Preparing for Plastic Surgery: A Comprehensive Guide to Optimize Your Experience

Introduction:

Embarking on a plastic surgery journey is an exciting step towards achieving your aesthetic goals. To ensure a smooth and successful outcome, thorough preparation is essential. In this blog post, we'll delve into key preparatory measures, discussing both scientifically supported techniques and also practical things to have a smoother recovery.

Some Practical Steps to Follow.

1. Confirm Surgery Details:

Double-check the date, time, and location of your surgery.
Confirm any specific preoperative instructions provided by your surgeon.
Arrange Transportation: If your having a procedure under sedation or general anesthesia you will not be able to drive yourself home. You will need a responsible adult you know to bring you home and is recommended to stay with you as well while the medications wear off. No Uber's or Lyft's!
Ensure you have assistance for the first 24-48 hours during your recovery.

2. Notify Work and Responsibilities:

Inform your employer and colleagues about your scheduled surgery.
Make arrangements for any necessary time off or delegation of responsibilities.
Coordinate Care for Dependents: Some times surgery will go longer than scheduled so make sure if children need to be picked up or meals prepared etc that someone you trust can perform those tasks.
Don't forget about pets, arrange for their care during your recovery period.

3. Organize Medical Information:

Create a list of current medications, including dosage and frequency.
Provide your surgeon and anesthesia team with a detailed medical history, including allergies and previous surgeries.
Review Preoperative Instructions:

4. Prepare Your Living Space:

Create a comfortable recovery space at home.
Stock up on necessary supplies, such as medications, bandages, and recovery-friendly foods.
A great substitute for medical gauze are feminine maxi pads. They are made of similar absorptive material as an ABD pad but are a fraction of the cost.
For plastic surgery procedures especially liposuction we always recommend picking up a box of puppy pads to put on car seat, sofa, or bed for the first few days as drainage is normal and can be significant. Alternatively, dark colored bath towels can also soak up drainage and can be easily laundered as needed.
Many procedures in plastic surgery it will be helpful to sleep more upright to help with swelling so a recliner or several pillows may be helpful but always check with your surgeon on specifics.
Tidy up and do household chores before surgery so for the first few days after surgery you will not have to worry about these tasks.
Meal prep or at least some thought on having appropriate foods after surgery available. Sometimes we have to deal with post operative nausea so it is a good idea to have some bland foods such as Jello, broth, soups available if we are unfortunate and develop nausea.
Prepare entertainment options, books, or soothing music for your recovery period.
Consider creating a playlist or downloading movies or shows in advance.

Financial Matters:

Settle any outstanding bills related to the surgery or consult with the billing office.
Make sure your regular bills are taken care of you don't want to forget those while you are on post operative medications and incur late penalties.

Communication Plan:

Inform a friend or family member about your surgery details.

Provide emergency contacts to the surgical facility.

Hygiene Preparation:

Remove nail polish, makeup, and avoid using any lotions or perfumes.

If you have body piercings that can be removed it is best to remove them. This is to decrease the chance during surgery, if cautery is needed, of a burn due to electrical arcing across any piercings.

Chlorhexidine Body Wash: The First Line of Defense

One evidence based step in preoperative preparation is ensuring proper skin hygiene to minimize the risk of infection. Chlorhexidine gluconate is a widely recommended antiseptic that effectively reduces bacteria on the skin. Using a chlorhexidine body wash before surgery can significantly contribute to a cleaner surgical field. Chlorhexidine is effective with a variety of skin bacteria including antibiotic resistant organisms such as methicillin resistant staph aureus (MRSA) and is a commonly used surgical skin prep during surgery that is well supported by the literature. Of note chlorhexidine is not to be used for ocular (eye) procedures because of the potential damage to the cornea if the concentration is too high. One should not use chlorhexidine prep for facial procedures and if your are having an operation on the face or neck region the typical recommendation would be for normal cleansing with your usual soap and shampoo the night before the procedure.

