Post-Operative Information
Advanced Cosmetic Surgery of New York Post-Op Information
WHAT TO EXPECT ON THE DAY OF YOUR SURGERY & AFTERWARDS
When you arrive at our surgical center on the day of your procedure, our staff will greet you and show you to the room where you will have your final pre-op exam. You will be provided with a surgical gown to change into. You will need to be sure that you have followed everything in our Pre-Op instructions sheet prior to arriving. If you are having local anesthetic during your procedure, you may have a light breakfast or small lunch up to 3 hours prior to arriving. For patients undergoing general anesthesia, you will be instructed to NOT eat or drink anything after midnight the night before. Your skin should be freshly washed with antibacterial soap (containing NO moisturizers) and your hair should be shampooed. You should not be wearing any lotion, body sprays (perfume or cologne), or have any antiperspirant on. All jewelry and piercings should be removed. If you are wearing a wedding band, we will tape it.
After one final trip to the restroom, you will have your before pictures taken and then be marked with a felt tipped skin marker. Your surgeon will meet with you to answer any final questions or concerns you may have before being escorted to the surgery room.
Please click on any of the links below to view specific Post-Op information for that procedure:
Body Lift (buttocks, thighs, hips, abdomen)
Laser Liposuction using SmartLipo and Tumescent Liposuction
Male Breast Reduction (Gynecomastia)
Once both arms have been corrected, they are wrapped in flexible bandage material (such as an ACE bandage). These flexible bandages offer the ideal amount of pressure to hold the tissues in their new placement and help to also reduce swelling. They must be worn on the arms for several weeks after an arm lift surgery. Our plastic surgeon will help guide you about how you can bathe without getting your incisions wet so that they can stay dry and reduce the risk of infection at the incision sites. Most of our arm lift patients recover fairly fast; slight discomfort and minimal swelling is all that remains after about 6-7 days post-surgery. Patients can return to light duty or work within 7 days.
A body lift procedure may include areas of the body such as the abdomen (panniculus), thighs, buttocks and hips. Patients can expect to have compression bandages or garments over the areas that were lifted. These garments are snug and hold just the right amount of tension to keep everything in its new place. Post-surgical discomfort, swelling and bruising are normal and to be expected. Our plastic surgeon will advise you about how much is to be expected for your individual situation. You will not be allowed to bathe (immerse the incisions under water) post-operatively until your wounds are healed enough to get wet. You can sponge bathe during this time. You will be prescribed pain medication and antibiotics to help keep you comfortable and lower the risk of infection afterward. Sometimes, patients also receive SmartLipo laser liposuction to help sculpt problem areas of the body after the lift is completed. Patients can expect to feel much more comfortable after about 7-10 days post-operative and can resume light duty at this time; getting up and walking around as tolerated after the first day is highly recommended. If you experience a fever over 100 degrees, please contact us right away. We have a doctor on-call every day after hours to help address any concerns you may have.
After your breast procedure, you will have incisions that will require dressing (gauze pads) or will be covered with surgical tape. You will be instructed not to bathe until the incisions are healed enough to immerse them under water. You may sponge bath during this time. You will be asked to wear a compression garment (surgical bra with a snug fit) to help keep the post-surgical swelling down as well as to minimize the discomfort that excessive swelling causes. Your chest may feel heavy or weighed down due to tightness in the breast tissues and stretching of the tissues (especially for patients who have had an augmentation or reconstruction).
Your breasts will show post-operative bruising in places for several weeks and will minimize steadily over time. Swelling and tenderness at the incision site(s) as well as in the breasts is normal and expected. We will prescribe you some oral painkillers and antibiotics to help you with discomfort and to lessen the risk of infection. Depending upon your individual situation, we may have other instructions for you which may or may not include massage, gentle manual downward coaxing, or an elastic band to hold your breast implants down so they heal in the proper position.
Stitches used in all breast procedures are dissolvable so you don’t have to worry about having anything removed from the delicate tissues post-surgery. If you experience any redness, pain, streaking under your skin, or a fever of 100 degrees or higher, please contact our office immediately. We have doctors on call 24/7 to assist you. Scars will be red at first, then purplish-red, then fade over time and become less noticeable.
