Surgery Instructions – Chin Augmentation
MEMORIZE THIS PAPER PRIOR TO SURGERY
The Preoperative Visit
This visit will be scheduled approximately two weeks before surgery. It will give you an opportunity to ask questions you might not have asked previously. We will review your medical history, give you a preoperative examination, arrange lab tests, and discuss what to expect during surgery. If you are over forty years of age or have a history of heart abnormalities, we will arrange for an electrocardiogram. We will also take preoperative photographs, which become a permanent part of your medical record, and remain strictly confidential. Your operative consent will be read and signed, preoperative instructions reviewed, and prescriptions given to you for the medications you will need. Payment of your fee will be due at this time.
Arrangements to facilitate overnight or postoperative care will be made to suit your individual needs. Facility and anesthesia charges are separate from the surgeon’s fee.
WHAT TO EXPECT DURING SURGERY
Chin Augmentation is usually performed at the Highland Park Plastic Surgery Center on an outpatient basis under twilight sleep sedation anesthesia. An anesthetist or nurse will be present to make you comfortable and unaware throughout the procedure.
Before surgery begins, you will be asked to change into a surgical gown and will be taken into a private operating room. An intravenous line will be inserted into a vein in your arm. This will make it possible for the anesthesia provider to administer fluids and to deliver the necessary medications to make you comfortable. Monitoring devices will be connected to you to assure your safety.
Dr. Toledo will talk with you and use a surgical marking pen to draw several lines on your face. These will guide him during the operation. Your face will be cleansed with an antiseptic solution and then covered with surgical drapes.
WHAT HAPPENS AFTER SURGERY
You will be transferred to a recovery room adjacent to the surgical suite, where you will be continuously monitored as you recuperate from the effects of the surgery and anesthetic. You will be allowed to go home after a recovery period of 30 minutes or more. You should feel fine, although it is not unusual to expect some minor discomfort.
If you are going home, the person taking care of you must stay with you for 24 hours and will be given instructions about your after care before you leave, or we can arrange for post operative care in an after care facility.
NOTE: If you live out of town, you must make arrangements to stay within a thirty minute drive of the Highland Park Plastic Surgery Center for the first twenty-four hours after surgery.
Medications: Take the medications we’ve prescribed according to the instructions on the bottle. You may feel a little drowsy, so have someone help you. If you need a refill, call the office and give us the telephone of your drugstore or pharmacy. Do not take aspirin for four weeks before surgery and two weeks after.
Smoking: Smoking or nicotine use (chewing tobacco, nicotine gum, snuff) can have a severe detrimental effect on wound healing. The nicotine decreases the vital blood supply to the skin and can cause poor healing or even skin death. STOP ALL NICOTINE PRODUCTS 2 MONTHS BEFORE AND AFTER SURGERY.
Caffeine: Excessive use of products with caffeine such as coffee, tea, or soft drinks, especially Diet Coke, can have similar effects as nicotine. STOP ALL CAFFEINE PRODUCTS 2 WEEKS BEFORE AND AFTER SURGERY.
You should expect:
Bruising. This could last a few days or up to 2 weeks. Feeling of tightness. This subsides over several weeks.
Sensation of numbness of the chin or mouth, usually temporary
Mild to moderate swelling. This will gradually decrease over a period of several months.
Call (214) 363-4444:
Severe pain which does not respond to medication. Significant swelling, and/or unrelenting pain
Deep pain in the legs/calves; which may indicate a blood clot.
Shortness of breath or labored breathing can be a sign of blood clots in your lungs.
Any problems or questions that we haven’t covered on this instruction sheet.
Activity: You should “take it easy” the day of your operation and the following days.
By keeping your head elevated above your heart, swelling can be minimized. Because of your medications, you may need assistance getting to and from the bathroom for the first day.
To Reduce Swelling: Sleep with your head and shoulders elevated using 2-3 pillows.
Showering: You can shower after the bandage is removed. Avoid long, hot showers or baths for the first week.
Pain: Most patients feel that the discomfort from the surgery is minimal. The greatest period of discomfort usually lasts about 24 to 48 hours. Thereafter, you should have less discomfort and less need for medication. Occasionally, it lasts a little longer, as different people have different pain tolerances.
Alcohol: Do not drink alcohol for five days after surgery or when taking pain medication.
Diet: Liquid diet for 24 hours then soft foods for 3 days after surgery.
After care: You will need to rinse your mouth out with Listerine 3-4 times daily, or after eating for up to 1 week.
Ice packs: Ice packs can reduce swelling and bruising. Apply ice packs to your chin area for up to 20 minutes per hour, while awake for the first 36 hours. Gel ice packs, Ziploc baggies with ice or frozen peas work well.
Sports: Strenuous sports, such as tennis, swimming, jogging, or aerobics, may be resumed after 3 weeks. For 3 weeks after surgery, refrain from any activity that significantly raises your body temperature and/or blood pressure.
Work: Depending on the kind of work you do, you may return to your job as soon as you’re comfortable.
Postoperative visits: You will be seen at our center three to five days after surgery.
Subsequent visits will be determined according to your progress, usually weekly for one month, and then less frequently.
You will feel more comfortable using the private postoperative waiting room for your initial postoperative visits. Park in the handicap spot in front of the Sherry Lane door. Press the doorbell and we will let you in from the inside.
Please feel free to call us at any time during your healing period. THE OUTCOME OF YOUR SURGERY IS IN YOUR HANDS AS WELL AS THE DOCTOR’S. IT IS YOUR RESPONSIBILITY TO FOLLOW ALL INSTRUCTIONS GIVEN TO YOU.
Possible Problems and Complications
No surgical procedure is without risk. Most complications associated with skin resurfacing, however, are minor. Here are some possible problems:
Collection of blood under the skin (hematoma). This can be removed.
Decrease or increase of sensation in the treated area. If this occurs, it will usually return to normal in time.
Soreness and itching in the treated area. If these sensations occur, they will soon disappear.
Depression. With aesthetic surgery, as well as with other surgical procedures, this sometimes occurs postoperatively. This is generally attributed to the normal response of the body to surgery and anesthesia.
Asymmetry. No patient is identical from side to side. Small differences exist in all patients. In the occasional patient with a major difference,
Persistence of the original problem.
Potential but unlikely complications: Infection:
Loss of small area of skin (necrosis).
Scarring can result from any operation, including chin augmentation. Scars can be raised or red, and usually fade with time. This complication is rare.
Complications of severe nature, which could be life threatening.
Deep venous thrombosis (blood clots) affects mainly the veins in the lower leg and the thigh. This clot may interfere with circulation of the area, and it may break off and travel through the blood stream. This clot can then lodge in the brain, lungs, heart, or other area, causing severe damage to that organ or even death.
There is evidence of an increased incidence of MRSA (methicillin-resistant Staphylococcus aureus) and other antibiotic resistant bacteria in our community. In the past, these resistant bacteria were typically found only in hospitals, but they are now found everywhere. Frequently people can be a carrier of the bacteria without their knowledge. An infection with this bacteria can cause severe damage to the skin and even death. We are diligent in cleaning and sterilizing our facility and try to limit the exposure of outside bacteria from patients into our surgery center. YOU MUST ENTER INTO YOUR SURGERY FULLY UNDERSTANDING NOT ONLY THE BENEFITS, BUT ALSO THE POSSIBLE PROBLEMS. ON RARE OCCASIONS, MINOR REVISION MAY BE NECESSARY TO ENHANCE THE FINAL RESULTS.
The instructions above are general and some portions may not apply to all patients. Changes in the instructions depend on your medical history, number and type of procedures and type of anesthesia.