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Get emergency help immediately for severe trouble breathing, chest pain, coughing blood, fainting or collapse, or heavy bleeding that will not stop. Contact your operating surgeon or plastic-surgery department urgently for fever, pus, spreading redness or warmth, increasing pain, wound separation, rapidly increasing swelling, or feeling generally unwell. Mild soreness, bruising, swelling and a small amount of drainage can be part of recovery, but your procedure-specific discharge instructions take priority because operations and risks differ.
Do not try to diagnose a complication from symptoms alone. Use the severity and direction of change—especially symptoms that are worsening, spreading or accompanied by fever or systemic illness—to decide how quickly to escalate.
The three levels of action after plastic surgery
When a symptom appears, first decide whether it threatens breathing or circulation, suggests an evolving wound complication, or fits the recovery pattern described by your surgical team. If you cannot tell, call the operating team or a local urgent-care service rather than waiting for a routine follow-up.
| Action | Situations that fit this level | What to do |
|---|---|---|
| Call your local emergency number now | Severe difficulty breathing, chest pain, coughing blood, fainting, collapse, or heavy bleeding that cannot be controlled. | State that you recently had surgery, describe the symptom and location, and follow the dispatcher’s instructions. |
| Contact the operating team urgently | Fever, pus or colored drainage, spreading redness or warmth, increasing wound pain, a wound that opens, rapidly increasing swelling, renewed bleeding, or feeling systemically unwell. | Use the surgeon’s postoperative number or the plastic-surgery department’s urgent pathway. If the service is closed, follow its out-of-hours instructions. |
| Monitor and follow the discharge plan | Mild, stable soreness, bruising, swelling or limited drainage that matches the written instructions and is not getting worse. | Keep the scheduled follow-up, record changes and call if the pattern changes or you are unsure. |
Symptoms can overlap. For example, increasing swelling may be a hematoma, infection or another problem; only an examination can distinguish them. A symptom that is mild now but rapidly worsening belongs in a higher-urgency category.
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What can be normal—and what makes it concerning?
Expected early recovery features
Operations commonly cause soreness, bruising, swelling and some drainage. The amount and duration depend on the procedure, the area treated, the closure method, medications and your health. Your discharge paperwork should state how to dress the wound, when to remove coverings, what drainage is expected and which pain medicines to use. Those instructions are more specific than any general checklist.
Changes that should prompt a call
A symptom becomes more concerning when it is severe, returns after improving, spreads beyond the operative area, or is joined by fever, low energy or a general sense of illness. Increasing pain rather than gradual improvement is particularly important, as is a wound that begins to separate or drainage that changes from a small expected amount to persistent, bloody, green or yellow material.
Use the trend, not just one observation
Write down whether a symptom is improving, stable or worsening. A small area of redness that is unchanged may be handled differently from redness that expands over several hours. Likewise, bruising can be expected, but a new, firm swelling that rapidly enlarges or becomes increasingly painful needs prompt assessment. If you are unsure how to interpret a change, call rather than waiting for it to declare itself.
Recognizing a possible surgical-site infection
Infection can be local, systemic or both. Chelsea and Westminster Hospital’s plastic-surgery patient leaflet lists fever, lack of energy, pus near the wound, increased pain, redness, swelling and warmer skin as warning signs. Guy’s and St Thomas’ guidance likewise describes red, sore, hot or swollen skin, green or yellow pus, wound opening, fever and feeling unwell. NICE describes heat, redness, pain and swelling as local surgical-site infection signs; fever or a raised white-cell count can occur in more serious infection.
Local wound signs
- Redness that is increasing or spreading rather than settling.
- Skin around the incision that feels distinctly hotter than nearby skin.
- Swelling that is enlarging, tense or associated with worsening pain.
- Pus or colored drainage, including green or yellow material.
- An incision or other wound that opens or separates.
- Pain that is increasing, throbbing or no longer controlled by the plan supplied by your team.
Whole-body signs
- Fever.
- Marked lack of energy.
- Feeling generally unwell, weak or ill in a way that is out of proportion to routine recovery.
What to do
Contact the plastic-surgery department or operating surgeon promptly and describe when each change began, whether it is spreading and whether you have fever or feel unwell. Follow the department’s advice about examination, dressings and medication. If the team tells you to attend emergency care outside normal hours, do so; do not wait for the next clinic appointment.
Do not put unapproved creams, antiseptics or antibiotics on the incision, and do not remove closure materials unless your team instructed you to. A wound photograph can help a clinician understand a change when sent through an approved secure channel, but an image cannot exclude a deeper infection.
