Preoperative Instructions

Five hours before your arrival at the clinic for surgery, do not consume any drinks, water, food, chewing gum, candies, and do not smoke!

For ladies: It is mandatory that you are not on your menstrual cycle on the day of your surgery.

Your surgery will be postponed if:

• Any of your required tests are missing;

• Test results are outside the reference values;

• You are ill on the day of surgery;

• You are on your menstrual cycle on the day of surgery (for ladies);

• You have not taken prescribed antiallergic medications if they were prescribed to you.

Three weeks before surgery, do not take Aspirin or its derivatives. Do not take high-dose contraceptives without specialist consultation.

On the day of the surgery:

• Do not wear makeup, contact lenses, or nail polish.

• All jewelry and piercings on the body and head must be removed before entering the operating room.

• If you have body hair (except on the head) in the surgical area, it must be shaved on the morning before the surgery (exceptions allowed only for religious reasons).

It is recommended to stop smoking one month prior to surgery to allow for faster tissue recovery post-operation.

You will be provided with pajamas and slippers needed for your stay at the clinic. Come in comfortable clothes and shoes so you can feel at ease after being discharged.

After breast surgery, it is recommended to wear a special supportive bra, which can be purchased at the clinic (120 BGN).

Required Tests

Tests should be performed seven days before surgery, and the results must be provided to the clinic either by mail or in person five days before the surgery unless otherwise agreed.

For ladies: Blood tests should NOT be performed during your menstrual cycle!

Required tests:

• Blood (laboratory) tests:

  • Complete Blood Count (CBC) – Leukocytes, Erythrocytes, Platelets, Hemoglobin, Hematocrit, MCHC, MCH, MCV, Differential Count (microscopic), ESR, CRP;

  • Coagulation profile: Prothrombin time, Prothrombin index, INR;

  • Biochemical blood tests: Blood sugar, Urea, Creatinine, Uric acid, C-reactive protein, Total and direct Bilirubin, AST, ALT, GGT, Alkaline phosphatase, Total protein and Albumin, Cholesterol profile, Potassium and Sodium;

• Urinalysis: pH, Specific gravity, Protein, Sugar, Ketone bodies, Urobilinogen, Bilirubin, Blood, Sediment;

• Specialized tests: Wassermann test (for syphilis);

• Blood group and Rh factor;

• Virology: HBsAg; anti-HBc IgM; anti-HCV; anti-HIV 1/2;

• Others: TIBC, Iron (Fe)…

Preoperative Consultations:

1. Chest and heart X-ray with interpretation;

2. Preoperative cardiology consultation, including:

   • ECG (electrocardiogram) with interpretation and a conclusion about perioperative cardiovascular risk;

3. X-ray of nasal bones and paranasal sinuses, when nasal correction surgery is planned;

4. Consultation with a breast specialist and imaging diagnostics when breast surgery is planned;

5. Preoperative consultation with an allergist in case of an allergic disease (no later than two weeks before surgery);

6. Preoperative consultation with a corresponding specialist if you have a history of other systemic diseases;

7. If there are accompanying diseases with specific changes in laboratory tests, it is recommended that these be additionally investigated.