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Preoperative Instructions » Preoperative Instructions: Laser Rejuvenation
Please read these instructions several times and make sure all of your questions are answered prior to surgery.
 
Prepare Skin 

To prepare your skin for proper healing, start your skin conditioning program using your skin care products as directed. Also take a multivitamin with minerals.

AVOID Vitamin E, garlic pills, aspirin, gingko, and fish oil pills.

Stop Smoking
Stop smoking at least two weeks in advance, and don't resume for a month or more after surgery because it interferes with healing and cause scaring.

Medications
You will be given prescriptions for an antiviral medication (to prevent a herpes viral infection), an antibiotic (to prevent a bacterial infection), a Medrol DosePak (to limit swelling) and two pain relievers.

The antiviral medication should be started the day before surgery and will help prevent fever blisters (herpes). The pain prescriptions will include a medication for moderate pain and one for severe pain. You may find that one works better than the other based on your physiology or personal preference. Take the pain medication as prescribed.

The following is a list of common medications which should be avoided:


Aleve, Advil, Alka-Seltzer, Anacin, Anahist, Anaprox, APC, Aspirin, BC, Bromo-Quinine, Bromo-Seltzer, Bufferin, Coricidin, Darvon, Dristan, Ecotrin, Empirin, Excedrin, Feldene, 4-Way Cold Tablets, Ibuprofen, Indocin, Liquiprin, Midol, Motrin, Naprosyn, Nuprin, Pepto-Bismol, Sal-Sayne, Stanback, Theracin, Tolectin, Trigesic

    Common Herbal Products: How They Can Affect Your Surgery

Name

Possible Clinical Significance

Before Surgery

Alfalfa

May interfere with Coumadin, and steroids.  May lower blood sugar levels. Possible allergic reactions.  Vomiting if taken with Flagyl.

Reduce use or stop for

7 days

Bilberry

Interferes with blood clotting, may cause excessive bleeding.  May lower blood sugar levels and cause diarrhea.

Stop 7 days before

Black Cohosh

May increase the effect of blood pressure medications, and interfere with blood clotting.

Stop 7 days before

Black Tea

Can interact with other prescribed drugs. May cause insomnia, increased blood sugar.

Reduce use or stop for 7 days

Coenzyme Q10

May cause dizziness, flu-like symptoms. May lower blood sugar and/or blood pressure.

Reduce use or stop for 7 days

Cranberry

Excessive use can result in increased bleeding, diarrhea, and kidney stones.

Reduce use or stop for 7 days

Echinacea

Patients with a history of liver disease should use with caution. Contraindicated in patients with autoimmune conditions. Interferes with anti-HIV medications.

Reduce use or stop for 7 days

Ephedra

(Ma Huang)

Banned by FDA. Ephedrine and pseudoephedrine-containing products are still sold. Many side effects. Discontinue use 1 week before surgery.

Stop 7 days before

Evening Primrose

GI side effects. Contraindicated for patients taking anticonvulsants.

Reduce use or stop for 7 days

Fish Oil

May cause excessive bleeding.  Stop 7 days before surgery.

Stop 7 days before

Garlic

Mild reduction of blood pressure. Interferes with blood clotting.

Stop 7 days before

Ginger

Few problems with low dosages. At higher dosages may cause cardiac arrhythmias, and interfere with blood clotting.

Stop 7 days before

Ginkgo biloba

May interfere with blood clotting and interact with anticoagulants and NSAIDs (potential for increased surgical bleeding). May lower blood sugar. Discontinue 7-14 days before extensive surgery. Seeds may be toxic.

Stop 7 days before

Ginseng

May interfere with blood clotting and interfere with anticoagulants (possibly causing excessive bleeding at surgery). May decrease blood sugar. May increase blood pressure.

Stop 7 days before

Green Tea

GI upset, insomnia, irritability, possible cardiac palpitations and headaches.

