In short. What a proper preoperative workup includes, which medicines and habits to change and when, and the practical preparation that makes recovery measurably easier.
Key points
- Blood-thinning prescription medicines, anti-inflammatory painkillers, high-dose vitamin E, fish oil, and many herbal supplements (ginkgo, garlic, ginseng among them) increase bleeding and are typically paused one to two weeks before surgery — but prescription drugs are stopped only in coordination with the prescribing doctor, never on your own.
- Bring a complete list, including the supplements you think do not count; they count.
Good outcomes are assembled weeks before the operating day. The preoperative period has two jobs: verify that surgery is safe for you specifically, and change the modifiable things — smoking, medicines, weight, logistics — that measurably shift results. This guide walks through what a proper workup involves and how to prepare, because patients who prepare well genuinely recover better.
The medical workup
A serious preoperative assessment includes a full history and examination, blood tests (blood count, clotting, biochemistry, and infection screening as indicated), an electrocardiogram for longer cases or relevant history, and imaging when the procedure calls for it — nasal CT for complex rhinoplasty, breast imaging before breast surgery at appropriate ages. An anesthesia consultation evaluates airway, heart and lung health, previous anesthetic experiences, and medication. In a tertiary hospital, abnormal findings trigger same-building specialist input rather than a cancelled date discovered on the morning of surgery.
Smoking: the one change with the biggest payoff
Nicotine constricts the small vessels that healing tissue depends on. Smoking measurably raises the rates of wound breakdown, skin-flap loss after facelift and abdominoplasty, poor scars, and graft failure. Most surgeons require stopping — all nicotine, not just cigarettes — for at least four weeks before and after surgery, and many will simply not perform flap operations on active smokers, because the complication is predictable. This is one area where the strictness is pure biology, not fussiness.
Medicines and supplements to discuss
Blood-thinning prescription medicines, anti-inflammatory painkillers, high-dose vitamin E, fish oil, and many herbal supplements (ginkgo, garlic, ginseng among them) increase bleeding and are typically paused one to two weeks before surgery — but prescription drugs are stopped only in coordination with the prescribing doctor, never on your own. Bring a complete list, including the supplements you think do not count; they count.
Weight, skin, and the month before
For body contouring, arrive at a weight you can hold: operating on a body that is actively losing or gaining sculpts a moving target and shortens the result's life. Skin preparation matters too — treat active acne or dermatitis near the surgical field first, and stay out of the sun, since inflamed or tanned skin heals worse and scars darker. Alcohol is reduced or stopped in the final week; sleep and nutrition in the weeks before are unglamorous and real.
The practical preparation people skip
Arrange the escort and the caregiver before you book the date: someone to take you home, stay the first night after larger procedures, and handle lifting, cooking, children, and pets for the first week or two. Prepare the house at waist height — chargers, medications, water, loose front-opening clothes — because you will not want to bend, reach, or stretch. Fill prescriptions and buy the garment and scar-care supplies in advance. Plan work absence from the honest timeline, not the optimistic one: two weeks minimum for most facial surgery and body contouring, more for abdominoplasty.
Tell the team, and possibly postpone, if
- You develop a cold, fever, skin infection, or new medication in the days before surgery — call rather than hoping it passes unnoticed.
- You have smoked, vaped, or used nicotine within the required window — saying so protects your tissue, not your schedule.
- You cannot arrange the escort, the aftercare help, or the recovery time the plan requires.
Frequently asked questions
What does a proper preoperative workup include?
A full history and examination, blood tests including count, clotting, biochemistry and infection screening, an electrocardiogram for longer cases, imaging where the procedure calls for it, and an anesthesia consultation assessing airway, heart, lungs, and medication. Abnormal findings trigger specialist input before the date.
Why must smoking stop before aesthetic surgery?
Nicotine constricts the small vessels that healing tissue depends on, which measurably raises wound breakdown, skin-flap loss after facelift and abdominoplasty, poor scarring, and graft failure. Most surgeons require stopping all nicotine, not just cigarettes, for at least four weeks before and after.
Which supplements and medicines should be declared?
All of them. Blood-thinning prescription medicines, anti-inflammatory painkillers, high-dose vitamin E, fish oil, and herbal supplements such as ginkgo, garlic, and ginseng increase bleeding and are usually paused. Prescription drugs are stopped only in coordination with the prescribing doctor, never on your own.
Risks & Limitations
- Bruising and swelling lasting weeks; after bone surgery, months pass before the final result is visible.
- Scars are permanent. They mature and fade over 6–12 months but never disappear.
- Numbness or altered sensation, which may be temporary or, after bone or nerve work, lasting.
- Asymmetry, under-correction or over-correction; final assessment is made at 6–12 months.
- Infection, bleeding or haematoma, which may need drainage or antibiotics.
- Breathing changes after nasal surgery, which may be temporary or require further treatment.
- Revision surgery carries higher risk and is less predictable than a first operation.
When to Seek Care
- Difficulty breathing or shortness of breath — seek emergency care immediately.
- Rapidly expanding swelling, or a tense, painful, tight area.
- Fever above 38 °C, spreading redness, warmth or pus.
- Bleeding that does not stop with gentle pressure.
- Any sudden change in vision after facial surgery or a facial injection.
References & Further Reading
- American Society of Plastic Surgeons (ASPS) — procedure and safety guidance
- International Society of Aesthetic Plastic Surgery (ISAPS)
- National Institute for Health and Care Excellence (NICE, UK) — relevant guidance
- Cochrane Library — systematic reviews in facial plastic surgery
This page is patient education, not medical advice, and it does not cite individual studies. Discuss your own case with a qualified clinician. To arrange an assessment at Chongqing West District Hospital, see Contact & Consultation.