Daniel S. Sellers, M.D.
2010 Utah Doctor of the Year
Plastic Surgeon
Call to schedule a consultation 801-295-6554
Sellers Plastic Surgery
Sellers Plastic Surgery
Sellers Plastic Surgery
Pre & Post Operative Instructions

Abdominoplasty Post Operative Instructions

Liposuction  Post Operative Instructions

Breast Augmentation Post Operative Instructions

Breast Reduction Post Operative Instructions

Breast Lift Post Operative Instructions

Facelift Post Operative Instructions

Blepharoplasty Post Operative Instructions

Laser Resurfacing Pre  & Post Operative Instructions

Rhinoplasty Post Operative Instructions

Carpal Tunnel Release Post Operative Instructions

Basal Joint Reconstruction Post Operative Instructions (please scroll to the bottom of the page)
ABDOMINOPLASTY
Post Op Instructions

Remember that you should not take any aspirin or anti-inflammatory medications for ten days before surgery or for a week after.  Make sure we are aware if you have a tendency for blood clotting in your legs (DVT).
After surgery:

1. Your abdomen will be snugly wrapped in an abdominal binder.  Leave it in place unless when showering.

2. You will have drains exiting from under the binder.  The nurses in the hospital should have shown you how to empty these.  Please record the time and volume emptied from each drain, and bring that record with you to your appointments.  The record should be kept in 24 hour totals.  A drain will be ready to pull when total accumulation in 24 hours is less than 25 cc.

3. You should be out of bed walking the night of surgery, and several times a day thereafter to prevent blood clots from forming in your legs, which could be dangerous.

4. Walk slightly bent over to avoid putting undue strain on your incision.  Stay flexed at the waist in bed also.

5.  You may shower in 2-3 days after surgery.  Keep the shower brief, and lukewarm to avoid lightheadedness.  It is best to have someone with you the first couple of times you shower.  Support the drain bulbs with either an Ace wrap type dressing around your waist or by wearing a pair of panties into the shower with the bulbs resting in them.  Blot incisions dry.

6. Avoid doing anything that will strain your abdomen, such as lifting, straining at stool, etc.

7. Take any prescribed antibiotics until gone.

8. Use pain medication as prescribed when needed.  You should not expect that the pain medicines will completely remove all of your pain, but they will help a lot.  Remember that we do not renew pain medicine prescriptions from 3PM Fridays until 9 AM Mondays, so call earlier if you think you may need a refill over the weekend.  Remember also that narcotics may constipate you, so take stool softeners such as docussate (Colace) to prevent this problem and the straining that may accompany it.

9. Please call Heather at the office (801-295-6554) for a follow-up appointment to see me in the office within the week after your surgery.

10. If you experience unusual symptoms, severe pain, uncontrolled bleeding, etc, call Karen at the office for help, or go to the nearest Emergency Room.


LIPOSUCTION
Post Op Instructions

General
You have undergone a procedure to remove excessive fat cells between the skin and muscle layers.  In general, these fat cells will not regenerate or come back.  It is still possible for you to gain weight, but you will have a permanently changed shape because of the removal of these fat cells.  It is now important to prevent the accumulation of fluids between the skin and the fat and to take care of your general health.

Dressings
You have been placed in a compressive dressing that constricts the skin down against the underlying muscle layer.  Fluids that accumulate in this space between the skin and muscle can become lumpy and bumpy as they congeal, so it is important to minimize the collection and to mobilize that collection as soon as possible.  You should leave your postoperative garments in place 24 hours, 7 days a week, except when showering. The dressings are quite difficult to take on and off; it is best to have help.  Furthermore, the first time you remove them, you may get lightheaded, so they should be removed while you are sitting or lying down and then you should stand up slowly and carefully.

Drainage
You should expect some drainage from the small incision sites for several days.  Place absorbent gauze or feminine protection pads over these drain sites until there is no more drainage.  You should expect some fairly significant bruising in the areas suctioned.

Activity
You should be walking the day of surgery and keep walking a minimum of four to six times a day every day after surgery.  You should not be involved in strenuous activities for three or four weeks, but walking is important to prevent blood clots from accumulating in the lower legs, which can be dangerous and occasionally fatal.

