Key Takeaways
- If you use nicotine in any form, stopping is one of the most important steps: at least six weeks before surgery (ideally eight) and at least six weeks after.
- Tell me about every medicine and supplement you take. Don’t stop a prescribed medicine on your own. Supplements that can affect bleeding stop two weeks before surgery, and anti-inflammatories ten days before. Paracetamol is fine.
- Ideally, have no alcohol for one week before surgery and one week after. If you drink heavily, raise it early, because stopping suddenly can need medical support.
- Follow your hospital’s fasting instructions exactly. Current Australian guidance generally allows a light meal up to six hours before anaesthesia, and many hospitals let you sip clear fluids until you’re called to theatre.
- Arrange time off, someone to take you home and ideally stay with you for the first 24 hours after you leave hospital, and a recovery space before the day.
How you prepare for surgery is one of the few parts of it you control. A smoother recovery isn’t guaranteed by any checklist, but arriving well, with your medicines sorted and your home ready, can reduce avoidable problems.
In this article I set out what to do and when, from six weeks out to the morning of surgery, along with how to prepare your home for recovery.
I’m Dr Scott J Turner, a Specialist Plastic Surgeon (FRACS). This is general information. Before your operation you’ll get written instructions for your procedure and hospital, and those are the ones to follow.
The preparation timeline at a glance
| When | What to do |
|---|---|
| Six weeks or more before | Stop all nicotine, including vapes, pouches, patches and gum. Keep your weight stable. Tell me about your medicines, supplements, the contraceptive pill or HRT, and any history of blood clots. Arrange time off and help at home. |
| Two weeks before | Stop supplements that can affect bleeding, including fish oil. Avoid sunburn on the area having surgery. |
| Ten days before | Stop anti-inflammatories such as ibuprofen, and aspirin unless a doctor has advised you to take it. Paracetamol is fine. |
| The week before | Stop alcohol, ideally until a week after surgery. Fill your prescriptions, set up your recovery space and confirm who’s taking you home. Tell the practice if you become unwell. |
| Three days before | Don’t shave the area having surgery. |
| The day before | Follow your fasting and medicine instructions. If you take a GLP-1 medicine, for weight loss or diabetes, have only clear fluids all day. Pack for hospital. |
| The day of surgery | Take only the medicines you’ve been told to take. Come without makeup, jewellery or piercings, in loose clothing, with your medicine list and any garment you’ve been given. |
Six weeks or more before
Stop all nicotine. If you use nicotine in any form, stopping is one of the most important steps. Nicotine and the other chemicals in smoke reduce blood flow to healing skin and raise the risk of wound breakdown and infection. I ask patients to be nicotine-free for at least six weeks before surgery, ideally eight, and for at least six weeks after. That includes vapes, pouches, patches and gum. I explain the evidence and the timing in smoking, vaping and nicotine before plastic surgery.
Keep your weight stable. A stable weight makes the result more predictable. A crash diet in the final weeks can leave you short of the protein and nutrients healing depends on. I cover the guides for each operation in BMI and plastic surgery.
Tell me about your health and medicines. Bring a full list of everything you take, including prescription medicines, over-the-counter medicines, vitamins and herbal products. I also need to know about:
- Blood thinners, which need a plan made with the doctor who prescribes them. Never stop them on your own.
- The contraceptive pill or HRT. You can usually keep taking these, but tell me, because those containing oestrogen can raise the risk of blood clots, and that’s part of how I plan clot prevention.
- GLP-1 medicines, for weight loss or diabetes, which slow stomach emptying and need specific anaesthetic instructions.
- Any previous blood clot, or a family history of clots.
- Medical conditions such as diabetes, sleep apnoea or heart and lung problems. Your anaesthetist may contact you before surgery if you have any of these.
Plan your time off and help. Recovery time varies with the operation, your job and how you heal. Plan for a little more than you expect.
Two weeks before
Pause supplements that can affect bleeding. Garlic, ginkgo and ginseng have been linked with bleeding, mostly in case reports and laboratory studies, and ginseng can lower blood sugar. Vitamin E is often included as a precaution, though the evidence that it affects bleeding is weak. St John’s wort speeds up the breakdown of many medicines used around surgery. I ask patients to stop these two weeks before surgery.
Fish oil is often on these lists. The evidence is more reassuring than its reputation: a randomised trial of 1,516 heart surgery patients given high-dose fish oil found it didn’t increase bleeding. I still ask patients to pause it as a precaution, because the trial wasn’t in cosmetic surgery.
Arnica and bromelain are often taken to reduce bruising. I cover what the evidence shows in arnica and bromelain after facial surgery.
Avoid sunburn on the area having surgery.
Ten days before
Stop anti-inflammatories. Medicines such as ibuprofen and aspirin can increase bleeding, so I ask patients to stop them ten days before surgery. Paracetamol is fine to take for pain in the meantime. If you take aspirin because a doctor advised you to for your heart or circulation, don’t stop it without talking to that doctor.
The week before
Stop alcohol. A review of 55 studies found that drinking before surgery was linked with more complications, including infections and wound problems. The link was clearest with heavier drinking, and there was too little evidence to say whether light to moderate drinking makes a difference. In three small trials of people drinking more than about three and a half standard drinks a day, intensive programmes, including medicines for withdrawal and complete abstinence for four to eight weeks before surgery, probably reduced complications, though the trials were too small for certainty.
