Plastic Surgery Pre & Post Op Care Guidelines

Presurgery↓

•Take a shower the night before your surgery. Scrub thoroughly with your germ-inhibiting soap.

•DO NOT EAT OR DRINK ANYTHING, NOT EVEN WATER, AFTER MIDNIGHT THE NIGHT BEFORE SURGERY. No gum, candy, mints, or coffee the morning of surgery. If you sneak anything, you can increase your risk of serious surgical complications.

•You may brush your teeth the morning of surgery, but do not drink anything.

•Dr. Lou will tell you whether or not you should take any of your regular daily medications the day of surgery.

•Fill prescriptions for postop medications (pain, nausea, stool softener, muscle relaxant)

•Hydrate, drink plenty of water days leading up to surgery

•Take a shower the morning of your surgery. Scrub thoroughly with your germ-inhibiting soap. Shampoo your hair the morning of surgery.

•Wear comfortable loose-fitting clothes: We recommend a button-up top and pull-on pants with easy-to-slip-on flats. Don't wear a shirt or other clothing that has to be pulled over your head.

•Make sure you have been assigned a time to arrive at the surgery center.

Postsurgery↓

•WALK, GET OUT OF YOUR BED EARLY AND OFTEN (WITH ASSISTANCE) TO HELP PREVENT POSTOP PROBLEMS.

•Walk with trunk (abdomen) in “slouched or bent over position to avoid excessive tension on the incision.

•You may need to sleep in an elevated position. Most patients choose to sleep in a recliner chair, but you may find it comfortable to sleep with pillows behind your back and head as well as under your knees.

•You MUST wear your compression garment continuously until Dr. Lou instructs you otherwise. You may want to use a funnel or cup to direct the flow of urine when using the bathroom to keep the garment as clean as possible.

•Please do not cut or alter the garment in any way unless permitted by Dr. Lou.

•Do not take a shower or bath until your drains are removed. You can “spot wash” or “sponge bathe” carefully, making sure to keep the area where the drain enters the body dry of any liquids.

•Take pain medication as instructed.

•NO SMOKING, smoking may cause wound healing problems.

•Strip and record drainage output at least twice daily, if more drainage will have to record more.

•Keep drainage bulbs collapsed.

•Resume home medications unless otherwise instructed.

•Begin scar treatment after drains and sutures have been removed.

•Remember that your body is going to take time to heal. Swelling, bruising, discomfort, fatigue are all things that will fade over time. Listen to your body and do not over-do it.

Instructions↓

The Jackson Pratt (JP) system is made up of a soft plastic bulb. At the top of the bulb are a catheter and a drainage outlet with stopper. The other end of the catheter is inserted near your incision to collect drainage. When the bulb is compressed with the stopper in place, a vacuum is created. This causes a constant gentle suction, which helps draw out fluid that would otherwise collect under the incision. To achieve the best healing results, the bulb should be compressed at all times except when you are emptying the drainage. Drainage is very individual. Your doctor will decide when to remove the drains based on the amount of drainage, so please be sure to bring the JP drain output record with you to all your follow‐up appointments.

CARING FOR YOUR JACKSON PRATT SYSTEM

1. Stripping the tubing to help move clots.
2. Emptying the drains several times a day and recording the amount of drainage on the JP DRAIN OUTPUT RECORD.
3. Caring for your insertion site (the area where the catheter enters your skin).
4. Recognizing when there is a problem.

STRIPPING THE TUBING

Helps move clots through the tubing to promote drainage. Do this before you empty and measure your drainage.

1. Wash your hands thoroughly with soap and water. Dry them thoroughly.
2. At the point closest to the insertion site, pinch and hold the tubing between the thumb and forefinger of one hand.
3. With the thumb and forefinger of your other hand, pinch the tubing right below your other fingers. Keeping your fingers pinched; slide them down the tubing as far as they will reach. If there is still tubing between the fingers of your lower hand and the bulb, keep the lower fingers pinched and release your upper fingers. Pinch the tubing right below the fingers of your lower hand. Slide them down the tubing as far as they will reach. Repeat until you reach the bulb. You may want to use alcohol swabs to help you slide your fingers down the tubing more easily.
4. Repeat steps as necessary to push clots from the tubing into the bulb.
5. The fluid may leak around the site if a clot is blocking the drainage flow. If there is fluid in the bulb and no leakage at the site, then the drain is working in spite of what appears to be a clot.

EMPTYING THE DRAIN AND RECORDING THE OUTPUT

You will need to empty your Jackson Pratt in the morning and in the evening.

