Aftercare facial feminization surgery
Table of contents:
Sutures and staples
- Absorbable—Only the blue or black sutures need to be removed (after Adam’s Apple reduction, blepharoplasty or lip lift). All white skin sutures are absorbable within about 2 weeks, so don’t need to be removed. In case staples have been used they need to be removed 8 days after the surgery.
- Move as soon as possible—It is important to try to move your limbs as soon as possible after surgery, to prevent blood clots. Do not stay in bed for extended periods of time during the day.
- Pain medication
- Dafalgan-Codeine—Every 4 hours, max 6 a day.
- Tramadol—Every 4 hours, max 6 a day.
- Diclofenac—Every 4 hours, max 3 a day.
- Antibiotics provided if necessary—One pill a day for three days, starting the day after surgery (after breakfast).
- Mouth rinse—We will provide you with a post-surgical antiseptic mouthwash to take care of the intra-oral incisions. You should rinse after every meal. However, you should clean with a toothbrush, toothpaste, and dental floss as soon as possible. The exception being when you've had chin surgery, seeing as you will have had an incision on the lower front teeth. The intra-oral incisions are absorbable and should not be removed. They will dissolve in about two weeks. When the bottle is finished you can stop the usage.
Swelling and bruising
- Tightness—Feelings of tightness and warmth, due to swelling, are normal and will subside over time.
- Icepacks—We will give you icepacks during your preop consultation. In the guesthouse we also have a cooling system in place especially for the eyes (see video). Use the machine as well as the ice packs as much as possible. It really helps.
- Leakage—In case you had a big hematoma (cheek, neck after Adam’s Apple reduction) it might become fluid again after a few days. This could cause some old blood leaking from the wound. This is not fresh bleeding but a way for your body to get rid of the hematoma.
- Evolution—Swelling is on its maximum 2 to 3 days after surgery. Swelling and bruising may be present for up to 2-4 weeks. It may take up to 3-6 months to see the final results. Patience is required.
- Place and extensiveness—Immediately after surgery the swelling will be mostly in areas of loose connective tissue (cheeks, lips, around eyes). During the first few days, the swelling will move downwards towards the lower jaw and neck due to gravity. Swelling and bruising differ strongly from one person to another and can be anywhere. Bruising may not appear immediately and will gradually fade over the course of several weeks.
- Elevation—Try to sleep elevated (ask for extra pillows). This helps the drainage and will alleviate the swelling.
- Cleaning—The incision areas should be cleaned carefully on a daily basis by bathing the area, removing the crusts and patting it dry carefully. After about 2 weeks the wounds will be healed enough to potentially begin applying a special ointment to improve the scars (cicaplast).
- Makeup—You may wear light make-up 7-10 days after surgery to help camouflage the incisions and bruising.
- Sunbathing—The young scar is very sensitive to the sun´s rays as it contains very few melanocytes. Therefore during the first 6 months after surgery, we recommend protecting the scar with sunblock or to stay out of the sun. During the first week after surgery, it’s better to stay out of the sun completely as the risk for infection might be higher if your face and body get too warm.
- Washing the hair— If you had forehead surgery the first 2 weeks after surgery you should wash your hair every day. For good wound healing, it’s important to remove all blood clots and crusts, even better when you use shampoo. Don’t be alarmed if the wound bleeds a little bit while washing your hair. If you also have a plaster cast on your nose (rhinoplasty) the plaster should stay dry.
- Scar ointment—After the wounds have closed (after two weeks), you may begin gentle massage of the incision sites with the scar ointment gel (Cicaplast). The scar ointment gel is very simple to apply and should be used at least twice a day. The recommended minimum duration of treatment is two months.
After forehead recontouring
- Double vision—It is possible the first two weeks because of the swelling around the eyes double vision occurs (5 percent of patients). This is annoying and even worrying but ALWAYS resolves. We never had a patient with permanent double vision.
After mid-facelift, canthopexy, and blepharoplasty
- Upward massage of the lid—To prevent ectropion (lid margin eversion) two weeks after surgery you should start regular upward massage of the lid several times daily for 3 to 5 minutes. This will improve the lid tone and lid position. Often when performing the transcutaneous blepharoplasty the orbicularis muscle is denervated and the lid tone is diminished. As the tone of the muscle returns the lid position should as well. Lower blepharoplasty takes one year to fully mature into postoperative results.
After facelift and jaw reduction and chin recontouring
- Facemask—The facemask provided is meant to give support to the soft tissues of your face after surgery. It keeps them in their desired position, prevents dead spaces and the creation of scar tissue in them and reduces postoperative swelling. The facemask should be worn 24 hours a day during the first week. That is really important for the proper re-attachment of the chin muscle to the bone. Only during eating and showering it can be removed for a short while. Dr van de Ven will tell you during the preoperative consultation whether the facemask should be worn afterward or not. It can be washed at 60°C.
- Soft food—If you had a chin height reduction you should not put force on your lower jaw during the first 4 weeks after surgery as it could break in the chin area. During these 4 weeks you shouldn’t eat raw meat or bite apples etc. Eat pasta or rice, well-cooked vegetables, and soft meat. Those shouldn’t pose any problems.
- If you didn’t have a chin height reduction you might still choose to eat soft food during the first few days because of the wounds and swelling on the inside of your mouth, but you can basically eat whatever you like.
- If you notice you can not open your mouth enough after jaw surgery—Muscles may have a cramped reaction after surgery. If this happens it is important to exercise the opening of the mouth every hour for 5 minutes with wooden sticks. Click here to watch a video with instructions of how to do this.
- Mouth rinse—We will provide you with a post-surgical antiseptic mouthwash to take care of the intra-oral incisions. You should rinse after every meal. However, you should clean with a toothbrush, toothpaste and dental floss as soon as possible.The exception being when you've had chin surgery, seeing as you will have had an incision on the lower front teeth. The intra-oral incisions are absorbable and should not be removed. They will dissolve in about two weeks. When the bottle is finished you can stop the usage.
After nose feminization surgery
- Nose cast—A nose cast is placed on your nose and fixed with tape. It should stay on the nose for one week.
- Vaseline—No crust may be formed in the nose as this is not good for healing. The crust has to be removed. Vaseline 3 times a day helps to soften the crusts so you can remove them gently (see the instruction video below).
- Breathing— Most people find it very difficult not being able to breathe through their noses after their rhinoplasty. We will give you some nose drops to open up the nose during your preoperative consultation.
- Stitches—The stitches underneath the nose will be removed by Dr Bart van de Ven 7 days after the surgery.
- Bleeding—Some sporadic bleeding could be expected during the first couple of weeks, which is normal and should not be cause for concern.
- Bruising— Most people get bruising around the eyes and cheeks. The bruises under the eyes will intensify during two or three days before they begin to vanish. 15 days later, only you and your surgeon will be able to notice any traces of the surgery.
- Appearance—Your nose will regain its normal appearance very soon, but the definitive results of the rhinoplasty can only be fully appreciated after six months. The tip is the area that takes the longest to acquire its new shape.
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