PLASTIC SURGERY PLANNER - Silkwood Medical · PLASTIC SURGERY PLANNER (02) 9387 3900 9 THE SURGICAL DIET Your result will be more long lasting if you are at your ideal body weight

PLASTIC SURGERY PLANNER


(02) 9387 3900

2

TABLE OF CONTENTS

This Is Your Guide To A Good Recovery .......................................................... 3

Our Team ................................................................................................ 4

Giving Yourself Time To Get Well .............................................................. 5

Preparing Your Mind ................................................................................ 6

Finding Your Support Team ....................................................................... 7

Medications, Supplements & Food To Avoid……….. .................................... 8

The Surgical Diet ...................................................................................... 9

Avoiding Constipation .............................................................................. 10

Your Medication Guide ............................................................................. 11

Medications That Can Help Your Recovery.................................................. 12

Do Not Smoke Your Results Away .............................................................. 13

Your Shopping List .................................................................................... 14

Clothing & Styling After Surgery ................................................................. 15

Your Checklist The Day Before Surgery ....................................................... 16

What To Do Once You Get Home .............................................................. 17

What Problems Require Immediate Attention? .............................................. 18

What Problems Deserve A Phone Call Even If They Are Not Urgent? ............. 19

What Will I Look Like After My Surgery?..................................................... 20

Showering After Surgery ........................................................................... 21

Drains ..................................................................................................... 22

Swelling ................................................................................................. 23

Riding Your Emotional Rollercoaster ........................................................... 24

Timetable For Exercise .............................................................................. 25

Driving After Surgery ................................................................................ 26

Scar Management ......................................................................................... 27

http://www.silkwoodmedical.com.au/


(02) 9387 3900

3

This is your guide to a good recovery.

Most patients make their surgical journey without a single problem. We know this. And our

patients know this, and yet plastic surgery is still a stressful process.

We hope that this guide helps by answering most of your questions

about your preparation and recovery from surgery.

Surgery can be thought of as a good play. While you, the patient, are the star

of the show, you are supported by a cast of caregivers and a production team

of friends, family, your surgeon and our office staff and the staff of the hospital.

As with any theatre production, careful planning is the key to a flawless performance on

the day. This Plastic Surgery Planner is the script for your play, and our team will direct you

through a smooth recovery.

It is a good idea to read the planner before your surgery. You can then use

the index to look up answers to any questions you may have after your surgery.

The advice in this guide is general, and most of it is applicable to most patients. You and

your surgery are unique, so please prioritise specific advice you receive.

A lot of thought has gone into preparing this guide. The information we provide you is

based on good science, our experience of what works well and finally, what our patients

have taught us.

THIS IS YOUR GUIDE TO A GOOD RECOVERY



(02) 9387 3900

4

D R . W A R W I C K N E T T L E

Plastic Surgeon MBBS FRACS

D R . A M I R A S A N K I

Plastic Surgeon MBBS Hons

FRACS PhD

OUR SURGEONS



(02) 9387 3900

5

GIVING YOURSELF TIME TO GET WELL

Everyone responds to surgery differently.

The time guide listed is based on the

average period our patients take to feel

ready to return to work. It is better to

overestimate the time you will require off

following surgery, as it is easier to go

back to work early than to have to delay

your return.

For patients in more strenuous work roles,

we recommend extending your recovery

time at home by at least one week. It is

also a good idea to extend your time off

if you are keen to conceal your surgery

and know that you bruise easily.

Many patients take this downtime as an

opportunity to book time away interstate

or in local holiday houses. Keep in mind

that you will need to return to Silkwood

Medical to have stitches removed and for

wound checks, up to twice weekly for the

first two weeks. After this, short trips (up

to 3 hours by car) are ok. Air travel (up

to 3 hours) is also ok at this point. It is

best to avoid international travel for 6

weeks.

B R E A S T & B O D Y S U R G E R Y

Type Return To Work

Abdominoplasty 2 - 3 weeks

Breast Augmentation 1 week

Breast Lift 1 week

Breast Reduction 2 weeks

Brachioplasty 1 week

Gynaecomastia 2 weeks

Liposuction (small area) 1 week

Liposuction (large area) 2 weeks

Combination body procedures (e.g. body lift)

3 weeks

F A C E & N O S E S U R G E R Y

Type Return To Work

Eyelid Surgery 10 days – 2 weeks

Facelift or Necklift 2.5 - 3 weeks

Facelift and Eyelid 2.5 - 3 weeks

Browlift 10 days – 2 weeks

Rhinoplasty 10 days – 2 weeks

Hairline Lowering 10 days

Dermabrasion 2 weeks

“ I T I S B E T T E R T O O V E R E S T I M A T E

T H E T I M E Y O U R E Q U I R E O F F

F O L L O W I N G S U R G E R Y … ”



(02) 9387 3900

6

PREPARING YOUR MIND

T H E W E E K S B U I L D I N G U P T O Y O U R

S U R G E R Y C A N B E Q U I T E N E R V E - R A C K I N G !

Knowledge and a great attitude help. It is a well-known and scientifically proven

phenomenon that patients who are well-researched, well-prepared, relaxed and

positive, recover faster and more comfortably from surgery.

