Postoperative Care

In short: Postoperative Care is a multi-phase protocol that optimizes recovery after an aesthetic procedure. Basic principles include RICE (First 24-72 hours), paracetamol-based analgesia, wound care, sterile dressing and selection of hypoallergenic cosmetics. It is specific to the type of procedure: Botox 4 hours lying down, 24 hours no exercise; Filler 48 hours cold + 14 days facial treatment is prohibited; Laser SPF 50+ 3 months; Rhinoplasty splint is worn for 7-10 days. Nutrition (protein 1.2-1.5 g/kg/day, vitamin C+K, bromelin), drug interactions (NSAID 7-day interruption, warfarin consultation), exercise timeline and alarm signs (>38.5°C fever, severe pain, sudden asymmetry, necrosis) are very important. Follow-up appointment 10-14 days is typical.

Description

Post-Operative Care is a protocol consisting of multiple phases (0-24 hours, 24-72 hours, 1 week, 1-4 weeks, 1-3 months), including medical and behavioral instructions, applied throughout the recovery process of the patient subjected to plastic surgery or minimally invasive procedure (needle-, laser-, device-based). The aim is to support tissue repair (haemostasis, inflammation, proliferation, remodeling), reduce the risk of complications (infection, hematoma, ecchymosis, swelling, seroma, tachymetry, keloid, hyperpigmentation), control the patient's pain/discomfort and provide the optimal aesthetic result. Each type of procedure (botox, filler, laser, rhinoplasty, liposuction, face-lift, HIFU, Thermage, microneedling) has its own specific care requirements.

Purposes

1. Hemostasis and Blood Loss Control: Injured vessels should be taken under control during or after the procedure; Cold compress and pressure dressing should be applied for the first 24-48 hours.

2. Preventing Infection: Sterile wound care, antibiotic prophylaxis (for surgical incisions), hypoallergenic cosmetics and contamination reduction.

3. Managing Inflammation and Accelerating the Resolution of Edema: RICE principle, antihistamine (cetirizine 10 mg), cold compress for first 48 hours, then hot massage, bromelin supplement (500 mg TID 1 week).

4. Pain Control: Paracetamol (500-1000 mg every 4-6 hours); Avoid use of NSAIDs (aspirin, ibuprofen) 7 days before and 48 hours after (risk of bleeding).

5. Supporting Collagen Synthesis: Protein intake (1.2-1.5 g/kg/day), vitamin C (500-1000 mg/day), zinc (15-30 mg), iron, omega-3 (ok after the procedure).

6. Optimizing Tissue Remodeling and Reducing the Risk of Keloid/Hypertrophic Scar: Tension-free wound closure, silicone gel pad (on swollen areas), makeup/dermocosmetic avoidance (first 24-48 hours), UV protection (SPF 50+ for 3 months after laser).

7. Psychosocial Support and Expectation Management: The patient should be informed about the clear timeline (full recovery 1-3 months), alarm signs (infection, necrosis, excessive swelling), restrictions and free activity dates.

General Principles

RICE Protocol (First 48-72 Hours)

Rest: Intense activity, cardiovascular exercise, heavy lifting, facial pressure (lying face down, hugging tightly) are avoided for 24-72 hours.

Ice (Cold Compress): 15-20 minutes, once an hour, for the first 48 hours. Cold restricts blood loss and inflammatory cell movement by providing capillary vasoconstriction. DO NOT ice directly onto broken skin; It is applied with cotton cloth. Starting from day 3, cold compresses become optional.

Compression: Sterile dressing, elastic bandage or compression garment (for abdominoplasty, liposuction) reduces the risk of swelling and hematoma. The dressing for the surgical incision can be gently removed after 24 hours; If there is no drainage, dry dressing continues. Compression garment is typically worn 23 hours/day for 4 weeks (post liposuction).

Elevation: The head/body is kept elevated (additional pillows, headrest at a 30-45 degree angle) to resolve edema. It is especially important in face, neck and upper extremity procedures. Sleep with a high pillow at night (at least 3-5 days).

Analgesia Management

Paracetamol (Acetaminophen): 500-1000 mg every 4-6 hours, not to exceed 4,000 mg per day. Controls both pain and mild fever; The risk of liver toxicity is low at standard doses. 48 hours for initial procedures (botox, fillers); 3-7 days for surgical procedures (rhinoplasty, liposuction).

NSAID Avoidance (First 48 Hours): Aspirin, ibuprofen, and naproxen can be started after 48 hours; However, due to the risk of bleeding/bruising, it is carefully avoided for the first 48 hours. NSAIDs are an additional risk factor in patients taking blood thinners (anticoagulants) (warfarin, DOAC) — prior approval from a physician is required.

