BEFORE BROWLIFT SURGERY
At your preoperative browlift appointment our nurse will provide all the instructions for you to follow before and after surgery. On the business day prior to the brow lift procedure we ask you to call to confirm your arrival time for surgery. Upon arrival for your browlift surgery, you will talk with a nurse (who will start an IV), discuss local anesthesia with IV sedation (you are asleep for the surgery) and meet with your doctor before going to the operating room. A browlift takes about two hours depending on the underlying structure and amount of excess tissue prior to surgery. If you are having a combination of plastic surgery procedures your surgery time will take longer. Recovery time from the anesthetic takes about an hour and most patients are discharged about four to five hours from the time of admission.
PREOPERATIVE BROWLIFT INSTRUCTIONS
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Please avoid any aspirin, aspirin-containing products, or ibuprofen (Advil, Aleve, etc.) for one week prior to and two weeks following your brow lift surgery. See our "Medication List" for products to avoid prior to surgery. If you are on any medications that affects bleeding (such as coumadin or warfarin) please notify the office immediately.
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Please refrain from tobacco products and alcohol for one week prior and three weeks following browlift surgery. Along with delayed wound healing, persistent skin redness and other complications may persist when tobacco and alcohol are not discontinued.
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Please notify us of all routine medications and significant health history. We ask that you remain on your daily medications unless instructed otherwise. At the preoperative browlift appointment, our nurse will tell you which daily medications to take with just a sip of water on the morning of surgery.
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At your preoperative appointment you will be given prescriptions for use following brow lift surgery including an oral antibiotic, antibiotic eye ointment (if you also have eyelid surgery) and pain medications. Please obtain these prescription medications before your browlift surgery so you will have them ready for use when you return home after surgery.
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We will ask you to take Arnica, a natural herb that significantly decreases bruising, before and after surgery. We will also ask you to take Vitamin C (ascorbic acid), which helps promote healing, before and after browlift surgery.
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Please call the Lindsay House Surgery Center at 267-8200 before noon on the business day prior to your procedure to confirm your arrival time.
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You may not eat or drink after midnight the evening before the browlift procedure unless instructed otherwise. You may brush your teeth. Your procedure will be cancelled if you do not follow these instructions.
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Do not bring valuables (cash, credit cards, watches, jewelry, etc.) to the Lindsay House on the day of your brow lift surgery. Remove all make-up and nail polish before arriving for your procedure.
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It is not required that a family member or friend to stay at the Lindsay House during your surgery. However, someone must be available at all times while you are here at the Lindsay House for browlift surgery. Someone will need to drive you home after your surgery and stay with you that evening. Transportation to the office for packing removal the day following brow lift surgery is also required.
AFTER BROWLIFT SURGERY
When you wake up from browlift surgery you will notice a soft, bulky head wrap dressing. Attached to your head dressing is a "ball" or drain(s). The drain(s) facilitates removal of excess tissue fluid and helps to prevent infection. Following your browlift, the nurses will ask you to meet the discharge criteria: to drink liquids, walk with a steady gait, void, manage your discomfort, and monitor and empty the drain(s). The nurses will review all instructions you will need for care following your browlift. You will be asked to come to our Lindsay House office (not the Surgery Center) the following day after browlift surgery for a dressing change and drain removal. Although most patients describe drain removal as discomfort rather than pain, you are encouraged to take your pain medication about an hour prior to drain removal. You will be asked to return in five to seven days after your brow lift surgery for suture removal.
POSTOPERATIVE BROWLIFT INSTRUCTIONS
Wound care
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Keep dressing dry and intact the evening after browlift surgery. Notify your doctor if the dressings become loose or fall off. Monitoring the amount in the drains is very easy. Our nurses will teach you how to manage the drains.
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Following dressing and drain removal the morning after brow lift surgery, you will notice little clips in your hair. We will again instruct you on wound care. Cleaning the suture with a Q-tip dipped in hydrogen peroxide and then applying the antibiotic ointment (polysporin/bacitracin) twice a day is an essential part of the healing process. Keep elastic wrap in place at all times for a few days following surgery, then we will ask you to wear it at bedtime only for about a week after browlift surgery.
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You will be asked to return to the office about seven days after your browlift surgery for removal of clips. Because most patients tell us their forehead is temporarily numb following browlift, it is uncommon for patients to complain of significant pain with clip removal.
Medications
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Most patients complain of discomfort more than pain. Use pain medication (Vicodin/hydrocodone) as directed/as needed. Vicodin contains Tylenol. Do not take additional Tylenol or acetaminophen while taking Vicodin. Do not drive or drink alcohol while taking pain medication. Taking pain medication with food helps minimize nausea sometimes associated with pain medications.
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Start your antibiotic (Keflex/cephalexin) when you get home and one at bedtime. It is not uncommon to have a low-grade fever for 24 hours following browlift surgery.
Start swelling medication (Medrol Dosepak/methyl prednisolone) when you arrive home and at bedtime. Then follow package directions. Take with food.
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Vitamin C (ascorbic acid) helps promote healing. Take 1000 mg three times a day for two weeks following browlift surgery.
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Arnica, a natural herb that significantly decreases bruising, is used under the tongue three tabs three times a day before meals.
Diet
Advance diet from liquids to soft food (oatmeal, French toast, yogurt, soup, pasta) to your regular diet as tolerated.
Activity
Rest for the entire day after brow lift surgery. Sleep with head elevated or use two to three pillows for one week after brow lift surgery. Absolutely no bending, lifting or straining. If you have little children, bend at the knees or sit on the floor and let them climb on to your lap. No driving for one week following browlift surgery. Two weeks off work is recommended.
After 24 hours, keep incisions dry except for cleaning and ointment. Bathing is ok as long as you don't get your incisions/hair wet. You are encouraged to shower and wash your hair twice: once on the evening before clip removal and once on the morning of clip removal (usually post-op day seven). Bruising can be camouflaged at one week postoperatively with make-up. Always protect your face from the sun. At this point, a hat and sunglasses are a good idea. Following surgery, our staff will tell you when it is ok to apply sunscreen, cosmetics or facial creams. Avoid unprotected prolonged sun exposure for three months following browlift to prevent pigmentation of incision lines.
Appointments
Your head dressing and drains will be removed the morning after endoscopic browlift surgery. Clips will be removed seven days following your surgery. You will need transportation to and from these appointments. For the first ten days following browlift surgery, please use our private side entrance (driveway entrance).
Please Remember!
Swelling, bruising and disrupted sleep are very normal postoperative symptoms for browlift surgery and will decrease as the healing process occurs. Assistance with daily activities the first two to three days after surgery is strongly recommended.
Final Result
Following a browlift, it takes time for the swelling to subside and for the skin to heal. Most patients return to work two weeks following surgery, however three weeks is ideal, depending on the degree of privacy one is trying to maintain. At three weeks postoperatively, swelling and bruising may be apparent to you but not to many of your coworkers and closest friends.
Final results following browlift are not apparent for one full year following surgery. After three months, the changes are ever so subtle, although still important. Being perfectionists about our work, you may tell us you are pleased long before the one year anniversary. However, we request that you follow-up with us at that time for postoperative browlift photographs and so that we can enjoy your final result.
Please notify the office 244-1000 and ask for our nurse for any concerns. For an emergency, please contact our office or professional answering service at 258-4851. Remember, we are all here to help in any way we can.
Copyright 2010 Quatela Center for Plastic Surgery