Please read and familiarize yourself with these instructions both before and after surgery. By following them carefully, you will assist us in obtaining the best possible result from your surgery. If questions arise, do not hesitate to communicate with us and discuss your questions at any time.

BEFORE THE OPERATION

1)Please refer to the list of medications not to take before surgery. If you are taking any of these medications, it is important that you stop taking them during the specified times.

2) If you smoke, please stop at least one week before and continue not to smoke until one week after your operation. Smoking delays wound healing and can lead to skin loss and scar formation.

3)Do not wear any clothing that you will need to pull over your head (ie. pullover sweaters, t-shirts, or turtlenecks). Please wear shirts or blouses that button down in the front. You should continue to do this during the first week after surgery as well.

4)It is highly recommended that you take at least one weeek off from work to recuperate following surgery. Your first post-operative appointment will be the day following surgery, and you will be instructed about further appointments at that time.

5)Alcohol consumption should be stopped or markedly reduced in order for the liver to be in optimal condition to manufacture the "building blocks" necessary for healing. Furthermore, we strongly recommend that you avoid alcohol intake for several days prior to surgery. If you have a drinking problem and are accustomed to daily alcohol intake, please discuss this with your surgeon. Special arrangements will be made to accommodate your health needs.

6)If you take high blood pressure or diabetes medication, special arrangement must be made. It is your responsibility to make us aware of any significant health condition(s), which you may have. Please let us know of any conditions that apply to you.

7)Please arrange for a companion to drive you home after surgery.

AFTER THE OPERATION

1)You may remove the head dressing the morning following surgery. It is important that you leave the dressing in place until that time to minimize bruising.

2)Avoid extreme physical activity. Obtain more rest than usual and avoid athletic activities and sexual intercourse for one week.

3)Do not get any incisions wet for the first forty-eight hours. During this time, you should only take tub baths. After this time, you may get your incisions wet, but do not scrub near any of the incisions. If the area is wet, gently pat it dry with a towel.

4)Do not swim for two weeks.

5)It is normal to feel tightness in the forehead and see bruising around the eyes. This usually clears within two to three weeks. In rare instances, some patients may require up to two months for all symptoms to resolve.

6)Take prescribed medications as directed. Pain medication is to be taken one tablet every four hours as needed for pain. Pain medication can be constipating, so you should take a stool softener and avoid constipating foods as necessary. Take the antibiotic medication as directed until you have finished the bottle. All medications should be taken with food to avoid upsetting your stomach.

7)After removal of sutures, the skin may be gently cleansed with a mild soap or lotion. Make-up may be worn after the first post-operative week. Use a hypoallergenic formula.

8)Please limit sun exposure for at least one month after surgery, as this can cause skin color changes. If you need to go outdoors, please wear a large brim hat. You may also start applying sun block SPF 30 or greater after the first week.

9)Please call immediately if you develop bleeding of bright red blood, extreme pain or swelling, or you experience fevers over 101 F.

10)Please note that the eyebrows will always appear overly raised immediately post-operatively. Patients will note a "surprised" look for the first couple of weeks following surgery. The eyebrows invariably descend to the ideal position within a matter of weeks.

A week after surgery, you are encouraged to go on little excursions, for walks, or to the grocery store. If convalescence is normal, you may feel comfortable attending social events after one to two weeks, depending on the amount of bruising and swelling. Appearance at that time may be near normal, but there will undoubtedly be residual swelling.