Ideally, I ask patients to have no alcohol for one week before surgery and one week after, and none while taking strong pain medicine. If you drink heavily, tell your GP and me at least four to eight weeks ahead, because stopping suddenly can cause withdrawal, which may need medical support.
Report any illness. Tell the practice if you develop a cold, cough, fever, a cold sore near the operation site, or a skin infection or rash near the area. Surgery sometimes needs to be postponed for safety.
Get organised. Complete the hospital’s admission paperwork, fill your prescriptions, and confirm who’s taking you home and staying with you.
Don’t shave the area for three days before surgery. Small nicks from shaving can raise the risk of infection. If hair needs removing, it’s done with clippers at the hospital.
The day before and the day of surgery
Fasting. Follow your hospital’s fasting instructions exactly, because getting them wrong can mean your surgery is postponed on the day. Australia’s anaesthesia guidance generally allows a light meal up to six hours before anaesthesia. Many hospitals now let you sip clear fluids, often water, up to about 200 ml an hour until you’re called to theatre. Others ask you to stop two hours before. Clear fluids are ones you can see through, such as water, clear apple juice, cordial, and black tea or coffee without milk, though some hospitals allow only water in the final hours.
If you take a GLP-1 medicine, for weight loss or diabetes, current Australian recommendations are to keep taking it, have only clear fluids for the whole day before surgery, and then only small sips of water on the day until the time your hospital gives you.
Your usual medicines. Take only the medicines you’ve been told to take on the morning of surgery, with a sip of water.
What to wear and bring. Come without makeup, jewellery or piercings, in loose clothing that’s easy to put on afterwards, and with a front opening for breast or upper body surgery. Bring your medicine list and any compression garment or support bra you’ve been given.
Getting home. Don’t drive for at least 24 hours after a general anaesthetic or sedation. After many operations it’s longer: after a breast lift, for example, at least a week, and not while you’re taking strong pain medicine. You’ll need a responsible adult to take you home, and ideally to stay with you for at least the first 24 hours after you leave hospital, whether you go home on the day or after an overnight stay.
Preparing your home for recovery
Setting up before surgery makes the first days easier:
- A rest space with everything in reach: water, medicines, phone charger and something to pass the time.
- Pillows to keep you propped up. After facial surgery, keeping your head raised helps swelling settle.
- Easy meals, ready in the fridge or freezer, with enough protein.
- Clothes that are easy to put on, such as button-up tops and slip-on shoes.
- Help with children, pets and lifting for the first week or more, depending on the operation.
The recovery guides for each operation cover what to expect week by week, for example after facelift, breast augmentation and abdominoplasty.
Preparing your mind
Make sure your questions have been answered, you understand what recovery involves, and your expectations match what we discussed. If you feel unsure as surgery approaches, raise it before the day. It’s always acceptable to ask to pause. A short delay matters far less than going ahead with doubts.
If you have questions about preparing for your operation, you can contact the practice.
Frequently asked questions
How do I prepare for plastic surgery?
Stop all nicotine at least six weeks before surgery, ideally eight, and for at least six weeks after. Keep your weight stable, and tell me about every medicine and supplement you take. Stop supplements that affect bleeding two weeks before and anti-inflammatories ten days before, and ideally have no alcohol for a week before and after. Follow your hospital’s fasting instructions exactly, and arrange someone to take you home and ideally stay with you for the first 24 hours after you leave hospital. Your written instructions for your operation take priority over general advice.
How long before surgery should I stop drinking alcohol?
Ideally, have no alcohol for one week before surgery and one week after, and none while you’re taking strong pain medicine. Research links drinking before surgery with more infections and wound problems, most clearly with heavier drinking. If you drink heavily, tell your GP and me at least four to eight weeks ahead, because stopping suddenly can cause withdrawal and may need medical support.
What supplements and medicines should I stop before surgery?
I ask patients to stop vitamin E, ginkgo, garlic, ginseng, St John’s wort and fish oil two weeks before surgery, and anti-inflammatories such as ibuprofen ten days before. Paracetamol is fine. Never stop a prescribed medicine, such as a blood thinner or aspirin for your heart, without talking to the doctor who prescribed it. You can usually keep taking the contraceptive pill or HRT, but tell me about them, and about any GLP-1 medicine, which needs its own plan.
How long before surgery do I need to stop eating and drinking?
Follow your hospital’s instructions exactly. Current Australian guidance generally allows a light meal up to six hours before anaesthesia. Many hospitals let you sip clear fluids until you’re called to theatre, while others ask you to stop two hours before. Clear fluids are ones you can see through, such as water, clear apple juice, cordial, and black tea or coffee without milk. If you take a GLP-1 medicine, for weight loss or diabetes, you’ll be asked to have only clear fluids the day before, then only small sips of water on the day.
What should I have ready at home for my recovery?
Set up a rest space with water, medicines and a phone charger in reach, pillows to keep you propped up, easy meals with enough protein, and clothes that are easy to put on. Arrange a responsible adult to take you home and ideally stay with you for the first 24 hours after you leave hospital, and help with children, pets and lifting for the first week or more.
