In short
- It is not minor surgery. In the series of 199 patients having gluteal and lumbar removal, the mean duration was 270 minutes and there was a mean fall in haemoglobin of 3.3 g/dl.
- 🔑 The most frequent complication arrives late. A seroma appeared on average at 31 days, when most people already feel recovered. Knowing that saves the fright and the hasty conclusions.
- Drains are usual. In the large series, 29.1% of patients needed them.
- For the face, the hospital stay is short. In a series of 160 patients the mean stay was 32 hours, with a range of 24 to 48.
- 🔑 In Spain a sick note is issued by a doctor in the public health service, after an examination — not by the surgeon who operates on you, even though they know your case best.
- What the surgeon does provide is the report. It is the document used to support the case with whoever does sign the note.
- The length is not a fixed figure. It depends on the extent of the surgery, on how the wound heals and, above all, on what you do for a living.
Almost everything written on this subject comes from Colombia, and there is one piece that simply does not appear there: how sick leave works in Spain. Anyone having surgery here needs to know who signs the note, what part the surgeon’s report plays and what the length depends on.
This page covers both: what the recovery is really like — including the complication that arrives once you thought you were fine — and the administrative side of sick leave.
The surgery is in the guide to biopolymer removal and, by area, in buttocks and face and lips.
What the recovery is really like
The first few days
What governs at the start is the wound and your posture. This is surgery in which tissue has been removed and a wide area closed, so the first days revolve around protecting that closure.
Two published references to give a sense of what is being talked about:
- In the series of 199 patients having gluteal and lumbar removal, the mean duration of the procedure was 270 minutes — four and a half hours — with a mean fall in haemoglobin of 3.3 g/dl. It is a long operation with appreciable blood loss.
- In facial surgery, the series of 160 patients with deep-plane facelift and reconstruction recorded a mean hospital stay of 32 hours, with a range of 24 to 48.
Our protocol, with the timings
This is what we do here for gluteal and lumbar removal. These are the practice’s own timings, not a sector average.
| How long | |
|---|---|
| Hospital stay | 1 day |
| Position: face down, on your side or standing | 2 weeks |
| Drains | 15 days |
| Compression garment | 1 month |
| Prophylactic antibiotic | 5 days |
🚨 During those two weeks you cannot sit down or sleep on your back. It is the restriction that governs all the others and the one people most underestimate when organising themselves. It is not a comfort recommendation: the operated area is the one that bears your weight when you sit, and resting it on a wide resection with freshly placed drains is what opens sutures and encourages a seroma.
What that means in practice, which is what nobody tells you until you are at home: you eat standing up or lying face down, you sleep face down or on your side, and you do not drive — driving means sitting. Long journeys, including the trip home if you have come from elsewhere, have to be planned lying down. If you live alone, this is the part of the recovery when it is worth having someone nearby.
The drains come out at fifteen days and are worn at home, not in hospital: you are shown how to measure what comes out and what to note down before discharge. The compression garment stays on for a month, and it is what holds the result of the lift while the tissue adheres. The antibiotic is five days and it is prophylactic — to prevent, not because there is an infection: you finish the whole course even if you feel fine.
The first few weeks
This is where most people start to feel well, and where it is worth not getting complacent. The complications described in the series are above all wound-related: dehiscence — the wound partially opening — in 21.1% of the large series, and tissue necrosis in 3.5%.
That the complications are wound-related and not material-related has a practical consequence: close follow-up in the first few weeks is not a formality. It is where what can be resolved in time gets picked up.
The seroma window
This is the part almost nobody warns about and the one that causes most distress.
In the series of 35 patients with mild to moderate involvement, the most frequent complication was seroma — a collection of fluid under the skin — present in 40% of cases, and its mean time to appearance was 31 days.
A month. That is: it appears once you have gone back to almost normal life, when the wound looks good and when you have started to think this is behind you. And then the area swells, feels soft or you can feel fluid.
