Should I be scared to go under the knife?

I am having a breast augmentation in a month and the nerves are kicking in. You'd think I'd be more nervous about how my boobs will turn out, but no, I'm more scared to go under the knife! Will I never wake up? Will I feel them cutting me open? Are there things I can do as a patient to make sure I avoid any complications? I heard of removing nail polish before to make sure the surgeon/nurse can see the circulation in your nail beds. Is there anything else I can do? Is this a common worry among patients?

Doctor Answers 9

Managing anxiety over surgical process

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It is completely normal to feel scared and anxious.

You see, we are naturally scared of things we do not know or things we do not understand. In order to overcome fear, you must educate yourself as much as possible about the surgical process.

  For example, you asked whether you will feel them cutting you open…the answer is no because you will most likely be under general anesthesia where you are made unconscious. Even the incision surgeons will make will be small and it will be a blood-less dissection due to electrical cauterization – which uses heat to close blood vessels. When there is less bleeding, there will be less pain when you wake up.

  The source of all this anxiety could be reading through tonnes of reviews of breast augmentation. Of course, if you read negative reviews, you are more likely to become anxious, but if you read more positive reviews, you are more likely to become excited about the surgery.

  You have to realize that one patient is not like another, so taking those negative reviews and applying it your own case is pointless. In fact, even the breasts in the same individual are never entirely the same which is why we may see that certain complications occur only in one breast and not the other.
  Please know that compared to the number of people who get BBAs each year (over 300,000) compared to the number of negative reviews you read, you will realize 2 things, 1) those with negative results are more likely to share their story, 2) compared to positive results, the likelihood of negative results is highly uncommon.

  So I urge you to look into the likelihood of the complications that are scaring you.

In fact, if you were to look at the list of complications to any surgery, or number of side effects to any drug, you would be more likely to reject the surgery or drug. The point to understand is not that there are many risks, but rather the rate of occurrence (i.e., incidence rate of the complications)

For example, infection is a very dangerous complication that could destroy BBA results, but the chance of infection following breast augmentation is 1% which means that there is 99% chance you will not get an infection. See how if you change the point of reference, things look much better. This is because of the psychological effect our body has to negative information.

Another example - many patients read blogs from others about how they are terrified of general anesthesia and start worrying excessively. They will read things such as, “oh, what if I wake up during surgery…oh what if I do not wake up at all?” These are worrisome questions for sure, but again, they are also highly unlikely situations as you will be supervised during surgery by a board-certified anesthesiologist and the whole surgical team.

Nevertheless, I would like to list the things you can do to prepare for the surgery and to help with recovery.

Note, I am listing things to make recovery easier and they do not serve as instructions for recovery (i.e., after surgery, you have to avoid intensive exercise for 6 weeks, you may have to take antibiotics, do breast massages, wear sports bras, etc.)
  • Firstly, if you smoke, then please stop smoking – 1 month before surgery. Smoking a cigarette within the month of the surgery can double your risk of infection. Smoking will also cause delayed wound healing, so it is important to cease smoking for 1 month after surgery as well.
  • If you have children, then have someone ready to take care of them for at least a week.
  • If you have a dog, have someone to walk the dog at least for 2 weeks.
  • Please arrange for someone to drive you to and from surgery and accompany you for 24 hours right after surgery – most patients bring ask a friend to help.
  • You do not want to have a lot of work waiting for you after surgery, so do them before
  • Cook extra food ahead of time, or you can simply order food if you are not recovering at home
  • You may start a healthier diet and engage in physical exercise, and avoid alcohol few days prior to surgery.
  • Make sure to inform your surgeon of all your medications – natural and pharmaceutical
    • You may have to stop some medications like aspirin and ibuprofen as then can increase bleeding.
  • The night before you will stop eating or drinking anything.
  • In the morning, you can brush your teeth while avoiding swallowing water.
  • You will also need to take shower and wash the areas where surgery will take place using antimicrobial soap
  • You cannot wear any makeup, or put any moisturizer/lotion or deodorant.
  • As you already know, you will also have to remove nail polish from one fingernail and toenail so that anesthesia person can monitor your blood circulation during surgery.
  • Bring loose-fitting clothes that open in the front and comfortable flat shoes that slip on – you will need such clothes while you recover for the 1st week.

Hope this helps!

