Post-Operative Care Guidelines: The Complete Version

By Dr. Rushapol Sdawat, MD — Thai Board-certified Plastic and Reconstructive Surgeon, Medical Licence No. 17689
Last reviewed: 28 AUG 2026

You have just been handed a discharge folder, a bag of medications, and a smiling wave — and somewhere between the hospital lobby and your hotel room it dawns on you that you are now the person in charge of your own recovery. In Bangkok, thousands of kilometres from your GP, that realisation lands harder than it does at home.

This page is the reference I wish every patient read before surgery rather than after. It is general — your procedure-specific instructions from your surgeon always override anything written here — but the fundamentals of healing are remarkably consistent whether your incision is on your eyelid, your breast or your abdomen. I have practised plastic and reconstructive surgery for around twenty-six years, and the patients who recover smoothly are rarely the luckiest ones. They are the ones who treat aftercare as a daily discipline for six weeks, not a set of suggestions for the first three days.

Read it all once now. Then come back to the section you need at 10pm when you cannot remember what the nurse said about showering.

How do I look after my wounds and dressings?

The core principle: your job is protection, not intervention. A surgical wound wants to be clean, dry, supported, and left alone. Do not lift dressings "to check"; every peek disturbs the fragile new surface and introduces the bacteria on your fingers. Dressings are changed on the schedule we give you — by us in clinic where possible, or by you with washed hands, prepared supplies laid out first, and the old dressing off for the shortest time possible.

Some seepage of thin pink fluid onto a dressing in the first days is normal; a dressing soaked through, frank blood, or anything with an offensive smell is not. Do not apply antiseptic creams, vitamin E oil, or anything from a pharmacy shelf to a fresh wound unless we have told you to — well-meaning ointments keep wounds soggy, and soggy wounds break down. Steri-strips and surgical tapes stay on until they lift off or we remove them; they are doing quiet work holding tension off the scar.

When can I shower, and what are the rules by closure type?

"When can I shower?" is the most-asked question in any recovery ward, and the answer genuinely depends on how you were closed. As a general guide:

Closure typeTypically may showerThe rulesSutured wound with waterproof dressingOften 24–48 hours after surgeryBrief, lukewarm shower; water may run over the dressing; no soaking, no scrubbing; pat drySutured or stapled wound, standard dressingWhen your surgeon confirms — commonly around 48 hours, sometimes laterKeep the wound itself out of direct spray; dressing changed after if dampWound with drains in placeUsually sponge-bathe only until drains are out, unless told otherwiseExit sites stay dry; never submergeTissue glue or dissolving sutures with sealed skinOften 24–48 hoursWater over is fine; do not pick at glue as it flakes

Two rules have no exceptions. First: no baths, pools, spas or the sea for at least three to four weeks, and longer if any area is still open — submerging a healing wound in standing water (and especially a Thai hotel pool or the ocean) is how infections are born. Second: lukewarm water and short showers early on, because fresh surgical patients faint in hot bathrooms. Sit on a stool if you feel weak, and have someone within calling distance the first few times.

How do I manage my medications without missing doses?

Your discharge bag typically holds some combination of simple analgesia, a stronger opioid for breakthrough pain, sometimes an antibiotic course, sometimes an anti-nausea tablet, and sometimes a blood-thinning injection or tablet if your VTE risk warranted it. The discipline that matters:

• Take pain relief by the clock for the first days, not "when it gets bad". Chasing established pain takes twice the medication for half the relief. Stay ahead of it, then step down.

• Finish any antibiotic course completely, even if the wound looks perfect on day three.

• Never double a missed dose. Take it when remembered unless the next dose is close, in which case skip it.

• Set phone alarms and use the checklist we give you. Jet-lag, anaesthetic fog and hotel time-zones destroy medication memory. Alarms do not get jet-lagged.

• No alcohol while on opioids or antibiotics, and ideally none for the first two weeks regardless — it thins the blood, dehydrates you, and worsens swelling. No smoking or vaping nicotine at all; nicotine strangles the small blood vessels your skin flaps are depending on, and it is a genuine cause of wound necrosis.

Declare every regular medicine and supplement to us before surgery — fish oil, ginkgo, and various herbal products increase bleeding, and some Australian patients arrive taking three of them.

How should I sleep after each procedure?