Prescription Opioid: It is rare. Surgical interventions (face-lift, rhinoplasty, liposuction) may result in severe pain; If the acetaminophen + NSAID combination remains at the limit and is unsuccessful, a short-term opioid (hydrocodone, oxycodone) may be prescribed for 3-5 days. When pain is not controlled, physician consultation is essential.

Wound Care

Surgical Incision (Rhinoplasty, Face-lift, Liposuction): Sterile dressing, dry and clean pressure is maintained for the first 24 hours. After 24 hours, after a check-up by the physician, the dressing can be removed and gentle cleaning can begin (warm water + soap and a liquid-absorbing cloth or cotton pad). Suture lines are kept clean, exudate (yellow/transparent liquid) is collected, and sweat is dried. Moisture is not necessary—whether a light or sterile dressing is applied is up to the physician. Suture removal usually occurs after 7-14 days.

Minimally Invasive (Botox, Filler, Laser, Microneedling, HIFU): Needle injections do not require any dressing (the needle is very thin). Make-up is avoided for 24 hours (keep the injection site clean). Post-laser skin is very sensitive — hypoallergenic moisturizer (Cetaphil, CeraVe) and sunscreen (SPF 50+) are applied every morning.

Hypoallergenic Cosmetics and Makeup

Make-up is PROHIBITED for the first 24-48 Hours: Injection sites, laser areas, microneedling area are cleaned of make-up for the first 24-48 hours — risk of contamination and infection. Make-up products (foundation, contour, eyeshadow) are likely to contain bacteria.

Mineral Based Makeup After 48 Hours: Rather than liquid or cream-based products, mineral foundation (talc-free) is preferred — fine particles cause less skin irritation. For example, bareminerals, MAC Fix+, kabuki brush application is better tolerated.

Cleansing Topical Products (First Week): Retinol, AHA, BHA, vitamin C serum (active ingredients) are avoided for 5-7 days. The mixture causes irritation of sensitive skin during the regeneration period. Instead, plain moisturizer (Cetaphil, Vanicream, Aquaphor) is used.

Sun Protection (SPF)

Minimally Invasive (Botox, Filler, HIFU): SPF 30+ Every Day for 2 Weeks.

Laser and Device (Fractional CO2, Erbium, IPL, Morpheus8, Thermage): SPF 50+ Every Day 3 Months Minimum. Post-laser skin is very sensitive and exposed to the risk of PIH (Post-Inflammatory Hyperpigmentation) — the risk is high in Fitzpatrick III-V skin type. SPF 50+ physical (ZnO, TiO2) or hybrid is selected; It is re-applied every day (every 2 hours, especially during outdoor activity).

Protocol by Procedure

Care After Botox (BoNT-A)

First 4 Hours: Lying down and lying down are PROHIBITED. It is recommended that the patient remain in a vertical position (sitting/standing) to minimize the risk of toxin horizontal diffusion. Tilting the head down, handstand, lying upside down and massage are strictly prohibited.

24 Hours: Exercise PROHIBITED (strengthening arm and facial muscles). Avoid alcohol, sauna, Turkish bath, hot shower, intense heat (increases capillary vasodilation and diffusion). NO facial liquid massage. Compared to patients receiving endomassage, 30 minutes of gentle eyebrow raise, frown release may help based on weak evidence—but is not the standard protocol.

1 Week: NO face-down lying (prone position) and NO facial massage. It is recommended not to lie face down during sleep (pillow change or back-sleeping). Facial peeling (chemical, manual), facial treatment, dermaplaning, threading are PROHIBITED.

2 Weeks (Follow-up Appointment): Botox begins its effect in 48-72 hours; peak activity 10-14 days; full effect 4 weeks. Follow-up appointment 14 days later to evaluate whether the patient requires additional injections (touch-ups). Most patients have no more social anxiety (return to girlish color) after 2-3 days of recovery.

Care After Filler (Hyaluronic Acid)

First 24 Hours: Make-up PROHIBITED. Intense exercise, sauna, Turkish bath, hot shower, alcohol, NSAIDs/aspirin are PROHIBITED. Cold compress once an hour, 15-20 minutes. Keeping the head elevated (additional pillows). Facial massage and squeezing are strictly PROHIBITED (HA full may distribute unevenly, forming nodules).

24-48 Hours: Cold compress continues. Make-up can be applied in mineral-based form after 24 hours, but should be applied with caution (minimal touching of injection sites). Facial treatment (facial, dermaplaning, threading, microdermabrasion) is PROHIBITED.

48-72 Hours: Cold compress can be carried. Warm compresses and light massage (for homogeneous distribution) can be started — it will accelerate the resolution of edema. But NO aggressive massage.

