After Aesthetic Surgery

Here are the answers to some questions you may have following your aesthetic surgery procedure. University of Chicago Hospitals' surgeons can better address questions specific to your type of surgery.

• Will there be swelling or bruising?
• Will there be pain and discomfort following surgery?
• What type of dressing and sutures will be used?
• Are there limitations following aesthetic surgery?
• Will I need to make follow-up appointments?

Q. Will there be swelling or bruising?
A. Surgical procedures are typically followed by variable amounts of swelling (edema) and bruising (ecchymosis) of the operated area. The extent of swelling and bruising will depend, in part, on the type of surgery performed and the location on the body. Surgery of the face tends to result in more swelling and bruising than, say, surgery of the abdomen or breast because of the relatively greater supply of blood in the face. In most circumstances, obvious swelling usually resolves within five to seven days. In people with thick skin, swelling may take longer to disappear. Bruising may persist for up to two weeks and typically changes from a dark purple color to various shades of brown, red, and yellow during this time. These discolorations are all part of the normal wound healing process and can be camouflaged by special cosmetics as directed by your surgeon.

The extent of swelling and bruising can often be minimized and their resolution hastened by elevation of the operated area above the level of the heart. For example, in surgery of the eyelids, elevation of the head on pillows may greatly reduce the extent of swelling. The application of cold compresses to the operative site during the first 48 hours following surgery may also minimize swelling. Your surgeon will define the techniques most appropriate to your specific circumstances.

Remember that medications containing aspirin (Bufferin, Anacin, Alka-Seltzer, etc.) and other non-steroidal anti-inflammatory agents (Advil, Motrin, ibuprofren, etc.) tend to delay blood clotting and increase the risks of bruising and bleeding complications following surgery. These medications should be discontinued at least two weeks prior to your surgery to lessen their undesirable effects on normal blood clotting. You should inform your surgeon about all medications you are taking or have taken within the previous six months so that he/she may evaluate the potential risks these medications may pose for your surgery.

Q. Will there be pain and discomfort following surgery?
A. The severity of pain and discomfort following aesthetic surgery procedures is typically low but relates to the type of surgery performed and individual pain tolerances. After 48 hours, most aesthetic surgery patients experience very little pain, with the exception of some abdominal procedures which may result in lingering pain and discomfort for up to one week following surgery. Your surgeon will prescribe pain medications for any post-operative discomfort. Severe or persistent pain or pain unrelieved by analgesics may indicate excessive bleeding or infection complications and should be reported immediately to your surgeon. To respond to your concerns or urgent needs, the University of Chicago Hospitals provides an emergency telephone service to put you into immediate contact with our plastic and reconstructive surgery staff--24 hours a day, seven days a week.

Q. What type of dressing and sutures will be used?
A. The type of dressing and method of wound closure will, of course, depend on the type and location of the surgical procedure performed. Most wounds are protected for at least the first 24 to 48 hours following surgery to reduce bacterial contamination that can lead to infection. Incisions of the head and neck are commonly treated with topical antibacterial ointments preceded by cleansing the incision site with saline or hydrogen peroxide solutions to remove accumulated crusts. Incisions of the breast, trunk, and abdomen are usually protected with skin tapes for one to two weeks following surgery. Specific instructions regarding wound care will be provided by your surgeon.

Every effort is made to make your post-operative dressing as comfortable as possible. For this purpose, custom elastic support dressings are frequently used following surgery on the face, breast, abdomen, or hip regions. These supports are easily applied and removed for wound inspections and showering and they may be washed. For face lift surgery, a bulky compression dressing is applied following surgery to reduce the risks of post-operative bleeding and to minimize swelling. This dressing is usually removed after 24 to 48 hours and replaced with a lighter, custom elastic support dressing. Most support dressings are worn for one to two weeks following surgery. In cases of body contouring (suction lipectomy), support dressings may be worn for up to eight weeks or longer following surgery. These dressing may be removed for showering and can be worn beneath regular clothing.

Skin sutures are removed after the wound has healed sufficiently to withstand local forces, such as motion and stretching. In most cases, the skin sutures are removed within five to seven days to avoid unsightly "stretch marks." Since healing occurs faster in areas having relatively more circulation, facial sutures are removed sooner than sutures of the chest, breast, or abdomen. Following early removal of skin sutures, skin tapes may be applied to help support the wound. In some cases, skin sutures may be placed beneath the surface of the skin to avoid suture marks yet provide greater and more prolonged support of the wound. These "sub-cuticular" sutures may be left in place for up to eight weeks following surgery.

Generally, it is safe to shower 48 hours following surgery. Specific instructions regarding the care of your incisions will be provided by your surgeon.

Q. Are there limitations following aesthetic surgery?
A. To provide the optimal conditions for normal healing of your surgical incisions and to avoid bleeding complications, it is best to avoid vigorous exertional activities (exercise, bending over, heavy lifting, pushing, pulling, etc.) for the first several weeks following surgery. Many people ask when they may return to work. A good rule of thumb is that if you are feeling well and your regular work activities do not require strenuous physical exertion, you may return to work within three to five days following surgery. Similarly, driving may be resumed after one to two weeks providing that you have no visual restrictions or limited use of your arms or legs. In general, allow at least four to six weeks for recuperation before resuming full, unrestricted activity. Your surgeon will instruct you in the gradual increase in your post-operative physical activities.

Also, minimize your exposure to ultraviolet sunlight for the first three to six months following surgery as sun rays can cause permanent pigmentation of your skin and incisions at the operative site. Sun screens with a protection value of SPF 15 or greater will help to reduce the effects of ultraviolet exposure. Use of a hat during this time is also recommended for facial surgery patients.

Q. Will I need to make follow-up appointments?
A. Follow-up examinations are an important aspect of your aesthetic surgical treatment. The timing and frequency of follow-up examinations will depend on the type of surgery. Initially, patients may be seen 24 to 48 hours after surgery and at the time of suture removal. Weekly and/or monthly visits are then scheduled as determined by your particular needs. Yearly follow-up appointments are desirable for evaluation of your post-operative result. It is not unusual for the final results of aesthetic surgical procedures to manifest themselves nine to 12 months following surgery with subtle changes occurring even beyond that time. Should you experience any unusual symptoms or are concerned about your condition following surgery, contact your surgeon.

More Information

• Your Initial Office Visit
• The Day of Your Surgery
• After Aesthetic Surgery
• Costs of Aesthetic Surgery