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How should I prepare for Plastic Surgery?

Dr. Kevin O’Grady will go over the necessary preparations with you depending on your health and chosen surgery.

Starting two weeks before the operation, and for one week after, you should avoid any medication containing acetylsalicylic acid, more commonly known as aspirin, as it increases the risk of excessive bleeding during and after surgery. You should also avoid anti-inflammatory medication such as Motrin, Advil and cold remedies. Homeopathic medicines such as garlic, gingko and vitamin E should also be avoided.

Abstaining from alcohol during the two weeks prior and week following surgery is also recommended, as it may interact with drugs used during and after surgery.

If you are a smoker, you are advised to quit at least 3 months prior to your procedure. Not only is this important for your overall health, it helps you recover from the surgery quicker and minimizes wound healing complications.

Will I have scars?

Some type of scarring occurs any time the skin is opened and heals. As a result, most surgeries will result in permanent scars, but the visibility of the scarring can be limited.

An experienced Plastic Surgeon will attempt to hide incision lines, for example inside the nostril during rhinoplasty (nose job) or under the crease of the breast in breast enhancement (augmentation).  A good Plastic Surgeon is an expert at hiding scars in your natural skin creases to minimize their appearance.

The extent of the scarring will depend on the operation performed and the patient’s health.

How long will it take me to heal?

Every patient heals differently. Full recovery times will depend on your health and the extent of the procedures performed.  Recovery times for Plastic Surgery are generally brief. Most patients will require assistance for the first two days following the procedure.

Depending on the operation, you may leave the hospital on the day of your operation after spending a few hours in the recovery room or you may require hospitalization for a few days.  Swelling, bruising and sensitivity may last anywhere from a few weeks to a few months.

In general, wounds take at least 6 weeks to gain strength and heal.  After that, the scars take many months to mature and fade.  It usually takes one full year to achieve the final scar and the final result after all the swelling has gone away.

General recovery times by procedure are listed below, but these are approximations only. You should discuss the expected recovery period with Dr. O’Grady for a personalized schedule based on your health and the operation.

Blepharoplasty (eyelid surgery):

Patients can usually take care of themselves at home by the second day and could return to work after a week to ten days. Bruising generally takes one to two weeks to subside.

Face lift:

Patients can usually take care of themselves by the second or third day. Patients often don’t feel comfortable going out in public for the first week or two. Most of the bruising and swelling will normally subside in two to three weeks.

Breast surgery (Augmentation, Reduction and Lift):

Patients usually can be independent by the second day, and may return to work after one to two weeks. Most of the swelling may last for up to three or four months, depending on the procedure.  It may take a full year for things to settle.

Liposuction (Lipoplasty):

Patients can usually live independently by the second day, earlier if a smaller area is treated. They can often return to work and normal activities within the first week. Some smart liposuction patients even go out for dinner later that same day.

Abdominoplasty (tummy tuck):

Patients require assistance for two to seven days. They may return to a desk job after two weeks, but most jobs require four to six weeks.  No exercise for 6 weeks and no sit-ups for 3 months.

Rhinoplasty (nose job):

Patients may require assistance for the first day or two following the operation. Bruising and swelling will normally disappear during the first two to three weeks.  Noses generally has some swelling that continues for up to a year.

Dr. O’Grady will be able to give you an accurate idea of recovery time based on your personal risk factors, such as age and type of procedure being performed.

What are the risks?

Any type of surgery involves a degree of risk. Close monitoring of the patient after surgery will allow any complications to be quickly noticed and promptly treated.

Possible complications from surgery include:

Internal bleeding:

Any type of surgery causes bleeding in the area of the operation. If the accumulation of blood, normally noticeable by swelling, discolouration of the skin and pain, is small, it will absorb by itself. If it is large, your surgeon may need to drain it.

External bleeding:

Blood leaking from the incision and onto your dressing can normally be stopped by applying pressure to the area. A small amount of ooze is entirely expected. However, if it continues and it is significant, your surgeon may need to reopen the incision to stop the bleeding.

Infection:

Any surgery risks infection. An infection normally becomes noticeable a few days after surgery, by pain, redness, heat and swelling. It can normally be treated with antibiotics and dressing changes. In severe cases, hospitalization may be required.

Some patients can experience nerve injury and have trouble moving muscles or lose feeling in the area of the operation. In most cases, this is temporary and sensation will return.

Tissue loss (necrosis):

Patients who smoke are at a greater risk for tissue loss, which occurs when tissue does not receive sufficient oxygen from the blood. When this happens, the skin becomes discoloured and forms a dark dry crust that will become black and fall off, leaving a scar. The underlying tissues heal by themselves. Tissue loss is uncommon in non-smokers.

Other risk factors are directly related to the type of procedure and area on which it will be performed. For example, breast enhancement (augmentation) related complications include sensory damage, skin discolouration, formation of scar tissue and asymmetry. On the other hand, Plastic Surgery of the face can cause tissue damage, unnatural looking features and premature aging.

A skilled Plastic Surgeon can help minimize the risk of complications however, no-one can completely eliminate the risk of complications.  Complications occur even when things are done correctly.  This is the nature of surgery.

Dr. O’Grady will evaluate your health factors and your surgery options and will discuss in detail any potential risk factors and answer your questions and concerns.

Does my insurance cover Plastic Surgery?

Provincial health insurance policies in Canada do not cover cosmetic Plastic Surgery. Only medically necessary procedures are covered.

Surgery to correct functional problems are covered. These include reconstructive procedures such as breast reconstruction after breast cancer. Functional septorhinoplasties, that is, a nose job to restore the shape of the nose after an injury or to improve breathing are also covered. If you would like cosmetic improvement of the nose at the same time, OHIP will only cover the functional part of the surgery – you are responsible for paying the rest.

Breast reduction surgery may also be covered by provincial health plans.

Dr. Kevin O’Grady will be able to tell you if your surgery may be covered by your health plan.

What are the fees for Plastic Surgery?

Expenses include the fees for the surgeon and anesthetist, the cost of hospitalization or operating room use, and the cost of any prosthesis (e.g. breast implants) or accessories, such as special garments needed during the post-operative period.

Will I need to be put under general anesthetic?

Thanks to advancements in surgery techniques, certain procedures may be performed under general or local anesthesia or a combination of local anesthesia and sedation.

General anesthesia puts the patient completely asleep. The drugs are administered and monitored by a specialist trained in anesthesia. Several techniques are available and the best one will be chosen depending on the operation. Side affects may include sore throat or nausea and vomiting for short periods. In extremely rare cases, patients suffer from an allergic reaction to the drugs used.

Local anesthesia is similar to the type of anesthesia used at the dentist. You will not be put to sleep. A liquid is injected into the area to be operated on, causing it to become numb. Adverse reactions to this type of anesthesia are very rare.

The other type of anesthesia used in Plastic Surgery is called neuroleptic anesthesia, which is a combination of local anesthesia and sedation. Patients are put into a light sleep and receive a tranquilizer to reduce anxiety. It is most commonly used for facial surgery.

How much is too much Plastic Surgery?

Your psychological make-up, motivation and physical health must all be taken into account when considering cosmetic Plastic Surgery.

Do not assume that because you come in for a consultation or want a procedure, that it will be offered to you.  A consultation does not guarantee that a procedure can be performed.

Any time you are thinking about a procedure you should consult with your friends and family as well as your surgeon. Your surgeon may refer you to a psychologist. Surgery is a serious decision and you should take your time to consider what is right for you.

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