Position is treatment. After facial surgery, rhinoplasty or blepharoplasty: head elevated on two or three pillows (or a wedge) for the first one to two weeks, sleeping on your back — elevation visibly reduces swelling and bruising. After breast surgery: on your back, slightly elevated, for several weeks; no lying on your front until we clear it. After abdominoplasty: the beach chair position — head and shoulders raised, pillows under the knees, hips flexed — so there is no tension on your abdominal closure; most patients need this for one to two weeks. Side-sleepers find the first fortnight genuinely hard, and it is worth practising back-sleeping before you travel. A travel neck pillow, a firm wedge, and the hotel's spare pillows are the cheapest recovery equipment you will buy.

What is the activity ladder?

Recovery is a ladder climbed one rung at a time, and both extremes cause trouble — the patient who lies motionless for a week risks clots and chest infections; the patient who walks a night market on day four risks bleeding and swelling. The general sequence: gentle walking around your room from the first day, several short walks daily thereafter, because walking is your main protection against venous thromboembolism. Light daily activity and short outings build over weeks one to two. No lifting anything heavier than a few kilograms — think a full kettle — for the first two weeks, and nothing genuinely heavy (groceries, toddlers, luggage) for four to six weeks after body procedures. No driving while on opioids or while pain would stop you doing an emergency stop. Exercise that raises your heart rate returns around week three to four with your surgeon's agreement; whatever loads the operated area directly comes last, often six weeks or beyond. When in doubt, the rule is: if it hurts, swells, or raises your pulse hard in the first fortnight, it is too early.

What should I eat and drink while healing?

Healing is construction work, and protein is the building material. Appetite is often poor in the first week — eat anyway, in small frequent amounts, and make protein the priority: eggs, fish, chicken, tofu, dairy, legumes, or a protein shake when a meal will not go down. As a practical rule I give patients: a palm-sized serve of protein at every meal, every day, for six weeks. Add fruit and vegetables for vitamin C and micronutrients, which wound healing consumes at an increased rate.

Hydration matters more in Bangkok than at home — heat, air-conditioning and anaesthetic recovery all dry you out. Drink steadily through the day (bottled water in Thailand); pale-yellow urine is your gauge. Restrict salt somewhat while swelling is at its peak, and be gentle with your stomach for a few days: bland food first, then normal Thai food when it clearly agrees with you. There is no supplement that accelerates healing beyond fixing a deficiency — save your money for the compression garment.

Why does bowel care matter so much on opioids?

This section is unglamorous and genuinely important. Opioid painkillers constipate almost everyone, anaesthesia slows the gut, and travel plus dehydration finishes the job. For most operations constipation is miserable; after an abdominoplasty with muscle repair, it is actually dangerous, because straining hard against a blocked bowel loads the very muscle closure we have just stitched, spikes your pain, and can contribute to bleeding or disruption of the repair.

So we treat bowels prophylactically, not reactively: start a gentle laxative or stool softener from day one of opioid use — do not wait until day four's misery; drink well; walk; add fibre as your appetite returns; and come off opioids onto simple analgesia as soon as pain allows, which fixes the cause. If you have not opened your bowels by day three, tell us — it is a two-minute fix early and an emergency-department visit late. Nobody has ever regretted raising this too soon.

When do stitches come out, and what are spitting sutures?

Many modern closures use dissolving sutures under the skin and need no removal at all. Where removable sutures are used: on the face, typically five to seven days; eyelids often earlier; body incisions commonly ten to fourteen days. If you fly home before removal day, we arrange it with a GP or practice nurse at home and put it in writing in your discharge summary.

Now, spitting sutures — the phenomenon that frightens patients most because nobody warned them. Weeks or even months after surgery, a small red pimple-like spot appears on a well-healed incision, sometimes with a tiny whitish thread emerging. This is a buried dissolving stitch your body has decided to expel rather than absorb. It is common, it is usually trivial, and the management is simple: keep it clean, do not dig at it with tweezers, and have a doctor or nurse lift the fragment free if it presents itself. It only needs escalation if the area becomes increasingly red, hot, swollen or discharging — occasionally a spitting suture becomes a genuinely infected one.

What follow-up schedule should I expect?

While you are in Bangkok, I typically review patients the day after surgery, again around days five to seven for wound checks and drain decisions, and once more for a fitness-to-fly assessment before departure — more often if anything needs watching. After you fly, follow-up continues by scheduled photo and video review at roughly two weeks, six weeks, three months and beyond, and you can contact my team between those points.

