What You Can Do to Minimize the Risks of Surgery

All surgeries carry inherent risks, some greater than others. While surgeons take every precaution to protect you, there are some things you can do before, during, and after the procedure to increase your safety and your healing.

Updated for 2026

Any surgical procedure has risks associated with it. You are putting an incredible amount of trust in your physician to place you under anesthetic, to incise your skin and organs, remove things from your body, place things into your body, and perform any number of maneuvers to help better your health. And with every surgery comes the risk of bleeding, infection, injury to your body, and even death.

This isn’t meant to scare you! It is essential that you feel comfortable with your surgeon (and anesthesiologist), and ask all the questions you need to before surgery. A good, experienced surgeon will go over the major risks of your operation, allow you ample space to ask your questions, and do their best to put your mind at ease.

One thing that should be emphasized, though, is that risk modification is a two-way street. You, as the patient, have the power to do quite a few things that can reduce your risk of both minor and major complications.

1. Quit smoking. I made this the first point because it has some of the strongest scientific data behind it. Smoking even one tobacco cigarette before surgery reduces the body’s ability to heal and ward off infection after surgery.1 Wound healing, infection, and even mortality rates are higher in smokers than non-smokers.2 There are some operations – in plastic surgery, for example – that smoking regularly before surgery is almost guaranteed to cause complications. Breathing after surgery can also be affected as long-time smokers may have chronic lung damage.Marijuana has not been studied as closely as tobacco cigarettes in this regard, but it does have a tendency to increase the body’s tolerability to anesthesia, influencing perioperative management and monitoring. Cannabis use may also affect heart rate, blood pressure variability, airway reactivity, and postoperative pain. The bottom line is this: the sooner you can completely stop smoking before surgery, the better. It’s a safe bet to cease all smoking for as long as possible before any surgical procedure and wait 4-6 weeks afterwards before resuming. (But you’ve gone that long, you may as well quit for good!)
2. Lose Weight. This one is not always easy, but if you can manage to lose even a few pounds, you’ll be ahead of the game. This is especially true for orthopedic
   operations and abdominal procedures such as hernia repairs.Being obese can increase your risk for infections and cardiopulmonary complications, depending on the type of procedure and extent of your surgery. Pre-op weight loss can improve blood pressure, blood sugar control, and other metabolic functions that make surgery more risky. Even modest pre-operative weight loss reduces liver size, which improves surgical access and visibility during minimally invasive bariatric procedures. Most surgeons will ask that you lose weight prior to surgery if the risk is too high.
3. Control Your Blood Sugar. If you have diabetes, carefully controlling your blood sugar can significantly decrease your risk of infectious complications. Make sure to speak with the physician who helps you manage your blood sugar and let them in on your surgical plans so that your health is optimized before the procedure.Elevated blood glucose levels have been linked to delayed wound healing, higher rates of surgical site infection, increased ICU admissions, longer hospital length of stay, and higher postoperative mortality risk.3 For this reason, preoperative evaluation often includes assessment of glycemic control, and if it has not been recently checked, hemoglobin A1c and current blood glucose levels may be obtained to better assess surgical risk. Be sure to take your medications as directed and maintain a healthy diet so that your body is at its best before, during, and after surgery.If you use GLP-1s to control your blood sugar your surgeon will let you know when to stop (usually 1-4 weeks before surgery)
4. Check in with your cardiologist. If you have a history of cardiovascular issues like hypertension, heart disease, or an arrhythmia, chances are that your surgeon will ask you to receive clearance for surgery from a cardiologist or internal medicine doctor. This means that they will assess your risk factors and try to optimize your medical problems prior to surgery.For example, atrial fibrillation is important to manage because surgical stress, inflammation, fluid changes, and shifts in electrolytes can trigger or worsen arrhythmias. Not only that, but surgery also raises the possibility of thromboembolic events such as stroke. Assessment before and monitoring after surgery is necessary to watch for rhythm fluctuations and decide if long-term anticoagulation is needed based on the patient’s risk of stroke and bleeding.4In patients with underlying heart conditions, the main concerns during surgery include blood pressure or heart rate fluctuations, rhythm disturbances, increased risk of ischemia (reduced oxygen delivery to the heart muscle), and the heart’s ability to increase output in response to physiologic stress (surgery, blood loss, anesthesia).

