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

OPERATIVE TIME:

add 1 hour to facelift, or 1 ½ hours alone

ANESTHESIA NOTES

Local Anesthesia: patient receives preop Valium, Demerol, and Clonidine. Moderate sedation protocol. Nasal O₂ cannula with CO₂ monitor

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 135^O. 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

ROOM SETUP

Warm room to 70^O, then lower to 68^O 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

EQUIPMENT

Headlight w/ [2] light sources, Gwen’s foot pad

[2] white hydraulic pump up stools

PREP

Chlorxylenol (PCMX), 4x4 sponge box - do not add water.

Prep lightly to face, eyelids, forehead, neck, hair

DRAPING

Head sheet w/ 2 towels, 1000 drape, split sheet

CAUTERY

✔ Valleylab flat short silver tip (E1450-X)

SUCTION

[2] blue 3/16" suction tubing for Saf-T-Vac & Yankauer

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

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

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

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

405 EXTENDED TEMPORAL LIFT

 PAGE 2/2

SETS TO OPEN

Dr C Facelift & Dr. C Special Plastic set

INSTRUMENTS

     ■ FORCEPS

01's Adsons, 08's

     ■ SCISSORS

Black Gorney, Metz regular and fine, short ceramics, ceramic Metz,

str Metz, str Mayo

     ■ NEEDLE HOLDERS

[2] Mayo Hagar NH

[2] Aesculup serr NH

     ■ RETRACTORS

Breast, Maxwell, Army-Navy, L-shaped retractor

     ■ KNIFE | BLADES

[4] No. 10 blades

     ■ OTHER

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

SPONGES

[4] Raytec, [1] Lap

No

Type

SN

status

        SUTURES  

●

>>> OPEN IN ADDITION TO FACELIFT SUTURES <<<

●

[ 2 ]

3-0 Chromic PS-2

1638

open

●

[ 4 ]

2-0 Stratafix FS

SXPD2B-420

open

DRAINS

No drains are used for temporal lift

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

POSTOPERATIVE

Remove head cushion, put 2^nd pillow under head

DATES MODIFIED

Jul 2016, Jan 2017, Feb 2018