Reference: Edmiston CE Jr, Krepel CJ, Seabrook GR, et al. Preoperative shower revisited: can high topical antiseptic levels be achieved on the skin surface before surgical admission? J Am Coll Surg. 2008;207(2):233-239.

Pre-Surgical Carbohydrate Drinks: Nourishing Your Body for Success

There are many practices within medicine that are dogmatic such as not eating or drinking after midnight for a procedure the next day. Changing these practices are incredibly hard and staying up to date with the scientific evidence is key to continued improvement. Fasting before surgery is common practice, but it's equally important to ensure your body is adequately nourished. Pre-surgical carbohydrate drinks can help reduce preoperative stress and improve postoperative recovery. The more up to date recommendations allow for fluid intake up to 2 hours before surgery unless patients have something that slows gastric emptying. Ozempic, Wegovy, and other weight loss medications do slow gastric emptying so be sure to tell your surgeon if you are on these medications for more specific instructions.

Reference: Ljungqvist O, Nygren J, Soop M, et al. Metabolic perioperative management: novel concepts. Curr Opin Crit Care. 2005;11(4):295-299.

Smith MD, McCall J, Plank L, Herbison GP, Soop M, Nygren J. Preoperative carbohydrate treatment for enhancing recovery after elective surgery. Cochrane Database Syst Rev. 2014 Aug 12;(8):CD009161.

Consultation with Your Surgeon: Personalized Guidance for Optimal Preparation

This blog is not specific information you should rely on but only for general educational purposes. Before implementing any preoperative measures, it's crucial to consult with your plastic surgeon They will provide personalized guidance based on your medical history, procedure specifics, and individual needs. Open communication ensures a tailored approach to your pre-surgical preparation.

Reference: American Society of Plastic Surgeons. (https://www.plasticsurgery.org/)

Hydration and Nutrition: Building a Foundation for Recovery

In addition to pre-surgical drinks, maintaining optimal hydration and nutrition is paramount. Adequate fluid intake and a balanced diet rich in vitamins and minerals contribute to a robust immune system and support the body's healing processes. In the days leading up to your surgery make sure to stay hydrated and eat a balanced diet.

Reference: McClave SA, Martindale RG, Vanek VW, et al. Guidelines for the Provision and Assessment of Nutrition Support Therapy in the Adult Critically Ill Patient: Society of Critical Care Medicine (SCCM) and American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.). JPEN J Parenter Enteral Nutr. 2009;33(3):277-316.

Nicotine and alcohol:

Nicotine should be stopped 4 weeks before and after any procedure to minimize risk of infectious and pulmonary complications. Some procedures can be safely performed despite nicotine however for elective cosmetic procedures why risk it?

Alcohol use should also be moderated leading up to surgery and avoided after surgery to avoid medication interactions. Alcohol use increases the doses require to deliver effective anesthesia and increases the side effects of those medications. Alcohol also affects the bleeding we encounter during surgery and thus increases risk of complications as well. Being transparent with your surgeon will allow developing an appropriate plan to manage any alcohol use safely in the perioperative period.

Reference: Sørensen LT. Wound healing and infection in surgery: the pathophysiological impact of smoking, smoking cessation, and nicotine replacement therapy: a systematic review. Ann Surg. 2012 Apr;255(6):1069-79.

Thomsen T, Villebro N, Møller AM. Interventions for preoperative smoking cessation. Cochrane Database Syst Rev. 2014 Mar 27;2014(3):CD002294.

Myers K, Hajek P, Hinds C, McRobbie H. Stopping smoking shortly before surgery and postoperative complications: a systematic review and meta-analysis. Arch Intern Med. 2011 Nov 14;171(20):983-9.

Conclusion:

Preparing for plastic surgery goes beyond the surgical suite – it involves thoughtful steps to optimize your overall well-being. By incorporating chlorhexidine body wash, pre-surgical carbohydrate drinks, and maintaining open communication with your surgeon, you set the stage for a successful and smooth surgical experience. Remember, your surgeon is your best resource for personalized advice tailored to your unique needs and goals.