7 Things To Know About The Plastic Surgery Operating Room

Of course your doctor is going to give you the low-down on how best to prepare for your cosmetic procedure at the all-important pre-op appointment. And we bet you’ve done your research on what to expect post-procedure, too. But there are still a few things that may catch you by surprise when you arrive in the operating room on surgery day.

“For me, it was not knowing just how cold the OR can get,” says Christina*, who underwent a breast surgery several years ago. “I was already nervous, and when I was wheeled into a super cold operating room, it just added to my anxiety.”

According to a study in the Journal of Clinical Nursing, surgery is often associated with increased stress and anxiety, which can have an adverse effect on patient outcomes. Of those surveyed, 23 percent of patients reported anxiety while being wheeled into the operating room, while 35 percent were anxious during the induction of anesthesia. All the while, 12 percent reported feeling anxious before the sedation kicked in.

But perhaps the most interesting finding was how the figures changed once patients received a bit more intel. Pre-op preparedness and education about what to expect in the operating room reduced anxiety levels in 49 percent of patients.

The bottom line? The more you know about what to expect in the OR, the better equipped you are to deal with it. The AEDITION spoke to board certified plastic surgeons and patients about how to tackle the unknowns of the operating room, so you can ace your cosmetic procedure like a pro.

1. Start with a clean slate

While your doctor is definitely going to let you know that you need to keep your precious jewels at home and skip out on your morning makeup and skincare routine before your procedure, patients may not be aware that you also should stay away from lotions, creams, deodorants, and talcum powder. “It’s a sterile procedure and you want to be as clean as possible,” says board certified facial plastic and reconstructive surgeon Jason Bloom, MD, founder of Bloom Facial Plastic Surgery in Bryn Mawr, Pennsylvania.

Another thing to nix? Your next trip to the nail salon. He recommends patients forgo their weekly manicure, so they have bare nails in the OR. Your doctor and nurse will be monitoring the nails to check your health during the surgery and in the post-anesthesia care unit. The color of the skin and nail beds is an important indicator of blood circulation and, therefore, need to be kept as clean as possible.

2. Yes, it’s going to be bright and chilly in the OR

It’s generally assumed that the temperature in operating rooms is lower to prevent the spread of bacteria, but that's only part of the equation. Most surgeons and nurses will be wearing sterile gowns and standing under bright lights for a long period of time, which can increase their body temperature. A cool room helps keep them comfortable and better focused.

From a patient’s perspective, it’s okay to request a warm blanket or ask that the room be kept at a reasonable temperature. “Once I let my doctor know that the cold was really bothering me, he was very patient and understanding and got the temperature to a comfortable number,” says Christina.

Something else that you should account for: the bright overhead lights that can no doubt be intimidating. “I have had a lot of patients comment on how bright the operating room is,” says board certified facial plastic and reconstructive surgeon Jonathan Cabin, MD, of the Center for Advanced Facial Plastic Surgery in Beverly Hills. “But keep in mind that the right surgical lighting is critical for patient safety.”

If you’re still concerned about bright lights or a cold room, simply remember that you’ll be induced in a matter of minutes and those worries will fade away faster than you can count to 10.

3. There may be music — and essential oils

While multiple studies in the past have shown that music helps both patients and doctors relax before a surgical procedure, a 2015 study from the University of Texas Medical Branch at Galveston went one step further. According to the study, when plastic surgeons listen to music they enjoy, their surgical technique and efficiency when closing incisions are improved. “I always have music on during surgery,” says Denver-based board certified plastic surgeon Gregory Buford, MD, of Beauty by Buford. “But recently I also started including essential oils.”

Much like music, essential oils are another favored practice for keeping patients calm. According to a recent study published in Laryngoscope Investigative Otolaryngology, aromatherapy helps combat preoperative anxiety that can have a negative impact on patient satisfaction and outcomes. “I don’t know if it’s a placebo effect, but it’s very pleasant and soothing,” says Dr. Buford. “So far, I have only gotten positive feedback.”

While he has taken to dabbing a bit of lavender essential oil on the inside of the patient’s mask, he also recommends using some post-surgery. Just ensure that you pick natural, plant-based essential oils that don’t irritate your wounds or interfere with your medication.

4. It could be a full house

From your very first consultation, you’ll be dealing with your board certified plastic surgeon and maybe a nurse or two, so it’s only natural to assume that these will be the only people with you in the operating room. While this may be true for quick, non-invasive procedures (think: Botox®, fillers, and the like), most surgical procedures (breast implants, facelifts, etc.) will have an operating room bustling with a number of medical professionals.

In addition to your surgeon, there will be one or two registered nurses, a scrub or surgical technician (to ensure that the surgeon has all the necessary tools), an assistant to the surgeon, and an anesthesiologist (i.e. the person who administers the anesthesia and monitors your breathing throughout the procedure).

“If I am going to have a fellow, resident, or medical student observing the procedure, I make sure to let the patient know beforehand,” says Dr. Bloom. For many doctors and surgeons, it’s a regular practice to allow fellows and residents to observe procedures as part of their training process — but they should give you an adequate heads-up. If it’s something you’re uncomfortable with, just let your doctor beforehand.

5. It’s normal to have a sore throat when you wake up

If you’re undergoing general anesthesia, keep in mind that you’ll likely be waking up with a sore and irritated throat. Once you’re sedated, you’ll be intubated and placed on a ventilator. And, while the breathing tube is resting in your mouth, it also extends into your throat and windpipe, which makes your mouth, teeth, and gums very dry.

The remedy to tackling a sore throat is rather simple:

• Drink plenty of fluids post-procedure
• Invest in some throat lozenges ahead of time
• Be sure your oral care routine includes brushing your teeth and tongue

“The recovery time is a maximum of three or four days,” says Dr. Cabin. “And, generally, the discomfort passes quickly.” But if it does last longer than the suggested time period, check in with your doctor.

6. Stay away from herbal remedies

Most patients know that alcohol and caffeine should be strictly avoided before and after a procedure, but even some natural alternatives (like ginseng, fish oil, milk thistle, ashwagandha, ginkgo biloba, St. John's wort, and kava) may be off-limits as well. “We recommend that patients stay off herbal remedies for two weeks before and post-procedure as a cautionary measure,” says Dr. Cabin. “Not only can they interfere with medicines used during anesthesia, but they also increase your blood pressure and risk of bleeding.”

Instead, both Dr. Bloom and Dr. Buford recommend supplements, like MEND, to help optimize the body in preparation for surgery and facilitate faster healing post-op.

7. Prepare for any allergies

Your doctor is going to have you tested for just about any kind of allergy to make sure that everything goes smoothly on the day of the procedure, but, as a patient, it’s also your job to help them cover all the bases.

Make sure you ask for a list of any medications they may be using and check that against any other medications you’re currently taking to ensure they can be used together. Also, ask your doctor for recommendations on how to combat allergies should they suddenly occur post-procedure.

In rare cases, some patients can develop a reaction to medical adhesives, like Mastisol, that are used to secure wound dressings. In such instances, it’s essential you immediately reach out to your doctor, so he or she can prescribe medication or offer alternatives to combat the allergy.

Some patients, meanwhile, can be moderately to severely allergic to latex products, which manifests as lip or tongue swelling, rashes, or unusual sensitivity. In this situation, doctors can use non-latex products during the procedure and suggest other options for post-op products as well.

*Patient’s name has been changed