Relax but stay active
Although you should rest and stay in bed, especially during the first 24 hours, it is important that you move the lower extremities after surgery as soon as possible, to avoid the formation of blood clots. This is normally done by doing flexion-extension movements of the feet or bending the knees while remaining in a semi-sitting position on the bed.
Sutures and stitches
The sutures on the skin will be removed after:
- 5 – 7 days in the cases of blepharoplasty
- 6 – 9 days in cases of rhinoplasty
- 8 – 12 days in cases of face lift, cervical lift or brow lift.
The reason for not prolonging the stitches removal is the risk of leaving some mark on the skin.
All wounds should always remain clean and dry. This means that they should be washed daily with a saline solution or soap and water.
Many of the wounds with stitches will have butterfly closures or so called steri strips.
Small adhesive strips used to close wounds and help the edges grow back together. Normally they should remain for 2-3 days and then they can be removed by the patient. It is always advisable to moisten them when they are removed.
In certain surgeries, there are intraoral absorbable stitches that do not need to be removed, but extreme hygiene is required.
In surgeries such as otoplasty or cervical incisions for Adam’s apple reduction, absorbable intradermal sutures are used so it is not necessary to remove stitches.
With normal analgesics such as ibuprofen, diclofenac, metamizole, paracetamol … usual dose taken every 8h is enough to control the pain. Sometimes the combination of analgesics is made to control pain.
Other prescribed medicines in the postoperative period
- Antibiotics: the use of penicillin derivatives or a substitute such as clindamycin is frequent if the patient is allergic to penicillin. It is usual to take them after nose, lips, chin and forehead surgeries.
- Antibiotic eye drops for blepharoplasty.
- Low-dose of orticosteroids during 3 days, to reduce inflammation.
- Gastric protectors such as omeprazole or similar.
If we have made mouth incisions, you should rinse it twice a day. The rinsing should start 24 hours after the intervention but will never replace the usual brushing of your teeth.
Intraoral incisions are absorbable and should not be removed. They will dissolve in about two weeks.
Swelling, bruising (ecchymosis) and bruising
The feeling of tightness, tension and heat due to the swelling are completely normal and will disappear in few days.
It is very important to apply cold compresses immediately in the first 24 hours to reduce inflammation during the postoperative period. After first 24 hours or even 48 hours, the cold still has an anti-inflammatory effect. The swelling will subside with the passing of days and usually ends after a week, depending on the type of surgery.
Ecchymosis or bruises are the violaceous colorations of the skin due to the extravasation of blood into the subcutaneous tissues and they usually appear depending on the type of surgery.
Please note that: Their appearance and intensity differ greatly from one person to another. There is no standard rule regarding how long they will last.
- After blepharoplasty: There are more bruises after complete blepharoplasty, or eyelid surgery. They change from purple to green and finally yellow. This process lasts from 2 to 3 weeks. They are always asymmetrical.
- After foreheadplasty, the bruises are located on the eyelids and their duration can be up to 2 weeks. The color also changes from purple to green and yellow.
- After rhinoplasty, mentoplasty, otoplasty or facial lifts, the bruises may not even appear and if they do, they usually have a yellowish color that disappears after a few days.
All this ecchymosis or bruises can be covered by makeup and usually appear asymmetrically.
Localized collection of blood due to a small hemorrhage that occurred during surgery.
Small hematomas are not important and are reabsorbed alone as the days go by. Larger hematomas may rarely appear. In these cases, the patient must be assessed by the surgeon to decide whether to choose to drain them or leave them to be reabsorbed.
Progress: The inflammation will reach its maximum 2 or 3 days after surgery. On the third day, it will subside as days pass by, until it disappears after 7-10 days. Bruises and hematomas may last longer depending on the surgery performed.
The final results are obtained after 2 months, except for rhinoplasty where the final result can be seen after 6 months or even 1 year.
The swelling will migrate to the more declining areas due to gravity.
That is, if surgery is performed on the chin or on the mandibular angles, the swelling and bruising will appear in the neck as the days go by.
The swelling and bruising are very variable and can differ greatly from one person to another.
Elevation: It is important to sleep with your head elevated during the first night (ask for extra pillows). This helps the drainage and will reduce the swelling.
Cleaning: the area of the incision must be carefully cleaned every day with a saline solution or simply water and soap, removing the most superficial crusts and drying it afterwards. After removing the stitches, it is necessary to keep the scar well hydrated with healing creams and to avoid the sun exposure. You can also apply sunscreen directly on the scar.
The fresh scar is very sensitive to the sun rays since it doesn’t contain many melanocytes. Therefore, during the first 6 months after surgery, we recommend protecting the scar with +50 SPF sunscreen or avoiding the sun. During the first week after surgery, it is better not to expose yourself completely to the sun.
You can use light makeup 7-10 days after surgery to help conceal the incisions and bruises.
Green makeup can help conceal the purple bruises.
Washing the hair
If you had forehead surgery, you should wash your hair every day with your usual shampoo during the first 2 weeks. You can start washing your hair 48 hours after surgery. For better wound healing, it is important to remove all blood clots and scabs which is easier while using shampoo. Do not be alarmed if the wound starts bleeding a little while washing your hair.
To know more about the postoperative period of each intervention visit the pages of the specific treatments.