Philadelphia Ear, Nose and Throat Associates: PENTA

Surgical Information

Surgical Information


General PRE-Operative Instructions

The doctor will review these instructions with you before your procedure. If you have any questions, please discuss them with your doctor before your procedure. Instructions ill vary based on the needs of each patient. 


General Post-Operative Instructions

Our goal is to achieve the best possible result from your surgery.  This requires a commitment from you to be an active participant in your post-operative care.  In order to do this, you should thoroughly familiarize yourself with all the post-operative information and instructions.  Patients who follow the instructions faithfully generally have the smoothest post-operative course and ultimately the best result. Failure to do so may lead to complications which could jeopardize the desired result.

  1. For the first two to three days, we recommend that you rest as much as possible (be a "couch potato").  After the third day,  you should begin to stay up during the day (sitting, standing, walking around) as much as possible.  THIS IS IMPORTANT!  Of course, you should rest when you tire.
  2. Sleep on your back with the head of the bed elevated (about 30 degrees) for two weeks post-operatively (for four weeks if you can tolerate it).  To accomplish this, place two to three pillows under the head of the mattress and one or two on top of it.  Try not to roll over on your side.  A small towel can be rolled and placed beneath the pillow on each side to help keep you from rolling over when asleep.  Some patients find it more comfortable to sleep in a recliner or on a couch.
  3. Avoid bending over, straining, or heavy lifting for one week.  Beside aggravating swelling, this may raise the blood pressure and cause bleeding.
  4. Avoid straining at stool, which also raises the blood pressure.  If you feel you need to take a laxative or stool softener, take one you are accustomed to using.  Pain medications can aggravate constipation.
  5. Try to avoid hitting or bumping your face.  It is NOT wise to pick up small children or pets for they will be very curious about your face.  Also, you and your mate must be careful not to bump your face while sleeping at night.  Even so, many individuals sustain accidental "bumps" to the face during the early post-operative period.  Do not be too concerned unless the blow is hard, or if significant bleeding or swelling occurs.  Report the incident at your next office visit or by telephone if you are sufficiently concerned.
  6. Take the medication as prescribed by our office.  If you are taking medications for any medical condition, you should continue these unless otherwise instructed.    Do not take any other medications (even over-the-counter medications) unless you check with us first.
  7. Smoking can be detrimental to the healing process and should be avoided.  Excessive alcohol use can also affect healing and should be limited.
  8. DO NOT DIET!  Dieting may contribute to post-operative complications.  Eat plenty of protein and well balanced meals.  It is important to keep yourself hydrated in the recovery phase, drink plenty of water!  Avoid salty foods, as they cause fluid retention (e.g. swelling).
  9. You should contact our office immediately at (404) 233-3937 if you experience any severe pain, dramatically increased swelling, fever, bleeding or anything else that concerns you.  Complications after facial plastic surgery are rare, but are best treated early if they occur.

General Expectations During the Healing Process

  • Swelling and Bruising. Tissue injury, whether accidental or intentional (e.g. surgery), is followed by localized swelling. After surgery, swelling increases progressively, reaching its peak by the third day.  It is generally worse when you first arise in the morning and decreases throughout the day. Following surgery, it is not unusual to have varying amounts of bruising about the face.  Like swelling, bruising may become more pronounced in one or two days after your surgery.  Most of this will subside within two weeks.
  • Surgical Incisions. The location of your incisions will be explained during your consultation.  Most incisions are closed superficially with sutures that are dissolvable and do not need to be removed. All incisions heal with some form of a scar.  This is nature's way of binding a wound together during the healing process.  Incisions heal in three stages.  The first stage is characterized by swelling and redness, and lasts a few days to one week.  Scar tissue then begins to form, causing the area to look pink, lumpy and sometimes noticeable.  This period can last up to six weeks, and is followed by a period of shrinking and softening that will continue for 12 to 18 months.  Eventually, for most scars, only a fine line remains.  Some numbness in the area of surgery is normal and should resolve with time.
  • Discomfort. There is generally little pain following facial plastic surgery, though you may experience soreness as a result of post-operative swelling.  Often the sensation seems worse at night when trying to sleep. Should you have discomfort, it is best to try the application of cold and take Extra Strength Tylenol. If the above measures have not made the discomfort tolerable, you may take one of the pain relievers prescribed by our office.  Strong pain medication is useful for severe pain but may cause feelings of light-headedness or nausea.  Should you become nauseated, medication has been provided to alleviate this symptom.
  • Insomnia. The medicines given at the time of surgery often cause a "rebound" wakefulness or insomnia.  This will subside after 2-3 days without treatment. Both pain medications and sleeping pills produce a "hangover" as they wear off, and may contribute to depression, fatigue and insomnia.
  • Weakness. It is not unusual after surgery for you to feel weak, break out in "cold sweats", or get dizzy.  This is temporary and will clear in a few days without medications.  Be careful when standing suddenly or bathing, and certainly avoid driving an automobile or working with dangerous machinery. This is not the time to be dieting.  You need good nutrition (protein, protein, protein!) and plenty of fluids to heal the tissues and regain your strength.
  • Depression. It is not unusual for you to go through a period of depression a few days after surgery.  This is due partly to the effects of medications and also that it may be disturbing to see swelling and/or discoloration of the face. Please realize that this is a temporary condition and will subside shortly.  The best "treatment" consists of busying yourself with the details of post-operative care and trying to divert your mind to other activities.

Using Cosmetics

Careful use of make-up can help camouflage bruising and discoloration during the healing period.  Hypoallergenic make-up is preferable if you have particularly sensitive skin.  Avoid products that contain fragrance, alcohol or red pigment during the first few weeks after surgery. If regular make-up does not adequately cover bruised or reddened areas, special corrective cosmetics are available and can be used by both men and women.  Such products come in a variety of shades for all skin tones.


Resuming Normal Activities

Depending on the type of surgery, most people can resume normal activities after one to two weeks.  We encourage activity such as walking within a few days after surgery, but will advise you regarding strenuous exercise.

In general, a gradual progression from walking to stretching and light repetitive exercises will help you prepare for resuming your normal exercise schedule.  You should wait approximately two to three weeks before resuming aerobics, tennis, weight-lifting, swimming or other heavy exercise.  Contact sports should be avoided for at least six to eight weeks.  Common sense will also help determine exactly what type of exercise to do and how much.

It is important to avoid sun exposure of the surgical sites for approximately six months, particularly after dermabrasion or chemical peeling.  A good sunblock (SPF 30 or higher) and a hat should be used when going outside.  Also, avoid excessive exposure to heat, cold and wind as these can also damage the skin.