Preparing for surgery

Pre-operative assessment and anaesthetic consultation

A few days or weeks before the operation, you will have a set of standard tests:

• Blood tests: Complete blood count, coagulation tests (INR, aPTT), blood glucose, kidney function (urea, creatinine), liver function and blood group with Rh factor.
• Cardiological assessment: Electrocardiogram (ECG) and, if needed, echocardiography.
• Chest X-ray: As recommended by the anaesthetist.
• Pre-anaesthetic consultation: The anaesthetist reviews the medical file, the history of allergies or associated conditions, and sets the details of the general anaesthesia.

If you have a non-palpable lesion, pre-operative localisation is also scheduled at this stage (the ultrasound- or mammography-guided placement of a metal wire or a localisation clip).

Medicines, anticoagulants and supplements

The surgeon and the anaesthetist must know every treatment you are taking:

• Anticoagulants and antiplatelet agents (Aspirin, Aspenter, Plavix, Sintrom, Eliquis, Xarelto, Pradaxa): These increase the risk of bleeding. They are stopped or replaced only on the explicit instruction of the medical team, following a precise schedule.
• Chronic treatments (blood pressure, thyroid conditions, diabetes): Most antihypertensive medicines are taken even on the morning of the operation with a small sip of water. Oral antidiabetic medication or insulin needs specific adjustments communicated by the anaesthetist.
• Food supplements, vitamins and herbal extracts: Preparations based on Ginkgo biloba, St John’s wort, concentrated garlic, ginseng, omega-3 or high doses of vitamin E increase the risk of bleeding and must be stopped at least 7–10 days before the operation.

One to two weeks before the operation

• Stopping smoking: Nicotine constricts the capillary vessels, dramatically reducing oxygenation of the skin. In breast reconstructions or oncoplastic techniques, smoking increases up to 4 times the risk of skin necrosis and infection. Stopping smoking (including vaping devices or heated tobacco) is essential.
• Avoiding alcohol: Especially in the 48 hours before admission.
• Nutrition and hydration: A balanced diet rich in protein and adequate hydration support the immune response and post-operative collagen synthesis.
• Report any acute problem: If you develop a respiratory viral infection, fever, cough, urinary infection or recent skin lesions (boils, scratches on the chest), tell the team; sometimes it is safer to postpone the operation by a few days.

The evening and morning before the operation

Fasting from food and fluids

General anaesthesia requires an empty stomach to prevent stomach contents from being aspirated into the lungs:

• Do not eat solid food for 6–8 hours before the operation.
• Do not drink water for at least 2 hours before the time given for the operation.

Personal hygiene

• Take a shower the evening before and/or the morning of the operation, using an antiseptic soap (chlorhexidine type) or a neutral soap.
• Do not apply body lotions, creams, oils, perfumes or deodorant.
• Remove nail varnish, gel or acrylic from at least two nails (the pulse oximeter sensor measures oxygen through the nail bed) and leave all jewellery (including earrings and piercings) at home.

What to pack for the hospital

• Medical and administrative documents: ID, health insurance card, referral, imaging results on CD/film (mammography, ultrasound, MRI), the histopathology report of the biopsy and recent test results.
• Comfortable clothing:
  • A nightdress or pyjamas that fasten at the front with buttons or a zip
  • Non-slip house slippers and a dressing gown
• Your regular medication in its original boxes.
• Strictly necessary toiletries and a phone charger.

Preparing for your return home

• Prepare a few extra pillows: in the first nights, a semi-sitting position (slightly raised at 30–45 degrees) reduces tension on the wound and local swelling.
• Make sure you have a companion to collect you at discharge and help you in the first 24–48 hours.

Frequently asked questions