Here is something most surgeons do not put on a billboard. A good result is half operation and half aftercare.
I can do a beautiful surgery, and if the aftercare falls apart, the result drifts. The patients who do their massages, wear their garments, and call early when something feels off are the ones who heal beautifully. The ones who skip all three are the ones who write the bad reviews.
So the questions I get after surgery are remarkably consistent, and I want to answer the common ones the way I do in a follow-up visit. These are pulled from real follow-ups and consultations, anonymized.
“Is This Firmness Normal?”
Usually, yes. After surgery, firm or hard areas are fibrosis and edema, which is a normal part of healing. I have patients massage these areas a lot, and I tell them it keeps getting softer over about three months. It is a lot better at three months than at three weeks.
What is not routine is new, painful, red, or rapidly changing firmness. That is a reason to call, not to wait.
“A Stitch Is Poking Out, or My Incision Opened a Little”
That is usually a suture working its way to the surface, which is common and minor. If a small area opens where a suture extruded, we keep it covered, sometimes with a little silver dressing because it is antimicrobial, and it heals. It does not mean something went wrong. Rarely an incision needs a few extra sutures, maybe one patient in fifty.
“How Do the Massages Work?”
For body work, the lymphatic massages are not optional in my book. They are how we keep fibrosis from becoming a problem. We have an in-house tech, and I recommend two or three a week for about four weeks. In the abdomen I leave a small drain so that when you massage, any trapped fluid comes out fast, because trapped fluid is what creates lumpiness.
“Which Garment, and for How Long?”
We provide them, two Marena fajas with clips so we can size you down as the swelling drops. You wear them for four weeks, taking them off twice a day to shower and let your skin breathe. If a standard post-op bra is uncomfortable, a supportive alternative is often fine. Comfort that keeps you in compression beats a “correct” garment you refuse to wear.
“When Can I Shower?”
The next day. My nurse actually visits to help with your first shower, check that you are healing well, give IV fluids if you need them, and go over instructions and questions.
What’s Routine vs. What’s a Call
| What You Notice | What It Usually Means |
|---|---|
| Firm, hard areas softening over weeks | Normal fibrosis and edema |
| A suture poking through the skin | Common, keep it covered |
| Soreness with movement after lipo | Like the gym after a layoff |
| New, painful, red, rapidly changing firmness | Call us |
“What About Nausea and Pain?”
If you tend to get nauseous from anesthesia, there is a pill called Emend you take the night before that usually prevents it. Facial procedures barely hurt at all. Liposuction feels like going back to the gym after a long break, sore with movement but tolerable, and easier than a C-section.
“Who Is Actually Taking Care of Me?”
My anesthesia is run by CRNAs who are army and combat trained and have been with me over ten years. They have done anesthesia on me and my family. My surgical techs are certified first assist and have been with me since 2012. After surgery you get a wristband with a 24-hour line to my nurses or nurse practitioner.
“Anything That Speeds Healing?”
A few things I like. NAD infusions with glutathione before and after surgery help clear the anesthesia. Post-op peptides, GLOW for face work and GLOK for body, help with inflammation and tissue regeneration. Arnica and bromelain help with bruising. And for facial recovery, our ElixirMD LED therapy starting seven days out roughly doubles the speed of healing.
The Three Habits That Separate Good Recoveries
If I had to put it on a sticky note, it would be three things. Do your massages. Wear your garment. Call early.
The patients who do their lymphatic massages on schedule are the ones whose tissue stays soft and even. The ones who skip them are the ones I am breaking up fibrosis on months later. The garment is the same story. It is not a fashion accessory, it is the mold your new contour sets into, and the patient who refuses to wear it is fighting against the result we built together.
The third one is the quiet hero. Call early. Almost everything that worries a patient at three weeks is normal, and the few things that are not are easiest to fix when caught early. I would rather take a hundred calls about normal firmness than miss the one that mattered.
“When Can I Travel or Go Back to Work?”
That depends on the procedure and how you are actually healing, so it is a per-patient answer, not a number off a chart. I would rather clear you based on how you look in front of me than on a generic timeline.
If a trip is coming up, tell me early. We can often plan around it, including any precautions to take with you, like movement on long flights and what to watch for. The worst version of this is finding out about the trip after the surgery is booked, so bring it up at the consult.
The Credential Behind the Care
Double board-certified by the American Board of Plastic Surgery and the American Board of Surgery, Mayo Clinic plastic surgery fellowship, and Clinical Associate Professor of Plastic Surgery at Texas Tech University Health Sciences Center Paul L. Foster School of Medicine. A good result is half operation and half aftercare, and I treat the second half with the same discipline as the first.
Ready to Talk?
Recovery questions deserve real answers from the surgeon, not the internet. For the patient-facing walkthrough, see the companion post on agulloplasticsurgery.com. For the recovery menu, see the version on swplasticsurgery.com.
Call (915) 590-7900, text 1-866-814-0038, or book online at agulloplasticsurgery.com. #StayBeautiful.
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