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Plastic Surgeon Dr. Dean Kane of Baltimore Answers Question Regarding Post-Surgery Recovery

Q. One Doc tells me “I’ll be back on my feet in no time” and another consultation outlines 4 to 12 weeks of activity cautions following a liposuction and tummy tuck. I need to plan my family leave from work, cooking needs, care and schooling for my 4 and 13 year olds, cooking, cleaning… what gives?!

Post-surgery, Recovery, PTO, Convalescence

DK: Most of us don’t have enough time in the day to do all our chores, make a living, attend to spouses and children and recover from elective cosmetic surgery. The following article is re-blogged in that interest; that it unfortunately takes time… a lot more that you may want to provide your body to heal for most of the rejuvenation procedures you desire. I will add intentional education to the marketing and short-sightedness of cosmetic physicians who promise you more than your body can deliver.

Healing is a dynamic, overlapping journey of platelets, white cells and red cells differentiating into different players to stop the bleeding and bruising, splint and stiffen your hurt tissues, clean up the dead cells and foreign bodies, develop a foundation for the scaffolding required to make scar, heal the skin and protect your from further injury.

As you read the article, remind yourself with the following bullet points. It takes:

  • 1-2 days to stop oozing.
  • 3-4 weeks to reduce swelling and bruising.
  • 3 weeks to obtain 30% incisional skin strength compounded with sutures dissolving 50% in 2 weeks.
  • 6 weeks to obtain 60% incisional skin strength which at this point feels like thickening lumps under the incision and skin
  • 12 weeks to maximum collagen (lumpiness and tightening scar formation)
  • And 1-2 years to remodel or thin the scar to its optimal appearance.

This odyssey is confounded with stress, poor nutrition, constant pulling against the incisions and lack of strength before called upon to respond to your everyday world of chaos.

The following article (edited for length) is not concrete in its prophesy of recovery time.  Every patient as an individual, will need more time to heal properly. If your pleasure and happiness of the procedure have anything to do with realistic expectations, educate yourself on how long you will need help at home (depends on which procedure and what arrangements you have made prior to your surgery. You will need help with: 1. getting in and out of chairs / bed; up and down stairs; personal hygiene; food prep and eating; hydration; taking meds; and so much more).  2. returning to social activities and work. 

How Many PTO Days You’ll Need To Take For Every Plastic Surgery Procedure

ALIX TUNELL, Refinery29.com

APRIL 12, 2018, 6:15 PM

See full article from Refinery29.com

If we want to alter something on our body, we not only have to fork over the money, but we also have to sacrifice some vacation days. So, just how much PTO (personal time off) is going to be required of elective (your choice), cosmetic (not medically necessary) surgery (real incisions, scars, emotional and physical healing) is necessary?

We asked three plastic surgeons to weigh in on the typical downtime for 10 popular procedures and walk us through the recovery process for each. Of course, (here’s the disqualifier fine print), everyone’s pain tolerance and tendency to bruise and swell varies, but use this as your guide for determining what you can get away with on a long weekend (breast implants) and what’ll require a two-week “trip to the spa” (a facelift).

Breast augmentation is performed by placing a breast implant beneath the pectoralis major muscle, and this step tends to be associated with moderate discomfort for several days postoperatively,” says plastic surgeon, AK, MD. He says most people return to work in five to seven days, whereas plastic surgeon, RM, MD, recommends his patients just take a relaxing weekend. Generally-speaking, in two weeks time, you’ll feel comfortable wearing a bathing suit without noticeable swelling or bruising; in three months, the shape and size should be fully settled.

DK: 3-5 days off is not realistic. Consider 1 week to wean off the pain meds and 2 or more weeks before you are driving! 3 weeks before the risk of post-operative bleeding is minimized.

According to Dr. K, a typical breast lift (that doesn’t involve implant placement) lifts the breast tissue for better support, raises the nipple, and tightens the external skin. “It doesn’t manipulate the pectoralis muscle, hence the discomfort and recovery are minimal,” he says, noting that bruising and swelling may persist for seven to 10 days, but is easy to cover with clothing. In approximately three months, you’ll see final results.

DK: The “typical” anchor style breast lift has considerable incisions which are their weakest (https://drdeankane.com/could-you-please-describe-in-detail-the-healing-process-in-the-year-following-a-facelift-thank-you/ ) between 2-3 weeks. Lifting your arms may separate the incision.

A breast reduction removes excess tissue and fat as well as raising the breasts, but similar to a lift, the process does not involve manipulation of the pectoralis muscle, so the discomfort is mild and the recovery is short, says Dr. K.

DK: Consider your activity restrictions with drains and fluid formation. No driving for at least 2 weeks!

