At Southwest Plastic Surgery, Dr. Frank Agullo tells patients something they do not always expect to hear: a good result is half operation and half aftercare. The patients who do their massages, wear their garments, and call early when something feels off are the ones who heal beautifully. That is why the practice builds recovery support into every plan rather than leaving patients to figure it out alone.
These are the recovery questions the team answers most, drawn from real follow-up visits.
Is This Firmness Normal?
Usually, yes. After surgery, firm or hard areas are fibrosis and edema, a normal part of healing. Dr. Agullo has patients massage these areas, and the firmness keeps softening over about three months. It is far better at three months than at three weeks. What is not routine is new, painful, red, or rapidly changing firmness, which is a reason to call the practice.
A Stitch Is Poking Out
That is usually a suture working its way to the surface, which is common and minor. If a small area opens where a suture extruded, the team keeps it covered, sometimes with a silver antimicrobial dressing, and it heals. It does not mean something went wrong. Rarely an incision needs a few extra sutures, about one patient in fifty.
How the Massages Work
| Aftercare Step | What the Practice Provides |
|---|---|
| Lymphatic massage | In-house tech, 2 to 3 times a week for ~4 weeks |
| Abdominal drain | Clears trapped fluid during massage |
| Compression | Two Marena fajas, sized down as swelling drops |
| Facial recovery | ElixirMD LED therapy from day seven |
For body work, the lymphatic massages are how the practice keeps fibrosis from becoming a problem. An in-house tech sees patients two or three times a week for about four weeks. In the abdomen, Dr. Agullo leaves a small drain so trapped fluid clears quickly during massage, because trapped fluid is what creates lumpiness.
Garments and Showering
The practice provides two Marena fajas with clips so the team can size patients down as swelling drops. They are worn four weeks, off twice a day to shower and let the skin breathe. If a standard post-op bra is uncomfortable, a supportive alternative is often fine, because comfort that keeps a patient in compression beats a “correct” garment they refuse to wear. Patients shower the next day, and a nurse visits to help with that first shower, check healing, give IV fluids if needed, and answer questions.
Nausea, Pain, and Who Is in the Room
If a patient tends to get nauseous from anesthesia, a pill called Emend taken the night before usually prevents it. Facial procedures barely hurt. Liposuction feels like going back to the gym after a long break, sore with movement but tolerable, and easier than a C-section.
The anesthesia is run by CRNAs who are army and combat trained and have been with Dr. Agullo over ten years. The surgical techs are certified first assist and have been with the practice since 2012. After surgery, patients get a wristband with a 24-hour line to the nurses or nurse practitioner.
What Speeds Healing
Several recovery supports are available through the practice and its Med Spa. NAD infusions with glutathione before and after surgery help clear the anesthesia. Post-op peptides, GLOW for face work and GLOK for body, help with inflammation and tissue regeneration. Arnica and bromelain help with bruising. And for facial recovery, ElixirMD LED therapy starting seven days out roughly doubles the speed of healing.
The Three Habits Behind a Smooth Recovery
Dr. Agullo sums up the patient’s role in three habits: do the massages, wear the garment, and call early. The patients who keep up with their post-surgical massage are the ones whose tissue stays soft and even, while skipping it is what leads to fibrosis that has to be broken up months later.
The garment is the mold the new contour sets into, not a fashion choice, which is why the practice provides two and sizes them down as swelling drops. And calling early matters because nearly everything that worries a patient in the first weeks is normal, and the rare exception is easiest to address when caught quickly.
Preparing Before Surgery Day
The smoothest recoveries start before surgery. The team coaches patients to set up at home in advance: loose clothing that does not require raising the arms overhead, water and easy meals stocked, elevation arranged if the procedure calls for it, and help lined up for the first few days. Arranging support ahead of time is far easier than scrambling for it afterward, and it lets the patient focus on healing.
When Can a Patient Travel or Return to Work?
This is a per-patient answer rather than a fixed timeline. Dr. Agullo prefers to clear patients based on how they are actually healing, not a generic chart. Patients are encouraged to mention upcoming trips early so the team can plan around them, including precautions for long flights. After surgery, every patient receives a wristband with a 24-hour line to the nurses or nurse practitioner, so questions never have to wait.
About Dr. Frank Agullo
Dr. Frank Agullo is the founder of Southwest Plastic Surgery in El Paso, Texas. He is double board-certified by the American Board of Plastic Surgery and the American Board of Surgery, a Fellow of the American College of Surgeons, and completed his plastic surgery fellowship at the Mayo Clinic. He is a Clinical Associate Professor of Plastic Surgery at Texas Tech University Health Sciences Center Paul L. Foster School of Medicine and has been named a Castle Connolly Top Doctor for thirteen consecutive years.
Ready to Talk?
Recovery questions deserve real answers from the surgeon, not the internet. For the surgeon’s editorial take, see Dr. Agullo’s essay on drworldwide.com. For the patient-facing walkthrough, see the companion post on agulloplasticsurgery.com.
Call (915) 590-7900, text 1-866-814-0038, or book online at swplasticsurgery.com. #StayBeautiful.
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