Post-Surgical Recovery: Complete Guide to Plastic Surgery
What to Really Expect from the Post-Operative Phase of Plastic Surgery
If there is one phase of plastic surgery that generates more questions and anxiety than the surgery itself, it is the recovery. Over more than twenty years performing facial and body aesthetic procedures, I have noticed that most of my patients arrive at the first consultation with questions much more focused on the post-operative phase than on the procedure itself. When can I return to work? How long will I be swollen? Do I need to wear a compression garment? Can I exercise? These are the questions that really keep you awake at night.
I completely understand this anxiety. After all, you are entrusting your body to the care of a surgeon and want to know exactly what will happen afterwards. My goal with this guide is to be completely transparent about each phase of recovery, from the first hours after surgery to the final result, months later. I will not downplay or exaggerate. I will tell you exactly what happens, why it happens, and what you can do to optimise each stage.
This guide generally applies to the plastic surgeries I perform most frequently: facelift, rhinoplasty, blepharoplasty, abdominoplasty, liposuction, and breast surgery. Each procedure has its particularities, which I address on the specific pages, but the fundamental principles of recovery are surprisingly similar. Your body follows a predictable biological sequence of healing, regardless of which surgery was performed.
A good recovery does not happen by chance. It begins even before the surgery, with the proper pre-surgical preparation, and fundamentally depends on your collaboration in following the guidelines that I will detail below. Patients who strictly adhere to the post-operative protocol recover faster, with fewer complications and superior results. This is not an opinion: it is what I have consistently observed for two decades.
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The first 24 hours: the most delicate period
The first twenty-four hours after any plastic surgery are the most critical and, paradoxically, the simplest from the patient's perspective. Simple because you basically need to rest, maintain the correct position, and take medication on time. Critical because it is during this period that the body begins the inflammatory process that will be the foundation of all healing.
Upon leaving the surgical centre, you will have compressive dressings on the operated area. In the case of a facelift, there will be a band around the head and neck, in addition to the hemostatic mesh from Auersvald that I use to prevent bruising. In rhinoplasty, there will be an external nasal splint and internal plugs. In abdominoplasty and liposuction, the compressive garment will already be in place. Do not touch anything. These dressings have been placed strategically and have a therapeutic function.
The discomfort in the first hours is real, but perfectly manageable with the prescribed medication. I prescribe painkillers on a fixed schedule, not just when pain appears. This strategy of preemptive analgesia maintains a constant level of comfort and avoids pain spikes that are much more difficult to control once they set in. Take each medication exactly at the indicated time, even if you are feeling well.
Position for sleeping and resting
The correct position in the first hours is essential. For facial surgeries, keep your head elevated at forty-five degrees, using two to three firm pillows. This reduces swelling by facilitating venous and lymphatic drainage. For abdominoplasty, sleep in a semi-flexed position, with pillows under your knees. Never lie completely flat in the first forty-eight hours, regardless of the surgery performed.
Cold compresses: how and when to use
Cold compresses are your greatest allies in the first twenty-four hours. The cold causes vasoconstriction, reducing bleeding and swelling. Apply cold compresses wrapped in a thin cloth for twenty minutes, with intervals of twenty minutes without a compress. Never apply ice directly to the skin, especially in areas with reduced sensitivity due to anaesthesia, as the risk of cold burns is real.
Normal signs versus warning signs
In the first hours, it is normal to feel: moderate discomfort, residual drowsiness from anaesthesia, mild nausea, and a tight sensation in the operated area. It is not normal: intense pain that does not subside with the prescribed medication, active bleeding that soaks the dressing, fever above thirty-eight degrees, shortness of breath or difficulty breathing. If any warning signs arise, contact my team immediately.
The first week: swelling, bruising, and patience
The first week is when the body works most intensively in the inflammatory phase of healing. It is also when the appearance is most impactful for the patient, and I must be honest: you will not look beautiful during this phase. And that is perfectly fine. Inflammation is the first essential step towards healing, and trying to suppress it completely would be counterproductive.
