FREQUENTLY ASKED POST-OPERATIVE QUESTIONS

{slider Bathing/Water Exposure}

When can I shower?
You will not have drains in any of your incision sites and will be generally able to shower 24 hours after cosmetic plastic surgery. Keep the showers brief. The water temperature should be warm, but not too hot, and the spray of the shower should be aimed away from your surgery site for most of the shower. It’s fine if the steri-strips get wet; just gently pat them dry when you get out of the shower. For the first shower, make sure you have someone supervising nearby, in case you become light-headed. You may become dizzy when you take the compression garment off initially due to the loss of fluid and compression. Simply lie down when you take the garment off before standing and moving around. Give yourself time to adjust and then move as you are comfortable.
You should not bathe, swim or use a hot tub until your incisions are completely healed. Swimming in a pool can be resumed after approximately 4 weeks. Hot tubs, and swimming in lakes/oceans/rivers should be avoided for at least 6 weeks after surgery. This is to avoid any bacteria from entering your surgical sites and causing infection.

{slider Tape/Drains}

Will I have any drains/tubes?
You will not have any drains for any cosmetic plastic surgery you have done at Aesthetics. You will have small ports in areas that liposuction is completed and surgical incisions with sutures for other surgical procedures. We have the ports drain on their own and they heal up from the inside out within a few days of surgery. It is typical to have drainage for about 2-3 days after liposuction and tummy tuck surgeries. There is no need to place any bandage or ointment to the port holes after surgery. Letting them drain naturally is best. Should you have a concern regarding the drainage, feel feverish, or the drainage has an odor, you should contact our office immediately.

How long will my steri-strips stay on?
Your steri-strips will usually be removed by Dr. Sult at your first or second follow up appointment, 5-10 days after surgery. If you have been cleared by Dr. Sult for showers and you still have your steri-strips on, simply shower over them and pat dry them after the shower.

{slider Bras/Compression Garments}

How long do I have to wear the surgical bra?
After breast surgery, patients are asked to wear a soft, non-underwire bra immediately after surgery and for 6 weeks. There are many non-underwire bras available. It is important to remember to purchase a size bigger or to accommodate your new breast size.

When can I use an underwire bra? Why the wait?
You may resume use of an underwire bra after 6 weeks or when comfortable after the 6 weeks. The reason underwire bras are restricted is to prevent sores or skin breakdown if the underwire rubs on the underside of the breast before the blood supply and nerves have completely re-established themselves. If you are going to a special occasion and need to wear an underwire bra for a few hours, this is acceptable.

Do I need to sleep in a bra?
It is advisable to sleep in a bra for the first few weeks after surgery. After that, if it is more comfortable for you, you may sleep braless.

What is the compression strap for and how long do I need to use it?
For breast augmentation patients: The compression strap is used to help settle the breast implants into a natural position. The compression strap should be high in the front so that it sits on the upper slope of the breasts. Make sure it is not bunched up in the armpit areas (you may need to readjust periodically). The compression strap does not need to be very tight-even gentle pressure over time is helpful, and if it is too tight, it will cause an indentation in your skin and pain. It is advised for a few weeks after surgery. At each follow-up appointment Dr. Sult will determine if the compression strap is still needed.

For male breast reduction patients: A compression tank is used to compress the surgical area for 6 weeks.

How long do I need to wear my surgical compression garment?
Tummy tuck and liposuction patients need compression to their surgical sites for 6 weeks. Compression garments specific to the surgical area will be given to you by Aesthetics. Any new compression garments that you may want to purchase must start below the lowest point of surgery (ie: at the knees if you had thigh liposuction) and go above the highest point of abdominal surgery (ie: up to just under the breasts if you had a tummy tuck). Make sure any new garment is snug and supportive, but not excessively tight. If it hurts to pull the garment on, it is too tight. As you heal, the compression garment will be easier and easier to pull on and wear.

{slider Activity/Exercise/Driving}

How soon should I get out of bed?
You should be up and out of bed (going to the bathroom counts) at least three times on the day of your plastic surgery and at least five times a day after that. This low level of activity will reduce your risk for blood clots in your legs. Make sure to move your feet up and down in bed to stretch and flex your calf muscles every once in a while as well.

When can I begin lifting?
Lifting restrictions depend on the surgery. For any surgery which involves lifting or tightening muscles (ie: breast implants and full tummy tuck surgery) you need to be very careful to avoid tearing a muscle and causing bleeding. Do not lift anything heavier than a pound for the first two weeks. Between two and four weeks, try not to lift more than five to ten pounds. After that, as each week goes by, you can slowly increase lifting. At six weeks, there are no specific restrictions- just use common sense. For surgery that does not involve muscle tightening, the same guidelines are helpful, but you do not have to be as strictly careful. Once again, just use common sense.

When can I exercise?
As you start to feel better (within the first 5-10 days), you may increase your level of activity, such as walking around the mall or gong to the office to do desk work. At four weeks, you can begin light, non-impact cardio exercise, such a recumbent (sitting back) bicycle. At six weeks after surgery you will be released to ease back into full exercise activity. The internal healing process takes longer than you think, so it is important that you return to your regular exercise routine slowly and carefully. When you resume an exercise you have not done in a while, try it in a small dose and see how you feel the next day. If you are sore, you probably pushed yourself too hard. Let your body be your guide to what is the right amount of exercise. Running and high impact exercises are the hardest on your body and you may need to put these off for a number of months (ie: an elliptical machine is better than jogging on a treadmill). For breast augmentation patients, it is also better to avoid or minimize pushups and bench press exercises because these can affect the appearance of your implants.

