This information provided by board-certified plastic surgeon Dr. Totonchi will prepare you for your surgery as well as the early recovery period following the operation. We have included general instructions that will help you prepare for surgery and to know what to do on the actual day of surgery. We will also provide instructions specific to the procedure that you are having. Feel free to call 216-778-2262 if you have any questions before or after your surgery.
TWO WEEKS BEFORE SURGERY
Your surgery plan will be determined well before your day of surgery. Contact your doctor as early as possible if you have any questions regarding your surgical plan.
Our nursing and office staff will help arrange a pre-surgical testing. It is very appropriate for many patients and can be completed at MetroHealth, by your own doctor, and occasionally at one of your preoperative visits in our office.
Some procedures require the use of post-operative compression garments. If your procedure requires these, you should order them before your surgical date so that you can bring them with you on the day of surgery. When ordering the sizes of the garments, be sure to order them according to your preoperative size and not the size you assume you will be following surgery.
A current list of medications to avoid before surgery will be provided to you and you need to review it before your surgery. Several medications contain aspirin or other compounds that could increase the risk of bleeding throughout and after the surgery. This will increase your risk of developing a hematoma and may lead to more bruising. If you are taking any medications that should be stopped around the time of your surgery, the doctor will provide you instructions to do so. However, if you have not received any instructions on your medication, please call within ten days before your surgery to receive direction from your physician.
THE DAY BEFORE SURGERY
You should report any changes to your health status that could affect your response to anesthesia or surgery. Make sure to pay attention to any flu symptoms, colds or upper respiratory infections, sores or skin infections around the surgical site. If you feel that anything could be an issue, call our office at 216-778-2262.
The day before surgery, the surgery center or hospital will call you to confirm the location and time of your surgery. If you have questions or concerns about the location or time, or miss the call, please call our office.
You should arrange for a ride to and from the surgery center or hospital the next day.
Twenty four hours before the surgery, avoid smoking or any alcoholic drinks.
With the exception of blood thinners, take all medications normally as directed the day before your surgery. Blood thinners will be managed differently.
THE DAY OF SURGERY
DO NOT take anything by mouth the night before surgery, starting at midnight. This includes, liquids, food, chewing gum, etc. Even if your surgery is scheduled for later in the day, please do not take anything by mouth, in case your surgery is moved up to an earlier time. Your routine medications CAN be taken with a small sip of water.
If you use a small amount of water to rinse, you may brush your teeth.
Discuss with your doctor the best way to manage your medications. You will be able to take some as directed, others may be modified (e.g. blood pressure medications, insulin), and others will be halted (e.g. blood thinners). When you come to your surgery, please bring a list of all your medications, which should also include any vitamin or herbal supplements you may be taking.
Have a friend or family drive you to the surgery and make sure you have a ride home that same day.
Be on time to your scheduled surgery. If you are going to be late or find that you need to cancel the surgery, call the office or have the doctor paged at 216-778-7800, in the case that the office is not open.
You will need to remove holding glasses, non-permanent dental appliances and contacts for surgery. Bring holding cases for them during the surgery. Wear clothing that is comfortable and can be stored in a locker throughout your surgery and recovery.
Do NOT wear jewelry including earrings, rings, tongue piercings, body jewelry, etc.
Do NOT wear hairpieces or wigs, Do NOT wear clips, rubber bands, pins or barrettes, do NOT use hairspray.
In order for the anesthesiologist to get accurate measures of your oxygen levels during surgery, please remove false nails, wraps or tips from at least one finger, preferably the middle or index finger.
Do NOT wear makeup, nail polish, perfume, creams, deodorant or lotion on the day of surgery. However, if your surgery requires an overnight stay, you may bring your personal care items with you.
Do NOT bring large amounts of money, credit cards or valuables. You may want to bring your prescription card and a small amount of money if it is necessary to fill your prescriptions.
If you have asthma, you should use your inhalers as usual if needed. You should bring all of your inhalers with you on the day of surgery.
If you have diabetes, instructions will be provided before surgery to manage your medications on the day of surgery. If you have not received these instructions or have any questions, call our office before your surgery.
If you are hearing impaired, please wear your hearing aids so that we can accurately communicate with you on the day of surgery.
If you require walking aids, please bring them with you on the day of surgery.
ONCE YOU ARRIVE AT THE SURGERY CENTER OR HOSPITAL
Please check in with the receptionist once you arrive at the hospital or surgery center. You will then be brought back into the surgical preoperative area. Here, the staff will ask about your current health, any medications you are taking, and any known allergies. They will also take your vital signs (pulse, temperature, blood pressure).
You will then be asked to change into a hospital gown and a small locker will be provided for you to place your personal belongings. They will then start an intravenous line (IV) in order to administer fluids. It may also be used to provide anesthesia or other medications. Then, the anesthesiologist will once again review your history and discuss with you your anesthetic plan. A nurse will come and introduce themselves and will be in the room with you. Several people will come in and ask the same questions multiple times. Please be patient as this is designed to avoid any medical errors.
You may have up to two friends or family members stay with you until it is time for you to go into surgery. Once the surgery begins, your visitors will wait in the waiting area. They should check in with the receptionist so that messages can be relayed to them regarding your status.
Right before you go into the operating room, some sedation to help you relax will be given by the anesthesiologist. Once you enter the operating room, the room might feel cool, but warm blankets will be provided. Your surgical team will be dressed in scrubs and surgical gowns. They will also be wearing masks and caps. The will be setting up the room and opening sterilized instruments. The room may seem somewhat noisy. In the meantime, the anesthesia team will apply blood pressure cuffs and monitors. Soon after that, you will be anesthetized.
After your procedure is completed, the surgeon will dress your incisions. You will wake up in the operating room and then transferred to the recovery room, where nurses can monitor your recovery. They may place an oxygen mask on your face and adjust your drains and IV’s as needed. They will also check your surgical site frequently and may change or adjust your dressings. They will follow instructions from the surgeon and anesthesiologist to treat your pain. It is normal and common to experience sore throat, drowsiness, thirst or dry mouth feelings.
GOING HOME – DAY OF SURGERY
If your surgery is scheduled as an outpatient surgery, then you will finish your recovery once you are alert, your vital signs are normal and you feel comfortable. The nurse will provide instructions regarding your post-surgery care upon your discharge from the hospital.
For a safe and comfortable trip home, please follow these instructions:
- When you are discharged, a friend or relative MUST accompany you
- Have someone stay with you for at least 24 hours after your surgery
- Gradually progress from clear liquids to solid foods
- Cough 10 times each hour and take deep breaths to clear your lungs
- Increase your activity as per your doctor’s instructions
- Until it has been at least 24 hours after surgery, and until you are no longer taking narcotic medication, DO NOT drive or operate a car.
- Do NOT drink any alcoholic beverages if you are still on narcotic pain medication and wait 24 hours after surgery.