Pre-Surgical Preparation: Your Complete Guide to a Safe and Smooth Surgery
If you have already scheduled your plastic surgery with me or are considering doing so, know that the success of the procedure begins long before you enter the operating room. In fact, I dare say that pre-operative preparation is just as important as the surgical technique itself. A well-prepared patient heals better, experiences fewer complications, recovers more quickly, and achieves superior results.
Over more than twenty years performing plastic surgeries in Londrina, with over eight thousand procedures, I have learned that the best results do not come solely from the surgeon's hands. They arise from a genuine partnership between doctor and patient, where every guideline is followed with discipline and every detail is attended to with care. That is why I created this complete guide to pre-surgical preparation.
Here you will find all the guidelines I personally provide during the first consultation: from the tests you need to perform, to the medications you should stop taking, to how to care for your sleep, nutrition, and emotional state in the weeks leading up to your surgery. If you prefer, I also offer online consultation for patients from other cities who wish to start this planning remotely.
Read carefully, save this page, and refer to it whenever you have questions. Your preparation starts now.
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Pre-operative exams: the foundation of your safety
Every surgical procedure I perform requires a battery of preliminary exams. This is not medical bureaucracy. Each exam has a reason for being and provides me with essential information to ensure that your surgery is absolutely safe.
Mandatory laboratory tests
I request the following blood and urine tests for all my surgical patients, without exception:
Complete blood count: evaluates your blood cells, detects anemias that could compromise tissue oxygenation during and after surgery, and identifies possible hidden infections.
PAT with INR and APTT: these are the coagulation tests. They check if your blood coagulates properly, which is essential to avoid excessive bleeding during the procedure.
Creatinine and urea: assess the function of your kidneys, the organs responsible for eliminating anesthetic medications from your body after surgery.
Fasting blood glucose: detects diabetes or pre-diabetes, conditions that directly affect healing and the risk of infection.
Total proteins and fractions: reveal your nutritional status. Patients with low protein levels heal worse and have a higher risk of complications.
Urinalysis: identifies urinary infections that need to be treated before surgery, as any infectious focus can contaminate the operated area.
Cardiological evaluation
Regardless of your age or the size of the surgery, I request a complete cardiological evaluation that includes an electrocardiogram and surgical risk classification by the cardiologist. This evaluation confirms that your heart is prepared to withstand anesthesia and surgical stress. In some cases, depending on your history, the cardiologist may request additional tests such as echocardiogram or stress test.
Validity of the exams
Laboratory tests are valid for thirty days. If your surgery is postponed for any reason, new tests will be necessary. I recommend that you complete all tests at least two weeks in advance, so there is enough time to address any abnormalities found.
Bring all results to your pre-operative consultation. I personally analyze each exam and discuss with you any relevant findings. Your safety is non-negotiable.
Medications that must be stopped before surgery
This is one of the most critical points of the entire pre-surgical preparation, and I need you to take it extremely seriously. Several commonly used medications interfere with blood coagulation and can cause dangerous bleeding during and after surgery. Stopping these medications in a timely manner can be the difference between a smooth surgery and a serious complication.
Fifteen days before surgery, you must stop:
Acetylsalicylic acid (Aspirin, AAS, Bufferin, Melhoral, Doril): even in low doses used for cardiovascular prevention, aspirin irreversibly inhibits platelet function for up to ten days. This means your blood loses the ability to form clots properly.
Non-steroidal anti-inflammatory drugs (Ibuprofen, Naproxen, Diclofenac, Nimesulide, Piroxicam, Ketoprofen): all alter coagulation to varying degrees. If you need pain relief during this period, use acetaminophen (Tylenol) or dipyrone, which do not affect coagulation.
Oral anticoagulants (Warfarin, Rivaroxaban, Apixaban, Dabigatran): these medications require special management. Never stop anticoagulants on your own. I always discuss the case with your cardiologist or hematologist to define a safe replacement protocol, which may include low molecular weight heparin as a bridge.
Antiplatelet agents (Clopidogrel, Ticagrelor, Prasugrel): if you use any of these medications after stent placement or for arterial disease, the suspension needs to be coordinated between me and your cardiologist. The risk of surgical bleeding needs to be balanced with cardiovascular risk.