I will be candid about the structural weakness here, because it is real: remote follow-up is inferior to hands-on follow-up. I cannot palpate a seroma or smell a wound through a phone. This is the honest cost of surgery overseas, and it is why I insist patients identify — before travelling — a GP at home willing to see them post-operatively, and why every patient leaves with a written surgical summary that names the procedure, materials used and dates. Some Australian and New Zealand patients also face doctors reluctant to manage overseas complications; a documented handover reduces that friction but does not always erase it. If you cannot arrange any home follow-up at all, that is, frankly, an argument for having surgery at home instead.

When to seek care

Know the difference between a question, a same-day review, and an emergency.

Contact the team (same-day review) — in Bangkok or from home: fever of 38°C or higher; spreading redness or heat around a wound; discharge that is thick, increasing or smells offensive; a wound edge opening; a swelling clearly larger than yesterday, especially one-sided; pain that escalates instead of easing; a drain that blocks, falls out, or turns frankly bloody; no bowel motion by day three; persistent vomiting that stops you keeping medication down.

Emergency — go, do not email: sudden breathlessness, chest pain, coughing blood, fainting, or a swollen painful calf (usually one-sided) — these raise the question of a clot on the lung or in the leg and are ambulance-grade whether you are in a Bangkok hotel or back in Ballarat. A rapidly expanding, tight, painful swelling in the first day or two after surgery may be a haematoma needing return to theatre. A wound turning dusky, purple-black or breaking open widely needs hospital review at once. In Bangkok, my team will direct you straight to Intrarat Hospital at any hour. In transit, tell cabin crew immediately. At home, go to your nearest emergency department, say "recent surgery overseas and a long-haul flight" at triage, and hand over your surgical summary — Medicare and the public system will treat you even though your surgery was overseas, so never let cost anxiety delay the presentation. Loop us in afterwards; we want to know.

The habits that carry recovery

Six weeks of small disciplines beat any single heroic effort: dressings left alone, medications by alarm, walks taken, protein eaten, water drunk, bowels managed early, garment worn, sun avoided, alcohol and nicotine refused, and every niggling worry reported early rather than Googled late. None of this removes surgical risk — haematoma, seroma, infection, wound breakdown, clots and disappointing scars can happen to careful patients of careful surgeons. But aftercare shifts the odds meaningfully in your favour, and it is the one part of this whole journey that is entirely in your hands.

Dr. Rushapol Sdawat (known to international patients as Dr. Dominic) is a Thai Board-certified plastic and reconstructive surgeon practising at Intrarat Hospital, Bangkok, Medical Licence No. 17689. He holds Thai Board certification in General Surgery (Phramongkutklao Hospital) and in Plastic and Reconstructive Surgery (Ramathibodi Hospital, Mahidol University), has been a member of ISAPS since 2008 and is an international member of the American Society of Plastic Surgeons. Dr. Rushapol holds Thai specialist certification; he is not registered with Ahpra and does not hold Australian or New Zealand specialist registration. His registration can be verified on the Medical Council of Thailand register at checkmd.tmc.or.th.

This article is provided for general information and education. It is not medical advice and cannot substitute for individual assessment by a qualified practitioner who knows your history. Surgery carries risk, including risk of serious complications and of outcomes that do not meet expectations. Results vary between patients.

Hotel, Recovery Retreat or Hospital Ward? Where to Recover in Bangkok

Where you sleep after surgery is a clinical decision, not a travel decision

Patients arrive with the hotel already booked. It is usually the last thing they think about and the first thing that goes wrong.

The reason is simple. You are choosing accommodation using the criteria you would use for a holiday: location, price, photographs, breakfast included. The criteria that matter for the ten days after an operation are entirely different. How far are you from the surgeon who operated on you? Is there someone with you at three in the morning? Can you get to a bathroom without bending? Would anyone in the building recognise a haematoma if they saw one?

There are three realistic options in Bangkok. Each is right for some patients and wrong for others. Here is how to tell which one you are.

First, the part of Thai law that decides this for you

Under the Sanatorium Act B.E. 2541 (1998), every medical facility in Thailand falls into one of two legal classes: those permitted to keep patients overnight, and those that are not. Hospitals sit in the first class and are sized as small (30 beds or fewer), medium (31 to 90) or large (91 or more). Clinics sit in the second class and may not admit you overnight at all.