G A T H E R I N G I N F O R M A T I O N

Well done, you are doing that right now. It is

important to take charge of your operation and

understand the goals, expectations, risks and

alternatives of your operation. While Dr Nettle,

Dr Sanki, and Cherieve are sensitive enough to

know you don’t need to know EVERYTHING

about how your surgery is done, it is still

important for you to have an understanding of

the technical details of your operation. You will

gather more questions as your date of surgery

gets closer. Have a note page dedicated to

these questions in your phone or keep a small

notepad to write these down when they come

to your mind.

T H E R E I S G O O D A N D B A D

N E W S O N T H E I N T E R N E T

The internet can be a helpful place to start your

surgical research, but it can also be very

misleading. Your surgeons are the best people

to answer your questions because they will

have their own special surgical styles and

techniques and they know YOU. Be careful not

to get lost watching videos and selfies of

patients on the internet - they are not you, and

your experience and result will be unique to

you.

P O S I T I V E M I N D F U L

R E I N F O R C E M E N T S

You have the ability to change and guide your

response to surgery. Stay positive in the days

leading up to surgery. Feel confident about

your surgical choices. Remain calm at each

stage. Replace your tension and anxiety with

catch cry’s that provide positive emotional

reinforcement. “I am confident, calm and

positive!” If you are finding it impossible to feel

positive about your surgery, then perhaps it

would be a good idea to spend some more

time thinking if the surgery is right for you.

S U R R O U N D Y O U R S E L F W I T H

Y O U R C H E E R L E A D E R S A N D B E

P R E P A R E D F O R T H E F E W W H O

L I K E T O B R I N G Y O U D O W N

Let your closest and most trusted friends and

family know that you are planning surgery.

They love you and will enjoy supporting you

through your journey. It will make them happy

to know that they are helping you.

Unfortunately, jealousy, carelessness and

selfishness can lead someone to say something

hurtful during your recovery. These comments

should be laughed off by remembering all the

wonderful compliments you have been

receiving from your cheer squad.



(02) 9387 3900

7

FINDING YOUR SUPPORT TEAM

The best aspect of surgery is that you finally get to be the

center of attention.

Most of our patients are wonderful people who support and

hold everyone else around them above sea level. It’s time to

let others support you.

The most important practical aspects are:

1. Someone to accompany you to hospital

2. Someone to take you home from hospital

3. Someone to spend the first day home with you

4. Someone to drive the kids to school

5. Someone to feed your pets

6. Someone to take you to Silkwood for

your follow up appointments

If you think you will need someone to help you at home, we

can recommend a home health care service to assist you.



(02) 9387 3900

8

MEDICATIONS, SUPPLEMENTS & FOOD TO AVOID T O P R E V E N T E X C E S S I V E B L E E D I N G , B R U I S I N G A N D S W E L L I N G

To prevent excessive bruising and swelling, we recommend you stop these

medications/supplements/foods for 2 weeks before and 2 weeks after surgery.

Q U I C K L I S T O F M E D I C A T I O N S , F O O D & S U P P L E M E N T S T O A V O I D :

1. Blood thinners – especially aspirin

2. Pain tablets – (period pain, arthritis tabs) except for Panadol & codeine,

which are ok

3. Anything oily – Vitamin E, Vitamin D, evening primrose oil and especially

fish oil, krill oil, flaxseed oil

4. Anything homeopathic or herbal – including herbal teas, green tea,

Chinese herbs, homeopathic or naturopathic supplements

5. Mediterannean diet – red wine, olive oil, tomatoes, fish

6. Multivitamins – frequently contain herbs and vitamin E, Vitamin D

7. Hormone Replacement Therapy (HRT)

BEFORE SURGERY



(02) 9387 3900

9

THE SURGICAL DIET

Your result will be more long lasting if you are at

your ideal body weight just before your surgery.

Having said that, there is not much point in crash

dieting or putting on kilos in the lead up to surgery,

only to return to your natural equilibrium weight

during your recovery.

Some people put on weight in the weeks after their

surgery because they are exercising less and

carrying some swelling. Others will find they lose

weight as their appetite is suppressed by the pain

relief medication. Either way, the best thing to do is

to maintain a healthy diet to ensure you get the

protein, vitamins and minerals you need for good

wound healing.

Minimise salt intake for 2 weeks before and 2 weeks

after surgery.

To prevent bloating and constipation before a tummy

tuck or body contouring we recommend you avoid

foods that give you bloating or flatulence, such as

chickpeas, legumes and root vegetables.

AFTER SURGERY

It can be pretty hard to chew properly after a facelift, facial

implant surgery, or rhinoplasty surgery. We recommend you eat

a soft diet for a week or two after surgery. Soft foods are foods

that you can get into your mouth easily and require minimal

chewing.

Over time common-sense and listening to your body will guide

you in your progression from a liquid to a soft, mushy, non-chew

diet and back to your normal diet.

Soft diets can be lower in fibre. Together with a lack of exercise,

the effect of medication and diminished fluid intake, low fibre

diets may contribute to constipation.

To increase fibre:

Consume prune juice regularly.

Ensure you have at least 6-8 glasses of fluid each day.

Alternatively, fibre supplements can be used (wheat

bran, oat bran, psyllium).

