Be sure your caregiver reads these instructions at least a day before surgery!

General Information

1. You must not take aspirin or anti-inflammatories, or medicines containing them for 2 weeks prior to surgery. This is because these medicines may interfere with blood clotting and increase bleeding. If you need a mild pain medicine, please use Tylenol. Some of the medicines containing aspirin or anti-flammatories, (which you must avoid) are as follows: Anacin, Ascriptin, BC Headache, Powders, Goody's Headache Powders, Ibuprofen, Bufferin, Coricidin, Darvon, Fiorinal, Dristan, Emprin, Excedrin, Midol, Nuprin, Sine-Off, Sine-Aid, Percodan, Stendin, Triaminicin, Vanquish. Also, anti-inflammatory or anti-arthritis drugs such as Motrin, Advil, Indocin, Naprosyn, Ibruprofen, Aleeve, etc. If unsure, call your surgeon or your pharmacist.

2. Also, many herbal medications contain aspirin-like products, so we ask you to stop all herbal medications 2 weeks before surgery. Bleeding problems can occur with Willowbark, Fever Few, Gingko Biloba, St. John's Wart, Saw Palmetto, Vitamins A and E.

3. Do not sun bathe or use a tanning bed for 2 weeks prior to surgery, as this causes swelling of the face and poor healing.

4. If you develop a cold or become sick in the week before your scheduled surgery, please call your surgeon immediately.

5. Be sure to have your lab work completed as instructed before the surgery. Lab work and medication will be extra charge, as these services are provided outside of your surgeons office.

6. Please do not smoke 2 weeks prior to surgery, and for 1 month afterwards, or until healing is complete. Cigarette smoke, either yours or from others, severely decreases blood supply and can cause poor healing, or even death of some skin, especially behind the ear. Furthermore, coughing makes surgery difficult and increases bleeding.

You Will Need

Neutrogena or baby shampoo, Q-tips, child's "sippy" cup, small (or child's) toothbrush and inexpensive thin washcloths.

TWO DAYS BEFORE SURGERY

Begin Valtrex medication to help prevent fever blisters (take 1/2 tablet every 12 hours).

EVENING AFTER SURGERY

1. Continue Valtrex medication.

2. Begin antibiotic medication (one every 12 hours)

3. Sleep medication, take one if needed.

4. Pain medications; take only if experiencing moderately severe pain. (Try Tylenol first.)

5. Apply eye ointment inside eyelids each time before sleeping or napping. This ointment will blur your vision for a couple of weeks.

6. Sleep with head elevated (45 degree angle) in a reclining chair or a 3-4 pillows. Surgeons strongly encourage you to put 2-3 pillows under your knees to make your back more comfortable.

7. Dressing on face and around head must be left in place.
IMPORTANT: If you accidentally pull away part of the clear plastic dressing, you must immediately begin coating this area with Aquaphor every 2 hours after soaking with very wet gauze. If you fail to do this, the skin can dry out and scarring can result.

8. You should soak your eyes and mouth with very wet gauzes for 10 minutes every 4 hours while awake. This helps dissolve some of the yellow discharge that builds up. After each soaking, use Q-tips to apply Aquaphor to exposed areas around the eyes and mouth.

9. Place moist gauze over eyes then ice mask over gauze. Change both every hour or two while awake, reapply Aquaphor to eyelids, too.

10. Drink nourishing liquids, NO STRAWS

**AT NO TIME DURING THE FIRST 4 WEEKS SHOULD YOU BEND OVER**

DAYS 1-2

1. Return to office for dressing change.

2. Continue medication -- (see medication list)

3. If the eyelids have been treated with laser, you should clean them 4-5 times a day. You may use a Q-tip dipped in plain tap water to clean the area directly beneath your eyes where the skin is not covered by the dressing. After cleaning with the wet Q-tip, use a dry one to roll over your eyelid to remove moisture and drainage from this area. Apply a very THIN layer of Aquaphor to the area. Expect the vision to be blurry for two weeks due to increased mucous production and the ointment you are using in your eye area. For the first two days, you are to keep and ice mask on your eyes. Continue to place a thin moist washcloth of moist guaze between the mask and your eyes. Change both every 1-2 hours.

4. Continue to apply eye ointment inside eyelids before bedtime or before taking a nap. Do not remove face or head dressings.

5. Wear white cotton gloves at all times while sleeping.

6. Continue to sleep in a recliner with your head elevated (or you may sleep on your back with your head on 3-4 pillows). During the day, you may want to walk, sit, or rest with your head elevated. DO NOT LIE DOWN FLAT. Remain indoors, out of the sun and wind.

7. If area around mouth is treated, you should keep taking minimum and eat only soft foods for one week. A child's "sippy"cup works well for drinking fluids. Also, you may have difficulty using your regular toothbrush for the first few days. Try using a child's toothbrush or a long Q-tip.

8. Drink plenty of liquids. DO NOT USE A STRAW.
Expect to have a swollen face. It is not unusual for the eyes to be closed for a few days due to swelling, especially if other facial surgery was done. The neck may also be swollen.

DAYS 3-6

1. Continue as on days 1 and 2.

2. Dressings will be removed day 4-7.

3. Stop using ice mask 48 hours after surgery.

4. Warm water should be placed inside ice masks beginning day 4. This helps remove the black and blue. Place warm mask over eyes with moist gauze between eyes and mask.

DAYS 4-6 (Beginning the day your dressing is removed)

1. You must begin to take a shower twice a day -- morning and evening. Let the warm water spray lightly over face. After 10-15 minutes of soaking, gently massage facial skin with your fingertips to remove some of the Aquaphor. The purpose is to gently dissolve the build up of yellow discharge on the skin. DO NOT rub hard, scrape, or use a washcloth. Let skin air dry and then reapply Aquaphor with fingertips.

