# How to Prepare for Plastic Surgery: Tests, Medications, Anesthesia, and Travel > A practical guide to preparing for plastic surgery: preoperative tests, medications and GLP-1 drugs, smoking, anesthesia and fasting, home logistics, travel to Brazil, and warning signs. - Author and medical reviewer: Dr. Walter Zamarian Jr. — CRM-PR 17.388 | RQE 15.688 - Published: 2026-02-19 - Updated: 2026-10-24 - Language: en - Canonical HTML page: https://www.walterzamarianjr.com/blog/how-to-prepare-for-plastic-surgery-guide/ - Topics: geral **At a glance:** Bring a list of your medications, supplements, allergies, medical conditions, and previous surgeries to your consultation. Confirm which tests you need, your fasting instructions, the anesthetic plan, who will stay with you, and how follow-up visits will work. The [American Society of Anesthesiologists’ preparation checklist](https://madeforthismoment.asahq.org/preparing-for-surgery/prep/preparing-for-surgery-checklist/) covers these steps and recommends quitting smoking as soon as possible. Do not stop any medication on your own. Before you are discharged, ask for written instructions on dressings, restrictions, and warning signs. Elective plastic surgery needs time to plan. The consultation defines the indication and the technique; tests assess safety; the anesthesia is planned; your home is organized; and you understand what to do, what to avoid, and when to contact the team. I am Dr. Walter Zamarian Jr., a plastic surgeon in Londrina, Brazil, CRM-PR 17.388 and RQE 15.688, and a member of the Brazilian Society of Plastic Surgery (SBCP) and the American Society of Plastic Surgeons (ASPS). I have performed more than 8,000 operations over two decades. Today, by deliberate choice, more than 90% of my surgeries are deep plane facelifts with fat grafting, at a pace of about three per week (roughly 150 a year); fat grafting is not added to every case. I consider the preoperative period an active part of treatment. ## Preoperative tests Preoperative tests vary with your age, the procedure, your medical history, your medications, and the medical assessment. They may include a complete blood count, coagulation tests, blood glucose, kidney function, an electrocardiogram, a cardiology evaluation, imaging, or other tests when needed. The goal is not simply to “clear” you for surgery. It is to identify anemia, clotting problems, infection, cardiovascular risk, poorly controlled diabetes, or any condition that needs to be addressed before the procedure. ## Medications and supplements Medications should be reviewed one by one. Anticoagulants, anti-inflammatory drugs, aspirin, some antidepressants, herbal products, supplements, hormones, and birth control pills may require specific instructions. Never stop a medication you take regularly without guidance from the physician who prescribes it and from the surgical team. GLP-1 medications are one example. For surgery with my team, we ask patients to stop GLP-1 medications three weeks before the operation. This is our practice protocol, not a universal interval for every surgical patient. Coordinate the pause with our anesthesiologist and the clinician who prescribes your medication, particularly if you have diabetes, so that blood glucose management is planned. Confirm when to restart treatment as well. The risk of blood clots also needs to be considered, especially in longer operations and in patients with a personal or family history of clotting, smoking, birth control use, immobility, or other medical conditions. The right preparation depends on an individual assessment. ## Smoking and nicotine Smoking and nicotine impair microcirculation, tissue oxygenation, and healing. This can increase the risk of wound separation, skin compromise, necrosis, infection, and unfavorable scarring. E-cigarettes and nicotine patches also need to be discussed. Quitting as early as possible is beneficial, even when surgery is close, according to the [American Society of Anesthesiologists](https://madeforthismoment.asahq.org/preparing-for-surgery/risks/smoking/). That does not mean automatic clearance to operate: your surgeon may recommend a longer period without smoking or postpone the procedure. Discuss any vaping or nicotine replacement as well. ## Anesthesia, fasting, and the hospital Anesthesia should be planned before surgery. The type of anesthesia, the pre-anesthetic assessment, your current medications, allergies, any history of nausea, test results, and the length of the operation all influence the plan. For my hospital-based facelift procedures, I use total intravenous general anesthesia, or TIVA. TIVA describes how general anesthesia is maintained; it does not mean light sedation or eliminate the need for an anesthesiologist, and it does not remove every anesthetic risk. My article on [facelift anesthesia and TIVA](https://deepplanefaceliftbrazil.com/blog/facelift-anesthesia-understanding-general-anesthesia-and-tiva/) covers these points in more depth. Fasting should follow the team’s instructions, which are given individually. It is also important to confirm the hospital, your arrival time, documents, test results, comfortable clothing, removal of jewelry, and whether you need someone to accompany you. These details reduce stress and delays on the day of surgery. ## Nutrition, hydration, and skin In the weeks before surgery, the focus is on arriving in good overall health. Adequate nutrition, hydration, sleep, control of any medical conditions, and avoiding excessive alcohol help your body prepare. Extreme diets close to surgery can hinder recovery. Skin care before and after surgery matters too. Sunburn, dermatitis, inflamed acne, wounds, or an active infection may need treatment before the procedure. ## Home, a companion, and transportation Arrange transportation back, a responsible companion, a place to rest, pillows, simple meals, your medications organized according to instructions, and toiletries. You should not drive after surgery or stay alone when the team advises that