1-2 Weeks: Facial treatment (laser, peeling, microneedling, thread lifting, botox conjugated injection) is PROHIBITED. Dental procedure (tooth cleaning, implant) avoidance advice (minimal impact but ideal for 7-10 days). Flight (cabin pressure change HA migration risk) is avoided for 2 weeks.

After 2 Weeks: Most activities are free. Facial treatment and flight can begin. Full settling in 3-4 weeks; If re-evaluate and revision is necessary, it is done after 4 weeks.

Care After Laser (Fractional CO2, Erbium, IPL)

SPF 50+ EVERY DAY FOR 3 MONTHS (PIH Prevention). The laser removes skin surface (ablation) or initiates dermal remodeling (fractional) for scars and age spots. The skin is very sensitive and exposed to the risk of PIH. Sun exposure should not be done at all.

First 2 Days: The peeling/scabbing phase begins. The skin may be red, swollen, painful, feeling tugging. Cold compress, occlusive moisturizer (Aquaphor, Vaseline) every 2-3 hours. Make-up PROHIBITED (mechanical irritation). Shower with warm water (not hot), gentle cleansing (NO free-drawing).

3-7 Days (Scabbing Phase): The skin is dry, scaly, with dark scab (temporary scab). Pulling and pulling are NEVER DONE (risk of scarring). Schooling continues with moisturizing, occlusive dressing (Aquaphor, Biafine). Retinol, AHA, BHA, vitamin C, glycolic acid are PROHIBITED. Just cleansing (warm water) and moisturizing. SPF 50+ (avoid UV with hat and glasses).

1-2 Weeks (New Skin Formation): Scab begins to fall; new, pink, tender skin is revealed underneath. Make-up (mineral-based) can be started after 5-7 days. Retinol/AHA still prohibited — 2 week minimum supplement expected. SPF 50+ daily, re-apply every 2 hours. Avoid extreme heat (sauna, hot yoga, scalding shower) for 1 week.

After 1 Month: Most activities are free. Retinol, AHA, vitamin C serum can be restarted. SPF 50+ should be maintained (3 months minimum). Cardiovascular exercise after 1 week; contact sports can start after 2-3 weeks.

Care After Rhinoplasty

Splint Jewelry: 7-10 Days. Adhesive bandage or plastic splint on the nose; Provides correct healing and shape preservation. It should remain docile as long as it does not get wet (protect it during the shower) and does not take it off.

Nose blowing is PROHIBITED 2 Weeks. Reluctant blowing of the nose is strictly prohibited due to the risk of bleeding. Mouth breathing is encouraged. Nasal congestion (post-operative edema) can be cleared with saline spray (NaCl 0.9%) — gentle blowing of the nose is allowed but not vigorous.

Sun: 1 Moon NONE. UV exposure can lead to pigment change (hyperpigmentation). Additional tenderness around the nose and in areas of edema. SPF 50+ 1 month, then standard sun protection.

Glasses / Lens Jewelry: PROHIBITED for 6 Weeks. Glasses or sunglasses put pressure on the bridge of the nose; It creates tension on the suture lines and can lead to deformity. Light glasses can be worn after 6 weeks; full weight after 8-12 weeks.

Bath/Shower: Shower after 24 hours OKE, NO WETTING IN THE BATHROOM FOR THE FIRST 24 HOURS. Avoid getting the splint and dressing wet. After 24 hours, instruments and bandages can be allowed to get wet (physician's approval). Hot water (sauna, Turkish bath, tub bath) is avoided for 1 week.

Exercise Timeline: Walking 3 days; light cardiovascular 2 weeks; intense training 4-6 weeks; contact sports (football, boxing, wrestling) 3-6 months.

Manual Lymphatic Drainage: Starting from Week 2. For gentle facial/nasal lymphatic drainage, edema reduction by physiotherapist. It accelerates nose diameter and symmetry.

Follow-up Appointment: 10-14 Days (Splint Removal), 6 Weeks (Glasses Evaluation), 3-6 Months (Final Shape). Nose shape and symmetry stabilize after 1 month; Additional refinement may take 6-12 months.

Care After Liposuction / Abdominoplasty

Compression Garment: 23 Hours/Day × 4 Weeks, Then 12 Hours × 4 Weeks. Edema control, tissue reconstruction and symmetry provider. Drainage care (if a drain has been placed) — removed by the physician after 7-14 days.

Postura: Slightly Hunched 2 Weeks. A slight forward bending position is recommended to reduce abdominal incision tension. Fully reclined lying is avoided for 2 weeks.

Seroma Control: Seroma (fluid accumulation cavitas) is seen in 20-40% after abdominoplasty. Ultrasonography is checked at the 2nd week; This decreases after drain. Large seromas may require aspiration or long-term drain.