Understanding swelling
Swelling peaks between the second and third postoperative days. Many patients are startled because they wake up on the second day more swollen than they were the night before. This is absolutely normal and expected. The body is sending fluids, proteins, and defence cells to the operated area, initiating the tissue repair process. This fluid accumulated in the tissues is what we call swelling.
In facelift surgery, the swelling concentrates in the cheeks, periorbital area, and neck. In rhinoplasty, the swelling extends to the lower eyelids and can cause impressive dark circles. In abdominoplasty, the abdomen will be swollen and hard, very different from the final result. In liposuction, the treated area will appear larger than before the surgery in the first days. All of this is temporary.
Bruises: the map of healing
Bruises are accumulations of blood in the superficial tissues. They follow a predictable colour pattern that reflects the phases of haemoglobin degradation: they start purple (days one to three), turn blue (days three to five), become greenish (days five to seven), and finally yellow (days seven to fourteen) before disappearing completely. Gravity influences the distribution of bruises, which can migrate to areas below the operated region. In facelift surgery, it is common to see purple spots on the neck and even on the chest, even if those areas were not operated on.
Care for stitches and dressings
At the first follow-up, usually in forty-eight hours, I assess the progress, change dressings, and, in the case of a facelift, remove the hemostatic mesh. The stitches are removed progressively over the first and second weeks, depending on the location and type of thread used. Some threads are absorbable and do not need to be removed. Do not touch the stitches, do not try to clean scabs, and do not apply any product that has not been prescribed.
Diet in the first week
In the first days, especially after facial surgeries, the diet should be soft and cold. Warm soups, yoghurts, fruit smoothies, and purees are excellent options. Avoid hot foods, which increase vasodilation and swelling. Avoid very salty foods, which promote water retention. Abundant hydration with water and coconut water is essential to assist in the elimination of anaesthetic residues and in reducing swelling.
The first month: the phase of tissue reorganisation
The first month marks the transition from the acute inflammatory phase to the proliferative phase of healing. Swelling begins to subside more noticeably from the second week, and by around the twentieth day, most patients feel comfortable resuming social commitments, although there may still be noticeable residual swelling for those who know that surgery was performed.
Weeks two to four: the gradual return
During this period, the body is actively producing new collagen to repair the tissues. This initial collagen is disorganised and abundant, which explains why scars and operated areas may appear hardened, raised, or irregular. This is completely normal and temporary. The collagen remodelling process will continue for months.
Many patients ask me why certain areas seem harder than others, or why one side is more swollen. Asymmetries in swelling and healing are the rule, not the exception. Each side of the body has slightly different lymphatic and vascular drainage. The final result will be symmetrical, but the path to get there is rarely so.
Return to work
The question of returning to work fundamentally depends on the type of activity and the surgery performed. For remote work or light administrative activities, the return can happen between seven and fourteen days. For activities that require public presentation or moderate physical effort, two to three weeks is more appropriate. For manual work or that involves intense physical effort, the minimum is thirty days.
One point I always emphasise: returning to work does not mean being one hundred percent recovered. It means that you are in a condition to perform light activities without compromising healing. Greater than usual fatigue, swelling that worsens at the end of the day, and discomfort at the end of the day are normal during this period.
Medications in the postoperative period
The medication protocol I prescribe includes: painkillers for the first seven to ten days, prophylactic antibiotics for seven days, anti-inflammatories for five days, and, when indicated, medication for the prevention of venous thrombosis. I strictly follow the guidelines of the Brazilian Society of Plastic Surgery regarding thromboembolic prophylaxis, especially in larger surgeries such as abdominoplasty.
In addition, I prescribe supplements that assist in healing: vitamin C, zinc, and, in selected cases, bromelain (pineapple enzyme) to reduce swelling. I do not allow the use of anti-inflammatories on your own, homeopathic medications, or herbal remedies without my authorisation, as many can interfere with coagulation or healing.
Three months: when the result begins to show
If there is a magical moment in recovery, it happens around the third month. It is when the residual swelling has significantly subsided, the scars are maturing, the tissues have settled into their new position, and the result of the surgery begins to reveal itself for real. Many patients tell me that it is during this period that they finally understand why they had the surgery.
