10 Things You Should Avoid Before Your Cosmetic Surgery: Ensuring Optimal Results and Safety

Written by Dr. Allan Wulc
On September 20, 2024

Whether you’re considering a facelift, a blepharoplasty, or any other facial cosmetic procedure, what you do—and what you don’t do—before your surgery can have a major impact on your results and recovery. 

Here are ten things you should avoid before undergoing cosmetic surgery to help ensure a smooth procedure and optimal healing.

Don’t take Aspirin or NSAIDs 

Aspirin and nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen (Advil, Motrin) and naproxen (Aleve) are commonly used to relieve pain and reduce inflammation. However, these medications can increase the risk of bleeding during and after surgery. Aspirin and NSAIDs inhibit platelet function, which is crucial for blood clotting. This can lead to excessive bleeding, prolonged healing times, and an increased risk of complications. It’s essential to avoid these medications for at least two weeks (Aspriin) or 5-7 days(NASIDs)  before your surgery unless otherwise directed. Always inform your surgeons of all the medications you’re taking.

Other Anti-Coagulant Medications to Avoid

Anti-coagulant medications, such as warfarin, heparin, and newer anticoagulants like rivaroxaban (Xarelto) and apixaban (Eliquis), are prescribed to prevent blood clots. However, these medications can pose significant risks during surgery by increasing the likelihood of excessive bleeding. If you’re on anti-coagulants, your surgeon and primary care physician will need to collaborate to manage your medication regimen before surgery. This may involve temporarily stopping the medication or switching to a different therapy under close medical supervision.

Stop Smoking

Smoking is one of the most detrimental habits you can have before any surgery, especially cosmetic procedures. Nicotine constricts blood vessels, reducing blood flow to tissues. This can significantly impair wound healing, increase the risk of infection, and lead to complications such as skin necrosis, where the skin tissue dies due to lack of blood supply. Surgeons typically advise patients to quit smoking at least four weeks before and after surgery to minimize these risks. Quitting smoking not only improves surgical outcomes but also has long-term health benefits.

Discontinue Marijuana (and Other Recreational Drugs…)

Marijuana and other recreational drugs can have unpredictable effects on the body during and after surgery. Marijuana, in particular, can interact with anesthetic agents, leading to complications such as increased heart rate, altered blood pressure, and respiratory issues, and behavioral issues postoperatively. Moreover, the use of marijuana can impair the body’s ability to heal properly and may exacerbate postoperative pain or anxiety. We’ve noted that marijuana can have some of the same effects on flap survival as smoking (see caution # 2 above).  You should stop using marijuana and other recreational drugs at least two weeks before your procedure.

Avoid Weight Loss Drugs

Weight loss drugs such as Wegovy or Mounjaro  are extremely popular means of getting excessive serum glucose under control, and producing weight loss and may have other health benefits which have only recently been described.  These drugs delay gastric emptying, and while usually the night before an operation you are directed to stop eating, there still may be food present despite being NPO past midnight.  For this reason, most hospitals and surgery centers have specific guidelines that must be followed to prevent the inadvertent spillage of undigested food into the lungs which can occur unless these guidelines are followed. We ask our patients to avoid solid foods for 48 hours and to be off these drugs for a week preoperatively.

Some over-the-counter supplements, and herbal products, can have a variety of effects on your body’s metabolism, cardiovascular system, and overall health. Some weight loss drugs can increase your heart rate, blood pressure, or interfere with anesthesia. Others might thin your blood, increasing the risk of bleeding. To ensure your safety during surgery, it’s best to discontinue the use of these drugs several weeks before your procedure, with guidance from your healthcare provider.

Cut Out Salicylate-Containing Foods

Salicylates are naturally occurring chemicals found in many fruits, vegetables, and other foods. While they are generally safe for most people, in the context of surgery, salicylates can act similarly to aspirin by thinning the blood and increasing the risk of bleeding. Foods high in salicylates include almonds, berries, cherries, grapes, oranges, tomatoes, and certain spices like turmeric and peppermint. It may be wise to limit or avoid these foods in the days leading up to your surgery. Consult us for personalized advice and a handout of foods to avoid.

Avoid Herbal Supplements

Many people take herbal supplements for various health benefits, but some can interfere with surgery. For example, supplements like ginkgo biloba, garlic, ginseng, and St. John’s Wort can increase the risk of bleeding, interact with anesthesia, or affect blood pressure. It’s important to inform your surgeon of any supplements you’re taking, and you may need to stop them at least two weeks before surgery. Your surgeon can advise you on which supplements are safe to continue and which should be discontinued.

Don’t Consume Alcohol

Alcohol consumption should be avoided before surgery for several reasons. Firstly, alcohol can thin your blood, increasing the risk of bleeding during surgery. Secondly, it can dehydrate your body, impair liver function, and interact with medications and anesthesia. Lastly, alcohol can negatively impact your immune system, making you more susceptible to infection. To promote optimal healing and reduce the risk of complications, avoid alcohol for at least one week before your surgery.

Reduce Vitamin E Intake

Vitamin E is a powerful antioxidant with numerous health benefits, but it can also increase the risk of bleeding during surgery. This is because vitamin E inhibits platelet aggregation, which is necessary for blood clotting. If you’re taking vitamin E supplements, you should discontinue them at least two weeks before your surgery. However, it’s important to discuss this with your surgeon, as the decision to stop any supplement should be based on your individual health needs.

Avoid Excessive Caffeine

While moderate caffeine consumption is generally safe, excessive intake can pose risks before surgery. High levels of caffeine can lead to increased heart rate, anxiety, and dehydration, all of which can complicate surgery and recovery. Caffeine can also interact with certain medications and anesthetics. To minimize these risks, reduce your caffeine intake in the days leading up to your surgery, and avoid consuming caffeine on the day of the procedure.

Preparing for cosmetic surgery involves more than just scheduling the procedure and showing up on the day of the operation. By avoiding these ten things—aspirin and NSAIDs, smoking, marijuana, weight loss drugs, salicylate-containing foods, herbal supplements, alcohol, vitamin E, anti-coagulant medications, and excessive caffeine—you can help ensure a smoother surgery and a quicker, more comfortable recovery. Always communicate openly about your lifestyle, medications, and any concerns you may have. This collaborative approach will help you achieve the best possible outcome from your cosmetic surgery, enhancing both your safety and satisfaction.

As you prepare for your surgery, remember that your surgeon’s instructions are tailored to your specific needs and medical history. Following these guidelines and avoiding potential risks will contribute to a successful surgery and the beautiful results you’re aiming for.

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