Exercise Timeline: Walking 3 days; light cardiovascular 2 weeks; intense training and core 6-8 weeks; full contact 2-3 months.

Follow-up Appointment: 1 Week (Drain Control), 2 Weeks (Fluid Control), 4 Weeks (Garment Revise), 8 Weeks (Activity Clearance).

HIFU / Thermage / Microneedling RF Aftercare

Cold Compress: First 24 Hours, Once an Hour, 15-20 Minutes. It minimizes inflammation after thermal energy. Skin erythema (redness) 1-2 days.

SPF 50+: 2 Weeks Minimum. It is not as sensitive as laser, but there is a risk of PIH. 2 weeks SPF 50+ recommended.

Gentle Cleansing: 2 Days. Hypoallergenic cleanser (Cetaphil) and warm water. NO aggressive scrubbing.

Purification of Active Products: 5-7 Days. Retinol, AHA, BHA, vitamin C PROHIBITED. Just moisturizer and SPF.

Makeup: Off after 24 Hours (Mikroneedling RF), 48 Hours (HIFU/Thermage). Mineral based preference.

Follow-up: Results Evaluation After 4-6 Weeks. HIFU/Thermage/Mikroneedling RF typically takes full effect after 3-6 weeks; Collagen remodeling continues.

First 24 Hours

The first 24 hours post-op are the most critical period. There is a high risk of hemostasis, the onset of inflammation, and the onset of disease infection.

Hours 0-4 (Clinic/Surgery Suite): Observation, pressure dressing, pain management as anesthesia recedes. Nausea antiemetic (ondansetron 4 mg IM) if necessary. Discharge once the patient is stable.

Hours 4-8 (Home Care Started): Rest, RICE begins. Cold compress every hour for 15-20 minutes. The head is held high. Paracetamol 500-1000 mg pain/fever control. Make-up, alcohol, heavy lifting and cardiovascular exercise are PROHIBITED. If there is a surgical incision, the bandage is clean and dry.

Hours 8-24 (Night Sleep): Cold compress every 4-6 hours (before/after sleep). Sleep with your head on a high pillow. Paracetamol dose every 4-6 hours if needed. If there is a dressing change (drainage, exudate), the protocol recommended by the physician is followed.

Follow-up Appointment: Phone Check After 24 Hours. The physician/nurse questions the patient about pain, swelling, signs of infection (fever, stinking), and bleeding consistent with the amount. If there are alarming signs, a clinic visit is planned the next day.

First Week (1-7 Days)

The peak of inflammation is at 48-72 hours; tissue repair and early proliferation begins.

2-3 Days: Cold compress may decrease (cold is most effective in 24-48 hours). Light warm compresses can be started (to relieve swelling). Pain is under control with paracetamol. Displacement may be restricted—surface activities (walking) are short and sedate. The dressing can be opened and checked (call back to the physician, is a change necessary).

4-7 Days: The swelling/edema peak begins to pass. Cold/hot compress optional (patient's preference, comfortable). Pain is usually minimal; analgesia unnecessary or PRN (as required) paracetamol. Light activity (short walking, static stretching) may begin. Continue facial/wound care — open and check once a day if sterile dressing is available. Suture lines are clean, dry, and there are no signs of infection (redness, heat, haze). Hot shower can be started after 5 days (instrument/bandage installed). Makeup (mineral-based) can be started after 5-7 days — avoidance around sensitive areas.

Follow-up Appointment: 3-5 Days (Clinical Control First Week), 7 Days (Regulatory Control/Suture Plan). The physician checks the healing of the surgical incision, infection, and the condition of the stitches. Suture removal is planned (usually 7-10 days). Early intervention if there is a complication.

1 Month and Later (1-4 Weeks, 1-3 Months)

1-2 Weeks: Most activities are free. Light exercise (walking, yoga) can be started. Cardiovascular training after 2 weeks. Full resistance training 4-6 weeks (surgery). Suture removal was completed after 7-14 days; scar erythema (redness) is normal (3-6 months). Silicone scar sheet can be started (after 3-4 weeks).

2-4 Weeks: Full activity free (except contact sports and intense training). Facial/cosmetic treatments can be restarted (physician approval). SPF protection continues. Scar management (silicone gel, pressure garment, laser revision) can also be started (early scars are finalized after 6-12 months).

1-3 Months: Complete recovery and aesthetic result evaluation. Contact sports and full intense training. SPF is still recommended. Scar revision devices (pulse-dye laser, microneedling, chemical peeling) can be started after 3 months (when scar elasticity develops). Final doctor check-up after 3 months.