Other medications that deserve attention
Inform me about absolutely everything you take, including medications you consider harmless. Some antidepressants, for example, can interfere with anesthesia. Medications for thyroid, blood pressure, and diabetes are generally maintained, but with adjustments that I define on a case-by-case basis.
If you take any continuous medication and are unsure whether to stop, contact my team via WhatsApp. Today's doubt can prevent a serious problem tomorrow.
Vitamins, supplements, and herbal products: the invisible danger
Many patients are surprised when I say that vitamins and natural supplements can be as dangerous as medications before surgery. There is a widespread belief that, because they are "natural," they pose no risks. This is a dangerous myth that needs to be debunked.
Stop at least seven days before surgery:
High doses of Vitamin E (above 400 IU): Vitamin E is a potent platelet aggregator inhibitor. In high doses, it hinders clot formation and significantly increases the risk of bruising.
Omega 3 (fish oil): the EPA and DHA fatty acids have a well-documented anticoagulant effect in the medical literature. Even in nutritional doses, I recommend stopping.
Ginkgo biloba: this popular herbal remedy for memory and circulation inhibits platelet activating factor (PAF), considerably increasing bleeding time.
Ginseng: interferes with both coagulation and glucose levels, potentially complicating anesthesia.
Garlic capsules: supplemental garlic contains allicin, which inhibits platelet aggregation. Garlic in food in normal amounts is not a problem.
Concentrated green tea: in capsule or concentrated extract form, it can interfere with coagulation and anesthetic medications.
Arnica: although widely used post-operatively to reduce bruising, oral arnica should be stopped before surgery due to its anticoagulant effect. After surgery, depending on the case, I may allow it.
Turmeric (curcuma): curcumin has potent anti-inflammatory properties and interferes with platelet aggregation.
Collagen and other proteins
Hydrolyzed collagen, whey protein, and isolated amino acids can generally be maintained, as they do not interfere with coagulation. In fact, good protein intake is beneficial for healing. However, always confirm with me before keeping any supplement.
The golden rule is simple: when in doubt, stop and ask me. It is much easier to resume a supplement after surgery than to deal with unexpected bleeding during the procedure.
Alcohol and nicotine: the two biggest enemies of your surgery
If there is one thing I could engrave in bold letters in the mind of every patient, it would be this: alcohol and tobacco seriously compromise the outcome of your plastic surgery. This is not my exaggeration. It is not conservatism. It is pure physiology and irrefutable scientific evidence.
Smoking: the number one villain
Nicotine causes vasoconstriction, meaning it narrows the blood vessels that supply oxygen and nutrients to the skin and tissues I am operating on. In a surgery like a facelift, for example, where the skin is lifted and repositioned, blood circulation needs to be perfect for the tissues to survive in the new position.
Patients who smoke have up to twelve times the risk of skin necrosis, widened scars, and infection. These are not numbers to scare you. They are data from the global medical literature, confirmed by my personal experience in over two decades of practice.
My requirement: total cessation of smoking for at least fifteen days before and fifteen days after surgery. This includes conventional cigarettes, electronic cigarettes, vapes, hookahs, cigars, pipes, and any product containing nicotine, including patches and nicotine gum. Yes, electronic devices are equally harmful, as the nicotine is the same.
Alcohol: do not underestimate its effects
Alcohol interferes with surgery in multiple ways. It dehydrates tissues, compromises liver function necessary to metabolize anesthetic medications, alters blood coagulation, and depresses the immune system. Additionally, it interacts dangerously with pain relievers and antibiotics that will be prescribed post-operatively.
My guidance: complete cessation of alcoholic beverages for at least seven days before surgery. After the procedure, alcohol should be avoided for a minimum of two weeks, or until I allow your return to moderate consumption. If you drink regularly, talk to me honestly during the consultation. It is not judgment. It is care for your safety.
Sleep and Rest: Preparing Your Body to Regenerate
Sleep is probably the most underestimated factor in preparing for surgery. We sleep one-third of our lives, and it is during deep sleep that the body performs its most important repair and regeneration functions. If you arrive on the day of surgery with a sleep debt, your body will have fewer resources to heal.
What Science Says
During the deep stages of sleep, especially slow-wave sleep, your body releases growth hormone (GH), essential for tissue repair. The immune system also functions better during adequate sleep, with increased production of anti-inflammatory cytokines and defense cells. Studies show that patients with sleep deprivation experience healing that is up to thirty percent slower and a higher risk of infection.