If it is necessary to treat constipation, you may want to use

Movicol, Coloxyl, Psyllium, Senokot or Metamucil. It is a good

idea to start one of these the day after surgery, rather than

waiting.

Tummy tuck patients should persist with a light, non-bloating diet

in the weeks after surgery.

S O M E R E C O M M E N D E D S O F T

N O N - C H E W F O O D S :

Protein smoothies

Scrambled eggs, poached eggs

Yoghurt

Soups

Peanut butter

Mashed vegetables, potato, carrot,

pumpkin

Semolina

Soft pasta

Custard

Jelly

Rice pudding

BEFORE SURGERY



(02) 9387 3900

10

AVOIDING CONSTIPATION

Constipation makes you feel bloated and uncomfortable. We especially want to avoid

constipation in facial surgery and tummy tuck surgery, where “pushing” or straining can increase

the risk of bleeding.

Constipation after surgery is very common and is due to many different factors, including

Bowel sluggishness induced by the anaesthetic

Strong pain relief e.g. endone, panadeine forte

Changes to your regular diet and fluid intake

Reduced activity

Fear of going to the toilet because it might hurt

H E R E A R E S O M E S U G G E S T I O N S T O A V O I D C O N S T I P A T I O N A F T E R Y O U R

S U R G E R Y :

Make sure you are going regularly before the surgery and start taking coloxyl and senna

or Movicol for two days before the surgery if you are prone to constipation

Keep up your fluids after the operation

Increase your intake of foods that keep you going regularly eg prune juice

Do a bit of gently walking every day

For patients having abdominoplasty surgery, you should commence both coloxyl and

senna AND movicol as soon as you are eating normally. If you start to get diarrhea, then of course

stop taking your aperients.



(02) 9387 3900

11

YOUR MEDICATIONS GUIDE

We will advise you at your preoperative appointment in

regards to which medications are safe to take the week

before and the morning of surgery.

We will usually ask you to stop any medications that “thin

the blood” or increase bleeding as listed previously.

Oral hypogylcaemics (medications for diabetes or insulin

resistance) should be reduced in dosage or omitted while

you are fasting. Dr Nettle or Dr Sanki may discuss whether

certain medications can be reduced or substituted (e.g.

immunosuppressive medications) with the physician that

originally prescribed them for you. The following

medications may be prescribed for you to help with your

recovery.

P A I N R E L I E V I N G M E D I C A T I O N S :

Pain medications fall into three basic families- paracetamol

(Panadol), non-steroidal anti-inflammatories (NSAIDs) and

opioids. Your surgeon and anaesthetist will discuss with

you the best combination of these medications to leave you

feeling comfortable after surgery.

Paracetamol is always a good first medication to try as it

raises your pain threshold and means that you require

lower doses of other medications to stay on top of your

pain.

Anti-inflammatories e.g. nurofen and voltaren worsen

bruising and increase the risk of bleeding. Anti-

inflammatories such as celecoxib (Celebrex, Mobic) do not

cause bleeding and bruising.

Opioids (e.g. oxycodone, endone, Targin, tramadol,

tramal, fentanyl, morphine) are stronger pain relief

medications that are usually used in the first 48 hours

after surgery. Thereafter, they are useful at night to help

ease pain that you may be more aware of because your

daily activities are not distracting you. They have a mild

sedative effect and should not be taken at the same time

as a sleeping tablet, nor before driving.

It is essential to take enough medication to control your

pain. You will not become addicted to normal pain relief

medication, and in fact are more likely to have problems

if you skimp on pain relief. Unfortunately, opioids also

have the unfortunate side effect of constipation. So make

sure you take something for your bowels if you are using

your bowels if you are using your opioids regularly. We

recommend either movicol sachets, coloxyl, metamucil,

psyllium husks, prune juice - you are your best guide to

determine what works best for you.

Codeine (found in Panadeine and Panadeine Forte) in

particular can cause constipation.

A Q U I C K N O T E O N A N T I B I O T I C S

Our body is covered inside and out with a clever

balance of bacteria to keep us healthy. After surgery, the

normal bacterial balance can become upset. We avoid

bacterial proliferation at the wound and under your skin

by giving you antibiotics through your drip during your

hospital stay. For many of our patients, we will also

prescribe one course of cephalexin 500mg capsules

taken four times a day. This can be on a full or empty

stomach.

Antibiotics can upset you digestive systems balance, and

can lead to upset tummies. Yakult or a probiotic can

help, especially if you need a second course of

antibiotics.

Sleeping Tablets (Temazepam most commonly

recommended): We often prescribe sleeping tablets to

help you get a good nights sleep following surgery.

Usually these are only needed for a few nights.

Antiswelling (Dexamethasone): Many facial and nose

surgery patients are prescribed this specific antiswelling

tablet. You will be given a sheet to tell you exactly how

and when to take these tablets if they are prescribed for

you.

Antinausea (Zofran): Nausea is not common following

modern anaesthetics, but some people are exquisitely

sensitive. If you are one of these patients you will be

prescribed a Zofran wafer that will dissolve on your

tongue.



(02) 9387 3900

12

MEDICATIONS THAT CAN HELP YOUR RECOVERY

B E F O R E S U R G E R Y :

We recommend you take Vitamin C and Zinc supplements in the week or two before surgery.