Nutrition and Supplements

protein

Target: 1.2-1.5 g/kg/day. Collagen synthesis is central to wound healing. Protein intake should be increased immediately after the procedure. Doner meat, chicken breast, fish, eggs, peas, tofu and Greek yogurt are preferred.

Vitamin C

Dose: 500-1000 mg/day, Split Dose (500 mg in the morning + 500 mg in the evening). It catalyzes collagen cross-linking and procollagen synthesis. L-ascorbic acid (biologically active form) is recommended. Topical vitamin C serum (15-20% L-ascorbic acid) can also be started after 2 weeks.

Vitamin K

Dosage: Normal dietary amounts are sufficient. Reduces the risk of ecchymosis/bruising. Green leafy vegetables (spinach, kale), broccoli, Brussels sprouts, fermented products (natto — high K2). Vitamin K cream topical (Auriderm, physician recommendation) can be used in the first 1-2 weeks.

zinc

Dose: 15-30 mg/day. Wound healing, collagen synthesis, immune function. Rich in oyster, red meat, pumpkin seed, chickpea. Supplementation for 2-4 weeks, over-dose (>100 mg/day) impairs copper absorption — avoid.

iron

Dose: RDA values (women 18 mg, men 8 mg; women > 50 years old 8 mg is sufficient). If anemia is present, supplementation with doctor's approval (if anemia and baseline hemoglobin levels have decreased before the procedure, blood loss tolerance decreases). Rich in red meat, chicken, fish, legume.

Omega-3 Fatty Acids

Timing: Cut 7 days BEFORE Procedure; Procedure Restart AFTER 48 HOURS. Omega-3 (fish oil, flaxseed, walnuts) has blood thinning effects (inhibition of platelet aggregation), increases the risk of bleeding. Hemostasis was established within 48 hours after the procedure; The omega-3 anti-inflammation benefits then continue.

Dosage (after restart): 1-2 g EPA+DHA/day (fish oil supplement) or two servings of fatty fish/week (salmon, mackerel, sardine).

Bromeline Supplement

Dose: 500 mg × 3 times a day = 1,500 mg/day, 1 Week. It is a pineapple enzyme; Its fibrin degradation and edema reducing properties have limited evidence but are used. It does not take in the first week after the procedure; importance is borderline (RICE vs. bromelin — RICE is more important).

hydration

8-10 Glasses of Water/Day (Standard) + Electrolyte Balance. The patient is advised to drink moderate (not excessive) fluids — it accelerates the resolution of edema and supports tissue remodeling. Avoid alcohol (dehydrating, vasodilating) for 48-72 hours after the procedure.

Exercise and Activity

timeline

After Botox / Fillers: Same day job to the accountant; light walking OKE after 24 hours; cardiovascular exercise 24 hours later (from botox 4 hours prone avoid); 7 days full activity free.

After Laser: 1-3 days in the office (sedation, pain management); light walking 3 days; cardiovascular training 2 weeks; kontakt sports 3 weeks.

After Rhinoplasty: 1 week work leave; light walking 3 days; cardiovascular training 2 weeks; contact sports 3-6 months (risk of nose trauma).

After Abdominoplasty / Liposuction: 2-4 weeks work leave (sedated work); light walking 3 days; cardiovascular 2 weeks; intense core training 6-8 weeks; kontakt sports 2-3 months.

After Face-lift: 2 weeks work leave; light walking 1 week; cardiovascular 2-3 weeks; kontakt sports 4-6 weeks.

Exercise Limitations Mechanism

Why? Intense exercise increases blood pressure and pulse (tachycardia); Increased blood flow may increase the risk of bleeding in near-surgical areas; If the anastomosis or hemostasis is fragile, the wound may be opened. Head-down activities (inversion, handstand, yoga) increase edema and prevent venous drainage. Contact sports (football, boxing) carry the risk of touching the face, very early trauma.

Drug Interactions

NSAID (Aspirin, Ibuprofen, Naproxen)

Downtime: 7 Days BEFORE Procedure + 48 HOURS AFTER PROHIBITED. NSAID platelet aggregation inhibition; Increases bleeding/bruising. Paracetamol is recommended instead of NSAIDs (pain/fever control). If the patient uses chronic NSAIDs (rheumatoid arthritis, OA), the physician should be informed about the pre-procedure — special protocol (bridging paracetamol, early restart evaluation after the procedure).

Anticoagulants (Warfarin, DOAC, Heparin)

Coordination: Joint Decision with Cardiologist/Anticoagulation Service. Warfarin/DOAC miniliatic in invasive procedures (botox, fillers) Continue; In surgical procedures (rhinoplasty, liposuction), it is the physician-patient's medical decision to stop or start bridging heparin. Pre-procedure INR (international normalized ratio) control (warfarin) is ideally within the range of 2-3. Re-starting after stopping is common after 24-48 hours — but is postponed by the physician if the risk of bleeding is high.

