Medically reviewed by Dr. Tom Biernacki, DPM — Board-Certified Podiatric Surgeon — Balance Foot & Ankle, Howell & Bloomfield Hills, MI. Last updated April 2026.

Why Preparation Matters

Well-prepared patients have better surgical outcomes. Understanding what to expect before, during, and after foot surgery reduces anxiety, improves compliance with post-operative instructions, and leads to faster, more complete recoveries. This guide walks through the key preparation steps our patients need to know before undergoing foot or ankle procedures at Balance Foot & Ankle.

Before Surgery: Medical Preparation

Your surgeon will review your health history and medications well before your surgery date. Certain medications require adjustment in the pre-operative period: blood thinners including warfarin, aspirin, clopidogrel, and direct oral anticoagulants (DOACs like apixaban or rivaroxaban) typically need to be stopped 5 to 7 days before surgery. NSAIDs like ibuprofen and naproxen should be stopped 5 days before surgery to reduce bleeding risk. Never stop prescription medications without explicit guidance from both your prescribing physician and your surgeon — this is especially important for blood pressure medications, diabetes medications, and cardiac drugs.

Patients with diabetes should have HbA1c below 8.0 percent before elective foot surgery — poorly controlled blood sugar significantly increases infection risk and impairs healing. If your HbA1c is above this threshold, your surgeon may recommend postponing elective surgery until glucose control improves. Patients who smoke should stop at least 4 weeks before surgery — smoking dramatically impairs wound healing and bone healing through nicotine-induced vasoconstriction.

Before Surgery: Practical Preparation

Arrange your home environment before surgery day. If you will be non-weight bearing post-operatively, move frequently used items to countertop level so you don’t need to reach or bend. Set up a comfortable resting area with pillows for limb elevation — the foot should be elevated above heart level for the first several days post-operatively. Install a shower chair or bench if needed. If your dominant foot is being operated on, practice using crutches before surgery day. Arrange for a driver for surgery day — you will not be able to drive yourself home regardless of anesthesia type.

Surgery Day: What to Expect

You will be asked not to eat or drink anything (including water) for a minimum of 8 hours before surgery if general or sedation anesthesia is planned. For local anesthesia only procedures, specific fasting instructions will be given. Wear loose comfortable clothing that accommodates a post-operative boot or splint over the operated foot. Remove nail polish from the surgical foot before your procedure. Leave valuables at home. Bring your insurance information and a photo ID. The check-in, preparation, anesthesia administration, procedure, and recovery typically take 2 to 4 hours total depending on procedure complexity.

Immediately After Surgery: The First Week

Expect more pain than you might anticipate during the first 3 to 5 days — this is normal even for minor procedures. Take prescribed pain medications as directed and don’t wait for pain to become severe before taking them. Keep the foot elevated above heart level as much as possible for the first 3 to 5 days to minimize swelling. Ice application over the outer dressing (never on bare skin) provides additional pain and swelling control. Keep the dressing clean and dry — use a waterproof cast cover or plastic bag secured at the ankle for showering. Do not remove or loosen the surgical dressing unless specifically instructed by your surgeon.

Your Post-Operative Appointment

Your first post-operative appointment typically occurs at 7 to 14 days, at which point your surgeon will inspect the wound, remove sutures in some cases, and transition you to the next phase of your recovery plan. Bring someone with you to this appointment as there may be new instructions that are helpful to have a second person hear. Write down any questions you have before the appointment — it’s easy to forget concerns once you’re in the room.

At Balance Foot & Ankle, we walk every surgical patient through a detailed pre-operative education session before their procedure day. If you have questions about an upcoming procedure, contact our office — we are here to make your experience as smooth as possible.

Foot or Ankle Pain? We Can Help.

Balance Foot & Ankle — Howell & Bloomfield Township, MI

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Preparing for Foot Surgery at Balance Foot & Ankle

Proper preparation makes foot surgery recovery smoother and more successful. Dr. Tom Biernacki and the team at Balance Foot & Ankle guide you through every step of surgical preparation at our Howell and Bloomfield Hills offices.

Schedule Your Surgical Consultation | Book Your Appointment | Call (810) 206-1402

Clinical References

1. American College of Foot and Ankle Surgeons. “Patient preparation guidelines for foot and ankle surgery.” ACFAS.org. 2024.
2. Coughlin MJ, et al. “Surgery of the Foot and Ankle, 9th edition: Preoperative Planning.” Elsevier. 2014.
3. McDonald S, et al. “Pre-operative education for hip or knee replacement.” Cochrane Database Syst Rev. 2014;(5):CD003526.

Dr. Tom Biernacki, DPM

Dr. Tom Biernacki, DPM is a double board-certified podiatrist and foot & ankle surgeon at Balance Foot & Ankle Specialists in Southeast Michigan. With over a decade of clinical experience, he specializes in heel pain, bunions, diabetic foot care, sports injuries, and minimally invasive surgery. Dr. Biernacki is a member of the APMA and ACFAS, and his patient education content on MichiganFootDoctors.com and YouTube has reached over one million views.