The collagen remodelling process
At three months, the body has already replaced a good portion of type III collagen (temporary) with type I collagen (permanent). The scars, which may have been pink and raised, begin to lighten and flatten. The areas of postoperative fibrosis progressively soften. In liposuction, the body contours are much more defined than at thirty days. In facelift surgery, the expression is natural and rejuvenated, without any stiffness.
Physical activity: gradual return
From the third month onwards, most patients are cleared for physical activities with virtually no restrictions. But this return should be gradual. In the first weeks after clearance, prefer low-impact activities: walking, light swimming, yoga. Increase the intensity progressively over the following weeks. High-impact exercises, heavy weightlifting, and contact sports should wait until I individually clear you, usually around the fourth month.
A common mistake is the patient who feels so well at three months that they decide to make up for lost time with intense exercise. This can cause reactive swelling, discomfort, and, in extreme cases, compromise areas still healing. Respect the process. Your body is working internally even when you feel perfectly fine on the outside.
Sun exposure: the silent enemy of healing
Sun exposure is perhaps the external factor that most harms the quality of scars and the final result. Ultraviolet radiation stimulates melanin production in forming scars, potentially causing permanent hyperpigmentation. Additionally, the sun increases the inflammatory process in the skin, prolonging swelling and potentially causing irregular spots in the operated areas.
My guidance is strict: sunscreen SPF fifty or higher on all exposed areas, reapplied every three hours, for a minimum of six months. Scars should be protected with silicone adhesive or micropore tape when exposed to the sun. Avoid direct sun exposure in the first six weeks. After this period, moderate exposure with adequate protection is acceptable. Tanning beds are absolutely prohibited for six months.
Six months to a year: the definitive result
The interval between six months and a year marks the final maturation of the surgery. It is when I can affirm that you are seeing the definitive result. The scars reach their final appearance, the deep structures have completely stabilised, and the soft tissues have found their permanent balance.
At six months, the scars from the facelift are practically imperceptible, hidden in the natural folds of the ear and within the hair. The scars from the abdominoplasty, although more extensive, become a fine and clear line that is concealed by underwear. In rhinoplasty, the nose reaches its definitive shape, with all the subtleties of definition of the tip and the dorsum finally revealed.
The importance of long-term follow-up
Even after the result is consolidated, I maintain periodic follow-up with my patients. Review consultations at six months and upon completing a year are essential to document the result, identify any asymmetry that deserves attention, and plan any complementary procedures.
This follow-up is not just about aesthetics. It is about health. I observe the quality of healing, assess if there are areas of fibrosis that would benefit from treatment, check the symmetry, and discuss with the patient their satisfaction with the result. The surgeon-patient relationship does not end when the stitches are removed. It continues for as long as necessary.
Complementary procedures
In some cases, small adjustments can be made after the complete maturation of the surgery. In facelift, the application of botulinum toxin complements the result by softening expression lines. In rhinoplasty, any minimal asymmetries can be corrected with cartilage grafts. In liposuction, areas of irregularity can be treated with lipofilling. These are individual situations that I discuss on a case-by-case basis.
Compression garment: your best ally in recovery
If I could choose a single item as the most important for post-surgical recovery, it would be the compression garment. This seemingly simple accessory performs crucial therapeutic functions that directly influence the quality of the final result. Unfortunately, many patients underestimate its importance or abandon it prematurely.
How the compression garment works
The uniform compression exerted by the garment promotes multiple simultaneous benefits. First, it reduces the dead space between the skin and the deep tissues, decreasing the accumulation of seroma (fluid) and the formation of bruises. Second, it aids in skin retraction, helping the skin readapt to the new body contour. Third, it reduces swelling by facilitating lymphatic drainage. Fourth, it provides comfort and security to the patient, limiting movements that could compromise healing.
How long to wear
The protocol varies according to the surgery. In liposuction and abdominoplasty, I prescribe continuous use for thirty days, removing it only for bathing. After this period, it is worn during the day for another thirty days. In mammoplasty, the surgical bra should be worn for sixty continuous days. In facelift, the compression band is worn for seven to fourteen days.
