How well you prepare has a direct effect on how safely you come through surgery and how well you heal. This page sets out what Dr Kumar asks of every patient in the weeks before an operation, and why.
In short: Stop all nicotine 8 weeks before body contouring after weight loss, or 6 weeks before other procedures, and stay off it for the same time afterwards. Stop herbal remedies and supplements 4 weeks before surgery. Blood thinners and antiplatelet medicines are stopped only on a timed plan agreed with Dr Kumar’s team and the doctor who prescribed them. If you take a GLP-1 medicine (a weight-loss injection), do not stop it on your own: tell Dr Kumar’s team and your anaesthetist, and follow a 24-hour clear-fluid diet before surgery.
Your preparation timeline
| When | What to do |
|---|---|
| 8 weeks before | Stop all nicotine if you are having body contouring after weight loss: cigarettes, vapes, patches, gum, lozenges and any other form. |
| 6 weeks before | Stop all nicotine for every other procedure. |
| 4 weeks before | Stop herbal remedies and supplements, including fish oil, vitamin E, ginkgo, ginseng, garlic, ginger and turmeric. |
| 7 days before | Stop anti-inflammatory pain relief such as ibuprofen, naproxen and diclofenac, and weight-loss tablets such as phentermine. Paracetamol is fine. |
| 10 days before | Antiplatelet medicines such as aspirin or clopidogrel, if Dr Kumar’s team and your prescribing doctor have agreed they can be stopped. |
| 5 days before | Blood thinners such as apixaban, if Dr Kumar’s team and your prescribing doctor have agreed they can be stopped. |
| The day before | If you take a GLP-1 medicine: clear fluids only from the morning of the day before. Everyone: shower, arrange your support person and follow the fasting instructions you are given. |
| The day of surgery | Fast as instructed, bring your medication list and garment if one was given to you, and have someone to take you home. |
| After surgery | No nicotine for the same 8 or 6 weeks. Supplements are usually restarted from 2 weeks after surgery, once this is checked at your 1-week review. |
Nicotine: why Dr Kumar asks for complete abstinence
Nicotine narrows the small blood vessels that keep the skin edges alive, and smoking also reduces the oxygen your blood can carry. The result is slower healing, more wound breakdown and more infection. In a review of 140 studies, smokers had markedly higher rates of wound complications than non-smokers, and stopping beforehand reduced that risk (Sørensen, Archives of Surgery, 2012). A separate analysis found that each extra week of abstinence before surgery added to the benefit, with the greatest gain after at least four weeks (Mills and colleagues, American Journal of Medicine, 2011).
This matters most in operations with long incisions and large skin flaps, such as abdominoplasty and body lift, and in breast surgery, where it raises the risk of losing skin or nipple tissue and of capsular contracture around implants. Smoking also reduces lung reserve under general anaesthetic.
Because nicotine itself is the problem, the rule covers every form: cigarettes, vapes, patches, gum and lozenges. Dr Kumar asks for none at all for 8 weeks before and 8 weeks after body contouring after weight loss, and 6 weeks before and after for all other procedures. If you cannot meet this, your surgery will be postponed for your own safety. Your GP or Quitline (13 78 48) can help you stop.
Medications and supplements
Some medicines and supplements increase bleeding during and after surgery. Tell Dr Kumar’s team about everything you take, including over-the-counter products and supplements.
| Type | When it is usually stopped |
|---|---|
| Herbal remedies and supplements | 4 weeks before surgery. Common ones include fish oil, vitamin E, ginkgo, ginseng, garlic, ginger, turmeric and guarana. |
| Antiplatelet medicines | 10 days before surgery, for example aspirin or clopidogrel, but only once agreed with your prescribing doctor. |
| Blood thinners (anticoagulants) | For example apixaban, usually 5 days before surgery where there is no reason to keep taking it. Only on a plan agreed with your prescribing doctor. |
| Anti-inflammatory pain relief | 7 days before surgery, for example ibuprofen, naproxen or diclofenac. Paracetamol is fine. |
| Diabetes, blood pressure and hormone medicines | Some are skipped on the day of surgery or stopped a few days before. The details are in the medicines sheet below, and Dr Kumar’s team will confirm your plan. |
| All other regular medicines | Usually continued. Dr Kumar’s team or your anaesthetist will tell you if any need to change. |
Never stop a prescribed medicine on your own. Some patients take blood thinners or antiplatelet medicines for a heart stent, a heart rhythm problem or a previous clot, and stopping them without a plan can be dangerous. Dr Kumar’s team will work out the timing with the doctor who prescribed them.
Download: Your medicines before and after surgery (PDF), a one-page guide to what to stop, what to keep taking, and when to restart, covering blood thinners, diabetes and blood pressure medicines, GLP-1 medicines, the Pill and HRT, and supplements.
