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"He went the extra mile to make a complete and dramatic improvement."
- Berkeley, CA
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    Prepare for Cosmetic Procedures



    Before your cosmetic treatment

    Please prepare for your initial consultation by completing the relevant patient forms and bringing them with you to your appointment.

    Check back here after your consultation for tips on preparing for your chosen cosmetic procedure. That’s also a good time to read about what to expect after treatment so that you have no surprises and can simply focus on resting and healing afterward.


    Planning for your cosmetic surgery

    Physical exam & pre-op paperwork

    To undergo any elective surgery, you must first be in generally good health. We require you to undergo a physical examination and routine lab work by your primary care physician.

    Results and any medical clearance required should be sent to our office as part of your pre-op routine at least 1-2 weeks prior to your scheduled surgery.

    At your pre-op visit, Dr. Macdonald also performs a general exam and orders any lab work that may have been missed in your primary care exam. Your health and safety is always Dr. Macdonald’s first concern.


    Schedule adequate healing time

    Adequate healing time varies by patient and by surgery. We would rather you plan for more downtime than less. It’s not helpful to your healing process when you are stressed and anxious about going back to work or being ready for social commitments.

    Review the chart below for an expected range of healing and recovery days required by surgery type.

    surgery recovery chart

    Arranging transportation to and from surgery

    For safety reasons, you may not drive yourself home after surgery, or any treatment that requires sedation or narcotic pain medication. Arrange for a friend or family member to drive you the day of surgery and perhaps to the first post-op visit.

    We are happy to arrange a private car service for you, if you prefer.


    Medications to take or avoid

    It is imperative you make Dr. Macdonald and his staff aware of any medical conditions you have, and all medications you are taking. Failure to do so puts your safety at risk.

    We strongly recommend that for 2 weeks prior to surgery and for 2 weeks after surgery, you:

    • Do not smoke.
    • Do not take aspirin, aspirin-containing products or NSAIDS. A list of common aspirin-containing products is given to you at your pre-op visit.
    • Avoid omega-3 fatty acid supplements.
    • Avoid high doses of Vitamin E. Be aware that substantial doses of Vitamin E (100 IUs) may be present in various green supplements.
    • Take Arnica for 3 days prior to and several days after your procedure. Arnica Montana is a homeopath remedy to minimize bruising and support rapid healing. You can purchase Arnica Montana from our office at your pre-op appointment.


    Diet and nutrition promotes good healing health

    You should be in the best nutritional state possible prior to surgery. We recommend you maintain a balanced, nutritious diet primarily of plant-based foods, augmented with vitamin supplements, especially Vitamin C.

    If you plan on preparing your own meals at home after surgery, shop ahead of time so that you have on hand easy-to-prepare foods. Make sure you have plenty of fluids to keep your body hydrated both before and throughout healing. It’s best to stick to water, diet ginger ale or other clear liquids vs. those loaded with caffeine and sugar.


    Skin care habits make a difference

    We encourage you to take advantage of a free consultation with our medical esthetician. She takes 15-20 minutes to assess your current skin condition and advise you how best to prepare your skin for optimal surgery results.

    She also regularly helps patients improve post-surgical healing and results by customizing a post-surgery daily skin care regimen.


    Consider post-op care options

    For more involved surgeries such as facelift and neck lift surgery, you may prefer to have a nurse care for you the first 2-5 days of healing. Most post-op care RNs also drive you to and from your initial 1-2 post-op appointments.

    Dr. Macdonald has long-standing relationships with trusted, experienced nurses to provide such care. One such preferred post-care relationship is with The Post-Op Recovery Place, a leading surgical recovery center in San Francisco.

    The Post-Op Recovery Place, Inc.,
    Contact person: Gwen Mancuso, RN

    Phone: 415-642-1201

    Post-op care services can be well worth the nominal additional investment above your surgery cost. It’s not every day you get major surgery, so it’s nice to be lavished in quiet, private, pampering comfort, with the security of 24-hour monitoring and healing care.

    Our Patient Coordinator is happy to arrange post-op care services for you, at your request.


    Arranging for laser procedures

    When pre-treatment of your skin is required

    Depending on your ethnicity and Frederick scale (I-VI) skin type, as well as your selected laser or chemical peel therapy, you may be required to pre-treat your skin for a period of weeks.

    Pre-treatment with our hydroquinone (HQRA+) product and Vitamin C serum ensures optimal results and minimizes the risk of post-treatment hyperpigmentation. Our HQRA+ is a specifically, highly concentrated formula with 7% hydroquinone, .05% Tretinoin, and .05% hydrocortisone.

    Dr. Macdonald or our laser specialty nurse thoroughly discusses with you any skin pre-treatment requirements at your initial consultation.