2. You may shampoo your hair while in the shower, but try not to get shampoo on your face (Use a mild shampoo such as baby shampoo or Neutrogena.)

3. Between showers, every 3-4 hours, you are to soak your face with water of any comfortable temperature. Soak a thin washcloth in warm water and place over your face for 10-15 minutes. This may sting slightly, but it is important.

4. Continue eye drops and eye ointment.

5. If you experience itching, you may take Benadryl 25-50 mg every 4-6 hours.

6. Continue to wear your white cotton gloves at all times while sleeping.

DAYS 7-14

1. Continue showers twice a day. Also, continue facial soaks twice a day between showers. Do this until all crusts are gone.

2. STOP USING AQUAPHOR ON DAY 7. YOUR FACIAL SKIN NEEDS TO DAY SO THAT CRUSTS WILL FLAKE OFF. DO NOT PICK OR PEEL CRUSTS OFF AS THIS MAY CAUSE SCARRING.

3. Wear cotton gloves while sleeping. (You could scratch or rub your face while sleeping. This causes red marks under the skin, which will last 4-6 weeks.)

4. Your skin will begin to feel very tight as it dries. If a particular area feels extremely tight and is bothersome, you may apply a SMALL amount of Aquaphor to that area. Using too much for too long, however, will delay the healing.

DAYS 14-21

1. You may be given products for cleansing your facial skin. You may also be given cover-up make-up and a moisturizer at this time. DO NOT APPLY MAKEUP THICKLY.

2. DO NOT attempt to remove your make-up completely. This make-up is designed to stick and you can damage your skin if you try too hard to wash it off.

3. Continue to sleep with head elevated.

4. DO NOT PUT ANYTHING ON YOUR FACE THAT YOUR SURGEON DIDN'T GIVE YOU FOR THREE MONTHS.

EVEN YOUR OWN MAKEUP, MOISTURIZERS, CLEANSERS, PERFUMES, OR ANY CREAMS AT THIS TIME MAY CAUSE SEVERE ALLERGIC REACTION AND MAY DELAY HEALING BY SEVERAL WEEKS.

IF YOU EXPERIENCE BOTH OF THE FOLLOWING DURING THE FIRST TWO WEEKS CALL YOUR SURGEON

NEW FACIAL PAIN, AND LASED SKIN LOOKS WORSE: MORE PAIN, MORE RED, MORE WEEPY, SKIN DEVELOPS TINY BLISTERS OR CRUSTY SORES OR MOIST WHITE LAYERS ON TOP

* DO NOT PICK THE CRUSTS OFF YOUR FACE. This may cause permanent scarring!!

* If your lased areas become darker (tan or brownish) after 3 or 4 weeks, call your surgeon; or you may need to begin a cream application to reduce the discoloration.

* If you develop any firm areas in the skin (especially around the lips), you should call for an appointment. Failure to do this may result in a permanent scar.

* You should avoid direct sun (even through a window) until all pinkness is gone. If you must be in the sun even briefly, you must wear a broad-brimmed hat and a chemical-free sun block, such as SkinCeuticals. This must be reapplied after 1 hour (or sooner if you are perspiring).

Long Term Instructions

1. Apply surgeon's sunblock and wear a hat whenever you are exposed to the sun.

2. If you have had eyelid surgery, be sure to use sunglasses with UVA and UVB 100% filters.

3. Wash your face gently with a neutral facial soap.

4. If milia (tiny white bumps) appear on your face, observe for 48 hours. If there is no improvement call your surgeon.

5. IMPORTANT -- PLEASE READ THIS: Normal skin holds several layers of dead cells on its surface, which serve to protect the skin. It also provides a suede-like layer the absorbs water and therefore holds make-up. After the laser removes the layer of dead skin cells and the old sun-damaged upper layers of living cells, the new cells lining the pores and glands of the skin rise to the surface to form a new healthier top layer for the skin (epidermis). In the first few weeks after the laser resurfacing, the skin looks shiny and doesn't hold makeup well. This is because it is brand new and has not had time to accumulate the suede-like layers of dead cells. Gradually, as the skin begins to mature over the next few months, it starts to hold onto clumps of dead cells, making the skin feel rough. Then it will lose these clumps of dead cells, and the skin will look flaky and then shiny again when all of the clumps are gone. This cycle of shiny-rough-flaky-shiny will repeat itself several times over the next several months until it finally matures and retains a nice soft layer.

6. You may use a temporary hair color or rinse 4 weeks after surgery. Permanent color can be used at 6 weeks.

7. Continue to wear your white cotton gloves while sleeping for three months. During this time, the skin will continue to itch, and no matter how strong your will power, you can't keep from scratching while asleep. Scratching can cause permanent scarring.

Comments from the Site Owner

Laser Rejuvenation

I had laser rejuvenation around my eyes and around my mouth. I was amazed how well the laser worked on my smile/laugh line. However, the fine lines under eyes didn’t take as well as they are starting to come back only 7 months after surgery. But, the laser did reduce the dark circles I had. The laser will leave you very red for a while. Plan to stay out of public for at least a week. After a week you should be able to apply special make-up (such as Jane Iredale) as regular make-up won’t stick to the slippery surface of lasered skin. Be sure to ask your surgeon what kind of make-up, and cleansers (my surgeon gave me Obagi), moisturizers, etc. you can wear and when.

You will also have to stay out of the sun. When you have no choice, you’ll need sunscreen and a hat for protection. My surgeon recommended using sunscreen for a year post-op. I was out once without sunscreen or a hat within the first month of surgery for about only 10 minutes and a small part of where I had the laser turned brown (but is easily covered with make-up). ~Rebecca (Site Founder and Laser Rejuvenation Patient)

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