This is one of the most common questions I get asked during a preoperative consultation. Sometimes it is the patient asking, sometimes the spouse. It gets interesting when the spouse asks, and the patient gives me a look with hidden meaning or vice versa. Some patients in troubled relationships have asked me to tell their spouses that sex is off limits for 6 months or longer. I love how honest my patients are with me and how they open up in this situation as I ending up being a sounding board for their most intimate personal issues.
So, when can you resume normal sexual activities after plastic surgery? There may not be a straightforward answer. It depends on the nature of the surgical procedure, your particular recovery process, the amount of discomfort you are in, the degree and location of bandages or drains, and if you feel ready for it.
After any surgical procedure, there will be activity restrictions. All patients have to protect their surgical sites to avoid bleeding, swelling, wound separation, or irritation. Some patients may need to keep their body in certain positions. For example, after a tummy tuck, a hips-flexed posture needs to be maintained for 1-2 weeks; for breast surgery, patients need to sleep on their backs with arms near sides for 2-3 weeks. Exercise should be avoided for at least 3-4 weeks, as increases in heart rate and blood pressure can increase risks for bleeding and swelling. Think of sex as exercise.
Pressure, shear, or tension forces can be detrimental to healing incisions. Many patients after breast augmentation in particular feel so much better about themselves soon after surgery and want to get intimate sooner rather than later. I had one patient who was several days after breast augmentation and opened up her incision during sex with her boyfriend. Luckily, we were able to get her to surgery asap and fix the problem, saving her implant. Why would you want to jeopardize the success of your surgery by being noncompliant with post-operative activity restrictions? Not only that, but a second trip to the operating room is a costly endeavor that you are responsible for.
Some patients will need to be wearing special bras or compression garments. Most patients don’t feel sexy in surgical support garments. Drains and bloody drainage is a turn-off to most partners. Visible healing incisions and sutures are unpleasant to most people.
Pain is also a turn-off. Sex isn’t that much fun if you are in pain or out of it from pain pills. Nausea associated with medication also makes for a bad sexual experience. So no sex until you are not in any pain is advised. Listen to your body and use some common sense. If something hurts, don’t do it.
The time you will need to wait will be longer for more involved operations. For instance, if you had concomitant breast surgery and tummy tuck (mommy makeover), you may want to wait 4-6 weeks.
The key in resuming sex is to use common sense. In many cases you may need to be somewhat inventive with positioning to enjoy sex. Having someone’s body weight on an area that is healing is not a good idea. But, if you can position yourselves to prevent this, you may be able to proceed without harm. Listen to your body. If nothing is hurting, it is probably ok. Start slow and be careful.
Another consideration is that many of our patients stop birth control pills or hormones prior to elective surgical procedures that involve a general anesthesia. So be careful. An unintended pregnancy during the perioperative period would be a big surprise, and something you hadn’t considered when planning your surgery.
In addition to your plastic surgeon’s recommendation, the most important consideration is when you, as the patient, feel ready for this both mentally and physically. Be patient with yourself. Many patients after surgery experience dramatic improvements in self- confidence and self-esteem and are ready to get out there and show off. They find that physical closeness is comforting and makes them feel great. Others take longer to feel ready and they want to be left alone for a period of time as they recover. Some individuals are in doubt about how they feel about themselves due to persistent swelling, scars, or changes occurring in their body. The key here is to be honest with you lover and work through this together. Understanding and reassurances can go a long way.
So the bottom line is that you invested a lot of time, money, and some discomfort when going through plastic surgery. It is important that you follow all post-operative activity restrictions for an uncomplicated recovery and success in your results. The first 3 weeks after surgery may be the riskiest so be careful during this time frame. Listen to your body and use common sense. If in doubt, ask your plastic surgeon.
Dr. Hayley Brown MD, FACS
Board Certified Plastic Surgeon
Desert Hills Plastic Surgery Center, Henderson and Las Vegas, Nevada