Constipation
The pain of surgery and the effect of pain medication combine to cause constipation in many patients.  It would be helpful to empty your bowels the day before surgery and then to take a stool softener such as Colace or its generic equivalent once or twice each day to prevent constipation after surgery.

Massage
Massage therapy is a very important adjunct to the liposuction operation.  That fluid that will accumulate between your skin and muscles must be mobilized soon after surgery or it may remain to give a lumpy appearance to the skin.  Therefore, beginning a massage therapy program as soon as possible after surgery is critical.  Massage should begin as “lymphatic drainage” in the areas of liposuction with the gradual addition of standard massage techniques as pain tolerance will allow.  Two or three times a week is generally recommended and that would continue until the firm areas are completely treated and the fluids mobilized, perhaps three to four weeks or longer.

Pain medications
We will provide prescriptions for your postoperative pain control at the time of surgery.  If you need a refill on your prescriptions please call us with plenty of notice as no prescriptions are filled between Friday at 12:00 p.m. and Monday morning at 9:00 a.m. Please plan ahead for needed weekend pain medications.  You should also know that certain medications such as Percocet, Demerol, and Dilaudid cannot be renewed over the phone, and you must come to the office and obtain a handwritten prescription, so please plan for that.

Showering
48 to 72 hours following surgery you may shower.  Before showering you will remove all dressings and girdles.  Removing the girdle may cause you to be light headed so please have someone available to help you for your first shower.  When the dizziness subsides you may proceed to take a short, lukewarm shower.  After the shower you should reposition the girdles as they were before.

 


BREAST AUGMENTATION
Post Op Instructions

We have had an opportunity to cover the operation, its risks and expectations through our discussions in the office. Such possible problems as capsular contracture, loss of sensation in the nipple area, bleeding or infection that may require a return to the operating room, irregularity in shape or symmetry, deflation of the implant and general dissatisfaction were covered, and your questions were answered. If you have any other questions now or in the time around surgery please do not hesitate to ask them!

Remember that you should not take any aspirin or anti-inflammatory medications for ten days before surgery or for a week after.

Your surgery will be performed as an outpatient; therefore you will need someone to be available to take you home and care for you until you can do so for yourself.

Some specific instructions for after surgery:

1. Keep your torso elevated to reduce swelling.
2. The day after surgery you can remove all of the dressings (except the steri-strips that are covering your stitches)  and shower.  After showering, apply the breast strap to the same position and no more bandages are required.
3. You may apply iced compresses to your breasts for the first 24-36 hours for pain control and also to reduce swelling and bruising.
4.  Wear the breast strap continuously for the first 3 weeks.
5.  Do not wear a bra for the first 3 weeks unless specifically instructed to do so by me. A camisole if fine to wear.
6.  Refrain from any activity that may increase the pressure in you breast area, such as bending over, lifting, straining, or aerobic exercise.
7.  It is not necessary to massage your breasts unless specifically instructed to do so.
8.  Use pain medication as prescribed when needed.  You should not expect that the pain
medicines will completely remove all of your pain, but they will help a lot.  Remember that we do not renew pain medicine prescriptions from 3PM Fridays until 9 AM Mondays, so call earlier if you think you may need a refill over the weekend.  Remember also that narcotics may constipate you, so take stool softeners such as docussate (Colace) to prevent this problem and the straining that may accompany it.

It is usual for one breast to hurt more than the other, to swell a bit more than the other, to have different sensations than the other, at different times and for different lengths of time then the other, etc.

I will see you in the office within the first few days after surgery, then at 3 weeks, 6 weeks, 3 months, 6 months, and one year, and any other time you may require.  Do not hesitate to call me or my nurse with any questions or problems.

 

BREAST REDUCTION
Post Op Instructions
It is certainly our pleasure to assist you in achieving your aesthetic and reconstructive surgery goals through breast reduction surgery. We have had the opportunity to review thoroughly the operation of breast reduction, the associated risks and expectations, and answer your questions. Should you have any further questions, or feel that your pre-operative preparation yet needs further clarification, please contact the office so that we can clear up any questions you may still have.
We have reviewed the concerns associated with breast reduction surgery: sensation changes of the breast and nipple area, delayed healing of the incision lines, tissue necrosis, asymmetry, bleeding, infection, and general dissatisfaction with the procedure. You have also had an opportunity to review and sign the ASPS-approved consent form. Again, any further information that you may require can be obtained by contacting our office before the day of surgery.

