Dr Roger Graham: Plastic and Reconstructive Surgeon

Before and After Your Surgery

Before Your Surgery

Obtain a Pre-Authorisation Number From Your Medical Aid

If you have a medical aid, it is necessary to ask your medical aid to authorise your upcoming surgery. Without this authority, you will not be reimbursed by your medical aid. We will supply you with the codes and information required. 

This practice prefers that all patients obtain their own authorisations as the medical aids will very often inform you of the rate you will be reimbursed at and from which fund the money will be deducted. This is important as Dr Roger Graham charges above medical aid rates.

What Time is My Surgery?

On the day of booking your surgery, you will be given an approximate start time for your surgery as well as the time that you need to be admitted to the hospital. Please call Sandy the day before to confirm the time as it often changes according to the number and types of other operations booked for that day.

May I Eat Before My Surgery?

If you are having a general anaesthetic or sedation, it is essential that you do not eat or drink anything at least 6 hours before your surgery. If you are having a local anaesthetic you may have your meals as usual.

Do I Take My Usual Medications Before Surgery?

Please discuss all medications with Dr Graham at your consultation. Generally, one can follow these guidelines: 

All blood-thinning medications (e.g: Warfarin, Ecotrin, Disprin, Cardiac Disprin, Xarelto, Pradaxa etc.) should be stopped 5-7 days before surgery. As these are prescribed for different reasons it is best to discuss with Dr Graham before booking surgery. People who take Omega 3 fish oil supplements need to stop these for a week prior to surgery because these also thin the blood predisposing to haematomas. Avoid other supplements like St John's wort, Arnica and Ginkgo Biloba because these also thin the blood.

High blood pressure medications: if these are usually taken in the morning, please take as usual with a small sip of water, only.

Diabetic medications: if you need to skip a meal because of being nil per mouth for surgery, please omit the dose related to that missed meal.

With any other medications you are concerned about, please ask Dr Graham if you may or may not take them before your surgery.

May I Wear Makeup During My Surgery?

It is best not to wear makeup during your surgery, this includes nail polish because the monitor that measures the concentration of oxygen in the blood is applied to one's finger. If there is nail polish on one's finger, the monitor is unable to make a measurement.  It is also a good idea not to apply any body lotions or creams. It is often necessary to plan the surgery by drawing on the skin using a surgical marking pen. The ink does not stick as well to skin that has cream on it and then gets rubbed off when the skin is sterilised with antiseptic.

Is There a Special Hygiene Regime to Follow Before My Surgery?

For most patients a normal bath/shower, including a hair wash, is adequate hygiene before surgery. 

If you have had a stubborn Staphylococcus skin infection before, or are a known or possible carrier of this bacteria, please inform Dr Graham and an eradication regime will be prescribed. This entails a daily whole body wash with Chlorhexidine liquid soap (Bioscrub) and daily application of Mupirocin cream (Bactroban, Nuban or Supraban) into one's nostrils. One needs to do this for the week prior to surgery. 

After Your Surgery

Dr Graham will advise you how to care for your surgical wound. Every wound is different and requires specific care instructions, but general principles are to protect it from knocks and to keep it clean and dry.

Everybody will have at least one follow-up appointment, usually one week after surgery.

If, for any reason, you are concerned about your surgical wounds and/or dressings, please contact Dr Graham or Nurse Bets.