Merkblatt

Report as inappropriate Your report has been received

Shared by: benbenzhou

Tags

Stats

views:: 0
posted:: 12/5/2012
language:: English
pages:: 5

Public Domain

Document Sample

Dear patients,

we want to make your intended nose job (rhinoplasty) as safe as possible. In order to achieve the desired result,
we kindly ask you for your support in respecting the following points.

About 3 weeks before the operation the following examinations and conversations are necessary:

• 3-4 weeks before the operation: Examination at family doctor/internist with body check-up and blood
withdrawal (you will received an adequate letter for this purpose)
• about 1-3 weeks before the operation: Examination by the operating ENT doctor
(you will receive a referral from us)
!!! Please note that older diagnostic ﬁndings are invalid

• about 2 weeks before the operation: preliminary operation talk in Dr. Berkei's medical practice at
Rossmarkt 13, 60311 Frankfurt

!! Please carefully read through and ﬁll out the brown information folder and bring it with you including all
papers (operation's declaration of consent, patient information sheet, etc.); Please write down any further
questions concerning the intended operation and and discuss them in course of the operation talk.
!! Please bring all diagnostic ﬁndings of the preliminary medical examinations we requested.

• about 2 weeks before the operation (only for operations planned at the “Klinik Maingau”!):
attendance at the open anesthetic consultation hours at “Klinik Maingau” (no application required)
!! Please bring the yellow declaration of consent concerning the anesthesia as well as your blood values.

Klinik-Adresse:

Klinik Maingau
Scheffelstraße 2-16
60318 Frankfurt
Tel. reception desk: 069-40330/403323

Anesthesis counsultation hour:

Monday-Thursday 2.30 p.m. - 4.00 p.m.

1. In consultation with your family doctor all medication affecting blood coagulation (amongst others ASS,
Aspirin, Markumar, Heparin, Togal and vitamin E) has to be stopped being taken 14 days before the operation.
2. Do not intensively expose yourself to sunlight and do not visit the solarium. This can cause swellings and
negatively effect wound healing.
3. All medication relevant to you will be subscribed by us.
4. Avoid the consumption of alcohol as well as nicotine on the day and evening before the operation.
5. Please step back from smoking 14 days before the operation, as smoking disturbs and delays the process
of healing.
6. In case of an outpatient treatment at the operation centre please plan a stay of 6-7 hours in order to rest
under observation after surgery.
7. For patients from outside the region we gladly assist the arrangement of an overnight stay at the “Klinik
Maingau” or in one of the afﬁliated hotels (only accompanied by a contact person).

In the evening prior to the operation:

1. Remove all facial make-up and wash your face the usual manner.
2. Do not apply face cream or oil.
3. It is recommended to wash your hair in the evening prior to the operation.
4. At about 6pm a disinfection followed by a thrombosis prophilaxis in the form of a pre-packaged syringe
is administered. For this an area with sufﬁcient fat tissue serves best (e.g. abdominal skin fold or inside of
the thigh). The syringe is handed out latest during the preliminary operation talk. The exact procedure
will be explained to you by our medical staff. In case of problems concerning the independent administ
ration please timely consult your family doctor or our staff.

On the day of the operation:

1. Do not eat or drink anything (unless we have reached another agreement) in the morning before the
operation (all together about 6h before the operation). Take your permanent medication (apart from
aspirin, ASS etc.) as usual with a mouthful of water.
2. Please acquire our prescribed medication in a pharmacy beforehand and bring it with you on the day of
the operation.
3. Wear comfortable clothes that you can easily pull over your head (preferably no tight t-shirts or pullovers)
4. Do not use any kind of make-up.
5. When arriving at the operation centre (in case of outpatient treatment), please leave the name and
phone number of the person picking you up with the sisters at the reception desk.
6. In case of a stationary treatment please get in touch with the reception desk (“Klinik Maingau vom Roten
Kreuz”) at the agreed time on the day of the operation.
7. Please leave jewelry, cell phones and other valuables at home.

1. Expectedly (in case of outpatient treatment) you can be picked up either in the evening following the
operation or in the morning after the visit at 10am (please do not drive yourself).
2. At night you may use two pillows to rest you head in a higher position.
3. Please do not face your head downward within the ﬁrst 7 days. After 3 days you can wash your hair, prefe
rably in a shower.
4. Please abstain from smoking for the ﬁrst 14 days after the operation.
5. What is to be expected after the operation?

• Swelling of the eyelids and nose
• red and blue skin around the eyes caused by the hematoma

These symptoms especially the skin's discoloration are to be expected within the ﬁrst 7 to 10 days. A small amount
of blood can come from the nose for the ﬁrst 3-5 days.
The possibly attached external splint has to stay located for at least 7 days by all means. An untimely removal can
negatively inﬂuence the shape of the nose. Please strongly avoid getting the plasters wet as this can loosen the
bandages.
.

