The surgeon will provide you with specific instructions that begin as early as two weeks before your surgery. Some instructions deal with safe practices to avoid unwanted medical events during and following your surgery. Other instructions help your body prepare for the surgery and the healing process afterwards, including steps to help reduce swelling.  Every surgery, every surgeon, and every patient are different. The swelling that occurs will depend on many variables. Pay attention to the instructions provided by your surgeon to reduce swelling. Be very clear, well in advance of your surgery, regarding the changes you need to make in your medications. This will involve a coordinated effort with your regular doctor, any specialists you see, and your surgeon. Some medications can cause changes that may lead to problems during surgery and difficulties after the surgery, such as additional and prolonged swelling.  Make the changes in your prescription drugs, over-the-counter agents, and herbal supplements, two weeks before your surgery. It takes time for the medications to get out of your system, and for your system to return to its baseline level of functioning. Provide your surgeon with a complete list of your medications, including herbal supplements and over-the-counter agents, at least 30 days before your scheduled surgery. It takes time for your doctors to communicate with each other and determine the drugs you can stop in advance and the ones you should not stop at all.  Never stop or adjust your prescription medications without consulting your doctor. Plan early with your regular doctor or specialist. Many agents require a gradual taper downward to stop the medication. Some prescription medications should not be stopped or dose adjusted at all. Let your surgeon know of the drugs you will need to continue to take routinely, including the day of surgery. Your surgeon will know if you can continue some agents, such as acetaminophen. You will need to stop many things but not everything. Your surgeon will let you know what you can continue taking.  OTC anti-inflammatory drugs, such as ibuprofen, naproxen, and aspirin, will need to be discontinued two weeks before your surgery. This group of medications can lead to additional bleeding which causes more swelling. Stop taking your herbal supplements should be stopped two to three weeks before your surgery. It may be best to plan on stopping everything you take that is an herbal product or supplement. Your surgeon will tell you exactly how to proceed.  Some herbal products can interfere with anesthesia and others can increase bleeding and swelling after the procedure. Plan on stopping products that contain omega 3’s and 6’s contained in fish oil supplements, flaxseed, ephedra, Ma Huang, feverfew, goldenseal, garlic, ginseng, ginger, licorice, valerian, and kava. This is not a complete list. Talk to your surgeon about all your herbal supplements. A healthy diet will promote healing and reduce swelling. This means you should start following this step as far in advance as possible and continue it through the entire post-op healing process.  Include fruits and vegetables that are high in fiber. Examples of high fiber foods include peas, lentils, artichokes, brussel sprouts, lima beans, and black beans. High fiber foods prevent constipation. Pain medications provided for surgical pain often cause constipation. Straining due to constipation can lead to bleeding at the surgical site and additional swelling. Reduce your sodium intake to help decrease swelling after the surgery. Stay hydrated the week leading up to the surgery. Plenty of water will also help to promote healing and reduce swelling. If you are a smoker, then you will need to stop smoking several weeks before your surgery.  The healing process is slowed in people that smoke. Smoking also increases the risk of developing an infection. Avoid ingesting alcoholic drinks. Since alcohol thins the blood, avoid drinking alcohol for at least five days before the surgery.

Summary:
Follow the directions provided by your surgeon. Start making changes two weeks before. Work with your doctor(s). Stop over-the-counter (OTC) drugs. Plan to stop all herbal supplements. Eat a healthy diet. Stop smoking and avoid alcohol.