A Note from Dr. Truesdale
“How well you prepare before surgery directly affects how smoothly you recover after. Every instruction in this guide exists for a clinical reason — not as a formality. Patients who follow the preparation protocol consistently have fewer complications, less bruising, and shorter recovery times. Please read this carefully and reach out if you have any questions before your procedure date.”
— Dr. Carl Truesdale, MD · Beverly Hills, California
One Month Before Surgery
Medical clearance & logistics
Begin these requirements at least one month before your surgical date so the office has time to receive every result.
Pre-operative labs. Blood work — PT, PTT, CBC and BMP, plus a pregnancy test (HCG) for women 65 and under. Drawn at Quest, or by your own doctor or an urgent care. Results must reach us three weeks before surgery.
Patients age 45 and over. Because you are 45 or older on the day of surgery, you also need a full physical examination, an EKG with interpretation, and a written letter of medical clearance. This applies whatever type of anesthesia you are having.
Patients age 60 and over. At 60 and older, a chest X-ray is always required, in addition to the physical, EKG and clearance letter.
Specialist clearance for listed conditions. If you have had a blood clot (DVT or PE), a heart attack, a stroke, atrial fibrillation, any heart concern, heart-valve disease, a weakened immune system, an autoimmune condition, or COPD, we also need clearance from your cardiologist or lung specialist — at any age. Special circumstances may require additional pre-operative testing as determined by Dr. Truesdale or your physician.
All clearance results received by the office. Make sure every result — your labs and, if you are 45 or older, the physical, EKG and clearance letter — reaches our office three weeks before surgery. Nothing can be more than three months old on the day of surgery, and any major change in your health voids an existing clearance.
Arrange your companion. Someone must stay with you for the first 72 hours (three days) after surgery. This is mandatory. If an overnight nurse is booked, the nurse covers the first night; days two and three need a companion — or our paid assistant can cover them.
Book your accommodation. If you live outside the immediate Los Angeles area, arrange your hotel before your surgery date. We have a negotiated rate at our preferred hotels, and your patient care coordinator will help you coordinate your stay. Face lift, neck lift and Masterpiece patients: please stay within 20 minutes of our office, even in heavy traffic, at a preferred hotel or at Luxe Serenity Aftercare, which we can help you book. Your hotel and travel arrangements, and their costs, are your responsibility. Provide our nursing staff with the hotel name and your room number on the day of surgery.
Balance paid in full. Your surgical balance is due four weeks before surgery.
Recovery Supplies
What to purchase before surgery
Have these items at home before your procedure date. Most are available at a standard pharmacy.
Hydrogen Peroxide — for incision cleaning — soap and water or peroxide, two to three times a day (never on the eyelids).
Gentle Antibacterial Soap — for pre-operative washing and daily cleansing. We recommend a gentle Dial antibacterial soap, which you can keep using after surgery.
Baby Shampoo — gentle hair washing during recovery.
White Vinegar — CO2 laser patients only, for the vinegar-water rinse solution.
High-Protein Foods and Protein Shakes — regular diet from day one — high protein, low sodium, plenty of water. There is no soft diet after any procedure.
Q-Tips — for careful incision care as instructed.
Paper Towels — for cleansing and drying around incision areas.
Aquaphor Healing Ointment — applied daily from day one, after cleaning, to keep incisions and laser-treated skin moist. Allergic to Aquaphor? Use Vaseline.
Cetaphil Gentle Skin Cleanser — CO2 laser, UltraClear and chemical peel patients only, for gentle daily cleansing of treated skin.
Plain Table Salt — chin implant, buccal fat, cheek implant and alarplasty patients only, for warm salt-water rinses after every meal (or use an antiseptic mouthwash), because your incisions are inside the mouth.
Antibiotic Ointment (Bacitracin or Polysporin) — for incision care as directed.
Silicone Scar Gel — begin twice daily about two days after sutures are removed, and continue for one month. Not on the eyelids.
Wedge Pillow, or 2–3 Extra Pillows — sleep on your back with your head elevated for the first two weeks.
Front-Closing or Zip-Up Tops — never pull clothing over your head during recovery.
Humidifier — rhinoplasty patients only, helpful while your cast is on (it comes off on Day 5).
Afrin Nasal Spray — rhinoplasty patients only, used on a small piece of cotton if a nosebleed persists.