BEFORE SURGERY:
1. Do not take any aspirin of anti-inflammatory medications for 10 days prior to the operation. If you have questions regarding any specific medications, please call.
2. If you would like to obtain your pain medications before surgery, you must call the office the day before your surgery to inquire as to whether this can be done for you. (This may depend on the type of pain medication that must be prescribed.)
3. The facility at which you are to have surgery will call you the day before your procedure to let you know the time you should arrive there. If they have not contacted you by 2PM the day before surgery, you should call them for arrival time and any other instructions.
4. Dr. Sellers will ask you to bring with you to surgery a sports type bra.  It should be the same size circumferentially that you usually wear and which fits a size C breast.  Example: If you usually wear a 38DDD you would bring a sports bra that fits a size 38 C.  This bra is used after surgery in the operating room to hold the dressings in place on the breasts.  This alleviates having to use a lot of adhesive tape that can be irritating to the skin of some patients. The bra should be a soft, knit fabric and should have as wide of a band top to bottom that you can find.  This helps put compression on the sides of the breasts where Dr. Sellers often does a little liposuction to give the nicest final contour to the area.  Black is a good color because it will not show any stains from blood or fluids that may occur during the first couple of days after surgery.  It is also important to have a front opening clasp. One need not spend a lot of money on a fancy, inexpensive label bra for this particular purpose.

THE DAY OF SURGERY:
1. Please arrive at the time requested.
2. Remember you will need to have a responsible adult accompany you home from the hospital or surgery center.
3. Wear a loose-fitting, front buttoning blouse for ease in re-dressing after surgery.

AFTER SURGERY:
1. Showering: You may shower the next day. Remove all dressings except the steri-strips directly over the incisions. Keep your shower short and not really hot, or you may get light-headed in the shower. You will probably need further gauze over the incision line steri-strips for a few extra days.
2. Bra: Wear a bra for three weeks day and night except to shower.
3. Sleeping: Sleep for the first night or two with several extra pillows or in a recliner to help reduce swelling and help with your comfort. You should not sleep on your side or stomach for at least 2-3 months.
4. Activities: Refrain from activities that would increase the pressure in your breast area, such as bending over, lifting, straining, aerobic exercising, etc.
5. Breast Massage: Do not massage your breasts unless specifically instructed to by Dr. Sellers.
6. Follow-up: You must call the office to arrange a follow-up appointment; we would generally like to see you within the first week after surgery, followed by appointments at 3 weeks, 3 months, 6 months and a final appointment at one year.
7. Additional Pain Medications: If you feel you will need more pain medications to get you through a weekend, you must call the office before noon on Friday!
8. What to call the office about: It is perfectly normal for one breast to hurt more than the other, to swell a bit more than the other, to have a different level of sensation than the other, etc. However, if one seems to be significantly more swollen than the other, significantly higher or lower on your chest than the other, or suddenly severely painful, then please contact us directly.
A window will be left in your dressings so that you can check the color of your nipple area.  The color should stay pink, with normal “capillary refill”, which means that you can gently press on the area and see the blood blanch out, then return when the pressure is removed.  Call immediately if the nipple area turns dark blue or purple (congested).  Remember that the sensation may be abnormal yet.

 

BREAST LIFT (MASTOPEXY)
Post Op Instructions

You have just had an operation to lift and shape your breasts. You should follow these instructions to help prevent complications, and to ensure a more comfortable recovery.

ACTIVITY
You will need to get up and walk around several times a day to keep the blood flowing in your legs. This will help prevent blood clots.  Do not attempt any exercise, lifting more than just a few pounds, or even straining for at least the first week or two.  Do not do anything that will increase the pressure in your chest area as this can promote bleeding in the first few days.

SLEEPING
Sleeping and resting with your torso upright will help take the pressure off your breasts and help with swelling.