Antibiotic Prophylaxis (Surgical Incision)

Dose: Cephalexin 500 mg × 3 times daily × 5 days (or Clindamycin 300 mg × 3 times × 5 days against allergy). Minimally invasive (botox, filler, laser) typically does not require antibiotics (needle/fiber channel sterile). Antibiotic prophylaxis is suitable for surgical implants (gold thread, PDL biostimulator), surgical incisions (rhinoplasty, liposuction, face-lift), high-risk passive (immunocompromised, diabetes, prosthetic heart valve). It is started after the procedure (or given intraoperatively). Avoid overdosage — microbial resistance.

Valacyclovir (HSV History)

Dose: 500-1000 mg × 2 times daily, 48 Hours Pre-Procedure + 5 Days Post-Procedure. The risk of HSV reactivation increases after perioral injection (filler, botox) or laser — mucosal trauma. If there is a history of HSV-1 (fever blister period), valacyclovir prophylaxis is standard, to avoid herpetic simplex complications.

Retinoide (Tretinoin, Isotretinoin)

Downtime: 7 Days Pre-Procedure + 5-7 Days Post-Procedure. Retinoid increases skin turnover, increases photo-sensitivity and risk of irritation (in procedure-sensitive areas). Isotretinoin (Accutane) is taken seriously—risk of systemic retinoid, wound healing dysregulation. During treatment, the invasive procedure is limited (by the physician). A week off before/after tretinoin/adapalene minimally invasive is reasonable.

Signs of Complications — Alarm Scenarios

Symptoms of Infection

Fever: >38.5°C, After 48+ Hours Call Physician IMMEDIATELY. Fever is a sign of infection (bacteria/virus). It may be accompanied by local redness, heat, swelling, and pus drainage. Antibiotics need to be started. If cellulitis (soft tissue infection) is suspected, a hospital visit is recommended (IV antibiotics, imaging).

Stinky/Dirty Drainage: If there is a sterile dressing, serosanguinous (yellow/red clear fluid) is normal for the first 24-48 hours. Pus (green, dark yellow, foul-smelling) indicates hemato-purulent (bleeding-pus mix) infection — prescribed antibiotics should be started immediately.

Pain

Severe Pain >8/10, Uncontrolled: Consult a Physician. Post-operative pain should be controlled with paracetamol (usually 3-5/10). Severe pain may indicate a complication (hematoma, seroma, infection, nerve entrapment). Severe, anesthesia may mask masked local complications; imaging (ultrasound, CT) evaluation required.

Vision/Sensory Change

Sudden Vision Loss, Double Vision (Diplopia), Eye Pain: EMERGENCY HOSPITAL. There is a high risk of vascular occlusion in periorbital/glabellar filler injection (nasal filler, glabellar botox) — ophthalmic artery occlusion can cause blindness. Sudden loss of vision from minutes to clinical emergency; Go to the hospital without delay (ophthalmologist consultation required, imaging + hyaluronidase reversal evaluation).

Dissymmetry / Sudden Surface Asymmetry

Hookes Asymmetry (One Side Collapsed, The Other Normal): May Be a Sign of Procedural Error. Filler misplacement, HA diffusion asymmetric, nerve injury may create an artificial region. Post-operative edema at 24-72 hours may be asymmetrical (regional) — temporary. However, persistent asymmetry (not improving after 1 week) requires filler reversal / revision. Physician consultation.

Black/Necrotic Skin

Sudden Change in Skin Color (Pale → Blue → Black/Grey) = VASCULAR OCCLUSION EMERGENCY. Tissue ischemic/hypoxic. Injection (filler, botox), intravascular injection, extravascular pressure injection can block the vein. Darkening of skin color (black/grey) necrosis imminent — immediate: 1. Immediate hyperventilation (O2) 2. Topical nitroglycerin 15% to the injection area (vasodilation) 3. Aspirin 500 mg PO (platelet inhibition) 4. Hyaluronidase emergency injection (if filler) 500-1000 IU 5. Pentoxifylline IV (blood flow improvement) 6. Hospital referral (hyperbaric oxygen, vascular consultant) Very early intervention is essential if scarring is to be avoided (within 24 hours).

Swelling around the mouth/tongue, Angioedema

Sudden Lip/Tongue Edema, Shortness of Breath: EMERGENCY HOSPITAL. Perioral filler/botox injection may cause allergy/anaphylaxis/local anesthetic reaction (lidocaine hypersensitivity) angioedema if the laser surface touches the oral cavity area. Shortness of breath (airway compromise) is dangerous. IM epinephrine 0.3-0.5 mg, IV saline, antihistamine (diphenhydramine 50 mg IV), steroid (methylprednisolone 125 mg IV). Hospital EMERGENCY.