Equipment Needed:

1. Measuring container given to you by your nurse.
2. JP drain output record sheet

Steps to Follow:

1. Wash your hands thoroughly with soap and water. Unplug the stopper on top of the Jackson Pratt. This will cause the bulb to expand.
2. Do not touch the inside of the stopper or the inner area of the opening on the bulb.
3. Turn the Jackson Pratt upside down, gently squeeze the bulb, and pour the contents into the measuring container.
4. Turn the Jackson Pratt right side up.
5. Squeeze the bulb until your fingers feel the palm of your hand.
6. Continue to squeeze the bulb while re‐plugging the stopper.
7. Check to see that the bulb remains fully compressed to assure suction.
8. Pin the collar of your Jackson Pratt securely to a piece of your clothing. Do not allow your drains to dangle.
9. Check the amount of drainage in the measuring container. Record this amount on your Jackson Pratt Drainage Record.
10. Empty the drainage down the toilet and rinse the measuring container with water.
11. Each day, add the total amount of drainage for the 24‐hour period and record it in the last column of the drainage record.
12. If you have more than one drain, measure and record each separately.

CARING FOR THE INSERTION SITE

Sometimes the drain causes redness the size of a dime at the insertion site. This is normal. Apply antibiotic ointment around the tubing and dress the wound with a piece of gauze attached by tape. You may clean around the JP sites with hydrogen peroxide and a Q‐tip to clean any dried blood or fluid.

PROBLEMS YOU MAY ENCOUNTER WITH THE JACKSON PRATT SYSTEM

Problem: The bulb is not compressed. Why?
• The bulb was not compressed completely because it wasn’t squeezed tightly enough.
• The stopper is not closed securely.
• The suction catheter has been dislodged and is leaking. What to Do:

•Compress the bulb. If the bulb remains expanded after following the above steps, notify our office during business hours.

Problem: There is no drainage, a sudden decrease in the amount of drainage, or drainage on or outside the catheter dressing. Why?
Sometimes a “string‐like” clot clumps the catheter. This can block the flow of drainage. What to Do.
• Follow the instructions for tube stripping

Problem: The Jackson Pratt catheter falls out from the insertion site. Why?
This rarely happens because the catheter is held in place with sutures. It can occur if the catheter is pulled. What to Do.
If this does occur, place a fresh dressing over the site and call our office at 713-932-7290 during business hours.

What do I report to my doctor?

• Immediate refilling of the bulb with drainage or blood after emptying (the entire bulb refills with fluid or blood). • The tube falls out.
• A fever.

Helpful Drain Hints:

•It is recommended that you safety pin the drainage bottle to your clothing during the day and to your night clothes during the night. Allow enough slack to prevent the tube from being pulled out or from pulling on the drain sutures. • Be careful not to puncture the tubing or the drainage bottle with the safety pin—use the plastic tab on the drain to put the pin through.
• Attach the container below the level of the tube exit site.
• Be very careful with daily activities so that you do not dislodge the tubing.

Presurgery↓

•Take a shower the night before your surgery. Scrub thoroughly with your germ-inhibiting soap.

•DO NOT EAT OR DRINK ANYTHING, NOT EVEN WATER, AFTER MIDNIGHT THE NIGHT BEFORE SURGERY. No gum, candy, mints, or coffee the morning of surgery. If you sneak anything, you can increase your risk of serious surgical complications.

•You may brush your teeth the morning of surgery, but do not drink anything.

•Dr. Lou will tell you whether or not you should take any of your regular daily medications the day of surgery.

•Fill prescriptions for postop medications (pain, nausea, stool softener, muscle relaxant)

•Hydrate, drink plenty of water days leading up to surgery

•Take a shower the morning of your surgery. Scrub thoroughly with your germ-inhibiting soap. Shampoo your hair the morning of surgery.

•Wear comfortable loose-fitting clothes: We recommend a button-up top and pull-on pants with easy-to-slip-on flats. Don't wear a shirt or other clothing that has to be pulled over your head.

•Make sure you have been assigned a time to arrive at the surgery center.

Postsurgery↓

• You will leave the surgery center wearing a compression bra. You MUST wear this bra continuously until Dr. Lou instructs you otherwise.

• Sleep with your head elevated. You may find it most comfortable to sleep with your full upper body elevated by pillows or in a recliner chair.

• Do not sleep on your stomach or side. Only sleep on your back.

• After your first post-op appointment in our office, you will need to change out any bandages covering the incision line. Remember to change these as often as needed to keep the areas clean and dry.

