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405 EXTENDED TEMPORAL LIFT (add on) SEE add-on sutures and instruments almost always done with facelift, but can be done alone Usually under Local Anesthesia; updated February 23, 2018 PAGE 1/2 |
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OPERATIVE TIME: |
add 1 hour to facelift, or 1 ½ hours alone |
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ANESTHESIA NOTES |
Local Anesthesia: patient receives preop Valium, Demerol, and Clonidine. Moderate sedation protocol. Nasal O2 cannula with CO2 monitor |
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PATIENT POSITION | SETUP |
Holding Area: On Stryker eye bed. Start IV on right side. Baer hugger. Apply warm Bovie pad, EKG pads, wrist restraints, etc. in holding. Give IV Kefzol, Zofran, Decadron and ½ to 1 mg Versed. Warm blankets, kisses and hugs. In OR: Position patient bed flat, pillow under knees, terry cloth towel, gel pad, towels for headrest. [2[ blue Chux under head, blankets to tuck arms. Rotate clockwise 135O. Nasal prongs with CO2 monitor. - Aquaphor to lips. - Kerlix roll wrist restraints. - Hair ties, comb and shaver box - extra pillow in room for end of case |
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ROOM SETUP |
Warm room to 70O, then lower to 68O after patient. draped Warm up Bovie grounding pad and EKG leads in warmer [for local] [2] ring stands for dirty sponges; [1] Double ring stand for ice bath [3] Mayo stands, [1] large back table Bovie machine at foot of bed; bipolar foot pedal taped to floor |
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EQUIPMENT |
Headlight w/ [2] light sources, Gwen’s foot pad [2] white hydraulic pump up stools |
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PREP |
Chlorxylenol (PCMX), 4x4 sponge box - do not add water. Prep lightly to face, eyelids, forehead, neck, hair |
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DRAPING |
Head sheet w/ 2 towels, 1000 drape, split sheet |
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CAUTERY |
✔ Valleylab flat short silver tip (E1450-X) |
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SUCTION |
[2] blue 3/16" suction tubing for Saf-T-Vac & Yankauer |
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SOLUTIONS | IRRIGATION |
[3] liters NS irrigation, [2] Asepto syringes, [1] saline bowl COLD SALINE BATH SETUP: get crushed ice in cooler, place ice into large basin on double ring stand, cover with warmer drape, place small sterile basin on top of warmer drape, pour saline in sterile basin |
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NEEDLES | SYRINGES |
[4] 3cc syringes, 30g needles ➤ for solution E-2 [2] 10 cc syringes, 1 each 25 and 27g needles ➤ for solution E-2 [2] 16g angiocath [2] 30cc syringes ➤ for Gwen irrigation |
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LOCAL ANESTHETIC & SOLUTIONS |
Solution E-2: Mix 50/50: 20cc 1% Lidocaine w/ epi + 20cc 0.5% Marcaine w/epi Tranexamic acid (TXA) solution: 2gm in 100cc NS irrigation |
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MEDICATIONS (for local) |
[4] Versed; [4] Fentanyl; [1] Zofran; [1] Kefzol; [2] Bactroban ointment tubes [3] Tranexamic acid 1 gm vials; 1gm to be given IV at first closing count; 2gm for irrig solution |
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405 EXTENDED TEMPORAL LIFT PAGE 2/2 |
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SETS TO OPEN |
Dr C Facelift & Dr. C Special Plastic set |
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INSTRUMENTS |
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■ FORCEPS |
01's Adsons, 08's |
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■ SCISSORS |
Black Gorney, Metz regular and fine, short ceramics, ceramic Metz, str Metz, str Mayo |
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■ NEEDLE HOLDERS |
[2] Mayo Hagar NH [2] Aesculup serr NH |
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■ RETRACTORS |
Breast, Maxwell, Army-Navy, L-shaped retractor |
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■ KNIFE | BLADES |
[4] No. 10 blades |
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■ OTHER |
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STERILE SUPPLIES |
● 1000 Steri-drape ● [2] needle counters ● cotton balls for ears ● ½" steri-strips (hold for general) ● plastic drape for iced saline |
● [4] surgical marker pens ● Mastisol vial ● magnetic pad ● [4] blue plastic bowels ● Plastic Yankauer ● [3] med glasses |
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SPONGES |
[4] Raytec, [1] Lap |
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No |
Type |
SN |
status |
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SUTURES |
● |
>>> OPEN IN ADDITION TO FACELIFT SUTURES <<< |
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[ 2 ] |
3-0 Chromic PS-2 |
1638 |
open |
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[ 4 ] |
2-0 Stratafix FS |
SXPD2B-420 |
open |
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DRAINS |
No drains are used for temporal lift |
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DRESSINGS place on Mayo stand start setup after injections over |
● Knife blade to cut rubber bands ● [2] Bactroban ointment tubes ● tongue blade ● [2] packs 4x4's soft sponges ● [1] Abd pad ● Lister bandage scissors |
● [1] 4" Ace ● [2] 3x18 Vaseline gauze ● [2] Kerlix ● [2] Safety pins ● Dr. C sterile gloves |
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POSTOPERATIVE |
Remove head cushion, put 2nd pillow under head |
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DATES MODIFIED |
Jul 2016, Jan 2017, Feb 2018 |
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