Preparing for Facial Plastic Surgery: What to Adjust

Preparing for Facial Plastic Surgery: Medications, Supplements, and Habits to Adjust Beforehand

Medically reviewed by Dr. Kim Ji Sun, M.D., Ph.D., Board-Certified Otolaryngologist

Most guidance on how to prepare for rhinoplasty concentrates on the days immediately before the operation. The decisions that actually move the needle sit further back. Le.J Plastic Surgery in Seoul reviews medical history, current medications and supplements, previous nasal surgery or treatment, surgical goals, and breathing concerns before nasal surgery, and for its forehead lift lists medical evaluation or laboratory testing, medication adjustments, stopping smoking, and avoiding aspirin, anti-inflammatory medicines, and supplements that can increase bleeding or bruising. Several of those items need weeks, not days.

The bleeding-risk list is the one to start with

Facial surgery is performed in tissue with a generous blood supply, and anything that makes blood slower to clot makes the operation and the recovery harder.

Le.J Plastic Surgery's own preparation guidance names the category directly: aspirin, anti-inflammatory medicines, and supplements that can increase bleeding or bruising are to be avoided, and medication adjustments may be needed.

MedlinePlus, the patient-education service of the US National Library of Medicine, supplies the specifics and the timing. In its instructions on getting healthy before surgery it says that two weeks before an operation you may need to stop medicines that raise bleeding risk, and it names three groups: non-steroidal anti-inflammatory drugs including aspirin, ibuprofen, and naproxen; blood thinners such as warfarin, dabigatran, rivaroxaban, apixaban, and clopidogrel; and vitamin E. It follows that with an instruction worth repeating — ask your surgeon which of your medicines you should still take on the day itself.

Supplements deserve their own line. StatPearls, the clinical reference published through the US National Library of Medicine, advises in its review of facelift surgery that medicines and herbal supplements with anticoagulant properties be discontinued where possible at least two weeks before surgery, and notes that exposures of this kind materially raise the risk of complications. Bleeding disorders, blood thinners, and uncontrolled high blood pressure are grouped there as concerns because each increases the chance of a hematoma.

The practical version: write down everything you take, including the things you do not think of as medicine. MedlinePlus asks patients to bring a list covering dose and frequency, to include products bought without a prescription and ones not taken daily, and to tell providers about vitamins, supplements, minerals, and natural remedies.

Smoking is the single biggest thing you can change

This is where preparation stops being paperwork.

MedlinePlus explains the mechanism in one sentence: smoking reduces the amount of oxygen reaching the cells in a surgical wound, so the wound heals more slowly and is more likely to become infected. It also notes that people who smoke have a higher chance than non-smokers of blood clots forming in the legs, and that the body, heart, and lungs work harder even when the operation itself goes smoothly.

The timing guidance is specific. Most providers advise stopping cigarettes and tobacco at least four weeks before surgery, and MedlinePlus adds that extending the gap to at least ten weeks reduces the risk further. It also warns against a common workaround: nicotine gum around the time of surgery is not encouraged, because the nicotine still interferes with wound healing.

StatPearls frames the surgical stake in blunter terms. Smoking is identified there as a major risk factor for death of the skin flap in facelift surgery because of its effect on blood supply, with cessation advised from two to four weeks before the operation and maintained for a month afterward — and the same source reports that this window has been shown to reduce the risk of skin necrosis significantly.

Le.J Plastic Surgery's candidacy criteria are consistent with all of it: people who have completed facial growth, are physically healthy, do not smoke, and have realistic goals may be suitable candidates for rhinoplasty. The American Society of Plastic Surgeons lists the same four points for prospective rhinoplasty patients.

What the pre-operative review is actually checking

A pre-operative assessment is not a formality that stands between you and a date.

MedlinePlus describes the pre-op checkup as usually taking place within the month before surgery, which gives providers time to treat any medical problem they find. It involves taking your medical history and performing a physical examination, and it warns that several members of a surgical team may ask you the same questions — deliberately, because the team is assembling as complete a picture as it can.

Depending on what that picture shows, other specialists may be involved. The same guidance lists referral to a cardiologist for a history of heart problems, high blood pressure, or diabetes; an endocrinologist where blood sugar is high; a sleep physician where obstructive sleep apnea is suspected; and a hematologist for a personal or family history of blood clots.

For nasal surgery specifically, StatPearls lists obstructive sleep apnea, recurrent or chronic sinusitis, hypertension, and bleeding tendencies among the conditions to discuss, since each may call for additional management or change the plan. It notes that people with obstructive sleep apnea carry a higher risk of complications around the time of surgery, that screening questionnaires for it have limited specificity, and that a sleep study remains the definitive test.

Le.J Plastic Surgery's forehead lift preparation includes medical evaluation or laboratory testing, which is the same idea from the clinic's side.

Things patients underestimate

Alcohol and recreational drugs. MedlinePlus asks patients to tell the surgeon about alcohol use, particularly above one or two drinks a day, and about illicit drug use. For nasal surgery this is more than routine: StatPearls records that inhaled cocaine causes intense constriction of blood vessels and chronic inflammation of the nasal lining, that people currently using it should avoid elective nasal surgery, and that impaired healing can persist long after use stops.

