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Hi all, Feel free to add on to the list below. Hopefully this will come in useful for those planning for their upcoming surgeries. Cheers. To check if a doctor is certified, please refer to my other post https://beautyhacker.com/topic/1012254-checking-if-a-doctor-is-certified-by-the-korean-association-of-plastic-surgeons/) For a list of pre-surgery pointers and sample consultation questions to ask, please refer to my other post. (https://beautyhacker.com/topic/1015406-pre-surgery-pointers-list-of-consultation-questions/). Packing List Notebook and pen to write notes during consultation Medical history / Drug allergies to inform clinic Button tops or loose fitting tops Electrical adapter Cotton bud / Q-tips (to apply medicine, dig nose, remove food particles for those with stitches inside mouth) Antibacterial wet wipes Lip balm (for rhino and FC as lips will get dry from breathing through the mouth) Pain relief medication Tissue paper (for running nose/teary eyes post-surgery & bleeding) Camouflage items (hoodie, sunglasses, face masks, caps) Vitamin K cream (e.g. Auriderm) (for bruising) Scar healing & reduction gel (e.g. Kelocote, Dermatix) Simple dressing set Arnica (e.g. Sineech) (for bruising) Bromelain (for swelling) Collagen powder (promotes healing) Vitamin C (promotes healing) Protein powder (if you have to be on a liquid diet) Dry shampoo Recovery Tips General Avoid spicy and high sodium food Sleep with head elevated 45 degrees for several days to minimize swelling Apply antibiotic ointment (if prescribed) to the incision site as directed Use ice packs (~10 mins on 10 mins off) for the first 3 days after surgery as often as you can to reduce swelling and bruising Do not take aspirin or any aspirin based pain medication unless approved by your surgeon Do not use scar reduction cream/gel on the incision site until the wound has fully healed No alcohol for 3 weeks as it causes fluid retention Do not smoke, as smoking delays healing and increases the risk of complications Limit your activity right after surgery (for the first 3 days) to reduce post-operative swelling and bleeding. Start walking as soon as possible from the 4th day onwards, this helps to reduce swelling and lowers the chance of blood clots Avoid activities that raise your blood pressure, including bending, lifting and rigorous sports Before you attempt to pull any dead skin, be absolutely certain that it’s not a stitch. Eye surgery-specific You can take showers from the neck down any time after your surgery. Don’t take full showers until your surgeon tells you it’s safe to do so. This is usually after stitches are out (~5 to 7 days). You may gently wash below your eyes with wipes or a soft washcloth. You can use dry shampoo for your hair. Once you can take full showers, you can wash your eyelids and shampoo your hair with mild products, such as baby shampoo. Wait at least 2 weeks before wearing contact lenses Do not apply any irritants or make-up on your eyelids or incision line for 2 weeks after the surgery Your physician may recommend Natural Tears (OTC eye drops) or OTC ophthalmic ointment or antibiotic eye drops as part of your post-op treatment. Don’t pull on your eyelids while using the eye drops. Nose surgery-specific You can take showers from the neck down any time after your surgery. Don’t take full showers until your surgeon tells you it’s safe to do so. This is usually after the nose splint and stitches are out (~7 to 10 days). For the first month after rhinoplasty, you should not rest your glasses on the bridge of your nose. Either wear contact lenses or suspend the glasses with the use of a small tape from your forehead. Bruising around your nose in your cheeks and lower eyelids is very common after this type of surgery. Numbness over your nose is also quite normal. You will slowly regain sensation over the top of your nose. But you can expect the tip to be slightly numb and “stiff” feeling for up to three months after surgery. Breathing through your nose will slowly improve after we clean your nose out at your first clinic visit. Go to bed on time. Yawning may cause you quite a bit of pain, so prevent it by getting the right amount of sleep during the proper hours. FC surgery-specific Post-Surgery 1. Keeping your head lifted up and above your chest (for at least a week) will speed up the healing process. 2. Use the ice pack for at least 3-4 days and after the 4th day, change to a hot pack. Be sure to treat both sides of the face equally. Any bruises or swelling will lessen in a week and heal after 3 weeks, so you do not have to worry. 3. After the surgery, you must abstain from food for one day. You may drink 6 hours after the surgery, and eat after 48 hours. For those with jaw or cheekbone surgery, you may eat rice porridge after going on a liquid diet (such as juice, milk, rice gruel) for a day. *Spicy or salty food: You may eat after 2 weeks; tough and chewy food after one month 4. When blood comes out of the mouth, spit it out. If you think you have swallowed too much blood or too much blood is coming out, then please contact the doctor. 5. Gargling with the disinfectant that we prescribe is very important. If you do not want any wounds or infection, you must gargle at least 10 times per day. First, gargle your mouth with water a couple of times then use the disinfectant last. Until the seam in your mouth is completely gone, you must gargle for at least 2 weeks. You may use a toothbrush 1 week after the surgery. At first, use a smooth children’s toothbrush to brush your teeth (do not brush your gums). 