What is preparation for surgery? Endless tests, appointments with specialists, vague expectations, insomnia, anxiety. If the surgery belongs to plastic, it is still complicated by the fact that this topic is delicate, you can’t even discuss it with friends, and it’s especially scary for your appearance: what will happen then?
The preparatory period, which is nervous for the patient and difficult for the doctor, is the first and, at the same time, a very important component of success. Indeed, the result largely depends on how well the operation will be prepared.
Let’s see what the preoperative period looks like from the point of view of a healthcare specialist.
Stage 1. First appointment
The patient came to a plastic surgeon for the first time. He knows what he wants, but he has no idea how to achieve it.
At the first appointment, a doctor finds out the patient’s demands to improve their appearance and compare them with the capabilities of the healthcare institution. The fact is that plastic surgery is not all-powerful. Often, the patient’s ideas correspond to aesthetic stereotypes, but not very much correspond to real possibilities – and a compromise has to be found. The task of the doctor at this stage is to develop an efficient work plan for the patient and realistic for the doctor.
Stage 2. Screening
This is a dreary and not very clear stage for the patient. However, for the doctor, the examination results carry very important information.
Before the operation, we conduct a clinical examination. We find out what kind of patient suffered diseases, injuries, operations. If there have been operations, we always examine the scars to understand how the patient’s wound is healing. Indeed, in plastic surgery, the aesthetic result depends not only on the surgical technique, but also on the processes of skin regeneration (restoration).
Doctors also find out if the patient is allergic, especially to medications. They ask if the patient smokes, abuses alcohol, takes medication. The conversation can be very detailed, since many of the insignificant stuff are actually very important.
Then, a laboratory examination is done. General and biochemical blood tests, general urine analysis, determination of the blood group and Rh factor, tests for infections (hepatitis, HIV, syphilis – are the reason for operation refusal), fluorography and electrocardiogram are mandatory. Based on the results of the examination, we can, in general, judge the functioning of all body systems, which allows us to identify “weak points” that can interfere with the operation.
In some cases, especially operations on the abdominal wall, it is necessary to check the function of external respiration. If during the intervention, the volume of the abdomen decreases, subsequently respiratory complications are possible, therefore, a preliminary directed examination is necessary. The fact is that with an increase in pressure in the abdominal cavity, the contents of the abdomen begin to press on the diaphragm – the main respiratory muscle – and prevent it from contracting during inhalation.
Finally, consultation of narrow specialists may be required, such as an ophthalmologist – for eyelid surgery, an endocrinologist – for removing fatty deposits, a mammologist – for breast surgery, and others.
The duration of this stage depends on the number of consultations, however, in multidisciplinary medical centers, the patient can be examined rather quickly.
Stage 3. Correction of violations
The task of a good surgeon is to bring the patient to the operating table as healthy as possible. If during the examination, violations were identified, they are treated if possible.
First of all, smoking is a big problem: in smoking patients, healing is about 20-25% worse, sometimes marginal necrosis occurs. If a person cannot give up cigarettes, doctors try to at least minimize vasospasm as a result of smoking by prescribing special drugs.
Another case when a preliminary correction of violations is required is surgery for fat deposits. Initially, we refer such patients to an endocrinologist, after which many do not need an operation at all, or its volume is greatly reduced. This is especially true for obese men of the female type.
Step 4. Decision on surgery
Only at the end of the examination, it can be decided whether the operation is dangerous for the patient.
After we have found out that there are no severe violations and contraindications for the operation, its day is assigned and the immediate preparation begins. This happens in most cases, but it must be said that sometimes, alas, the operation has to be refused.
First, some patients with severe comorbidities are too at risk from surgery.
Secondly, in some cases, we understand in advance that the result of the operation will be unsatisfactory. For example, if the patient takes hormonal drugs and cannot do without them. Another example – it is impossible to do eyelid plastic surgery with a low tone of the circular muscle of the eye. They also have to refuse when patients are trying to solve the problem of obesity with the help of surgery: this is an endocrinological disorder, and it must be treated in other ways.
Stage 5. Preparation immediately before surgery
Now the day of the operation is known – what else should we have to do?
Doctors withdraw hormones, including oral contraceptives three weeks before the operation. As for other medications that the patient uses, it is necessary to assess the situation individually, but, most importantly, the anesthesiologist must definitely know about them.
The day before, the intestines are prepared. A special drug is prescribed, which, without any unpleasant and painful sensations, contributes to its cleansing. Doctors also prescribe sedatives to the patient so that he can sleep the night before the operation, otherwise it is difficult to do.
On the day of surgery, you must not eat or drink. If possible, do not smoke. Preoperative preparation, performed with high quality and in full, greatly simplifies the task of the surgeon and anesthesiologist. By the time a patient enters the operating table, we already know well what to expect from his body.
If everything goes as it should be, a short period of time before the operation the doctor and the patient become friends, striving for a common goal – a good aesthetic result and health preservation.