Many of our brow lift procedures are done using endoscopic techniques so that the incisions are very small and healing occurs more quickly. Every patient, no matter where the incision or technique used, will experience some bruising, swelling and discomfort for about 7 days after surgery. This will lessen over time. We will prescribe painkillers for you and antibiotics to reduce discomfort and the risk of infection. You will be advised to keep your head elevated above your heart for about the first week to help reduce swelling. Ice packs may be advised as well which can further reduce swelling and discomfort. If you experience a fever over 100, any unusual discharge from your incisions, or sudden redness or pain, you may have an infection. Call our office immediately and one of our on-call surgeons will get in touch with you immediately, 24/7.
You will experience post-operative swelling and bruising around the eyes after your eyelift surgery. This is normal and can be reduced by keeping your head elevated above the heart at all times for the first week or so. You may also apply gel ice packs to the eyes (an eye mask ice pack is ideal) as often as the surgeon recommends. We will prescribe antibiotics and painkillers for you to take post-operatively for the first 7 days or so. If you notice any of the incisions are especially red and tender or if you notice unusual discharge or have a fever over 100, please contact us immediately. This may be a sign of an infection. We have an on-call surgeon available after hours seven days a week. Your incisions will be dissolvable and will not need to be removed after surgery; they will dissolve on their own.
A facelift involves moving facial skin, muscle and tissues around, so discomfort and swelling is to be expected after surgery. Additionally, post-op bruising is also normal and should lessen gradually after about 7 days. It is advised to keep your head elevated above the level of your heart 24 hours a day for about the first week. Ice packs may be used to reduce swelling and discomfort as well. We will help you manage your pain and lessen the risk of infection by prescribing painkillers and antibiotics. Most times, patients will wear a light compression bandage around the face to hold the skin and tissues in their new places. If you experience sudden pain, redness or unusual discharge from the incisions, or a fever over 100, you may have an infection. This requires immediate medical attention, so please call our office right away. If this you call after hours, one of our on-call surgeons will return your call immediately.
These two procedures involve some minor discomfort and swelling afterward, but require only over the counter pain relievers after a couple of days. We will prescribe stronger painkillers if you need as well as antibiotics to lessen the chances of an infection. Post-op bruising (minor) is normal as is some blood-tinged fluid will escape from the tiny incisions where the tumescent fluid was injected. You will be required to wear a compression garment for the next four weeks to reduce swelling and allow the areas where the fat was harvested to heal properly. If you experience a fever over 100, have greenish or white discharge or experience sudden redness or swelling in a treated area, you may have an infection. Call us immediately so we can see you in the office or if you call after hours, one of our on-call doctors will return your call immediately.
Laser Liposuction using SmartLipo
Because local anesthesia is used and the SmartLipo laser technology leaves blood vessels and nerves undisturbed for the most part, patients will experience only 1-2 days of down time. Discomfort and swelling are very minor. Patients can expect to have blood-tinged fluid discharge (this is normal) from the tumescent fluid that was injected into the fatty tissue during the procedure and will lessen within a few days.
Compression garments must be worn as recommended by our surgeon and will likely be worn for a full 4 weeks after the procedure. The risk of infection with laser liposuction is extremely low, but do let us know if you experience a high fever (over 100) or have redness, pus, or green discharge coming from any of the micro-incisions. Patients do not have stitches after SmartLipo, so you may be asked to avoid bathing for several days to allow for the micro-incisions to heal up.
Tumescent liposuction patients and gynecomastia patients who have had liposuction can expect copious drainage of tumescent fluid. The drainage will be bloody, but it is thin and drains easily. This wound drainage may soak through the dressing before you can take a shower the following morning. If this occurs, you may either leave it wet or change the absorbent gauze pad. If you decide to change it, be sure to do so while lying down. Open one side of the compression garment, pull out the soaked padding, replace with new dry dressing, and then close the compression garment before standing up again. Removing the compression garment while standing up will likely make you feel dizzy and weak or lightheaded and you may also feel nausea during the first day after surgery. If possible, have someone help you change your dressing, or you may also stay wet until you are able to shower. You should not (and do not) need to remove the compression garment in order to use the restroom.
Tumescent liposuction patients may take a lukewarm shower the next morning. You may feel nauseous when removing your compression garment so take care to remove it while sitting down in the tub or on a shower bench. Stand up very slowly (hold on to someone or a shower rail) and then begin to shower. Do not take an excessively hot shower; high water temperatures can also make you feel lightheaded. Again, please try to have someone help you if possible. Do not take a bath or get into a Jacuzzi, pool or the ocean for 14 full days after surgery.
