Preparing a patient physically and emotionally for surgery is an important element to achieving a successful outcome. There are several related health and emotional issues to consider before entering an operating room.
General Health: A precise history and physical exam is part of any pre-operative evaluation. Specific clearances or tests from a patient’s primary care physician or a specialist, such as a cardiologist, may be performed in cases with associated medical conditions.
Medications: Some medications may have an effect on bleeding or anesthesia. A list of these medications is reviewed with each patient to confirm that any risk is reduced as much as possible. Interestingly, certain herbal products and vitamins that are taken by many patients present a unique problem since most have not been scientifically evaluated with regard to bleeding risks. Therefore, we ask patients to stop all of these types of supplements at least 10 days prior to surgery.
Additionally, hormones such as estrogen or progesterone and birth control pills may cause an increased risk of forming blood clots during surgery. Since these hormones can make the blood more likely to clot–the opposite problem from bleeding–we request that all patients stop hormonal supplements at least 2-3 weeks prior to surgery to reduce the risk.
Emotional Factors: Elective cosmetic surgery can be very enticing and many times the motivation is less than ideal. Determining that the expectations and goals from a cosmetic procedure are realistic is important for several reasons. First and foremost to make sure that the patient’s expectations and satisfaction are realistic and aligned with the surgeon’s expectations and satisfaction and not associated with an external motivation, such as fixing a troubled personal relationship or getting a work promotion. Also, support from family and friends that provide encouragement and assistance in the anxious moments before and after surgery is very important. Lastly, although less common, some patients may require a professional psychological evaluation to determine if surgery is appropriate and that the patient can emotionally make a “good decision” for themselves.
Recovery: Communicating the proper recovery time following surgery is essential to a successful cosmetic surgery experience. Time away from the work environment, household duties, childcare responsibilities and exercise activities is important to discuss with each patient. Each circumstance varies based upon the procedure performed and the patient’s work and domestic role. Therefore, the timing should be carefully selected to avoid unrealistic recovery expectations that leave little or no “wiggle room.” Although most recoveries go as planned, some bruising, swelling, aches and pains can be a bit residual. Earlier this year I discussed recovery times for common plastic surgery procedures . Working around important life events such as weddings or other social events requires thoughtful planning and honest communication between the patient and the surgeon.