• After your first post-op appointment with Dr. Lou, you may shower, but do not take a bath or submerge your breasts in water at this time. After you shower, pat dry the incision site, cover with gauze, and put your compression bra back on.

• You will need someone to help with washing your hair for the first time or two to avoid lifting your arms above your head.

• You will need to limit all upper body activity and movement.

• Do not reach for anything above shoulder height or make sudden movements that will contract the pectoral muscles (chest muscles).

• It is very important that you do not use your pectoral muscles while in the healing process. You may require help getting in and out of bed or from a lying down position to avoid using the upper body.

• Remember that your body is going to take time to heal. Swelling, bruising, discomfort, fatigue, etc. are all things that will fade over time. Listen to your body and don’t over-do it.

Presurgery↓

•Take a shower the night before your surgery. Scrub thoroughly with your germ-inhibiting soap.

•DO NOT EAT OR DRINK ANYTHING, NOT EVEN WATER, AFTER MIDNIGHT THE NIGHT BEFORE SURGERY. No gum, candy, mints, or coffee the morning of surgery. If you sneak anything, you can increase your risk of serious surgical complications.

•You may brush your teeth the morning of surgery, but do not drink anything.

•Dr. Lou will tell you whether or not you should take any of your regular daily medications the day of surgery. [1]: /dr-lou

•Fill prescriptions for postop medications (pain, nausea, stool softener, muscle relaxant)

•Hydrate, drink plenty of water days leading up to surgery

•Take a shower the morning of your surgery. Scrub thoroughly with your germ-inhibiting soap. Shampoo your hair the morning of surgery.

•Wear comfortable loose-fitting clothes: We recommend a button-up top and pull-on pants with easy-to-slip-on flats. Don't wear a shirt or other clothing that has to be pulled over your head. •Make sure you have been assigned a time to arrive at the surgery center.

Postsurgery↓

• You will leave the surgery center wearing a compression garment covering any areas that you had liposuction done. You MUST wear this garment continuously until Dr. Lou instructs you otherwise.

• Please do not cut or alter the garment in any way unless permitted by Dr. Lou.

• Sleep with your head and liposuction areas elevated. This will assist with reducing swelling. You may find it most comfortable to sleep with your full upper body elevated by pillows or in a recliner chair.

• You will have small incisions that will be covered with glue or steri-strips. There is still a possibility to have some drainage or blood from the incision site, which is normal.

• If you do experience any drainage or blood from the incision sites, keep the areas covered with a bandage or gauze and change those out as often as needed to keep the areas clean and dry.

• You may shower 48 hours after surgery. Remove and discard any gauze or bandages covering the incisions (Leave any glue or steri-strips in place. Do not pick these off), wash the areas with soap and water, pat dry the areas, and apply a new bandage if needed.

• Mild pain, pulling or pinching sensations, burning and electric shock sensations are common to experience in the first few weeks.

• It is normal to have areas of numbness and even some weakness for weeks to months after the procedure.

• You will be extremely swollen and bruised. THIS IS PERFECTLY NORMAL.

• It is common to have foot, ankle, and leg swelling or swelling on other parts of the body, even though they were not operated on.

• You may look the same size, if not larger, than before the surgery. THIS IS PERFECTLY NORMAL.

• It is also common to weigh more than before surgery due to the swelling and extra fluid. This will improve over time.

• It is especially important to be patient with your body and its healing process. Swelling for at least the first 4-6 weeks is to be expected and you will start to see everything slim down to your desired aesthetic goal around this time.

• You may continue normal daily activities (excluding working out) as soon as you feel okay to do so. Please keep in mind that as you increase your activity an increase in swelling is to be expected.

• BE PATIENT WITH YOUR BODY AND EXPECTATIONS. It will take time until you fully see your results, and this is perfectly normal.

• Lymphatic Drainage Massages are required. You will need to get your first massage 1-3 days after surgery. No later than 3 days. This is essential to your healing process and results of surgery.

• You will continue Lymphatic massages 3 times per week for the first 2 weeks after surgery, then once a week for 2 weeks after that.

Presurgery↓

•Take a shower the night before your surgery. Scrub thoroughly with your germ-inhibiting soap.

•DO NOT EAT OR DRINK ANYTHING, NOT EVEN WATER, AFTER MIDNIGHT THE NIGHT BEFORE SURGERY. No gum, candy, mints, or coffee the morning of surgery. If you sneak anything, you can increase your risk of serious surgical complications.

