The science of cosmetic healing

After your cosmetic plastic surgeon has finished your surgery, you will begin the healing phase. In a previous post I discussed the effects of surgery and healing on your brain and psychology. Here I want to tell you about what happens to your body!

After any cosmetic procedure, or any surgery for that matter, the healing process is the same. Your body goes through a series of predictable, expected and totally normal changes and phases before you will be fully healed. Depending on the type of cosmetic surgery, the time it takes to heal will vary, but the processes are the same. There are three main phases of wound healing.

Phase 1: the inflammatory phase (swelling)

Swelling after any surgery is a normal and desired response! In plastic surgery, though, it is much more noticeable, as most cosmetic procedures are performed on the skin and so on the surface of the body. If you have your appendix out, you also have swelling, but you don’t see it! To a great extent, it is the swelling that causes pain after surgery.

Swelling is the process whereby lymphatic fluid carrying white blood cells, healing proteins, oxygen, etc. leaches out of the blood and into the area of the surgery as a response to the “injury” of the tissues. This is also known as the inflammatory phase.

Swelling starts within a few minutes after an incision has been made and can last, in the case of a tummy tuck, for six months! Obviously, the swelling is initially more noticeable and will decrease slowly over time.

Compression garments or bandages are sometimes used in some areas of the body to mitigate the effects of swelling. In some cosmetic procedures, such as liposuction, garments can actually be deleterious.

Phase 2: the proliferative phase (scar formation)

While on a cellular level all sorts of cells, such as fibroblasts, are busy making collagen and contracting the wound, and blood vessels are reaching into the area of healing, skin cells are also mobilized to go into the area of the incision. The culmination of these processes is the formation of the scar.

For the first eight weeks after surgery, your body is making scar tissue. The wound will actually reach its maximum strength at eight weeks. During these two months, patients will slowly begin to get their sensation back and have less discomfort.

Phase 3: the remodeling phase (scar maturation)

During this phase of healing, the scar that has formed remodels by becoming softer, narrower, less raised, lighter in color and less noticeable. In some cases, the scar does none of these! This is when you have a hypertrophic scar or even a keloid.

This phase can take up to two years to complete, and if your body does not heal well, you may need to have the scar re-excised and start the whole process again from phase 1!