Wear your compression garment 24hrs/day for the first week. Wash it 2x per day for the first three days. After the first week, wear it for at least 12 hours per day while you are awake. You must wear the compression garment for a total of 2 weeks. When you wash the compression garment, do so in cold water and dry on your dryer’s air cycle or fluff only. Heat cycles will shrink the garment. Wear biking shorts or support stockings while waiting for the garment to dry. After 3 days you may wear whatever clothing is comfortable – the compression garment, biker shorts, firm stockings or nothing at all.
Male Breast Reduction (Gynecomastia)
Post-Operative Healing:
Normal healing after male breast reduction surgery involves a limited but fixed degree of discomfort, swollen tissues, bruising and a texture of lumpy firmness to the skin. A mild numbing (temporary) of the skin may last for up to 4 months post-surgery. Most of our patients can see improvement to their chest within several days after surgery. However, due to the gradual resolution of post-procedure swelling, optimal results after gynecomastia correction are usually seen 12 to 20 weeks afterward.
Realistic Expectations:
Although the results of male breast reduction surgery are often quite remarkable, it is not realistic to expect perfection. It is impossible for us to guarantee the exact amount of improvement that you will have after surgery. Patients should have reasonable expectations, which will be established with the help of our surgeons prior to surgery. Although patients can generally expect to see substantial and noticeable enhancement, it is unreasonable to expect perfect results. For perfectionists, or for patients with moderate to severe breast enlargement, maximum improvement may require another corrective surgery for which there would be an additional fee.
Longevity of Results:
THE FAT CELLS AND GLANDULAR TISSUE REMOVED DURING THE SURGERY DO NOT GROW BACK. Although one can expect some reasonable changes as aging takes place (provided that a large amount of weight is not gained), your new, masculine chest contour can be considered relatively permanent.
After a neck lift has been completed, you will be required to wear a compression garment that holds the skin and muscles in their new position. It must be worn for about four weeks post-surgery. You can expect to have some swelling and bruising as well as discomfort afterward. We will prescribe painkillers for you to last through the first week to ten days after surgery. After that, over-the-counter pain medicine like Extra Strength Tylenol is enough. You may return to work in 10-14 days. Strenuous physical activity should be avoided for 3-4 weeks, maybe longer, depending on how well you are healing. If you begin to develop a fever over 100 or have unusual discharge from any of the incision sites, you should contact us immediately. We also have an on-call surgeon after hours that will help you.
You will be woozy and possibly dizzy from the anesthesia and surgery. It is important for there to be someone present to help you around, get food for you and to help keep you hydrated. Painkillers will be prescribed to manage pain and help you rest better. You will have some post-operative swelling which can be reduced by keeping your head elevated above your heart with a few pillows or a wedge pillow. Due to the anesthesia, you may want to eat only bland, soft foods that are easily digestible for the first two days or so. We generally prescribe antibiotics for the 7-10 days after otoplasty surgery to lessen the risk of infection. It is important to follow these post-otoplasty instructions (as well as our general post-op instructions on this page) to avoid complications and unnecessary risks to your health.
You will be asked to wear a compression garment for the first 7 days or so which will reduce swelling. If you experience sudden pain in one of your ears, please call us right away; it may be the beginning stages of a hematoma (a rare but serious complication that needs immediate attention). The stitches will be removed from the outside of your ears after about two weeks. For about 6 weeks after the compression garment is worn, you will be required to wear an elastic ear band while you sleep to hold the ears in their new positions.
You will have several post-op follow-up appointments with us so we can monitor your progress and to make sure you are feeling well.
After your rhinoplasty procedure the inside of the nose will be bleeding and you may also be required to wear a nose splint to hold the nose (tip or the bones) in their new placement. Sutures will either be dissolvable or will need to be removed after seven to ten days post-surgery (our plastic surgeon will let you know which type he used). There will be some post-op swelling and bruising of the skin, with bruises having the potential to reach the under-eye area depending on the extent of reshaping that was done.
We recommend keeping your head elevated at all times for the first two weeks (including when you sleep). You will be prescribed narcotic painkillers to help keep you comfortable for the first week to ten days and then can use Extra Strength Tylenol after that. Our plastic surgeon may recommend using ice packs during the healing process. Strenuous physical activity should be avoided for several weeks to 1 month and we will discuss this with you during your post-op follow-up appointments. If you have a fever over 100, severe pain, or unusual discharge please contact our office immediately. Even though you will be taking oral antibiotics to prevent infection, if you have any of these warning signs, you may have an infection that requires immediate attention. We are on-call after hours and on the weekends to help you with any health concern you may have.