Saline Nasal Spray — rhinoplasty patients only, two sprays per nostril, five to six times daily, after cast removal.
SPF 50 Sunscreen — SPF 50 daily, a hat when you can, and limited sun — for at least six weeks once you are cleared.
Pre-Operative Timeline & Medications to Avoid
What to stop — and when
Follow these instructions precisely. Many of these substances affect bleeding, healing, anesthesia, and surgical outcomes. The high-level timeline appears first; full category-by-category lists with brand names follow below.
Three Weeks Before
Stop all nicotine — cigarettes, cigars, vaping, hookah, nicotine patches, nicotine gum, chewing tobacco, and smoked or vaped marijuana — three weeks before surgery, and stay off it for three months afterward. Nicotine constricts blood vessels and reduces oxygen delivery to healing tissue, sharply increasing the risk of skin necrosis, delayed healing, infection, and poor scarring. There are no exceptions.
Two Weeks Before
Stop GLP-1 and weight-loss medication — stop semaglutide, tirzepatide, and all GLP-1 receptor agonists (Ozempic, Wegovy, Mounjaro and similar) two weeks before surgery. These medications slow gastric emptying, which significantly increases the risk of aspiration under anesthesia when combined with fasting requirements. They also affect blood sugar regulation and wound healing. You can resume them two weeks after surgery.
Stop aspirin and NSAIDs — two weeks before surgery, stop aspirin and aspirin-containing products, ibuprofen, and all NSAIDs including Advil, Motrin, Aleve, and Naproxen. These thin the blood and increase bruising and bleeding. Tylenol (acetaminophen) is the only over-the-counter pain reliever approved before and after surgery. After surgery, NSAIDs restart only once Dr. Truesdale approves — usually at two weeks. If you take aspirin for a heart condition or another medical problem, your cardiologist or prescribing doctor decides when you restart it; if you take it only as a precaution, restart it two weeks after surgery.
Stop all vitamins, herbal supplements and diet pills — including 'natural' weight-loss supplements — two weeks before surgery, unless Dr. Truesdale has specifically approved them. That includes fish oil, vitamin E, St. John's Wort, garlic, ginkgo, ginseng and melatonin. Many supplements thin the blood or interact with anesthesia. You can resume them two weeks after surgery.
Artisa — start priming on arrival. If you receive your Artisa products before surgery, start the priming products as soon as they arrive.
Artisa — pause actives before surgery. Stop your Artisa Age Reversal Cream — and any retinoid or skin-thinning topical — two weeks before surgery. After surgery, the Artisa cleanser and moisturizer start at your one-week visit; the Age Reversal Cream and vitamin C serum start at two weeks.
Avoid sun exposure and tanning — tanned or sun-damaged skin heals less predictably, increases the risk of pigment irregularity, and complicates laser and incision outcomes. Use SPF 50, wear a hat when you can, and limit sun exposure.
Prescriptions sent — your prescriptions are ready one to two weeks before surgery.
One Week Before
Stop alcohol one week before surgery, and do not drink again until three weeks after. Alcohol increases bleeding risk and impairs healing.
Remove eyelash extensions before surgery — they must be off by the day of surgery, because they cannot be safely worked around during facial surgery. They can go back on one month after surgery.
Every nail completely bare — remove all nail polish and nail enhancements from both hands and feet. Every nail must be completely bare — no polish of any color including clear, no gel, no gel-X, no acrylics, no extensions. Pulse oximetry monitoring requires bare natural nails for accurate readings.
Remove extensions and weaves; bring your wig — remove hair extensions and weaves before surgery. If you wear a wig, bring it on surgery day — it comes off for surgery, and bringing it lets us design your incisions where it will cover them. Please bring it to your follow-up appointments too; at first, wear it only briefly (for example, for follow-up photographs).
Stop caffeine one week before surgery, and do not resume until one week after. It reduces vasoconstriction concerns around surgery.
Last hair coloring — color your hair no later than one week before surgery, and do not color it again until one month after — the same for every procedure.
Begin a high-protein diet — eat protein-rich meals to prepare your body for healing. Avoid salt, alcohol, and caffeine.
Begin purchasing all recovery items on the shopping list above so they are ready at home before your procedure date.
Detailed Reference · By Category
Medications & substances to avoid
A complete category-by-category reference of every medication, supplement, and substance that must be discontinued before surgery. Click any category to expand the full list with explanations. If a medication you take is not listed here but you are unsure, contact our office before stopping or continuing it.
