*This article is brought to you by APRASSA: The Association of Plastic, Reconstructive and Aesthetic Surgeons of Southern Africa*
Find a plastic surgeon www.aprassa.co.za | +27 (0)11 784 4537
Dr Isabel Do Vale underlines the importance of knowing what to expect post-op, as well as ensuring you have a detailed plan ahead to assist you with a speedy, uncomplicated recovery.
When it comes to plastic surgery, most patients are naturally preoccupied with what their final cosmetic result will be. And even though many will ask questions about what level of pain can be expected (as well as when they are able to return to work), very few rarely spend the time educating themselves on what the recovery process entails.
This is surprising really, because from the crucial first 24-48 hours post-op, to the day when you ultimately resume full normal activity (including your regular gym workouts), being fully prepared will not only ease the recovery process – but will also improve the patient safety, and, ultimately, the post-operative satisfaction as well.
What’s more, your surgical recovery may depend on a number of factors; including, type of surgery, length of surgery, pre-operative health status, co-morbid conditions, and age and mental well-being. Your surgeon will discuss all of this with you, in detail, and will give specific post-operative instructions, including how to get in touch with his or her staff if necessary. It is essential to follow these instructions closely as they will be tailored to your specific needs and type of surgery.
The best preparation is done in advance. Planning your recovery should happen well before your procedure. Consider some of the following aspects and plan ahead to ensure your recovery is stress-free, safe and uncomplicated.
Designated driver and help at home
Some procedures may require that you stay overnight in the hospital for a day or two, but many aesthetic procedures can be performed as day cases, thereby allowing you to be discharged on the day.
However, if you are going home on the same day, first ensure that you have a designated driver to chauffeur you home, as well someone to stay with you and assist with your care (especially over the first 48 hours while the effects of anaesthesia slowly wear off). This is imperative as you may not drive after any form of general anaesthesia or sedation, even if you feel fine.
And should you have young children, it’s advisable that you arrange some extra babysitting or childcare help for the first few days. You cannot be picking up anything heavy, as you will need to rest and take it easy, especially over the first 48 hours.
Rest aids recovery, but it’s important to ambulate early by getting out of bed 3- 4x daily
Time off from work and exercise
Arrange for sufficient time off work as guided by your surgeon. It helps to plan your surgery for a quieter period of your work calendar so that you don’t need to worry about project deadlines or commitments leading up to your surgery or during your recovery.
Some patients anticipate getting back sooner than advised, which can create undue stress when they realise they might not be ready. Don’t try to rush getting back into the gym – accept that healing is a process that allows your body the time it needs. Plan on easing back into exercise by starting with gentle walks, then slowly progressing back to your pre-surgery fitness schedule.
Postoperative Activity
As much as you need to rest for your recovery, you also cannot be a complete couch potato or be confined to bed. Early ambulation is extremely important after surgery as a means of preventing the development of deep venous thrombosis and pulmonary embolism. You should ideally ambulate within 12 hours of surgery and be assisted to walk three to four times a day.
This might include walking to the bathroom and back, getting up for meals or working toward taking a short walk in the garden. Getting up and moving about also facilitates movement of the diaphragm, thus improving lung ventilation and mobilisation of mucous secretions. Incentive spirometry or simple deep breathing exercises can help with this too.
Pain Control
Adequate pain control with postoperative analgesics is essential for recovery by allowing early ambulation, improved pulmonary clearance, and decreased overall stress. The most effective regimen for pain control requires small frequent dosing, preferably via the intravenous route while in hospital, but easily achieved with oral analgesics once discharged.
Whilst in hospital, your doctor may give you a PCA (patient-controlled analgesia)- a pre-programmed infusion pump that you can control by a hand-held button to deliver a safe, premeasured intravenous dose of narcotic analgesia in a timely manner. PCA use has been linked to decreased overall narcotic use and improved pain control.
On discharge, you will be prescribed oral analgesics.
Nutrition and hydration
In the immediate post-operative period, you may experience transient loss of appetite and mild nausea – usually due to the anaesthetic agents and other perioperative medications. However, these symptoms are easily managed by antiemetics.
