Stephen McCulley, Reconstructive and Aesthetic Surgeon. MBChb, FCS(SA)Plast, FRCS(plast)

Reducing the Risk of Surgery

Are you fit?

Fit and slender patients tend to have fewer problems with general anaesthesia and surgery such as blood pressure and bleeding problems, coughing and chest infections. They mobilise faster after surgery, reducing the risk of blood clots in the leg (called DVT or Deep Vein Thrombosis). It is important to ensure known medical problems (raised blood pressure, asthma, diabetes etc) are well controlled prior to surgery and that you make sure that you inform Mr Stephen McCulley of any of these issues. If you suffer with diabetes or are markedly overweight these can increase the risks of infection or wound healing problems.
Going to the gym is great but simple walking and swimming are excellent ways to get fitter. If you have a date for surgery, especially general anaesthesia try to get fit!!

Do you smoke?

Smoking causes the blood to carry less oxygen. This can stop wounds healing, increases the risk of infections or even skin death (necrosis). This applies to all surgery but is very important in Facelift, Tummy Tuck and Breast Reduction Surgery. Try and stop smoking for a minimum of six weeks before surgery but ideally for 3-4 months. Patches are good to help you stop but are just as problematic for surgery so also need to be avoided.

Are you on tablets or herbal remedies?

Avoid certain tablets that increase the risk of bleeding. Aspirin and all Anti-inflammatory tablets (Brufen, Voltarol, etc) are examples. These should be stopped 10 days prior to surgery. Similarly a number of herbal remedies including Arnica cause the same problems. DO NOT TAKE ANY HERBAL MEDICATION FOR 4 WEEKS prior to surgery.

Deep Vein Thrombosis (DVT) and Pulmonary Embolus (PE)

This is the formation of blood clots in the deep veins of the leg that can travel to the lung. This can be fatal. (This is the same problem as can occur on long flights). Death from Pulmonary Embolus is VERY RARE. However, precautions are always taken. You will have compression stockings or special compression boots during/after surgery. Some patients at higher risk will receive blood thinning injections. Risks are higher for overweight patients, smokers, Tummy Tuck patients and any surgery taking many hours.

Being fit, not overweight and moving after surgery are the best ways to avoid problems. Move your ankles up and down as an exercise post surgery. Avoid crossing your legs in bed and try to walk regularly after surgery even if only short distances.