•You may brush your teeth the morning of surgery, but do not drink anything.

•Dr. Lou will tell you whether or not you should take any of your regular daily medications the day of surgery.

•Fill prescriptions for postop medications (pain, nausea, stool softener, muscle relaxant)

•Hydrate, drink plenty of water days leading up to surgery

•Take a shower the morning of your surgery. Scrub thoroughly with your germ-inhibiting soap. Shampoo your hair the morning of surgery.

•Wear comfortable loose-fitting clothes: We recommend a button-up top and pull-on pants with easy-to-slip-on flats. Don't wear a shirt or other clothing that has to be pulled over your head.

•Make sure you have been assigned a time to arrive at the surgery center.

Postsurgery↓

• You will leave the surgery center wearing a compression garment covering any areas that you had liposuction done. You MUST wear this garment continuously until Dr. Lou instructs you otherwise.

• Please do not cut or alter the garment in any way unless permitted by Dr. Lou.

• Do not sit on your buttocks for the first weeks of recovery (2 to 8 weeks, depending on your doctor’s recommendation).

• Use the BBL Pillow to sit on the back of your thighs.

• Do not put any stress on the area of the buttocks that received fat transplants.

• You will have small incisions that will be covered with glue or steri-strips. There is still a possibility to have some drainage or blood from the incision site, which is normal.

• If you do experience any drainage or blood from the incision sites, keep the areas covered with a bandage or gauze and change those out as often as needed to keep the areas clean and dry.

• You may shower 48 hours after surgery. Remove and discard any gauze or bandages covering the incisions (Leave any glue or steri-strips in place. Do not pick these off), wash the areas with soap and water, pat dry the areas, and apply a new bandage if needed.

• Mild pain, pulling or pinching sensations, burning and electric shock sensations are common to experience in the first few weeks.

• It is normal to have areas of numbness and even some weakness for weeks to months after the procedure.

• You will be extremely swollen and bruised. THIS IS PERFECTLY NORMAL.

• It is common to have foot, ankle, and leg swelling or swelling on other parts of the body, even though they were not operated on.

• You may look the same size, if not larger, than before the surgery. THIS IS PERFECTLY NORMAL.

• It is also common to weigh more than before surgery due to the swelling and extra fluid. This will improve over time.

• It is especially important to be patient with your body and its healing process. Swelling for at least the first 4-6 weeks is to be expected and you will start to see everything slim down to your desired aesthetic goal around this time.

• You may continue normal daily activities (excluding working out) as soon as you feel okay to do so. Please keep in mind that as you increase your activity an increase in swelling is to be expected.

• BE PATIENT WITH YOUR BODY AND EXPECTATIONS. It will take time until you fully see your results, and this is perfectly normal.

• ***Lymphatic Drainage Massages are required all lipo areas except fat transferred areas. You will need to get your first massage 1-3 days after surgery. No later than 3 days. This is essential to your healing process and results of surgery.

• You will continue Lymphatic massages 3 times per week for the first 2 weeks after surgery, then once a week for 2 weeks after that.

• Do not smoke. Avoid smoking for at least 2 months after the procedure. The use of cigarettes and drugs can seriously increase the risk of developing complications.

• BE PATIENT WITH YOUR BODY AND EXPECTATIONS. It will take time until you fully see your results, and this is perfectly normal.

Presurgery↓

•Take a shower the night before your surgery. Scrub thoroughly with your germ-inhibiting soap.

•DO NOT EAT OR DRINK ANYTHING, NOT EVEN WATER, AFTER MIDNIGHT THE NIGHT BEFORE SURGERY. No gum, candy, mints, or coffee the morning of surgery. If you sneak anything, you can increase your risk of serious surgical complications.

•You may brush your teeth the morning of surgery, but do not drink anything.

•Dr. Lou will tell you whether or not you should take any of your regular daily medications the day of surgery.

•Fill prescriptions for postop medications (pain, nausea, stool softener, muscle relaxant)

•Hydrate, drink plenty of water days leading up to surgery

•Take a shower the morning of your surgery. Scrub thoroughly with your germ-inhibiting soap. Shampoo your hair the morning of surgery.

•Wear comfortable loose-fitting clothes: We recommend a button-up top and pull-on pants with easy-to-slip-on flats. Don't wear a shirt or other clothing that has to be pulled over your head.

•Make sure you have been assigned a time to arrive at the surgery center.

Postsurgery↓

• You will leave the surgery center in a compression garment with drain tubes attached. Empty drains once or twice daily as instructed and record the output (in cc’s) on the drain output sheet provided. Make sure to bring this sheet to your post-op appointments.

