The body reacts to any injury with a series of signals to the area that was injured. These chemical signals direct exactly how the response to the injury will take place. Although each injury is unique, there are some consistent processes that happen with each injury, whether that injury is a bruise, a sprained ankle or surgery. Even cosmetic surgery will trigger some of these processes to the area of surgery. One of the most common responses that we see after surgery is swelling.
Rates Of Swelling
Swelling will begin shortly after plastic surgery. Typically, the swelling will increase fairly rapidly for the first four days and usually peeks about day five after surgery. Then there is a slow decrease in swelling that may continue on for several weeks and in some cases even months.
Usually about 6 to 8 weeks after surgery the swelling has decreased by about 80%. During these first 6 to 8 weeks the rate at which the swelling decreases is relatively fast. After this time the rate of decrease in the swelling slows down significantly so that the remaining 20% of swelling may slowly decrease over the next several months.
What You Can Do To Decrease Swelling
During the period of swelling there are several things that can be done to decrease the amount of swelling. Decreasing the amount of swelling, in turn, decreases the amount of discomfort that patients have and can improve recovery time.
- First and foremost let gravity help you. Keep the area that has been operated on as elevated as practical. If you’ve had facial surgery, don’t bend over in the first few days and sleep propped up or in a recliner the first several nights. If you’ve had surgery on your arms or legs (such as liposuction), keep them elevated so that the natural tendency of any swelling is to run downhill towards your body.
- Ice the areas where the surgery has been performed. Icing is extremely useful in the first 5 days but has also shown to be helpful even for several weeks. Generally icing for 20 minutes on then resting for 20 minutes will be sufficient. Do this throughout the day and night as much as practical. Do not put frozen items directly on the skin as it can cause frost bite and actually damage the skin. This is especially true for areas where the sensation may be decreased.
- Rest the area of surgery. If you’ve had surgery, do not use or move that part of your body more than necessary during the initial swelling phase. The more movement there is, the more swelling. We commonly recommend wearing a sports bra after breast surgery (breast lift, breast augmentation and breast reduction). There are a few exceptions to this, so be sure to check with your surgeon for his/her recommendations.
- Compression garments may help. In some areas of the body and depending upon what type of surgery was performed, compression garments can limit the amount of swelling. Although they won’t stop all of the swelling, they can decrease the maximum amount of swelling that takes place. This is especially helpful for liposuction procedures where the compression garments also decrease the amount of bruising. We commonly use compression garments for liposuction, tummy tucks and some breast surgery. The garments or any compression device used should only provide firm pressure (similar to support stockings). The garments should never be painful nor restrict blood flow. If there are any concerns about the garment being too tight, loosen it and contact your surgeon.
- Steroids are sometimes given to limit inflammation. Steroids such as prednisone or decadron may be given at the time of surgery to limit the amount of swelling that takes place. This decision should be made by the surgeon based on the nature of the surgery, medical conditions of the patient and potential risks.
- Some herbal supplements may help. Supplements such as Arnica Montana are touted to be useful to decrease post-operative swelling and bruising. Although many people including some surgeons believe in the value of this and some other similar supplements, true scientific data is lacking. If you are interested in herbal supplements, be sure to discuss this in detail with your surgeon. Some supplements have been shown to prolong bleeding and can increase the risk of surgery.