Explained by Dr. Madnani and Nurse Lisa

Hey, guys. I’m very happy to introduce you to our head operating room nurse, Lisa Calhoun here. Hello. many of you who know me and my practice have met or interacted with Lisa in some way or the other, Lisa’s primary responsibilities is to manage everything that happens in the operating room and to manage all of the pre-surgical and post surgical care of our patients.  Now, what does that mean? That means we have a team of nurses that help me with my surgical patients, and we have a team of operating room personnel and aftercare clinical personnel, which includes physician assistant and surgical technicians. So there’s a there’s a big team behind the scenes that helps me do what I do in the practice.

And even now we have Dr. Singh, and other doctors to be coming on board. So there’s a lot that goes on behind the scenes.  We get a lot of questions about after care, before care, so we will be reviewing this.  We have Mallory behind the camera over there, our PA Mallory who’s our surgical PA and helps me manage all of my clinical, surgical patients, and she’ll be asking some frequently asked questions, and Lisa will be answering them.



What are the different types of anesthesia offered in your practice?

I’m going to start by saying that there are in general, three types of anesthesia offered for Facelift surgery:

One is general anesthesia, which is most commonly performed by most surgeons in the country. Then there’s IV sedation, which is also considered twilight, and then there’s oral sedation with  local anesthesia. In my practice, we mostly do oral sedation with local anesthesia or IV sedation, at least I’m gonna go over some of those two the nuances between the two. We do about ninety percent of our surgeries under oral sedation with local anesthesia (also known as our “awake Facelift”). So there’s a combination of medications that will be sent to the pharmacy. And what that means is the patient will get some oral Valium, which will help relax them during the procedure. They will also get some type of pain medication, which will help keep them pretty pain free during the surgery. We’ll also get an antibiotic and an anti-nausea medication. So that’s the oral sedation local anesthesia.

IV sedation is performed with an anesthesiologist, they are present throughout the procedure. And the patient will get an IV and will be administered propofol to keep them very comfortable during the surgery. So that’s primarily also known as twilight. So those of you that have had a colonoscopy before that’s what the IV sedation is.

General anesthesia is performed by an anesthesiologist where the patient is asleep and has a complete loss of consciousness.

The choice is completely up to the patient.

And so the patients who are asleep throughout the whole case?

Yes. Exactly. And we do have an anesthesiologist present. Yes. And the difference between that in terms of the patients prep before surgeries, they require a medical clearance. So all patients getting IV submissions will require a medical clearance even if you’re healthy, and if you are healthy and you’re having it under local with oral sedation, no medical clearance is typically needed.


Are there any medications that I need to take before surgery?

So generally speaking, no. We want you to pick up all the medications patients from your pharmacy that we send to you and bring them with us. There, it it will depend on the procedures that you’re scheduled for whether you start the medications before or not. And your nurse during your pre op appointment will review that with you.


What should I wear the day of surgery?

So, day of surgery, what we would like you to wear head to toe would be no makeup on your face. So no harsh chemicals, no heavy lotions, anything like that. A bra with no underwire, so make sure that you don’t have any metal on your body that includes any jewel where your valuables leave those at home. A tank top of some sort. would be preferred and comfortable sweatpants or shorts are are preferred for day of surgery. Also, slip on shoes are generally better.


Do I need someone to stay with me overnight?

It is recommended that we have that you have somebody to stay overnight for the first twenty four hours post-operatively. That does include someone to physically come and pick you up from our facility. An Uber driver or cab does not count as a responsible adult does have to pick you up.


If I’m getting a facelift, when is my post operative appointments?

You’ll be seen in our office by one of our nurses or PA’s (Physician Assistants) the next day, so that’s twenty four hours after your surgery. You’ll come in for a post operative wrap change. During that appointment, we welcome your significant other or caregiver to come in and witness that appointment. They will will show you and your caregiver how to clean the incisions how to do the post operative dressing change during that appointment. And then there’s a one week follow-up appointment after facelifts for the sutures to come out and then typically a two week (follow- up) appointment. In terms of when you get to see me after surgery, I try to see all my patients, but I’m usually in the operating room. I will see you within the first couple weeks after surgery.  Obviously, if there’s any kind of complication or issues, we’ll be right there with you.


If I’m not having a facelift, if I’m having eyelid surgery or liposuction or a different type of procedure that your office offers, When are my follow-up appointments?

The next follow-up would be one a week following surgery. And if there’s any issues or concerns, we can definitely see you sooner than that. a physician assistant or nurse will be following up with you every day up until your one week follow-up. Our office is in touch with you regularly after surgery, and you can also be in touch with our office. We have an online system, a messaging system where you can send pictures and text us, it’s called Klara. So you’ll be getting that information at the time of your pre op appointment and after search.


What do I do if I have a concern pre or post op?

So we have an online messaging service that you can communicate right after your pre op appointment up until even after your surgery that you that it monitored by a physician assistant and nurses all day every day. From that during this normal business hours, nine AM to five PM, Monday through Friday, and the occasional Saturdays we are open. After your surgery, if you have a postoperative concern, you will have the operating physician’s cell phone number to contact in case of emergency or any urgent concerns.


What should I eat before surgery?

So if you’re going under oral sedation with local anesthesia, we do recommend that you have a light meal before arriving. Please do avoid caffeine though. If you do go under IV sedation, we recommend that you not eat or drink anything after ten PM thing.

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