Patient Instructions

Patient Instructions Northern Virginia

At the Virginia Center for Plastic Surgery, we believe that patient education is an important part of your plastic surgery experience. We strive to provide you with very detailed information to help ensure you are completely comfortable with your desired treatment course, and we will always explain the necessary steps to take immediately following your procedure to ensure proper healing.

The following pages contain valuable information for you as you begin researching your desired procedure. At your initial consultation, Alexandria plastic surgeon Dr. Eric Desman will go into greater detail to make sure that you achieve the exceptional results you deserve.

Please contact our experienced plastic surgeon today to schedule your initial consultation at the Virginia Center for Plastic Surgery, serving patients in Alexandria, Northern Virginia, and Washington, D.C.

Obagi

The following instructions should be followed when using the Obagi Skin Care system:

  1. Cleanser: Wash your face with your hands. Put a small amount of cleanser on your fingertip and apply to your face using fingertips to lather. Rinse with water. You can use this treatment more than twice a day if you want to wash your face more often, but always follow with toner application. TWICE A DAY: MORNING AND NIGHT
  2. Toner: Apply with a cotton ball. Do not do your eyelids. Do not rinse. TWICE A DAY: MORNING AND NIGHT
  3. Clear: Apply with fingertip to your entire face. Let this absorb into the skin before applying the next step. TWICE A DAY: MORNING AND NIGHT
  4. Exfoderm: Apply to your entire face except the eyelids. Let it absorb into skin. ONCE A DAY: MORNING
  5. Blender: This is to be mixed with Retin-A prescription. Mix on the back of your hand before applying. Instructions for variations in mixture strength are in your booklet on page 1. Standard mixture is equal parts of blender and Retin-A. Either use the diagram in the book across from page one which means using a line from 0 to A on the package, or use a green pea size circle of each. Blend together and apply to your entire face. ONCE A DAY: NIGHTTIME
  6. Sunfader: Apply to your entire face. This has a sunscreen in it and it will help to protect you from sun damage. Try to avoid direct sun exposure during the restoration phase. However, if this cannot be avoided, apply additional sun block and wear a covering. ONCE A DAY-ONLY IN MORNING

Do not use any other products while on the Obagi system. Use all six of the products while in the skin restoring phase. Expect redness, flaking, dryness and worsening of the problems for a couple of weeks as impurities are being brought to the surface and the top layer of old skin is sloughed off.

It normally takes six to eight weeks for skin to complete the restoration process. At this time, you will need to come in for a follow-up appointment with Dr. Desman to see which activation/maintenance schedule you need to follow for your skin type.

Breast Augmentation

Dr. Desman will give you detailed post-operative care instructions after your rapid recovery breast augmentation procedure. It is important to follow these instructions carefully to ensure proper healing.

Immediately Following Your Procedure

When you return home from your breast augmentation procedure, you should take a two-hour nap. After your nap, you should continue to rest at home, but do not sleep again until bedtime.

Start taking the prescribed antibiotic within two hours of arriving home, and then follow the instructions on the bottle. A good time to take your first dosage is after your nap. Make sure you eat something substantial at this time. You should not have to worry about nausea from the anesthesia. This would occur in the first few hours after surgery while you are napping.

Before going to bed, it is important to lie on your breasts and put your full weight on them for about 15 minutes. This should be done for four to six weeks. To get up afterward, simply roll to your side and sit up.

Showering and Dressings

Once you feel comfortable moving after your nap, take a shower. The shower will help loosen things up and wipe away the fog from anesthesia. When getting into the shower, remove the horizontal tape and the white gauze pads that the tape is holding onto your skin. Below this, you should see vertical paper Steri-strips. Leave these strips intact. They can get wet.

After your shower, pat the Steri-strips dry. If you have any drainage or leakage, put some more gauze pads over the Steri-strips. Otherwise, they do not need to be covered.

There are no special dressings needed after surgery. A sports bra is frequently the most comfortable thing to wear, but it is not necessary. Over the long term, a bra is always recommended to support the breasts. However, immediately after surgery you should wear whatever is most comfortable to allow for maximum movement.

The Morning after Surgery

When you wake up, eat breakfast and take 800 mg of ibuprofen. Wait 30 minutes and then take a warm shower. After your shower, place your arms above your head in a slow jumping jack motion. Keep the arms straight out all the way up and touch the back of the hands to each other. Repeat this motion five times. Do another set of five every hour.

You should get out of the house and do something – drive a car, run errands, go to the grocery store. Normal movement is essential to promote proper healing. You will most likely run out of energy around mid-day, so plan ahead to ensure that you will be home to rest. After your nap, get up and start moving around again. The more you move, the better you will feel. You may feel tighter and more swollen at the end of the day. This is normal and temporary.

Additional Considerations

It is normal to hear squishing or sloshing sounds after surgery. This is caused by air and fluid trapped underneath the skin. This is normal and will be absorbed by your body within the first week after surgery.

You may experience sharp or burning pains on the sides of your breasts. This is due to nerves that have been put under significant stretch. Massage the area that feels uncomfortable in a circular motion for a few minutes until the burning goes away.

