The result of facial surgery doesn't end when the wound is closed. What happens in the following weeks and months (how swelling is managed, how the scar evolves, when and how check-ups take place) largely determines the final result. At ARQÉA, postoperative follow-up is part of the process, not an optional add-on.
This article explains what to expect at each stage of recovery, how the check-up schedule works, and when you should contact us without waiting for your next appointment.
The first week: what's normal and what isn't
The first 3 days
Swelling peaks between 48 and 72 hours after surgery. It's normal for your appearance to get worse over these days before it starts to improve. Bruising, tightness in the operated area and general tiredness are expected responses from your body, not signs of a problem.
During these days it's important to keep your head elevated (even while sleeping) to help the swelling drain. The team explains exactly how to do this for your procedure when you're discharged.
What's normal in the first week
- Progressive swelling that starts to subside from day 3–4
- Bruising that can spread to adjacent areas (with forehead surgery, it can travel down towards the eyelids)
- A feeling of tightness, numbness or pressure in the operated area
- Moderate discomfort when chewing, swallowing or moving your neck, depending on the procedure
- General tiredness and a need for rest
- A mild temperature of up to 38.5 °C in the first 24–48 hours
- Itching in the operated area from day 3–5 (a sign that healing is progressing)
Signs that require immediate contact
In any of the following situations, message us on WhatsApp or call the emergency number you receive at discharge. Don't wait for your check-up:
- Active bleeding that doesn't stop with gentle pressure
- Fever above 39 °C beyond 48 hours after surgery
- Pain that doesn't respond to the prescribed medication or that increases instead of improving
- A feeling that something has given way or changed in the operated area
- Intense redness, local heat or discharge from the wound
- Significant difficulty breathing or swallowing
Team availability: we reply on WhatsApp within 24 hours during working hours. For genuine emergencies outside those hours, you receive a direct contact number at discharge.
Care at home: what to do and what to avoid
Position and rest
- Keep your head elevated while sleeping for the first 7–10 days (two pillows or a semi-upright position as instructed)
- Avoid sleeping face down or on the operated area for at least 3–4 weeks
- Rest as much as you need (your body is putting its resources into healing, and tiredness is part of the process)
Hygiene and wound care
You receive your specific wound-care instructions in writing at discharge, adapted to your procedure. As a general rule:
- Don't get the surgical wound wet until the team tells you to (usually after the first check-up)
- Don't apply any cream, oil or product to the scar without checking with us first
- Don't expose the scar to the sun for at least 6–12 months (newly healed skin is especially prone to UV pigmentation)
- If you're wearing a dressing or splint, don't remove it yourself (the team removes it at the first check-up)
Diet
- In the first days: a soft or liquid diet depending on the procedure (especially relevant in jaw, chin or upper-jaw surgery)
- Avoid hard, fibrous foods or anything requiring heavy chewing during the first weeks
- Stay properly hydrated, especially if your medication includes anti-inflammatories
- Don't drink alcohol while on medication
Physical activity and daily life
- Relative rest for the first 5–7 days: gentle walking is fine, physical exertion isn't
- Avoid intense exercise, sport and activities that raise your heart rate for at least 3–4 weeks
- Don't drive while on pain medication or in the first days after general anaesthesia
- Office or remote work can be resumed within 5 to 10 days in most cases
- Work with public contact or physical effort requires 2 to 4 weeks
Tobacco
We ask you not to smoke for at least 3 weeks after surgery, just as before it. Tobacco reduces the oxygen supply to tissues in the middle of the healing phase, which increases the risk of infection, delays recovery and can compromise the quality of the scar.
The check-up schedule
Postoperative check-ups are included in the price of your surgery. They aren't an additional service, they're part of the protocol. Follow-up doesn't end until the result is consolidated.
- 5–7 days: first check-up (removal of stitches, dressing review, state of the surgical wound)
- 3–4 weeks: second check-up (initial scar assessment, progress of swelling, answering questions)
- 3 months: first real assessment of the result (most of the swelling has settled)
- 6–12 months: final result (comparative photographs and records)
Check-ups can be held in person in Barcelona or by video call depending on where you live. If you're from outside Barcelona, the team arranges the most suitable format for each one.
How swelling evolves: week by week
Post-surgical swelling follows a predictable curve. Understanding it helps you keep realistic expectations and not panic at the moments when your appearance doesn't yet reflect the final result.
Days 1–3: swelling increases and peaks. It's the worst-looking stage and the hardest to handle emotionally. It's normal.
Days 4–7: swelling begins to subside slowly. Bruises start to yellow and reabsorb. The first check-up happens in this window.
