What to Expect the Day of Surgery

The information in this section is made available through the generous support of Dr. Grant Stevens.

The Day of Your Surgery

For those of us who have never had surgery before, it's a very scary prospect.  The following was complied with the help of our member Bess and details what generally happens on the day of your surgery.

*  Once you arrive at the hospital or the surgery center, you will be taken to a pre-op area. This could be a private room or a ward with curtains. Some establishments allow you to have your family in this area and some don't, depending on their policy.  

*  You will be given a hospital gown and asked to disrobe.  

*  You may or may not be able to keep your panties on, so make sure you ask.  

*  You most likely will have to wear a surgical cap over your hair, and you may be asked to put it on as soon as you change into the gown or later when you are ready to be transported into the operating room.

*  You might be given the option of wearing surgical slippers as well, once again either put on when you disrobe or right before you are transported to the operating room.

After you have undressed, your plastic surgeon will come into the room.  

*  If you have not already had your surgical markings done, they will be done at this time.

*  You will be asked to uncover only the area being operated on so your privacy will be preserved. Depending on the policy of the establishment, there may or may not be a nurse in the room with you. If there is not and you are uncomfortable for any reason, please request that a nurse be present.

*  You may be seated or standing while the markings are done. This just depends on the doctor.

*  Some plastic surgeons will take photos of the pre-op markings when they are completed.

Generally a nurse starts your IV after the markings are completed, but this may be done prior to the markings.

*  The general IV location is on the back of the hand -- usually the hand that you do not write with.

*  If the nurse that is putting in your IV has trouble and has to try more than one time, you can request that another nurse try to get your IV started.

*  What is actually inserted into your vein is a hollow needle with a very thin tube inside of it. Once your IV is in place, the needle is removed, leaving the tube in your vein.  

*  Your IV site will be taped to prevent the tube from falling out or being jarred.

*  Once everything is inserted and taped into place, the tubing is connected to a bag that hangs from either a hook on your bed or a stand with wheels on it.  At this point only a saline solution is being delivered, which should not affect the way you feel.

After the IV is in place, you should be visited by your anesthesiologist.  You may or may not have met him or her at your pre-op appointment.

*  The anesthesiologist will ask you some very pointed medical history questions, such as whether you are pregnant or if you have ever had problems with anesthesia in the past.

*  You will be asked if you have had anything to eat or drink in the last so many hours.

*  Be totally honest with your anesthesiologist.

*  If you have been sick or nauseous in the past with anesthesia, make sure you let him or her know at this point.

*  If you have any questions you should also be able to ask them at this time.

Once you have finished speaking to the anesthesiologist, the next step is the operating room. You might have to wait some time before going to the operating room, so try to be patient. When the time comes you may be transported by wheel chair, on the bed you are in, or you may be asked to walk.

*  Operating rooms are cold, so don't be alarmed by this.

*  You will either get onto or be transferred to the operating table. These tables are not very large and are generally covered with a sheet.

*  You may be given heated blankets to warm you.

*  Once you are lying down you will be asked to put your arms on arm rests, which are extensions on the sides of the table. You may or may not have your wrists secured to the arm rests with straps.

*  A nurse or the anesthesiologist will attach an automatic blood pressure cuff, EKG leads (sticky pads with little "nubs" on the end that will be used to monitor your heart during surgery), and a pulse oximeter (this is a plastic clip attached to your fingertip and is used to measure the amount of oxygen in your blood during surgery).

*  You may be given a mask and asked to breathe deeply. Don't worry about a bad smell as it is usually a very sweet smell or undetectable.

*  The anesthesiologist will inject anesthetic into your IV. This will most likely burn slightly or feel "tight" at the site of your IV.

This should be the last thing you remember until you wake up in the recovery room. Some people are nauseous when they wake up. If you are, make sure that you let the nurse or the anesthesiologist know, as they can give you something to either lessen or take it away. In the recovery room you should be visited by your plastic surgeon or an assistant. They will check your dressings, and they may let you know how the surgery went. You are attended very closely by the nurses in the recovery room. They question you about pain and regulate the medications you get. Your medications are delivered via your IV. Generally most people don't remember much about the recovery room.  

Your time in recovery is dictated by how well you come out of the anesthesia, your blood oxygen level, your blood pressure, your heartbeat, and your surgery site. If there are problems with any of these areas, you might spend a longer time period in recovery. You are not allowed to have visitors in the recovery room. Once you are deemed fit to leave, you will be taken to either the same room you were in before surgery or another room. This room may or may not be private. You can usually have family with you once you are out of recovery.

At this point you should not be in pain and your medication should still be getting delivered via your IV. If you do have pain let your nurse know so she can give you more medicine. You will gradually be weaned off the IV medication and onto the pill form as you continue to recover from your surgery and the effects of the anesthesia. You may be asked if you would like something to eat or drink. If you are thirsty, try to stick with something that is easy on your stomach, like ginger ale. If you are hungry, you will most likely be given the choice of soup, Jell-O, or a light sandwich. Go with the light foods -- it's easier on your stomach.

Your plastic surgeon or assistant should come to visit you before you are discharged. You can ask questions about your surgery at this time, and they also will examine the surgery site. You should be reminded about your post-op care instructions. If not, make sure you have told the family member with you to ask about them before you leave the hospital.

Time spent in the hospital following your surgery should have been discussed previously with your plastic surgeon. If you are being discharged the same day you will be asked to urinate before you can leave. Once you have done that, you will be taken to the door in a wheelchair after you have signed your discharge papers and discharge instructions and have been given any prescriptions you have not previously had filled.

Anesthesia

The idea of being "put under" or "put to sleep" terrifies many people. While no one can say there will never be a complication, in this day and age these are very rare. Is is the job of the anesthesiologist to to monitor you closely in the operating room. In fact, anesthesiologists run the operating room. Their whole attention is focused on you and your health and safety. They are very sensitive to everything on the monitors that are reading your vital signs. Readings are taken and notes made about your condition every 15 minutes.  Medicine has advanced so much, and patient safety is the priority.

We hope that this has helped allay your fears about your upcoming surgery.  Please remember that this is a general picture and things may be done differently where you have your surgery. If you have any fears please discuss them with your plastic surgeon, the nurses who will be attending you, or the anesthesiologist.