Eye For God
Bert Bowden, MD
Cosmetic and Reconstructive Eye Surgery

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Cosmetic Procedures Performed by Dr. Bowden

Below, you'll find detailed information about specific procedures.

Instructions for Nausea
Tearduct Surgery Post Op
Oculoplatic Surgery Post Op
Chemical Peel Post Op
Hard Palate Graft Post Op
Instructions for Ice Pocket
Brow Surgery Post Op
Instructions for Pain Medication
Instructions for Warm Compress
Laser Post Op

Instructions In Case Of Nausea Or Vomiting
Following surgery you may experience a feeling of indigestion, gas, the desire to burp and at times, nausea.

You can sip small amounts of fluid slowly after surgery. You may find that a carbonated soda (7-Up) may get rid of the feeling of gas by helping you to 'burp'. Sometimes it helps to walk about a little.

If you only drink clear fluids and perhaps a little toast or a plain cracker for 3 - 4 hours after surgery your stomach will tend to get back to normal.

If you are feeling hungry and want to have a light lunch or dinner, that is fine.

Please follow all the other instructions you have been given.

IF YOU EXPERIENCE ANY NAUSEA THEN PLEASE REMEMBER THE FOLLOWING: You have been given some suppositories. Please insert one as soon as you think you feel the least bit nauseated. Please lie down and rest quietly. A cool wet compress over your forehead is often soothing. You can expect the suppository to make you sleepy and usually after a short nap the nausea passes. If you really think you are nauseated it is better to use the suppository at once rather than waiting "just in case the feeling passes". If you wait for too long, it is much more difficult to break the cycle of nausea and vomiting.

The suppository will not harm you.... it may make you sleepy but in general will not cause any other problems.

Most patients do not experience any nausea following surgery, but we want you to be prepared. We expect you may not need any of these suppositories.

For Patients Who Have Undergone Tear Duct Surgery
Do not be surprised if your nose runs after surgery.

Try not to blow your nose as this can cause bleeding. If your nose does bleed: -- Apply ice to nose with gentle pressure. -- Sit up straight. A pillow may help with support. -- Spit out any fluid (blood) at the back of your throat. -- Try not to swallow any blood. Try not to bend over as this can occasionally start bleeding. Hot fluids have a tendency to make your nose run more frequently. Wear a drip pad under your nose for 2-3 days after surgery to catch the material that might run down. Beginning the day of surgery, use the following: Normal Saline nose spray--spray in the nostril on the side that had surgery. Beconase Nasal Spray-this will help control the healing to make the best surgical outcome. Antibiotics-take these as directed on the bottle.

Post Operative Instructions for Oculoplastic Surgery
Please rest quietly all day following surgery. You do not have to remain in bed. A recliner is OK. You may read if you want or watch TV. Do not take a shower or a bath today. (Make do with a sponge bath if needed.) You may begin showering and wash your hair on the day following surgery unless you have a patch or head covering. You may drink water, clear fluids, 7-Up, clear broth, or tea. You may have a light lunch or dinner as long as you are not feeling nauseated, and you are hungry. You may have your regular diet whenever you feel like eating it. Use the Ice Pocket from your post-op kit to minimize swelling and reduce "black and blue." Use the Ice Pocket for 2 full days after surgery, then switch to the Warm Pocket the next morning, Thursday. Continue the Warm Pocket until all bruising is gone or Dr. Bowden tells you that you may quit. Beginning on the day after surgery, after applying the pockets, cleanse the incision gently with Q-tips or a washcloth to remove any crusting of blood or other debris. This helps make the nicest scar. Your post-op kit has some ointment and artificial tears (Bion tears and Duralube ointment) for the eye. To put the ointment or tears in the eye, pull down gently on the lower eyelid and placing a drop or a small amount of ointment in the space between the eye and the lid. Put the ointment in the space just like you put toothpaste on a toothbrush. Continue this until your post-operative appointment. You are to put ointment (Ciloxan) on the incisions following surgery. Apply a small amount to the tip of your finger and then gently rub this on the incision. You should do this 3-4 times daily to keep the area moist and "glistening" and allow the least amount of scarring. Some dissolving stitches will not dissolve without the ointment. Continue this until your post-operative appointment. If your eye is patched, try not to crush the patch while sleeping. You may sleep on that side. Your post operative appointment is scheduled for.

Chemical Peel to Localized Areas of the Skin
Variable concentrations of solutions will be applied to your skin. This may sting and burn for two to five minutes.You will be leaving shortly after the procedure is performed. You may resume normal activities.

