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Surgery
Elective surgery
What is Elective Surgery?
What are the different types of Elective Surgery?
Which kind of surgeries are termed Elective?
How is the patient diagnosed and prepared for an elective surgery?
What is the post-operative procedure for an elective surgery?
What are the complications of an Elective Surgery?
Are all Elective Surgeries successful?
What is elective surgery?
Elective surgery is a term used for non-emergency surgery which is medically necessary, but which can be delayed for at least 24 hours. People who need emergency treatment will not be placed on the elective surgery list.
Elective surgery is usually performed in an operating theatre or procedure room under some form of anaesthesia by a surgeon. Elective surgery is different to cosmetic surgery, which is not performed in public hospitals.

Elective surgery procedures are categorised by a medical specialist. Patients with the most urgent medical need (Category 1 – urgent) will be scheduled for surgery first.

Category Clinical description Desirable waiting time
Category 1 – Urgent Has the potential to deteriorate quickly to the point where it may become an emergency. Admission within 30 days.
Category 2 – Semi urgent Causes pain, dysfunction or disability.
Unlikely to deteriorate quickly.
Unlikely to become an emergency.
Admission within 90 days.
Category 3 – Non-urgent Causes minimal or no pain, dysfunction or disability.
Unlikely to deteriorate quickly.
Does not have the potential to become an emergency.
Admission within 365 days.


There are literally hundreds of elective surgeries spanning all the systems of the body in modern medical practice. Several major categories of common elective procedures include:

•Plastic surgery. Cosmetic or reconstructive surgery that improves appearance and in some cases, physical function.
•Refractive surgery. Laser surgery for vision correction.
•Gynecological surgery. Either medically necessary or optional surgery (e.g., hysterectomy , tubal ligation ).
•Exploratory or diagnostic surgery. Surgery to determine the origin and extent of a medical problem, or to biopsy tissue samples.
•Cardiovascular surgery. Non-emergency procedures to improve blood flow or heart function, such as angioplasty or the implantation of a pacemaker. •Musculoskeletal system surgery. Orthopedic surgical procedures, such as hip replacement and ACL reconstruction.

Diagnosis/Preparation

Diagnostic and/or radiological testing may be performed to confirm the diagnosis or assist the surgeon in planning the surgical procedure. Typically, a complete medical history, physical examination , and laboratory tests (e.g., urinalysis , chest x ray , bloodwork, and electrocardiogram) are administered as part of the preoperative evaluation.

Other preoperative preparations will be dependent on the surgery itself. If a general anesthetic is to be used, dietary restrictions may be placed on the patient prior to the operation. If blood loss is expected during the procedure, advance banking of blood by the patient (known as autologous donation) may be recommended.

Aftercare

Recovery time and postoperative care will vary by the elective procedure performed. Patients should receive complete, written postoperative care instructions prior to returning home after surgery, and these instructions should be explained completely to them by the physician or nursing staff.

Risks

The risks for an elective surgery will vary by the type of procedure performed. In general, by their invasive nature most surgeries carry a risk of infection, hemorrhage, and circulatory problems such as shock or thrombosis (clotting within the circulatory system). The anesthesia used may also present certain risks for complications such as anaphylactic shock (an allergic reaction).

Normal results

Elective surgical results depend on the type of procedure performed. Optimal results for an elective procedure should be discussed with the patient prior to surgery. In some cases, the "normal" results from a surgery may only be temporary (i.e., follow-up surgery may be required at a later date), while other results are life-long. For example, a facelift may eventually require a second procedure as a patient ages whereas a tubal ligation offers permanent results.

Morbidity and mortality rates

Success, morbidity, and mortality rates are also dependent on the elective procedure itself. A physician and/or surgeon should be able to provide a patient with statistical information on success rates for a specific elective surgery.

Alternatives

Here are further guidelines.

Rhinoplasty

Surgery Overview

Rhinoplasty is surgery to reshape the nose. It can make the nose larger or smaller; change the angle of the nose in relation to the upper lip; alter the tip of the nose; or correct bumps, indentations, or other defects in the nose.

During rhinoplasty, the surgeon makes incisions to access the bones and cartilage that support the nose. The incisions are usually made inside the nose so that they are invisible after the surgery. Depending on the desired result, some bone and cartilage may be removed, or tissue may be added (either from another part of the body or using a synthetic filler). After the surgeon has rearranged and reshaped the bone and cartilage, the skin and tissue is redraped over the structure of the nose. A splint is placed outside the nose to support the new shape of the nose as it heals.

Rhinoplasty may be done using general or local anesthesia. It is usually done as an outpatient procedure but sometimes requires a 1-night stay in the hospital or surgery center.

Surgeons who do rhinoplasties typically have training in either plastic surgery, otolaryngology (ear, nose, and throat specialty), or both.

What To Expect After SurgeryThe splint and bandaging around your nose will be removed in about a week. Your face will feel puffy and the area around your eyes and nose will be bruised and swollen for several days. Cold compresses can help minimize the swelling and reduce pain. Your doctor may also recommend pain medicine. It takes about 10 to 14 days before most of the swelling and bruising improves.

You may need to keep your head elevated and relatively still for the first few days after surgery. It may be several weeks before you can return to strenuous activities.

Why It Is DoneRhinoplasty can change the size, shape, and angle of your nose and bring it into better proportion with the rest of your face.

Rhinoplasty may also correct structural problems with the nose that cause chronic congestion and breathing problems.

How Well It WorksThe results of rhinoplasty may be minor or significant, depending on what kind of correction you want. It is important that you and your plastic surgeon agree on the goals of the surgery. If your expectations are realistic and your plastic surgeon shares them, he or she will probably be able to give you the results you want.

The results of rhinoplasty are permanent, although subsequent injury or other factors can alter the nose's appearance. Cosmetic surgery should only be done on a fully developed nose. Complete development has usually occurred by age 15 or 16 in females and by age 17 or 18 in males. If surgery is done before this time, continued development of the nose can alter the surgical results and possibly cause complications.

RisksYou can always expect temporary swelling and bruising around the eyes and nose after rhinoplasty. Other problems that may occur include:
•Bleeding.
•Injury or holes to your septum (the wall that separates your nostrils). •Skin problems, including breakdown of skin tissue (skin necrosis) and irritation from the tape and bandaging.
•Infection. Preventive antibiotics may be given after surgery to reduce the risk of infection.
•Serious nasal blockage caused by swelling inside the nose. •Complications of anesthesia.
It is also possible that the cosmetic results of the surgery will not be what you wanted.

What To Think About

If you choose to have local anesthesia, be prepared for the sounds of your doctor working on the bones and cartilage of your nose.

One of the prominent features of the face, the nose can have a big impact on your self-image and appearance. If you're unhappy with your nose and have been so for a long time, rhinoplasty is a reasonable option to consider. As with other cosmetic procedures, you are more likely to be happy with the results of rhinoplasty if you have clear, realistic expectations about what the surgery can achieve and if you share these with your plastic surgeon.