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Patient's often want to know when they're having a rhinoplasty or a facelift what they need to do to prepare for surgery. In both of those surgeries, in a rhinoplasty and in a facelift, one of the things that can ultimately effect the quality of the result and certainly effect the postoperative course and how soon they can return to normal activities where they're interacting with other people is the degree of swelling and the degree of bruising that the patients have. And there are some things that patients can do prior to surgery that can help reduce both bruising and swelling. There are also things that the plastic surgeon can do during the surgery to reduce bruising and swelling and there are also some prescription, i.e. not over the counter medications that physicians can prescribe the patients to reduce both bruising and swelling. The things that a patient can do to prepare for a rhinoplasty surgery or facelift surgery to help reduce swelling are to avoid extremely salty foods before the surgery and certainly after the surgery for the first week or two weeks. Avoiding pre prepared foods, fast foods, canned foods, all of those foods are high in sodium and they can increase the amount of swelling following surgery. Another thing that I like to have patients do prior to surgery is avoid simple carbohydrates in the form of sugar but more importantly grains, and some dairy products even if they're willing to do so and stick to a diet that consists mostly of fresh prepared proteins, vegetables, and fruits. It's a modification of the paleo diet that many people are familiar with nowadays and the paleo diet is one that's designed to reduce inflammation and so the benefits of that type of diet and again especially avoiding grains and dairy products for two weeks prior to surgery reduces the inherent inflammatory state that the patient might have to a lower level so that the response to the surgical interventions is one that's characterized by less inflammation.
What kind of pain is involved with a facelift and a rhinoplasty and right off the bat when I respond to that kind of question with a patient, I start to use the word discomfort instead of pain and I don't do that as a trick but I think to start to have the patients mentally understand that they can have some power over the pain they experience, that they can enact their own placebo effect by instead of getting anxious about discomfort prior to surgery, start to recognize that they can internally decrease the amount of pain that they have by anticipating less pain. I talk to patients and I tell patients that there's a spectrum of pain. Everybody has their own personal and different relationship with pain and that if they start off at not expecting there to be a lot of pain, they may very well decrease the amount of pain that they experience. I find that with rhinoplasty patients, if they have to have bony work done, they're going to have a little bit more discomfort than if they did not have bony work done. I tell patients that they can expect to experience the most significant amount of discomfort for the first 24 to 48, sometimes 72 hours and then after that point many patients don't regard pain or discomfort as a significant factor in their recovery. Patients often want to know what the pain is going to be like from a facelift and I think that's a really interesting question because it's often less than patients would expect. Patients often surprise me when they come back and they tell me that they only need a pain pill once or twice the evening of the surgery and then after that go on to take very little pain medication, maybe once or twice a day, maybe once in the evening to help them go to sleep. Surprisingly facelifts don't have to have a lot of discomfort associated with them.