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Facial Reconstruction Post-Operative Guidelines


  • Have someone drive you home after surgery and help you at home for 1-2 days.
  • If you have received Medication for pain or sedation while under our care, you should not drive, operate machinery, drink alcohol, or sign any legal document for 24 hours.
  • Get plenty of rest.
  • Follow a balanced diet.
  • Take pain medication as prescribed.
  • Take any antibiotics as instructed. It helps to eat cultured yogurt or over the counter Acidophilus tablets while on antibiotics to minimize intestinal side effects.
  • Dr. Khosh may instruct you to take the herbal supplement Arnica-Montana. This is intended to minimize bruising.
  • You may be prescribed steroid tablets to minimize post op swelling. If so, take them as instructed on the packet. Note that steroids can make you feel anxious; this is a common side effect.
  • Do not take aspirin (or products that contain aspirin) for 3 days.
  • Do not drink alcohol while taking pain medication.
  • DO NOT SMOKE. Smoking decreases blood flow to the skin, and particularly to the area of the operation. It can delay wound healing or cause tissue loss.

What to Expect

  • Maximum discomfort should occur in the first few days, improving each day thereafter.
  • Expect bruising, swelling, numbness, tightness and tenderness of the skin for 10 – 14 days.
  • Sensation around the area of the operation may be decreased. This may or may not fully return.


  • Start walking as soon as possible, this helps to reduce swelling and lowers the chance of blood clots.
  • Do not drive while you are taking pain medication (narcotics).
  • You may tire easily. Plan on taking it easy for the first week.
  • No strenuous activity, including sex and heavy housework for 2 weeks post op.
  • Sleep with your head elevated at a 45 degree angle (half way between lying down and sitting up) for 3 days and 3 nights. You can use 2 couch pillows to do this or sleep in a recliner.

Incision Care

  • Apply cold compresses to the surgical area. Frozen peas in a Ziplock bag work well for this purpose.
  • You may shower the morning after surgery.
  • If there is a steri-strip on the incision, leave it on for at least several days, if possible.
  • If there is no steri-strip on, you can wash area with soap and water and apply an over the counter antibiotic ointment such as Bacitracin 3 times/day.
  • Avoid excessive sun exposure and tanning beds until the scar is no longer pink (6-12 months). Casual and intermittent sun exposure is fine.
  • Always use a strong sun block (SPF 30 or greater), particularly on the scar, if prolonged sun exposure is unavoidable.
  • Skin Graft/Bolster Dressing (sewn or clipped on over the graft)
    • Do not remove this dressing. It will remain in place until your first post op appointment.
    • You may shower the morning after surgery – avoid having the water hit the dressing directly. It is ok if the dressing gets a bit wet.
    • The graft may be mottled or purplish when the bolster is removed. This is normal.
    • Call if you experience increase swelling. There may be fluid accumulating under the graft.
    • Mild oozing is expected and not uncommon.
  • Donor Site – where the skin or cartilage graft was harvested
    • The usual places for donor sites of the face are the skin in front of your ear, your lower neck or collarbone areas, or the firm part of your ear (if cartilage was needed).
    • These donor sites are generally closed with sutures (stitches).
    • If the donor site has a steri strip on it, leave it on until the first post op day.
    • If the donor site does not have a steri strip on it, you can wash it after 24 hours with soap and water and then apply antibiotic ointment daily.
  • Nasolabial or Forehead Flap
    • There will be a small bridge of skin leading to the flap on the nose. This will lead to increased drainage, particularly for the first few days.
    • Use a Q tip with peroxide and water (1/2 and 1/2) to gently clean around and underneath the bridge.
    • The stitches will be removed at the first post op visit.
    • No dressing is necessary.
    • Apply antibiotic ointment three times a day to all incision lines and on the exposed tissue of the bridge.
    • This bridge will stay in place for 3-4 weeks. Another surgery will be scheduled at that time.

When To Call

  • If you have increased swelling or bruising.
  • If you have increased redness along the incision.
  • If you have increased pain that is not relieved by your pain medication.
  • If you have any side effect from your medication; rash, nausea, vomiting, diarrhea, etc.
  • If you have a temperature greater than 101.0F
  • If you have yellow or green drainage from the incisions or notice a foul odor.
  • If you have bleeding from the incisions that is difficult to control with light pressure.
  • If you have any questions or concerns you may reach Dr. Khosh at 212-339-9988.

What Dr. Khosh's Patients Say


Based on 174 reviews

Meredith G.
Saw Dr. Khosh for a fractured nose. He reset my nose beautifully (and with little discomfort to me) and then discussed some of my sinus issues with me upon my follow up visit. Never felt like he was rushing me out and felt very confident in his abilities. I would highly recommend to anyone needing plastic or reconstructive options!
Jackie C.
Great front office, really good experience after what was a terrible accident. I was made to feel comfortable. Dr. Khosh is very good at what he does. I'm still healing but I'm confident of the results
Kaitlin M.
Dr. Khosh takes exceptional care of his patients. He has operated on me twice, each time making me feel extremely comfortable and satisfied with the results. His staff is also very kind and knowledgeable.
Diana G.
Dr. Khosh & his staff Susan & Christine are absolutely amazing! They were so supportive & helpful from beginning to end & they are just wonderful people. Thank you guys I truly appreciate everything you guys have done for me. I would recommend them to anyone & everyone!
Joann M.
After visiting and being evaluated by several doctors, I kept going back to Dr. Khosh. His tranquil spirit and professionalism were captivating. Thank you for a job well done and keeping me calm throughout the entire process. A special thanks to your staff Susan and Christine for all of their support as well. Hi highly recommend Dr. Khosh.
Leah G.
Upon hearing of the overwhelmingly positive experience a friend of mine had in choosing Dr. Khosh as her surgeon, I decided to make an appointment for my own septoplasty/rhinoplasty/turbinate reduction. Although I was slightly skeptical as the praise I had heard seemed a bit hyperbolic, all uncertainty dissipated after meeting the Doctor and his staff. My pre- and post-operative experience was excellent in terms of concerns adequately addressed prior to the surgery and mitigation of any bruising in the convalescent period. Despite my apparent predisposition to rather slower healing, a year after the surgery, my nose looks really pretty and my breathing entirely unobstructed! I highly recommend Dr. Khosh!
Courtney G.
AMAZING!!!!!! I had Dr Khosh perform lipo on my chin/neck and my result is unbelievable! Better than I could have expected! I met with a couple of surgeons and the second I met with Dr Khosh I knew he was the one I was going with. He was compassionate and explained every detail of what would take place during the surgery and what to expect during recovery. I even emailed a few times during recovery with various questions and he got right back to me asap which was really comforting! I honestly fully recommend Dr Khosh, he did an amazing job and is an amazing person.
Frieda S.
i can finally breathe!! Dr. Khosh made the entire experience a breeze, it was truly a pleasure to be under his care. I am forever thankful and highly recommend him. Not only does his work speak for himself, but he has excellent bedside manner. His kindness and patience is above and beyond. He takes the time to answer to every question you have to help you understand the process while at the same time making you feel so comfortable. From the first consultation i knew i was in good hands. I am so pleased with the result and forever thankful.
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