I know that wearing a garment twenty-four hours a day for a month is not comfortable, especially in the heat. But each day of consistent use directly contributes to a better result. Patients who abandon the garment early experience more swelling, more irregularities, and a higher risk of seroma. The temporary discomfort is worth the permanent result.
Choosing the right garment
The ideal garment should exert firm and uniform compression without constricting. It should be made of breathable material, preferably with flat seams that do not mark the skin. I recommend specific brands and models for each type of surgery during the pre-operative consultation, and I check the fit in the post-operative period. A garment that is too tight can cause pain, hinder circulation, and create marks. A garment that is too loose simply does not fulfil its function.
Lymphatic drainage: speeding up recovery
Manual lymphatic drainage is a physiotherapeutic resource that I consider an integral part of the recovery protocol for body surgeries. This technique of gentle and rhythmic massage helps the lymphatic system reabsorb the excess fluid accumulated in the tissues, speeding up the resolution of swelling and improving patient comfort.
When to start
I recommend starting lymphatic drainage from the third or fifth post-operative day, depending on the surgery and individual progress. For liposuction and abdominoplasty, early initiation is especially beneficial. For facial surgeries, drainage can be started after the removal of stitches, usually in the second week.
Frequency and duration
The protocol I recommend is three sessions per week during the first three weeks, reducing to two weekly sessions in the following weeks. The total number of sessions varies between fifteen and twenty, but I adjust individually according to each patient's progress. Sessions last on average fifty minutes.
Who should perform it
Post-surgical lymphatic drainage should be performed exclusively by physiotherapists or specialised professionals with experience in the post-operative phase of plastic surgery. The technique differs from conventional aesthetic drainage. The movements must respect the incision areas, the directions of anatomical lymphatic drainage, and the fragility of the healing tissues. Poorly performed drainage can be worse than no drainage at all.
What drainage does not do
It is important to have realistic expectations. Lymphatic drainage accelerates the reabsorption of swelling, but it does not magically eliminate swelling overnight. It does not replace the use of the compression garment, does not compensate for lack of rest, and does not correct surgical problems. It is a valuable complement, not a magic solution. Be wary of professionals who promise miraculous results with aggressive massage techniques in the first days. Excessive force on healing tissues causes more harm than benefit.
Healing: what influences the quality of your scars
Every surgery leaves a scar. This is an undeniable truth that needs to be understood before any procedure. What differentiates a good result from an exceptional result is the quality of these scars: thin, discreet, aligned with the lines of tension in the skin, and positioned in strategic areas that make them almost invisible.
Factors you cannot control
Genetics is the main determinant of scar quality. Patients with fair and thin skin tend to heal with more discreet lines. Darker skin has a greater tendency towards hypertrophic and keloid scars. Age also influences: younger patients produce more collagen and may initially form thicker scars, although in the long term the final quality is generally excellent.
The location of the scar on the body also matters. Areas of greater skin tension, such as shoulders, anterior chest, and pubic region, tend to produce wider scars. Areas of less tension, such as eyelids and natural folds, heal in a practically imperceptible manner. Therefore, I position my incisions strategically to minimise the visibility of scars in the long term.
Factors you can control
Sun protection is the most important modifiable factor. As I have already mentioned, ultraviolet radiation can hyperpigment scars in formation permanently. Use sunscreen religiously.
Proper nutrition provides the building blocks for healing. Proteins, vitamin C, zinc, and vitamin A are essential for collagen production. Undernourished patients or those on very restrictive diets heal worse.
Smoking is the greatest enemy of healing. Nicotine causes vasoconstriction in the skin's microvessels, reducing the supply of oxygen and nutrients to the repairing tissues. Smokers have a significantly higher risk of dehiscence (opening of stitches), skin necrosis, and poor-quality scars. Therefore, I require complete cessation of smoking for at least fifteen days before and fifteen days after surgery.
Treatments for scars
From the third week, when the scar is sealed, I start treatment with silicone sheets or silicone gel. These products create an environment of hydration and pressure that modulates collagen production, resulting in thinner and flatter scars. Treatment should be maintained for three to six months for maximum benefit.
