Sutured Wound Care

• No strenuous activity for 48 hours. Resume moderate activity in 72 hours. No heavy exercising for 2 weeks after surgery. Unless directed otherwise
• On the day of surgery, if allowed, alternate Tylenol and Ibuprofen every 2 hours beginning 1 hour after surgery for pain relief. DO NOT TAKE NSAIDs (ALEVE, ADVIL, MOTRIN, ETC.) IF YOU ARE TAKING BLOOD THINNERS.
• Keep the pressure bandage in place for 48 hours. If the bandage becomes bloodtinged or loose, reinforce it with gauze and paper tape. (Refer to POSSIBLE COMPLICATIONS for management of bleeding)
• Keep the bandage dry. Wash around it carefully. Ok to shower after 48 hours.
• Remove the pressure bandage in 48 hours
• Do not drink alcoholic beverages for 48 hours.
• No dietary restrictions.
• Continue your normal medications
• Do not smoke for 3 weeks; smoking is detrimental to wound healing.
• It is normal to have swelling and bruising around the surgical site. The bruising will fade in approximately 10-14 days.
• Numbness, itchiness and sensitivity to temperature changes can occur after surgery and may take up to 18 months to normalize.

POSSIBLE COMPLICATIONS

BLEEDING:

1. Leave the bandage in place. Do NOT remove the bandage.
2. Use tightly rolled up gauze or a cloth to apply direct pressure over the bandage for 30 minutes. NO LOOKING- just hold pressure for 30 min.
3. Reapply pressure for an additional 15 minutes if necessary
4. Call the office or go to the nearest emergency room if pressure fails to stop the bleeding.
5. Use additional gauze and tape to maintain pressure once the bleeding has stopped.

PAIN:

1. Post operative pain should slowly get better, never worse.
2. Alternate Tylenol 500mg and Ibuprofen 400mg every 2 hours beginning 1 hour after surgery for pain relief. Do NOT take more than the recommended dose on the medication label. Do NOT take more than 3,000mg mg of acetaminophen (Tylenol) and 1,200mg of Ibuprofen. Only take these medications as allowed.
3. A severe increase in pain may indicate a problem. Call the office if this occurs.

Daily Wound Care

• As long as the wound is open and healing, keep the area covered with bandage and change it daily as follows:
• Clean and dry the area with plain tap water using a Q-tip or gauze pad.
• Apply Vaseline to the open area.
• Cover the wound with a band-aid or sterile non-stick gauze pad and paper tape.
• One week after surgery you may resume your regular skin care routine, including washing with mild soap & water, applying moisturizer, make-up, & sunscreen.
• Repeat Instructions above until the wound is completely healed.
• Once all the bandages are removed, the scar will be red and firm (especially in the lip/chin area) This is normal and will fade in time. It might take 6-12 months for this to happen.
• Massaging the area will help the scar softener and fade quicker. Begin to massage the area one month after the bandages have been removed. To massage, apply pressure directly and firmly over the scar with the fingertips and move in a circular motion. Massage the area 10 times a day for 30 seconds.

Approximately 6-8 weeks after the surgery it is not uncommon to see the formation of "tender pimple-like" bumps along the scar. This is normal. As the scar continues to mature and the stitches underneath the skin begin to dissolve, this might occur. Do not pick or squeeze, this will resolve on its own. Should one break open producing a small amount of drainage, apply Vaseline a few times a day until the wound is completely healed.

Numbness in the surgical area is expected. It might take 12-18 months for the feeling to return to normal. During this time sensation of itchiness, tingling and occasionally sharp pains might be noted. These feelings are normal and will subside once the nerves have completely healed. Applying Vaseline and massaging the area can help.