Mistake #1: Not Budgeting for Massages Post Op

Sadly, many surgeons generally don’t tell you that you will need massages after plastic surgery, and that they are a very important part of your recovery.  Not budgeting for after care (or not budgeting enough)  is one of the worst things you can do post op.  

Why is this such a problem?  Well, either people end up not getting the massages they need at all – or worse, they end up going with the cheapest possible person.  This is a HUGE mistake.  

If you are paying between $30-60 for your post op massages in the United States, there’s a good chance that your “massage therapist” is not trained, licensed or insured.  That is a risk to your surgical results, and even more so – a risk to your health.

Going to someone who has no training and no license means that they do not have the education needed to keep you safe.  What they do know was probably learned on YouTube – and is more likely than not completely wrong – and probably dangerous.  Read here about that in the Dirty Little Secrets About the Plastic Surgery Recovery Industry.

In short, don’t skimp.  You don’t get bargain-basement plastic surgery, so don’t go to an under-qualified therapist just because it is cheaper.  In this case, you do get what you paid for.  Here’s an article about how to make sure your therapist is properly licensed in the state where you are getting your massages.

If you haven’t yet had surgery and are still in the planning phase, it is safe to say that you should set aside up to 40% of your surgery cost for after care supplies, garments, and massages.  Yeah, it’s not cheap.  Remember that neither was your surgery, so don’t skimp on your aftercare and don’t let the surgical after care costs catch you by surprise after the fact.

Mistake #2: Waiting Until After Surgery to Schedule Your Massages

You want to be sure that you begin your massages as soon as you are able to do so after surgery.  What most people don’t realize is that massage therapists are usually booked out a few weeks – especially those who do post op massages.  They get their surgery, then wait until they are feeling better until they reach out to the therapist in their area to make an appointment.

“Sure you can make an appointment,” the therapist on the phone says, “The first available spot I have is on the 21st.  Should I put you down?”

“But that is THREE full weeks away!  I can’t wait that long.  I’m recovering from surgery.” The person on the other end exclaims.

If I had a nickel for every time I have had this conversation, I could probably retire today and move to Tahiti.  Therapists can’t fit you into an already full schedule, no matter how much they care and want to help.  Believe me when I tell you that the therapists who care really feel bad turning you away.

The way to avoid this is to book ahead of time.  Sadly, most surgeons don’t tell you this information in advance – again, because they know you are already focused on cost.  Some people are lucky and find out about the massages online before surgery.  If that is you and your surgery is booked – or about to be booked – start doing your research now on therapists in your area and get on their schedule. 

Mistake #3: Not Getting Enough Massages

This can be a very confusing topic, so I want to be clear here that there is no absolute number of massages that is right for everyone across the board.  Consumers beware of people telling you that you need EXACTLY 10 (or however many) sessions or your results will be ruined.  If someone tells you that – especially if they have never seen you –  be concerned.

That being said, it is not unreasonable for someone to give you an approximate estimate for what is typical for the surgery(ies) that you had.  Most people in my practice come between 7-10 times for a 360 lipo/BBL, for example.  That does not mean that every single person needs exactly that many, but the majority of people will. A few people may need even more, depending on how they are healing, their genetic makeup, their diet, how well they are following post op guidelines, and their overall state of health prior to surgery.

If someone forced me to make a suggestion for how many is the bare minimum for *most* people post op, I’d say about 6.  So, if you are budgeting for your massages in advance, find out what a legitimate therapist charges in your area and set aside money for at least that many.  Once your surgery is done, go for your first appointment and discuss with your therapist about how you feel, and what your goals are.  From there you can decide how many sessions you are likely to need.

Mistake #4: Getting Massages All In the First Week

This mistake pairs closely with the previous mistake of not getting enough massages.  Why?  Because many people begin getting their massages right after surgery when they are still out-of-town (or out-of-country).  That’s fine, provided that they have found a legitimate provider.

The problem arises when someone spends most of their massage budget getting 1 or more massages each day in the first week or so.  There is really no need for this.  The people who sell massages in this manner are usually the unlicensed folks who just are out to make a buck.  Yeah, I said it.

Here’s the problem with that:  Recovery. Takes. Time.

While there is nothing wrong with getting some massages right away, if you have budgeted for let’s say 10 massages and you got 7 of those in the first week post op, you have wasted a lot of money.  Swelling is inevitable and is necessary for healing.  The relationship of swelling and periodic massages is like a dance between partners who alternate who is leading.  One day the massage has the upper hand.  The next day it’s the swelling – and maybe the day or two after that – and that is ok.  It is normal for swelling to have days that are better and worse.  Let’s see why…

Mistake #5: Assuming that Swelling Is Your Enemy

Does that mean that if you get rid of swelling that you won’t heal?  No.  It is actually good to move swelling away from the tissues periodically.  Here is why that is true:

The body delivers the food (energy) and repair molecules from the bloodstream to damaged tissues using fluid as its delivery mechanism – a type of “Door Dash or Grub Hub,” if you will.  That’s great up until the “Door Dash” (fluid) tries to make its exit as it does under normal conditions.  