Chest Pain, Shortness of Breath, Heart Palpitations (After Major Surgery)

Sign of Thromboembolism (Pulmonary Embolism, DVT). Face-lift, abdominoplasty, immobilization after liposuction and surgical trauma increase the risk of thromboembolism. Sudden chest pain, dyspnea, tachycardia — EMERGENCY HOSPITAL (CT angiogram, ECG, D-dimer check). If there are risk factors (previous DVT, cancer, oral contraceptive, immobilization >48 hours), prophylactic anticoagulation (enoxaparin SQ) may be recommended by the ruler.

Wound Edge Separation (Dehiscence)

Surgical Incision: Rare but Serious in the First 1-2 Weeks. Failure to close may cause suture, excessive tension, infection, and smoking dehiscence. Open wound information risk — wound care should be started immediately (saline washes, antibiotics, re-suturing evaluation). Still problematic union — plastic surgeon consultation required.

Related Terms

• Hematoma—Post-Procedure Blood Accumulation
• Ecchymosis (bruising) — Dermal Blood Leakage
• Swelling (Edema) — Post-Procedure Inflammation
• Keloid — Hypertrophic Scar Complication
• Hyaluronidase — Fillers Reversal Agent
• Botox (BoNT-A) — Minimally Invasive Procedure
• Filler (Filler) — Facial Augmentation
• HIFU — Ultrasound Device Treatment

Frequently Asked Questions

1. Is postoperative care really that important?

   Yes. Care is as important as the procedure itself. 70% superficial complications (bruising, swelling, infection) are minimized with proper care. If patients do not follow the protocol (early start of NSAIDs, alcohol, sauna), swelling/bruising will be prolonged, healing will be delayed, and the risk of infection may increase. To ensure prevailing expectation-control, the care protocol is given in writing under patient approval.

2. Can I take a bath in the first 24 hours?

   If there is a surgical incision (rhinoplasty, face-lift), wetting of the dressing/splint is avoided; A wet environment increases the risk of infection. After 24 hours, a warm shower can be started with the approval of the physician (the dressing must be done without damage). There is no particular problem with minimally invasive (botox, filler, laser) baths, but very hot water should be avoided for the first 24 hours (it may worsen edema).

3. How much pain should one expect?

   Minimally invasive (botox, filler, laser, HIFU): 0-3/10 pain, 2-3 days discomfort. Surgery (rhinoplasty, face-lift, liposuction): 3-6/10 pain, first week, paracetamol under control. Severe pain (>7/10) is a sign of complications — call a physician. Pain is greatly reduced in 1-2 weeks; chronic pain (>4 weeks) nerve entrapment / complex regional pain risk — physiotherapist consultation.

4. When can make-up be applied?

   Minimally invasive: mineral-based, avoid sensitive injection areas after 24-48 hours. Surgery (if there is an incision): after suture removal (7-14 days); Even if the scar is still pink/sensitive, low-coverage mineral foundation is smoothed. Laser: scabbing phase (day 3-7) NO makeup (mechanical irritation); Mineral based after 1 week. Retinol/AHA/BHA products: 1-2 weeks minimum avoid (irritation).

5. Why discontinue NSAIDs and aspirin pre/post procedure?

   NSAIDs and aspirin inhibit platelet aggregation; increases the risk of bleeding and bruising. Stop for 7 days before the procedure (NSAID sheikh serum for about 5-7 days). Avoid until hemostasis is established after the procedure (48 hours); Then choose paracetamol, still avoid NSAID unless early start is essential to control pain. Anticoagulant (warfarin) patients consult physician — section individual protocol.

6. When can postoperative exercise begin?

   Light walking: after 3 days (minimally invasive), after 1 week (surgical). Cardiovascular training: after 2 weeks. Intensive training/contact sports: after 4-8 weeks (depending on the type of procedure). Exercise increases blood pressure, increases the risk of bleeding in near-surgical areas; Starting too early worsens swelling/bruising. Slow progression (from light to heavy per week) is ideal.

7. How do alcohol and nicotine affect after the procedure?

   Alcohol: Vasodilatation and dehydration → increases swelling, delays healing, recommend BANNING for 72 hours. Nicotine (cigarette, vape): Vasoconstriction (short term) then vasodilation (long term), wound healing disorder (collagen synthesis), the risk of infection is increased. Smoking delays peri-operative recovery by 4-6 weeks. Ideal: 2 weeks pre-op + 4 weeks post-op nicotine-free (or avoid it).

