Why It’s Important To Have a Medical Exam Before Plastic Surgery
We are conditioned to believe that cosmetic procedures aren’t “really” surgery and are inherently safer and risk-free. But ultimately, surgery is surgery, and a lot of the same precautions will exist whether you are getting a tummy tuck, nose job or an illness-related medical procedure.
While the media sometimes tends to downplay the significance of cosmetic surgery, making it almost seem like a spa procedure, the truth is that all surgery has risks and must be treated with respect, says board-certified plastic surgeon, Dr. Arthur W. Perry A preliminary and thorough examination of all patients should be done, regardless of the complexity of the procedure. This includes having their blood pressure and other vital signs taken, along with an examination of the heart, lungs, and other systems. It could save your life.
In a recent episode of Botched, a patient who’d had a botched nose job following a motorcycle accident wanted her nose fixed. Given her history, the surgeon recommended a CT scan prior to performing any procedure. Results from the scan showed she had two brain aneurysms which could have been fatal if she’d undergone surgery without a medical exam.
What to expect
Some exams can be relatively cursory, such as an exam before Botox, but others must be much more in-depth, says Dr. Perry. “For example, a tummy tuck is a several hour procedure performed under general anesthesia. It is important for the doctor to know that the patient’s heart can withstand this procedure. Patients over the age of 50 would be required to have an EKG and may require a stress test. My own policy is to have all patients examined by a board-certified, internal medicine physician prior to surgery to obtain clearance in advance,” explains Dr. Perry.
Every plastic surgeon has a checklist of preoperative requirements, Dr. Perry explains. Breast surgery patients may need a pre-operative mammogram to ensure that there are no premalignant or malignant changes that could affect surgery. Other requirements are age related. “EKGs and sometimes even chest X-rays are usually performed on patients over the age of 50. Some of the requirements are individualized for the patient depending on their history. For instance, if a woman has a history of easy bruising and heavy periods, it would be reasonable to obtain blood tests that would determine if she clots properly,” says Dr. Perry.
Never lie to your doctor
“I have had many patients who have tried to hide illnesses from me so I will not turn them down for the procedure. These undisclosed conditions are often revealed in a letter of medical clearance from their internists. I have seen dozens of people who have “never had surgery” but have the telltale scars from their prior procedures,” says Dr. Perry. It is never smart to hold back information from your surgeon - there is a reason why it is important. It places the patient at extreme risk for complications or even death if something unexpected occurs because of withheld information the doctor isn’t aware of. Also, the doctor/patient relationship should be one of mutual trust, and when the patient withholds information, the doctor would be within his or her rights to cancel surgery.
And that includes lying about your age….
There is no question that there is a linear relationship between risk and age, says Dr. Perry. “At some point, the riskier procedures, such as a tummy tuck, might be too risky to justify. If a patient requires continuous blood thinners, such as after coronary stents, certain procedures, like a facelift may be too risky to perform. Fortunately for such patients, we are in an era where we have many noninvasive alternative procedures such as Botox, wrinkle fillers, lasers, high-energy ultrasound, and peels that can improve a person’s appearance without the need to go under the knife,” notes Dr. Perry.
Be honest with your plastic surgeon. Your life depends on it!