September 26, 2019Expert Perspective

10 Things To Know About Post-Procedure Blues During Recovery

During the healing process, it’s not uncommon for patients to feel uncertainty, doubt, and even regret about their cosmetic procedure, and The AEDITION talked to board certified plastic surgeons about how to handle the post-surgery blues.

Krista Smith

Cosmetic surgery can cause a whirlwind of emotions, especially during the initial stages of recovery. Feelings of excitement, joy, and relief are all common — but so are nervousness and apprehension. Because of post-procedure swelling, bruising, and scarring, actual results may not appear for weeks, months, or even years after surgery. While plastic surgeons do their best to prepare patients for these inevitabilities, less often discussed pre-operatively is the emotional and psychological toll that elective surgery can have.

Melinda* underwent a comprehensive facial rejuvenation three years ago, which included a facelift, brow lift, and neck lift. She’d done her homework and been thoroughly briefed by her doctor, UCLA plastic surgeon Jason Roostaeian, MD, but there was simply no way to prepare herself for what she encountered in the mirror in the early days of her recovery. “I was swollen and a little shocked when I looked in the mirror,” she shares. “ I didn’t look like myself.”

During the healing process, it’s not uncommon for patients to feel uncertainty, doubt, and even regret about their procedure(s), and The AEDITION talked to board certified plastic surgeons Dr. Jason and Richard Brown, MD, about how to handle these post-surgery blues.

Understanding Post-Surgery Blues

All types of surgery — elective or otherwise — are traumatic for the body and mind, especially when performed under general anesthesia. The cocktail of anesthesia drugs combined with the depressive effects of post-operative narcotics prescribed to control pain have both physical and emotional effects. Additionally, post-surgery restrictions limiting mobility and basic self care activities can also take their toll on self esteem. Lethargy, brain fog, emotional sensitivity, sleeping problems, irritability, appetite changes, and anxiety are all common post-surgical complaints.

These feelings may be even more pronounced in cosmetic surgery patients due to the inherent psychological dilemma. Not only is there uncertainty about the outcome and results, but there can also be the burden of physical and mental turmoil that is magnified by potential guilt over feeling lousy about an elective procedure.

“There are definitely patients who are worried early on about what their end result will look like because they’re still in the healing process. It’s an evolution,” says Dr. Jason explains. “Because they don’t have the experience and knowledge that we do as surgeons, patients can have moments of remorse and wonder ‘Did I do the right thing?’”

Chris*, a patient of Dr. Jason’s, experienced a period of uncertainty after his rhinoplasty. “It’s a bittersweet couple of months,” he shares. “You’re so excited about looking like a new person but you’re also dealing with the reality of being a new person.”

While it’s impossible to predict whether or not a patient will experience feelings of post-surgical depression, certain types of cosmetic surgery may make it more likely. “Among my rhinoplasty patients, the people who are most at risk are those who are seeking fine refinements,” explains Dr. Jason. “When swelling sets in during the healing process, it looks worse than when they started.” These patients often wait months to experience their final results, whereas those seeking, say, a dorsal hump reduction get to see that change almost immediately. “They’re happy right when you take off the bandages because they can see you accomplished their goal,” he says.

According to Arizona-based Dr. Brown, author of The Real Beauty Bible, it’s especially common for post-operative moms to feel guilty about not being able to care for their families. That “mom guilt” can lead to self-questioning and doubt. “Occasionally when women come in for their follow-up visit, I can tell that something is going on in their heads,” he says. “That ‘something’ is usually the post-procedure blues.”

When to Seek Help for Post-Operative Depression

In some patients, post-procedure blues can linger or even worsen over time. This could be a sign of a larger mental health concern, like clinical depression, whether it’s related to elective surgery or not. Symptoms of depression include frequent feelings of hopelessness, anxiety, overwhelming fatigue, and a lack of interest in normal activities. Patients — especially those who already experience or are treated for depression — should be open with their doctor about their symptoms. In the vast majority of cosmetic surgery-related cases, however, the feelings pass as the healing process progresses.

How to Cope with Post-Surgery Blues

While feelings of mild depression, anxiety, and/or uncertainty post-surgery are unpredictable, there are measures patients can take to reduce their likelihood. Communicating with your plastic surgeon — both before and after a cosmetic procedure — is key. Considering the following advice could also foster a smoother recovery, though it is never meant to replace your own surgeon’s instructions.