Recent infections and dental work. A cold, flu, fever, or herpes outbreak in the days before surgery should prompt a call to the surgeon, since the operation may need rescheduling. MedlinePlus lists recent dental problems, including infections and dental surgery, among the things a surgeon needs told.

Allergies of every kind. Not only to medicines, but to foods, skin tapes, adhesives, iodine and other skin-cleaning solutions, and latex — all of which appear on the same disclosure list, and all of which a facial operation may involve.

Existing conditions being controlled rather than merely known about. MedlinePlus states that the risk of problems after surgery is lower when diabetes and other medical conditions are under control beforehand.

Your state of mind. StatPearls asks surgeons to recognize body dysmorphic disorder early in the preoperative process, because symptoms may worsen after surgery and no validated instrument diagnoses it consistently, and to defer surgery where depression is poorly controlled until mood symptoms stabilize.

Getting home, and the first night

The unglamorous logistics belong in the plan. Le.J Plastic Surgery's forehead lift preparation includes arranging transportation home and assistance during the first night — a requirement rather than a courtesy, and one that is harder to satisfy if you are traveling alone.

For patients coming from the United States, that connects to the wider planning problem. The concerns Le.J Plastic Surgery records for this market are access to medical care after returning home, carrying the relevant medical information with you, understanding the limits of your insurance, and having a plan for complications or unexpected needs. Each of those is easier to solve before departure than after.

Translated documents are available from the clinic, which is worth knowing when you are assembling the paperwork you will carry home.

A rough timeline

• Ten weeks out. If you smoke, this is the point at which stopping delivers the largest reduction in risk.
• Four weeks out. The minimum smoking cessation window most providers advise.
• Within the month before. The pre-operative checkup, with history and physical examination, and any specialist referrals it generates.
• Two weeks out. The point at which bleeding-risk medicines and anticoagulant supplements are typically stopped, on your surgeon's instruction rather than your own.
• The last few days. Report any new illness immediately, and confirm which regular medicines to take on the morning of surgery.

None of this is self-administered. Every stop-and-start decision belongs to the clinician who knows why you are taking the medicine in the first place, and the list above is a prompt for that conversation rather than a substitute. You can raise it before you travel through the clinic's consultation page; background on how Le.J Plastic Surgery structures care from consultation through recovery is set out on its about-us page.

The Bottom Line

• Le.J Plastic Surgery's preparation covers medical history, current medications and supplements, previous nasal treatment, goals, and breathing concerns, and for its forehead lift adds laboratory testing, medication adjustment, and stopping smoking.
• Bleeding-risk medicines and anticoagulant supplements are typically stopped around two weeks before surgery — but only on your surgeon's instruction.
• Stopping smoking at least four weeks beforehand is the standard advice, and ten weeks reduces risk further; nicotine gum is not a workaround.
• The pre-operative checkup usually happens within the month before surgery and exists to find and treat problems while there is still time.
• Transportation home and help during the first night are part of the plan, and need arranging early if you are traveling internationally.

Frequently Asked Questions

How far in advance should I stop taking aspirin or ibuprofen?

MedlinePlus places the usual point at two weeks before surgery for medicines that raise bleeding risk, naming aspirin, ibuprofen, and naproxen among them. Confirm the exact instruction with your surgeon, since some medicines are continued deliberately.

Do supplements really matter?

Yes. Le.J Plastic Surgery's preparation guidance names supplements that can increase bleeding or bruising, and StatPearls advises discontinuing herbal supplements with anticoagulant properties at least two weeks beforehand where possible.

When should I stop smoking before surgery?

Most providers advise at least four weeks, according to MedlinePlus, with at least ten weeks reducing risk further. StatPearls reports that stopping from two to four weeks before facelift surgery and staying off nicotine for a month afterward significantly lowers the risk of skin necrosis.

What will the pre-operative checkup involve?

Taking your medical history and a physical examination, usually within the month before surgery, and possibly referral to another specialist. Le.J Plastic Surgery's forehead lift preparation also includes medical evaluation or laboratory testing.

Should I mention conditions that seem unrelated to my face?

Yes. MedlinePlus advises telling the surgeon about allergies, alcohol and drug use, previous problems with surgery or anesthesia, bleeding history, recent dental infection, and tobacco use, and notes that surgical risk falls when existing conditions are well controlled.

What if I get sick the week before?

Call the clinic. A cold, flu, fever, or herpes outbreak in the days before surgery is grounds for rescheduling, and MedlinePlus advises contacting the surgeon right away.

Do I need someone with me afterward?

For the clinic's forehead lift, transportation home and assistance during the first night are part of the stated preparation. If you are traveling from abroad, arrange that support before you book.

This article is for general informational purposes and does not constitute individualized medical advice. It is not a self-diagnosis tool. Surgical candidacy, technique, and expected outcomes can only be determined through a consultation with a qualified surgeon.

References

• MedlinePlus: Getting Yourself Healthy Before Surgery
• MedlinePlus: Smoking and Surgery
• MedlinePlus: Tests and Visits Before Surgery
• StatPearls: Rhinoplasty
• StatPearls: Cervicofacial Rhytidectomy
• ASPS: Rhinoplasty Candidates