During the next three to five days, your skin may turn dark and begin to peel. SUPPLIES NEEDED:

  • 3% Hydrogen Peroxide
  • Vaseline Petroleum Jelly or Crisco
  • Q-tip cotton swabs

POST PEEL INSTRUCTIONS

Twice a day, morning and evening: dip nonsterile Q-tip swabs in hydrogen peroxide (the typical household variety) to get them very wet. Apply the hydrogen peroxide saturated swab to the skin and scrub lightly to remove all debris and dead skin that comes off easily. Do not peel skin off manually. It will come off naturally. Using a Q-tip swab, or your finger, apply a coating of Vaseline to keep skin smooth, supple and lubricated. It must appear glistening at all times.

If during the first few days of the healing process, you experience marked swelling of the face with noticeable heat of the skin, you are not removing enough of the debris and dead skin. Please re-cleanse the area.

You may swim, shower, bathe, shave and have your hair done, even on the day of the procedure.

Do not apply sunscreens for at least two weeks or until your skin is completely healed.

You may use make-up and cover-ups when the skin is healed and pink.

You may experience one or more of the following conditions (these are normal reactions):

Burning or itching eyes or puffiness around the eyes. If this occurs, bathe the eyes with cool water and apply iced, wet, cold compresses for relief. Stretching or pulling of the treated skin, causing a feeling of tightness. This will be alleviated when the peeling begins and by keeping the skin lubricated with Vaseline. A general feeling of fatigue or low energy level. This will disappear after a few days. While you do have this feeling, try to get some extra rest and/or sleep.

Hard Palate Graft instructions
These instructions are to help your mouth heal after surgery on the hard palate.

SUPPLIES:

Benadryl Elixir - This may be obtained over the counter and is used for the soreness in the mouth. INSTRUCTIONS: Swish 2 Tablespoons in mouth then spit out as needed for soreness in mouth. DO NOT SWALLOW AS THIS CAN MAKE YOU VERY SLEEPY. Mouthwash of choice - (This is used for your own comfort) Use as needed . If bleeding in the mouth should occur, place your thumb directly on the graft site in the roof of the mouth and apply pressure for 10 minutes. Make sure you are sitting up when doing this and not bending over.

Wear your plastic stent at all times. You may remove it as desired for cleaning, but should immediately replace it in your mouth.

Avoid very hot foods as heat can cause bleeding. Avoid foods that have rough edges such as toast or crackers.

Healing takes place in about 5 to 7 days. During this time the graft site may be sensitive, especially when not wearing your stent, but will eventually return to normal.

Ice Pockets
Why Cold?

After surgery, blood vessels leak. This leakage leads to swelling. In order to minimize swelling, it helps to decrease the flow of blood to the swollen area. The more ice you apply and the longer you apply it, the less swelling there will be.

Ice Pockets

Your post-op kit contains the ice pocket. Just wet it, open it, and fill it with crushed ice. Apply this to where you had surgery. It may get wet and drip, but you can catch the fluid with towels wrapped around your head. Leave the ice pocket on as much as you can tolerate for the first 2 days. Don't stay up and put it on during the night, since your sleep is more important. You can, of course, go to sleep with it on your face. Remember, the more you do the ice, the less swelling and black and blue you will have and the sooner you can return to work.

FYI

In order to be adequately cold, something must be wet. If you reach into a bucket of ice and grab a Coke, it is easy. But if you reach into a garbage can filled with ice and water looking for a Coke, it is VERY COLD. You may have to reach in three or four times to get it. The moral of this story is that ice is not as cold as ice and water. The next moral is-DON'T USE ANYTHING BUT THE ICE POCKET TO APPLY COLD TO THE SURGICAL AREA.

Post Operative Instructions For Brow Surgery
Please rest quietly all day following surgery. You do not have to remain in bed. A recliner is OK. You may read if you want or watch TV. Do not take a shower or a bath today. (Make do with a sponge bath if needed.) You may begin showering and wash your hair on the day following surgery unless you have a patch or head covering. You may drink water, clear fluids, 7-Up, clear broth, or tea. You may have a light lunch or dinner as long as you are not feeling nauseated, and you are hungry. You may have your regular diet whenever you feel like eating it. Use the Ice Pocket from your post-op kit to minimize swelling and reduce "black and blue." Use the Ice Pocket for 2 full days after surgery, then switch to the Warm Pocket the next morning, Thursday. Continue the Warm Pocket until all bruising is gone or Dr. Bowden tells you that you may quit. Your post-op kit has some ointment and artificial tears (Bion tears and Duralube ointment) for the eye. Use the tears during the day every 2 hours and use the ointment at bedtime. To put the ointment or tears in the eye, pull down gently on the lower eyelid and placing a drop or a small amount of ointment in the space between the eye and the lid. Put the ointment in the space just like you put toothpaste on a toothbrush. Continue this until your post-operative appointment. You should not use any ointment on the brow incision.