My Guidelines for the Two Weeks Before Surgery
Sleep between seven and nine hours per night: this is the ideal range for most adults. If you usually sleep less, start adjusting your routine two weeks in advance.
Maintain regular schedules: go to bed and wake up at the same times every day, including weekends. A regular circadian rhythm optimizes hormone production.
Avoid bright screens before bed: the blue light from phones and computers suppresses melatonin, the hormone that induces sleep. Turn off screens at least one hour before bedtime.
Avoid caffeine after three PM: the half-life of caffeine is five to six hours, meaning that a coffee at four PM will still affect your sleep at midnight.
Create a conducive environment: a dark, quiet room with a comfortable temperature. Invest in a good mattress and pillow if necessary.
On the night before surgery, it is natural to feel some anxiety that may hinder sleep. If this happens, do not worry excessively. A poor night's sleep does not compromise the surgery. But weeks of inadequate sleep do.
Hydration and Nutrition: Fuel for Recovery
Your body is an extraordinary biological machine, and like any machine, it needs quality fuel to function well, especially when facing the challenge of surgery. Proper hydration and nutrition in the weeks leading up to the procedure create the ideal conditions for quick and uncomplicated healing.
Hydration
Water makes up more than sixty percent of your body and is involved in absolutely all biochemical reactions, including healing. Dehydrated tissues heal worse, are more susceptible to infections, and respond poorly to anesthesia.
Drink at least two liters of water per day in the two weeks before surgery. If you exercise or live in a hot climate, this volume should be higher.
Observe the color of your urine: it should be light yellow. If it is dark, you are dehydrated.
Reduce the consumption of coffee and diuretic teas: they increase fluid loss.
Preoperative Nutrition
In the two weeks before surgery, prioritize a nutrient-rich diet that promotes healing:
High biological value proteins: lean meats, fish, eggs, dairy. Proteins provide essential amino acids for tissue repair, including proline and lysine, which are fundamental for collagen synthesis.
Colorful fruits and vegetables: rich in vitamin C, necessary for collagen production, and antioxidants that protect cells during surgical stress.
Zinc: found in red meats, pumpkin seeds, and nuts. Zinc is essential for cell division and healing.
Iron: important for hemoglobin formation, which transports oxygen to tissues. Red meats, beans, and dark green vegetables are good sources.
Vitamin A: found in carrots, pumpkin, and sweet potatoes. It participates in epithelial regeneration and immune response.
The Preoperative Fasting
On the eve of surgery, strictly follow the fasting guidelines that my team will provide. Generally, for surgeries under general anesthesia, the fasting for solids is eight hours and for clear liquids is two hours. However, each case may have particularities. Fasting is essential to prevent pulmonary aspiration during anesthesia, a rare but potentially fatal complication.
Attention: do not follow restrictive diets before surgery. Arriving malnourished at the surgical center is much worse than arriving one or two pounds heavier. Your body needs reserves to recover.
Anesthesia: Understanding What Will Happen
The fear of anesthesia is one of the most common among patients preparing for surgery. This fear is understandable but is often based on outdated information or exaggerated stories. Modern anesthesiology is one of the safest specialties in medicine, with extremely low rates of serious complications.
Types of Anesthesia I Use
Depending on the procedure, I may use different anesthetic modalities:
General Anesthesia: used in larger surgeries such as facelift, abdominoplasty, and breast surgery. You are completely asleep and feel absolutely nothing. An experienced anesthetist monitors every vital parameter from start to finish.
sedation with local anesthesia: for smaller procedures. You remain in a state of deep relaxation, conscious but without anxiety, while the operated area is locally anesthetized.
Epidural or spinal: regional block that anesthetizes half of the body. It can be combined with sedation for greater comfort.
The Pre-Anesthetic Evaluation
Before surgery, the anesthetist will conduct a specific consultation with you. In this consultation, they will assess your medical history, your exams, possible allergies, previous experiences with anesthesia, and determine the best technique for your case. If you have had any adverse reactions to anesthetics, please report them in as much detail as possible.
On the Morning of Surgery
Take only the medications that I or the anesthetist expressly authorize, with the minimum amount of water necessary to swallow the pill. Arrive at the hospital or clinic at the indicated time, wearing comfortable clothes and without makeup, nail polish, jewelry, or piercings. Nail polish, for example, needs to be removed because the pulse oximeter measures oxygen saturation through the nail.