Toronto Plastic Surgeon
4.9 out of 5 stars 521 reviews

Nervous about surgery

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Thank you for this question. Really. It is so common and I am happy to answer this for you. Having had surgery 3 times myself and I am a surgeon, I still get nervous every single time. I am healthy and I know I am going to be ok, but it still is scary in this day and age where the media sensationalizes everything. The bottom line is you will not feel anything during surgery. You will be out. That talk about people remembering does not happen with general anesthesia. It really does not. If you are going to a board certified surgeon who will be using a board certified anesthesiologist you should do just fine. If you are a young healthy person you have a better chance of being injured in a car accident then from having this elective surgery. The fear is normal and everyone has it. It is surgery, and there is not a chance of zero risk, but your risk is likely very, very, very miniscule. I do not know your health so I am basing this on the fact that you are otherwise very healthy. Best of luck, you will do great!

Richard J. Brown, MD
Scottsdale Plastic Surgeon
5.0 out of 5 stars 54 reviews

Should I be scared to go under the knife?

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Yes, your concerns are quite common. It is rare to find a preop patient that does not express the same concerns. You will not feel anything during surgery, you will not wake up during surgery, but you will wake up fairly quickly after the surgery is over. Statistically you are at far more risk of dying on your next trip to the mall than you are in an accredited surgical facility under the care of a board certified anesthesiologist.

Ronald V. DeMars, MD
Portland Plastic Surgeon
5.0 out of 5 stars 29 reviews

Pre Op Questions/Concerns

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It is common for patients to be nervous about all the things you are before surgery. For the most part, your Plastic Surgeon should be the one to address all these concerns with you, provide answers and ensure that you have the instructions you need before surgery. Be sure that you choose a board certified Plastic Surgeon with plenty of experience. The facility, staff and safety protocols in place are important for you to ask about. Please see attached link for a list of questions you can ask when planning your surgery.
All the best

Pre-op instructions

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I have attached a document containing the pre-op instructions I give all my patients.I hope this helps calm your nerves. Always insist on a board certified surgeon.\

Good luck!

Should I be scared to go under the knife?

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Anxiety prior to surgery is very normal; its complete elimination is usually not possible. Assuming you have chosen your plastic surgeon carefully, other important "variables" such as anesthesia provider and surgery facility will be selected based on everyone's first priority: safety. This careful selection should give you some peace of mind that you will be safe around the time of surgery. Discuss your specific areas of concerns with your plastic surgeon who will be in the best position to help you calm your nerves. 

I ask my patients to try to be as calm as possible prior to surgery; this “calmness" tends to translate to a smoother postoperative course. You may be able to alleviate some pre operative anxiety with music, exercise, meditation, a glass of wine (if ok with your surgeon), and positive/objective focus on the long term outcome/benefits etc. prior to your procedure.

Again, I think you will be best off, given that your surgery is coming up very soon, spending additional time with your plastic surgeon communicating your goals/concerns/questions carefully (preferably prior to the day of surgery). In doing so will you likely find peace of mind and decreased anxiety. Generally, in our practice, patients find that they did “get worked up for nothing” after their recovery is completed. I hope this helps.

Should I be scared to go under the knife?

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It is normal to feel nervous before elective surgery.  Although there certainly are risks with surgery and anesthesia, for most healthy patients in accredited operating facilities, the risks of outcomes like "never waking up" are exceeding low.  Best to discuss your specific concerns with your plastic surgeon, you can do much to allay your anxieties about your upcoming surgery.

Michel C. Samson, MD
Daytona Beach Plastic Surgeon
5.0 out of 5 stars 9 reviews

Concerns about going under

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Thank you for sharing. This is a common feeling with many patients. You have many questions and concerns. Rest assured that breast augmentation is a common procedure that has a high satisfaction rate and result rate! Talk with your PS and anesthesiologist about your concerns. They will be able to guide you and allay any concerns! Best wishes!

Should I be scared to go under the knife for breast implants?

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It is very normal do have anxiety when you are having elective surgery.  Honestly the best person to discuss yyour concerns with his your plastic surgeon. It is important that you have these issues resolved before surgery and if you still have an extreme amount of anxiety as surgery date approaches I would recommend canceling surgery and waiting until you are comfortable with your decision.   Please arrange to see her plastic surgeon again and discuss her fears in detail.

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.