Pre-Operative History and Physical:
The most important step after deciding to have the procedure is making sure that you’re healthy. You want to feel comfortable that the risk in having any elective procedure is absolutely minimal. Therefore, the first step is to have a complete history and physical examination with your personal doctor, including appropriate laboratory tests. And if you don’t have a personal doctor, our office is glad to make appropriate referrals.
That examination might include a basic physical examination, blood tests, urinalysis and depending on your age and history, electrocardiogram and chest x-ray. The examination should be done three to four weeks before your rhinoplasty procedure or elected cosmetic surgery so that there is adequate time for us to receive all the reports and, as necessary, review them with our anesthesiologist.
Anesthesia is very important for your comfort and safety. I work only with doctor anesthesiologists and the small corps of these specialists have worked with me for many years. They are part of my team, which includes my surgical assistant. A good surgical team is like a good basketball team; everybody knows each other’s moves. And that translates into efficiency and safety.
The anesthesiologist will call you one or two nights before the surgery. This is important because you may have some concerns that you want to address and we want you to sleep well before surgery. The doctor will ask you the usual questions about your health history, allergies, etc. Remember, all this is designed so we don’t “miss anything” and to ensure the best possible medical care for you during your procedure. The anesthesiologist will explain the type of anesthesia used and what to expect when you come to the surgery center.
The Day of Surgery:
When you arrive at the outpatient surgery center on the day of surgery, you will fill out some paperwork. You will then be escorted to the changing room where you will undress and put on a surgery gown. The nurses will then take your pulse and blood pressure then hook you up to cardiac and oxygen monitors to again make sure everything is “ok” before we begin the procedure. All this is done in the holding area where I’ll see you before we take you into the operating room. Of course, I’ll answer any questions that you have. For some procedures, such as neck sculpting, face and neck lifting and eyelid surgery, this is where I will take an ink pen and mark my incision lines. Before you go into the operating room, you will be given some medicine intravenously which will help you relax, and in fact even act as an amnesiac.
Following the procedure, I will be with you in the recovery room. You will be attended to by a registered nurse and other members of the staff to make sure you’re comfortable, to check your pulse, blood pressure and oxygen, and to make sure that everything is A O.K. The anesthesiologist, of course, will check you and only when he’s said it’s okay for you to be discharged, will you be discharged. Typically, patients spend an hour to an hour and a half in the recovery room.
If you’re going to our professional post-operative recovery care facility, one of their staff will pick you up at the surgery center and drive you to the recovery hideaway. There, the nurses will keep a close watch. While not all procedures require it, the more lengthy procedures such as face and neck lift and chemical skin peeling are best followed by a stay in a facility devoted only to the care of post-operative cosmetic surgery patients. The facility occupies a wing of a hotel and our patients have access to all hotel services including meal service. We notify the staff as to what the appropriate diet should be but there are choices for you.
If you’re staying at the hideaway, I will be calling the facility several times on the day of your procedure to make sure everything is in order and answer any questions the nurses may have. The day after the procedure the facility will bring you to the office for a check and then return you to the facility.
If you’re recovering at home from nasal surgery, eyelid surgery, chin augmentation or ear surgery, I’ll call you the evening of your operation to see how you are feeling. I’ll answer any questions and remind you to call our office the next morning to check in and give us an update. Then we’ll set an appointment for the next visit which may be the following day or more likely, four or five days later.
Every patient has my home phone and my cell phone because I want you to be able reach me if there are any questions. I want to be available to you. Colleagues have commented on how uncommon it is for a doctor to give patients their home phone number and I remind them that I want to be available at all times for my patients. Your questions are important and concerns that you have need to be addressed. That’s an important part of my service. As I like to remind patients, the care of the patient doesn’t end with the last stitch; post-operative care is extremely important to ensure a superior result.
Whether you’re recovering at home or at our post-operative facility, all your medications and supplies are provided at no extra charge. It’s included in our service. I don’t want you or a relative or friend to have to stand in line at a drugstore at midnight to get a pain medication prescription filled. We provide all the medications that you need (and they are specific for each procedure). They are filled by our local pharmacy and ready for you prior to your surgical date. Your “post-operative bag” will contain your medications, printed instructions and all dressing and wound care supplies.
Speaking of pain medication, we don’t want anyone to be uncomfortable. We have a wide array of pain medications available. We’ll ask you what your experience has been with certain medications such as Vicodin or Tylenol with Codeine since these are the most appropriate medications. If one has worked well for you, that’s what we’ll have the pharmacist fill and you can feel comfortable that your pain will be controlled. Depending on the procedure, we will provide a mild sedative such as Valium to keep you comfortable and relaxed.
Remember that the anesthesiologist will ask you about medications that you normally take including non-prescription medicines, herbal and homeopathic. In almost all cases prescription medications should be continued. but if there are any questions at any time concerning your medications, call us and we’ll have the answer for you.
Our aim is that you have a comfortable and smooth post-operative course.