That distinction is not administrative. The Ministry of Public Health's official inspection form for a medical clinic operating a minor operating room defines that room explicitly as one where procedures are performed using local anaesthesia only. IV sedation and general anaesthesia are outside that classification. Meanwhile, the Department of Health Service Support's standards for facilities that do admit overnight require a standard operating table and lights, a medical-standard general anaesthesia machine and a piped medical gas system, an intensive care ward with cardiac monitoring and mechanical ventilators, a diagnostic laboratory, and resuscitation equipment distributed across the emergency department, operating rooms and critical care in defined ratios to bed capacity.

So when you ask "can I stay the night at the clinic?", you are really asking which class of facility you have chosen. And if you are having anything under general anaesthesia, that question should have been answered before you paid a deposit.

One further point, reported in Thai health media in 2017: the Department of Health Service Support has publicly prohibited clinics from sending post-operative patients to recover in mansions and condominiums. That is the practical corollary of the no-overnight rule. If a provider proposes that arrangement to you, they are proposing something Thai regulators have specifically objected to.

Option one: the hospital ward

Right for: general anaesthetic, abdominoplasty, large-volume liposuction, combined procedures, anyone with a cardiac, respiratory, clotting or diabetic history, anyone travelling alone.

For the first night or two after significant surgery, nothing else is equivalent, because nothing else has an anaesthetist down the corridor. The complications that kill people after cosmetic surgery, being airway problems, bleeding and pulmonary embolism, declare themselves early and move fast. Proximity is the whole treatment.

The honest downside: cost, noise, and the fact that hospital rooms are not restful. Patients who have never been admitted before are often surprised by how little they sleep. That is a fair trade for the first night. It is a poor trade for the eighth.

Option two: the recovery retreat or recovery service

Right for: days three to ten, facial surgery, patients travelling without a support person, patients who want nursing without being in a ward.

This is the fastest-growing option in Bangkok and the one most worth scrutinising, because "recovery retreat" is a marketing term, not a licensed category.

What the better services actually provide is visible in their own published inclusions. One Bangkok operator, Beauty Butler Thailand, lists private recovery rooms; daily nurse visits covering wounds, medication and vital signs; trained caretakers available on 6, 12 or 24-hour shifts; transport for airport pick-up, hospital drop-offs and pharmacy runs; a dedicated client manager during the stay; and a follow-up video call with the surgeon. Another, Amani Thailand, publishes packages including four-star hotel accommodation with breakfast, a dedicated medical liaison and translator, a 24/7 English-speaking companion during the hospital stay, post-surgical nursing at the recovery accommodation after discharge, medical supplies, transport, a fit-to-fly letter and airport wheelchair assistance. Its advertised prices at the time of writing run from about 408,000 baht for a facial package to about 620,000 baht for a larger body package.

I list those because they are the specifics you should be comparing, not because I am endorsing either operator. Both are commercial businesses describing their own products.

The questions that separate a real service from a serviced apartment with a logo:

• Is the person doing the daily checks a registered nurse? Ask for the licence number, not the job title.

• Who do they escalate to at 2am, and how far away is that person?

• Is my surgeon contactable, and does the retreat have a direct line to the operating facility, or only to a booking agent?

• What is the arrangement if I need readmission? Who transports me, and who pays?

• Is the nursing included, or billed per shift once the package hours run out?

A service that answers all five in writing is worth what it costs. One that answers in adjectives is a hotel.

One caution on the extras. Manual lymphatic drainage massage is sold almost universally by Bangkok recovery services. The best-known comparative study, of 20 women, 10 per group, published in The American Journal of Cosmetic Surgery, concluded that manual lymphatic drainage after abdominoplasty and core liposuction reduced oedema more than compression garments alone, but not by a statistically significant amount. A 2025 review in Lymphatics notes the physiological mechanisms are still under investigation. It is pleasant, it is probably harmless in trained hands, and it is not a clinical necessity. Price it accordingly.

Option three: a hotel or serviced apartment near the hospital

Right for: the later half of the stay; minor procedures without general anaesthesia; patients travelling with a capable, briefed support person.

