For Patients

Pre-operative instructions:

1. Bring Something to Do. For the one hour-long waiting periods, bring books or work to occupy yourself. If you’re having surgery near your forehead, upper nose, or eyes, it is normal to experience swelling and to have a bulky dressing that may block your vision. This may make reading or watching television difficult while you’re in the waiting room. So, to entertain yourself, consider bringing something to listen to with earphones, of course.

2. Antibiotics. If I’ve prescribed antibiotics for you, start taking them before surgery as we have instructed. Continue taking your antibiotics according to the directions until you have finished every last pill, even after surgery. If, at the time of our surgery, another physician has prescribed for you an antibiotic, you must notify our office — you should not be on 2 antibiotics at the same time unless it has been OK’d by our office and your prescribing physician.

3. Medications. Unless otherwise advised, it is important to take your regular medications — including your antibiotics — on the morning of your surgery.
a. Aspirin. If you are taking any amount of aspirin on a daily basis, please notify our staff. We generally allow you to continue taking your aspirin, but we may ask you to stop it. If you do stop taking aspirin, you will be able to resume your regimen two days after surgery unless otherwise directed.
b. Blood thinners- If you are on prescription blood thinners continue to take them as directed, unless told to discontinue them by our office. We will discuss possible discontinuation of you blood thinners pre operatively at the time of your preoperative consult.
c. Diabetes medications- If you are on insulin or other medication to control your blood sugar, bring them with you. Also, bring any diabetic testing supplies that you may need to monitor you blood sugar during the course of the day.

4. Vitamin E. Do not take Vitamin E two weeks before surgery. Like aspirin, Vitamin E can increase bleeding during surgery and recuperation. It is permissible, however, to take Vitamin E contained in a multivitamin tablet.

5. Pain Relief. Do not take any non-steroidal anti-inflammatory agents, such as Motrin, Ibuprofen, Advil, Celebrex, Nuprin, Feldene, Clinoril, Alleve, Naprosyn, or Anaprox for two days before surgery. For minor aches, pains, and headaches, take regular or extra- strength Tylenol (Acetaminophen), as directed on the label.

6. Supplements. Do not take any supplemental garlic tablets or Gingko biloba for two weeks before surgery.

7. Alcohol. Do not consume alcoholic beverages — beer, wine, liquor — for three days before, and three days after surgery.

8. Tobacco products. If possible, stop smoking or using the these products — or attempt to reduce their use significantly — for at least two weeks before and after surgery. Nicotine products deprive the blood of oxygen and constrict blood flow, which is needed for proper wound healing. The use of products containing nicotine may cause the death of a graft or flap (common reconstructive procedures). This could necessitate additional surgery or result in an unsightly wound.
9. Contact Lenses. Do not wear them on the day of surgery. Instead, wear glasses.

10. Clothing. Do not wear your finest clothing on your surgery day. We recommend wearing a button-down shirt that will not disrupt your post-operative dressing when changing later that night. Wear something that you wouldn’t mind being stained by blood or surgical preparations.

11. Bathing. On the morning of your surgery, you may bathe or shower normally. If you get your hair done on a weekly basis, remember to get your hair washed the day before surgery. You will not be allowed to wet your surgical site for, at least, 24 hours.

12. Eating. On the morning of your surgery, have breakfast. But limit your intake of caffeinated beverages. Bring Snacks. Because your day here could be long, you may bring snacks or lunch with you. If you are following up with another surgeon for reconstruction, you must receive permission to eat from your repairing physician.

13. Bring a Sweater. The office waiting area is always very cool, regardless of the temperature outside. To stay warm, bring a sweater, preferably a sweater or jacket that buttons or zips down the front and will not disturb your dressing during removal.

14. Other Appointments. It is important for you to realize, no matter how small the skin cancer appears to be, looks can be deceiving. Since your surgery may last the entire day, you must not schedule any other appointments for that day.

15. Special Occasions. Facial surgery often creates swelling and bruising. Also, the post- operative dressing may be rather large and obvious. Keep this in mind as you arrange your social and/or work schedule. If an important event is already planned, please check with your referring physician or me to see if the surgery can be postponed for two or three weeks.

16. Stay Close. Remember to be available to have your stitches removed in follow-up visits in one, two, and three weeks after surgery. Do not travel overseas for two weeks after surgery — a routine medical precaution.

17. Plan Your Meals. If you’re having surgery near the lips, you may experience significant swelling for a few days to a few weeks. Immediately after surgery, limit your meals to soft foods — such as eggs, yogurt, and those that are pureed in a food processor or blender. Or stock up on such products as Slim Fast, Ensure, and Sustecal (available without a prescription in drug stores). After 5 to 7 days, you may have pasta, chopped meats, and small bites of chicken or fish.

18. Immediately after surgery you will be told when your first follow-up appointment is, and we will be happy to see you frequently until we are both satisfied with your outcome. In order to avoid complications, I encourage all my patients to call as questions arise between their appointments. It is better to be safe than sorry. Don’t feel that you are bothering my office if you have any questions concerning your convalescence. Your care does not end when you leave my office.


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