Today’s cosmetic surgery patient is vitally interested in rapidly returning to normal activity. Many of the procedures that we carry out at our Center have been modified to help enhance early recovery. Utilization of lasers, electrosurgery, and injection techniques assist the surgeon in reducing bleeding and postoperative swelling. Improvements in postoperative care are also important. Remember that recovery is a team effort involving both the surgeon and the patient. These are some of the things that have helped speed recovery at the Facial Plastic & Cosmetic Surgical Center.
Tumescent infiltration
One of the most important modifications in surgical technique that has come about in the past several years is the use of tumescent infiltration. By tumescent infiltration, we are referring to the injection of fairly large quantities of fluid to which we add small amounts of it medication to constrict blood vessels and thereby prevent bleeding. This technique has reduced operative bleeding to levels that are only a fraction of what we use to see years ago. This has the direct affect of minimizing postoperative bleeding and swelling.
Surgical lasers
Another innovation that has significantly help to reduce it bleeding is the use of the carbon dioxide laser as a cutting tool and surgery. This instrument allows for bloodless dissection and has been particularly useful in eyelid and nasal surgery. When used in eyelid surgery, the technique often results in a little or no bruising and much more rapid recovery. This is also true in nasal surgery. And added advantage is the increased precision that is afforded by this technique. Lasers are also very helpful in facelift surgery where they are used to dissect out the deeper layers of tissue. Since we are working close to delicate nerves and vessels, the combination of surgical lasers and magnification enhances safety.
Dressings
In the past, bulky pressure dressings were commonly used after surgery. We have found these dressings not only to be unnecessary, but counterproductive. By avoiding pressure dressings, we feel that swelling is significantly reduced, patient comfort is enhanced and, as an added advantage, it allows us to detect problems at an earlier stage. Furthermore, it avoids the need for on comfortable dressing changes. Not only do we generally avoid bulky dressings, but also in most cases we find it unnecessary to use post surgical drains. An abdominoplasty is the one exception to this generally rule.
Post operative care
While surgical technique has much to do with recovery time, postoperative care is equally important. Of course each operation is different, but there are some general rules that apply to all surgery. In general, patients seem to recover faster when they resume activity soon after surgery. Of course, we don’t necessarily mean full activity, but it is certainly better to be up and about rather than lying in bed for long periods of time. Not only will this help to prevent blood clots in the leg, but it also stimulates the general circulation and enhances recovery. Patients who have facial surgery should attempt to keep their head elevated as much as possible, and may find it helpful to sleep sitting in a recliner for the first few nights.
As a general rule, cold packs are helpful in preventing swelling, and therefore most useful during the first few hours after surgery. After a day or so, warm packs tend to be more useful since they stimulate the circulation and help to resolve swelling. Since many patients have in numbness after surgery, it is extremely important to avoid anything that is hot since it could lead to a burn. In spite of our warnings, over the years we have seen several patients who have burned their skin with postoperative hot packs or heating pads.
Medications
Many drugs have been found to interfere with the normal clotting mechanism. Aspirin is a prime offender. Patients should avoid any medications containing aspirin for at least two weeks before and after surgery if at all possible. Additionally, non-steroidal anti-inflammatory agents such as Advil or Motrin also interfere with blood clotting and should be avoided for several days before and after surgery whenever possible. Many patients are taking herbal supplements these days, and since the effect of these agents is not clearly understood, we generally recommend that patients discontinue most supplements during the time of their surgery.
An exception is the homeopathic agent Arnica Montana. Arnica has been observed to significantly reduce bruising and swelling by many patients and we are currently recommending its use. Patients generally take Arnica for two or three days before and after surgery. It comes in several forms including tablets that are swallowed or capsules that are dissolved under the tongue. Both seem to work equally well.
Smoking
Nothing is more detrimental to healing than smoking. The combination of nicotine and carbon monoxide produced by cigarette smoke deprives the body of oxygen needed for healing and resistance to infection. This is so important that we have adopted a policy of not operating on patients who are actively smoking at the time of surgery.
Of course these general suggestions are only meant to supplement the specific recommendations made it by your surgeon the time of your operation. At the Facial Plastic and Cosmetic Surgical Center we share your desire to make your recovery is prompt as possible. We’re constantly striving to adopt techniques and procedures that enhance this goal.