1. Educate Yourself

Learn as much as possible about your procedure beforehand by asking plenty of questions during your consultation and pre-op appointments and by conducting your own research. Ask your cosmetic surgeon’s office if they can put you in touch with past patients who may be able to offer personal insight. Knowing what to expect and having realistic expectations about your results can help keep you calm during recovery. “I knew I’d be swollen and bruised, so I wasn’t troubled that I didn’t look perfect overnight,” recalls Kimberly*, one of Dr. Brown’s mommy makeover patients.

2. Plan Ahead

The key to resting without stress or guilt is to prepare as much as possible beforehand. Kimberly, for example, heeded Dr. Brown’s advice to prepare meals, arrange transportation, and put friends on standby prior to her procedures. As a result, the mom of five, who underwent a breast augmentation, tummy tuck, and liposuction, could better focus on taking care of herself. “I was really emotional for the first couple of weeks,” she shares. “I got post-op blues but never was truly depressed about my decision. I read Dr. Brown’s book and his office prepared me well.”

3. Don’t Suffer in Silence

While it’s important to understand that your feelings are likely completely normal, it’s wise to share them with your physician and supportive friends and family members. “Don’t be nervous to share your feelings with your surgeon,” says Dr. Brown. “We’re here to support you.”

4. Get Out of Bed

While many people envision their recovery period as an opportunity to stay in bed all day and binge Netflix, being too sedentary can hamper healing. Instead, be as active as your surgeon allows. Even short, gentle walks around the house can stimulate mood-boosting brain activity.

5. Meditate

Practicing mindfulness not only helps increase positive feelings — it’s also been proven to aid in the physical healing process. “The concept of neuroplasticity tells us that the brain is constantly adapting,” says Dr. Jason. “Using relaxation techniques and guided imagery can increase well-being by reminding your brain to focus its energy on healing.”

6. Stay Away from the Mirror

We know this is a tough one, but do your best to not overly scrutinize your surgical site. Monitor your progress as directed by your doctor to ensure you are healing properly, but do not obsess. The healing process often gets worse before it gets better. “I tell patients that swelling is like a checkerboard. It doesn’t come in uniformly, and it doesn’t leave uniformly,” says Dr. Jason. “While you’re going through the healing process, you’re going to see small differences in certain areas.”

7. Medicate Only as Directed

Controlling your pain is a key component of a comfortable recovery, but prescription pain medications can have both physical and emotional side effects. Weaning off pain meds will allow the body to start detoxing, and many patients find they get necessary relief with over-the-counter remedies as soon as one or two days post-op (again, always adhere to your surgeon’s advice). Gentle exercise (in accordance with your doctor’s recovery plan) and meditation can also ease or distract from discomfort — no pills necessary.

8. Be a Patient Patient

Healing takes time — it’s sometimes two steps forward, one step back — so practice being kind to yourself. Dr. Jason warns that patients should expect to encounter some minor setbacks, like renewed swelling, as a result of basic things like sleeping on one side or resuming normal workouts, and it shouldn’t be a cause for concern. “Don’t lose patience,” Dr. Brown adds. “Get past that attitude of expecting immediate results and remember that positive change takes time.”

9. Focus on the Positive

Don’t let stress, guilt, or impatience allow you lose sight of why you made the decision to have cosmetic surgery in the first place. Instead, imagine the weeks and months down the road when your recovery will start to be a thing of the past. Envision the positive changes — whether or not they are visible yet.

Dr. Jason, for one, takes photos in the OR that can be helpful for rhinoplasty patients trying to push through post-procedure anxiety. “The end result on the table has less swelling than when you first take the cast off,” he says. “I’ll often show that to the patient because they like how that looks and they feel good about that. It gives them some perspective and a glimpse into what their ultimate result will be.”

10. Trust the Process

“You’ve got to have faith,” says Dr. Jason. Remember: Your body is designed to heal itself, and your plastic surgeon has taken every measure to promote a positive outcome. Melinda was able to overcome her post-op apprehension after recalling conversations she had with Dr. Jason prior to surgery. “We’d talked about how much I wanted a natural look,” she shares. “We have similar views about plastic surgery, and I liked the pictures of his work.” Feeling confident about her surgeon’s past results helped ease Melinda’s mind.

Two years after her facelift with Dr. Jason, Jenna* says that her recovery is nothing but a distant memory. “It was kind of depressing for a bit, but Dr. Jason was very encouraging,” she recalls. “The second day, you look great — and then a week later, you look terrible. But it got better, and now I just remember the good parts.”

Dr. Jason’s rhinoplasty patient Chris offers this analogy: “It’s like seeing yourself in the mirror after getting a new haircut and wondering if the look works or not,” he shares. “Hair grows back, but cosmetic surgery is permanent. So, you’ve got to find the surgeon who can best translate what you want into reality.”

*Patients' names have been changed

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