This information sheet, provided by board-certified plastic surgeon, Dr. Totonchi, will prepare you for your surgery as well as the recovery period following you operation. We have included general instructions that will help you prepare for surgery and what you need to know and what to do on the day of surgery. We will provide specific instructions about the procedure that you are having done. Feel free to call the office at 216-778-2262 if you have any questions before or after your surgery.
NO SMOKING or nicotine products for 2-3 months prior to your elective surgery. The use of nicotine products can result in poor wound healing and will have a negative impact on your final result.
TWO WEEKS BEFORE SURGERY
Your surgical plan will be determined well before the day of surgery. Dr Totonchi would like you to contact the office if you have any questions regarding your surgical plan.
Our nursing and office staff will help arrange a pre-surgical testing which may be either an office visit or a telephone encounter, depending on your medical condition. Your pre-surgical evaluation can be completed at MetroHealth or by your own physician. If you choose to have your pre-surgical evaluation by your own physician, you must have the physicians report sent to our office for Dr Totonchi’s review prior to surgery.
Some procedures require the use of post-operative compression garments. If your procedure requires ta garment, you should order it before your surgical date so that you can bring it with you on the day of surgery. When ordering the sizes of the garments, be sure to order it according to your preoperative size and not the size you assume you will be following surgery. We will assist you in selecting the appropriate garment style and item number through Marena, www.marenagroup.com.
A current list of medications to avoid before surgery will be provided to you and you need to review it two weeks prior to your surgery. Several medications contain aspirin or other compounds that could increase the risk of bleeding during and after the surgery. Increased bleeding elevates your risk of developing a hematoma and may lead to more bruising. If you are taking any medications that are on the list that should be stopped around the time of your surgery, inform Dr. Totonchi, and he will provide you with specific instructions. If you have not received any instructions on your medication, please call within ten days before your surgery to receive instructions.
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, fevers, cough and 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.
One business 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 need to arrange for a ride to and from the surgery center or hospital. You will not be discharged home via cab or Uber. It is best to arrange for someone to stay with for at least the first night after surgery.
With the exception of blood thinners, take all medications normally as directed the day before your 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 and have any questions, call our office before your surgery date.
DO NOT take anything by mouth the night before surgery, starting at midnight. No liquids, food, chewing gum, hard candy 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.
THE DAY OF SURGERY
Your routine medications CAN be taken with a small sip of water.
When you come to your surgery, please bring a list of all your medications. 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.
DO NOT take anything else by mouth. No liquids, food, chewing gum, hard candy 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.
You may brush your teeth and rinse your mouth but do not drink the water.
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.
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.
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.
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.
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.
Have a friend or family drive you to the surgery and make sure you have a ride home that same day.
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.
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 216-778-2262 or have the doctor paged at 216-778-7800, in the case that the office is not open.
ONCE YOU ARRIVE AT THE SURGERY CENTER OR HOSPITAL
Please check in with the receptionist once you arrive at the hospital or surgery center. After registration you will then be brought back into the surgical preoperative area. The staff will then ask you about your current health, any medications you are taking, and any known allergies. They will also take your vital signs which include: pulse, temperature, and 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. The nursing staff will then start an intravenous line (IV) in order to administer fluids. The IV line may also be used to provide anesthesia or other medications. The anesthesiologist will once again review your history and discuss with you your anesthetic plan. The nurse that will be in the surgical room with you will come and introduce themselves. 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, surgical gowns, masks, and caps. The room may seem somewhat noisy as the staff will be setting up the room and opening sterilized instruments. 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.
GOING HOME – DAY OF SURGERY
If your surgery is scheduled as an outpatient surgery, 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 surgery center or 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, Do NOT smoke
•Increase your activity as per Dr. Totonchi’s instructions
•Until it has been at least 24 hours after surgery, and 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.