By the time my cosmetic plastic surgery patients come in for their third post-operative visit a couple of weeks after their plastic surgery procedure, I see a familiar look on their romantic partners’ faces.

It’s a forlorn look that shouts out “I’ll never have sex again!” After all, the poor partner has up until now received no benefit from the cosmetic surgery their partner has had and cannot possibly see what benefit they could ever gain. In fact, they have probably been abused by a demanding patient they have had to take care of, whose every whim they have had to satisfy and whose bursts of emotion they have had to endure. They have been confused, confounded and have become consumed. If only they could release some of their tension through a little sex…

I always tell my patients, in a matter-of-fact way, that they can resume their sexual life “when they feel comfortable”; this applies, of course, to most surgeries, but not to vaginoplasties or other genital rejuvenation surgeries, for which a healing period of up to six weeks is required.

Hesitancy to have sex on the patient’s side

After cosmetic plastic surgery, patients are initially understandably not interested in having sexual relations. During the first few days, they may be swollen, in pain and generally feeling miserable. Sex is not on their radar. After a few days, however, when the patient is typically off narcotic medications and things are returning to normal, some sexual desire may return. The patient is by no means healed yet, but sexual activity would not really cause any problems if the couple is judicious.  Some plastic surgeries actually require the patient’s partner to help in massaging the back or breasts after breast augmentation, or an abdomen after a tummy tuck. This type of massage relaxes the patient, increases lymph and skin blood flow and may act as foreplay leading to other things. Obviously, surgeries of the lower parts of the body may cause swelling and temporary bruising of the pubic areas and vagina, which would make for some discomfort, but if your plastic surgeon OKs it, you can start to try to get sexual pleasure.

Hesitancy to have sex on the partner’s side

Often, though, it is the patient’s partner who is hesitant to perform, lest they harm their partner. Sometimes the partner is actually turned off by the sight of bandages and scars and may not be able to get “in the mood.” Nevertheless, after some time, the sexual urge becomes too great and the subject is approached.  The partner is now in an uncomfortable position. They want—need—sex but do not want to seem callous or selfish by asking the patient, who may still be in pain or discomfort.

On the other hand, I have seen some patients actually use sex to manipulate their partner during this healing period…

When to have sex after plastic surgery?

The decision to resume sexual activity after cosmetic plastic surgery is one that should be reached after discussion with a board-certified cosmetic plastic surgeon, the patient and the patient’s partner. The plastic surgeon will tell the patient when it is medically safe to have sex. After that, it is between the patient and their partner to decide when to resume relations. The patient must be assured that no pain or medical complications will occur during the act, so it is ultimately the patient who must decide.

Napoleon Bonaparte apparently often said “Not tonight, Josephine” in response to Empress Josephine’s sexual advances. How about that for a nuanced code phrase when you are not quite ready for sex?