What To Know Before Having A Surgery
Results of the surgery
The Australian Society of Plastic Surgeons has a detailed information sheet for most plastic surgery procedures - from excision of skin cancers to cosmetic surgical operations.
Make sure you and the surgeon are on the same page in regards to the outcomes of the surgery.
Patients vary in their knowledge of post-surgery results and side effects, so the surgeon’s consultation is tailored to the individual.
Sequelae, risks and complications
All operations have sequelae such as swelling of the wound, which is an inflammatory response. Swelling can settle faster with the help of gravity, so patients are often asked to elevate the hand that has had an operation in a sling, or to rest quietly with their head on two pillows for few days. Minor oozing from the wound is not uncommon, and usually stops with a pressure dressing applied for the first 24 to 48 hours.
Risks are categorised into general risks of any operation, and risks specific to that operation. There are risks associated with anaesthesia, depending on the patient’s medical condition. What is acceptable depends on the indication for the operation.
Complications such as bleeding and infection can follow any operation. Even if the utmost care had been taken during the operation, such as tying off or cauterising a bleeding artery, bleeding can start again if the blood vessel is disturbed and the clot dislodged. Therefore, quiet resting for the first 48 hours is usually advised so as to minimise the risk of bleeding.
Sterile aseptic techniques are used in the operating theatre to minimise infection, and for some procedures, prophylactic antibiotics are given.
Depending on the operation, the patient’s medical condition and their anxiety level, the anaesthetist decides on the type of anaesthesia to be given, and explains this to the patient. Anaesthetics are generally safe, and allow patients and surgeons to embark on discretionary surgery that was once considered unjustified two generations ago.
Duration of the operation
Prolonged surgery can be associated with pressure area complications. If operations can be limited to four to six hours, the risks are low.
The facility must be able to cope with potential complications and be able to keep the patient for a period to allow the patient to recover adequately. The facility may range from day surgery units to small hospitals to large hospitals with intensive care. Nursing support is essential for good patient outcome.
Day or overnight surgery
The majority of operations are short, less than two hours, and the patient usually recovers in four to six hours, so are able to go home the same day. Longer admissions may be required for different medical reasons.
Patients on blood thinners are advised to consult their cardiologist or general practitioner to find out if and when they can stop the blood thinners to minimise the risk of bleeding during the operation. Patients fast for a minimum of six hours before any general anaesthetic or sedation.
Before the procedure, the surgeon gives the patient instructions on the management of dressings, elevation of the limb, mobilisation allowed, and time to the first post-operative check.
Limitations on activities
The body takes time to heal, so rest for the first seven to 10 days is usually requested of the patient.
Time to full recovery and final result
Swelling usually distorts the appearance for several weeks after, and scars can thicken for the first two months before settling around four to six months. Skin grafts can take a minimum of three weeks to be less fragile, and months to blend in with the surrounding skin. The surgeon may follow the progress of the patient for up to 18 months.
Plastic surgeon Dr Sawjin Tew has worked on the Northern Beaches since 2001, and has privileges at Delmar Private Hospital and Manly District Hospital. Phone 9411 2266 or visit cosmeticplasticsurgeryaustralia.com.au