In selected cases of hypertrophic scars, I may use infiltration with diluted corticosteroids, fractional laser, or microneedling to improve scar quality. These interventions are performed after three months, when the scar has already completed the initial maturation phase.
Warning signs: when to seek immediate help
Although the vast majority of recoveries proceed without complications, it is essential that you know how to recognise signs that require immediate medical evaluation. Early detection of complications is the most important factor for their proper management. Do not hesitate to call me or send a message if something seems wrong. I prefer to evaluate ten normal situations than to miss a real complication.
Hematoma
A hematoma is the accumulation of blood under the skin in the operated area. It differs from normal swelling by being asymmetric (usually affecting one side more), progressive (increasing rapidly over hours), tense, and painful. In a facelift, a hematoma may present as sudden and intense swelling on one side of the face, accompanied by pain that does not subside with analgesics. The hematoma requires immediate surgical drainage. It is precisely to minimise this risk that I use the Auersvald hemostatic net in my facelifts.
Infection
Signs of infection include: progressive redness around the incision (different from the normal redness of the first few days, which is stable or decreases), local heat, purulent secretion (yellowish or greenish) with an unpleasant odour, fever above thirty-eight degrees that persists for more than twenty-four hours, and worsening pain after a period of improvement. Post-surgical infections are rare with the antibiotic prophylaxis I prescribe, but when they occur, they require immediate treatment.
Seroma
A seroma is the accumulation of serous fluid (clear or yellowish) in the operated area. It is more common in abdominoplasty and large volume liposuction. It manifests as a floating increase in volume, without significant pain, usually after the first week. Treatment involves aspiration with a needle in the office, a simple and practically painless procedure. Multiple aspirations may be necessary.
Deep vein thrombosis
Deep vein thrombosis (DVT) is a rare but potentially serious complication. Signs include: pain in the calf of one leg, asymmetric swelling of one leg, redness, and local heat. If untreated, DVT can progress to pulmonary embolism, which manifests as sudden shortness of breath, chest pain, and tachycardia. Any of these symptoms requires immediate attendance at the emergency room.
When concern is excessive
Having said all this, I want to reassure you: the vast majority of post-operative cases progress without any of these complications. Asymmetry of swelling, tingling, transient numbness, a pulling sensation, and local discomfort are normal situations that do not require intervention. When in doubt, always get in touch. My team is prepared to guide you by phone and, when necessary, schedule an immediate in-person evaluation.
Nutrition and habits that accelerate recovery
Post-surgical recovery is an intense metabolic process. Your body is simultaneously fighting inflammation, producing collagen, regenerating blood vessels, and remodelling tissues. All of this requires energy and specific nutrients. Inadequate nutrition during this period can prolong swelling, delay healing, and compromise the final result.
Proteins: the foundation of healing
Proteins provide the amino acids necessary for collagen synthesis and cellular regeneration. I recommend consuming one and a half grams of protein per kilogram of body weight per day during the first month post-surgery. Ideal sources include: eggs, chicken, fish, lean meat, cottage cheese, and natural yoghurt. For vegetarian patients, combinations of legumes with cereals ensure adequate intake of essential amino acids.
Essential vitamins and minerals
Vitamin C: essential for collagen synthesis. Citrus fruits, strawberries, kiwis, peppers, and broccoli are excellent sources. Supplementation of five hundred milligrams to one gram per day is recommended.
Zinc: essential for cell division and tissue repair. Red meats, seafood, pumpkin seeds, and nuts are good sources.
Vitamin A: helps modulate the inflammatory response. Carrots, sweet potatoes, spinach, and liver are rich in this nutrient.
Iron: necessary for transporting oxygen to healing tissues. Red meats, beans, lentils, and dark green vegetables.
Omega 3: anti-inflammatory properties that help modulate swelling. Salmon, sardines, chia, and flaxseed. Attention: suspend omega 3 supplementation in high doses fifteen days before surgery, resuming only after medical clearance.
What to avoid
Alcohol: interferes with coagulation, increases swelling, and is hepatotoxic, compromising drug metabolism. Total abstinence for thirty days.
