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Not Pleased With Browlift Surgery Recovery. Incision Seems To Be Opening. Have To Use Sterile Gauze. Gentler Shampoo?

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Posted on Sat, 16 Jun 2012
Question: I recently had browlift surgery - on 11/10 - I am not pleased with the rate of recovery. I have been washing my hair every 4 days with Johnson's baby shampoo, letting it dry, then applying vaseline to the incision line. On the days between, I take sterile gauze, wet it with water, lather it up with Johnson's baby shampoo, and gently, gently clean the incision line. Then I take additional sterile gauzes, wet them with water, and gently remove the shampoo. Let it dry. Then apply vaseline. The incision looks like it is "opening" in the middle of my forehead, and is red surrounding it. It does not look infected. I am taking an antibiotic as prescribed by my surgeon. I can't help but wonder if I am doing something wrong - perhaps I am allergic to Johnson's baby shampoo. Can you recommend another gentler shampoo I can use?
doctor
Answered by Dr. Robert Galamaga (59 minutes later)
Hello and thanks for the query.

Your question is a good one. The main issue with healing in your case is that the skin in that area of the body can take a bit longer to heal in light of a limited bood supply. You are honestly doing all of the right things and being quite vigilant in taking care of the incision line.

I don't think you should change the shampoo at this time as I do not feel that is the issue at hand. I would recommend however that you purchase some doctor also recommended you to limit extreme facial expressions for the next coupleof weeks as well - this is very difficult to do but you should try your best as activation of facial muscles will pull on the incision line. It is not unusual for incisions to sometimes open a bit and usually they will close on their own. Keep an eye on things for a couple of days and if the incision does not appear to be improving at that point I recommend you visit with the surgeon for a brief consult - his nurse may even be able to see you. Sometimes we apply steri-strips around an incision to pull the skin together in areas where separation occurs. Another option would be to use a skin glue but I dont think you are at that point just yet.

Thanks again for the query. I hope you found my response to be helpful and informative. If you have any additional concerns I would be happy to address them.

Sincerely,

Dr. Galamaga
Above answer was peer-reviewed by : Dr. Raju A.T
doctor
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Follow up: Dr. Robert Galamaga (1 hour later)
Thank you Dr. XXXXXXX for your prompt and clear response.

I was using polysporin (as prescribed by my surgeon) for the first week after surgery, but when i went in to have the stitches removed from cancer removal incision - on 11/18 - the area in the center of my forehead was reddish and he suggested switching to vaseline, just in case I was getting a reaction to the polysporin. Then, on Tuesday 11/22 I went back to him because it was redder and slightly bumpy looking. I had had an appointment to go to him on 11/23 for removal of the brow incision stitches, but he suggested going ahead and removing the brow incision stitches that day, 11/22, because they might possibly be causing an irritation. Anyway, today I did not use the Johnson's baby shampoo to clean it (that was before your response) and instead used a foaming wound cleaner containing an active ingredient of Benzalkonium Chloride 0.13%. Let it dry, then dabbed the area with a sterile saline solution (I forgot to mention that I have been using the sterile saline solution as a last step all along). Then, when dry again, I applied the vaseline. We'll see what it looks like tomorrow. I like the idea of the steri-strips, but imagine they might be difficult to apply as this incision is right in my hair line. In any case I will do as you suggest and go to see the surgeon if there is no improvement in several days. I have an appointment with him on 12/6, but I won't wait that long if it doesn't begin to look better. December 1 will be 3 weeks after the surgery. Thanking you in advance for your time and thoughts - XXXXXXX
doctor
Answered by Dr. Robert Galamaga (7 hours later)
XXXXXXX
Thanks for the detailed update. You are obviously keeping a very comprehensive approach in caring for yourself after the procedure.

You are right in that if the incision is close to the hairline it can be a bit difficult to use adhesive dressing there.

Have you considered an alternative antibiotic ointment such as single agent bacitracin ointment? Just a small thin film is all you need - same if you use vaseline there.

The foaming wound cleanser may be a bit much in this setting and if you do use it be very very gentle.

I suspect that within 48 hours the inflammation around the incision site will calm down and some of the irritation will begin to clear.

On a side note - I cannot emphasize enough the mind-body connection in the healing process. Think positive, meditate and picture the wound healing gradually. This positive energy while impossible to measure has an impact on healing - this is my personal belief.

As we get wiser (or older some may say) our skin is less elastic and heals more slowly. I suspect this is part of the reason we are seeing a prolonged recovery but I am confident you will do fine.

One last suggestion is for you to take some extra vitamin C for the next few days as well to promote healing - in addition to your daily vitamin.

Again I am confident you will be pleased with a good recovery within the next few weeks.

Thanks again for the query. As always i am here if you have any additional concerns.

Sincerely,

Dr. Galamaga
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Above answer was peer-reviewed by : Dr. Raju A.T
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Dr. Robert Galamaga

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Practicing since :2002

Answered : 2635 Questions

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Not Pleased With Browlift Surgery Recovery. Incision Seems To Be Opening. Have To Use Sterile Gauze. Gentler Shampoo?

Hello and thanks for the query.

Your question is a good one. The main issue with healing in your case is that the skin in that area of the body can take a bit longer to heal in light of a limited bood supply. You are honestly doing all of the right things and being quite vigilant in taking care of the incision line.

I don't think you should change the shampoo at this time as I do not feel that is the issue at hand. I would recommend however that you purchase some doctor also recommended you to limit extreme facial expressions for the next coupleof weeks as well - this is very difficult to do but you should try your best as activation of facial muscles will pull on the incision line. It is not unusual for incisions to sometimes open a bit and usually they will close on their own. Keep an eye on things for a couple of days and if the incision does not appear to be improving at that point I recommend you visit with the surgeon for a brief consult - his nurse may even be able to see you. Sometimes we apply steri-strips around an incision to pull the skin together in areas where separation occurs. Another option would be to use a skin glue but I dont think you are at that point just yet.

Thanks again for the query. I hope you found my response to be helpful and informative. If you have any additional concerns I would be happy to address them.

Sincerely,

Dr. Galamaga