What to know so as neither to panic nor to be complacent:
- It is frequent, and not a sign that something was done badly.
- In that series, the complications described did not require further procedures. They are managed with drainage, aspiration or compression, depending on the case.
- But it has to be looked at. A seroma left to run can become infected or delay healing.
- In that same series there were no cases of flap necrosis or haematoma, which helps put the seroma in its place: it is the most frequent thing, and also the most manageable.
The pain
This is wide-resection surgery, averaging four and a half hours in the gluteal case, on an area that bears weight when you sit: it is not comparable to a day-case procedure or to a filler. With that in front of you, the honest answer to “does it hurt a lot?” is that the pain is usually tolerable. Not painless — there is a large wound and drains — but manageable with analgesia, and it is not what patients find hardest about this operation. What they find hardest is the two weeks of not being able to sit.
The pain relief is individualised. There is no single prescription because it depends on the extent of the surgery, on what you usually take and on how you respond in the first few days; you leave hospital with the name, dose and timing written down. What is common to everyone: the pain relief is taken to a schedule during the first few days, not on demand. Waiting until it hurts before taking it is what turns tolerable pain into pain that is not.
⚠️ Pain that increases rather than decreasing, that localises to one point or that comes with fever or redness is not post-operative pain: that has to be reported, not endured with more painkillers.
Sick leave in Spain
This is the part Spanish-language content on biopolymers does not cover, because almost all of it comes from a different health system.
Who signs the note
It is worth being clear about before having surgery, because it surprises a lot of people: a sick note is issued by the doctor in the public health service who examines you, and that holds whatever the cause.
It is in the rules governing the management of temporary incapacity in Spain: a declaration of sickness absence is made in the medical note issued by the public health service doctor who has examined the worker, and every note requires a prior examination that allows incapacity for the usual work to be determined objectively. The only exception provided for is an industrial accident or occupational disease in companies affiliated to a mutual insurer, which is not the case here.
Put plainly: your surgeon does not sign your sick note, however well they know your case and however private the surgery is.
What the surgeon does provide
The report. And there it is decisive: the document setting out what has been done to you, with what extent and what limitations you have, is what you take to the consultation where the note is issued.
In practice, that means two useful things:
- Ask for the surgical report and the reports from your follow-up appointments, not just the discharge summary.
- Make sure the report describes the functional limitations, not just the diagnosis. “Cannot remain seated for more than X” says more, for what is going to be decided, than the name of the technique.
What the length depends on
On three things, and none of them is a number that can be given in advance on a website:
- The extent of the surgery. A localised removal is not the same as a wide resection with flaps.
- How the wound heals. A seroma at a month or a dehiscence changes the timetable.
- What you do for a living. An operated area that bears weight when you sit affects someone who works standing up, someone who drives and someone who spends eight hours seated in very different ways.
The range we work with
A month off is the reference we work with for this surgery.
Office work can go back sooner, at around two weeks, and there is one condition that is not administrative but physical: when you can start sitting down, and provided the wound is healing well. The two weeks do not come from the working calendar: they come from the fact that it is exactly when the restriction on sitting is lifted. If at two weeks the wound is not doing well, there is no going back at two weeks.
And the other half has to be said: going back to the office at two weeks means sitting for eight hours at a stretch, which is exactly what the operated area tolerates worst. Anyone who can alternate with working from home, get up regularly or work standing for part of the day will cope better. Jobs on your feet, involving physical effort or long car journeys go to a month, not two weeks.
Book an appointment
You can book your own appointment. Pick the day and time from the free slots in the diary, in a panel that opens right here, without leaving this page.
Frequently asked questions
How long will I be off work?
It depends on the extent of the surgery, on how the wound heals and on your job. There is no single figure, and be wary of anyone who gives you one without having seen your case or knowing what you do.
Does the surgeon who operates on me sign my sick note?
No. In Spain a sick note is issued by a doctor in the public health service after examining you. What the surgeon provides is the report used to support the case.
