Ice or heat? Woman’s World put the question to doctors on September 29 and Dr. Frank Agullo reviewed the piece. Yahoo Health and AOL ran it the same day.
That was for sore muscles. This is the version his surgical patients get, in his words.
1. In the first couple of days after surgery, ice or heat?
“The first couple of days after surgery, ice is better, because it vasoconstricts, which decreases swelling and inflammation.”
2. How long, how often, and anything between the ice and the skin?
“Usually we don’t actually use ice per se. We have little ice packs that have a gel inside, which you put in the freezer. They’re covered with silicone, and this protects the skin so that it doesn’t suffer direct contact with the ice. We like to use it as often as possible, every hour, for the first three days.”
3. When do you switch to heat, and what is heat actually for?
“After the third day, heat will actually vasodilate and help get more blood flow and oxygen to the area, as well as all the growth factors and repair cells that we need.”
4. Any warnings, and what should patients watch for?
“The patient should be able to hold the ice pad or heat pad in their hands comfortably. If it’s too hot or too cold to hold comfortably, it can burn the skin. You should be very careful, especially in areas that are numb, so that you don’t injure yourself.”
The short version
| Days one to three | Day four onward | |
|---|---|---|
| What goes on the area | Silicone-covered gel pack from the freezer | Gentle heat |
| What it does | Narrows the small vessels; less swelling, less inflammation | Opens the vessels; more blood, oxygen, growth factors and repair cells |
| How often | Every hour, as often as possible | As needed, once the swelling is down |
| The test | Comfortable to hold in your bare hand | Comfortable to hold in your bare hand |
| Extra care | Numb skin, operated skin | Numb skin, operated skin |
5. How long is one session?
Dr. Agullo, in Woman’s World: “Longer than 20 minutes does not help. The skin can be injured, and the body starts pushing blood back into the area to warm it, which undoes the benefit.”
6. I am swollen on day two. Is something wrong?
Dr. Agullo, in a pre-op consult: “It does take patience because you’ll be swollen. You’ll have bruising. It takes a couple of weeks for people to be comfortable with other people seeing them. So, usually, two weeks, and then if you have any very special events, usually it takes six weeks to really look your best.”
“But physically, on day two, day three, you’re gonna feel fine. There’s no pain. It’s just the feeling of swelling. But physically, you feel like you can do anything.”
Our pre-op nurse: “You might be one of the lucky ones that don’t swell up a lot, you might be one of the not so lucky that swell up a lot. It varies per patient. Just remember, if you’re very, very swollen, you’re not gonna stay like that.”
7. And after day three?
Heat, and the massages. Our nurse practitioner on the hard spots that linger: “If it’s more like a hard area that feels a little hard to touch, like a little lump, then it could be more like fibrosis, swelling of the tissue that is still present at the time. And the only thing to remove that would be with lymphatic massage, continue massage in the area to soften up the tissue.”
More: lymphatic drainage massage, aftercare when you had surgery elsewhere, Dr. Agullo’s own read on drworldwide.com and the procedure-by-procedure version on agulloplasticsurgery.com.
Why Choose Dr. Agullo
Dr. Frank Agullo is certified by the American Board of Plastic Surgery and the American Board of Surgery, completed his plastic surgery fellowship at the Mayo Clinic, and serves as Clinical Associate Professor of Plastic Surgery at Texas Tech University Health Sciences Center. He has been a Castle Connolly Top Doctor for thirteen consecutive years, 2014 through 2026. Every surgical patient at Southwest Plastic Surgery goes home with the gel packs and a 24-hour nurse hotline wristband.
Ready to Talk?
Call (915) 590-7900, text 1-866-814-0038, or book online at swplasticsurgery.com. #StayBeautiful
Find Dr. Agullo at @RealDrWorldWide on Instagram, TikTok, and Snapchat, @Agullo on X, or @AgulloPlasticSurgery on Facebook.