6. Keep the bandage around your head for at least one day. Wearing the bandage will help reduce the swelling faster. You may wash your face or hair after taking off the bandage and you may go to the sauna or the hot springs after 2 weeks. After the surgery, if the bandage is too tight or your neck feels uncomfortable, please tell the doctor. · You can wash your hair after 3 days, you can take a shower after 5 days · Fitness workouts (sports, health centers) after one month 7. In order to prevent infections, you must take the prescribed medicine. 8. No matter how perfect the surgery came out, if you do not diligently take precautions after the surgery, problems may arise or your face shape may change. Therefore, caring for your face after the surgery is just as important as the surgery itself. We ask for your participation in the process, as well. Diet Even though you can open your mouth a small amount, you still will not be able to chew for approximately 6-8 weeks. You therefore will be on what we term as a swallowing diet. This means anything that you can swallow without chewing. Anything blended or liquid is acceptable. You may also have any foods that are soft enough or small enough to be mashed between your tongue and teeth without chewing. These things may include any liquids, soups, scrambled eggs, applesauce, pie, cake, ice-cream, yogurt, pasta that is well chopped and small and soft, as well as meat which is ground up fine. High-calorie, high-protein meals are the best with plenty of liquids. This may require eating a small meal 5-6 times a day rather than three large meals. Use a cup or glass when eating. Pull the lower lip forward on either side and just pour the contents of the cup into your mouth. Straws are okay to use, but you may find this difficult at first. The reason it is difficult is because your lips may be swollen and with decreased feeling in the upper or lower lip creating a vacuum necessary to use a straw may be difficult. If you can use a straw, it is okay. Take in smaller amounts and eat more frequently, it may be necessary for you to eat 5-6 times a day in order to satisfy your body requirements. Try not to miss any meals. A small, plastic syringe with a piece of rubber tubing or catheter at the tip can be helpful in the feeding process. You may use one of these at the hospital and this may be helpful when you go home from the hospital. These syringes and rubber tubing may be picked up at any pharmacy or drug store and may be quite useful Try to get something fresh every day. A malt or a shake with fresh fruit and a vitamin supplement blended in it is ideal. (e.g. juices, smoothies, puddings, yogurt, etc.) Start drinking from a cup as soon as you’re physically able to. Your upwards trek back to having full energy begins the day you can throw your syringes in the garbage. Eat solid food as soon as your surgeon gives you the go-ahead. It’ll be a slow, tedious and frustrating process, but you need to go through with it in order to build your jaw muscles back up and learn how to chew properly once again. Hygiene Brush and rinse using a small amount of toothpaste and mouthwash. Oral hygiene is the single most important thing you can do to minimize possible infections. After each meal, brush your teeth with a soft-bristled toothbrush (child-size works well). Stand over the sink with your head tilted down and use a circular motion and angle the brush at 45 degrees toward the gum line. Use Peridex or a mouthwash without alcohol such as Biotene instead of toothpaste. Brush to the best of your ability and take your time. You may not be able to brush the inside of your teeth. Rinse your mouth with a solution of warm salt water (1 teaspoon salt in one 8 oz glass of warm water). Oral rinsing should be done after every meal. A moistened Q-tip or cotton swab may be used to wipe over the gums and tooth surfaces when brushing is impossible. You may follow brushing with a mild fluoride mouthwash to leave your breath and tongue feeling refreshed. Avoid the use of products such as lemon glycerin swabs and commercial mouthwashes containing alcohol (these products can have a drying or irritating effect on the mucous membranes in the mouth). Use a Waterpik ONLY if ordered by your surgeon. If any skin incisions were made, clean them with 50% peroxide-water solution, remove scabs and apply Neosporin. At times, your breath may be indicative of the fact that you are not allowed to brush your teeth or floss during the first several weeks of recovery. To aid in freshening your breath, try gurgling with warm salt water a few times each day. Soon enough, you’ll be given the go-ahead to brush and floss again. Activities Take it easy the first week. You may resume most of your normal routine after the first week as tolerated. Avoid activities that might cause an injury to the face (athletic like football, basketball, racquetball, weight lifting, etc.). Aerobic exercises may be started after two weeks. For the first 3-4 days following surgery please limit your activity. It is important that you not confine yourself to bed. Try to spend most of the day sitting in a comfortable chair and taking short walks around the house. You should limit your visiting time to 1-2 hours. Although you may feel well, you have had a major procedure and your body needs to recover. Uninterrupted rest is very important in your healing period. Do not participate in sports or strenuous activities, or return to work until permitted by your surgeon. Driving any motorized machinery or vehicle or signing any legal documents while taking pain medications is not recommended. The pain medications may cause alterations of visual perception and impair judgment. Medications Antibiotics use only the first 4-6 days following surgery. Use pain medications only as needed. Anti-nausea use as instructed and notify doctor if relief is not quickly obtained. Acute pain management should always start with over-the-counter pain medications, such as acetaminophen (Tylenol®) or ibuprofen (Motrin, Advil). If your surgeon approves these medications for you, you should take them as directed on the pill