Can you fly after surgery?

One of the common questions we’re asked is can you fly after surgery?

The answer to “Can you fly after surgery?” isn’t a simple yes or no because although we’d prefer you didn’t as the oxygen levels and air pressure changes can affect your swelling and thus healing; many people don’t have a choice. Particularly as many people are now travelling abroad, to places like Turkey, Florida and Bulgaria for what is pretty major surgery, even though we consider it normal today.

Also, each commercial airliner may have their own regulations which differently answer whether you can fly after surgery. It’s also checking which medical equipment they carry aboard.

It’s easy to discount what our body goes through with plastic surgery, thinking that this isn’t surgical intervention for brain surgery or hip and knee replacement. But however, ‘normal’ it is for us nowadays, it is still a surgical procedure and thus huge trauma that our body has to recover from.

We all have busy lives and commitments that mean we can’t always live the perfect way. And so, here are some tips on preventive measures to minimise your risk factors if you have to fly after surgery.

Reduce swelling when you travel

Be sure to wear your compression garments when you are flying after surgery. This is even more important when taking a flight because of the pressure change. In the research article, “The effect of compression stocking on leg oedema and discomfort during a 3-hour flight: a randomised controlled trial,” published in the European Journal of Internal Medicine, Olsen et al. 2019, found “compression stocking reduced oedema formation in young healthy passengers during a three-hour flight.”

Many of the Post-plastic surgery patients must travel for their careers. While travelling, it’s a good idea to wear compression garments as much as possible, walk around during the flight or at rest stops if travelling by car, and book extra lymphatic drainage massage sessions prior to surgery and after your trip to reduce swelling.

Quantas airlines have a video of stretching exercises you can do in an airplane. A simple tip is to perform one minute of ankle pumps, flexion and extension, once or twice per hour when you are awake on the flight — it may increase blood flow and thus reduce blood clots, for up to thirty minutes.

It’s always advisable to reach out and contact the airline about your travel plans and ask them can you fly after surgery with them, some may have their individual rules. They may ask you to leave it a day or so to reduce your personal risk.

Plenty of water helps reduce swelling

Water pressure is another form of external compression. Spending time in the water helps to reduce swelling. The bone, muscle and joint team at the Cleveland Clinic recommend exercises that move the ankle and knee joints, like walking and swimming. This all reduces swelling Cleveland Clinic 2016.

The pressure of the water on the lower body when standing in a pool or other body of water is also effective for reducing swelling, so water aerobics is another great option. But of course, you need to get sign off from your doctor when this is safe. After surgery, your wounds will have needed to heal sufficiently for it to be OK to get into water and your surgeon will advise.

How do you know it’s working?

You’ll want to pee!

Help! I’m swollen down there.

Do you have swelling in your private parts right after surgery? Shiffman says “labial and scrotal oedema is common but temporary” (2006, 99). Dixit and Wagh (2013) say “we have observed a unique seroma like presentation when the fluid gravitates to the scrotum or labia following abdominal, especially public fat liposuction.

In our experience, it usually settles over 10 days to two weeks. We have largely prevented this problem by restricting excessive mobility for the first 3 days after surgery and having the patients wear a snug fitting compression garment.” On this, because you are flying, also add graduated compression stockings to the list for ultimate protection when you fly after surgery whatever the types.

According to women’s health physiotherapist, Michelle Lyons, “Orgasms can be a great way to decrease stagnation and improve circulation in the pelvis, as the female orgasm is a series of rhythmic contractions which cover the pelvic floor muscles, 0.7 seconds apart.” She points out that “orgasm will also promote happy hormones like domaine, coytocin and serotonin and keep cortisol levels down–all great for your parasympathetic functionality, wound healing and immune resilience.” What a great way to reduce your individual risk factors when you fly after surgery.

Lyons share that “the other key driver of success would avoid constipation—so hydration, a diet rich in vegetables and fruit and movement.” Of course, this isn’t ideal when we’re travelling so you can back up your fibre rich diet before and after and of refer to the movement we discussed earlier. Under normal circumstances, “a 20-minute daily walk has been shown to be effective — and would generally be beneficial for surgical recovery as well.” So, don’t shirk on the plane walking!

Ask your surgeon when it is OK to have sex either with yourself or another person then go ahead and make your trip fun!

Kinesiology taping

We’ve seen nothing but bad results from clients who have been taped up instead of a compression garment. This is because it secures the skin against the fascia below the surface and then this is where you ‘set’.

However, many lymphedema therapists, massage therapists, physical therapists and athletic trainers use kinesiology tape to reduce swelling. The theory is that the tape gently lifts the skin changing the interstitial pressure and encouraging lymphatic vessels to take more fluid back to the heart. The key to effective lymphatic kinesiology taping is to put absolutely no stretch on the take as it is applied. Many doctors don’t understand this.

Kinesiology taping has been proven to work after orthopaedic surgery. This makes sense as it is a different process to lipo, they’re not separating the skin from the deep tissue.

But, when you fly after surgery, ask your surgeon whether they recommend this for the duration of the flight to help your lymphatic system better cope with the changes in air pressure. We would say just be sure to remove it after you have flown and wear your garment throughout. And always do a patch test!

To remove tape when you get home, saturate the taped area with a cotton ball soaked with olive oil before removing it. Wait a few minutes, and then re-saturate the area with more olive oil as you remove the tape.