Both of these medications are co-factors in collagen formation and collagen is the important

protein that heals your wounds.

Arnica is a herbal agent that helps to reduce swelling and bruising. We advise you to spray it

under your tongue in the few days before surgery and for one week after surgery.

T O S P E E D H E A L I N G :

Vitamin C 1000mg daily, 1-2 weeks before surgery

Zinc 1 tablet daily, 1-2 weeks before surgery

Arnica oral spray (to decrease bruising), start a few days before surgery.

After surgery 6 sprays under the tongue 4 times per day for 1 week.

A F T E R S U R G E R Y :

Patients who are having longer procedures eg combination breast and tummy surgery, may

require a boost to their iron levels after surgery. Iron is best absorbed when taken with an acid

such as Vitamin C or a glass of orange juice. Its absorption is impaired by coffee, tea, dairy and

soy milk and cereals. So it makes sense to have your iron supplement with dinner and not

breakfast! Iron liquid drinks are gentler on your tummy. We recommend taking Floradix or

SpaTone brands.

We often prescribe B Group multivitamins, commencing 2 weeks after surgery for our facial

surgery patients.



(02) 9387 3900

13

DO NOT SMOKE YOUR RESULTS AWAY

There are very few plastic surgeons that will operate on smokers as

there is unquestionable scientific evidence that smoking greatly

increases the probability of anaesthetic and wound healing

problems.

Dr Nettle and Dr Sanki have both had patients sneak a cigarette or

two before surgery. These patients delayed their recovery and

compromised their result. In plastic surgery, no one wants an “OK”

result. We all want a perfect operation and a perfect outcome. So

why compromise this process by smoking?

While cigarettes are a toxic mixture of carcinogenic, mutagenic,

radioactive and toxic compounds, the two most concerning

ingredients for our patients are nicotine and carbon monoxide.

These reduce the ability of your skin to get oxygen and also impair

your white cells from entering the wound to heal it and prevent

infection. All plastic surgery depends on rearranging the blood

supply of your skin and then getting it to heal nicely.

You should stop smoking for 6 weeks prior to and at least three

weeks after your surgical date. During this time, your blood oxygen

levels will rise and your lung cells will regenerate.

“ S K I N N E C R O S I S ( S K I N D E A T H ) O C C U R S I N 2 0 % O F P A T I E N T S

W H O S M O K E I N T H E L E A D U P T O F A C E L I F T S U R G E R Y ”



(02) 9387 3900

14

YOUR SHOPPING LIST

T H E R E A R E M A N Y

T H I N G S O U R

P A T I E N T S H A V E

T A U G H T U S T H A T

C A N M A K E Y O U R

T I M E I N H O S P I T A L

A N D A T H O M E M O R E

C O M F O R T A B L E .

C H I L L E D E Y E M A S K ( F A C E L I F T ,

B R O W L I F T & E Y E L I D S U R G E R Y ) :

These can be purchased from pharmacies

and possess a clever gel that refuses to get

too cold so that you cannot get an ice burn.

An inexpensive alternative is to place gauze

squares or makeup pads into iced water and

lay them on your eyes.

A T R I P T O T H E B E A U T Y S A L O N :

There is no better way to make you feel good

after surgery than ensuring you look good

before the surgery! Make sure you have your

hair trimmed and dyed just before

facelift/brow lift/hairline lowering. We think

it’s best to avoid dying your hair after these

procedures for 4 weeks. You will also feel

fresher and more comfortable if you have a

pedicure and wax or shave beforehand. No

one wants to be bothered by their raggedy

toenails or spikey legs when they are

recovering from surgery. It can be tricky

trying to wash and style your hair after breast

surgery. You should consider a trip to the

hairdresser a week after surgery for a wash

or cut. It will also distract your friends and

family from the more obvious changes that

have happened to your chest!

.

F L E X I B L E S T R A W S O R A

S Q U E E Z Y W A T E R B O T T L E :

These make it so much easier to drink water

while lying in bed or on your couch.

T H I G H L I F T & T H I G H

L I P O S U C T I O N P A T I E N T S :

There is a very special item that is specific to

only you! A Shewee is a hygienic, washable

silicone female urination device that will

make your life a lot easier when you are

wearing a tight compression garment. It

comes in a compact and discrete case.

http://shewee.com.au/

E N T E R T A I N M E N T :

You will feel too tired and apathetic to

perform any work when you go home. It is

best to plan at least one week of being

“thought free”. It is still a good idea to

distract yourself with good TV, podcasts and

great magazines. Most people find

themselves unable to concentrate for longer

than twenty minutes. Keep your entertainment

entertaining and make sure it’s mood

boosting!

S K I N W I P E S :

Moisturising skin cleanser wipes come in

handy when you are in hospital but not

able to shower yet. Patients having body

procedures can properly shower only once

their drains have come out (usually after the

fourth day following their surgery) while

face patients can shower the day after

surgery. A moistened hand towel can

alternatively be used to help you bird bath.

S O F T , Y U M M Y F O O D :

It can be hard to chew after facial

surgery and most people don’t feel up

to a big meal after body contouring!