Weeks 2–4: visible improvement week by week. The operated area still has residual swelling, but the result starts to show through. Most patients can return to a normal social life.
Months 1–3: deep swelling (the kind you don't see but feel as tightness or firmness) resolves progressively. At 3 months there's a real assessment of the result.
Months 6–12: final result. The scar has matured, residual swelling has gone and the tissue has recovered its normal behaviour. This is when the definitive comparative records are taken.
One important note: in facial bone surgery (forehead, jaw, chin, orthognathic), deep swelling takes longer to resolve than in soft-tissue procedures. It's common for patients who have full FFS and/or orthognathic surgery not to see the real result until 4–6 months have passed. That's not a sign of a problem; it's the biology of bone and periosteal tissue recovering at its own pace.
Caring for the scar
The scar is part of the result. Its final quality depends partly on surgical technique (Dr Gutiérrez always works with incisions in areas of minimal visibility when the procedure allows it) and partly on how it's cared for over the following months.
Active healing phase (first 6–8 weeks)
- Don't expose the scar to the sun under any circumstances (use physical protection such as a cap or hat, plus high-factor sunscreen)
- Don't apply products without the team's approval (some common cosmetic ingredients can irritate a scar in its active phase)
- Don't massage the scar until the team tells you to (massage has a specific place in the protocol and starting early can be counterproductive)
From 6–8 weeks onwards
Once the wound is fully closed and the scar has entered its maturation phase, the team tells you when and how to start scar massage and whether there are specific products recommended for your case. There's no single protocol; it depends on the type of incision, how it has healed and the procedure performed.
Scars in the scalp area
In forehead procedures involving a coronal or trichophytic incision, the scar sits in the scalp and is practically invisible once the hair has grown back. Temporary hair loss around the incision is normal in the first weeks and recovers in most cases between 3 and 6 months.
The emotional side of recovery: what protocols don't mention
Physical recovery is only one part of the postoperative period. For many facial feminisation patients, the time after surgery also has an emotional dimension that deserves to be named.
It's common to experience a mix of emotions in the days and weeks after surgery: relief, anxiety, impatience to see the result, moments of insecurity when your appearance doesn't yet reflect what you're hoping for. All of this is normal and doesn't mean something has gone wrong.
The real result isn't visible until months have passed. What you see in the mirror during the first weeks (with swelling, bruising and dressings) is not the result. Dr Gutiérrez and the team accompany this process, and we answer questions at every check-up, including the ones that aren't strictly clinical.
If at any point you feel you need to talk to the team outside the check-up schedule, write to us. We're here.
Frequently asked questions about recovery
When does the swelling go away?
It depends on the procedure. In soft-tissue surgery (lip lift, tracheal shave), visible swelling usually resolves in 3–4 weeks. In bone surgery (forehead, jaw, chin, orthognathic), deep swelling can persist for 4 to 6 months. The final result is assessed at 6–12 months.
When can I exercise again?
Gentle activity such as walking: from the first days. Moderate exercise: from 3–4 weeks depending on the procedure. Intense exercise, contact sports or high-impact activities: from 6–8 weeks, and always with the team's approval at your check-up.
When can I go out in the sun?
The scar mustn't be exposed to direct sun for at least 6–12 months. Always use physical protection (cap, hat) as well as high-factor sunscreen. Sun exposure during the active healing phase can cause permanent hyperpigmentation.
When can I wear make-up again?
On non-operated areas, from day one if you need to. On the operated area or the scar, the team tells you the right moment (usually from 2–3 weeks, once the wound is fully closed). Ask at your first check-up.
Are check-ups in person, or can they be by video call?
Both options are available. We recommend the first check-up (5–7 days) be in person whenever possible, because it includes removal of stitches or the dressing review. Later check-ups can be by video call depending on where you live and how your case is progressing.
What if I have a question between check-ups?
Message us on WhatsApp. We reply within 24 hours during working hours. Don't wait for your next check-up if a question is causing you uncertainty.
When is follow-up considered finished?
Active follow-up closes when the result is consolidated, usually between 6 and 12 months after surgery. Beyond the first year you're formally discharged, but our door stays open. Whatever problem or question needs resolving, we'll be here to listen and try to help.
In summary
Recovery at ARQÉA follows a clear protocol: specific care at home during the first weeks, a schedule of four check-ups included in the price, and team availability on WhatsApp for any question. Swelling follows a predictable curve (the real result isn't visible until 3–6 months in bone surgery, and the final result is assessed between 6 and 12 months). Follow-up lasts as long as recovery does.
If you have questions about the recovery for your specific case, write to us. We reply within 24 hours during working hours.
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