Normally, our patients feel substantial discomfort for the first 1 to 2 weeks (we will prescribe prescription-strength pain killers to help you through the first 2 weeks). After that, pain may be easily managed with only extra strength Tylenol. Walking, sitting up, and turning over in bed can be painful and difficult for the first few days, so you will need to have someone there to make food for you, to help you out of bed and to the restroom, for sitting up or lying down and to sponge bathe.
A compression garment will be worn around your tummy immediately after your tummy tuck surgery and you will likely have drains inserted in both ends of the incision with a flexible negative pressure (vacuum) plastic container attached to some tubing. The compression garment must be worn for 4-6 weeks, 24 hours a day, while the drains will be taken out as early as 1 to 2 weeks after surgery.
We recommend that our patients walk around a little after a few days following abdominoplasty surgery and they can increase activity a little at a time as tolerated. Physical activity helps increase blood flow to the incision site, will help prevent blood clots from forming in your legs (due to inactivity) and can also help boost your immune system.
GENERAL INSTRUCTIONS AFTER SURGERY
- DRIVING: You will not be allowed to drive yourself home after surgery. You will be required to have a responsible adult take you home. If this is not possible, we can arrange to have pick up and drop off for you with our driving service. Your safety is our first priority; anesthesia and sedatives make for an unsafe situation for driving yourself around. You should plan to have someone at home to help you for the first day after surgery.
- MEALS: You may start eating normally again right after surgery, if your stomach tolerates (general anesthesia patients may feel like having only light broth and Jell-O for a day or so). Drink plenty of water, fruit juice or soda to prevent dehydration. Do not consume alcoholic beverages TWO FULL DAYS before and after your procedure. Directly after surgery, you may start off with drinking clear fluids such as water, lemon-lime soda, ginger ale or broth. You can resume eating a regular diet as soon as you feel hungry.
- PHYSICAL ACTIVITY: Quiet rest is the very best environment after surgery. You must get up and move around on the first day after surgery. You do not have to walk far, but at least get moving!! Again, DO NOT operate dangerous machinery or drive for 24 hours. Do not make any critical decisions for 24 hours after surgery either. At the latter part of the first day or evening following surgery, you are encouraged to take short walk as tolerated. The following day after surgery, you may drive your car and participate in light to moderate physical activity if you feel well enough to do so. You may resume exercise and normal physical activities about two to four days after surgery, though we may advise you otherwise depending upon the procedure(s) you have had done. A suggested amount of activity to begin with is: 25% of your normal workout routine and then increasing your daily activity as tolerated. Most people can return to a sit-down job within 2 days after surgery, but one must expect to be uncomfortable and easily tired out for several days and even up to a week depending upon the procedure(s) you have had.
- POST-OP GARMENT: After many of our procedures include those where tumescent liposuction and SmartLipo have been performed, compression garments must be worn in order to hold the absorbent gauze pads in place and to provide gentle pressure that encourages the blood-tinged anesthetic solution to drain out steadily. The morning after a tumescent liposuction procedure, when the compression garment is first removed, you may have a brief sensation of dizziness. This lightheadedness compares to what you may experience when standing up too quickly from a sitting down or kneeling position. This occurs as the result of rapid decompression of the legs as the compression garment is first removed. Should dizziness occur, you should sit or lie down until it passes
For breast procedures and tummy tucks, patients will be required to wear a compression garment around the surgical area(s) to reduce swelling and promote blood flow to the area. This aids in healing and minimizes bruising and discomfort post-surgery. For tummy tuck patients, the compression garment is required for the first 4-6 weeks and for breast surgery patients, approximately 4 weeks afterward. - POST-OP FLUID DRAINAGE: After any procedure that includes SmartLipo laser liposuction or tumescent liposuction, you can expect a substantial amount of blood-stained anesthetic solution to drain out of the small incisions for about the first one to two days after the procedure. In general, the more drainage that occurs, the less swelling and bruising you will experience. During the first two days, you should sit down or lie on top of a thick bath towel. For instances where there is a large quantity of fluid drainage, we recommend placing plastic sheet (or vinyl tablecloth) under the bath towel to avoid staining the carpeting or rug. After several days you may only require minimal absorbent gauze dressings over your incisions as they continue to drain.
