ERAS: A program for early recovery after aesthetic surgery

In recent years, the term "early recovery" has become more frequent on beauty consultation websites, accompanied by promises of "going home in a few hours," "coming back home the same day." Behind this trend is a model of care that has been validated in general surgery for over two decades: ERAS - an abbreviation for Enhanced Recovery After Surgery, temporarily translated as "enhanced recovery after surgery." As the beauty industry in our country becomes more standardized, ERAS is gaining attention from many institutions. So what is ERAS, what benefits does it bring, and where is the boundary between science and exaggerated advertising?

What is ERAS and why did it come about?

ERAS is not a single machine or technology, but a multimodal care process combining various small measures based on evidence to reduce psychological stress caused by surgery for the body. This model was initiated by Professor Henrik Kehlet from Denmark at the end of the 1990s, initially applied in major abdominal surgery, then spreading to obstetrics and gynecology, plastic surgery, and recently aesthetic procedures.

The core principle of ERAS is: instead of keeping patients in the hospital for days, fasting for an extended period, and relying on addictive pain-reducing drugs, people optimize each small step throughout the surgery process so that the body can recover faster and more safely. This is a change in mindset, not just a "technical trick."

Pre-surgery optimization: Preparing half of the result

The pre-surgery phase in ERAS focuses on putting patients in the best possible physical and mental condition:

• Consultation and setting realistic expectations: clearly explaining the process, actual recovery time, helping reduce anxiety - a factor directly affecting pain perception.
• Optimizing the underlying health: controlling blood sugar, blood pressure, quitting smoking, improving nutrition, and correcting anemia if any.
• Shortening fasting and drinking time: instead of fasting from midnight, many surgeons allow patients to drink carbohydrate-rich fluids a few hours before surgery, helping reduce hunger, thirst, and insulin resistance.

For aesthetic procedures, which are scheduled interventions, this preparatory phase is more valuable as it allows enough time for the patient to be screened and meticulously optimized.

Surgery optimization: Inducing sleep and minimally invasive techniques

During surgery, ERAS aims to minimize tissue damage and body physiological interference:

• Multimodal pain management: combining different types of drugs with varying mechanisms, inducing local anesthesia or regional anesthesia to limit opioid (pain-reducing addictive) use - a common culprit causing nausea, constipation, and drowsiness after surgery.
• Temperature control and proper fluid administration: avoiding excessive cooling and handover of fluids, two factors that slow down recovery.
• Minimally invasive surgical techniques: gentle handling, good blood control, minimizing unnecessary drainage tubes.
• Preventing nausea and vomiting: one of the main reasons causing patient discomfort and delayed discharge.

Post-surgery optimization: Early mobilization and early eating

After surgery, two key principles of ERAS are early eating and early mobilization. Sitting up, gentle walking in the first few hours (when allowed) helps reduce the risk of venous thromboembolism, pneumonia, and constipation, while shortening recovery time. Patients are encouraged to eat and drink early instead of fasting for an extended period, managing pain according to a protocol so they can actively mobilize.

It is important to understand correctly: "early recovery" means reducing unnecessary delays, not forcing the body to bear loads earlier than safe levels. The schedule is always personalized based on the type of surgery and individual response.

Benefits and limitations that need honesty

Based on evidence from general surgery, ERAS shows potential to reduce hospital stay time, decrease certain complications, and improve patient satisfaction. In the field of reconstructive - aesthetic surgery, preliminary reports (mainly on breast reconstruction, tummy shaping) also indicate positive trends in pain control and reduced opioid use.

However, it is important to acknowledge the limitations:

• Individual studies for each type of aesthetic surgery are significantly fewer than those for general surgery, mostly small-scale research.
• ERAS is a collective process, requiring coordinated teamwork among anesthesiologists, surgeons, and nurses - not something a single institution can "label" with just one technique.
• Efficacy depends heavily on full adherence to all components; partial application often does not yield the expected results.

Readers should be wary of advertisements that turn ERAS into slogans like "no pain," "instant recovery," or labeling a device as "exclusive." The essence of ERAS is meticulous and disciplined care in every detail, not promises about speed.

Safety considerations and underlying factors

Not everyone is suitable for all components of ERAS. Patients with pre-existing heart disease, diabetes, bleeding disorders, obesity, or history of blood clots need individual evaluation; exercise and pain management protocols must be adjusted to each person. Individual responses to drugs, pain thresholds, healing speeds vary, so results are individualized and cannot be promised uniformly. The decision to apply ERAS should be made by a specialist after direct consultation at an institution with sufficient anesthesia recovery team and monitoring equipment.

Dr. Vo Thanh Sang's Perspective

According to Dr. CKI Vo Thanh Sang, ERAS is a step forward because it puts patient safety and experience at the center rather than solely focusing on speed. What he emphasizes is: ERAS is not "technology for advertising," but a care philosophy requiring a coordinated system running at standard levels. An early recovery process only truly has meaning when accompanied by correct indications, well-coordinated teams, and close monitoring of each patient. Those seeking procedures should be cautious about promises like "fast - no pain - absolute," prioritizing transparent institutions regarding processes over attractive advertising.

If you are considering an aesthetic procedure and want to understand the recovery process suitable for your individual needs, schedule a direct consultation for specific advice. Contact the hotline 079 7479 222 for support.

This article is for informational reference only and does not replace direct medical consultations and advice.