Excess sodium: promotes water retention and worsens swelling. Avoid processed meats, canned foods, industrial seasonings, and snacks.
Excess refined sugar: promotes systemic inflammation and can delay healing.
Tobacco: as already mentioned, it is the greatest enemy of healing. Absolute abstinence.
Hydration
Proper hydration is often underestimated. I recommend at least two litres of water per day, which can increase to three litres in the first few days when the body is retaining fluids in the operated tissues. Coconut water is an excellent option as it provides potassium and natural electrolytes. Avoid excessive caffeinated beverages, as caffeine is diuretic and can contribute to dehydration.
Frequently asked questions about post-surgical recovery
How long does recovery from plastic surgery take?
Social recovery (being presentable to leave the house) varies from ten to twenty-one days, depending on the surgery. Functional recovery (returning to normal activities without restrictions) takes thirty to ninety days. Complete recovery (final result stabilised) occurs between six and twelve months. In a facelift, for example, most patients are socially presentable in two weeks, but the definitive result reveals itself between six months and a year.
Can I drive after plastic surgery?
Do not drive while taking medications that cause drowsiness, which usually corresponds to the first five to seven days. After this period, the return to driving depends on the surgery: for facial procedures, seven to ten days; for abdominoplasty, fourteen to twenty-one days (due to difficulty in trunk movement); for liposuction of the lower limbs, ten to fourteen days.
When can I return to physical exercise?
Light walking is allowed from the first week for most surgeries, as it helps prevent thrombosis. Moderate exercises (light weight training, pilates, yoga) are allowed between four and six weeks. Intense exercises (running, crossfit, vigorous swimming) between eight and twelve weeks. The release is always individual and based on the progress of your healing.
Is it normal to feel numbness after surgery?
Yes, transient numbness is absolutely normal and expected. Surgical dissection inevitably interrupts small sensory nerves in the skin. Sensitivity returns progressively over weeks to months as the nerves regenerate. In abdominoplasty, the area below the navel may remain numb for three to six months. In rhinoplasty, the tip of the nose may have altered sensitivity for up to a year.
Can I sunbathe after plastic surgery?
Direct sun exposure should be avoided for at least six weeks. After this period, use sunscreen SPF fifty on the operated areas and scars for at least six months. Scars exposed to the sun can hyperpigment permanently. If possible, protect the scars with micropore tape or silicone adhesive when exposed to the sun.
Is lymphatic drainage mandatory?
For body surgeries such as liposuction and abdominoplasty, I consider it strongly recommended, although not mandatory. Patients who undergo lymphatic drainage experience faster resolution of swelling, less discomfort, and final results with more homogeneous contours. For facial surgeries, drainage is optional and should be performed by a professional with specific experience in post-operative facial care.
How long should I wear the compression garment?
For liposuction and abdominoplasty: continuous use for thirty days, followed by daytime use for another thirty days. For breast surgery: surgical bra for sixty days. For facelift: compression band for seven to fourteen days. Adherence to wearing the garment is one of the most important factors for the quality of the final result.
Can I travel by plane after surgery?
Short flights (up to two hours) can be taken after fourteen days for most surgeries. Long flights (over four hours) should wait at least thirty days, due to the increased risk of venous thrombosis. For blepharoplasty and rhinoplasty, cabin pressurisation may temporarily increase periorbital swelling, so it is wise to wait three weeks.
What should I do if the scar becomes thick or red?
Scars that are initially pink and slightly raised are normal and part of the maturation process. Worry if the scar continues to grow in thickness and extent after the third month, if it causes intense itching, or if it exceeds the limits of the original incision (a sign of keloid). In these cases, schedule a consultation for me to evaluate and initiate specific treatment, which may include silicone sheets, infiltrated corticosteroids, or laser.
Is the result of the surgery permanent?
The result is long-lasting but not eternal. Surgery does not stop the ageing process. A facelift, for example, rejuvenates appearance for ten to fifteen years, after which natural ageing continues. Liposuction permanently removes fat cells from the treated area, but significant weight gain can expand the remaining cells. Rhinoplasty produces permanent structural changes, although the nose continues to undergo subtle changes over decades.
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