Weight-loss injections (GLP-1 medicines) and surgery
Many of Dr Kumar’s patients have lost weight with GLP-1 medicines, the weekly or daily injections used for weight loss and diabetes. These medicines slow the emptying of the stomach, so food can still be in the stomach after the usual fasting time. Under anaesthetic, that increases the risk of stomach contents being breathed into the lungs.
The current Australian recommendations from the Australian Diabetes Society, the Australian and New Zealand College of Anaesthetists (ANZCA), the Gastroenterological Society of Australia and the National Association of Clinical Obesity Services (2025) are:
- Keep taking your medicine. In most cases it is not stopped before surgery. Do not stop it on your own.
- Clear fluids only for 24 hours. From the morning of the day before surgery, have clear fluids only, such as water, clear broth, clear juice without pulp, black tea or coffee and clear jelly, then follow your fasting instructions.
- Tell Dr Kumar’s team and your anaesthetist that you take a GLP-1 medicine, the dose and the day you last took it.
- If you use a daily injection, your anaesthetist may ask you to skip it for a few days before surgery.
- If you have diabetes, talk to your GP or diabetes specialist about managing your blood sugar during the clear-fluid day.
Your anaesthetist confirms the final plan for you. Weight stability still matters too: if you are still losing weight on one of these medicines, Dr Kumar plans your surgery once your weight has been stable for at least three months.
Weight, nutrition and tests
After major weight loss, Dr Kumar is happy to see you once your weight has been stable for at least three months, and plans your surgery from there. Where a Medicare item number applies, it requires six months of weight stability by the date of surgery; because surgery is usually scheduled a few months after your consultation, this is normally met along the way. There is no single ideal weight, but outcomes are generally best with a BMI below 30, particularly for operations on the abdomen and breasts. If that is not realistic for you, Dr Kumar will plan your surgery around your circumstances.
Good nutrition, particularly enough protein, helps wounds heal. Dr Kumar can refer you to an Accredited Practising Dietitian to prepare you for surgery and support your recovery. Any blood tests, imaging or specialist reviews you need before surgery are organised from Dr Kumar’s rooms; these are especially important after bariatric surgery.
The day before and the day of surgery
- Fasting: follow the instructions from the hospital and your anaesthetist exactly. The timing depends on when your operation is scheduled.
- Shower: before you come in, using your usual soap and shampoo. No special wash is needed.
- Sleep: it is normal to feel anxious; a good night’s sleep helps.
- Bring: your medication list, loose clothing that opens at the front, flat slip-on shoes, your phone charger, and your compression garment if one was given to you before surgery.
- Leave at home: jewellery and valuables. Remove nail polish and false nails.
Support at home
You cannot drive, walk or take public transport home after a general anaesthetic, so a support person must take you home. After a day procedure, someone should stay with you for the first night. Larger operations usually mean one to four nights in hospital, and you will need help at home afterwards. If you have young children, arrange care for them for at least the first two to three weeks.
Common questions about preparing for surgery
Do I need to stop my weight-loss injection before surgery?
Usually not. Under the 2025 Australian recommendations, GLP-1 medicines are generally continued, with clear fluids only for the 24 hours before surgery. Do not stop it on your own; tell Dr Kumar’s team and your anaesthetist, who will confirm your plan.
Can I vape or use nicotine patches or gum before surgery?
No. Nicotine itself slows healing, so every form is stopped: 8 weeks before and after body contouring after weight loss, and 6 weeks before and after other procedures.
When should I stop fish oil and other supplements?
Four weeks before surgery. They are usually restarted from 2 weeks after surgery, once this is checked at your 1-week review.
Should I stop aspirin or my blood thinner?
Only on a plan agreed with Dr Kumar’s team and the doctor who prescribed it. Antiplatelet medicines are usually stopped 10 days before and blood thinners such as apixaban 5 days before, but some patients need to keep taking them.
How stable does my weight need to be?
At least three months after major weight loss, whether it came from bariatric surgery, medication or diet and exercise. Dr Kumar is happy to see you from that point and plans your surgery accordingly.
Do I need someone to stay with me after surgery?
Yes. Someone must take you home, and after a day procedure someone should stay with you overnight. Larger operations need help at home for longer.
Questions about your own preparation?
If you are a patient of Dr Kumar, call his nurses on the number in your pre-operative pack. If you are considering surgery, request a call from Dr Kumar’s team or call 1300 267 726. Before deciding on any operation, read the risks and considerations of surgery.
About Dr Kumar
Dr Rohit Kumar (MED0001630444) is an ANZBCPS Board Certified specialist plastic surgeon with over 20 years of surgical experience. His main focus is body contouring after major weight loss, along with breast surgery and abdominoplasty. More about Dr Kumar.