It is normal for the implants, particularly saline implants, to appear slightly high on the chest. As your skin stretches out and accommodates the breast implants, they will drop. This should occur during the first two weeks after surgery. The final shape and position of the implants usually is not seen until about three to six months after surgery. It is also normal for saline breast implants to feel very firm right after surgery. They will soften up over the first weeks to months after surgery.

Remember, we are here to help you. Please call our Alexandria plastic surgery office sometime during the day after surgery and let us know how you are doing. If you have any questions or concerns during the recovery period, please do not hesitate to give us a call.

Liposuction

The following post-operative instructions should be closely followed to ensure proper recovery from your liposuction procedure:

  • You will start showering after your first appointment in the office.
  • Make arrangements for someone to bring you to the office for your first appointment to see Dr. Desman since you will not be able to drive for approximately five days after surgery.
  • The compression garment must be worn 24 hours a day for one full month after your surgery.
  • While taking pain medication, drink at least eight glasses of water a day and take a stool softener to help decrease the chances of constipation.
  • Please sleep on your back for two weeks.
  • Bruising may last as long as six to eight weeks following surgery, depending on the nature of your liposuction procedure. If pain exceeds the coverage of your prescription, call our office.
  • All dressings and compression garments must stay on, dry, and clean until you are seen by Dr. Desman on your first post-operative visit to our office.
  • After you stop your pain medication, start with deep, firm massage to the areas that were operated on.
  • No strenuous activity is allowed for one full month after surgery. This includes aerobics, weight lifting, tennis, and any other athletic activity which you normally participate in. Walking is permitted at two weeks.
  • Do not resume sexual intercourse for three weeks.
  • Your final result will not be seen for approximately six to nine months, as your skin will need to tighten up over the treated area(s). However, you will notice a significant improvement in your body contour and how clothes fit within several weeks.

Remember, we are here to help you. Do not hesitate to call if you have questions or concerns about your recovery.

Tummy Tuck (Abdominoplasty)

You will receive the following post-operative care instructions after your tummy tuck. It is important to follow them closely to ensure proper healing:

  • You will not be able to drive for approximately ten days following your tummy tuck, so you will need to arrange for someone to bring you to our office for your first post-operative visit.
  • Follow the drain care instructions you were given to manage your drain. The most important part of the process is to keep the collection bulb squeezed when you re-apply the cap. This is what creates the suction to remove more fluid. If you have any questions, please call our office at any time.
  • All dressings, compression garments, and binders must stay on, dry, and clean until you are seen by Dr. Desman on your first post-operative visit. Dr. Desman will tell you when you can start showering.
  • Your compression garment must be worn 24 hours a day for one full month after your surgery. Please sleep on your back until told otherwise.
  • No exercising, lifting objects more than five pounds, or jogging is allowed for one full month following surgery. You may start walking one to two miles starting two weeks after surgery.
  • Do not resume sexual intercourse until at least three weeks after surgery.
  • Have your antibiotic and pain medication prescriptions filled, and begin taking it as prescribed as soon as possible.

Remember, we are here to help you. Do not hesitate to call us if you have any questions or concerns about your tummy tuck post-operative care.

Medications

There are many commonly used medications that may have an adverse impact on the outcome of your plastic surgery procedure. It is important to be aware of the risks associated with consuming these drugs immediately before, during, and after your procedure. If you regularly use any of the drugs listed below, be sure to discuss this with Alexandria plastic surgeon Dr. Eric Desman at your initial cosmetic surgery consultation.

Common Drugs to Avoid

You should avoid using the following over-the-counter and commonly prescribed medications before your surgery. All products containing aspirin should be stopped as part of your preparation. If you have a headache or minor pain, you may take Tylenol (acetaminophen).

Please remember that the following list is not comprehensive. If you regularly take any medications, it is important to tell Dr. Desman at your initial consultation:

  • Advil
  • Aleve
  • Alka-Seltzer
  • Bufferin
  • Celebrex
  • Fiorinal
  • Ibuprofen
  • Midol
  • Naproxen
  • Motrin
  • Pepto-Bismol
  • Propoxyphene
  • Sine-Aid
  • Sinutab
  • Triaminicin
  • Vitamin C > 1000 mg/day
  • Vitamin E

Foods to Be Limited

Many common foods contain chemicals that are similar to aspirin and therefore affect blood clotting. It is best to limit your intake of these foods for two weeks prior to your surgery:

  • Almonds
  • Apricots
  • Berries
  • Cherries
  • Cucumbers
  • Curry
  • Grapes
  • Grape juice
  • Jellies
  • Nectarines
  • Oranges
  • Peaches
  • Pickles
  • Plums
  • Prunes
  • Raisins
  • Tomatoes and tomato products
  • Wine
  • Vinegar

Herbal Medications and Plastic Surgery

Herbal medicines are medicinal products that contain plant materials as their pharmacologically active components. Many herbal remedies can lead to potentially adverse effects and drug interactions. You can improve your chances for an optimal outcome to your procedure by discussing your use of these medications with Dr. Desman at your initial consultation. Also, we recommend that you stop using these supplements at least 14 days prior to your surgery.

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