Special instructions for the Use of Pain Medictions
In your post-op kit you will find Tylenol 500 mg. These extra strength caplets should control most of the pain. You may take one or two of these every 4 hours. In addition, you have been given a prescription of

  • Tylenol # 3
  • Percocet
  • Darvocet N-100
  • Lorcet Plus 7.5 mg.

These are for pain that is not controlled by the regular tylenol caplets. You can take 1 tablet every 4 hours as needed. You may take them in addition to the caplets, but do not take more than 8 pills (caplets or prescription medicine) in 24 hours.

If you have any nausea discontinue the medication and call the office.

If you are taking a product with Codeine you may experience constipation. You may take any laxative you are accustomed to using or try some Milk of Magnesia. If you have any questions please call the office.

Warm Pockets
Why Warm Pockets?

The third day after surgery, the blood vessels are no longer leaking. Heat dilates the blood vessels and increases the blood flow through the area. This carries away the black and blue and waste products.

Warm Pockets - How to Make Them

Use the ice pocket from your post-op kit. Get it wet and then heat it in the microwave for 30 seconds to 1 minute until it gets warm, then place it over the face. You also can get a bowl of warm water and dip the pocket in it, wring it out, and then place it over the face. Either way, the cloth will not remain warm very long. You must continually warm the cloth for it to have the desired effect. THE POCKET SHOULD NOT BE SO HOT AS TO CAUSE A BURN-IT IS A WARM POCKET, NOT A HOT POCKET. Some people put dry rice in the pocket and heat this. This will hold the heat longer but may get too hot and require other cloths between the pocket and the face.

Some other things to remember:

After sleeping all night, the eyelids will always be the most swollen early in the morning. Fluid accumulates in the face by gravity. As the day wears on, gravity allows the fluid to return to the normal circulation and leave the eyelids and face. You will frequently be MORE swollen on the second and third post-operative day than on the first post-operative day. Continue using the warm compresses until all the black and blue is gone

Laser Skin Resurfacing After-Treatment Instructions
Immediately After Treatment Areas treated should always be kept moist with Vaseline, applied at least three times per day or so to keep the area glistening.

Follow a daily skin care regimen three times per day as follows:

Splash the face with warm water. Clean the entire treatment area with white vinegar and distilled water mixture (One tablespoon white vinegar to one pint of distilled water). Apply Vaseline to the entire treatment area. The area should remain moist to facilitate healing. Pain Medications

Most patients experience minimal pain with this procedure and do not require pain medication. However, to accommodate individual tolerances, a pain medication prescription may be provided in case you should need this.

Warning Signs

Call Dr. Bowden's office immediately if you develop fever or chills.

Antibiotics

If prescribed, complete the entire course of antibiotics and/or Zovirax.

Crusting/Itching

Crusting that occurs is expected. Do not be alarmed. This will gradually fall off over a seven to ten day period. Do Not remove any crusting because this may cause bleeding or scarring. Itching is a normal sign of healing but if it is intolerable, oral Benadryl may be used according to manufacturer's instructions.

Red Skin Beneath the Crust

The underlying skin is healthy but will have the appearance of red sunburned skin. Don't be alarmed. This color is normal and usually fades after a 2-12 week period. Sun Exposure Direct sun exposure must be avoided. When outside, use a sun screen with SPF 15 or greater. That will further protect you from ultra violet radiation. Excessive sun exposure in the early postoperative period could cause pigmentary changes.

Make-Up/Moisturizer

Make-up can be applied after all of the crusting has resolved - usually seven to ten days. The most effective approach is the use of a green cover stick that can be complemented by a natural overlay. Your usual moisturizer may be used after crusting has resolved. Please feel free to ask if you have any questions.

Excess Skin Pigment

Should you notice any skin pigmentation or browning (this is usually first noticeable 2 weeks or more after resurfacing), call Dr. Bowden's office the next business day. Dr. Bowden may suggest that you begin using anti-pigment liquid. This is applied twice daily for 14 days.