The stress of surgery on the body can result in increased energy requirements and a concurrent rise in the basal metabolic rate, meaning that a healthy balanced diet (and in some cases nutritional supplementation) is essential for timely wound healing and immunological defence.
Postoperative fluid balance is affected by current deficits, maintenance requirements and abnormal losses. It’s important to maintain good hydration, both leading up to your procedure as well as after surgery.
Wound care
Your wounds will be dressed with appropriate dressings in the theatre. These usually do not need to be changed until your first post-operative visit with your surgeon. You may also have drains coming from your wounds to facilitate drainage of excess fluid or blood from the surgical site. Look after the drains, ensuring that they do not hook or pull on anything, as this could result in them coming out. In some instances, you may need to wear a post-operative compression garment for support and to minimise swelling.
Contact your surgeon
If you are concerned about anything that seems abnormal or contrary to what your surgeon explained, don’t hesitate to contact his or her office and ask. The sooner you alert the team to a potential problem, the better.
In the event of a major complication or emergency (e.g. abnormal leg swelling/ pain, shortness of breath, excessive bleeding), go to your nearest Emergency Room at the hospital, even if you have not yet managed to reach your surgeon.
If you are concerned about anything that seems abnormal or contrary to what your surgeon explained, don’t hesitate to contact their office and ask
Tips for easing your recovery at home
- Planning ahead for what you need in your recovery space
Lifting, reaching, and straining are usually off-limits after plastic surgery, so think about where you are likely to spend most of your recovery time and plan to have everything you may need within easy reach. - Pillow-up for a good night’s sleep
Your surgeon may advise you to sleep on your back or keep your head elevated after surgery. Use extra pillows to help you maintain a comfortable position. In a double-storey, you may prefer to use a temporary bedroom on the lower level to avoid using the stairs. - Stock the fridge
Save on cooking by preparing some healthy snacks (yoghurts, pre-cut fruits/ veggies) and meals (that easily reheat) ahead of time. Keep up your intake of fibre-rich foods and fluids, because pain meds can be somewhat constipating. - Tie up any loose ends before your procedure
In the same way that you might prepare before going on vacation, rid yourself of undue stress by ticking off as many routine tasks / chores as possible. Pay your bills, spring clean, fill your chronic prescriptions, and prepare for any upcoming school-related events your children may have. Ensure that you haven’t scheduled any meetings or appointments for your recovery period. Prepping ahead means you can relax and focus on looking after yourself for optimal recovery. - Prepare yourself emotionally
Take time to prepare your mind for your recovery. Experiencing emotional ups and downs during your cosmetic surgery recovery process can be perfectly normal. You may feel amazing one day, and then doubt your decision the next (but keep in mind that these second thoughts usually occurs when it feels like your recovery is taking a little longer than you hoped. Don’t worry, it will be ok.)
Take home message
Having a clear, realistic, idea of what to expect ahead of time can make a huge difference.
APRASSA is the Association of Plastic Reconstructive and Aesthetic Plastic Surgery of Southern Africa.
To find an APRASSA member plastic surgeon please go to www.aprassa.co.za or call +27 11 784 4537).
Written by Dr Isabel Do Vale
Dr Isabel Do Vale
MBChB (Wits), FC Plast Surg (SA)
- Practises at www.plasticsurgeon-johannesburg.co.za
- Executive committee member of APRASSA (The Association of Plastic, Reconstructive and Aesthetic Surgeons of Southern Africa) www.aprassa.co.za
- Member of ISAPS (International Society of Aesthetic Plastic Surgery) www.isaps.org
- Currently holds a consultant teaching post at Charlotte Maxeke Johannesburg Academic Hospital, and practises at Netcare Linksfield Hospital
A2 Disclaimer: This article is published for information purposes only, nor should it be regarded as a replacement for sound medical advice.
This article was written by Dr Isabel Do Vale and edited by the A2 team EXCLUSIVELY for the A2 Aesthetic & Anti-Ageing Magazine Summer 2021 Edition (Issue 39 – Dec 2021 to Mar 2022).
Summer 2021 Edition (Dec 2021-Mar 2022) – Issue 39
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