Instructions Prior to Plastic Surgery

Any surgery has inherent risks. In order to decrease some of these risks, following proper instructions is very important around the time of surgery. A complete discussion of medical problems or conditions, medications, alcohol and tobacco use are necessary with Dr. Wiener.

What medications should I stop around the time of my surgery?

Do: Stop all anti-inflammatory medications, steroid products (including inhalers), ADHD and diet medications. Don’t: Start any new medications around the time of surgery without notifying Dr. Wiener first. Certain medications can cause greater risks for problems both at the time of surgery and afterwards. Anti-inflammatory medications such as aspirin (Excedrin, Ecotrin), ibuprofen (Motrin, Advil, Midol), naproxen (Naprosyn, Nuprin), Aleve, combination medications containing anti-inflammatories, and prescription anti-inflammatory medications thin the blood and will increase the risk of a postoperative bleed. These must be stopped 2 weeks before until 3 weeks after surgery.The only anti-inflammatory that can be used during this time is Tylenol (acetominophen). Other blood thinners such as coumadin must also be stopped but this would need to be done at the advice of your physician. Vitamin E and fish oil (Omega-3) also act as blood thinners. Other medications that can potentially cause problems are prescription steroids which also include nasal inhaler steroids such as Flonase, Nasonex, and others. Flonase is now available over the counter and this also must be stopped. Asthma inhalers with steroids are also included. Steroids should not be abruptly stopped, but must be tapered at the advice of your prescribing doctor until they are stopped at least 2 weeks pre-op and not restarted until cleared by Dr. Wiener due to the risk of extremely serious wound healing problems, and in surgeries such as breast implant surgery, a wound healing problem can cause implant loss. Non-prescription and prescription body-building steroids (anabolic steroids) can also cause serious problems, as can prescription and over-the-counter diet pills. Most herbs and herbal products act as blood thinners and are also stopped 2 weeks before until 3 weeks after surgery. All ADHD medications such as Adderall must be stopped 2 weeks before until 3 weeks after surgery to prevent dangerous interactions with anesthesia.

What about Energy Drinks like Red Bull, Monster, 5-hour Energy?

Please also stop all energy drinks 2 weeks before until 3 weeks after surgery.

Does smoking and nicotine need to be stopped?

Do: Stop cigarettes and any nicotine for a tummy tuck or breast lift. Certain surgical procedures cannot be done in someone using nicotine. This even includes the “occasional” smoker. All forms of nicotine are included, such as cigarettes, cigars, chewing tobacco, nicotine gum and patches. If you use these at any time whatsoever, you must tell your plastic surgeon as extremely serious loss of skin and extreme scarring will occur with certain surgeries. Some of these surgeries include almost all facial procedures, breast lift and breast reduction, abdominoplasty or tummy tuck, aggressive chemical peels and laser resurfacing. Alcohol use (beer, wine, mixed drinks) should be stopped 2 weeks prior to surgery, as alcohol can act as a blood thinner.

How does my diet affect surgery and what should I be eating?

Don’t: Eat junk food around the time of surgery. A healthy diet, especially containing meat protein such as fish, chicken, beef, pork, eggs, etc., is necessary for wound healing. Major surgery puts the body under nutrional and energy stress as the body heals postoperatively. Good nutrition is essential to the healing process. If you are on any type of special diet, calorie restriction, even if the calorie restriction is just calorie counting, you must inform Dr. Wiener. Also, unusual diets or vegetarian diets must be disclosed because even though this type of diet may be adequate during normal times, during and after a surgery, it may not provide adequate nutrition and may cause extremely serious wound healing problems. This warning also includes diets that are just poor, such as meals that are primarily junk or fast food, as the nutritional content may not be good enough to allow adequate wound healing. Therefore, three regular meals of high quality meat, fish, poultry, and fresh fruits and vegetables need to be started as far ahead of surgery as possible and continued for at least two months postop.

Should I start any Vitamins before my surgery?

Dr. Wiener recommends that you begin a plain, over-the-counter Vitamin C tablet, 500mg, with no other herbal components or additives as soon as possible, at least 2 weeks before surgery and continue this for two months after surgery.

What about medical conditions that I have?

Any medical condition that you have must also be discussed with your surgeon. Certain conditions can greatly increase your risk of serious problems with surgery or anesthesia. All previous surgical procedures that you have had also need to be discussed. Although risks are present with any surgery, good, honest communication with your plastic surgeon and following preoperative and postoperative instructions can decrease certain risks and make your surgery and recovery safer. Dr. Wiener’s office is located in Clear Lake. Conveniently located near Houston, Pearland, Friendswood, and Galveston.