   You should not hesitate to see your doctor or cardiologist, even if you have no known heart issues and a routine pre-surgical screening is not recommended. A periodic assessment of your heart function can be life-saving, especially right before surgery or when you go under anesthesia. This can be about you being proactive about your health.

5. Eat well. Before surgery, and well after it, no matter what!Good nutrition is not only a requisite for daily cellular functioning and mood stability, but it’s also essential to healing. Poor nutritional status can lead to infections, failure to heal, and even breakdown of new connections of intestines or other organs that your surgeon creates during a bariatric or abdominal procedure.Undernourishment and malnutrition are associated with poor outcomes; if your body is not getting the fuel it needs, it has a harder time undergoing the stress of surgery. Patients with poor nutritional habits have mortality rates up to 2 times higher than their well-nourished counterparts, and usually stay in the hospital longer than those who are diet-savvy. Also, up to 80% of patients who arrive at the hospital with poor nutrition can get even worse during their stay if they do not receive specific nutritional support.5

   Eating enough protein prior to and after surgery, as well as receiving the necessary vitamins and minerals, are the key. Don’t hesitate to ask for a full nutritional panel prior to surgery if you suspect your diet has not been optimal.

There are many factors that contribute to the risk of surgical complications. These are within your control, and paying attention to the above can be a strong step in ensuring your best chances in having a complication-free surgical outcome.

Strive Surgery is led by Shawn Tsuda, MD, MBA, FACS, who has helped countless patients achieve life-changing results. Dr. Tsuda specializes in minimally invasive and robotic surgery, including bariatric procedures, hernia repair, gallbladder removal, and anti-reflux surgery. By using the latest advancements in surgery, we help our patients get back to their lives sooner while achieving excellent long-term results.

1. World Health Organization. (2020, January 20). Smoking greatly increases risk of complications after surgery. World Health Organization News Release. https://www.who.int/news/item/20-01-2020-smoking-greatly-increases-risk-of-complications-after-surgery.
2. Fan Chiang, Y. H., Lee, Y. W., Lam, F., Liao, C. C., Chang, C. C., & Lin, C. S. (2023). Smoking increases the risk of postoperative wound complications: A propensity score-matched cohort study. International wound journal, 20(2), 391–402. https://doi.org/10.1111/iwj.13887.
3. Dogra, P., Anastasopoulou, C., & Jialal, I. (2024, January 25). Diabetic Perioperative Management. National Library of Medicine | National Center for Biotechnology Information; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK540965/.
4. Thompson, A., Fleischmann, K. E., Smilowitz, N. R., de las Fuentes, L., Mukherjee, D., Aggarwal, N. R., Ahmad, F. S., Allen, R. B., Altin, S. E., Auerbach, A., Berger, J. S., Chow, B., Dakik, H. A., Eisenstein, E. L., Gerhard-Herman, M., Ghadimi, K., Kachulis, B., Leclerc, J., Lee, C. S., & Macaulay, T. E. (2024). 2024 AHA/ACC/ACS/ASNC/HRS/SCA/SCCT/SCMR/SVM Guideline for Perioperative Cardiovascular Management for Noncardiac Surgery: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Circulation, 150(19). https://doi.org/10.1161/cir.0000000000001285.
5. Gazouli, A., Georgiou, K., Frountzas, M., Tsourouflis, G., Boyanov, N., Nikiteas, N., Gazouli, M., & Theodoropoulos, G. E. (2024). Perioperative nutritional assessment and management of patients undergoing gastrointestinal surgery. Annals of gastroenterology, 37(2), 142–154. https://doi.org/10.20524/aog.2024.0867.
   surgical outcome.