We advise having a supply of nutritious

but tasty single serve meals packed into

your freezer. Protein smoothies can also

be a great alternative to keep the

calories up.


http://shewee.com.au/


(02) 9387 3900

15

CLOTHING & STYLING AFTER SURGERY

What we put on our face and bodies can make a big difference to how

we feel after surgery. It is important to wear practical, loose clothing to

and from hospital. After that, your appearance becomes a reflection of

your mood and your recovery. It is an important part of your physical

transformation to go back to wearing flattering clothing and makeup to

make yourself feel confidant and beautiful. Your bruising, swelling, aches

and pains will improve in leaps and bounds after the first 48 hours. You

are not the first person to ever have plastic surgery - everyone recovers!

It just takes time.

F A C I A L S U R G E R Y P A T I E N T S :

The last thing you want to put on after having a delicate operation on your nose or face is a tight skivvy!

Wide necked or front-opening button up shirts and dresses are the most comfortable thing to allow for

your reduced neck movement after face and neck lifting surgery or a sore nose after rhinoplasty.

Wide legged pants that easily fit over your shoes or slippers are better than skinny jeans or leggings

as you will not need to bend over to push them over your ankles. Rather than wearing your best

designer clothes, it’s best to wear clothing and use old pillowslips and bedsheets that you don’t

mind getting possible stains.

B R E A S T S U R G E R Y P A T I E N T S :

Please purchase a Berlei Electrify Sports bra ($40) online or from David Jones or Myer. Keep in mind that

this is an extremely tight fitting style and you will be advised to purchase a strap size that is bigger than

your usual size. It is a good idea to purchase two (wear one, wash one). You will be desperate to go bra

shopping with your new cleavage, but we recommend staying in your Berlei bra

for at least 2-4 weeks after surgery. Button up and wide neck tops are easier to get on and off as you

will not be able to lift your arms above shoulder level for a few weeks.

B O D Y C O N T O U R I N G P A T I E N T S :

Shock horror! Your normal clothes are too tight! While kilos of skin and fat are removed in this surgery,

you will gain a lot of swelling and you will be wearing compression garments. This will settle, many

patients lose a dress size after abdominopalsty, brachioplasty or thigh lift surgery.

Plan to hang out in a maxi dress or a loose tracksuit for a few weeks after your operation. You will be

measured up for a compression garment at your preoperative appointment, and this will be applied to

your operation site at the end of the operation.

Your garments will get blood stained and sweaty while you are in hospital. Small stains are fine and will

not cause infection. It is helpful though if your partner or a friend can wash your garment for you once

you get home. A soft cotton singlet can be worn under your abdominal binder to avoid chaffing and also

to help keep the binder clean.



(02) 9387 3900

16

We know you’ve thought and re-thought everything you need to do

for tomorrow, but here is a final checklist for you to go through.

Then you can relax, go to bed early and sleep well. Please make

sure you:

Know your fasting time and expected time to arrive in

hospital

Know which medications to take tomorrow morning (if any)

Shower in antiseptic soap and wash your hair

Have a loose, comfortable outfit and cotton underpants

ready to wear to and from hospital

Remove your nail polish and false nails from your hands

Remove all jewellery and piercings

Have your glasses packed

Do not wear any skin moisturizer or makeup to hospital

Arrange someone to take you into hospital and take you

home

Pack your ID card, insurance card, Medicare card and

a pen for filling out forms.

That’s it! Now do something that makes you feel relaxed and happy!

YOUR CHECKLIST THE DAY OF SURGERY



(02) 9387 3900

17

WHAT TO DO ONCE YOU GET HOME

R E S T & M O V E :

While you will feel quite tired after your surgery, it is

important to either walk around your home every two hours

or wiggle your legs and toes just as recommended on a long

haul aircraft flight every hour. This helps to avoid blood clots

in your legs (DVTs). It is a good idea to go out once you are

physically able (at day 5-7). This will train your mind that you

are getting back to normal.

C O O L P A C K S & I C E D G A U Z E S :

These can help to improve your comfort after facelift, eyelid

and rhinoplasty surgery. Apply them gently to your eye area

as soon as you get home and replace them with another cool

pack once it goes to room temperature. Use a cool pack for

the first 48 hours.

Y O U R M E D I C A T I O N S A L L S E R V E

A P U R P O S E :

Start your medications as soon as you get home. Try to stay

on top of your pain as it is harder to get rid of severe pain

once it has set in.

D R I N K & E A T :

It is important to keep well hydrated after surgery to prevent

headaches and DVTs. Pain relief medication can make you

nauseated, so it is best to ease slowly into eating. Your

appetite will let you know when it is “safe” to eat normally.

SURGERY IS A SHOCK TO YOUR SYSTEM.

YOUR BODY THINKS IT HAS TAKEN A

MAJOR PHYSICAL INSULT AND WILL GO

INTO OVERDRIVE TO MAKE YOU HEAL

AND FEEL BETTER. THE BEST THING YOU

CAN DO IS TO TAKE IT EASY TO ALLOW

YOUR BODY TIME TO MEND.

E L E V A T E T H E W O U N D :

Gravity works on everything. Including your wounds. You

will have less swelling and less pain if you manage to keep

your wounds elevated.

The exception to elevation is facelift patients who should

sleep completely flat, the reasons for this will be explained.

Patients who have had arm surgery should keep their arms

elevated on pillows.

