Truths About the OR and Surgery!

Having surgery can be a scary experience. Here are some truths about the experience and answers to common questions.

What happens right before my cosmetic surgery? - You will drive yourself or be driven to the surgery center. If you drive, please be aware that you will need someone to drive you home after surgery. - You will change into a surgical gown. - The surgical nurse will meet with you. Among other things, your nurse will check your vital signs, review your labs, and the consent. - You will meet with Dr. Katzen again to discuss the surgery. - After Dr. Katzen has answered all your questions and explained everything about the procedure, you will sign the surgical consent. - Dr. Katzen will take "before" pictures. - Dr. Katzen will examine you and draw on you. These markings will help Dr. Katzen during surgery. - Dr. Katzen will take pictures of his markings. - An IV will be placed in your hand. - You will meet the anesthesiologist. The anesthesiologist may ask some more questions. - Once all your questions and the staff's questions have been answered, and all the paperwork is complete, you will be given medication to help you relax. - You will then be brought to the operating room.

Why can't I eat or drink before surgery? Usually, you can eat and drink up until midnight before your surgery. The reason you cannot drink or eat after midnight is that you are given medication during surgery to help you completely relax. Whether you are undergoing general anesthesia or IV sedation, medication is given to relax your muscles. If you have food in your stomach and you are too relaxed, you may regurgitate or throw up this food and fluid. This fluid can then go into your lungs. This regurgitated fluid can cause a burn to the lungs. This condition is called chemical pneumonitis and often leads to pneumonia. This type of pneumonia can take months to heal.

Why can't I smoke before surgery? Cigarette smoke contains many carcinogens and nicotine. Nicotine causes vasoconstriction. Vasoconstriction means vessels are constricted. If the blood vessels are constricted, this decreases the amount of oxygen delivered to tissues. During plastic surgery procedures, tissues are pulled tightly. Healing depends on oxygen delivery to the ends of the tissue. If there is vasoconstriction due to nicotine, there is decreased blood flow and therefore, decreased oxygen delivery to the edges of the surgical incision. Therefore, nicotine has been shown to reduce healing ability in hundreds of medical papers. Also, there are many other harmful elements in cigarette smoke. Damaging the lungs before a surgical procedure under general anesthesia is unwise. It is best just to quit smoking altogether at least two or three months before your elective procedure. There are no medical studies which show that smoking is beneficial to your health. Why is the operating room so cold? We keep the operating room cold to decrease the bacteria load in the operating room. Cold temperatures have been shown to reduce the number of bacteria and viruses on any surface. Also, the surgical staff wears many layers of clothing in the operating room; these include a thick waterproof, blood impervious gowns. Unless the operating room is kept cold, the operating room personnel wearing the garment may get too hot. To keep you warm during your surgery, you will be covered with warm blankets, and a machine called a “BAIR hugger.” A "BAIR hugger" blows hot air across the surface of your body to keep you warm. Keeping warm during surgery is important to regulate normal body functions, especially, including normal bleeding and subsequent clotting.

Who is in the OR during my surgery? The people in the operating room consist of your surgeon, surgical tech, anesthesiologist, and a surgical nurse.

What is it like when I wake up? After surgery and anesthesia, you will be monitored by a nurse. It may take up to an hour to be fully awake. Time may vary depending on the length of surgery. Every individual is different. Most patients may feel groggy and slightly dazed. These feelings are normal. Some patients may feel mild pain or nausea. Both these conditions can be treated easily with IV medications in the recovery room. Once you are awake, you will be given sips of water. Once your vital signs are deemed stable, you will be discharged home or transferred to an aftercare facility.

Why is my vision blurry? During surgery, to prevent your eyes from drying, ointment is placed in your eyes. After your surgery, some of this ointment may be still left in your eyes. This ointment can cause blurry vision. Also, visual blurriness can be caused by the general anesthetic medications.

Why is a bladder catheter necessary? During some plastic surgery procedures, a catheter is placed in the bladder. A bladder catheter is also called a Foley catheter. A Foley catheter is a hollow, flexible tube that is inserted into the bladder. At the tip of the catheter, there is a balloon that is inflated with sterile water. This balloon keeps the catheter in place. Once inserted, the catheter will drain urine into a collection bag. The Foley catheter serves several functions. The Foley catheter collects and monitors how much urine is being produced during surgery. The amount of urine produced is important because it can help to determine how much fluid to give a patient and can help the anesthesiologist titrate and regulate medications. Typically, a nurse will insert the Foley catheter after the patient has been anesthetized prior to the first incision.