Returning to Exercise after Plastic Surgery

            One of the most common questions I get asked following a surgical procedure, right after When can I have sex? is How soon can I get back to exercise? Perhaps a future article will deal with permissible sexual positions is the post-operative period. For now, I'll limit my advice to exercise. While it's best to ask your own surgeon for guidance, I can give you some general advice.  These guidelines come from my experience both as a plastic surgeon and as a competitive bodybuilder. Some guidelines are general and some are specific to a procedure. Remember, medical opinions can differ.

            A General Approach

First let's consider the general principles. The first concern is the initial healing phase. While every effort is made during surgery to control any potential bleeding, this also has to be considered during the first few days to a week after surgery. Any sudden surges in blood pressure can start bleeding in the operative site. This can cause swelling and distortion. Inflammation caused by the blood collection, or hematoma, will lead to more scar tissue that can distort the area permanently. The presence of any sudden swelling should be immediately brought to the surgeon's attention. Appropriate measures should be taken to drain the collection of blood and locate the source of the bleeding.  Failure to do this can increase the risk of infection. 

There should be a period of at least one week in which there is little to no likelihood of raising blood pressure. After that time, mild low-impact aerobic activity can usually be started. It should be discontinued at any sign of discomfort. The body heals in response to stress and strain. If there is tension on, or inflation of, a healing area, the body will attempt to create more scar tissue to handle the stress. In the case of various body implants, too-early motion can lead to unwanted displacement.

Light resistance training to areas away from the site of surgery can usually be started in three to four weeks. I advise using a super slow routine to get started- something incorporating a 15-20 count concentric and 15-20 count eccentric motion. Not only will this prevent ballistic motions that can be harmful, but it will clean up previous cheating motions for additional benefits.  The areas involving the surgery can then be started at five to six weeks. Usually, after six weeks, there's a return to full pre-operative routines.

            It's common sense that the healing areas should not be subjected to trauma, abrasions or unnatural stretching. People who exercise usually know the messages they receive from their bodies. In the post-operative period, you should respect any feelings of pain and discomfort. Unlike your usual efforts to ignore or work through them, let them be an indicator of when to stop.

            Getting Specific

Now here are some specific guidelines. After surgery involving the head and face, such as rhinoplasty (nose), blepharoplasty (eyelids), otoplasty (ears), face lift or facial implants (chin and cheekbones), the head should be kept higher than heart level for several weeks, especially when lifting. This will prevent sudden blood flow to the healing areas and excessive swelling. You probably shouldn't drop anything on your face, either.

            Recuperation after liposuction is fairly rapid. I permit my patients to do full workouts after two weeks as long as they are wearing the post-operative compression garment. The muscular action combined with the elastic compression can speed the resolution of the swelling. Again, the rule is to do what's comfortable. After six weeks, all restrictions are lifted.

            Surgery involving the chest, such as breast or pec implants, necessitate restriction of both the direct pushing motions of chest workouts and the stretching involved with working the back. Light chest and back can be started at four weeks, progressing to full workouts in six to eight weeks. It should be noted that even though these implants stretch the pectoral muscle, most of my patients report full return to pre-operative lifting weights.

            Calf implants not only involve the motions of leg workouts, but also the need to balance in order to work the rest of the body. For this reason, I restrict standing exercises for four weeks. Any seated exercise is fine. I wouldn't want anyone with a weight pressed overhead to have a sudden spasm of the calves.  After six weeks, full exercise can be done, as well as a return to calf raises, should the individual want to augment the results of the surgery.

            Surgical lifting procedures such as tummy tucks, buttock lifts and mammoplasty (breast) are divided into those that involve only a skin tightening and those that have a muscle tightening component, as well. If no muscle is involved, full exercise can be started when comfortable, after two weeks. If a muscle tightening is part of the procedure, four weeks should pass.

            These are general guidelines. In some cases they're modified due to specific needs and requirements. Other surgeons may be more conservative. Many are not conversant with exercise and bodybuilders, but fortunately for my patients, that's not a problem I encounter.