- CARING FOR WOUNDS AND BATHING: Keep your incisions meticulously clean. After you are cleared to immerse your incisions under water, we recommend showering one or two times a day. Changing dressings: Thoroughly wash your hands first with an antibacterial soap and then wash your surgical incisions very gently using cool water and soap. After the areas have been cleansed properly, gently dab the incisions with a freshly laundered towel and allow to completely air-dry for a few moments. Next, apply some triple antibiotic ointment (such as Neosporin) to the incisions and apply clean, new absorbent dressings (if they are still draining). Incisions that have stopped draining fluid no longer need to be covered with absorbent gauze padding and can be left in the open air to heal. Contact our office immediately if you notice any signs of an infection such as a fever over 100 degrees, any foul-smelling discharge, or redness, swelling, and pain anywhere near the surgical sites.
DO NOT APPLY ICE PACKS OR A HEATING PAD to the skin that lay over the areas treated by liposuction.
DO NOT USE HYDROGEN PEROXIDE OR APPLY PLASTIC BAND-AIDS to your incisions.
DO NOT SOAK in a bathtub or hot tub/spa and do not go into a swimming pool or the ocean for TWO WEEKS after surgery. These environments are laden with germs that can cause skin infections in open wounds such as the incisions that you will have after your surgical procedure. - Take Tylenol OR the pain medication we have prescribed for you. Remember to never take aspirin, Aleve, Vitamin E supplements, ibuprofen (i.e. Motrin) or alcohol for three days after your procedure. These substances can cause an increase in bleeding and bruising and can interfere with your body’s blood clotting ability.
- COMPLETE ALL ANTIBIOTICS AS PRESCRIBED.
- CALL OUR OFFICE IMMEDIATELY IF:
A) Your temperature is above 100º or if you experience extreme pain.
B) You notice any thick, bloody drainage from your incisions.
C) You experience severe dizziness while standing.
D) You notice pus (greenish or white discharge) from any incision site.
E) Call us even if you are unsure whether your question or problem is urgent! We are here to help! - Care for your incision wounds by washing them 2x per day. Scrub them very gently with antibacterial soap, lukewarm or cool water, and a freshly laundered clean wash cloth (do not use a bath sponge as these can harbor bacteria and raise the risk of wound infections). Pat your incisions dry with a laundered soft towel, apply a modest amount of triple antibiotic ointment such as Neosporin, and then cover your incisions with a non-plastic bandage. Do this for ten to fourteen days until the incisions stop trying to form a scab. The less scabbing that is allowed to form, the less scarring you will have.
- No strenuous physical activity, weight lifting, running, or swimming for two weeks. Increase exercise as tolerated.
- We will let you know what follow-up schedule you will need to keep after surgery so we can monitor your healing progress after surgery.
MOST COMMON SIDE-EFFECTS AFTER SURGERY
SLIGHTLY ELEVATED BODY TEMPERATURE during the first TWO DAYS after a procedure is a normal reaction of the body after undergoing trauma of surgery.
DISCOMFORT AND SORENESS will likely be worse by the second day post-surgery and will improve daily. Take extra strength Tylenol every four hours during the day for the first two days. It will help to reduce the inflammation, swelling, and discomfort from surgery. DO NOT take aspirin, ibuprofen, naproxen or medications containing any of these substances for three days after surgery because they can thin the blood and inhibit blood clotting.
Bruising is minimal with procedures such as tumescent liposuction. Nevertheless, the more extensive the surgery you have had, the more bruising you can expect to see. Regardless of what procedure(s) you have had done, bruising will gradually lessen every day over the next two to three weeks.
PAIN AND SWELLING due to the body’s inflammatory reaction to surgical trauma is normal and can even increase for five to ten days post-surgery. We will treat you with antibiotics and anti-inflammatory drugs to help you feel as comfortable as possible post-procedure.
PLEASE CALL OUR OFFICE IMMEDIATELY AT 631-499-1831 or 212-206-0023 AFTER SURGERY IF YOU HAVE ANY CONCERNS OR QUESTIONS. WE WANT TO HELP YOUR HEALING PROCESS TO PROGRESS AS QUICKLY AS POSSIBLE. WE ARE HERE TO HELP YOU IN ANY WAY WE CAN
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