This is the cheapest and, for the right patient at the right stage, entirely reasonable. Rates near the major private hospitals in the Sukhumvit area are modest by Australian standards. Hotels listed as near Bumrungrad International Hospital start from around USD 37 per night, with the well-reviewed properties within half a mile clustering roughly USD 50 to 100; short-term serviced apartment listings in the same area sit around 600 to 1,200 baht per night. Those are advertised rates observed on 27 August 2026 for that one hospital precinct, not a rate survey. Check the current figure and the current exchange rate yourself before you build a budget on them.

What to check that has nothing to do with the star rating: a lift; a walk-in shower rather than a step-over bath; a bed you can raise, or enough pillows to sleep at 45 degrees; a kettle and a fridge for medication; and genuine walking distance to the hospital, verified on a map rather than trusted from the listing. "Ten minutes from Bumrungrad" in a brochure and ten minutes on foot with drains in are not the same ten minutes.

What a hotel cannot do: notice. Nobody at the front desk is monitoring your calf for swelling or your abdomen for firmness. If you are going to be in a hotel in the first 72 hours after a general anaesthetic, someone competent has to be in the room with you, which brings us to the part most patients get wrong.

The support person is not optional, and "my partner is coming" is not a plan

The Australian Society of Plastic Surgeons put this plainly in its January 2024 cosmetic tourism statement: "Immediate post-surgery care often includes rest and access to medical assistance, and international plane travel and residing in resort-style accommodation does not provide this." The same statement notes that ASPS does not recommend combining surgery with a holiday. You do not have to accept every position a professional body takes on overseas surgery to accept that specific point, which is simply correct.

A support person needs to be briefed, not just present. Before you fly, they should know what your drains are supposed to look like, what your medication schedule is, what a wound infection looks like on day four, what number to call, and, critically, that their job is to call it rather than wait until morning to avoid making a fuss.

If nobody is coming with you, that is a strong argument for the hospital ward followed by a staffed recovery service, and a strong argument against the cheapest hotel with the best photographs.

What happens when the accommodation choice goes wrong

It shows up back home. A 2026 retrospective review from Westmead Hospital in New South Wales, published in the ANZ Journal of Surgery, looked at 24 patients presenting to one Australian public hospital after overseas cosmetic surgery. Wound dehiscence occurred in 45.8%, infection in 41.7% and seroma in 20.8%; the median time from surgery to presentation was 3.8 weeks, and 54.2% required surgery. That study does not name the destination countries, so it should not be read as a statement about Thailand specifically.

An older Gold Coast University Hospital study in Eplasty (2015) does name it: 12 patients in one financial year, all of whom had their procedures in Thailand, at a total cost to the Australian public hospital of AUD 151,172.52, averaging 12,597.71 per patient. It is now eleven years old, and the Thai private sector has changed a great deal since, but the pattern it describes, of problems surfacing weeks later, at home, at someone else's expense, has not.

Wound dehiscence and infection at those rates are, in large part, aftercare problems. Aftercare happens where you sleep.

The arrangement I would suggest you price first

Hospital for the first night or two, depending on the procedure. A staffed recovery service or a well-chosen apartment with a briefed companion for the middle stretch. And a genuine contingency, in money and leave rather than optimism, for the days you did not plan to be here.

Australia's own travel advisory is blunt about the alternative: "Standards at discount and uncertified medical establishments can be poor." That sentence is about clinics. It applies just as accurately to the place you spend the fortnight afterwards.

By Dr. Rushapol Sdawat, MD — Thai Board-certified Plastic and Reconstructive Surgeon, Medical Licence No. 17689. You can verify my registration and specialty directly with the Medical Council of Thailand at tmc.or.th.
Last reviewed: 27 August 2026

This article is provided for general information and education. It is not medical advice and cannot substitute for individual assessment by a qualified practitioner who knows your history. Surgery carries risk, including risk of serious complications and of outcomes that do not meet expectations. Results vary between patients.

Sources: Sanatorium Act B.E. 2541 (1998); Ministry of Public Health clinic inspection standard for minor operating rooms; Department of Health Service Support standards for overnight-admitting facilities; Hfocus (2017); Beauty Butler Thailand; Amani Thailand; Expedia and RentHub listings for the Bumrungrad precinct (27 August 2026); Maningas et al., The American Journal of Cosmetic Surgery; Phondge et al., Lymphatics (2025); Australian Society of Plastic Surgeons cosmetic tourism statement (January 2024); Res et al., ANZ Journal of Surgery (30 January 2026); Livingston et al., Eplasty (2015); Smartraveller, Thailand.