PAIN MEDICATIONS
Take the pain medication as necessary and plan ahead so that you do not run out at night or over the weekend. (Prescriptions are not normally renewed from Friday afternoon at 3:00 to Monday morning at 9:00 a.m.)  Pain medications have a tendency to cause constipation.  Taking over the counter stool softeners (like Colace) is often helpful.  You may take 2 or 3 capsules a day if necessary.  Also, drinking a lot of fluids is helpful.  You may eat your normal diet, but if you have nausea it is often helpful to start with “beige” foods such as toast, crackers, mashed potatoes, chicken soup, and apple juice.  If the nausea persists a medication may be prescribed for you that can help.

SHOWERING
You may shower 24 hours after your surgery.  You can remove all the dressings that are over the incisions except the steri strips that are directly on the skin.  These should stay over the wounds for about two weeks or until they come off by themselves.  Use warm, not hot, water and be aware that you may be light headed the first time you shower after surgery.  It is desirable that you have someone with you the first time.  You do not need to put further dressings back over the incisions unless they are oozing a little.  The Doctor will have give you specific information if your instructions are different.

FOLLOW-UP
Please call the office to make an appointment with Dr. Sellers.  If you have any questions or concerns please feel free to call the office at 801-295-6554.

 

FACELIFT
Post Op Instructions

Remember that you should not take any aspirin or anti-inflammatory medications for ten days before surgery or for a week after.

After surgery:

1. You will be comfortably wrapped in a soft, absorbent head bandage for the first several days.  Leave it in place.

2. You may use lightweight ice packs over the bandages for 24-48 hours to reduce the swelling and bruising.

3. Sleep in a  recliner for the first 2-3 nights to reduce the amount of swelling and pain.

4. You should avoid hot baths for the first three days, but you may bathe in tepid water the day after surgery if you feel up to it.  Avoid getting the bandages wet.

5. Avoid doing anything that will raise the pressure in you face, such as lifting, straining, etc.

6. Take the prescribed antibiotics until gone.

7. Use pain medication as prescribed.  The pain of facelift surgery is usually not severe.  Remember that we do not renew pain medicine prescriptions from 3PM Fridays until 9 AM Mondays, so call earlier if you think you may need a refill.  Remember that narcotics may constipate you, so take stool softeners such as docussate (Colace) to prevent this problem and the straining that may accompany it.

8. Please call Heather at the office (801-295-6554) for a follow-up appointment to see me in the office within the week after your surgery.

9. If you experience unusual symptoms, severe pain, uncontrolled bleeding, etc, call Karen at the office for help, or go to the nearest Emergency Room.  You may experience an inability to move your facial muscles normally–this is generally just a temporary condition.

 

BLEPHAROPLASTY (Eyelid Surgery)
Post Op Instructions

As we discussed in the office, blepharoplasty is a surgical procedure designed to improve the appearance of your eyes by removing excess eyelid skin and/or fat.  The procedure also may include treating the skin with chemicals or laser to smooth and tighten it.  The result should be a more rested, alert appearance.  We have discussed the risks of the operation, including bleeding, swelling, dry eyes, and even blindness, and have answered your questions.  If you have other questions now or at any time surrounding the procedure, do not hesitate to ask them!
Your operation will be performed as an outpatient, which means you will need someone to attend you the day of surgery-to take you home and assist you there for as long as you may need assistance.

BEFORE SURGERY:
Do not take any aspirin of anti-inflammatory medications for 10 days prior to the operation. If you have questions regarding any specific medications, please call.
 

AFTER SURGERY:
1. Showering: You may shower the day after surgery. Keep your shower short and lukewarm, or you may get light-headed in the shower.  Do not remove the steri-strips until instructed to do so.
2. Elevation: Keep your head elevated to diminish swelling.  This could be accomplished by resting in an easy chair, or lying down with several pillows behind your head.
3. Activities: Refrain from activities that would increase the pressure in your face, such as bending over, lifting, straining, aerobic exercising, etc.  for at least two weeks.
4. Ice: Apply the iced compress to your eyes continuously for 24-36 hours.  You may apply them even longer if you would like.
5. Follow-up: You must call the office to arrange a follow-up appointment about 7 to 10 days following surgery.
What to call the office about: Sudden pain and pressure in one or both eyes.  Sudden bleeding from your incisions (some oozing is expected).  Go the emergency room immediately if vision is lost in an eye.

