Top Doctors Reveal the Secrets to a Perfect Surgical Recovery

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Top Doctors Reveal the Secrets to a Perfect Surgical Recovery featured image
Photo Credits: Fancy / Veer / Corbis / Getty Images
This article first appeared in the Winter 2019 issue of NewBeauty. Click here to subscribe.

In the movies, makeovers happen in an instant: Meryl Streep drinks Isabella Rossellini’s breast-lifting, wrinkle-reducing potion in Death Becomes Her and instantly rewinds 20 years of aging. In that moment, when Meryl looks in the mirror to see herself completely remade, we too imagine snapping our fingers for an on-the-spot upgrade. But in real life, there is no magic potion. We can’t fast-forward to the end of a transformation. It takes time, and more than a little bit of patience, to see the results of top aesthetic treatments.

THE RULES OF RECOVERY
No one really talks about the waiting, healing and compliance required between before-and-after photos. Recovery is where the real magic happens, and what a patient does or doesn’t do can make or break a doctor’s good work. The reality is, good results don’t happen in the operating room—that’s just where they start.

1. Choose your squad carefully.
It seems like a no-brainer, but ensuring your doctor is board-certified and specializes in the procedure you are seeking is key. Vero Beach, FL plastic surgeon Alan Durkin, MD says, “How your surgery is performed will define what happens during recovery. You want your doctor to be succinct and crisp in their decision matrix and practiced in the execution of those decisions. You can only do that with training and experience, working with the same team day in and day out. Consistency and predictability are essential.”

2. Live slow, heal fast.
All doctors agree, a healthy lifestyle is the foundation for a seamless recovery. “A patient who is active and a nonsmoker can expect less risks or complications during recovery,” explains West Orange, NJ plastic surgeon Mokhtar Asaadi, MD. “Those who smoke and have not taken good care of themselves may have looser, crepier skin and take longer to heal.” Montclair, NJ dermatologist Jeanine Downie, MD adds, “Patients who are sun-damaged from tanning beds, and those who vape also heal slower.” Pre-op blood work will reveal crucial health information to the doctor: “When I order labs, it’s not just for anesthesia. It can also tell me things like whether a patient has elevated liver function tests. If so, I’m going to shorten the procedure time as much as I can because the patient already has stress on their liver.”

3. Be a follower.
“Only use products that your doctor gives you,” advises Beverly Hills, CA dermatologist Rhonda Rand, MD. “One doctor’s laser procedure may be different from another’s. Don’t Google it, don’t use a cream from a facialist and don’t listen to your friend. Follow your post-treatment care sheet to the letter.”

4. Stay off the scale.
Swelling is an inevitable side effect, and even a tiny needle prick can cause tissue to react. “The procedure time, trauma to the tissue and the amount of IV fluids administered can affect how much swelling there will be,” Louisville, KY plastic surgeon Chet Mays, MD says. Miami, FL plastic surgeon Sean Simon, MD explains: “Fluids are temporarily forced outside of the vascular circulation and then slowly get taken back up and reaccumulated into the vascular tree.” Excess fluid is then eliminated via the kidneys. “Fluid retention is why some patients gain weight right after surgery,” he says. “It will disappear over the coming weeks.” Dr. Downie adds, “This is a good time to decrease salt intake.”

5. Take your lumps.
Some irregularities are to be expected. For bumps under the skin at injection sites after injectables, ask your doctor what to do. West Palm Beach, FL dermatologist Kenneth Beer, MD explains: “With hyaluronic acid fillers, I advise patients to massage the bump to help smooth and flatten it out. With longer-lasting fillers, you can massage for up to a week.” Dr. Downie cautions, “Nodules that flare up months after treatment may need to be dissolved. Consult your doctor.” Hardness under the skin after liposuction is typically caused from maturing scar tissue. “Lumps can be areas where some fat was left behind or is being reabsorbed,” says Dr. Mays. “With massage, they will soften, smooth out and start to feel like surrounding skin.”

6. Don’t scratch.
“Tingling, burning, aches and pains in the surgical areas can occur for weeks to months and typically represent recovery of sensory nerves of these areas,” says Dr. Simon. “Topical Benadryl and a good Aveeno moisturizer can help subside excessive itching.”

7. Don’t do what Cardi B did.
“Stay active post-surgery,” advises Dr. Mays. “We want patients up, walking and slowly increasing activity every day.” However, that doesn’t mean it’s OK to go back on tour like Cardi B did just days after lipo. “Patients get frustrated when they start feeling better,” adds Dr. Mays. “We advise not to lift more than a gallon of milk for two to four weeks.”