Following a tummy tuck (muscle fascia tightening, skin excision and umbilicus restoration,“generally, patients feel good enough to resume parts of their daily life in five days to two weeks,” says Dr. M. He adds that avoiding increases in intra-abdominal pressure for at least six weeks is crucial, which means wearing a compression garment and making sure not to lift anything heavy. According to plastic surgeon, SG, MD, you can expect to see final results anywhere between six to eight months out. Time off about 10 days.

DK: You will return to most activities in 6 weeks but not tummy exercises until the healing strength is much stronger; like 3 months! Expect 3 to 6 weeks bent forward at the waist or expect problems like seroma or incision separation!

A Brazilian Butt Lift includes 2 to 3 times the liposuction volume needed to fat graft the “booty”.  Depending on where the fat was harvested from, you’ll need to wear a compression garment for about eight weeks, and you’ll want to avoid sitting or sleeping directly on your butt for the same amount of time, but you should be up and walking around after two days. The swelling for this procedure takes awhile to dissipate, so you can expect to see your new shape at around the four-month mark.

DK: There are 2 areas of surgery, the fat harvested body sculpted region and the fat grafted bottom. My patients complain of “pain” for 1 to 2 weeks, difficulty taking care of themselves with hygiene, incision care, feeding and daily activities.

Dr. K says that the recovery time for liposuction is generally pretty short, in terms of being able to resume daily activities, so you should be able to return to work after a long weekend. But Dr. M urges his patients to get the treatment done in the winter months, since there will be significant bruising for two weeks and a compression garment for six weeks.

DK: My patients show a spectrum of pain, discomfort and immobility. The amount of fat removed and the surface areas performed will determine how much time off you need. Plan on 1 week. More if the more sensitive arms, axilla and upper inner thigh are lipocontoured.

Vaginal rejuvenation is the catch-all term for both internal tightening and external labiaplasty, and Dr. M. says the recovery for both is relatively quick and easy, so long as you don’t do an incisional-based tightening procedure (he uses a fat grafting technique to add healthy vascularized tissue and pad the walls). There will be some swelling and you’ll need to refrain from sexual intercourse for three to six weeks after, depending on your doctor’s recommendation, but you’ll be able to return to work after a couple days of minimal activity.

DK: Vaginal rejuvenation includes: non-surgical radio-frequency internal and external tightening which may need only one day of recovery and surgical recovery of 3 to 6 weeks to allow fat survival and incisional healing.

DK: Traditional rhinoplasty or nose reshaping includes cartilage cutting, bone breaking and lots of swelling and bruising.

Post-rhinoplasty, you can expect to feel mild pain for the first 48 hours, during which time you should limit activity and remain upright. If you have packing in place, your doctor will likely remove that on day three, and the splint on day five, but bruising under the eyes will be significant (as in: too big of a task for concealer) for about a week. After a month or so, Dr. K says you’ll see early settling, but it’ll be one year for the end result to show.

DK: There is a spectrum of rhinoplasty techniques from septoplasty, tip rhinoplasty and total nose reshaping with cartilage and bone grafts. Consider 1 to 14 days of recovery before you are socially acceptable (especially teens) and 3 to 12 weeks before exertional activities like running -to lacrosse.

Liposuction of the neck and chin area, often referred to as submental liposuction, has “a relatively rapid and painless recovery,” according to Dr. K. He says that although bruising is common for seven days and he prefers patients wear a compressive neck strap for the full week if possible, most choose to return to work in four days.

DK: This is somewhat reasonable and dependent on your activities. Patients feel swollen and bruised for up to 3 weeks. Return to sedentary work in 1 – 2 days but no pushing, pulling, running or lifting for 3 weeks or more.

Not all facelifts are created equal, says Dr. M: “Many are marketed as a ‘lunchtime lift’, referring to the minimal recovery time, but these are skin-supported facelifts, which never really fare well.” A true facelift refers to what is called an SMAS lift, which manipulates the muscle and connective tissue and involves a much longer recovery. “I tell patients that they should be socially presentable with makeup within two weeks, but the final, settled-in result is a month or so away,” he says.

DK: Like so many procedures today, there is a spectrum of invasiveness and therefore longevity of results! Men’s social expectations are typically different then women. Men can be socially ready in a week, women 3 weeks or more. Both need 3 to 6 weeks before exertional play.

Don’t be disappointed by failing to allow enough healing time. Enjoy your special social gatherings like weddings, reunions and travel before you pressure yourself with elective, cosmetic, healing times.

This information is not meant as medical advice. It is provided solely for education. Our practice would be pleased to discuss your unique circumstances and needs as they relate to these topics.

Give us a call at  410.602.3322  or email Lauri@DrDeanKane.com and make an appointment soon. We’re located on Reservoir Circle just a block off the Baltimore beltway, convenient to greater Baltimore, Annapolis, the Eastern Shore, Southern Pennsylvania, Delaware and Carroll County.

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