Post-Operative Pain Management
In my practice, I use a multi-modal approach for my post-operative pain management! This allows me to minimize the opioid requirement. This creates a snowball effect of faster recovery, decreased constipation, and more patient comfort!
My post-operative pain control starts intra-operatively! This starts with tumescent anesthesia- a numbing solution that is injected into the surgical fields. The other is Exparel- which is a long lasting numbing medication that can last up to 48 hours!
Post-operatively, I prescribe opioid medications to all of my patients. This is to take the edge off of the pain. My ultimate goal is to minimize this requirement! Opiates include Norco, Vicodin, Percocet, etc.
In the immediate post-operative period, please avoid NSAID medications. These include Aspirin, Alleve, Motrin, etc. These medications bind your platelets and inactive them, increasing your likelihood for oozing/bleeding. Instead, use things like Tylenol or Acetaminophen. But, remember, you shouldn’t exceed more than 3,000mg (or 3g) in a 24 hour period. This becomes important as most opiate medications have Tylenol mixed in. Doses greater that 3g in 24 hours have been found to be toxic to the liver.
I’m here to help make your post-op journey as easy as possible while helping you become the best version of you!
Surgical Infection Prevention
All surgical procedures involve incisions!
Generally speaking, the sutures used to close the incisions are dissolvable. Overlying these incisions, we place either a surgical tape (steri-strip) or surgical glue (Dermabond) which serve as an additional layer of closure.
The key is to always make sure that you’re monitoring your incisions.
While you’re in my office and post-op visits, we do that for you. But, it’s always a good idea to do the same while you’re at home!
Remember, a CLEAN and DRY wound has a low likelihood of getting infected where as it’s DIRTY and WET counterparts doesn’t.
Surgical Infection Prevention
Surgical compression garments are categorized into two categories:
Stage/Phase 1- loose fitting yet snug. The goal of the garment is to be tight enough to cause compression yet not too tight to kill off the blood supply of the overlying tissues. We also don’t want the skin to have indentations from the garment. Compression foams may be used during this time. This period is roughly 1-2 weeks.
Stage/Phase 2- after the majority of the initial fluid is evacuated (via drains), the body is far less swollen, and can thus undergo tighter compression. This is worn for approximately 3 months.
We’ll go over your post-operative care in detail prior to your surgery!
Regaining Sensation After Cosmetic Surgery
A huge determining factor is what kind of surgery are you planning to have?
Immediately after liposculpting, the surgical areas will be numb from the tumescent solution. This last about 24 to 48 hours. During this period, you want to make sure that you avoid any ice packs or heating pads to avoid any burns to the skin!
Procedure that involve larger incisions, such as abdominoplasties (tummy tucks) or breast lifts, will understandably require a longer period of time to regain sensation.
There is a wide spectrum for the sensation timeline- for some patients, it may take less than three months while it may take others six months to a year, and for some, the sensation over the incision line may never return (although a small subset of patients).
Tummy Tuck Recovery Timeline
Recovery times vary from patient to patient!
But, on average, most patients are able to return to work at or around 2 weeks- without heavy lifting or strenuous activities! Remember- at the 2 week mark, your drains are also removed!
At 6 weeks, you essentially have no restrictions as 80% of your wound healing is complete.
At 3 months, you begin to see a major difference as the majority of the swelling subsides.
At 6 months, your body has 90% of healing complete.
The 1 year mark marks your new baseline!
Liposculpting Recovery Timeline
The recovery timeline of liposculpting is actually pretty short!
You’ll be able to return to work in about 7 days post-operatively.
You will have limitations on what you can lift though! You want to restrict strenuous activities and heavy lifting for about 4 weeks!
Breast Augmentation Recovery Timeline
The recovery timeline is actually really short!
You’ll be able to return to work in about 7 days post-operatively. You will have limitations on what you can lift though!
You want to restrict strenuous activities and heavy lifting for about 6 weeks- that’s when your body has reached approximately 80% of its tensile strength!
How Do I Minimize My Scarring Risk?
My goal is to always minimize your scars while maximizing your results! It’s noteworthy to mention that everyone scars differently- even siblings!
Fortunately, we have different tools that can help us minimize the scars:
1- Experienced Cosmetic Surgeon
2- High quality products (IE, sutures)
3- Taking it easy after your surgery
4- Avoiding the sun
5- Use of topical scar management (IE, silicone gel and ointment)
6- Energy based treatments (IE, lasers)
7- Wound care teams
Scars & Tattoos
One of the most commonly asked questions I get is, “Can I get a tattoo over my scar?”
The answer is yes BUT timing is everything.
I recommend waiting one year after your operation before committing to a tattoo.
This is because the remodeling phase of your incision can take up to one year. In addition during this period, you will also be applying topical scar agents to minimize the scarring of your incision line.
We will go over the after care of your incisions in great lengths!
Scars & Tattoos
Lymphatic Massage Importance
Our bodies are very dynamic. In addition to our arteries and veins, we have a complementing system called the “Lymphatic System.” It’s a system of tissues, vessels and organs that all work together to maintain your body’s fluid levels, maintain your immune function, and keep your blood circulating.
Your arteries and veins carry your oxygenated and deoxygenated blood, respectively. Your lymphatic system, on the other hand, carries lymph.
Lymph is a clear fluid that has proteins, waste, fat, and metabolized cells that are filtered through your lymph nodes. As the fluid flows through your lymphatic system, waste is removed and normal lymph is returned to circulation.
When there is a blockage to this system, you end up with swelling, or edema. When it comes to cosmetic surgery, your body sees this as an insult, or trauma, and floods the areas with pro-inflammatory markers. This then causes edema.
Lymphatic massages will thus- reduce edema (swelling), minimize scar tissue and fibrosis, decrease healing time, and increase patient comfort.