Facelift


Pre-op Meds: Ancef or Clinda

Anesthesia: GETA wired or sutured w 0 silk to 1st premolar if there is no crown

photo-5


Patient position: supine, one arm tucked

Bed position: turn 90 degrees

DVT ppx:  compression boots on and working BEFORE induction of anesthesia

Lights: Headlight and Fiberoptic lighted retractors

Bovie Settings: colorado tip, 20/20; Bipolar that activates when tips touch (Stingray) 10

Pre-Prep Injection: none

Prep: Chlorhexidine in hair, iodine on face. After prep, hair in ponytail

Drapes: head drape (3/4 drape & 2 blue towels down after prep, wrap head in superficial most blue towel, staple, towel off face, split sheet

Instrument sets: Spear facelift tray

Special Instruments: Fiberoptic lighted retractors

Special supplies on field: Methylene Blue with marking pen

Devices/Implants: Tumescent cannulas and machine

Anesthesia on field: 500cc Tumescent (300mL NS, 30mL 1% lidocaine, 2mL of 1:1000 epi), 27 gauge w 1% liodocaine 1/100k epi 20cc

Drains: 10 Blake

Suture: 4-0 Ethibond on SH taper needle, 2-0 PDS on SH, 3-0 Monocryl on SH, 4-0 Monocryl on SH, 5-0 Monocryl on SH, 4-0 chromic gut, 6-0 prolene

Dressing: Antibiotic ointment, xerofrom strip gauze, ABD x 3, Kling x 2, Coban 4", Jawbra to go

Admission status:TBD

Estimated time: 4 hours

Coding: CPT=15829, ICD-9=v50.1

Post-op wound care:dressing off next day and switched into jaw bra

Post-op activity restrictions:

Follow up: next day

©2013 STEPHEN B. BAKER, MD, DDS, FACS