The problem arises when it’s exit is blocked.  This is because the surgery has caused damage to many of the lymphatic vessels nearby (the exit), and those vessels that weren’t damaged are completely clogged up.  When the fluid can’t get away, it gets backed up and causes swelling.

Of course, we are well aware when this happens because we get stiff and uncomfortable.  Moving is difficult, and there can be some aching involved.  We want it gone, so we go get a lymphatic massage.  It gets better.  Then, it comes back.  This is because the body is constantly delivering a supply of food and materials to rebuild the damaged area.

The cells in the surgical area eat the food they were brought, then they “poop.”  The “poop” is protein that is considered a waste product.  Under normal conditions this “cell poop” is taken up by the lymphatic vessels and carried away.  In this case, though, due to damaged and/or clogged vessels it continues to hang out.  So, you go and get another massage a few days later to move all that waste it away to make room for – yes, you guessed it – more swelling.

It is back and forth for many weeks, usually beginning to steadily improve after about 3 weeks, but factor in hormonal changes throughout the month; consuming foods like sugar, salt, and alcohol (eventually for many folks); and heat or altitude, and you still have a ways to go.  It really won’t be until after 2 months that swelling does a much better job at staying reduced for longer periods without massage.

While this is extremely annoying and frustrating – because you want to look better now, not later, try to keep in mind that despite how it may look or feel, that swelling is doing important work.

Mistake #6: Expecting Your Faja and Your Massages to Do ALL the Work

Mistake #7: Having a Faja That Is Too Tight or Too Loose

This is a problem that I see on a daily basis.  When fajas are not fitted properly, people are extra uncomfortable and don’t wear them like they should.

The mistaken belief that you must squish yourself half to death can cause a whole host of problems.  Fajas that are too tight cause pain, upset stomach/gastric reflux, and can cause skin necrosis (skin death) in extreme cases.  Don’t think that you need to suffer to get great results.

On the other side of this coin is the faja that is too loose.  Now, for post lipo you should be in a support (not compression) garment similar to the material found in Spanx brand undergarments for about 7-10 days.  For tummy tucks this can be a 14-21 day window depending on how fast your scar is healing.  It’s important not to compress too soon.  But, that doesn’t mean that you should just stay in a loose-fitting comfy garment for your whole recovery.  When I see clients that do this, they often develop seromas and the likelihood of getting fibrosis is much higher.

The same thing goes for sleeping – you need to be compressed (once you reach that stage) 23 hours a day, so don’t take off your faja at night or switch into a Stage 1 because it makes it easier to sleep.  The torso swells at night, so you will lose a lot of ground if you do this.

Mistake #8: Wearing a Waist Trainer During Your First Couple of Months

If you take away one thing from this post, let it be that *waist trainers are not appropriate garments immediately post op*!  They are not post op garments at all, and wearing them instead of a faja can cause uneven compression (pushing fluid to one area where it pools) or even permanent indentations in the fat due to the stays (rods) that are in many waist trainer models.

Remember that waist trainers are not fajas!  They are not made to be worn over a faja to get more compression.  If you feel like this is necessary, change to a different faja because yours is not offering adequate compression.  Layering a waist trainer over a faja is asking for problems.  Yes, I know a lot of social influencers tell you to do this.  They are not trained in compression and are giving out advice not based in the science of compression.

If you are dead set on wearing a waist trainer at some point, then wait 3-4 months post op – and then you should be good.  Just keep in mind that you cannot permanently alter your bone structure (ribs) with compression.  The implication that you can just squeeze the crap out of yourself and you will stay that way is not true.

Mistake #9: Not Wearing Foams and Boards

Not wearing foams and boards with your faja is asking for trouble.  Yes, they are hot.  Yes, boards can be uncomfortable if you don’t have one that is well-fitted for your body.  That all being said, you don’t want to go without them – especially in the first 8 weeks when everything is getting settled post op.

After surgery, the manner in which compression is applied to the body is critical to getting a good surgical result.  Foams and boards distribute pressure where fajas tend to dig – usually at the waist.  While some fajas may have a lot o extra fabric in the torso for short-waisted people, it is totally normal for them to bunch up at the waist.  This is due to a law of physics called the Law of Laplace, which roughly states that if you have a compression garment over a body, the area of highest compression is where the diameter is the smallest (the waist).

If we do not do something to distribute this extra pressure that is exerted at the waist, it can cause a permanent indentation and it creates a tourniquet that keeps lymph from moving properly.  In the case of a tummy tuck, it can cause additional backup of fluid just above the scar because it prevents it from getting up to the armpit where it has to go to return to the bloodstream.