    No sun exposure

    • For 2-4 weeks prior to each BBL™ laser session, you should avoid active tanning. You want the unwanted pigment (i.e., in hair follicles, sun spots, red spots, acne) to stand out distinctly from the color of your natural skin vs. competing with the pigment created by a suntan.
    • At the time of treatment, if you have extra melanin in your skin from tanning, you can still be treated. However, laser settings must be adjusted accordingly so that you get the safest and most effective treatment.
    • When you buy your custom laser package, plan ahead and include a bottle of Dr. Macdonald’s specially formulated, medical-grade sunscreen, Total Protection. It contains 17% zinc oxide. The zinc ingredient creates a physical barrier between the sun and your skin.



    It is very important to communicate any medical conditions you have and all medications you are taking. Your safety is always our first priority.

    Prior to your free laser consult appointment with our nurse, please complete the forms entitled Medical History for Laser/BBL™ Procedures and Skin Type Matrix under our Patient Forms page. These forms help identify medications and other pertinent skin details necessary to plan the most safe, effective treatment.

    • Stop use of Accutane™ for acne at least 6 months prior to receiving any laser therapy. Stop use of tetracycline type prescription medications for acne at least 2 weeks prior to receiving any BBL™ laser therapy. Lingering pharmaceutical effects could have a negative impact on the outcome of your BBL™ laser treatment.
    • Do not take aspirin or aspirin-containing products for 2 weeks prior to any ablative laser procedure (MicroLaserPeel®, Contour TRL™ or ProFractional™).
    • If you are prone to cold sores, Dr. Macdonald will prescribe an antiviral medication prior to your ablative laser procedure. Be sure to take it as directed. This medication combats any potential breakouts that could be instigated by the heat of the laser.
    • If you have a medical condition making you prone to seizures, whether or not you take specific anti-seizure medications, laser therapy is not an appropriate treatment for you due to the associated risks. Ask Dr. Macdonald about other cosmetic treatment options that may still accomplish your goals without these risks.


    Planning for driving and post-laser care

    For all deep ablative laser therapies including ProFractional™ and Contour TRL™ deep resurfacing, we highly encourage you to arrange for a friend or family member to be available to drive you to and from your procedure.

    You are offered prescription pain and anti-anxiety, relaxant medication prior to your treatment. This medication helps ensure maximum comfort throughout your procedure. However, if you elect to take these medications, you may not drive yourself home afterward. So, plan ahead.

    Any post-treatment medications required are provided at the time of your treatment. Downloadable, detailed post-treatment instructions are available in the after laser treatment section.

    The most critical after-care measure you can take is to avoid sun exposure as much as possible. Use a sunblock containing zinc oxide or titanium dioxide for at least 6 months.

    Post-treatment discomfort with any BBL™ or Varilite™ treatment is rare. With any ablative resurfacing treatment (MicroLaserPeel®, Contour TRL™ or Profractional™), some discomfort can be expected during the first 2-4 days following your treatment—depending on the aggressiveness of treatment. An occlusive healing balm applied to treated areas helps minimize any discomfort.


    Schedule adequate healing time

    • BBL™ and VariLite™: With the BBL™ or VariLite™ laser therapies we offer, no downtime is usually required for healing. At most, you experience minor redness or irritation for a couple of hours. It can easily be covered with concealer makeup.
    • MicroLaserPeel®: The MicroLaserPeel® is a superficially ablative procedure, sometimes referred to as a “weekend peel” or “3x microdermabrasion”. For a lighter MicroLaserPeel®, the healing downtime you should plan for is 3-4 days.
    • ProFractional™: ProFractional™ therapy, if administered alone vs. part of a combination laser therapy approach, has a downtime of approximately 1-2 days.
    • Contour TRL™: Ablative Contour TRL™ deep resurfacing procedures require the most downtime, usually ranging from 5-10 days.

    When scheduling time off work and absence from public social engagements, we recommend conservatively allowing for the longer estimated healing days. Planning for maximum downtime relieves anxiety and stress during your healing process.


    Preparing for Injectable Treatment

    Tips to avoid bruising

    • Do not take aspirin or aspirin-containing products (i.e., Advil, Motrin, Aleve, and generic ibuprofen), or omega-3 fatty acid supplements for 2 weeks prior to your injectable procedure.
    • Please avoid Vitamin E 2 weeks prior, especially in high doses. Read your existing supplement labels. Often, 100 IU of Vitamin E is contained in various green supplements. It increases bruising risk.
    • We recommend you take Arnica to support the healing process beginning 3 days preceding and continuing a few days following your procedure. Arnica is available for purchase at our office.
    • Apply ice the first 12-36 hours to help relieve any swelling and bruising.


    Bring along post-treatment makeup

    Dr. Macdonald cleans the injection site prior to treatment and applies a topical numbing ointment to minimize any minor discomfort.

    To prepare your face for greeting the public immediately following your injectable treatment, you may want to bring along some light, preferably powder cosmetics (i.e., powder cover-up or ColorScience® light powder sunscreen).

    A dusting of light makeup can camouflage any temporary discoloration (injection marks or redness) that may occur immediately following your procedure.

    Bruising is a common side effect, particularly in treating the hollows and dark circles under the eyes. Be sure to plan for the likelihood of bruising and thus book a light work and social calendar post-injection.