Chin Surgery in Boston

• In the week before your Chin Surgery (Genioplasty) or Facial Implant Surgery:
  • Consider eating pineapple, it may help reduce bruising
  • Consider supplementing with Arnica montana, it may help reduce bruising
  • Complete household chores and prepare meals for the first few days of postoperative recovery
  • Follow preoperative instructions with eating, drinking, and medications
• Postoperatively, get out of bed and walk (with assistance) every few hours after your operation to decrease the chance of postoperative problems such as blood clots.
• Practice 15-20 deep breaths every hour to keep your lungs open.
• After Chin Surgery (Genioplasty) or Facial Implant Surgery, it is important for you to have someone available to stay with you for the first 24 hours, as you may feel drowsy. You may require help the first few times you get out of bed.
• Please take your medications as directed by Dr. Taylor or Dr. Sullivan to manage discomfort or symptoms.
  •  Acetaminophen (Tylenol) 1000 mg every 8 hours, space doses 4 hours after Ibuprofen so one or the other is taken every 4 hours 
  •  Ibuprofen (Motrin) 800 mg or Colecoxib (Celebrex) 200 mg every 8 hours, space doses 4 hours after Acetaminophen so one or the other is taken every 4 hours 
  •  Gabapentin 300 mg every 8 hours for 7 days 
  •  Vitamin C 500 mg daily for 50 days
  •   Oxycodone 5 mg – 1-2 tablets every 6 hours as needed for pain, though many patients may not need it
  •   Colace 100 mg twice daily to prevent constipation, it is important to have a bowel movement each day 
  •  Zofran 8 mg every 8 hours if needed for nausea 
  •  Scopolamine patch may be placed on the neck on the day of surgery and can stay for 3 days to prevent nausea 
  •  Peridex 15 cc swish and spit in mouth twice daily for one week

DIET AND WOUND CARE

• If there are incisions inside your mouth:
• They will be closed with dissolving stitches but the repair is delicate for several weeks after surgery. In order for the repair to heal well, do not eat hard or crispy foods, such as hard toast, potato chips, bread sticks, pretzels, or hard candy. Hard foods could damage the repair.
• Your diet after surgery will progress as follows: Day of surgery and Day 1 after surgery: clear liquids. Some examples are apple juice, water, jello, cranberry juice, popsicles (take off the stick), or clear broth. Days 2-7: full liquids. Some examples are milk, yogurt, thin cooked cereals, puddings, ice cream, creamed soups, and thinned pureed foods. Day 7 to 14: soft foods. Some examples are mashed potatoes; cereal soaked in milk, cooked vegetables, finely ground meats, pasta, bananas, or canned fruits.
• Rinse the mouth with peridex rinse or saline, at least 4 times a day, and after any oral intake. Do not use peridex for more than one week.
• If there are no incisions inside your mouth, only under the chin:
• Most wounds will be closed with absorbable sutures and skin glue. The skin glue forms a barrier to water. Over the skin glue you may have Steri-Strips (white or tan tape). Please do not remove the Steri-strips. Leave them in place until they fall off on their own.
• Your diet may advance as tolerated back to a regular diet
• You may have a head wrap to help reduce swelling. This can usually be removed the day after surgery. 
• You may shower or sponge bath the day after the operation and wash your hair and your face per your usual routine. 
• Elevate your head and shoulders and when in bed keep your head elevated about 30 degrees (two pillows under your head and back) to help with the swelling. 
• Do not smoke or expose yourself to smokers or nicotine as nasal skin and wounds can be compromised. 
• You may apply ice packs to the face for the first 48 hours to reduce swelling and bruising. Bags of frozen peas and corn make for excellent ice packs. You might also consider Icewraps Gel Packs or Swiss Safe gel packs, which can be ordered from Amazon or online. Apply the ice packs for 20 min of each hour while awake. 
• Cosmetics can be worn on the face as early as 1 day after surgery.

ACTIVITY

• For the first week following Chin Surgery (Genioplasty) or Facial Implant Surgery, raising your blood pressure and heart rate can cause bleeding. Avoid straining or vigorous activity. We recommend walking 2 to 3 times per day for 15 minutes.
• Please do not drive with swollen eyelids or while taking pain medications such as oxycodone. 
• Do not lift anything heavier than 10-20 lbs, run, lift weights, or perform strenuous exercise for 3-5 days after Chin Surgery (Genioplasty) or Facial Implant Surgery. 
• Please wait at least 3 to 4 weeks after Chin Surgery (Genioplasty) or Facial Implant Surgery to start massage to avoid increased swelling. Massage can help increase circulation and soften firm areas. 
• Avoid contact sports for 2-3 weeks following Chin Surgery (Genioplasty) or Facial Implant Surgery.

GENERAL OUTCOMES

• Moderate swelling and bumpiness is to be expected and will increase for 48 to 72 hours. Lips can become particularly swollen. Much of the swelling usually resolves within the first few weeks after Chin Surgery (Genioplasty) or Facial Implant Surgery though some mild swelling can take several weeks to months to resolve. You may get black and blue bruising under your eyes, cheeks and neck. Please be patient. The swelling and feeling of tightness will gradually subside over the following weeks. 
• Tightness of the skin and fuller appearing facial features is also normal and will smooth out as the swelling resolves and the tissues soften. 
• Tingling, itching, and numbness are all normal after Chin Surgery (Genioplasty) or Facial Implant Surgery. Tingling and itching are signs of healing and will resolve. Sensation to the skin may return gradually and slowly over several weeks, though some areas may always have loss of or decreased sensation. Please be patient and avoid resting against hot surfaces, which can injure or burn the skin. 
• Scars and tissues take one full year to mature. You may notice that they become red, raised and firm for several weeks to months before becoming soft, flat and pale. Avoid Vitamin E as it can irritate the skin and scars. Mederma has no proven benefit and is not worth the expense. All incisions will be sensitive to sunlight during the healing phase. Direct sun exposure or tanning booths are to be avoided. Silicone cream, such as Biocorneum Advanced Scar Treatment, or skin moisturizer with sunscreen and gentle massage may be helpful. 
• Chin implants are made of porous polyethylene and held in place with micro titanium screws. Chin advancements are held in place with micro titanium plates and screws. You do not need to take prophylactic antibiotics with future dental treatments. The implants do not set off metal detectors at the airport or elsewhere. 
• Please call our office (617-492-0620) if you have:
• Continuous bleeding
• Significantly more swelling on one side of the face when compared to the other 
• Worsening facial or neck pain 
• Fever, spreading redness, or irritation of the skin or scalp
• Shortness of breath

It is important to be seen by Dr. Taylor or Dr. Sullivan after your operation. They will see you in follow-up appointments at 1 week, 3-6 months, and 1 year or as often as needed post-op. Call to schedule your appointments at Taylor & Sullivan Plastic Surgery office at (617) 492-0620 between the hours of 8:30 – 5:00 or visit our webpage at www.massplasticsurgeons.com. We are always available for postoperative concerns or emergencies and can be reached through our paging service 24 hours per day at (617) 492-0620.