bottles, or by your surgeon. If you take the first pill before the anaesthetic has worn off, you will be able to manage any discomfort better. Precede each pain pill with a small amount of food, and chances for nausea will be reduced. The effects of pain medications vary widely among individuals. For severe pain, you may take your prescription opioid (narcotic). Do not take more opioid pills, or more often, than prescribed by your surgeon. If prescribed, Vicodin / Norco may be taken every 4-6 hours for pain. DO NOT USE TYLENOL. If you notice that the pain medication is not providing comfort for long enough, alternate the Vicodin / Norco and Ibuprofen throughout the day (ex: take 1 Vicodin, then 2 hours later, take ibuprofen…2 hours later another Vicodin / Norco). If your pain is chronic (i.e. consistent and throbbing), you may have an infection and should schedule a visit with your surgeon just to be safe. On the other hand, if your pain comes in small bouts, it’s likely your nerves reawakening or your teeth being pulled by the elastics. In this case, just be patient and the pain will subside in due time. If you were prescribed pain medication, that may help as well. Nausea/Vomiting DON’T PANIC. Use medications as instructed. For mild vomiting or any empty stomach feeling lay in a face down position to allow fluids to drain out of mouth and nose. Notify the doctor of any nausea problems. Swelling The swelling will not become apparent until 1-2 days following surgery and will not reach its maximum until 2-3 days post-operation. However, the swelling may be minimized by the immediate use of ice packs. Two baggies filled with ice, or ice packs should be applied to the side of the face where surgery was performed. The ice packs should be left on continuously while you are awake. After 48 hours, ice has no beneficial effect. If swelling or jaw stiffness has persisted for several days, there is no cause for alarm. This is a normal reaction to surgery. Thirty-six hours following surgery, the application of gentle moist heat to the sides of the face is beneficial in reducing the swelling and stiffness. Sleep with your head elevated on two pillows for the first week. Exercises Most often following these type of procedures, teeth must be kept together with wires or elastics after surgery. This allows the jaw bones to be held still while healing. Most of the time small bone screws and plates are used to hold the bone segments together during the healing period. With the use of these screws and plates, the jaws can still move slightly during the post-operative period. It must be remembered that the bones are not healed and are simply held together by screws and plates. Therefore, a gradual progression of movement and use of the jaws is encouraged, keeping in mind that complete healing does not take place for approximately two to three months after surgery. Immediately following surgery: Since surgery causes soreness in the muscles and bones of your jaw, movement will be difficult initially. We do not recommend any specific exercises during the first week to ten days after surgery. 10-14 days following surgery: Stand in front of a mirror and attempt to open and close your mouth. At ten days you should be able to get at least 1 finger between your teeth. This will increase gradually in the next several weeks. Simply move your jaws open and closed then side to side. Moist heat to the side of your face prior to these exercises can be beneficial. Do not use your fingers to force open your jaw. 4-8 weeks after surgery: At this time you should be able to get 2 fingers between your teeth comfortably and can begin using gentle finger pressure to stretch your jaw muscles. By week 8 you should be able to get 3 fingers between your teeth. Again, stretch the muscles open and closed as well as side to side. Breathing Difficulty Following your procedure, you will develop difficulty breathing through your nose. This is a transient problem that peaks at about day 3-4. You may feel that your airway passage is being blocked by the swelling, but be assured that there is plenty of room to breathe through. Limit your activity to reduce post-operative swelling and bleeding. Dried blood in the nasal passages is best cleaned by the spraying of saline spray and gentle suction with the bulb. Repeat this process as needed until nasal passages are free of dried blood. You may use a facial humidifier or steam in the shower to help loosen nasal secretions prior to suctioning. DO NOT blow your nose following surgery for a minimum of two weeks. Use Afrin Nasal Spray as directed by your surgeon. Sleep with your head elevated on two pillows for the first week. Miscellaneous Use nose spray if needed and no more than twice a day. Use ointment on lips to reduce swelling and avoid drying and chapping. Sleep with head elevated (2 pillows) the first week then normal elevation after that. Sleep with your head elevated on two pillows or in a comfortable recliner chair for the first week following surgery. Before you attempt to pull any dead skin off of your lips, be absolutely certain that it’s not a stitch. Start using medicated lip balm immediately following your return to your own home. If you don’t, you’ll end up with flaps of dead skin that are half an inch in diameter, and I promise you they won’t feel good when they catch on your braces. Begin each day at a decent time. If you sleep most of the day, you won’t be able to sleep at night, and you’ll hate yourself for it. Get out of bed, shower, eat some breakfast and brush your teeth and you’ll enjoy each day a lot more. (This is good advice for any day of your life, but it especially applies when you’re on the verge of depression from having jaw surgery.) Go to bed on time. Yawning will cause you quite a bit of pain, so prevent it by getting the right amount of sleep during the proper hours.