Breast patients do not need to sleep with their chest

elevated, but it is a good idea to rest with your torso

propped up on pillows when watching TV.

P H Y S I O T H E R A P Y :

You don’t need a physiotherapist to help you stretch,

breathe and cough, but have a system in place to

remind yourself to:

Take 5 really deep breaths every hour until

you are walking and moving normally

Roll your shoulders five times forward and

backwards every hour if you have had breast

augmentation

Ask your friend or partner to massage your

lower back if you have had a tummy tuck

.



(02) 9387 3900

18

WHAT PROBLEMS REQUIRE IMMEDIATE ATTENTION?

IF YOU LOSE CONSCIOUSNESS, DEVELOP CHEST PAIN, OR SHORTNESS OF BREATH, SOMEONE SHOULD CALL AN AMBULANCE ON 000.

If you experience any of the following concerns, please contact us immediately.

▪ A high fever (over 38 degrees Celsius)

▪ Severe nausea and vomiting

▪ Bright red skin that is sore or hot

▪ Bleeding or seepage through a wound that cannot be controlled with pressure for 3 minutes

▪ New swelling e.g. one breast is much larger than the other or one side of the neck is larger

than the other

▪ Inability to urinate

▪ Difficulty breathing

▪ Calf pain

DURING BUSINESS HOURS

9am to 5pm Monday to Friday: Silkwood Medical: (02) 9387 3900

AFTER HOURS:

Your surgeon’s mobile phone number OR

The Registered Nurse in charge at the hospital where you

had your surgery.

Bondi Junction Private Hospital (02) 8305 2519

East Sydney Private Hospital (02) 9001 2000

Kareena Private Hospital (02) 9717 0000

St George Private Hospital (02) 9598 5555



(02) 9387 3900

19

WHAT PROBLEMS DESERVE A PHONE CALL E V E N I F T H E Y A R E N O T U R G E N T ?

ALL OF THEM!

We really want to know. Honestly. You are experiencing what it

is like to be healing from plastic surgery for the first time. A

problem that leads you to lose sleep or spend hours on the

internet researching is usually something we can solve in a brief

conversation with you. It is very satisfying to be able to educate

and help our patients through their concerns.

H E R E A R E A F E W O F O U R M O S T

C O M M O N L Y A S K E D Q U E S T I O N S :

When will my bruising and swelling go away?

This is very individual. We anticipate a

significant improvement in 2 weeks and

dependent on the procedure up to 6 weeks for it

all to go.

When can I return to work?

This is very individual but also procedure

dependent. Some people will return to work

within 2 weeks but others will be up to 4 weeks.

See our approximate timeline guides for the

most common return to work and exercise times

for your procedure. Remember this is a guide –

everyone is different.

When can I return to exercise?

We are happy for you to go for a gentle walk

as soon as you feel up to it as long as you don’t

raise your pulse or blood pressure. We would

like you to avoid any straining (weights, lunges

and any downward yoga or pilates) for up to 6

weeks depending on the procedure.

See our guideline timetable for return to exercise

in a few pages We will guide you through this

as we assess you through your recovery.

Will it hurt when my sutures/staples/drains

come out?

People tolerate this differently. We suggest you

take some pain relief before you come in.

There is a pimple in my wound.

This is usually due to a dissolving suture under

the skin and will resolve on its own.

My right side doesn’t look like the left.

Most people will heal asymmetrically to some

degree as we are all naturally asymmetrical.

You will not be any more asymmetric

postoperatively than you were preoperatively.

I have shooting/ pulling/ tugging pains.

This is due to firing and recovering nerves and

also in some cases muscles and skin being

pulled to help you achieve your desired result.

This usually takes 2-6 weeks to settle dependent

on the procedure.



(02) 9387 3900

20

WHAT WILL I LOOK LIKE AFTER MY SURGERY?

No patient goes through this journey without wondering if their healing is normal

and if they are going to look ok. In fact, it is normal to wonder after the surgery why

on earth you are going through this as you may look and feel terrible!

Remember time is your friend, and you will start to see the great effects of your

surgery very soon.

Everybody heals very differently, these are just some examples of what you might

expect. The rate of healing will depend on several factors like; genetics, lifestyle,

how well you follow your surgeons pre-operative and post-operative advice.

If in the hospital you are given conflicting advice to what your surgeon or

Silkwood’s Practice Nurse has told you, please call Silkwood Medical to clarify.

Here are some pictures of patients straight

after and weeks after their surgery.

FACELIFT HAIRLINE LOWERING

BREAST REDUCTION TUMMY TUCK

4 weeks post surgery 1 week post surgery

5 days post surgery 1 week post surgery

RHINOPLASTY

5 days post surgery



(02) 9387 3900

21

SHOWERING AFTER SURGERY & EARLY WOUND CARE

Most patients desperately want to jump in the shower to wash

away the stale feeling they get from being in hospital. A bit

like how we all feel after a long haul plane flight. After

surgery, standing in a warm shower with strong pain relief in

your system can be a perfect storm for feeling dizzy and

woozy.

Have a close friend or your partner nearby when you have

your first shower, or try to have it before you leave hospital

with the help of your nurse. A plastic chair or a shower chair

can be a great aid when you are having trouble standing

comfortably after major body surgery.