Why do I have to wait so long to exercise?
During the first few weeks after surgery, straining yourself puts you at higher risk for bleeding or disrupting stitches and needing to go back to the operating room. Even after this early period, your body is working hard to heal all of the surgery areas, so you do not want to divert the energy of healing to unnecessary exercise. Your body will recover faster and get more benefit from exercise if you are patient and wait the appropriate amount of time.

When can I drive?
You drive when you are completely off all pain medications and are healed up enough that you can react quickly in an emergency situation without causing pain or damage to your surgery site. Remember, it is a DUI if you are caught driving within 8 hours of taking prescription pain medications. Many patients are off prescription pain medications after 2-3 days after surgery and start using over-the-counter Tylenol for discomfort.

{slider Medications Refills/Non-Prescription Meds/Ointments}

What should I do if I am running low on pain medications?
You do receive a quantity of pain medication that should keep you comfortable for many days, however, if you are low and feel like you still need them to function well, please call our office early, rather than waiting until after hours or the weekend. Some medications, such as scheduled narcotics, can only be refilled with a written prescription and cannot be called in over the phone. There are alternative medications that can be called in, but it is always better to call us during office hours so that we will have the most options available to help you.

Do I have to take Colace (stool softener) after surgery?
You do not need to take a stool softener after surgery, however, if you have trouble having a bowel movement you may consider taking one. The pain medications during surgery and after surgery dry out your stool and put you at high risk for constipation unless you use are active, stay hydrated and potentially use stool softeners. You may take Colace but due to the AWAKE procedures and quick recovery most patients are up walking around and resuming a regular diet that same day. Many patients do not feel that a stool softener is necessary, however, if you do not have a bowel movement after a few days after surgery, you should take Colace or a suppository to move your bowels. If you have concern, please contact our office for further recommendations.

Should I use Mederma, Vitamin E, or a similar product on my scars?
There is not a lot of evidence that Mederma has any special powers against scars. You are certainly welcome to use it after the incisions have healed. Vitamin E can be used, but again it could not provide real scar healing as well. If there are any issues with raised scars, the best product is silicone sheeting, which will be given to you after your incisions have healed. Silicone sheeting needs to be worn around the clock for a few months and then up to a year to have an effect. Alternatively, simply rubbing any firm areas of scar tissue will help soften and remold the scars. Scars will generally fade from pink to white over a period of a few months to a few years depending on the person. If there is a concern with a scar or area we also have the option of using laser treatments here in our office to soften the appearance of scars.

{slider Sex/Alcohol/Tobacco/Tanning}

When can I resume sexual activity?
Although some patients that have cosmetic plastic surgery are embarrassed to ask this question, it is certainly an important issue. Resuming sexual activity depends on the type of procedure you have undergone. If you have had breast augmentation and/or breast lift, or a breast reduction, you may resume careful sexual activity around the two week mark. You should be lying on your back, and your partner should be very gentle. You should not have the full weight of your partner on top of you. This timeline also applies to liposuction, mini-tummy tucks, and facial surgery. If you have had a full tummy tuck surgery, or labia reduction, you may resume sexual intercourse after a few weeks. Use your body as a guide: if it hurts, don’t do it!

When is it ok to consume alcohol?
Alcohol use should be discontinued a week prior to surgery. It is reasonable to consume alcohol modestly starting a week after surgery. DO not drink more than 1-2 drinks in a day until at least 4 weeks after surgery. Do not drink alcohol when on pain medications or antibiotics. Drinking alcohol could increase your risk of injury and inhibit your healing process.

When can I resume smoking cigarettes or using tobacco?
Smoking and tobacco use are about the worse things you can do with regards to wound healing and infection risk, so in reality you should never start again. One puff of a cigarette essentially stops micro-vascular circulation for anywhere from 1 to 10 seconds. This can seriously compromise the blood supply to your tissues, which disrupts proper healing. Wound complications have been reported as high as 50% in smokers. It is essential to refrain from smoking or using any other tobacco products for a minimum of 3 weeks prior to surgery and 6 weeks after surgery. During this time it is also advised to avoid second hand smoke as well.

When can I tan?
Once again, the best answer to this questions is to minimize tanning after surgery as it causes darkening of the scars and weakening of the skin elasticity. With proper use of sunscreen, it is acceptable to have prolonged sun exposure after four to six weeks. Even if your scars are covered by a bathing suit, you need to keep sunscreen on your incisions under your bathing suit. You should avoid any tanning of your scars for 1 year after surgery to minimize darkening of the scars (this does not mean you have to avoid the sun for a year-just remember to protect your scars with clothes and/or sunblock.

{slider Breast Augmentation Exercises}

What type of exercises do I need to do after my breast augmentation surgery?
Anyone who has breast implants placed needs to begin a daily regimen of exercises to stretch the muscles and to help form a cavity for the implant to sit in. These movements help minimize the risk of capsular contracture (tightening scar tissue around the implant). Immediately following your surgery you should begin these exercises: Perform 5 over the head arm movements every hour until bedtime (think of a jumping jack without the jump or leg movements). Also, you should lay on your chest for a minimum of 15 minutes twice during the day and again at bedtime. This should be done on a harder surface (carpeted floor, wood floor, vinyl floor, etc.) not on your bed. You should try to keep up with these exercises daily for 6 weeks.

Is it ok to massage the breasts?
It is ok to massage the breasts after breast implant placement. This is also a way to inhibit capsule contracture and to also help the breast implant fall into place and make a pocket. It may feel sore after any of these exercises, it is important to stop before you feel true pain. If you have questions regarding the exercises, pain, or if you experience hardening of the breast or any other concern, never hesitate to contact our office for further recommendations.

{/sliders}