• After your first post-op appointment in our office, you will need to change out any bandages covering the incision line. Remember to change these as often as needed to keep the area clean and dry.

• You MUST wear your compression garment continuously until Dr. Lou instructs you otherwise. Please wear your arm compression continuously for 3-4 weeks.

• Avoid lifting arms above shoulder level.

• Please do not cut or alter the garment in any way unless permitted by Dr. Lou.

• Do not take a shower or bath until your drains are removed. You can “spot wash” or “sponge bathe” carefully, making sure to keep the area where the drain enters the body dry of any liquids.

• Once drains are removed, you may shower, but do not take a bath or submerge your incisions in water until the following day. After you shower, pat dry the incision site, cover with gauze, and put your compression garment back on.

• Remember that your body is going to take time to heal. Swelling, bruising, discomfort, fatigue are all things that will fade over time. Listen to your body and do not over-do it.

Presurgery↓

•Take a shower the night before your surgery. Scrub thoroughly with your germ-inhibiting soap.

•DO NOT EAT OR DRINK ANYTHING, NOT EVEN WATER, AFTER MIDNIGHT THE NIGHT BEFORE SURGERY. No gum, candy, mints, or coffee the morning of surgery. If you sneak anything, you can increase your risk of serious surgical complications.

•You may brush your teeth the morning of surgery, but do not drink anything.

•Dr. Lou will tell you whether or not you should take any of your regular daily medications the day of surgery.

•Fill prescriptions for postop medications (pain, nausea, stool softener, muscle relaxant)

•Hydrate, drink plenty of water days leading up to surgery

•Take a shower the morning of your surgery. Scrub thoroughly with your germ-inhibiting soap. Shampoo your hair the morning of surgery.

•Wear comfortable loose-fitting clothes: We recommend a button-up top and pull-on pants with easy-to-slip-on flats. Don't wear a shirt or other clothing that has to be pulled over your head.

•Make sure you have been assigned a time to arrive at the surgery center.

Postsurgery↓

• You will be walking in a waddled or straddle position, this is normal, and you will gradually start walking up right over the next week.

• Perform ankle and knee flexion and extensions for five minutes every hour while you are awake.

• You may need to sleep in an elevated position. Most patients choose to sleep in a recliner chair, but you may find it comfortable to sleep with pillows behind your back and head as well as under your knees.

• You will leave the surgery center in a compression garment with drain tubes attached. Empty drains once or twice daily as instructed and record the output (in cc’s) on the drain output sheet provided. Make sure to bring this sheet to your post-op appointments.

• After your first post-op appointment in our office, you will need to change out any bandages covering the incision line. Remember to change these as often as needed to keep the area clean and dry.

• You MUST wear your compression garment continuously until Dr. Lou instructs you otherwise. You may want to use a funnel or cup to direct the flow of urine when using the bathroom to keep the garment as clean as possible.

• Please do not cut or alter the garment in any way unless permitted by Dr. Lou.

• Do not take a shower or bath until your drains are removed. You can “spot wash” or “sponge bathe” carefully, making sure to keep the area where the drain enters the body dry of any liquids.

• Once drains are removed, you may shower, but do not take a bath or submerge your incisions in water until the following day. After you shower, pat dry the incision site, cover with gauze, and put your compression garment back on.

• Remember that your body is going to take time to heal. Swelling, bruising, discomfort, fatigue are all things that will fade over time. Listen to your body and do not over-do it.

Postsurgery↓

• You will leave the office wearing a compression face garment. You MUST wear this garment continuously until Dr. Lou instructs you otherwise.

• You may take a shower like normal the next day. Wash the face and neck with soap and water only. PAT DRY with a towel gently and let it air dry. Then put the face garment back on.

• If you have any bleeding or draining from the incision sites, you may take the face garment off to clean the areas. You want to make sure the areas stay clean and dry.

• DO NOT use any skincare products or makeups on the face or neck until Dr. Lou says you may.

• DO NOT sleep on your sides for the first two weeks after your procedure. You will need to sleep on your back to avoid any tugging on your face and neck. It may be helpful to place pillows on both sides of your face to prevent you from rolling over onto your side during the night.

• You may apply an ice pack to the face and neck for 15 minutes throughout the day to help with swelling.

• Your face and neck will feel and look tight. This is normal and will get better over the next few weeks. • You can expect swelling and bruising. This is normal. • Do not workout for the first 7-10 days after surgery.