F A C E , B R O W , H A I R L I N E & E Y E L I D

P A T I E N T S :

You can shower and get your wounds wet the day after

surgery. Remember to shower in lukewarm, NOT hot water.

R H I N O P L A S T Y P A T I E N T S :

The warmth of a shower can melt the thermoplastic splint sitting

on your nose and cause it to fall off. Try to avoid getting your

face wet in the shower until your splint is removed. If you can

get your hair washed in a salon, you are welcome to.

B R E A S T A N D B O D Y S U R G E R Y :

You can have a shower and get your wounds wet once your

drains have come out AND the drain holes have sealed over

with a scab or the drain holes can be properly covered with a

waterproof dressing.

B R E A S T A U G M E N T A T I O N P A T I E N T S :

Your waterproof dressing over your wound will keep it

protected during your shower. This dressing should be

removed and replaced with something similar if it gets

soaked through. This dressing will be removed at your

first follow up appointment.

B R E A S T R E D U C T I O N / L I F T , T U M M Y T U C K ,

T H I G H A N D A R M P A T I E N T S :

Micropore paper tape or prineo tape will be applied to your

wounds in theatre or before you leave hospital. This should

remain intact for one week and will be removed at your first

follow up visit. The tape can get wet and will then air dry.

The tape can be removed earlier if you see there is a moist

area in your wound that is leaking some fluid. Breast patients

should wear their bra day and night for 2 weeks.

Tummy tuck, thigh lift and liposuction patients should wear their

garments for 3 weeks during the day and night. It is important

to take off your garment for at least half an hour in the morning

and evening to check your wounds and skin look healthy.

Tummy tuck patients can swap to an underpants style

abdominal binder if this is more comfortable after the first week.

There is no strong evidence behind the duration recommended

for wearing garments. After the first week of surgery, garments

provide support to sore wounds and skin and can help you

mobilize. You can continue to wear your garment after 3 weeks

if it is giving you support and comfort.



(02) 9387 3900

22

DRAINS

Drains are silicone tubes that siphon away the excess fluid of swelling that accumulates under your

skin after surgery. Drains create negative pressure (a vacuum) under your skin and help to get your

skin to stick down into its new location.

A drain has three components. A soft perforated tube that sits under the skin, a connector tube and

finally, a bulb to create the vacuum and collect the swelling fluid.

The fluid in your drains will look bloody at first and become yellow over time. The yellow fluid is

lymph and serum (the fluid our red blood cells swim in).

F O R B R E A S T A N D B O D Y P A T I E N T S :

It’s time for your drain to come out once the fluid turns yellow and the drainage has dropped off.

Make sure you bring your diligent volume recordings to your appointment.

It is important to empty, measure and re-vacuum your drains twice daily (or whenever they fill up). This

will ensure you are measuring the drainage accurately and also improve the suction pressure of the

bulb.

F O R F A C E L I F T P A T I E N T S :

Drains are normally left for 4 or 5 days. Empty and revacuum your drains as we show you three times

daily. For facelift patients it is NOT necessary to record the drainage volume.

WHY DO PEOPLE GET

ANNOYED WITH

THEIR DRAINS?

Well, it can be tricky trying to work out

where to hide the little bulbs and the

connector tube can sting a bit where it

rubs against your skin.

Drains come with little silicone tabs that

allow you to safety pin them to your

clothing or compression garments. The

bulbs also fit perfectly into jacket or pant

pockets.



(02) 9387 3900

23

SWELLING

Swelling is your friend. Swelling is due to

inflammatory fluid welling up under your skin

bringing white blood cells and important proteins

to heal our wounds and help our surgery stick.

Swelling does become a nuisance if it persists and

delays you from seeing your beautiful result.

Surgery to the skin can cut the lymphatic channels

that carry the bodies excess fluid back to the

heart. It takes weeks to months for the body to

rebuild and rearrange these lymphatic channels.

Fluid is subject to the pressure effects of gravity.

So you will notice that tummy and leg swelling will

worsen after long periods of standing and

walking. Lymphatic massage and compression

can help to move the fluid out of swollen zones.

Ultimately, swelling does go away. It will vary

from day to day and worsen in warmer weather.

A rough time line is to expect your swelling to

peak at day 2 after surgery and gradually subside

over the next 12 weeks.



(02) 9387 3900

24

RIDING YOUR EMOTIONAL ROLLERCOASTER

This section has been written for you, your family and your

friends. It is a lot easier to cope with the breadth and force

of emotions you are going to experience if everyone

around you knows why you are experiencing them.

No matter how emotionally soft or strong you are, surgery

will take you through lows and highs. The depth of the lows

and the peaks of the highs can vary from person to person

but tend to reflect the length of your physical recovery. So

patients having combination procedures on either their face

or body tend to feel emotionally unpredictable for a bit

longer.

The change in your emotions is driven by external and

internal factors. Strong medication, steroids, poor sleep

and pain all leave us feeling very irritable. The good news

is that once you recover a little bit, you will stop feeling

pain, require less medication and be able to sleep

comfortably.

Your body pushes out a powerful combination of hormones

to keep you alive during surgery including adrenaline and

corticosteroids. After one or two days it works out that you

are doing really well, and it stops the hormonal drive.

