck skin crease. The cartilages are reduced by shaving or burring them down but without making them unduly weak or disrupting the attachments of the underlying vocal cords. How much reduction of the neck bulge that can be achieved highly depends on the thickness of the cartilages.

The following are typical after surgery tracheal shave instructions:

 

1)  Most tracheal shave procedures have virtually no pain after surgery. Patients usually only feel the need to use Tylenol or Ibuprofen for just a few days after the procedure, if any medication at all.

2) There  will be a flesh-colored tapes glued on over the incision. That will stay on for a week or so. It will either be removed by Dr. Eppley at the first postoperative follow-up (in town patients) or you may peel it off after a week for out-of-town patients.

3) There may or may be some spotting of blood on the tapes. This is normal and not a cause for concern.

4. The sutures used in the small neck incision are all under the skin and will dissolve on their own. There is NO need for suture removal.

5. You may shower and wash your hair as normal the following day. There is no harm in getting the  neck tapes wet.

6) There may be some mild neck stiffness and soreness when you extend your neck backwards after surgery. Avoid excessively stretching your neck backwards for a few weeks after surgery once the tapes are removed.

7) Once the neck tapes are removed, you may begin to apply any topical scar treatments if you desire.

8) There are no limitations to any physical activities after tracheal shave surgery. You may feel free to run, workout and do any non-contact sporting activity as soon as you feel comfortable.

9) There are no restrictions on what you can eat or drink after surgery. Swallowing has no adverse effects on neck healing.

10. If any neck redness, increased tenderness or swelling, or drainage develops after the first week of surgery, call Dr. Eppley and have your pharmacy number ready.


Dr. Barry EppleyDr. Barry Eppley

Dr. Barry Eppley is an extensively trained plastic and cosmetic surgeon with more than 20 years of surgical experience. He is both a licensed physician and dentist as well as double board-certified in both Plastic and Reconstructive Surgery and Oral and Maxillofacial Surgery. This training allows him to perform the most complex surgical procedures from cosmetic changes to the face and body to craniofacial surgery. Dr. Eppley has made extensive contributions to plastic surgery starting with the development of several advanced surgical techniques. He is a revered author, lecturer and educator in the field of plastic and cosmetic surgery.

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