A soft lump has appeared at a month — is that normal?
It may be a seroma, which is the most frequent complication of this surgery and which appears at exactly that point — at 31 days on average in the published series. It is not a sign that something was done badly, but it has to be looked at.
Will I need drains?
It is usual. In the series of 199 patients, 29.1% needed them.
When can I sit normally?
It is one of the specific restrictions of gluteal recovery, and it depends on the approach and on the closure. It is one of the instructions given in writing on discharge.
When can I exercise?
Once the wound has consolidated and there are no active complications. As a guide to the calendar, it is worth bearing in mind that the seroma window arrives around the first month.
When will I see the final shape?
Not while there is swelling or a seroma. Judging the contour before the recovery is complete makes no sense. What it is reasonable to expect is in results to expect.
And the scar?
It evolves over months and has a page of its own: scars after removal. The general approach to improving them is in scar improvement and the post-surgical protocol in the scar protocol.
Will I need a transfusion?
In the series of 199 patients the mean fall in haemoglobin was 3.3 g/dl, which gives an idea that blood loss is appreciable. It is one of the reasons the pre-operative and post-operative checks include blood tests.
Sources
- Osorio E, Ramírez B, Herrera O, Suarez C, Ciro C, Varela A. Three-flap Technique: Comprehensive Approach for Biopolymer Removal in the Gluteal and Lumbar Regions. Plast Reconstr Surg Glob Open. 2026;14:e7870. A retrospective cohort of 199 patients; mean surgical duration of 270 minutes and a mean fall in haemoglobin of 3.3 g/dl; complications: need for a drain 29.1%, dehiscence 21.1% and tissue necrosis 3.5%. https://pubmed.ncbi.nlm.nih.gov/42495057/
- Eusse Llanos JC, Posada López S. Paramedian open approach for gluteal biopolymers removal: a case series of 35 patients. JPRAS Open. 2025;45. A series of 35 patients with mild to moderate involvement; the most frequent complication was seroma (40%), with a mean time to formation of 31 days, followed by wound dehiscence and infection; there were no cases of flap necrosis or haematoma; 42.85% had no complication at all and the complications described did not require further procedures. https://pubmed.ncbi.nlm.nih.gov/40837208/
- Ghoraba S, Loucas M, Loucas R. Management of Permanent Filler Complications Using Deep-Plane Facelift and Temporoparietal Fascial Flap Reconstruction: A Retrospective Study. Aesthet Surg J Open Forum. 2025;7:ojaf106. A retrospective study of 160 patients; mean hospital stay of 32 hours (range 24-48); overall complication rate of 22%, with transient swelling and bruising in 15%, minor infections in 4% and haematomas in 3%. https://pubmed.ncbi.nlm.nih.gov/41376670/
- Spain. Royal Decree 625/2014 of 18 July, regulating certain aspects of the management and control of temporary incapacity during the first three hundred and sixty-five days. BOE no. 176, 21 July 2014. Article 2: a declaration of sickness absence, whatever its cause, is made in the medical note issued by the public health service doctor who has examined the worker; every note requires a prior examination allowing temporary incapacity for the usual work to be determined objectively; in cases arising from an industrial accident or occupational disease covered by a mutual insurer, the notes are issued by the medical services of the mutual insurer or of the collaborating company. https://www.boe.es/buscar/act.php?id=BOE-A-2014-7684
Book your consultation
If you are organising the logistics — work, children, who will be with you — before making up your mind, that conversation is part of the assessment and not of the small print. The expected extent of your surgery is what makes it possible to estimate how long we are talking about.
And if you have already had surgery and a soft lump has appeared after a few weeks, do not wait for your scheduled appointment: ask to be seen.
Clinical confirmation by the surgeon
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Registration no. 46/4624503
Last reviewed: 6 September 2026. This content is for information only and does not replace an individual assessment by a healthcare professional.
