Top Ten “Before Surgery” Preparations
July 15th, 2009
Preparation for surgery is essential to make the post operative course for patients easier and safer. Both pain and risk of complications can be reduced. I can’t stress more strongly the importance of patience responsibility in regard to these instructions. Following these guidelines can significantly reduce both pain and risk of complications. Here are my Top 10 recommendations for our patients, although it is important for patients to follow whatever instructions their chosen surgeon provides. Surgery by and large is safe. Complications are always an inherent risk, however you can help in reducing post-operative risks by doing these simple recommendations before surgery.
- Stop all aspirin and NSIDs. Both of these drugs affect platelet function in the blood. The result is a reduced ability to clot the blood when tissue is divided in surgery. This can lead to unwanted bleeding and bruising after surgery. These effects last for two weeks. Stop taking these medications two weeks before surgery.
- Take A Shower. Any time you shower, the number of bacteria on the skin is reduced. Taking a shower the night before and the morning before surgery can go a long way in reducing the risk for infection. Regular soap is fine for the task.
- A Dose Of Celebrex. Pain after surgery is inevitable. We do everything we can do to reduce the post operative discomfort. One of the most dramatic changes has been the institution of a single oral dose of Celebrex immediately before surgery. This alone reduced the need for strong pain pills after surgery in my practice by 30%! Of course, this is not a choice if a patient is allergic to the medication or related medications. This must be given by the physician or their staff at the surgical facility. This must not be done yourself.
- Do Not Eat or Drink Before Surgery. Eating solid food before surgery is dangerous. It can lead to vomiting during surgery which can result in aspiration. Aspiration pneumonia is very serious and can result in death. Always know the recommendations regarding how long before surgery you are not supposed to eat or drink. Generally this 8 to 12 hours before surgery.
- Avoid Health Store Medications. Unfortunately, natural medications can be variable in preparation and strength. Some of the lead to unsafe increased blood pressure during surgery. Excess intake of some vitamins can interfere with clotting. For this reason, consider only taking a single multivitamin for two weeks before surgery. Stop taking other over the counter medications as directed by your surgeon. Continue taking prescription pills. Make sure you tell your surgeon and your anesthetist all the drugs you have been taking before anesthesia and surgery.
- Stop All Illicit Drugs. Illicit drugs can be dangerous. Their formulation and content is unknown. Their interaction with anesthetic drugs is serious and can lead to death during and after surgery.
- Stop Smoking and Alcohol. The nicotine in tobacco products and in “stop smoking” aids makes blood vessels smaller as a result of its action on the blood vessel muscle. Many plastic surgery procedures (face lift, tummy tuck, breast reduction) reduced blood flow to the skin. The risk of skin loss and bad scarring is increased ten-fold when these two effects are combined. Smoking tobacco or weed also increases the chance of coughing after surgery. Coughing can lead to unwanted bleeding. It is best to quit all nicotine containing products two to four weeks before surgery.
- Drink A Gallon Of Water. The day before surgery drink a gallon of water. Drink water before you go to bed. This will insure you are well hydrated the morning of surgery. This will make it easier to start your IV if necessary and it will help stabilize your blood pressure during the anesthetic.
- Arrange To Have Someone Stay With You. The first 24 hours after surgery are critical. You may need help to get around at home after surgery. In addition, emergencies can occur and you safety will be assured by having assistance. Home nursing care is also an option. We provide this service for all our face-lift patients.
- Read All Your Materials. Most physicians give written instruction prior to surgery. We provide before surgery instructions, after surgery instructions, a list of medications to avoid, and the surgical consent. Go over these things a couple of times and make sure you understand everything. If you have questions, call and get them answered.
In summary, follow all Before and After Surgery Instructions. This bears repeating! When in doubt or unclear about something, contact your surgeon to check. Surgery by and large is safe. Complications are always an inherent risk, however you can help in reducing post-operative risks by doing these simple recommendations before surgery.
Patient Perspectives:
July 13th, 2009
It is such a personal decision to have cosmetic surgery and I thought it was only something for glamorous people in movies or television. I never even considered cosmetic surgery until my body changed after four pregnancies. I was always known in the small town I grew up in as having a nice chest. There weren’t many augmentations in the eighties when I graduated from college, so my rather ample cleavage stood out. I felt proud of my figure. But the toll of running 6 days a week with athletic bras of questionable quality and nursing three children finally caught up with me. I felt sad about my new shape.
I started to look into the possibility of a breast lift or other corrective surgery. I brought up my concerns to my husband. He didn’t think it was necessary, but understood how it bothered me. I’d have to tuck my breasts carefully into bras or they would droop terribly. The cute running bras were out of the question. I’d joke to my sister that if I’d lie down on my back, they’d fall into my armpits! I decided to set up a consultation. I didn’t know what to expect. I was a little nervous, but very excited too. Dr. Bashioum was very easy to talk to and I felt comfortable asking him questions. After leaving the consultation, I was even more excited and very well informed! It turns out that I was a wonderful candidate for elective surgery. I set up a surgery date for a short while later. I then started counting the days until surgery. I’d dream of having my pre-baby body again.
When I arrived the day of surgery, I felt like a princess. It sounds strange, but I really did feel special. Everyone was taking such great care of me. When I woke up, I felt a lot of pressure on my chest. I don’t remember too much other than my nurse giving me ice. I went home, had lunch, watched TV and iced. I received a call that night from Dr Bashioum to check on me. I was doing great and I didn’t have much discomfort. The next day, I took a shower as instructed and looked at my new breasts. The swelling made my chest look kind of strange. I thought, “Oh, what did I do?†A few weeks later the swelling went down and my new shape took form. I really love my new breasts. I can wear nice bras and workout tops now. The hardest thing for me during recovery was to take it easy. I couldn’t wait to start my work outs again. I’d do this surgery again in a minute. I just wish I would have done it a few years earlier. Now I feel much better about myself.
Patient name withheld upon their request.
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