I work with anesthetists whom I have known and trusted for years. They will be by your side throughout the procedure, monitoring heart rate, blood pressure, oxygenation, body temperature, and depth of anesthesia. You will be in good hands.
Informed Consent and LGPD: Your Rights and Our Responsibility
The relationship between doctor and patient is, above all, a relationship of trust. And trust is built with transparency. That is why I dedicate significant time to explain every aspect of your procedure and ensure that you make a truly informed decision.
The Free and Informed Consent Form
Before any surgery, you will sign a consent form that details:
The procedure that will be performed and its alternatives
The expected benefits and realistic limitations
The risks and possible complications, no matter how rare they may be
The type of anesthesia and its specific risks
The necessary pre and post-operative care
The estimated recovery time
This document is not a bureaucratic formality that you sign quickly and forget. It is the record of our conversation, and I hope you read every word carefully. All your questions must be answered before signing. If there is any lingering uncertainty, the surgery can wait. Your peace of mind is priceless.
Protection of Your Personal Data (LGPD)
As a doctor and responsible for your clinic, I have an absolute commitment to protecting your personal and health data, in accordance with the General Data Protection Law (Law 13.709/2018). In practice, this means:
Your medical data is confidential: records, exams, photographs, and any information about your treatment are stored in secure systems with restricted access.
Pre and post-operative photographs: are an essential part of medical documentation. They will be used only for clinical purposes, comparison of results, and surgical planning. Use for educational or promotional purposes only occurs with your express and specific authorization, and always preserving your identity when possible.
Sharing with other professionals: your data may be shared with the anesthetist, laboratories, and other doctors involved in your care, always within what is strictly necessary for your treatment.
Your rights: you can request access, correction, or deletion of your personal data at any time, as provided by law.
I take my patients' privacy as seriously as I take surgical technique. Both are non-negotiable.
Physical exercises: when to stop and why
If you are a physically active person, you are probably wondering when you need to stop your workouts before surgery. This is an important question because physical exercise has both positive and potentially negative effects in the pre-operative period.
The benefits of being in good shape
Patients who exercise regularly tend to have better cardiorespiratory capacity, better blood circulation, more muscle mass, a more efficient immune system, and faster post-operative recovery. Therefore, I am not saying to abandon physical activity. On the contrary, maintain your exercise routine until the appropriate time to stop.
Reduction schedule
Up to two weeks before: maintain your normal exercise routine, including weight training, running, swimming, or any activity you usually practice.
From two weeks to one week before: reduce the intensity to seventy percent of your usual. Avoid strenuous exercises that could cause last-minute muscle or joint injuries.
Last week before surgery: only light activities such as walking, stretching, and gentle yoga. Nothing that significantly raises the heart rate or causes muscle pain.
Forty-eight hours before: rest. Your body needs to be rested and free of any residual muscle inflammatory processes.
Exercises and bleeding risk
Intense exercises in the days leading up to surgery can increase capillary fragility and the risk of bruising in the post-operative period. Additionally, micro muscle injuries elevate inflammatory markers that can interfere with healing. The gradual reduction I described above minimizes these risks without sacrificing the fitness benefits you have built over time.
After surgery, I will guide the gradual return to physical activities as your post-surgical recovery progresses. Each procedure has its specific timeline.
Pre-surgical psychology: preparing mind and emotions
I decided to include this section because, over two decades, I have realized that emotional preparation is as important as physical preparation. The body and mind are not separate entities. The psychological state directly influences the physiological response to surgery, pain tolerance, healing quality, and satisfaction with the outcome.
Pre-operative anxiety: it's normal
Almost every patient feels some degree of anxiety before surgery. This is absolutely normal and, to some extent, even healthy, as it indicates that you are taking the procedure seriously. The problem arises when anxiety becomes debilitating, causing severe insomnia, panic attacks, or catastrophic thoughts.
If this happens to you, talk to me openly. It is not weakness. It is wise to recognize that you need support. In some cases, I recommend brief psychological support in the pre-operative period, which makes a huge difference in the overall experience.
