General preparations
As mentioned
previously, one of the most important parts of preparation for the operation
is the consultation. It is then that the patient forms a realistic idea
of the expected result, the risks involved, etc. As to other general preparations,
at least before more extensive surgery, the patient should be in the best
possible physical and psychological balance. I usually recommend exercise
in the form of long walks, jogging or workouts at a gym during the time
prior to the operation. An operation, especially a major one, is a physical
and psychological stress, and the patient should therefore be well rested
before the procedure. It may also be wise to take vitamins before the operation,
and for major operations extra iron as well. With regard to weight, substantial
overweight or underweight should be corrected before the operation. This
is particularly important for some kinds of operations. One example is breast
reduction, where weight loss during the period after the operation can drastically
affect the results or even destroy them. The patient should therefore be
as close to her or his normal” weight as possible before undergoing an operation
of this type. Substantial overweight also increases the risk of complications:
fatty tissue may heal poorly, for example.
Smoking is another
widely recognized factor with a negative effect on healing. We know that
many substances in tobacco smoke impede healing; nicotine, for example,
constricts blood vessels. Poor blood circulation around the incision increases
the risk of post-operative complications and poor healing. This applies
particularly to operations in which large areas of skin are loosened: face
lifts or stomach tucks, for example. In the worst case some portions of
the loosened skin can develop necrosis. This means that parts of the skin
and the attached subcutaneous fat die after the operation, resulting in
a sore that takes a long time to heal and often leaves an ugly scar that
must be amended when the skin has softened, six months to a year later.
Therefore, especially prior to operations of this type, smokers are advised
not to smoke at all for at least two weeks. It can also be wise to cut down
on smoking or preferably quit for good – before operations other than stomach
tucks and face lifts. People in smoke-filled rooms also inhale a fair amount
of tobacco smoke which can have a negative effect on healing.
Alcohol itself has no directly negative effect on healing, but
large amounts of alcohol can affect the bloods
ability to clot. Prolonged overconsumption of alcohol may also cause liver
damage which impairs blood clotting ability. Moderation in alcohol consumption
before an operation, and also afterward, is therefore recommended. It is also
important to know that some painkillers given after an operation may have
dangerous side-effects if they are taken together with alcohol.
Most patients who undergo aesthetic operations are healthy, active people.
They therefore normally do not need any special medical examinations such
as blood tests, ECGs or lung x-rays. There is no rule stating that patients
with illnesses such as diabetes, high blood pressure or heart-lung problems
can not have surgery, but in these cases a special examination or consultation
with another medical expert may be necessary to determine whether an operation
is appropriate and whether special precautionary measures should be taken.
