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Preparing for Plastic Surgery

For the Plastic Surgery Patients of

Dr. Paul S. Howard

• Do not plan on doing anything taxing for a week because you may become tired.

• You can count on some bruising, swelling, and being tired. You can count on some discomfort for the first couple of days, but if you don’t have that, what a nice surprise!

• Make sure you have a positive companion taking care of you for the first few days following your surgery. Dr. Howard requires his patients to not be alone for the first 24 hours following your surgery. Make sure your caretaker is someone who will be supportive of your decision to have cosmetic surgery. The emotional stages patients experience following surgery affects the caretaker too.

• Dr. Howard requires his patients stop smoking at least 2 weeks prior to facial surgery. Tobacco replacement products should be finish two weeks prior to your scheduled surgery date as well due to the nicotine in these products being equivalent to the nicotine in tobacco. For more information about Smoking and Plastic Surgery, read Dr. Howard's Blog.

• Dr. Howard recommends his patients consider a daily vitamin regimen prior to surgery. Do not take additional Vitamin E products other than the recommended daily allowance. Large doses of Vitamin E prior to surgical procedures has been proven to actually inhibit the body’s ability to heal. Be sure to read Dr. Howard's Blog for more information on herbal supplements.

• In conjunction with daily vitamins, Dr. Howard strongly recommends the use of two herbal supplements that help reduce bruising and swelling: Bromelain and Arnica. Do plan to have plenty of food that will be easy for you and your caretaker to prepare. Extra movies and books on tape have been very popular with previous patients.

• Two weeks prior to your scheduled surgery date, you need to make sure you avoid medications that contain aspirin and/or ibuprofen. These types of medications thin the blood and increases your chance for bleeding, bruising, swelling, and anesthetic complications.
• If you have any specific health concerns, you should consult with your family medical doctor before having any surgical procedure.

The following is a detailed listing of aspirin/ibuprofen containing medications to avoid prior to surgery:

Am I healthy enough for plastic surgery?

If you are taking any medications listed above, they should be discontinued 2 weeks prior to surgery and only Tylenol should be taken for pain. All other medications that your are currently taking must be specifically cleared by your doctor prior to surgery. It is absolutely necessary that all of your current medications be specifically cleared by your doctor and the nursing staff.

Hospitals, outpatient surgical facilities and surgeons are all seeking to improve the surgical outcomes of the patients they treat especially those patients facing surgical procedures. Improving the surgical outcome is important for both surgeon and patient.

Taking steps during the pre-operative period prior to surgery can make a difference between a successful procedure and an unsuccessful outcome. Plastic and Reconstructive surgery depends on patient compliance before and after the surgical procedure. By reducing their risks of complications, patients should follow physician instructions before and after their surgical procedure. Some very important steps occur prior to surgery such as:

• Stop smoking at least two weeks prior to your surgical procedure. This includes the cessation of any nicotine products such as nicotine gum and/or patches. Nicotine can impair the patient’s ability to withstand anesthesia and also directly affects the wound healing process.
• Maintain a healthy weight within your BMI rage and limit consumption of sugar in the diet. Elevated blood sugar can increase risk of surgical site infections and delay wound healing in diabetics and pre-diabetic patients.
• Unless otherwise instructed, stop taking any aspirin or similar products two weeks prior to your procedure to reduce bleeding risks. This includes BC Powders, Advil, Aleve, etc. Abrupt withdrawal of some medications can lead to post-surgical complications. Continued use of other medications such as blood thinners can raise bleeding risks. Discuss with your doctor any history of deep vein thrombosis (DVT) or clotting issues.
• Refrain from consuming alcohol for two weeks prior. The period you may consume alcohol products post-operatively will depend on your healing progress and will be directed by your surgeon. You should make plans not to consume alcohol post-operatively for at least two weeks.
• Maintain a healthy fitness program prior to your scheduled procedure. The surgeon will instruct you when you may resume activities post-operative. Dr. Paul Howard abides by a thorough policy to determine the current medical status of his plastic surgery patients. Patients need to meet particular medical criteria to determine if they are healthy enough for elective surgery. In addition, Dr. Howard must feel comfortable performing elective surgery and feel confident with the doctor/patient relationship. Risks of complications must be within reason to justify an elective procedure.

Since post-operative complications can occur, Dr. Howard will need to see the patient should a complication come into question. Please contact Dr. Howard’s office for instructions should you believe you are experiencing a post-operative complication. Expect Dr. Howard to request you report to his office so he may evaluate your condition. For your convenience, an afterhours answering service phone number is available on Dr. Howard’s voicemail message system by calling our office at 205-871-3361. Maintaining patient compliance by following Dr. Howard’s post-operative instructions and keeping your appointments are important to your surgical outcome.

Prescription narcotics policy

As of 2014, federal law requires all narcotic prescriptions be presented in written form. Refills of narcotic prescriptions require a new written prescription. Narcotic pain medications are no longer allowed to be “called-in.” Narcotics will only be prescribed between one to two weeks after your procedure. There are, of course, occasional exceptions to the rule. We will need to see you to re-evaluate your condition prior to renewing your prescription.

If you are currently taking or have been recently prescribed narcotic prescriptions, you will need to discuss your elective surgery plans with that physician so a sufficient post-surgical pain management treatment plan can be arranged between that physician and Dr. Howard. If you are under the supervision of a pain management physician, we expect you to disclose this information at your initial visit. Failure to do so will jeopardize your relationship with Dr. Howard and could violate your relationship with your pain management physician.

205-871-3361

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