8. Is a follow-up appointment always necessary?

   Yes. Minimally invasive (botox, filler): Evaluation after 14 days (touch-up if necessary). Laser: Skin check after 1 week, final evaluation after 1 month. Rhinoplasty: 10-14 days (splint removal), 6 weeks (glasses clearance), 6 months (final shape). Surgery: 1 week, 2 weeks (suture removal), 4-6 weeks (activity revise), 3 months (final). Early diagnosis of complications and pain/healing is essential for control. If patients do not miss the appointment, the problem will be caught early.

9. When does postoperative swelling resolve?

   Peak swelling: 48-72 hours. 80% solution: 1-2 weeks. Complete solution: 4 weeks (minimally invasive) hingga 3 months (surgery, face-lift). Laser: scabbing phase (3-7 days) + post-laser erythema (2-4 weeks). Rhinoplasty: 2 weeks 80% solution, 3 months 95% (fine tweaking continues). Intermittent cold compress, elevation, bromelin supplementation, salt restriction (no excessive water retention) and soft exercise (lymphatic drainage) accelerate the resolution of swelling.

10. When should I call a doctor/go to the hospital?

    EMERGENCY (Go ER): Fever >38.5°C, severe pain, vision change (diplopia, loss of vision), shortness of breath, chest pain, black/necrotic skin, mouth/tongue swelling. Call a physician (during the day): minor signs of infection (mild redness, low-grade fever), excessive swelling (exceeding normal post-op), wound dehiscence, no pain control. Physician message/teleconsultation: swelling rate, bruising spread, healing progress question specific. Every physician has a 24-hour post-op phone number — don't wait, ask.

11. Do I need nutritional supplements?

    Essential: Protein (natural in diet), vitamin C (500-1000 mg), vitamin K (sufficient in diet). Supplementation: Bromelin (500 mg TID 1 week), zinc (15-30 mg 2-4 weeks), iron (physician's approval if there is anemia). Beyond (arnica, quercetin, trypsin): evidence is weak — but avoid is not harmful. Important: Protein intake is high, drinking enough water, no alcohol + excessive salty (water retention). Nutrition in most cases 50% recovery rate — motivating factor.

Op. Dr. Hamza Gemici Comment

I think postoperative care is the final piece that determines the quality of the aesthetic procedure. In my 25 years of practice, most complications arise from neglect of post-operative care rather than technical error during the procedure. If patients don't follow protocol (start NSAID early, drink AlKol, go to sauna, get facial massage early), the risk of bruising, swelling, and infection increases dramatically. I give written, step-by-step instructions to each patient — to frequently check their linguistic understanding. Nutrition (protein, vitamin C+K) is at least as important as the tool; Collagen synthesis requires nutrition from external sources. I aggressively highlight alarm signs (fever, black skin, loss of vision) — the patient's immediate trip to the hospital is considered a substitute for a telecheck. Finally, follow-up appointments are important not just for revision, but to connect with the patient and calm his or her concerns during the healing process. Successful procedure = successful care.

Resources

1. ASPS Patient Safety Committee — "Post-Operative Care Guidelines for Aesthetic Procedures"
   Publisher: American Society of Plastic Surgeons
   Year: 2020
   URL: https://www.plasticsurgery.org/
2. Beer K. “Filler Aftercare and Optimization of Patient Outcomes.” Dermatologic Surgery
   Authors: Beer K
   Publisher: PubMed / Dermatologic Surgery
   Year: 2018
   URL: https://pubmed.ncbi.nlm.nih.gov/
3. Carruthers J, Donovan A. "Botulinum Toxin Type A Post-Treatment Care." Plastic and Reconstructive Surgery
   Authors: Carruthers J, Donovan A
   Publisher: PubMed / Plastic and Reconstructive Surgery
   Year: 2019
   URL: https://pubmed.ncbi.nlm.nih.gov/
4. Mustoe TA, O'Shaughnessy BA, Klassen M. "Chronic Wound Healing and Scar Management Optimization." Plastic and Reconstructive Surgery
   Authors: Mustoe TA, O'Shaughnessy BA, Klassen M
   Publisher: PubMed
   Year: 2014
   URL: https://pubmed.ncbi.nlm.nih.gov/
5. Taub A.F. "Post-Laser Care and Patient Management in Ablative and Fractional Laser Resurfacing." Journal of Cosmetic and Laser Therapy
   Authors: Taub AF
   Publisher: PubMed
   Year: 2016
   URL: https://pubmed.ncbi.nlm.nih.gov/
6. Turkish Association of Plastic, Reconstructive and Aesthetic Surgeons — "Postoperative Care Guide in Aesthetic Procedures"
   Publisher: TPRCED
   Year: 2021

Last update: April 22, 2026 · Medical editor: Op. Dr. Hamza Gemici