Unfortunately your emotions will plummet once your

hormonal levels return to normal at about day 4 after

surgery. It is very similar in feeling to post-baby blues.

You know you are doing really well and should be really

happy, but somehow you still feel sad.

Here are some great cognitive behavioural therapy strategies to help train your mind into thinking positively.

1. Wake up and smile for one minute. It works. Smiling has been shown to cause the release of happy

neurotransmitters in your brain. Smiling also makes those around you smile back at you.

2. Surround yourself with happy, positive people (the Cheerleaders).

3. Watch funny TV shows.

4. Once you are well enough, gently exercise for 20 minutes a day and eventually build this up to 30 minutes a

day (check the section on exercise after surgery to see what you can safely do).

5. Block negative predictions. Your brain cannot emotionally decipher between an “imagined expectation” and

reality. If you start imagining what it is like to have a poor outcome from surgery, then your brain will start

preparing for this imagined reality.

6. Avoid comparing your recovery to other patients on the internet. They are not you.



(02) 9387 3900

25

TIMETABLE FOR EXERCISE

Exercise makes us feel healthy, happy and fit. You won’t feel like walking further than from your couch to your bathroom for the first few days after surgery.

After a week, you will feel a desperate urge to get some fresh air and feel your body moving again.

Here is a guide for when it is safe for most patients to get back to exercise. Of course, you should listen to your body.

If something hurts, your body is telling you to stop what you are doing and take it easy.

Procedure Walking <20 minutes,

no sweating or rise in

HR

Walking > 20

minutes, not

vigorous

Jogging or brisk

walking

Pilates/ Yoga High impact e.g.

Cross Fit,

swimming

Sexual

Intercourse

Eyelid surgery Day 3 Day 5 4 weeks 4 weeks 6 weeks Day 14

Facelift Day 5 Day 7 4 – 6 weeks 6 weeks 6-8 weeks Day 14

Rhinoplasty Day 5 Day 7 3 weeks 6 weeks 6 weeks Day 7

Browlift/Hairline lowering Day 3 Day 5 3 weeks 6 weeks 6 weeks Day 7

Breast augmentation Day 2 Day 7 4 weeks 4 weeks 6 weeks Day 7

Breast Lift or reduction Day 2 Day 7 4 weeks 4 weeks 6 weeks Day 7

Tummy tuck Day 7 Day 14 4 weeks 6 weeks 6 weeks Day 14

Brachioplasty Day 2 Day 7 4 weeks 6 weeks 6 weeks Day 14

Thigh lift Day 7 Day 14 6 weeks 6 weeks 6 weeks 4weeks



(02) 9387 3900

26

DRIVING AFTER SURGERY

You are safe to drive your car once you are:

Not taking strong (opioid) pain relief. Strong

medications have a sedative action and will

inhibit your response time.

Able to slam your foot down on the brakes.

Able to turn your head and neck around your

right shoulder to check your blind spot.

Most people are able to drive after one week following

facial or breast surgery, and after two weeks following

abdominal and lower body surgery.



(02) 9387 3900

27

SCAR MANAGEMENT

SCAR MANAGEMENT IS VERY IMPORTANT TO YOUR END

RESULT AS ONCE YOUR SWELLING AND HEALING HAS

TAKEN PLACE, YOUR SCARS WILL BECOME THE ONLY

TELLTALE SIGN OF HAVING HAD SURGERY.

T I M E S C A L E O F N O R M A L W O U N D H E A L I N G :

Your wounds are sealed to the external world within 48 hours of surgery. It is most important to keep your

wounds protected in this time to avoid infection. Your body will gradually produce more and more scar

tissue to support your wound over the next 12 weeks. In this time, your wounds will go from being fine

pink lines to thick, raised pink lines. As your body deposits more collagen into the scar, the tensile strength

of your wound increases. At 6 weeks post op, the tensile strength of your wound will be half that of normal

skin. This is strong enough to withstand the day to day movement our skin experiences such as exercise.

Scars are pink because they are filled with tiny blood vessels feeding the scar with healing cells and

proteins. The scar becomes paler and softer over time. It takes a full year for a scar to completely reach its

“end point”.

W H A T T O P U T O N Y O U R S C A R :

Treat your scar as delicate skin. Do not apply makeup for one week. Direct sun exposure should be

avoided while the scar is maturing.

In face and eyelid surgery, it is difficult to put tape on wounds and often we will recommend silicone gel

ointments from an early stage. We will advise you about this during your recovery.

In breast and body surgery, paper taping and silicone products are recommended to help achieve a good

result as soon as possible. Our nurse will take you through the use of these products. Micropore paper

tape should be placed over suture lines for the first two weeks after your postoperative visit. This can be

showered over, and changed when it peels away. If silicone products are not used continue taping for

another four weeks.

In breast and body surgery, silicone products can be started three weeks after surgery. Sheets, such as

Newgel, yield the best results. Follow the included instructions. This involves placing a silicone sheet over

the wound almost all day over three months. This can be impractical in exposed areas such as the face. In

these cases a silicone ointment, can be substituted during the day.


Documents

PLASTIC SURGERY PLANNER - Silkwood Medical · PLASTIC SURGERY PLANNER (02) 9387 3900 9 THE SURGICAL DIET Your result will be more long lasting if you are at your ideal body weight