Surgery is surgery. There are risks. Since New Years is all about lists, I thought I would make one too. There are 5 things you need to tell your plastic surgeon before you have surgery, as these can affect the risk and outcome of the procedure.
1. Smoking. You knew this one was coming. Do not have your eyes glaze over. Smoking is bad for your body and particularly bad for healing. Infection rates, wound breakdown (your incision doesn’t heal well), and tissue loss are clearly correlated. There are some surgeries (tummy tucks, facelifts, and breast lifts and reductions) we won’t do on smokers. Period. I am not your mom. I am not making judgements on you. I am trying to make sure you heal uneventfully.
- Tell your doctor if you were a smoker in the past. Even if it was a little bit in college, smoking is smoking and your doctor needs to know. We can adjust what we do a bit to help make sure things heal well when we know you are an ex smoker.
- If you “smoke just a little bit on weekends when you have a drink” you are a smoker. Yes, it isn’t as bad as chain smoking a pack a day, but you are still a smoker.
- If you smoke something other than cigarettes you are still a smoker. Tell your doctor.
2. Medications, vitamins, herbals, fancy power protein shakes, chinese medications, etc etc. It is important your doctor knows everything you take. Many medications make you bleed (aspirin, NSAID, vitamin E, fish oil, are among the common ones.) ADHD medications should be stopped two weeks before surgery. Birth control pills. Diet pills should be stopped. Many herbals have a lot of stuff in them you may not know. What exactly is in your “hair and nail health” formula?
- Medications can make you bleed, affect your anesthesia, interact with other medications. Tell you doctor. It doesn’t have to be a prescription- tell them of everything you take.
- Medications also help us know what your medical issues are. If your cholesterol or blood pressure is normal while you are on medications, it doesn’t change the fact you have an medical problem: high cholesterol, blood pressure, thyroid issue, etc.
3. Any history of blood clots. Do you or anyone in your family have a history of blood clots? A blood clot is a “DVT” (deep vein thrombosis) or PE (pulmonary embolism). You may have had one or had a relative who had one, particularly after a surgery, long plane flight/car trip, immobilization, or during pregnancy. See my blog on the subject for a questionaire.
- Why does this matter? One of the biggest risks after surgery is a DVT. Blood clot. If you hear of a patient dropping dead a week after surgery, this is a comon reason why.
4. Bleeding issues. Just like clotting too easily is an issue, bleeding too much is an issue as well. If you have a genetic issue, blood disorder, “bruise easily” or just know that when you cut yourself you don’t stop the bleeding for a while, please tell your doctor.
5. Your goal and expectations. This is particularly important in my field of plastic surgery. When you come into surgery, you have in your mind what you think will happen with surgery. When I do surgery on my ….. I will look like ….. when I am done. It is important for your surgeon to know what your expectations are.
- Have realistic expectations
- Meet with a few board certified plastic surgeons to get different opinions of your options
- Make a wish list. Review it with your doctor.
- If you have seen photos of what you don’t want, bring those in as well
You and your doctor need to be on the same page. There are things which are easy to fix, and things which are unfixable. Your doctor can help you navigate and explain what can be done.
We plastic surgeons are not your mom (except for my three kids. For you guys, I am your mom.) I don’t want to know these things for any reason except for your safe, good outcome surgery.