Realistic expectations: the key to satisfaction
The happiest patient is not the one who achieves the perfect result because perfection does not exist in medicine. The happiest patient is the one whose expectations were aligned with reality from the beginning. Therefore, I make it a point to be absolutely transparent during the first consultation:
I show what is possible to achieve and what is not
I explain the limitations of each technique
I discuss the individual factors that influence the outcome, such as skin quality, age, and anatomy
I make it clear that every scar is permanent, although my technique aims to make them as discreet as possible
I emphasize that the final result may take six months to a year to fully establish
Support network
Organize your support network before surgery. You will need someone to accompany you on the day of the procedure, take you home, help in the first twenty-four to forty-eight hours, and be available for any needs in the first week. Knowing that you will have adequate support significantly reduces anxiety.
Practical preparation of the home environment
Keep the house organized and clean before surgery
Prepare light meals and freeze them in individual portions
Provide extra pillows to keep your head elevated if necessary
Place essential items in easily accessible locations, without the need to bend down or climb on stools
Install grab bars in the bathroom if the procedure limits your movements
Notify your work, family, and commitments about the time off
The more prepared you are, both physically and emotionally, the smoother the surgical experience will be overall. The surgery lasts a few hours. The preparation and the result last a lifetime.
Frequently asked questions about pre-surgical preparation
How long before should I start preparing for surgery?
The ideal is to start preparation at least thirty days before the procedure. During this time, you will undergo tests, adjust medications, suspend vitamins and supplements, organize your sleep, diet, and physical activity routine, and prepare the home environment for recovery. The sooner you start, the smoother the process will be.
Can I take my blood pressure medications on the day of surgery?
In most cases, yes. Antihypertensives are generally maintained on the day of surgery and taken with a minimal sip of water on the morning of the procedure. However, each case is individualized. During the pre-operative consultation, the anesthesiologist and I will determine exactly which medications to keep and which to suspend.
What if I have a cold close to the surgery date?
If you have a cold, flu, fever, urinary infection, or any infectious process in the days leading up to surgery, contact me immediately. In most cases, we will postpone the procedure until you are fully recovered. Operating with an active infection dramatically increases the risk of complications, including infection at the surgical site.
Does the pre-operative fasting include water?
The fasting of solids is eight hours before surgery. For clear liquids like water, non-dairy tea, and strained fruit juice, the fasting is generally two hours. However, strictly follow the specific guidelines that my team will provide, as they may vary according to the type of anesthesia and your individual conditions. Chewing gum is also prohibited during the fasting period.
Can I paint my nails before surgery?
No. Remove all nail polish from your hands and feet at least one day before surgery. The pulse oximeter, a device that monitors your oxygenation throughout the procedure, needs the nail free to function properly. Dark polishes, gel, and porcelain nails interfere with the reading and can mask a drop in oxygenation.
Should I follow any special diet before surgery?
I do not recommend restrictive diets. The ideal is a balanced diet rich in proteins, fruits, vegetables, and minerals such as zinc and iron. Arriving at surgery with nutritional deficiencies compromises healing and immunity. If you follow special diets for conviction (vegetarianism, veganism), we can supplement the necessary nutrients with proper guidance.
Can I drive to the hospital on the day of surgery?
No. You must have an adult companion on the day of surgery, both to take you to the hospital and to pick you up after discharge. After any procedure with sedation or general anesthesia, it is prohibited to drive for at least twenty-four hours. Plan this in advance.
Do I need to shave the hair in the operated area?
Do not shave anything on your own. The shaving, when necessary, will be performed by the surgical team in the operating room, with the appropriate technique and at the right time. Shaving the skin at home can cause micro-injuries that increase the risk of infection.
How to deal with anxiety on the eve of surgery?
It is perfectly normal to feel anxiety. Some strategies help: deep breathing techniques, guided meditation through apps, a light walk in the late afternoon, a relaxing warm bath, and avoiding researching about the surgery on the internet the day before. If the anxiety is intense, contact my team. In some cases, I may prescribe a mild anxiolytic for the night before.
What should I bring to the hospital on the day of surgery?
Bring personal documents, health insurance card (if applicable), all test results, the cardiological evaluation, comfortable and loose clothing to wear upon discharge (preferably button-up in the front), slippers, and basic personal hygiene items. Leave jewelry, watches, and valuables at home. Also, bring the phone charger for your companion.
Schedule via WhatsApp
If you are preparing for plastic surgery and want to make sure you are doing everything right, schedule a consultation with me. My team is ready to assist you, answer your questions, and find the best time for your evaluation.
