The commonest ligament to require reconstruction is the anterior talo-fibular ligament (ATFL). It is always the first to fail when you twist your ankle. Most of the time it heals well with a compression bandage or splint followed by early weight-bearing.
A small percentage of ligaments do not heal and this causes chronic instability. When that happens, a reconstruction of the lateral ligaments is undertaken.
No specific pre-operative preparation is required other than perhaps practicing on crutches which you will need to use post-operatively.
This is done through a small incision over the front of the lateral side of your ankle. The ligaments are mobilised shortened and thickened and sutured back into place with absorbable suture material. The ankle is then immobilised in a light-weight cast.
For the first two weeks, you will be non-weight-bearing on crutches until the wound has healed. When wound healing has occurred, weight-bearing is permitted in a boot. After six weeks, the cast is removed and physiotherapy and full weight-bearing commence immediately. This is a very reliable operation and it is reasonable to expect normal ankle function to recover after this.
As this is a minimally invasive procedure the risks are reasonably small but do exist. You may develop a blood clot, sustain an injury to the nerve at the front of the ankle or even develop an infection in the joint. These problems are generally exceedingly rare.
Once the ankle has been injured multiple times or your ankle remains chronically painful and unstable it is not possible to relieve the pain by just training your muscles so there is no non-surgical alternative to deal with this form of ankle pathology.