As you begin your cosmetic journey, you likely have many questions regarding preparation for the procedure. As always, you should discuss all aspects of the surgery (including preoperative and postoperative recommendations) with your aesthetic surgeon; however, here are a few preoperative recommendations that we commonly provide to our patients to help them have the best possible experience and results.
Cosmetic Surgery Preparation - General Guidelines
Smoking: If you smoke cigarettes, by far the most important thing to do prior to your cosmetic operation is to quit. Nicotine causes vasoconstriction, which is where small blood vessels clamp down and decrease blood flow to certain areas. This is especially true for the skin. When cosmetic surgery is performed, the skin and tissue deep to the skin are rearranged and the blood flow to these areas may then depend on small blood vessels (until your body makes more blood vessels over the course of months). If you smoke and undergo cosmetic surgery, you will clamp down these small blood vessels and will have a much, much higher chance of infection, not healing properly, and even having parts of your skin die and become necrotic. Smoking is simply not worth the risk. Academic studies regarding how long you should stop smoking prior to cosmetic surgery vary; however, the general consensus is that you must stop as soon as possible, and at least two to four weeks prior to your operation. Most aesthetic surgeons will not operate on patients who do not quit tobacco before their operation.
NSAIDs and Aspirin: Non-steroidal anti-inflammatory drugs (NSAIDs) include medications like ibuprofen, Advil, Motrin, Aleve, Midol Extended Relief, Midol Liquid Gels, naproxen, etc. These medications impair the function of your platelets and may make you bleed more during the operation or form a hematoma (collection of blood) postoperatively. If you have ongoing pain and feel that you need these types of pain relief medications, please speak with your primary care physician regarding potential safe substitutes. If you are instructed to take any of these medications by a physician, you must speak with that physician before stopping the medication.
Prescribed Blood Thinners: If you take a prescribed blood thinner (Plavix, Coumadin, Xarelto, etc) you must speak with the physician prescribing this medication regarding if it is safe to stop for cosmetic surgery. The risk of excessive bleeding and hematoma formation when performing cosmetic surgery on an individual taking any of these medications is too great and surgery will not be performed in most practices. On the other hand, if you have a high likelihood of forming blood clots if you stop any of these medications, you should likely not undergo cosmetic surgery at all. You must speak with the physician prescribing this type of medication before stopping it as the risk of stopping the medication may be extremely high.
Alcohol: Individuals who drink alcohol infrequently or “socially” should abstain from alcohol for at least three days prior to your operation. The data among academic studies regarding this topic vary, but this is our practice’s recommendations. Those who drink alcohol excessively may need further testing and may not be suitable candidates for cosmetic surgery.
Herbal supplements: Patients often do not realize that many herbal supplements thin the blood and may cause significant bleeding during surgery or postoperatively. The supplements that increase the risk of bleeding, and should generally be discontinued for one week before surgery, include, but may not be limited to: Gingko biloba; Garlic (capsules, or foods with excessive garlic); Ginseng; Fish oil; Dong quai; Feverfew. Also, if you take Ephedra, you must stop this medication at least one week before surgery as it increases your risk of adverse cardiovascular events. As always, you must speak with your primary physician and/or surgeon regarding stopping any of these medications medication prior to doing so.
Illicit drugs: Plastic and Cosmetic Surgeons are medical professionals, who like other physicians, are bound by HIPPA which is an act that protects patients’ information. Your surgeon should never disclose your information to another party without your prior knowledge and written consent. Therefore, please inform your surgeon if you use any illicit drugs including, but not limited to marijuana, cocaine, heroin, etc. These questions are asked solely for your safety.
Preoperative testing: Please have your bloodwork, mammogram, chest x-ray, EKG, etc performed as ordered by your surgeon and/or primary care physician. Not everyone will need all these tests. Please have the tests that you were asked to do completed by the date requested. This will provide your care team time to review your results and make any adjustments to scheduling/treatment if necessary.
Medications to take: Many cosmetic surgery practices prescribe certain types of medication prior to the operation. These may include medications such as multivitamins, Arnica, vitamin C, etc. Please take these medications as instructed.
You will also likely be provided particular instructions regarding when to stop eating and drinking prior to your operation, when to shower prior to the operation, what to wear, and what to bring with you the day of surgery. Please follow these instructions closely as well.
As always, you should have open communication with your surgeon and office staff. If you are interested in cosmetic surgery and would like to learn more about our practice’s specific pre- and postoperative recommendations, please contact us to schedule your consultation.