Anesthesia Consultation Before Plastic Surgery Abroad: 20 Questions Worth Asking

Why anesthesia deserves its own conversation

Surgeons tend to dominate the consultation because they talk about the result. The anesthesia provider talks about something less glamorous: keeping you breathing, warm, still, comfortable and safe for the hours you cannot speak for yourself. For a long body-contouring operation in a country you are visiting, that role is not a formality.

It also explains a lot of the "small print" on your pre-op instructions. Fasting rules, which pills to take on surgery morning, whether you go home the same day, and why a nurse keeps asking about snoring all come from the anesthesia side of the plan.

When to have it, and in what form

Ideally there are two touchpoints:

• Before you book flights: a remote review of your history, by video call or written questionnaire, so anything that needs testing or a medical clearance is found while your dates are still flexible.
• In person in Medellín: a pre-anesthesia assessment before surgery day, when the provider examines your airway, reviews your labs and confirms the plan.

Many clinics combine the in-person part with the pre-op visit a day or two before surgery. That is fine as long as the remote review happened first. If the clinic says you will only meet anesthesia on the morning of surgery, ask whether anyone with anesthesia training has reviewed your file in advance.

Language matters too. Ask whether the conversation will be in English or with a medical interpreter. A family member translating your anesthesia history is not ideal.

What to send ahead

Anesthesia teams look for different things than surgeons do. Put these in one short document.

If you take a GLP-1 medication such as semaglutide or tirzepatide, flag it on the first line. Guidance on these drugs changed in 2024, and the details are in our guide to GLP-1 medications before plastic surgery.

The 20 questions

You do not have to read these out like a deposition. Pick the ones that apply and send them in writing ahead of time, so the answers come back in writing too.

Who and what (1–5)

1. Who will give my anesthesia, and what is their training? Is it a physician anesthesiologist?
2. Will that person stay in the operating room for the whole operation, or supervise more than one room?
3. What type of anesthesia is planned: general anesthesia, deep sedation, moderate sedation, regional or local?
4. If I become more deeply sedated than planned, who manages my airway, and what equipment is in the room?
5. Which monitors will be used during surgery, and who watches them?

Question 4 matters because sedation is a continuum, not a set of switches. The American Society of Anesthesiologists' statement on depth of sedation (amended 2024) describes four levels:

• Minimal sedation: you respond normally.
• Moderate sedation: you respond to voice or light touch.
• Deep sedation: you are hard to rouse and your breathing may become inadequate.
• General anesthesia: you cannot be roused, and your breathing often needs support.

The statement says anyone giving a planned level of sedation should be able to rescue a patient who slips into the next, deeper level. "We only use light sedation" is therefore not a complete answer. The follow-up is: who rescues me if it becomes deeper?

My history (6–10)

6. Does anything in my history make my anesthetic more complicated, and what are you changing because of it?
7. I have (or may have) sleep apnea. How does that change medication choices and how long I am monitored afterward?
8. Which of my medications and supplements should I stop, and exactly when? Which should I keep taking, including on surgery morning?
9. I had severe nausea, or a bad reaction, last time. What will you do differently?
10. Do you need any extra tests or a clearance from my own doctor before you can confirm the plan?

On sleep apnea, the American Society of Plastic Surgeons' guidance on patient selection for ambulatory surgery (2021) says the evidence does not rule out outpatient surgery for patients with sleep apnea. It does point to a higher risk of airway obstruction and breathing depression. Its suggestions include keeping opioids to a minimum and considering longer monitoring after surgery. A good answer to question 7 should sound like a plan, not reassurance.

The operation itself (11–15)

11. How long do you expect me to be under anesthesia, from start to finish?
12. What position will I be in, for example face-down, and how are my eyes, nerves and pressure points protected?
13. How will you keep me warm during a long procedure?
14. What is the plan if I bleed more than expected? Is blood available, and where?
15. What is being done to lower my blood-clot risk during and after surgery?

Anesthesia time and the number of procedures go together. If the answer to question 11 surprises you, read our article on when plastic surgery should be staged instead of combined. Clot prevention is usually shared between the surgeon and the anesthesia team. The Caprini score guide explains how that risk is usually scored.

Waking up and going home (16–20)

16. Where will I recover after surgery, and who monitors me there?
17. What has to be true before I can leave: breathing, oxygen level, pain, nausea, walking, urinating?
18. Is an overnight stay planned? If not, what would turn a same-day discharge into an admission?
19. What is the pain plan, and how will you limit opioids?
20. Whom do I call at night if I am drowsy, short of breath or vomiting after I get back to my lodging?

The same ASPS guidance recommends having a responsible adult present at discharge and through at least the first evening. If you are travelling alone, raise this early. A recovery house can fill some of that gap, but it is not an anesthesia recovery unit.

How to tell a useful answer from a comforting one

For the separate question of how Colombian clinics organise anesthesia staffing and facilities, see Anesthesia Safety in Colombian Clinics. This article is about the conversation itself. That piece covers the setting.

Frequently asked questions

Can the anesthesia consultation be done by video before I fly?

A video call or written questionnaire works well for the history-taking part, and it catches problems while your dates can still change. An in-person check of your airway, vital signs and labs is still usually needed in Medellín before surgery.

Is sedation safer than general anesthesia for body contouring?

Not automatically. Sedation is a continuum, and the ASA statement says the team must be able to rescue you if you become more deeply sedated than intended. The right choice depends on the operation, its length and your health. Ask why that type of anesthesia was chosen for you.

Do I really need to mention cannabis or alcohol?

Yes. Regular use can change how much medication you need and how you wake up. The information is used to plan your care, and leaving it out removes something the team would otherwise plan for.

What if I only meet the anesthesiologist on surgery morning?

Ask the clinic in advance whether someone with anesthesia training has reviewed your records. If your history includes sleep apnea, a past reaction or a complex medication list, ask for the review before you travel rather than accepting a first look on the day.

Will I need a sleep study before surgery?

That is a clinical decision for your team. If you snore loudly, stop breathing at night or feel very sleepy in the daytime, tell them early. Then any testing or change of plan can happen before your trip, not in pre-op.