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Bleeding, drainage and hematoma
Distinguish minor drainage from active bleeding
A small amount of blood-tinged drainage or bruising may be included in your discharge instructions. Bleeding is more concerning when it is heavy, persistent, starts again after stopping, or continues despite the pressure method your team taught you. Cambridge University Hospitals advises seeking help when bleeding continues despite pressure and lists renewed bleeding, increasing pain, heat, throbbing, fever or feeling unwell as reasons to contact a clinician. NHS cosmetic-surgery guidance identifies excessive bleeding and hematoma—blood collecting under the skin—as possible complications, including after liposuction.
Signs that swelling may be a hematoma
A rapidly enlarging, firm or tense swelling, especially with escalating pain or renewed bleeding, needs urgent assessment. Do not attempt to drain, massage or puncture it yourself. Use pressure only exactly as instructed in your discharge paperwork; if that does not control the bleeding, escalate immediately according to the triage table.
Information to give the team
Report the procedure and date, the site, whether the blood is soaking dressings or running, whether the swelling is expanding, and any dizziness, weakness, fever or increasing pain. If bleeding is heavy or you feel faint, use emergency services rather than waiting for a callback.
Blood clots and pulmonary embolism
Venous thromboembolism includes a clot in a deep vein (deep-vein thrombosis, or DVT) and a clot that travels to the lungs (pulmonary embolism, or PE). The American Society of Plastic Surgeons describes venous thromboembolism as a life- or limb-threatening concern in plastic surgery. Its 2023 resource reviews prevention evidence for symptomatic DVT, PE and bleeding complications in hospitalized plastic-surgery patients.
Possible DVT symptoms
A DVT often affects one leg rather than both. Watch for one-sided leg pain or tenderness, swelling or warmth. These signs require prompt medical assessment, even if the operation was performed elsewhere on the body. Do not wait for a routine postoperative visit to mention them.
Possible pulmonary embolism symptoms
Call emergency services immediately for sudden or worsening breathlessness, chest pain, coughing blood, rapid breathing, fainting or collapse. Chest or breathing symptoms together with leg pain or swelling are especially concerning for PE. Tell responders that you recently underwent surgery and list any medicines you take.
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Prevention advice is individual
Follow the walking, leg-movement, hydration and medication instructions supplied for your operation. Wear compression stockings only when your clinician prescribed or recommended them for you. Stockings do not treat a suspected DVT or PE; emergency assessment is required when those symptoms occur.
Severe reactions after anesthesia or other medicines
NHS cosmetic-surgery guidance lists allergic reaction to an anesthetic among general operative risks. Facial or throat swelling, severe breathing difficulty, blue lips, confusion or collapse after anesthesia can signal a life-threatening reaction. Call emergency services rather than attempting to manage these symptoms with leftover medication. If symptoms are less severe but unexpected—such as persistent vomiting, rash or worsening dizziness—use the postoperative contact route promptly and follow the anesthetist’s or surgeon’s instructions.
Questions to settle before leaving the surgical facility
Clear instructions make it easier to act quickly at home. Before discharge, confirm:
- Which amount and color of drainage are expected, and how often a dressing may be changed.
- Exactly how to apply pressure if minor bleeding occurs, and how long to try before calling.
- The temperature or wound changes that require a same-day call.
- The direct daytime and out-of-hours telephone numbers for the surgeon or department.
- Whether you should walk, rest, limit lifting or use a prescribed garment, and for how long.
- Which medicines to take, avoid or hold, including any blood-thinning medicine.
- Where to go if the team cannot be reached and an urgent examination is needed.
Keep the written instructions, medication list and contact numbers where family members or another caregiver can find them. If sedation or anesthesia has impaired your concentration, ask the person accompanying you to listen and repeat the plan.
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Postoperative services can triage faster when you provide a concise, factual account. Have your discharge sheet and medication list available.
- Identify yourself and the operation. Give your name, procedure, date and the body area involved.
- State the change first. For example, say that redness has spread, the wound has opened, bleeding restarted or pain is increasing.
- Give objective details. Mention your temperature if measured, the color and amount of drainage, the size or growth of swelling, and when the change began.
- Describe associated symptoms. Include weakness, fever, breathlessness, chest pain, leg swelling, fainting or feeling generally unwell.
- Ask for a specific next step. Confirm whether you should attend the department, an urgent-care service or an emergency department, and what to do while travelling.
Send a wound photograph only through a secure channel the practice has approved. A photograph cannot rule out a deep infection, hematoma or clot, so do not delay urgent care while trying to obtain one.
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A practical home-monitoring checklist
Use the written plan from your surgeon as the primary checklist. A brief record can help you identify a trend and communicate it accurately.
- Measure temperature with a digital thermometer if your team advised temperature monitoring, and record the time and result.
- Note whether pain, redness, warmth, swelling or drainage is improving, stable or worsening.
- Check whether the dressing is becoming soaked, whether bleeding has restarted and whether the wound edges remain closed.
- Observe both legs for new one-sided pain, swelling or warmth, without massaging a painful area.
