Let’s talk swelling, surgery and recovery

Post-operative swelling is a component of any surgery. Patients will expect some swelling but often do not understand the complexities of the healing process and the variability of swelling. Swelling occurs because extra cells migrate into a healing area. As the healing process continues these new cells will cause maturation and eventually softening of the operated area. This process is a lot longer than one would imagine.

To help understand the overall process I have enclosed a Graph of post-operative swelling (see bottom section of this post). One can see the immediate substantial amount of swelling that occurs after surgery. Within a few days the swelling starts to improve as the cells change. If you follow the Graph carefully one can see that there are periods where the swelling is dropping rapidly and other periods where the swelling seems to be increasing. This is exactly what happens in the healing process.

There are good days and bad days or more likely good weeks and bad weeks. However the overall trend over a period of time – in this case 12 months – is that swelling is going down all the time perhaps with some minor hiccups along the way.

This mathematical illustration is exactly the same as the clinical course. What I have not shown on this graph is that swelling also relates to softening of wounds. The less swelling the softer the tissues. Complete softening may not occur for up to and sometimes more than one year. If a surgeon deems a small revision is necessary it is usually wise to wait one year so that the effects of the primary surgery have all resolved and any revision will therefore have greater impact.

A lot of patience is called for after a surgical procedure!