Additional Pain Medications: If you feel you will need more pain medications to get you through a weekend, you must call the office before noon on Friday!

 

LASER SKIN RESURFACING
Post Op Instructions

Laser resurfacing removed damaged or wrinkled skin layer by layer.  We have discussed in the office the potential risks and anticipated outcome of this procedure.  If you should have any other questions regarding any aspect of this procedure do not hesitate to contact me or my staff.

In preparation for the procedure:

Two weeks prior to your laser procedure:
1.  Keep your face clean and free of sunburn
2. Begin Retin-A Cream nightly
3. Begin Solaquin Forte 4% (Hydroquinone)

Two days prior to the laser procedure:
1. Begin taking Zovirax, 400 mg, twice daily
2. Begin taking the oral antibiotics as prescribed

The morning of the procedure:
1. Do not eat or drink anything for 6 hours before the procedure
2. Do not apply any makeup, creams, lotions, etc.
3. Wear loose-fitting clothing, and a shirt that buttons or zips
4. Remove all jewelry
If you develop a cold, sore throat, or other infection please call the office immediately.

Immediately following the procedure your skin will appear reddened and slightly swollen, much like you’ve gotten a blistering sunburn and the blisters have been removed.
Therefore:
1. For the first evening or two keep your head elevated above the heart level.  Sleeping with two or three pillows, or in a reclining chair works well.
2. If you find it difficult to eat, then just take fluids by straw for the first day, then resume a soft diet after 24 hrs.  You should drink a minimum of 6-8 glasses of fluids per day for the first 2-3 days.
3. Keep your face covered with the EMLA/VASELINE mixture for a least the first 48 hrs.  You may then switch to plain while Crisco or Vaseline for the next 5 days, although most will remain using the EMLA/VASELINE mixture.  Do not let your face dry out!
4. Continue the antibiotics (usually Keflex) and Zovirax (or Famvir) as prescribed.
5. Take pain medicines as needed, not exceeding the prescribed dosage.
6. Remember that narcotic pain medicines are constipating.  Take a stool softener (Colace or Dulcolax) 1-2 days before surgery to prevent problems.  Continue taking it until you are done take the pain medication. Pain medicines are not renewed after 3 pm Friday.
7. Short (2-3 minute) showers with mild soap (even on your face) are permitted each day.  Make sure to re-apply the ointment!
8. ***SMOKING OR BEING SUBJECT TO SECOND-HAND SMOKE SIGNIFICANTLY INCREASES THE COMPLICATIONS OF LASER SKIN RESURFACING.

 

RHINOPLASTY
Post Op Instructions

1. You will experience some bloody oozing from the nostrils for several days.  Do not vigorously blow your nose, but simply gently wipe it to keep it clean.  You may use a saline nasal spray to loosen crusts and for general comfort.  If bleeding is more than an ooze, try keeping your head upright while sitting in a chair, holding ice on the nose.

2. Keep a lightweight ice pack on the nose and eye area for 24-48 hours to reduce the swelling and bruising.

3. Sleep in a  recliner to for the first 2-3 nights to reduce the amount of swelling and pain.

4. The splint must remain on until it is removed in the office, usually at about 10-14 days.  The splint is then worn at night for another several weeks.

5. Packing left in the nose by Dr. Sellers should be removed within the first two days after surgery.  Remove it yourself by gently grasping the end and pulling slowly.

6. You should avoid hot showers or baths for the first three days, but you may bathe or shower the day after surgery.  Avoid getting the splint wet as much as possible.

7. Take the prescribed antibiotics until gone.

8. Use pain medication as prescribed.  The pain of rhinoplasty is usually not severe.  Remember that we do not renew pain medicine prescriptions from 3PM Fridays until 9 AM Mondays.

9. You need to call Heather at the office to set up your follow-up appointment, which should be set at about 10 days after your surgery.

10. If you experience unusual symptoms, severe pain, uncontrolled bleeding, etc, call Karen at the office for help, or go to the nearest Emergency Room.

 

CARPAL TUNNEL RELEASE
Post Op Instructions

You have just had (or are about to have) surgery to correct a common problem-carpal tunnel syndrome.  The surgery has released a tight and very strong ligament that formed the “roof” of your carpal tunnel.  One of several surgical approaches has been used: an endoscopic approach, which has left you with a small incision on your wrist, an open approach using a vertical incision in your palm, or an open approach using both an incision transversely at your wrist plus a small incision vertically in your mid-palm.