- Record new breathlessness, chest discomfort, coughing blood, dizziness, fainting or confusion as emergencies.
- Keep your discharge instructions, emergency number and the surgical team’s out-of-hours contact together.
Monitoring is not a substitute for assessment. A normal temperature does not exclude a local infection, and the absence of pus does not make severe pain or rapidly increasing swelling safe to ignore.
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- Do not wait for a routine appointment if symptoms are worsening or you feel systemically unwell.
- Do not start, stop or share antibiotics, blood thinners or pain medicines unless a clinician who knows your case directs you.
- Do not squeeze pus, open a wound, puncture a swelling or massage a painful swollen leg.
- Do not use compression garments or stockings to self-treat suspected bleeding, infection, DVT or PE; use them only as prescribed.
- Do not assume that bruising or swelling is harmless simply because it is common after surgery; the direction and speed of change matter.
Why complication rates cannot be reduced to one number
Risk varies by operation, patient factors, anesthesia, mobility, wound location and the setting in which care is delivered. Cambridge University Hospitals gives an “about one in 20” infection figure for a specific skin-surgery context; the leaflet’s year is not stated, and that figure should not be generalized to every plastic-surgery procedure. No universal complication-rate statistic applies to all plastic surgery.
The most useful question for an individual patient is therefore not “What is the average rate?” but “What did my surgeon say to expect for this procedure, and what changes require a call?” Ask before discharge how to reach the team, which symptoms require emergency care, how to manage a dressing that becomes wet or bloody, and which medicines or activity limits apply to you.
When uncertainty itself is a reason to call
Recovery does not always follow a neat pattern, and patients may have more than one symptom. If you are unsure whether a change is expected, contact the operating team or local urgent-care service and explain that the symptom is postoperative. Escalate immediately for breathing or chest symptoms, collapse, severe allergic-type swelling, or uncontrolled heavy bleeding. Prompt advice is safer than trying to classify a complication at home.
Short decision examples
A stable bruise and mild soreness that match the discharge sheet can usually be documented and discussed at the planned review. If the same area becomes rapidly more swollen, firm and painful, call the surgical team urgently because the pattern has changed. If a dressing has a small expected stain, follow the instructed dressing plan; if blood continues through the dressing despite the prescribed pressure, seek urgent help. Redness with increasing warmth, pus or fever requires prompt contact even when the incision itself looks small.
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Leg symptoms need separate attention. New swelling, warmth or tenderness in one leg should not be attributed automatically to inactivity after surgery. If those symptoms occur with breathlessness, chest pain, coughing blood, fainting or collapse, bypass the clinic and call emergency services.
Frequently Asked Questions
How do I know whether swelling is normal after plastic surgery?
Some swelling is expected, but your discharge instructions control. Swelling that is rapidly increasing, tense, firm, newly painful, associated with renewed bleeding, spreading redness, fever or feeling unwell needs urgent contact with the surgical team.
What are the warning signs of infection after cosmetic surgery?
Increasing or spreading redness, warmth, swelling or pain; pus or green or yellow drainage; wound separation; fever; marked lack of energy; or feeling generally unwell should prompt a same-day call to the operating team or plastic-surgery department.
When should I call my surgeon about bleeding?
Call if bleeding is persistent, heavy, starts again after stopping, soaks dressings or continues despite the pressure method you were taught. Heavy uncontrolled bleeding or bleeding with faintness requires emergency services.
What symptoms mean I need the emergency department after surgery?
Call emergency services for severe breathing difficulty, chest pain, coughing blood, fainting, collapse, severe facial or throat swelling, blue lips, confusion, or heavy bleeding that cannot be controlled. One-sided leg swelling or pain with breathing symptoms is also an emergency.
Can I wear compression stockings if I think I have a blood clot?
No. Use compression stockings only when your clinician prescribed or recommended them. They do not treat suspected DVT or pulmonary embolism; obtain urgent medical assessment instead.
Should I send my surgeon a photograph of the wound?
Use a photograph only through a secure channel approved by the practice, and provide the symptom history as well. A photograph cannot rule out deep infection, hematoma or a clot, so do not delay urgent care while taking or sending one.
What should I do if I cannot reach my surgeon?
Follow the out-of-hours instructions on your discharge paperwork. Contact the plastic-surgery department or local urgent-care service for worsening wound symptoms, and call emergency services immediately for breathing or chest symptoms, collapse or uncontrolled heavy bleeding.
The Bottom Line
Mild soreness, bruising, swelling and limited drainage may be expected, but worsening, spreading or systemic symptoms are not reassuring. Call the operating team promptly for infection, wound, swelling or bleeding changes. Call emergency services now for severe breathing trouble, chest pain, coughing blood, collapse, severe allergic-type swelling or uncontrolled heavy bleeding.
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