You could also apply a thin coat of magnesium hydroxide (milk of magnesia) although we haven’t used this.

Cooling treatments

Cooling techniques encourage vasoconstriction and are a good way to reduce pain, inflammation and swelling temporarily. So, if you’re planning a flight directly after surgery, think about getting a cooling pack from somewhere like amazon which stay chilled for a few hours after removing them from the fridge.

Cooling can also be used for everyday swelling, especially in the morning after a fun night out! Worth noting if your trip is for fun, even though, we of course it’s advisable to avoid alcohol. Make sure you ask your plastic surgeon if it is okay to use cooling techniques on your face and body before trying these produces. We’d recommend not using them on the area if you have had a fat transfer. And to reduce the risk of frostbite, please don’t use cooling treatments on areas of skin that still feel numb post-surgery.

More ways to reduce swelling when flying after surgery

What to eat to reduce swelling

It’s important to make sure you’re getting enough protein, vitamins and minerals to support your healing process. Whilst you’re away it’s never as easy to have the control over your diet that you would normally so think about taking some vitamin supplements.

Dixit and Wagh (2013) say “persistent oedema can also be related to pre-operative anaemia, reduced serum proteins and kidney malfunction all of which are a contraindication to surgery”. However, some surgeons don’t check these functions before they go ahead and take your money. So, make sure you are getting enough iron and protein in your diet before you travel too. Some supplements including turmeric, may inhibit your body’s ability to absorb iron (Smith and Asher 2019).

In the article “Factors that impair wound healing” published in the Journal of American College of Clinical Wound Specialists, Anderson and Hamm note, “insufficient protein intake can be assessed utilising haematological markers such as albumin and pre-albumin or total lymphocyte count. Other diagnostic tools namely the Raines MacDonald nutritional index 9RMNI) or the Mini Nutritional assessment (MNA) are useful in assessing risk or a presence of protein malnutrition! (“014).

If you are concerned about diet, discuss it with your surgeon, primary care physician or dietician to make sure you are getting the nutrition you need.

How to sleep to reduce swelling (face patients only).

Many plastic surgeons recommend their patients sleep with their head elevated on two or three pillows for a few weeks after facelift surgery. Elevating your head uses gravity to help drain the post-surgical swelling through your lymphatic system. Yes, your neck is likely to feel stiff from sleeping like that, but it’s worth it. ASAPS recommends that while recovering from a facelift, you “Sleep with your head elevated to forty degrees for 2 weeks; an additional pillow or 2 under your mattress may help if necessary”.

This isn’t relevant to everyone, but at least if you’ve had a facelift and then you fly there is some benefit to being seated upright for the entire duration of your flight!

Generally, surgeons will advise patients not to sleep on their side. But how can you make sure you don’t do this? In his book straight talk about cosmetic surgery Dr Arthur W Perry recommends his facelift clients also use a U-shaped travelling pillow or pillow with arms, to remind them not to turn over whilst sleeping. Or you could place pillows under your arms whilst sleeping.

Dry brushing.

Before you get on a plane, we’d recommend some dry brushing to stimulate your lymphatic system before it gets hit by the cabin air pressure. Dry brushing involves brushing the skin with a specific type of brush in order to engage your lymphatic system.

Does it work? What are some tips to have the best results?

The trouble is that most of what we read on line are the exact same ‘rules’ with no explanation of why and where they came from. And you’ll struggle to find any scientific backing.

However, it is out there. The Cleveland Clinic recommends dry brushing to promote lymph flow and drainage (Starkey 2015). The New York Times reports Dr Tina S Alster, a clinical professor of dermatology at Georgetown University Medical Center, finds that using a dry brush on your skin helps your lymphatic system to ‘work better’ (saint Louis 2010).

The key is to ensure that your brush is soft enough to care for the integrity of your skin. This is especially so when your immune system is compromised. You shouldn’t stroke not be a glide, you need to stretch your skin which opens up your lymphatic vessels to reduce swelling.

Also, because you have open wounds, it’s imperative to ensure that the brush you use is new. That it has never been wet and therefore a space to fester bacteria.

Typically, brush up from your feet to your torso. Then from your belly button down to your groin. And above your navel, brush towards your armpits and middle abdomen.

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You can do all of this and still end up with swelling. The bad kind that means you must seek medical advice from your doctor.

If only one leg or arm is swollen and the swelling came on suddenly, let your doctor know immediately. It may be a blood clot.

If a limb is swollen because of infection, a blood clot, heart or kidney failure, lymphatic massage is not allowed. Don’t underestimate the side effects you could suffer with even weeks after surgery. It’s common to have bleeding after surgery, so the risk of developing blood clotting complications is greater. Especially if you have a family history of clotting, or what we commonly call deep vein thrombosis or pulmonary embolism. Again this is increased risk.

You may well end up in an ambulance jet if you’re not sensible if you fly after surgery. And this can apply to eye surgery too, if you’ve had e.g. posterior vitreous detachment, repair surgery ask your surgeon for advice on flying. Speak to your doctor about whether it’s appropriate to take a blood thinner.

Another point, not strictly related to aftercare as such, but still important is this. Get yourself a great travel insurance plan which will cover the costs if the worst does happen.

A quick note if you are having surgery on an eye condition. We don’t deal with healing post surgery on your eyes, so if e.g. you’ve had laser cataract surgery for corneal transplant or retina repair, surgery for glaucoma or lenses, then this may not be appropriate advice, so please double check the specifics.