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Lumps and Bumps
Dr. Coniglio will provide information specific to your individual surgery. This handout provides general and essential information about removal of lumps, bumps and lesion of the head and neck. After your consultation with Dr. Coniglio, if you have any questions regarding your surgery, please call our office
Any lumps or bumps with an unknown cause will be sent to Pathology at Strong Memorial Hospital for review. Due to special stains that are required to obtain a diagnosis, results of pathology takes, at a minimum, five business days, and may take anywhere up to two weeks. As soon as it is available, Dr. Coniglio reviews the pathology report and our nurse will telephone you with the results. If you have not heard the pathology results before your two week follow-up appointment, our office will review the pathology results with you at that visit.
As with any surgery, along with the benefits of surgery, certain risks must be discussed in order to obtain an informed consent.
Anesthesia
Complications from anesthesia are known to exist. These complications are quite uncommon since patients are usually young and healthy.
Bleeding
Postoperative bleeding is rare. Prevention, by avoiding aspirin, ibuprofen, many muscle relaxants, arthritis medications and blood thinners for one week preoperatively is the best treatment. If you routinely take any of these medications, please notify Dr. Coniglio at least one week prior to surgery. Hematoma, a collection of blood (usually clotted) is caused by a break in a blood vessel. Treatment is usually performed in the The Surgery Center.
Infection
Infection is an uncommon risk for this procedure. On the day of surgery, you will receive preventative antibiotics during your procedure. At your preoperative visit your doctor will provide you with a prescription for antibiotics so you can start antibiotics at home the day after your procedure.
Numbness and Weakness
Every effort is made to protect all nerves in the immediate surgical area. Depending on the location of your incision, you may experience numbness or weakness. This may be due to swelling or stretching the nerve and can be temporary or permanent.
Swelling
Due to the increased blood flow of the head and neck to the brain and sensory organs, it is not uncommon to have swelling following surgery. This is usually temporary and will subside if activity restrictions are followed.
Procedure
You will be asked to call the Surgery Center on the business day before the procedure to confirm your arrival time. Your arrival time will be about one hour prior to the procedure. Upon arrival at the Center you will talk with a nurse (who will help you change into gown, obtain blood pressure and pulse, and start an IV), an anesthesiologist and Dr. Coniglio before the procedure. In general, surgery will take between one to two hours. During the preoperative visit, our nurse will tell you the estimated length of surgery time for your specific procedure. Recovery takes about one hour and you will be discharged about three to four hours after the time of admission.
Pre-Operative Instructions
Please do not take aspirin or aspirin-containing products, ibuprofen or ibuprofen-containing products or Vitamin E for one week prior to your surgery. If you take any medications that may effect your bleeding time (Coumadin or Warfarin, arthritis medications, muscle relaxant, to name a few) please let Dr. Coniglio know at this time. Tylenol® is always OK to take.
- For surgery at the Westfall Surgery Center, please call 256-3862 before 12:00 noon on the business day prior to your scheduled surgery to confirm your arrival time. Your Anesthesiologist will contact you regarding instructions for oral intake and medications prior to your surgery.
- Do not have anything to eat or drink after midnight prior to your surgery unless otherwise instructed by your Anesthesiologist. This includes all food, all liquids, water, candy, mints and gum. Your surgery will be cancelled if you do not follow these instructions. You may brush your teeth.
- Please inform Dr. Coniglio at this time if you take routine medications. You may be instructed by your anesthesiologist to take some of your daily medications with a sip of water.
- Prior to your arrival at the Surgery Center, please be certain that all make-up, nail polish or fake nails are removed.
- Please leave all valuables (money, credit cards, jewelry, watches) at home.
- During your surgery your family may wait in the Family Waiting Room. Dr. Coniglio will contact your family there immediately following your procedure.
Someone will need to drive you home from the Center, and stay with you that evening. If an appointment is scheduled in Dr. Coniglio's office the day following your surgery, it is a good idea to have someone drive you to the office for that appointment.
Post-Operative Instructions
Following your procedure you will have a bulky dressing over the incision. This will provide gentle pressure to minimize swelling and protect your clothing from any draining tissue fluids following the surgery. Directions for removing this bulky dressing will be provided at the time of discharge from the Surgery Center. Under the dressing will be steristrips covering the dissolvable sutures. These steristrips help protect the suture and the wound edges as healing takes place. You may also have a drain to prevent accumulation of tissue fluid under the incision. This will be removed in the office within 24 to 48 hours after your surgery. Most patients state that drain removal is not more than a minor discomfort.
The nurses will ask you to meet the discharge criteria: to drink liquids, walk with a steady gait, manage your discomfort, and be certain that you and your family have good understanding of the discharge instructions. At the time of your discharge from the Surgery Center, the nurses will teach you any special instructions that you may need to know.
Sleep with head of the bed elevated or use two to three pillows. Absolutely no bending, lifting or straining for two weeks postoperatively. If you have little children, bend at the knees or sit on the floor and let them climb on to your lap. In general, seven days/weeks off from work is recommended following surgery.
Please remember, swelling, facial fullness, headache and disrupted sleep are very normal postoperative symptoms and will decrease as the healing process occurs. It is not uncommon initially to have some numbness at the site of surgery in the immediate postoperative period.
Diet
Advance diet from liquids to soft food to solids as tolerated. Avoid extremely hot liquids or foods.
Wound care
It is important that the steristrips covering your surgical incision remain dry and intact for two weeks following surgery unless other arrangements have been made.
You may be given refills on all prescriptions. You do not need to use the refills unless instructed to do so.
Use pain medication as directed and as needed. It is uncomrnon for there to be significant (intense and unbearable) pain after surgery of the head and neck.
Start your antibiotic on the day following your procedure. (During your surgery you received antibiotics through your IV, which will cover you for the day of surgery.) Take as directed (usually one in the morning and one in the evening until gone). It is not uncommon to have a low-grade fever for 48 hours following surgery.
Appointments
Your bulky dressing will be removed the day following your surgery and the sutures are dissolvable. If you have a drain, you will need to come to the office for wound check and drain removal. All patients need to come to the office two weeks postoperatively for removal of any remaining sutures.
Special Instructions
The sedative medication and/or general anesthesia may make you drowsy for as long as 24 hours. Therefore, following surgery do not
- drive or operate machinery for 24 hours
- drink alcoholic beverages for 24 hours
- make major decisions, sign contracts, etc. for 24 hours
Following surgery, please call for any of the following:
- difficulty breathing or swallowing
- persistent bleeding
- fever above 101°
- pain unrelieved by medications or instructions
- inability to eat or drink
- nausea and/or vomiting
- to make a two week post-op appointment
For an emergency please call our professional answering service at 585-258-4840.
Please notify the office 585-256-3550 for any concerns. We are here to help in any way we can.
Dr. John U. Coniglio and Staff
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