Topics to be considered and discussed
Harmony/Other procedures (eyelids, face, neck and others)
Details of the surgical procedure and follow up
This procedure is normally performed with other facial procedures such as face lifting, eyelid surgery and /or lipofilling
Marking of surgical site before surgery
General Anaesthetic (detailed explanation by Anaesthetist)
1.5 hours of operating
Local anaesthetic infiltration
Incisions in scalp
Sub-periosteal dissection and forehead mobilisation
Cranial bone holes drilled to allow forehead fixation
Close the incisions
Home when ready - Day case or 1 night stay
Review at 7-10 days
No upper body or high impact exercises 6-8 weeks
Out patient Follow up
Advice for before and after the procedure
Two-three weeks prior to surgery take 1gm of vitamin C twice daily. If you are taking vitamin E stop taking this as it can cause bruising.
Do not take Aspirin for 3 weeks before surgery. Please check first with the Doctor who prescribed this for you that this course of action is medically safe for you. If you do have a headache or tummy ache take Paracetamol or Panadol.
No alcohol of any kind prior to surgery; 10 days for major facial surgery and 5 days for most other procedures. It is also advisable to avoid alcohol following surgery for up to 5 days.
Smoking should be stopped 2 weeks prior to surgery. It has been conclusively shown that smoking does increase the complication rate in cosmetic procedures considerably.
Please have your hair cut and coloured just before the surgery as you may not want to do this during the postoperative healing process.
It is wise to wash your hair before surgery, especially important for facial surgery.
Arnica 30 tablets should be taken 3 days prior to surgery and a week following surgery. If it is difficult to obtain Arnica 30 then Arnica 6 will be fine. This is a very old homeopathic remedy and is excellent for the prevention of bruising and swelling. Bromelain tablets (has an enzyme in it derived from pineapple) will also help with the bruising and swelling; this should be taken for the same period of time as Arnica. Both of these products are available from a large chemist, homeopathic chemist or health shop.
Do notify us of any underlying medical conditions that you may have. Medical histories are taken at your first consultation but this may be quite some time from your surgery, so let us know any recent problems that may have arisen in that time.
Do not take valuables to the hospital with you, they do have a patient’s safe deposit box, but unless it is important for you to have it with you it is best to leave valuables at home.
It is normal to feel a little nervous the night before surgery. Try and rest in the knowledge that we will be looking after you.
You will arrive at the hospital where you will be admitted by the administrative and nursing staff and you will then see your Consultant Anaesthetist and myself.
You will then be taken to the operating theatres for your surgery.
After surgery you will wake up in the recovery room and will have dressing covering the operated areas including the eyes. These are to protect the surgical sites but can be removed if you feel they are restricting or worrying you.
It is important that you sleep in a reclined position, using a number of pillows, for the first nights after surgery as this reduces swelling.
It is important not to bend over, pick up heavy objects or strain (ie constipation etc) as this increases the pressure in the head and can lead to to bleeding in the tissues. Please keep your intake of roughage, fruit and vegetables high.
Following surgery do call the office immediately if you develop a temperature, notice excessive swelling, bruising, persistent vomiting or excessive pain.
It is normal to feel tired for a few days following surgery, get as much sleep and rest as possible.
Almost all patients develop a case of ‘Post Op’ blues several days after surgery and question why they have gone through with the surgery. This is perfectly normal and temporary and your spirits will improve as you see the postoperative bruising and swelling subside and disappear. Try reading, watching TV or listening to music to occupy yourself.
You will be closely reviewed the immediate postoperative period to check your progress, change dressings and remove sutures.
Bruising will improve on a daily basis but often take two to three weeks to completely go. Do not be surprised when bruises move as gravity pulls them down the tissues.
Swelling is often at its worse on the second day after surgery and then will start to reduce on a daily basis. The majority of the swelling should have subsided after the first month after surgery.
After surgery patients study the operated area in fine detail and their awareness of the changes made and natural differences from one side to the other will be greatly heightened. The tissues may feel different to what you expected and will change as you go through your recovery period.
Do not use make-up on incision lines while sutures are in place. You can use hypoallergenic make-up 5-7 days following surgery.
Vitamin E oil gently massaged into your scars is beneficial approximately two weeks after the removal of your sutures. Initially scars feel lumpy when touched. The majority of this will settle down and soften over the first six weeks and will continue to fade over the next 12 to 18 months.
Avoid sun on your scars for 6 weeks following surgery. Wear a good sun block if in a sunny climate and also a hat if you have had facial surgery.
You should refrain from strenuous physical activity including impact exercises for 6 to 8 weeks following surgery.
Do not expect miracles overnight! A good idea about the final result from your surgery will be obtained at approximately 6 weeks but the optimal results can be 6 months or more.
We are here to look after you and answer any questions and reassure you if you have any concerns.
Whilst the chance of risk is very low, it must be discussed and understood
Facial nerve weakness
Additional advice provided by the British Association of Aesthetic Plastic Surgeons