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Stresses and Emotional Factors During the Immediate Recovery

It's hard to completely prepare our patients for their experiences, because each individual's reaction is unique. Most people sail through the recovery without incident, and although pain isn't usually a big deal, in a minority of cases, it can be significant. For example, with our liposuction patients, many need only Tylenol® the night after the surgery. For the rest, recovery may require heavier medications for a couple of days. The tradeoff to taking heavier medicines, such as codeine or codeine/Tylenol combinations (Vicodin®), may be nausea, vomiting, or constipation. Patients who have used heavy doses of prescription pain killers in the past may experience more pain and/or need these medicines during their recovery. And people who have had major physical experiences such as childbirth often find the relatively minor discomfort of cosmetic surgery a breeze. Recovery — as with any stress — is easier for those individuals in good overall physical and emotional health.

Our patients are warned that they may experience a brief depression a week to a month after the surgery because body image distortion during the recovery period can be particularly difficult. This is a temporary stress rather than a full-blown depression needing medication and occurs most often after extensive facial procedures. Depression can also occur if there are complications, when the whole process demands more time and energy than patients have budgeted for emotionally (see chapter 14 and for more information on complications). For example, an infection, facial nerve injury, area of skin death, or eyelid problem, though rare, can happen occasionally even with the best of care. In these cases, a recovery that should have taken weeks can drag out for months, and possibly longer.

For some people — five to ten percent or less, depending on the procedure — cosmetic surgery recovery is quite emotionally demanding. Your physician should make sure you are prepared for the possibility of depression. What you should not expect from your physician is psychoanalysis, a warning about every possible psychological reaction before it happens, or even possibly antidepressant medications, although he must be willing and able to refer for this if needed. You should expect compassion, professionalism, emotional support and a thorough, sensitive follow-up to help you deal with your reactions, whatever they may be.

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