Eight assessments your cosmetic surgeon should suggest before a procedure.

I’ve always been a proponent of working your best assets and being comfortable in the skin you’re in, but I also think that if cosmetic surgery can help you fix a problem or change something you can’t be happy with, then go for it. And when I write, go for it,” I mean explore every viable option with a trusted medical professional and do your due diligence to make sure you are physically and mentally prepared for surgery and post-operative recovery.

In 2009, then Governor of California Arnold Schwarzenegger signed the Donda West Plastic Surgery Law, requiring health checks be conducted prior to all major plastic surgery procedures in the state, following the death of Kanye West’s mother. It was later determined that her heart attack was spawned by a combination of numerous postoperative complications and pre-existing coronary artery disease. Just because you may desire cosmetic surgery does not mean you are physically or mentally fit for it at this moment. Dr. Stanley Poulos, a board-certified San Francisco area plastic surgeon, shared with Glamamom, what he looks for in patients to assess if they are ready for surgery.

Dr. Poulos stresses that it is essential for a surgeon to take a good medical history and exam of the patient. Current and past illnesses, especially cardiac or pulmonary problems, surgeries, and medications should all be discussed. Lab tests may be required on a case by case basis depending on patient history and planned procedures.

Urinalysis

When it comes to preparation for a plastic or cosmetic surgery procedure, a urinalysis can inform the doctor if you have certain types of infections, like a urinary tract (UTI), bladder, or kidney infection. Urine tests are also effective in detecting high blood pressure and diabetes.

Blood Count Test

Also known as a complete blood count (CBC), this blood test literally counts your blood. It takes note of the number of red blood cells, white blood cells, and platelets. This tells physicians if you’re anemic (red blood cell deficiency) or have a blood clotting disorder like hemophilia. CBC tests also detect infectious bloodborne diseases like HIV or hepatitis.

Heart function: Electrocardiogram (ECG or EKG)

The ECG is a medical test that tells if your heart is in good condition through detecting any heart abnormalities by measuring the electrical activity of the heart when it contracts. Cosmetic surgery basically causes tremendous stress on the body, with the heart being one of the most important organs when it comes to stress response. That is why it is crucial for the doctor to assess whether your heart can endure the trauma during the operation.

Chest X-Ray

A Chest X-Ray is also one of the tests that may be required for your procedure. This is usually carried out to check the condition of your lungs and see whether you have breathing difficulties when you are put in anesthesia. This test is especially requested if you are a smoker or have a history of smoking. Signs of pneumonia or any breathing disorder may result to the postponement or cancellation of your surgery.

Smoking Use and History

Mixing nicotine with plastic surgery can result in problems:

  • Loss of cheek skin, nipples or tummy skin after a facelift, breast lift, breast reduction, or tummy tuck surgery
  • Infections
  • Death of fat cells (fat necrosis), causing hard lumps
  • Delayed wound healing
  • Thick, wide scars
  • Blood clots, which can be fatal
  • Increased pain
  • Permanent small vessel damage adding risk even if you quit
  • Loss of breast implants
  • Life-threatening complications like stroke, heart attack, blood clots, and pneumonia.

Mammogram

A mammogram is typically required for women who want to get breast augmentation or breast lift done. This is to help detect signs of breast cancer.

Psychological Screening

Although there is no formal psych test to assess a patient’s readiness and motives for cosmetic surgery, a surgeon should take the time to learn a patient’s reasons for desiring cosmetic change. Immediate red flags include, having surgery to try to keep a wayward spouse, an exaggerated concern over a minor problem, someone who seems addicted to cosmetic surgery, or a patient with body dysmorphic disorder. This syndrome is most appropriately treated by psychological treatment not surgical intervention.

Alcohol Habits

It is important not to drink alcohol before undergoing plastic surgery – or any type of surgery for that matter - as it can cause unforeseen complications and seriously impact the final results and the way you heal. Alcohol, especially when consumed to excess, can dry out your skin, which can result in cracks appearing. If you're having a plastic surgery procedure where skin is stretched (facelift, breast augmentation or abdominoplasty for example) then dry, cracked skin will make it harder for the surgeon to staple or stitch the skin together, resulting in a less than optimum result and possibly scar.

Body Weight

Sometimes patients will enter a plastic surgeon’s office excited about a decision to finally move forward with breast or body contouring surgery, but then afterwards emerge having found out they are not currently a candidate because of excess body fat. This scenario is not only disappointing, but it can be an emotionally deflating and potentially embarrassing experience for patients. There are several specific reasons that your plastic surgeon might recommend weight loss prior to undergoing a procedure. In addition, the results that you can achieve are likely to be much better if your weight is in a better range. Consider an overweight woman who wants breast reduction surgery. Even when the breasts become smaller and more uplifted, it is extremely difficult for us to deal with the fullness lateral to the breasts (the “bra roll”), which significantly compromises the aesthetic result. In addition, it is much harder to get a beautiful transition between the breast and the abdomen due to the excess weight. On the other hand, let’s consider the patient that is overweight and wants a tummy tuck or liposuction. In this instance, the surgeon will not be able to remove all the excess fat in these areas, as it is technically challenging and can look odd as it is out of proportion to the surrounding fatty deposits. Even large volume liposuction cannot fully solve this problem. Body contouring surgery is great for shaping your body, but it is not a method or substitute for weight loss or weight control.