someone be with you. Young children, physically demanding work, stairs, travel, or distance from the clinic all need to be part of the plan. Recovery does not begin when you get home; it begins earlier, with realistic logistics. ## Traveling from another city or country: how we can help We can start with an [online consultation](https://www.walterzamarianjr.com/us/online-consultation/) before you organize your trip to Londrina. An in-person preoperative consultation is still required; when your first consultation was online, that in-person visit does not carry a new consultation fee. My team provides guidance on accommodation in Londrina, including hotel or Airbnb options. Booking and paying for accommodation are arranged separately. We can recommend a trusted driver and a companion or caregiver, both hired separately. While you are in Londrina, you have support with dressings and frequent in-person evaluations with me. After you return home, we continue follow-up online for up to one year after surgery. Before booking, confirm with the team where you will stay, how you will get to your appointments, and whether you need a companion. How long you stay and when you are cleared to travel depend on the in-person assessment and on how your recovery progresses. More information is available on my [international patients page](https://www.walterzamarianjr.com/us/international-patients/). ## Expectations and recovery Pain, discomfort, swelling, bruising, fatigue, irregular sleep, and anxiety can all be part of recovery. It is also important to set [realistic expectations](https://www.walterzamarianjr.com/blog/plastic-surgery-realistic-expectations/). Surgery should not be planned around haste, comparison with someone else, or a promise of unlimited change. ## Warning signs Before surgery, tell the team about fever, a bad cold or flu, infection, skin wounds, a significant flare of rhinitis or sinusitis, abnormal test results, and any change in your health or medications. After surgery, worsening pain, fever, foul-smelling discharge, or persistent bleeding require prompt evaluation. **Shortness of breath or chest pain requires emergency care; do not wait for a reply to a message.** New pain or swelling in one leg also requires urgent evaluation, according to the [NHS guidance on deep vein thrombosis](https://www.nhs.uk/conditions/deep-vein-thrombosis-dvt/). My article on [limits and risks in plastic surgery](https://www.walterzamarianjr.com/blog/plastic-surgery-realistic-expectations/) explains why early communication is part of safety. ## Choosing your surgeon Preparation starts with a sound indication. Check the surgeon’s CRM and RQE registration, experience, hospital, anesthesia, clarity about risks, and follow-up. My article on [how to choose a plastic surgeon](https://www.walterzamarianjr.com/blog/how-to-choose-plastic-surgeon-criteria/) brings together objective criteria. Good preoperative preparation is not bureaucracy. It is the set of decisions that makes surgery more predictable, safer, and better aligned with what you can realistically handle during recovery. ## Frequently asked questions ### Which preoperative tests will I need? It depends on your age, the procedure, your medical history, and your medications. Tests may include blood work, coagulation tests, blood glucose, kidney function, an electrocardiogram, a cardiology evaluation, or imaging. Their purpose is to find conditions that should be addressed before surgery. ### Should I stop my medications before plastic surgery? Never stop a regular medication on your own. Each medication and supplement should be reviewed with the surgical team and the physician who prescribes it. For surgery with my team, GLP-1 medications are paused three weeks before the operation; this is our protocol, coordinated with the anesthesiologist and your prescriber, not a universal rule. ### Is it too late to quit smoking if surgery is close? Quitting as early as possible is still beneficial, according to the American Society of Anesthesiologists. It does not guarantee clearance, however: your surgeon may recommend more time without nicotine or postpone the operation. Vaping and nicotine replacement should be discussed too. ### What anesthesia is used? The plan is defined individually with the anesthesiologist. For my hospital-based facelift procedures, I use TIVA, a form of general anesthesia maintained with intravenous medication. It still requires an anesthesiologist and does not eliminate anesthetic risk. ### Can I start with an online consultation if I live abroad? Yes. An online consultation can come first, but an in-person preoperative consultation in Londrina is still required. How long you stay and when you can travel home depend on the in-person assessment and your recovery. ### Which warning signs require emergency care? Shortness of breath or chest pain requires emergency care immediately; do not wait for a reply to a message. New pain or swelling in one leg needs urgent evaluation. Worsening pain, fever, foul-smelling discharge, or persistent bleeding also need prompt assessment. ## Medical sources and further reading - American Society of Anesthesiologists. [Preparing for surgery checklist](https://madeforthismoment.asahq.org/preparing-for-surgery/prep/preparing-for-surgery-checklist/). - American Society of Anesthesiologists. [Smoking and surgery](https://madeforthismoment.asahq.org/preparing-for-surgery/risks/smoking/). - American College of Surgeons. [Preparing for surgery](https://www.facs.org/for-patients/preparing-for-surgery/). - American Society of Plastic Surgeons. [Patient safety](https://www.plasticsurgery.org/patient-safety). - Centers for Disease Control and Prevention (CDC). [About surgical site infections](https://www.cdc.gov/surgical-site-infections/about/index.html). - NHS. [Deep vein thrombosis (DVT)](https://www.nhs.uk/conditions/deep-vein-thrombosis-dvt/). --- Medical information for educational purposes. Suitability, risks and treatment planning require an individual consultation.