Prior to your consultation visit, our office will have asked you to complete the medical history questionnaire and bring it with you. Be sure to list and describe any medical condition(s) you have had in the past or have presently. Please list all of your previous surgeries. Please also list all allergies and all reactions you have had to foods, medicines, synthetic products, latex rubber, soaps, ointments, surgical tape adhesives, etc. In addition, carefully list all medications, vitamins, aspirins, ibuprofens (Advil, Motrin, Nuprin), antihistamines, decongestants, or any medication for skin conditions you currently take or use, and what you have taken within the last six months. Be sure to include all dosages of each medication and how often you take them. During your visit we will discuss your desires and the conditions you wish to have corrected or improved. This will be followed by an examination and an analysis of each condition. We will give you an idea of what we believe can be accomplished in your particular situation. The expected improvements of each procedure will be discussed along with the limitations, risks and alternatives. Please ask any questions that may concern you about the proposed surgical procedure. During that first visit, we will take a set of medical photographs as we previously discussed. This is to help us accurately record the existing condition or problem and to allow us a means for comparison after surgery is complete. Patients who have time schedules to meet, such as returning to school or work, vacation or other commitments, should advise our scheduling staff. If you are interested in surgery as soon as possible, we need to know so that a period of time can be reserved in the surgery schedule for your procedure. Preliminary tests such as blood counts, x-rays, EKGs, and consultations with other medical specialists also may be necessary prior to surgery depending on your specific condition.

We may ask you to return to the office at least once prior to surgery to further discuss the proposed surgical improvements. This may be particularly true if we have asked you to see another physician or obtain other medical consultations. Should you desire an additional visit before undergoing surgery, please contact our office staff and schedule another office visit. If the surgery is planned long after your initial visit, we may ask you to return to the office prior to surgery to conduct a more recent evaluation, to update laboratory and other tests, to review and refresh your memory, and to answer any new questions you may have.

We ask that you not take any aspirin, ibuprofen or any drugs containing aspirin compounds, or vitamin E over and above what already is in a multivitamin, for two weeks prior to surgery. These medications can prolong bleeding and increase the risk of post-operative hemorrhage. Medicines that contain acetaminophen (i.e., Tylenol) can be used safely in place of aspirin for pain. They are available without a prescription. We also ask patients who smoke to refrain from doing so for two weeks before and two weeks after the surgery. The nicotine contained in the tobacco causes constriction of the blood vessels which supply nourishment to the skin and underlying tissues. Any restriction of this blood flow will jeopardize the healing process and lead to a less favorable outcome from the procedure. Surgery can be stressful. Do not try to wedge in your procedure between multiple trips and other commitments. Give your body and yourself time to adequately prepare for, and recuperate from, the effects of surgery. It is important and helpful for you to be well-rested and relaxed pre-operatively. In this way, your body will be better able to handle the stress of surgery.

Do not eat or drink anything, including water, after midnight the night before your surgery. Wear comfortable clothes that button down the front (i.e., no pullovers or turtlenecks). Leave your valuables at home and please do not wear jewelry. Shower and shampoo either the night before or the morning of the procedure prior to checking into the outpatient facility. For those patients undergoing browlift or facelift procedures, we advise leaving the cream rinse/conditioner in the hair and letting it dry without rinsing it out. This will facilitate the first post-operative shampoo which we will perform in the office. For your own safety and comfort, do not wear any facial or eye make-up the day of surgery. Wash your face thoroughly with a mild soap (Ivory or Neutrogena) and warm water. Do not wear contact lenses. If you wear dentures, keep them in. On the morning of your surgery, you will be admitted to the OHSU DayStay area. You will exchange your street clothes for a hospital gown. An intravenous line will be placed, through which you will receive pre-operative medication. A nurse from the Outpatient Surgical Suite will transport you to the operating room. Your nurse will be with you during the entire procedure and can answer any questions you may have. Medication given in the operating room will be administered through the I.V. There will be no shots. Be sure to arrange for someone to pick you up after your procedure, as you still may be somewhat affected by the anesthesia. We will not, under any circumstances, allow you to drive yourself home.

Following your surgery you will go to the recovery room until you become alert enough to return to DayStay. The DayStay nurses will give you specific care instructions. You will remain in DayStay until you are discharged later in the day by your physician. Upon discharge you will receive a set of discharge instructions to follow at home. These are very important and should be followed very closely. You also will receive any prescriptions for medications at this time. The medications you receive will allow you to be comfortable and relaxed. Upon discharge, be sure to have someone available to take you home who will remain with you for the first 24 hours. If you are hospitalized for surgery, you can expect to be discharged the following morning. Patients who live outside the Portland Metropolitan area must plan to stay in Portland the night of surgery for their safety and convenience. Our staff would be happy to assist you in making local hotel arrangements and arrangements for private duty nurses as needed. Patients who live out of state may desire to remain in Portland for several days, depending upon the procedure performed and when post-operative visits are required. During the first post-operative checkup, you will be given instructions on how to take care of the surgical area as well as instructions on taking any medication during the healing period. A return appointment also will be scheduled at that time. All sutures and surgical clips usually are removed during the first week after surgery. Subsequent appointments will be scheduled at two or three months, six months and one year until the healing process is complete. It is most important for you to keep these appointments since they are vital to ensuring the best possible results from your surgery. It is our policy that patients are not charged for routine post-operative visits when they have paid their surgical fee in advance. It is your responsibility to assist us in monitoring the healing process and to call us and see us when a problem or concern arises. Finally, please remember that the foregoing discussions are general in nature. The specific details relating to your individual needs will be thoroughly discussed with you. Always keep in mind that following plastic surgery, it frequently takes time for the intended final result to become apparent. Be patient while your body goes through the process of healing. Not infrequently we will be able to make suggestions for a more rapid improvement. A successful outcome results from a combination of three variables: 1) your general health and your body's ability to heal; 2) the competence of your facial plastic surgeon; and 3) your cooperation and determination to follow all instructions, both pre- and post-operatively.