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Each Category Has Its Own Stop & Resume Dates
Each category carries its own stop and resume dates — there is no single flat rule. Tylenol (acetaminophen) is the only over-the-counter pain reliever approved before and after surgery: never more than 4,000 mg a day, and each Norco tablet already contains 325 mg.
No Smoking
No Vaping
No Hookah
No Nicotine
SMOKING, VAPING AND NICOTINE (stop 3 weeks before)
GLP-1 RECEPTOR AGONISTS AND WEIGHT-LOSS MEDICATIONS (stop 2 weeks before)
ASPIRIN AND ASPIRIN-CONTAINING PRODUCTS (stop 2 weeks before)
NSAIDs (stop 2 weeks before)
BLOOD-THINNING SUPPLEMENTS, HERBALS AND DIET PILLS (stop 2 weeks before)
PRESCRIPTION BLOOD THINNERS (consult prescribing physician)
RETINOIDS AND SKIN-THINNING MEDICATIONS (stop 2 weeks before)
CORTICOSTEROIDS (consult prescribing physician)
OTHER MEDICATIONS TO DISCUSS WITH DR. TRUESDALE
Not sure about a specific medication? Call our office at (424) 363-4112 or email contact@doctortruesdale.com before your procedure date. Never stop a prescription medication without first consulting the prescribing physician.
Final Preparation
The day before and the day of surgery
The Night Before
- ■Antiviral before your laser — because you have a history of cold sores and your plan includes a laser, start your antiviral 24–48 hours before the laser and continue it for seven days. Most patients already have a supply from their primary care doctor — tell us if you don't.
- ■Keep taking your blood pressure medication as usual, including the morning of surgery with a small sip of water.
- ■Wash with antibacterial soap — wash your face, neck and hair with a gentle antibacterial soap, such as Dial, the night before surgery, and wash your face again the morning of surgery. You can keep using the same soap after surgery.
- ■Nothing to eat or drink after midnight the night before surgery if you are having sedation or general anesthesia. There are no exceptions, apart from a small sip of water with your blood pressure medication. If your procedure is under local anesthesia only, you can eat and drink as usual.
- ■Confirm your arrival time with the surgical center.
- ■Brush your teeth. Wash off all products from your body and hair before bed.
- ■Prepare your question list. Make a list of any final questions for Dr. Truesdale or the anesthesiologist.
- ■Collect your prescriptions — all of your surgical prescriptions are filled at a California pharmacy. Pick them up after you arrive, before the night before surgery.
- ■Take your diazepam the night before surgery, as prescribed.
- ■Do not exercise the day before surgery.
- ■Expect a confirmation call from the nurse and anesthesiologist to review your surgical plan.
Day of Surgery
- ■Nothing to eat or drink after midnight the night before surgery if you are having sedation or general anesthesia. There are no exceptions, apart from a small sip of water with your blood pressure medication. If your procedure is under local anesthesia only, you can eat and drink as usual.
- ■Wash face again with antibacterial soap before leaving home
- ■Wear front-closing or zip-front clothing. Never pull clothing over your head.
- ■Remove contact lenses before arrival.
- ■Leave all valuables, jewelry, and unnecessary items at home. Make sure you remove all metal, piercings, and jewelry from your body.
- ■Arrive on time at True Surgical Center — 150 S. Rodeo Drive, Suite 220, Beverly Hills.
- ■Provide nursing staff with your hotel and room number, plus an emergency contact. If you've booked an aftercare nurse, the nurse picks you up after surgery; your travel companion can wait at the hotel, and we'll send updates throughout the day. Otherwise, your companion will be briefed on post-surgical care when picking you up.
- ■Female patients take a urine pregnancy test the morning of surgery. It's required unless you have been post-menopausal for two consecutive years or no longer have a menstrual cycle (for example, after a hysterectomy). Being on birth control or having an IUD does not exempt you. Our nurse will go over this with you that morning.
- ■Bring your dentures on the day of surgery and to all of your follow-up appointments.
- ■Because you have sleep apnea, bring your CPAP machine. You may need a breathing tube during surgery.
- ■Because you have asthma, bring your inhaler.
Still have questions?
If you have any questions about your pre-operative instructions or what to expect, contact our team directly. We respond same-day, Monday-Friday.
(424) 363-4112