Ways to decrease swelling after plastic surgery

Swelling is a normal part of healing after cosmetic plastic surgery.

Here are some posts on the science of healing:

Swelling after liposuction

Heat or ice after surgery

Causes of swelling

After any “injury,” cells release chemicals that affect the permeability of blood vessels in the area of trauma (surgery is trauma as far as the body is concerned). This permeability (porousness) increase allows fluid-containing proteins, white blood cells and other chemicals to reach injured areas to begin healing. This causes swelling in those areas. The process is also known as inflammation.

How to reduce swelling

Sometimes an area can become swollen without having a bruise present; no blood vessels are injured. For example, when you have a cold or an allergy, areas around the eyes can swell without blood vessel damage.

Techniques to stop swelling are aimed at decreasing the permeability of blood vessels so that fluid (lymph) does not pass through them to the tissues. Some of these include:

  • Elevation of the injured area

One way to drain lymph from injured areas is to elevate injured body parts so the lymph can drain back toward non-injured body areas to be absorbed. This is why elevating your injured foot feels good. It decreases swelling and thus pain.

  • Ice

The application of ice will contract blood vessels and decrease the amount of blood and lymph going through them. Ice should be applied to injured areas as soon as possible in a 15 minutes on/15 minutes off cycle to prevent frostbite on already injured skin. It can be applied for up to 72 hours, though after the initial 24 hours its effectiveness decreases. This is not as bad as it seems, since permeability of the injured blood vessels returns to normal around the same time period. Thereafter, applying ice can feel good but does not really reduce swelling.

  • Anti-Histamines

Medications such as antihistamines (Benadryl) can also decrease swelling by decreasing the effects of histamine. Histamine is released from cells when they are injured or irritated (e.g., with pollen).

  • NSAIDs

Non-steroidal anti-inflammatory drugs (NSAIDs) such as Aspirin, Motrin, Naprosyn, Aleve, etc.—but not Tylenol/acetaminophen—will decrease swelling in injured areas. They will decrease inflammation. They will increase bruising, so beware—see below. They will also help reduce pain, which often accompanies injury and swelling. A pinch of the skin, for example, hurts since the skin is being stretched; swelling does the same thing in stretching skin.

  • Steroids

Steroid creams, pills and injections help decrease or rather prevent swelling by stabilizing the cells of blood vessels and decreasing their porousness. There is a limit to their use, as they also have less favorable effects on healing, so they must be used judiciously.

  • Anti-inflammatory foods/herbs

A number of anti-inflammatory/anti-swelling foods and homeopathic drugs have been touted as helping to reduce inflammation. There is no proof other than the fact that some swear by them. They include:

  1. Arnica Montana
  2. Bromelain—a compound found in pineapples
  3. Ginger
  4. Chili peppers
  5. Herbs such as parsley
  • Massage

Gentle massage of injured areas or even of other areas of the body will encourage healing of  the lymphatics and re-establish normal lymphatic flow.

Decreasing swelling after any cosmetic plastic surgery will help decrease pain and speed up your recovery.

Morad Tavallali, M.D., FACS