When approaching a surgical procedure, often the goal is the only clear thing in mind and the path between here and there is a mire of questions and uncertainty. The difficulty, as I'm sure your surgeon has told you, is that recovery looks a bit different for everyone and you may encounter some unexpected bumps along the way. In an effort to provide some expectations to hang your hat on, I have identified 5 stages in the recovery process that I have seen clients progress through after surgery. This isn't with a medical or diagnostic categorization in mind, but rather is focused on painting a picture of what your experience may be like.
1. The Inflammatory Phase
This is the stage that begins directly after surgery and is probably the most intimidating one if you are preparing to go under the knife. Some people blaze through this phase quickly and move on to the next phase in a week or less, but for most people, this will be more like a couple weeks, sometimes more if you are more prone to swelling or if it was a more extensive procedure.
You will likely experience:
Deep and widespread pain
Numbness in some areas
Extensive swelling that may make area feel hard of skin feel stretched
Stiffness related to swelling that makes it difficult to move well and bend joints
Constant exhaustion even if you have been doing nothing (your body is using all of its energy to heal)
Leaking fluid from incisions
People who do well are:
Moving consistently (gently, to keep pumping fluid through)
Staying hydrated
Gently brushing hands over the skin to direct fluid toward lymph nodes
Elevating swollen area if possible
Using ice packs in many short sessions (10-20 min) throughout the day
Sleeping as much as they are able
Using pain meds to facilitate sleep and movement better
Wearing compression garments all the time
Receiving lymphatic drainage massage 3 times a week
Faithfully sticking to the post-op care plan from their doctor (Yes, this makes a huge difference. Don't skimp on this, whether it's physical therapy or a certain diet or anything else.)
2. The Mending Phase
This is the phase where you will notice your incisions are actually starting to close and you have a bit more energy. Most of my clients have reached this stage in 2 weeks though for some it takes closer to a month, especially if they have not been getting regular lymph drainage and the swelling has not been cleared well by their body.
You will likely experience:
Scabs coming off to reveal skin that has knitted together
Some areas of the incision are still open, or areas that pop back open after having been closed
Minimal leaking from the incision, though still some low-level seepage
Feeling more energy but still tiring quickly
Much less pain and therefore better quality sleep
Still significant numbness in some areas
People who do well are:
Faithfully keeping to their doctor's post-op care plan (Yup, it's a theme.)
Continuing to get plenty of rest (even though you won't feel like you need it as much)
Proper hydration and consistent movement will still be key
Still using ice to manage pain rather than heat
Gently massaging over numb/tingly areas and pockets of swelling
Receiving lymph drainage massage 2 times a week
Wearing compression garments most of the time (second-stage)
3. The Restoration Phase
This is when you start to feel normal again, and may even think you are totally healed until you try to get back to your usual routine and find yourself a bit more swollen and in pain the next day. You may reach this phase after as quickly as a month, or it may take as long as 3 months, especially if you are pushing yourself too hard. Even though you look healed from the outside, the layers underneath are still knitting back together to restore function.
You will likely experience:
Incisions appearing fully healed
Feeling a normal amount of energy again
Little to no stiffness and close to normal mobility
Occasional recurrence of pain and localized swelling from pushing yourself too hard
Frustration with not being "back to normal" yet
Return of sensation to numb areas (though others may remain numb for longer)
Change in texture of scars or layers beneath skin of affected areas (this is when lumps and bumps may begin to appear after liposuction)
People who do well are:
Listening to when their body says they are pushing themselves too hard
Beginning to do stretching if this was not part of immediate post-op plan
Shifting to heat to manage pain for muscles surrounding affected area, or muscles impacted by compensation patterns (e.g. tension in low back from abdominal incision, tension in thigh from knee replacement)
Receiving massage therapy that addresses fascial tension, breaks up adhesions (those lumps and bumps under the skin), and softens muscles tight from compensation.
Receiving gentle scar work to improve scar appearance and texture as it stabilizes
4. The Maturation Phase
This is when you can consider yourself totally healed! But it's not the last phase, so you know that there is still other stuff going on. You may be able to do all the normal things you were hoping to, but there will be some changes still taking place in your body. The scar tissue will mature over time, and the discoloration should begin to fade and become closer to color of the rest of your skin. Muscles, fascia, and skin will all settle in to the new normal of movement after surgery and may continue to soften and smooth. It is usually about a year before your are where your results will be permanently, though for some it can take up to 2 years post-op.
You will likely experience:
Feeling totally normal energy levels again
Notable redness, whiteness, or raised texture to scar still present (but slowly fading over this period)
Remaining numbness may continue to resolve
For joint replacements, there still may some pain and discomfort as the soft tissue continues to "settle in"
Skin at or around scar area not moving or gliding like the rest of your skin, may result in some pulling or discomfort
Pain or tension may develop in a seemingly unrelated area (e.g. upper back pain after hip replacement, shoulder pain after gall bladder removal, low back pain after tummy tuck)
People who do well are:
Building muscle strength again and moving normally (not accommodating previously injured area at all anymore)
Keeping scar tissue well-moisturized if it begins to dry out or stiffen
Receiving massage to manage compensation patterns
Receiving deeper scar work to soften adhesions and allow skin (and deeper structures) to glide more smoothly
5. The Stable Phase
You have reached the stage where your healing process is totally resolved, and whatever you feel or experience at this stage is how things will continue to be without additional intervention. If you are comfortable at this point, then that should happily stay the way it is (aside from the normal impact of aging). If you have some lingering issues, then it is worth pursuing a way to resolve those, as time alone won't do it. Do not confuse this with a problem being "unfixable." Between physical therapy, massage therapy, acupuncture, chiropractic care, and revision surgery, there are plenty of options to explore before resigning yourself to just live with an issue.
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