• What can I expect after surgery?
• Call the Office promptly if you notice any of the following
• How do I care for myself after surgery?
• Recovery timetable

What can I expect after surgery?

After the peeling pain should not be a major problem for you. The skin often feels like it has been lightly sunburned.

Within 48-72 hours, the top layer of the skin will become brownish, dry out and start peeling. It is not unusual to have some slight drainage or sipping for the first few days after surgery. This will most often significantly improve or disappear by the end of the first week.

Peeling will be complete around day 5-7.

For optimal healing always keep your skin moist during the first week.

After 5-7 days, the skin will appear slightly pink, a sign of your new skin. You may use a commercial non-allergic moisturizer such as Cetaphil to keep your skin moist. If you plan on being outside, wear sunscreen.

Call the office promptly if you notice any of the following:

• Development of a temperature elevation exceeding 101.0 degrees.
• New onset of pain.
• Development of cold sores, or small blisters on the resurfaced skin, or development of yellow discharge.

If any of the above should occur after regular office hours, do not hesitate to reach Dr. Siegel directly on his cell phone at 832-265-1935. For whatever reason if you notice one of the above changes and cannot reach us at our office or through the answering service, present yourself to the emergency department for evaluation.

How do I care for myself after surgery?

Make arrangements to have someone drive you to, and from, your surgery.

Having someone stay with you on at least the first night after your surgery is highly recommended.

Be sure to fill your prescriptions before your surgery since you will start taking some of the medications before the procedure. You will receive an antibiotic, an antiviral, and pain pills.

You should also purchase the following supplies prior to surgery:

• A new tub of CRISCO.
• Cetaphil facial wash and Cetaphil moisturizer.
• Hibiclins liquid soap and or shampoo.
• We will provide you with tongue blades

Arrive for your surgery in loose comfortable clothing. Your top should button or zip rather than pull over your head. Use the medications only as prescribed by the office.

Start taking the antiviral the night before your surgery. After the surgery, try to avoid taking pills on an empty stomach.

Start taking your antibiotic after your peel and after you have had your first meal.

If concomitant surgery will be performed with your chemical peel avoid any aspirin or any anti-inflammatory compounds for 2 weeks before and 2 weeks after your surgery.

If you have only mild discomfort, you may use plain Tylenol (acetaminophen). Instead of pain pills.

If you are a smoker, you should avoid any nicotine, including nicotine patches 3 weeks before and after surgery. Tobacco inhibits your circulation and can significantly compromise your surgical outcome.

You should thoroughly wash your hair with an antibacterial shampoo or soap, such as Hibiclins, (available in drug stores) the night before surgery.

After the peeling, the treated areas may blister and peel (usually takes 24-72 hours). It is critically important to always keep the treated areas moist, they should never be allowed to dry and form crusts. Starting on day one apply CRISCO to the peel areas to ensure your skin is moist at all times-usually 3-4 times per day. Only use the tongue blades for application. (Do not use your hands as they may carry over bacteria to your face).

It is not uncommon to experience some itching as the treated skin heals. This commonly occurs between 5 to 7 days. You may take Zyrtec, or Allegra if the itching bothers you. You may also use benadryl to ease the itch (follow product instructions). Note that Benadryl will cause sedation. It should generally not be used at the same time as sleeping pills or pain pills. If in doubt, ask your pharmacist. It is not unusual for patients to get itchy at night while they are sleeping. This can cause scratch marks on the healing skin that will slow healing. Wearing bulky mittens (with no finger pockets) to bed may decrease this problem.

Sleep with the head elevated for 1-2 weeks after the peel.

Between 2 weeks and 2 months after the surgery, it is not uncommon to note the presence of what looks like white heads on the treated areas. These are, in fact, milia. They represent areas where fresh epithelium has overgrown the underlying glands. They may be gently scrubbed and removed. If you are having trouble removing them, we will be happy to help you in the office.

You should not do vigorous exercise and should avoid any significant physical exertion, lifting, or straining for a minimum of 2 weeks after your surgery, Plan on taking it easy.

Do not rub or massage your face until after you are examined and told it is all right to do so.

Likewise, do not wear make-up until your surgeon says that it is all right to do so. Generally, you will be able to cover the treated areas with make-up within 10 to 14 days. At this time the skin will be fully resurfaced (no weeping, blistering, or breaks in the skin).

You will find that make-up is somewhat more difficult to apply to the treated areas. They are, in fact, so smooth, that the make-up will often almost slide off. We will suggest certain products if you are having this problem.

Contact lenses should not be worn for the first 7-10 after peeling surgery to the eye area.

You should avoid the sun and use sunscreen with at least SPF 15 for six months after peeling surgery. Sun exposure may lead to hyperpigmentation or excess darkening of the treated areas.

Although this is generally treatable with pigment gels, they may take a while to work. Therefore, avoid the sun. If at all possible. Broad-rimmed hats are also quite useful in this regard.

Your skin will be lightly red after the procedure. This is to be expected. The redness will gradually fade and begin to return to a more normal color around the second to third week after surgery. However, some residual pink or light red color will persist for up to 6 to 12 weeks. The length of time it will take for a complete return to normal coloration is variable. Generally, persons with red hair or freckles will be red for somewhat longer periods than other people.

Retin-A, glycolic, and vitamin C preparations should not be used after the surgery until you are instructed to do so. Generally, you should start back on this regimen 4 to 6 weeks after the surgery. This should be a gradual process. The Retin-A should be started first and used alone for 2 weeks. Then, the glycolic products should be added 2 weeks later. Finally, the vitamin C preparation is added a further 2 weeks after that. Using this skin care regimen will enhance your surgical results and help restore damaged skin.

You will notice that the treated skin looks smoother and generally more youthful at 2 to 3 weeks after the surgery. It will look even better in a few months as the effects of the peel act to slowly tighten the skin’s collagen.

Recovery timetable

Approximate recovery after chemical face peeling is as follows:

DAY 0 Return home. Treated areas may begin to swell and the areas may look pink to red.

DAY 2 May shower. Ensure to thoroughly wash your hands before washing your face, or use a fresh towel each time to gently wash your face using the Cetaphil soap.wash you handsStart soaks with peroxide once upper layers of skin Apply CRISCO after you shower using the tongue blades, and repeat this throughout the day to keep the skin areas moisturized.

DAYS 2-3 Skin will start turning brown and sloughing off. Allow the skin to fall off on its own, and do not attempt to pull it off.

DAYS 5-7 Skin peeling will be almost complete. May start to itch. Skin will appear lightly pink. May stop CRISCO and start Cetaphil moisturizer, or equivalent.

DAYS 10-14 Usually the skin is fully resurfaced by now. May start using makeup if approved by Dr. Siegel.

WEEKS 6-12 Your new skin will be sensitive, ensure the use of sunscreen and and hat if you will be outside.

3 MONTHS Enjoy your results and avoid the sun. You should be back on Retin-A, glycolic acid, and the Vitamin C preparation.

REMEMBER: If you have any concerns or questions, please contact our office at any time. Our office should be a source of information and reassurance throughout this entire experience, from the time of your first consultation to after your surgery.