Plastic Surgery FAQ
Dressings and Bathing
- When can I take a shower? If your dressing is plastic (Tegaderm), you can shower immediately after your procedure, even if you have drains. Dressings can be removed in 48 hours if the dressing becomes saturated. After 48 hours, the top layer of skin is sealed, and it is okay to take a shower, even if your dressings have been taken off.
- Do I need to change the dressing? – Most dressings are meant to stay on until you are seen in the office for your first postoperative visit. If the dressing becomes wet or has an odor, it is best to change it. Wait 48 hours after your surgery to do your first dressing change if you can.
- When can I take a bath? – It takes two weeks for incisions to heal well enough for you to take a bath. If there are any open areas in the skin, you may need to wait longer.
Activity after Surgery
- Is it okay to lift? After breast surgery, liposuction, and body contouring procedures (such as abdominoplasty), you should not lift more than ten pounds until instructed otherwise (generally one to two weeks).
- What about walking? Light walking is strongly encouraged after surgery. This improves circulation in your legs and prevents clots in your leg veins (deep venous thrombosis). Going up and down stairs is also okay. Aerobic activity, including biking, running, and sexual intercourse, should be suspended for at least one week after surgery.
Drainage or Bleeding after Surgery
- Is it normal to have some drainage on the dressings? – It is normal to have some drainage after surgery. This should be clear and thin. Small spots of blood may also be normal in the first few hours after surgery. If you have any drainage that concerns you, call the office immediately.
- When can I take ibuprofen or aspirin? Ibuprofen and aspirin can cause increased bleeding or bruising after surgery. You need to wait one week before you restart these medications unless you are explicitly told otherwise by Dr. Banks.
Tobacco and Alcohol
- When is it okay to smoke? Cigarettes and other tobacco products that contain nicotine reduce the blood flow to your skin and can cause poor wound healing or skin necrosis. You should refrain from using these products for three weeks before surgery and for at least three weeks after your surgery.
- What about alcohol? Excessive amounts of alcohol can prevent your blood from clotting normally and lead to bleeding after surgery. Alcohol should not be mixed with narcotic strength pain medications, anxiolytics (such as Xanax and Ambien), or muscle relaxants.
- Is it okay to shower when I have drains? Yes.
- When will the drains be removed? Most drains are removed when the output is less than 30 mL in a 24 hour period. The drains need to stay in until this amount is reached. This can take one to three weeks depending on the type of surgery you have had. The more active you are, the more the drains may put out.
Post-Operative Bra and Garments
- Will a garment be provided for me? If you need to wear a special garment after your surgery, it will be provided for you. We generally provide two garments so that you always have a clean one.
- Can I wash my garment? Yes. It is best if you wash it on a gentle cycle and use a dryer setting at a low temperature.
- When can I stop wearing the garment? For liposuction and body contouring procedures, we ask that you wear your garment day and night for two weeks, unless you are in the shower. After two weeks, you may benefit from wearing your garment for half the day. For breast surgery, we ask that you wear your garment until edema has resolved and your incisions have healed well enough to wear regular bras (usually three to four weeks). After breast reconstruction with a TRAM flap, you need to wear your abdominal binder for six weeks.
- How do I know my scar is healing normally? Everyone heals differently but there are some generalities. It takes 48 hours for the top layer of skin to seal so that your incision is water tight. At about two weeks, the incision has healed well enough that topical lotions and creams will not enter the incision. It takes six weeks for a scar to get to its maximum strength. Scars often start out raised and red but settle down over three to six months. It takes one to two years for a scar to be fully mature.
- What can I do to improve scarring? Follow your postoperative instructions regarding garments and activity. Do not smoke or use tobacco products. Keep your incisions clean once the dressings have been removed. At two weeks, you can massage your scars, apply topical creams, and start using silicone sheeting.
- What if I develop a keloid? A keloid is a scar that grows beyond the original boundaries of the incision or cut. Keloids are raised, rubbery and can be flesh colored to purple. If you have a history of keloids, early steroid injections may help improve the scar appearance. If you develop a keloid after surgery, steroid injections or scar revision often improve the final scar quality. For the occasional patient with a history of recurrent keloids, scar revision followed by immediate postoperative radiation is appropriate.
Meet Dr. Nia Banks
Dr. Nia Banks is a board-certified plastic surgeon who treats patients in Washington, DC and Columbia, MD and the surrounding communities. Dr. Banks received her surgical training from Johns Hopkins Hospital in Baltimore, where she completed the Integrated Residency Program in plastic and reconstructive surgery.Click to read more