6. How can the nose be cleaned during the ﬁrst 7 days?

• A cotton bud soaked in lukewarm water serves most suitable. Avoid heavy snorting as this might
cause heavier bleedings.

After-Treatment:

Because you will be breathing trough your mouth for several days after the operation the mucous membranes are
likely to dry out.

1. What can be done against a dry mouth?

• Place a humidiﬁer or waterbowls in your bedroom.
• Fequently cream your lips

2. Please keep in mind that the nose's bone structure doesn't solidly heal until 6 weeks after surgery. You
shouldn't go in for sport in this period of time.
3. Information for wearers of glasses:

• It is advisable to wear contact lenses for about 6 weeks (no spectacles or sunglasses).

Dr. med. Julia Berkei Specialist for plastic and aesthetic surgery
Practice for plastic surgery at the Goetheplatz Roßmarkt 13 / 60311 Frankfurt am Main
Tel +49 (0) 69 92 02 00 96 Fax +49 (0) 69 92 02 00 93 Mail info@berkei-aesthetik.de Web www.berkei-aesthetik.de
Generally checkups take place on the 1st, the 3rd, the 7th and the 14th day after a nose job. After this further
checkups follow in bigger intervals. In case of emergency we can be reached at all hours during the immediate
post operative phase. The appropriate numbers will be handed out.

Please take the following medication after the operation (to be ﬁlled in by the doctor):

Painkillers: Ibuprofen 600 mg, 1 tbl. mornings - midday - evenings
Novamin-Sulfon drops 30 drops every 4-6 hours
Tramadol drops 30 drops every 4-6 hours

Antibiotics: Panoral 500mg, 1 tbl. mornings - midday - evenings

Antithrombosis: Clexane 20 mg in the evening before surgery 6 pm subcutaneous
Clexane 40 mg (into fat tissue) eg. abdominal skinfold

Decongestants: Bromelain 200 mg 2 tbl. mornings
Arnika C 200 let 3 globes melt under tongue in the evening

Wound care: Coldastop nosal oil 2 x daily 2 drops in every nostril
Rhinomer-soft-nasal-rinse 3 x daily from the 3rd day after surgery
Bepanthen-eye-noseointment apply mornings and evenings on
nosebridge/nostril scar

After every nose job heavy swellings or hematoma can partially develop on nose, cheeks and eyelids.
Occasionally such bruises can last for a longer period of time. Secondary bleeding are rare and generally unprob-
lematic. Operative hemostasis is only required in exceptional cases.

Very uncommon are injuries

• of the tear duct (with continuous tears), which can necessitate follow-up surgery
• of the sensory nerve (furry sensation in the cheek area)
• of the olfactory nerves (olfactory disfunction) or
• of the skull base with the emission of cerebral ﬂuid; because of the risk of a meningitis a follow-up
surgery is necessary

Only exceptional cases lead to infections of the soft tissues, the cartilage and the bone, which can require medi-
cal treatment (eg. antibiotics) or follow-up operation.

Generally smokers suffer from a greater risk of infections and wound healing disorders.

Very rarely excessive bone regeneration occurs in the area of the bone cuts resulting in a broadening of nose's
bone structure. Occasionally the bone's cutting edge can be palpated.

Even provided normal wound healing the scars of an external transection can remain hardened at ﬁrst. In the
course of time though they will fade and become soft and inconspicuous.

Because the operation necessitates the transection of skin nerves a parethesia (e.g. numb or prickling sensation)
in the nose tip can often not be avoided. These sensational disorders mostly clear away after a few weeks, but
sometimes not entirely.

A dry sensation in the nose can make an ointment treatment necessary.

Due to internal stress implanted cartilage can bend or in rare cases be broken down by the body. This risk rises in
use of a bone transplant. Corrective surgery can be required.

If the nasal septum is additionally corrected, it can bend or shift from the middle anew after the operation. Occa-
sionally a link (hole=septumperforation) between the left and right main nasal cavity can cause a whistly breathing
noise, stronger crust formation or repeated nose bleedings. An operative closure mostly successful only with
small or middle sized perforations can be required.

Dr. med. Julia Berkei Fachärztin für Plastische und Ästhetische Chirurgie
Praxis für Plastische Chirurgie am Goetheplatz Roßmarkt 13 / 60311 Frankfurt am Main
Tel +49 (0) 69 92 02 00 96 Fax +49 (0) 69 92 02 00 93 Mail info@berkei-aesthetik.de Web www.berkei-aesthetik.de