Reduce use or stop for 7 days

Horse Chestnut

Possible excessive bleeding at surgery. GI upset and decreased kidney function possible.

Stop 7 days before

Kava (Kava-Kava)

Possible dizziness, depression, headaches. May prolong effects of  anesthetic drugs. Interferes with blood clotting.

Stop 7 days before

Lavender

Drowsiness possible. May enhance sedative drugs like Valium. May increase bleeding problems.

Stop 7 days before

Licorice

May increase absorption of prescription drugs. Possible toxicity if used with digoxin. May lower potassium levels in patients taking diuretics. Increased bleeding risk in patients taking anticoagulant drugs.

Stop 7 days before

Pycnogenol

Possible increased bleeding risk, cardiovascular effects, and drug interactions (especially anti-hypertensive drugs). May lower blood sugar.

Stop 7 days before

St. John’s Wort

May reduce the effectiveness of many drugs including antibiotics, ibuprofen, Valium, sedatives, cardiac drugs, antidepressants, anti-HIV drugs, contraceptives, and many others.  Prolongs the effect of narcotics. Stop use 7 days before surgery.

Stop 7 days before

Valerian

May increase the effect of sedative medications.

Reduce use or stop for 7 days

Vitamin E

Long-term use in high does may increase risk of death from all causes. No significant problems from short-term use, lower doses. Doses >400 IU/day may increase bleeding and delay wound healing.

Stop 7 days before

 


Escort 


Arrange for someone to accompany you to our office. We will review the postoperative instructions with them based on your needs. Someone should remain with you during the first 12-24 hours to assist you with medications, suture care, ice applications and bathroom needs. That person should read and be familiar with the postoperative instruction information given to you at your pre-surgery office visit.

Hormones
If you are taking birth control pills or estrogen, it may be helpful to discontinue for one month before surgery and not resumed for at least a month after surgery. Discuss this with Dr. McBride. You should consult your family physician or gynecologist for alternate birth control modalities.

Makeup
Your skin needs to be completely free of makeup before surgery, so do not use any makeup the day of surgery.

Antibiotic wash
The face, neck and hair should be washed with antibacterial soap (such as Hibiclens or Cetaphil) the night before, and the morning of surgery.

Driving 

You must have someone drive you to the office and take you home. Because of the sedation you will not be able to drive yourself.

Diet 

You must not have anything to eat or drink after midnight on the night prior to surgery. If you need to take medications, you may have just
 enough water to swallow the pill.

Before surgery, purchase the following items
·         Vaseline ointment, medium jar
·         Benadryl 25mg capsules - to take after surgery for itching and to help you sleep.
·         Cetaphil or other antibacterial liquid soap - to wash your face prior to surgery
·         Antiviral medication,  Start taking the day before surgery.
·         Antibiotic (prescription) Start taking when you get home after surgery.
·         Pain medications (prescription) Start taking when you get home from surgery if needed.
·         Cotton pads (like those used to remove makeup), 3 packages
.         Small bottle of white vinegar

Have your medications and a pitcher of water at bedside so it will be easy to take them. 

Put some cans of protein drinks in the refrigerator for simple no-cook meals after surgery.

Read Home Care Instruction Brochure

Read the home care instructions pamphlet several times prior to your surgery. The more familiar you are with your home care needs, the easier your recovery will be.

Night Before Surgery

Do not have anything to eat or drink (including water) after midnight on the night before surgery. You may take necessary medications with a very small amount of water.

Remove all remnants of makeup and wash your face, hair and surgical sites with antibacterial soap before you go to bed on the evening before surgery. Reduction of skin bacteria will decrease the risk of infection.

Day of Surgery

Again, remove all remnants of makeup and wash your face, hair and surgical sites with antibacterial soap on the morning of surgery.
Wear loose fitting clothing. Your top should button or zip up the front. Do not wear a pullover top, it may be difficult to put on after surgery.
Slip-on shoes are more convenient and comfortable.