Is HBOT FDA-approved for plastic surgery recovery?

HBOT is FDA-approved for compromised skin grafts and flaps — a medical indication involving graft failure or threatened flap loss. It is not FDA-approved for cosmetic surgery recovery (facelifts, breast augmentation, tummy tuck). Cosmetic use is off-label and not covered by insurance.

How much does HBOT after cosmetic surgery cost?

A typical post-operative protocol runs 20 sessions. At $250-$450 per session, that's $5,000-$9,000 added to your surgery costs. Insurance won't cover it for cosmetic procedures. Budget for this before surgery if your surgeon recommends it.

Does HBOT reduce swelling after surgery?

Studies on post-operative edema support HBOT's anti-inflammatory effects. The mechanism involves initial vasoconstriction (reduces swelling) followed by angiogenesis (supports tissue repair). For cosmetic surgery specifically, formal trials are limited, but the mechanism is sound and some surgeons recommend it based on clinical experience.

When should HBOT start after surgery?

Post-operative HBOT typically starts within 24-72 hours after surgery. Your surgeon determines the timing based on your specific procedure and healing status. Don't start without your surgeon's clearance.

Will insurance cover HBOT for a compromised skin graft?

Insurance may cover HBOT for compromised skin grafts and flaps when the graft shows signs of failure or threatened loss. This is a medical indication. The insurer will require documentation that standard wound care criteria are met and that a physician has ordered HBOT. Coverage is not guaranteed. Contact your insurer for prior authorization.

HBOT After Plastic Surgery: What Evidence Supports

The evidence for HBOT and plastic surgery splits into two distinct categories. One has solid clinical support and insurance coverage. The other is off-label. Knowing which applies to your situation affects both your treatment decisions and your wallet.

The FDA-Approved Case: Compromised Skin Grafts and Flaps

Skin graft and flap surgery fails when the transplanted tissue doesn’t receive enough oxygen to survive. The graft or flap becomes ischemic, and without intervention, it dies.

HBOT is FDA-approved for this indication. It addresses the core problem directly: oxygen delivery to tissue that’s struggling to survive.

Thom’s 2011 review published in Plastic and Reconstructive Surgery estimated approximately a 29% improvement in graft take rates with adjunctive HBOT compared to standard care alone (PMID: 21200260). The mechanism involves increased plasma-dissolved oxygen reaching the ischemic tissue edges, along with anti-inflammatory and angiogenic effects that support new vessel growth.

If your surgeon identifies graft or flap compromise after surgery, HBOT may be covered by your insurance as a medical indication. Coverage requires prior authorization, documentation of graft failure criteria, and treatment at an accredited facility. Ask your surgeon and your insurer before assuming coverage — it’s not automatic.

Off-Label: Cosmetic Surgery Recovery

The cosmetic surgery application is different. Facelifts, breast augmentation, abdominoplasty, liposuction — recovering from these procedures is not an FDA-approved HBOT indication. Some plastic surgeons recommend HBOT as part of their elective recovery protocol, and some cosmetic surgery practices have chambers on-site or partner with nearby HBOT clinics.

The rationale is mechanistically sound. HBOT reduces post-operative edema through initial vasoconstriction, then supports tissue repair through angiogenesis. Patients often report faster resolution of bruising and swelling. But formal clinical trials specifically for cosmetic surgery recovery are limited, and insurance won’t cover this use.

Before surgery, ask your surgeon directly whether HBOT is part of their post-operative protocol. If they recommend it, get a clear picture of the cost and timing so you can plan accordingly.

What HBOT Does in Healing Tissue

Three mechanisms drive most of the interest in post-surgical HBOT.

First, plasma-dissolved oxygen delivery. HBOT at 2.0-3.0 ATA with 100% O2 delivers oxygen that’s dissolved directly in plasma, bypassing hemoglobin. In hypoxic post-operative tissue where blood flow is reduced, plasma-dissolved oxygen can reach cell layers that hemoglobin-bound oxygen can’t.

Second, angiogenesis. HBOT promotes vascular endothelial growth factor (VEGF) production, stimulating new blood vessel formation. New vasculature supports long-term healing in ways that acute oxygen delivery alone doesn’t.

Third, anti-inflammatory effects. Studies show HBOT reduces pro-inflammatory cytokines in healing tissue. For surgical recovery, this translates to reduced swelling and less post-operative pain in some patients.

Cost and Logistics

For cosmetic use, plan on 20 sessions as the standard protocol. At $250 to $450 per session, that’s $5,000 to $9,000 on top of your surgery costs. This is fully out-of-pocket.

Sessions typically run 60 to 90 minutes at 2.0 ATA. You’ll need access to a clinical HBOT facility near you. See our guide on how to choose a clinic and use the UHMS facility directory at uhms.org.

If your situation involves a compromised graft or flap, the cost equation changes because insurance may cover it. Work with your surgeon’s office to pursue prior authorization through your insurer.

For more on costs, see our HBOT cost guide.

What to Ask Your Surgeon Before Elective Surgery

If you’re considering cosmetic surgery and wondering whether HBOT is right for your recovery, ask three questions before the procedure.

Ask whether your surgeon has experience with HBOT as part of post-op care. Surgeons who use it regularly have established protocols and often have relationships with local HBOT facilities.

Ask whether your procedure type has any published data on HBOT-assisted recovery. Some procedures (complex reconstructions, large flap surgeries) have more evidence than simple cosmetic ones.

Ask about timing and logistics. HBOT within 24 to 72 hours post-op requires planning. You’ll need transportation to a facility during your recovery period, which may not be realistic depending on where you live and how extensive your surgery is.

FAQ

Can HBOT replace other post-surgical recovery steps? No. HBOT is an adjunct — it works alongside standard care, not instead of it. Rest, wound care, activity restrictions, and follow-up with your surgeon all remain necessary.

My surgeon has a hyperbaric chamber in their office. Is that normal? Some plastic surgery practices have added on-site HBOT chambers, particularly those focused on reconstructive or high-end cosmetic work. In-office chambers are convenient but check whether the facility is UHMS-accredited and the equipment meets clinical standards.

Can HBOT help with scarring after surgery? HBOT’s collagen-stimulating effects are a plausible mechanism for scar improvement, but formal evidence for scar reduction specifically is limited. Some practices market HBOT for this purpose. Manage expectations and don’t pay premium pricing based on this claim alone.

Does HBOT help with healing after rhinoplasty? There’s interest in this area among patients, but published trials for rhinoplasty specifically are minimal. The general post-surgical mechanism applies, but your surgeon’s experience with HBOT for rhinoplasty recovery should guide this decision.

Medical Disclaimer: The content on this page is for informational purposes only. It is not medical advice and does not create a doctor-patient relationship. HBOT carries risks and requires physician evaluation. Ask your surgeon and a qualified hyperbaric physician before starting HBOT before or after any surgical procedure.