Before Surgery. Preparing well is half the outcome.
The weeks before your procedure — consultation, personal pre-operative evaluation with Dr. Rand Scott, medication planning, smoking cessation timing, and home preparation. This is where good outcomes begin.
Preparation is surgical care.
Most patients think of surgery as what happens in the operating room. In reality, surgical outcomes are shaped by what happens in the weeks and days before the operation as much as by what happens during it. Medications carefully adjusted. Smoking status honestly addressed. Recovery space thoughtfully arranged. A body arriving well-hydrated, well-rested, and well-nourished. These are what determine how you heal.
At NCSS, preparation is a defined phase of care, not an afterthought. Every scheduled surgical patient is offered a free personal pre-operative consultation with our founder and medical director, Dr. H. Rand Scott — a board-certified anesthesiologist with interventional pain training. Medical history, medication planning, and discharge coordination are handled personally, before the day of surgery. Some patients accept the offer; some don't. It stands for all.
What happens and when.
Every surgery follows a slightly different preparation timeline based on complexity and individual health status. The general framework:
Your consultation with your surgeon to discuss goals, review candidacy, understand the specific technique, and see whether NCSS is right for you. This is a conversation, not a sales pitch.
Once you have decided to proceed, the surgery is scheduled. Pre-operative testing (lab work, EKG, chest X-ray as indicated) is arranged based on age and health status.
Nicotine reduces skin blood flow, impairs wound healing, and lowers oxygen delivery to tissues. Marijuana affects anesthesia dosing and post-operative pain response. Both raise complication rates. The more time between your last use and surgery, the more it improves your surgical experience.
Your free personal pre-operative consultation. Medical history reviewed in depth. Medication planning — blood thinners, supplements, anti-inflammatories, others — timed to reduce surgical risk. Discharge planning discussed.
Home recovery space set up. Medications adjusted per protocol. Fasting instructions confirmed. Transportation arranged. Family or support person confirmed for pickup and 24-hour post-op company.
Nothing to eat or drink after midnight (specific instructions per surgery). Shower with the antiseptic wash provided. Avoid any exercise that makes you sweat — fluid loss the day before surgery is not helpful. Focus on hydration throughout the day; well-hydrated veins make IV placement easier and more comfortable. Arrive rested. Wear loose, comfortable clothing.
What to stop, what to continue.
Medication planning is one of the most consequential parts of pre-operative preparation. Guidance is individualized based on your specific medications; the framework below is general.
Prescription blood thinners — individualized timing
Warfarin, apixaban, rivaroxaban, clopidogrel, and similar prescription anticoagulants require careful coordination between your prescriber and our team. Timing depends on why you take them and the specific medication.
Aspirin — typically stopped 2 weeks before
Aspirin irreversibly inhibits platelet function, greatly increasing bleeding and bruising during and after surgery. If your prescribing physician has placed you on aspirin for cardiac or other essential reasons, we coordinate with them directly rather than assume stopping is safe.
NSAIDs (ibuprofen, naproxen) — typically stopped 7–10 days before
These impair platelet function and increase bleeding risk. Acetaminophen is fine to continue.
Herbal supplements — typically stopped 2 weeks before
Vitamin E, fish oil, garlic supplements, ginkgo, ginseng, St. John's Wort, and others can affect bleeding or anesthetic response. When in doubt, stop.
Cannabis and CBD — discuss honestly
Regular cannabis or CBD use affects anesthesia dosing and post-operative pain management. Being honest with our anesthesia team is safer than trying to disclose after the fact.
Diabetes medications — adjusted per protocol
Insulin and oral diabetes medications require specific holding schedules based on your regimen and morning-of instructions.
Blood pressure and cardiac medications — typically continued
Most cardiac and blood pressure medications are continued through surgery, with morning-of instructions provided.
Weight-loss medications — discuss timing carefully
GLP-1 agonists (semaglutide, tirzepatide) can affect gastric emptying and are typically held for a specific period before surgery. Timing is discussed individually.
Every medication conversation happens with Dr. Scott personally in your pre-operative evaluation. Nothing is guessed at; everything is planned.
Setting up for a good recovery.
Recovery happens at home. A well-prepared home makes recovery easier, safer, and more comfortable.
A dedicated recovery space
A comfortable place to spend the first 3–7 days — ideally with a bed or reclining chair that keeps you upright or semi-upright depending on your procedure. Bathroom access without stairs is a priority for the first days.
Prescriptions filled in advance
Have your prescriptions filled before surgery, not after. Pick up compression garments, wound care supplies, and prescribed medications before your surgery date.
Meal preparation
Simple, nutritious meals prepared and frozen ahead. Protein-rich foods support healing. Adequate hydration is critical; keep water within arm's reach at all times.
Support person for 24 hours
A responsible adult must be with you for the first 24 hours after surgery. This is not negotiable for anesthesia safety and is a firm discharge requirement.
Transportation home
You cannot drive yourself home after anesthesia. Uber and rideshare are not accepted as safe transportation after outpatient surgery.
Pets and children
If you have young children or pets who require lifting or physical care, arrange help for the first 1–2 weeks. Lifting restrictions after most procedures are firm.
Time off from work
Return-to-work timelines vary by procedure and by the physical demands of your job. Discuss this with your surgeon during consultation, not the week before.
Surgery-day checklist.
The morning of surgery, bring these items and leave the rest at home.
- Photo ID and insurance card (even for self-pay cases)
- List of all current medications including dosages, or your medication bottles
- Comfortable loose-fitting clothing — button-front or zip-front tops so you don't need to pull anything over your head
- Slip-on shoes — you may be too tired to tie laces after surgery
- Payment for any remaining balance if applicable
- Reading glasses if you use them
- Your responsible adult driver and the phone number of your 24-hour post-op companion if different
- Jewelry and valuables
- Contact lenses
- Makeup
- Nail polish — fingernails and toenails must be bare for pulse oximetry monitoring
- Body piercings (if possible)
- Large sums of cash
Every arrival at NCSS is greeted personally — not slotted into a check-in queue. Your Rest-Assure nurse takes over care from arrival and stays with you through discharge.
Talk to Dr. Scott personally, before surgery.
Every scheduled surgical patient is offered a free personal pre-operative consultation with Dr. Rand Scott — medical history, medication planning, and discharge coordination handled personally before the day of surgery. Some accept the offer, some don't. It stands for all.
(949) 644-8182Monday–Thursday, 8am–3pm · Friday by appointment only.
Continue your journey.
Surgery Day
Arrival, physician anesthesia, one-to-one nursing, the private recovery model, and going home safely.
Continue →After Surgery
The first 24 hours, the first week, follow-up appointments, and direct access to your surgeon.
Continue →The Rest-Assure Program
The full perioperative care standard at NCSS — the reason our surgeons choose to bring their patients here.
Continue →