July 05, 2026 | Recovery
A patient texted me at three weeks, worried sick. A firm spot near her incision had her convinced something had gone wrong. It had not. It was exactly the fibrosis I had warned her about, on schedule, and by three months it had softened the way I told her it would. She is fine. But that text is one I get some version of every single week, which tells me the questions matter and the answers do not travel well by internet search.
So here is how I actually answer them, pulled from real follow-up visits and consultations, anonymized.
Is This Firmness Normal?
Usually, yes. After surgery, firm or hard areas are fibrosis (scar-like firmness in the tissue) and edema (swelling), both 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, and that is a reason to call.
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 (pushed out through the skin), 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 prevent 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 Compression 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 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 (certified registered nurse anesthetists) 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.
When Can I Travel or Go Back to Work?
That depends on the procedure and how you are healing, so it is a per-patient answer. I would rather clear you based on how you actually look than a generic timeline. If a trip is coming up, tell me early so we can plan around it, including any precautions to take with you.
What Should I Have Ready at Home?
The patients who recover most smoothly are the ones who set up before surgery, not after. A few simple things make a real difference: loose, comfortable clothing that goes on without raising your arms over your head, plenty of water and easy meals stocked, and a recliner or extra pillows if your procedure has you sleeping elevated.
Just as important is help. For the first few days, especially after body work, you will want someone to assist with meals, errands, and anything that involves lifting. I would rather you arrange that in advance than discover on day two that you needed it.
Why Do You Want Me to Call Early?
Because almost everything that worries a patient in the first few weeks is normal, and the rare thing that is not is easiest to handle when caught early. New, painful, red, or rapidly changing firmness, unusual drainage, or a fever all deserve a call rather than a wait-and-see.
You get a wristband after surgery with a 24-hour line to my nurses or nurse practitioner for exactly this reason. I would much rather answer a hundred calls about normal healing than have you sit at home worrying, or worse, wait on something that needed attention. There is no such thing as a question that bothers us.
Why I Care About This Part
I am double board-certified by the American Board of Plastic Surgery and the American Board of Surgery, a Fellow of the American College of Surgeons, and I completed my plastic surgery fellowship at the Mayo Clinic. I am also a 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 the patients who do their massages, wear their garments, and call early are the ones who heal beautifully.
Ready to Talk?
Recovery questions deserve real answers from the surgeon, not the internet. For the surgeon’s editorial take, see the companion essay on drworldwide.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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