Now that the actual surgery is completed, you become a key player in ensuring a rapid and successful outcome.

1.  ELEVATE your hand above the level of your heart for the next 48 hrs.  Pillows stacked by your bed or couch are most comfortable.  A special foam rubber block may be provided for this purpose.
Elevation is the most important thing you can do right now to help your hand recover!  Swelling slows the healing process, creates stiffness, and increases the chances for infection.

2.  SPLINT.  Your hand and wrist have been splinted for your comfort.  The splint has left your fingers free although your thumb may be held palmarward to take tension off your incisions.  You may remove your splint, along with all the dressings (except the small tape or steri-strips across the wounds) to SHOWER the day after surgery if you would like to shower.  For your comfort you should wear the splint all the time for the first 3-4 days. Thereafter, wear the splint at night for another three weeks.

3.  MOVE your fingers and thumb gently and often to prevent stiffness and adhesions within the carpal tunnel.  Concentrate on moving each individual joint separately from all the other joints in the hand several times each day.

4.  CLEAN.  If you have an incision in your palm, you may wash the hand in soap and water, or hydrogen peroxide to remove any blood or surgical soap as needed.  Showers are acceptable; however, do not soak your hand until the day after the sutures are removed if you have had an open carpal tunnel release.  If your release was done endoscopically your sutures are dissolvable and do not need to be removed.

5.  MEDICATIONS.  You have been given a prescription for a pain medication.  Take the medicine as directed when needed.  If you have any problems with your medications, or need a refill, call the office and talk to Karen during regular office hours.  Prescriptions are not refilled between 3 p.m. Friday and 9 a.m. Monday.  Remember that narcotics may constipate you, so take stool softeners such as docussate (Colace) to prevent this problem.

6.  FOLLOW-UP with me in the office in about 9-14 days.
You must call the office to make the appointment: (801)295-6554

7.  RETURNING TO WORK.  You may do light work with your hand to your comfort level, but only after the swelling has gone and the hand is fairly comfortable when held below your heart level.  Check with me before returning to your regular job if it require any heavy lifting or strenuous repetitiuos movements.

8.  PILLAR PAIN.  You WILL have pain in the heel of your hand which may last for several weeks to several months.  This is called “Pillar Pain” because it arises from the attachment of the muscles in your hand to the pillars of bone which support the transverse carpal ligament which is cut during the operation.  This pain will eventually go away.  You may use the hand despite this pain, just use wisdom in not aggravating the pain unduly or it will last even longer than it would otherwise.

If you experience unusual problems that may need immediate attention, call us at the office for help or go to the nearest Emergency Room.

 

BASAL JOINT RECONSTRUCTION (LRTI)
Post Operative Instructions
1.  The operation takes about 1 ½ hours to complete.  You will have a splint.
2.  You should not eat or drink anything the day of surgery until after surgery.
3.  You will need to have someone there with you who can understand instructions and take you home.
4.  Elevation of the hand is CRITICAL to prevent swelling and infection.  You will be given a foam rubber block to assist you in keeping your hand elevated ABOVE YOUR HEART LEVEL.  The block is not what is important-elevation is.  You may use pillows or anything else if the block is not convenient for you.
5.  You must call the office to make a follow-up appointment for within one week after surgery.  We will change your splint to a cast at that time.
6.  IF THE SPLINT received at surgery SEEMS TOO TIGHT (you are swelling and you may need better elevation), you may CAREFULLY cut the soft part of the wrap along the back of your forearm and hand down to the skin to loosen it, then tape it back to hold it on until your appointment.
7.  You may wiggle your fingers and thumb within the splint or cast.
8.   If you think you need additional pain medications for a weekend, CALL BEFORE FRIDAY AT 2 p.m.
9.  If you experience uncontrolled pain, fever, or think you might have an infection then call the office right away, or go to the emergency room for help.
10.  Your hand will be immobilized for 4-5 weeks.  You will then be referred to a Certified Hand Therapist for an additional month of different removable splints along with movement and strengthening therapy. 
Sellers Plastic Surgery