"When can I go home?" It is one of the first questions of the consultation, often before the price. In Lima that makes complete sense: a good share of the people who have surgery here come from another region or another country, with their days counted and the flight already picked out.
The short answer is a number of days. The useful answer is something else.
The aeroplane is not the main problem
What really weighs is not flying: it is being far away. The complications of surgery do not turn up evenly over the course of a month. They cluster in the first few days: bleeding that forms a haematoma, a wound that opens, an infection starting, a seroma that needs draining.
Almost all of that is resolved well if it is seen in time, and almost none of it is resolved well over WhatsApp from two thousand kilometres away. The waiting time is not set by when your body can cope with a flight, but by how many days it is worth being close.
The risk is not the aeroplane. It is being a two-hour flight away from the person who operated on you on the day something goes wrong.
What the flight does bring: thrombosis
There is one risk the journey itself adds, and it is worth naming: venous thrombosis. A clot forming in a deep vein of the leg which, if it breaks loose, can reach the lung.
Three things encourage it, and a flight after surgery brings all three together:
- Recent surgery. Being operated on activates clotting; that is how the body closes what was opened.
- Hours sitting still. Blood leaves the legs because the muscles push it up as you walk. Sitting still, it does not.
- Dehydration. Cabin air is very dry and hardly anyone drinks enough on a flight.
It is uncommon, but it is the serious complication that simple measures prevent best, and the one that is least forgiven for not having been prevented.
Altitude, which in Peru changes the question
A pressurised cabin is roughly equivalent to being at two thousand metres, and that already lowers the oxygen available. But here the real question is usually not the flight: it is where you are flying to.
Going back to Cusco, Juliaca, Puno or Huancayo is not the same as going back to Trujillo or Piura. These are places well above three thousand metres, where there is permanently less oxygen, the body responds by thickening the blood, and any walk takes more out of you.
If your city is at altitude, say so at the first consultation, not when you ask to be discharged. It changes the timings and sometimes it changes the plan.
How long to wait, by procedure
These are indicative ranges for a healthy person and surgery without incident. The number that counts is the one you are given, in writing, for your case:
- Minor procedures under local anaesthetic — skin lesions, buccal fat removal, a mole excised: usually a few days.
- Eyelids, ears, nose. About a week, and with the nose congestion matters too: flying with a very swollen airway is uncomfortable and can bleed.
- Breast surgery without liposuction — augmentation, lift, reduction: one to two weeks, depending on the technique and the drains.
- Abdominoplasty, liposculpture, body lift, mummy makeover. The highest thrombosis risk and the longest wait: two to three weeks at least, sometimes more.
- Hand surgery. The flight itself bothers little, but keeping the hand elevated and attending the check-ups still decide.
In every case the type of surgery counts for more than how you feel. By day five almost everyone feels fine; that does not mean the risk has passed.
If you are going to fly, do it like this
- Get up every hour and walk as much as you are allowed. If you cannot, flex your ankles up and down: that is what pumps.
- Drink water throughout the flight. No alcohol, which dehydrates and also sits differently with your medication.
- Compression stockings, if you were told to use them. On before you leave home, not at the airport.
- Ask for an aisle seat. It is the difference between getting up six times and not getting up at all so as not to disturb anyone.
- Do not sleep through it on pills. Four hours motionless is exactly what you do not want.
- Take with you the operative report, your list of medicines and the clinic's telephone number. If something happens, whoever sees you there needs to know what was done.
- Ask your airline. Some require a fitness-to-fly certificate after recent surgery, and it is better to know before you reach the desk.
Do not have surgery the day before you fly home
It looks obvious written down, and it is still the most attempted plan: arrive Thursday, have surgery Friday, fly home Sunday with the family. It is the plan that ends badly most often, and not through bad luck.
If you are coming from outside, what works is the other way round: arrive with time to spare, have the surgery early in your stay and keep the following days for the check-ups. The first orientation can be arranged remotely, but the in-person assessment is not skipped: nobody is operated on without having been examined, and that takes a day too.
If the calendar does not allow for that, the calendar is telling you something. Postponing surgery by two months costs nothing; flying back in an emergency does.
What is up to you
Say all of it when you book. Where you are coming from, how many days you can stay, what altitude you live at, whether you are travelling back alone or with someone, whether you have to be at work on Monday. With that, surgery can be arranged in as few trips as possible; without it, surgery gets arranged that does not fit your life.
And one more thing: buy the return ticket once you have the confirmed date and the waiting time in writing, not before. A ticket bought too early is the worst possible reason to be discharged sooner.