8. Trust the process.
Patients should be patient,” says Dr. Simon. “You won’t see your final surgical result for three to six months.” Dr. Asaadi adds, “This is why we don’t redo a rhinoplasty after one or two months if the nose doesn’t look good. It takes months for the swelling to resolve and the skin on the nose to reshape.” Dr. Mays notes, “Healing is a physiologic process that takes time—we cannot speed up physiology.”

Photo Credit: Pearl Recovery Retreat

VIP HEALING
Hotels and House Calls

When Le Petit Ermitage in Beverly Hills opened in the ’70s, plastic surgery was a hush-hush endeavor reserved for the rich and famous. In a town full of notable faces and their surgeons, hiding and healing in a “spa” for the first 48 hours were the norm. Famous faces like Liz Taylor and Michael Jackson were whisked away from ORs by limo and transported through subterranean garages to luxe suites at Le Petit Ermitage or Shanteque in the ’90s (aka “Facelift Hotel”), under the careful watch of a team of nurses, masseuses and private chefs.

After-Care Affair
Today, private hideaways like Beverly Hills’ Pearl Recovery Retreat, The Carlyle in Manhattan and Dallas’ Rosewood Mansion offer VIP guests gourmet fare and amenities like in-room lymphatic drainage massage and hyperbaric oxygen chamber therapy. “Certain procedures require a higher level of care and monitoring by someone trained to recognize possible but rare post-op complications,” says Beverly Hills, CA plastic surgeon Leslie Stevens, MD. “For facelifts, some tummy tucks and Mommy Makeovers where a patient may need help with getting out of bed, I prefer they spend one night in a recovery facility.” To preserve anonymity, Dr. Stevens often arranges for a stay at the Peninsula Hotel, where guests are given a key to the hotel’s back door leading directly to his office.

On the Upper East Side in New York, facial plastic surgeon David Rosenberg, MD, who has worked on more than a few famous faces says: “Nearly all of my surgical patients stay overnight in one of several hotels within a few blocks of my surgical center. These patients are cared for around the clock by a private-duty nurse specializing in post-op care.”

Awards Prep
Dr. Rand says many of her VIPs prefer the comforts of home, and because of this she often makes house calls, especially when the client is prepping for a high-profile event. “There isn’t much recovery needed with Botox, so I have been called on to inject before a red-carpet event. Unless it requires a particularly large device, I can do pretty much any treatment at their home.” Dr. Rand, who counts some of the biggest stars in Hollywood as her loyal patients, says she’s been known to say no if there isn’t enough time to heal. “I say 10 days, at least, are required before a big event. If I know they have to be camera-ready, I’ve been known to say ’no’ because there isn’t enough time to heal and look good.”

POST-PROCEDURE TOOLBOX
The First Few Days

1. Arnica: Essentially vitamin K, this homeopathic herb is an industry standard for reducing inflammation, swelling and bruising.
2. Healing Ointment: “During the first week of surgery, most incisions will benefit from antibiotic ointment to keep a nice moist environment, which allows the skin to restore,” says Dr. Mays. Seattle dermatologist Heather D. Rogers, MD cautions to be careful with lanolin, although it is a common ingredient. “A recent study looking at allergic reactions in patients with chronic wounds found 11 percent reacted to lanolin. This is not what our skin needs when it is trying to heal!”

The First Few Weeks
3. Compression Garments: Most procedures—on areas from the chest to the ankles—will benefit from a compression garment. “They help support the tissue and can keep fluid from filling into the surgical sites,” advises Dr. Mays. “Every doctor will recommend a different length of time. I find that most of my patients like how their garment feels and continue to wear it even longer.”
4. Lymphatic Massages: Some doctors, like Dr. Simon, say massages are important after body contouring with liposuction: “They aid in the stimulation of blood flow and the reduction of swelling and scar tissue.” Dr. Durkin agrees. “There’s an emotional component to touching the area that has gone through trauma,” he says. “The faster you recreate that human connection, the better you heal.”

Anytime After
5. ScarAway Silicone Scar Sheets: Shrink, flatten and fade new and old scars with these silicone scar sheets. $21
6. Doctor Rogers Restore Face Lotion: Hypoallergenic and hydrating, this healing lotion boosts moisture levels to restore even the driest skin. $72 
7. skinbetter science sunbetter Tone Smart SPF 68 Compact: Cover and protect scars from damaging UVA/UVB rays in style with this mineral-active tinted sunscreen in a super luxe compact. $55 

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