What Health Tests Are Recommended Before Cosmetic Surgery?

Question

I am considering a Revision Rhinoplasty and procedure for the lower eyes.  I had a complete blood test done about six months ago and everything came out fine. I'm 37 years old and not on any medication. Is there any other pre-screening that needs to be done before surgery?

Raffy Karamanoukian, MD, FACS · Answer

I always start out with routine physical examination in preparation for surgery. Requirements for blood analysis depend on the results of previousl blood tests and your overall state of health.

Otto Joseph Placik, MD · Answer

Your tests will be determined by any other health factors such as diabetes or use of potassium wasting diuretics in addition to the preferences of the surgeon and anesthesiologist. There are no hard and fast rules. Clearly if you are a female of child bearing age, you will probably get a urine pregnancy test prior to general anesthesia at the very minimum.

David C. Pearson, MD · Answer

I couldn't agree more with Dr. Aldea. The history and physical are the most important aspects of pre-op clearance and have strong scientific support, whereas most of the pre-op lab work in otherwise-healthy patients is a waste of time and resources.
The main exception to this is that for women of child-bearing age, a pre-op pregnancy test is performed by surgery center personnel on the morning of surgery. Other tests such as chest x-rays, EKGs, CBCs, and chemistries would only be obtained based on specific medical indications in a given patient, but they are not routine.
All the best,
--DCP

Pat Pazmino, MD, FACS · Answer

Before your cosmetic surgery, your surgeon should evaluate your overall medical health and determine if you are healthy enough for the procedure. If you are over 40 years old, you benefit from a medical clearance which can include a chest x-ray and an EKG. If you have active medical problems a medical clearance from the physician is managing these medical issues is necessary. Be sure that you're working with a board-certified plastic surgeon who has a great deal of experience in rhinoplasty and will be able to assess not only are nose but your overall health to make sure you received a safe and effective procedure.

Peter A. Aldea, MD · Answer

A thorough history and physical examination are the most important precursors to elective surgery (cosmetic or not). According to the American Society of Anesthesiologists, your (ASA) risk goes up on your 35th birthday and as a result many doctors, reflexively order often useless tests to protect themselves from potential future litigation. Millions of useless, noncontributory blood counts, chemistries, chest x-rays are ordered every year. Each facility differs in which tests it will require, if any and there is nothing you can do about it.

Michael Elam, MD (retired) · Answer

If you are in general good health and do not have any under lying health problems your surgeon will order a few tests prior to your procedure. In my surgical center in Newport Beach I have preoperative appointment set two weeks prior to surgery. I typically order EKG for patients forty and over a CBC which is a blood count, and a bleeding profile. Pregnancy tests  are run  the morning of surgery and a preoperative history and physical is performed. You should be off of all possible medications containing aspirin and aspirin containing compounds, herbs, some vitamins and other known blood thinners. Our anesthesiologist reviews each patients prescribed medications and will discuss these with the patient and their other physicians for clearance. Best regards and best of luck!

Richard W. Fleming, MD (retired) · Answer

Tests will vary dependng on the age and health of the patient, the specific procedure, and the type of anesthesia. In your case, having a rhinoplasty using some form of general anesthesia, i would request studies to rule out anemia, clotting disorders, and exposure to Hepatitis C and HIV.

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