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Before And After Surgery

Dr John Kippen

Surgery takes planning and preparation so as a patient, this should also be considered. This is obviously applicable to elective, non urgent surgery. Check your surgeon’s qualifications and membership of organisations such as the Australian Society of Plastic Surgeons and the Royal Australasian College of Surgeons.

All treatable associated medical conditions should be optimised, such as heart disease, lung disease, blood pressure, kidney or liver disease, etc. Consideration needs to be given to blood thinners as these may need to be altered, adjusted, substituted, or occasionally stopped. Certain cardiac or heart stents require accurate blood thinning and can clot if blood thinners are not substituted. Surgeons will often require notes, investigations or reports from other specialists. Fish oil, vitamins, herbal and other supplements may affect clotting and should be reported to your surgeon. Anti-inflammatory medications may also change clotting and bleeding.

Obesity has been shown to be associated with increased risk of heart attacks (may be due to associated conditions such as high blood pressure or diabetes), wound infections, nerve injury and urinary tract infection. Drip insertion, positioning, airway and breathing may all be more difficult. Post operative mobility and recovery may also be affected. These can all result in a longer hospital stay. Getting close to or being at your idea body weight helps and recovery is often quicker. Surgery may also be the incentive required to initiate a weight loss program.

Smoking increases most risks. For elective surgery and especially in certain procedures surgeons will request stopping smoking for between four and six weeks. This includes nicotine patches and e-cigarettes. Nicotine can cause vasoconstriction, or narrowing of blood vessels, required to expatiate healing. A single cigarette has been shown to reduce blood flow to replanted fingers by twenty five percent.

Keep up with good nutrition. Don’t change your diet. If you have had weight loss surgery the surgeon may want to check nutrition markers. Remember to keep up fluids if you have to fast overnight. Check these requirements. Do not chew gum on the morning of surgery.

It is also important to make the post-operative period as stress free as possible. These circumstances vary with each person. It may be necessary to get help with children. Prepare some food in the freezer or have current take-away menus and home deliveries. Make sure fresh linen is on the beds and the washing is done. Depending on the surgery it may be difficult to bend, lift or twist. You may not be able to drive for some time. Prepare the family that you may have to do less.

Check the directions and duration of travel to the hospital. Remember it may be busier at the time that you need to travel. Drive carefully around hospital – people often thinking of other things and may not be concentrating on the road. You may need to arrange to be dropped off or picked up.

The night before surgery remove nail varnish or acrylic nails. Remove piercings, don’t wear make up or moisturisers. Pack your toiletries, underwear, pyjamas, dressings gown and slippers (non slip). Add comfortable clothes to go home. Buttons or zippers are easier than pull-ons. Some people like their own pillows, children may like a comfort toy or teddy-bear. Take a note pad and pen. Some coins or small notes are useful for small purchases. Be prepared to wait so take a book, magazine, e-reader or music.

Dr Kippen is a practicing plastic, cosmetic and reconstructive surgeon and a member of the Australian Society of Plastic Surgeons. Dr Kippen consults from rooms in Mona Vale, Brookvale and Wahroonga. Phone 1300 547 736 or email


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