Dr Scott J Turner | Specialist Plastic Surgeon (FRACS) | Sydney
Key Takeaways Hyperbaric oxygen therapy (HBOT) delivers oxygen at increased pressure, and the biological reasons it might support healing after surgery are sound. For routine facial surgery, though, the evidence is still limited, drawn mostly from small studies rather than large trials. Dr Turner offers HBOT as an optional recovery adjunct to many facial surgery patients, based on his clinical impression and that developing evidence. It is not a substitute for careful surgery or standard aftercare, and suitability is assessed individually.
Recovery is where a great deal of a surgical result is either protected or lost, and patients quite reasonably ask what they can do to support it. One option that comes up more and more is hyperbaric oxygen therapy. If you are planning a facelift, a deep plane facelift or rhinoplasty, you may have come across it, and wondered whether it is worth doing. A fair question.
This guide gives you a straight answer. It explains what hyperbaric oxygen therapy is, the biological reasons it may help healing, what the research actually shows for facial surgery, and where the evidence is still thin. As a Specialist Plastic Surgeon (FRACS) consulting in Sydney at Bondi Junction and Manly, I offer this therapy to many of my facial surgery patients, but I want you to understand it clearly before you decide, including its limits.
What is hyperbaric oxygen therapy?
Hyperbaric oxygen therapy involves breathing pure medical-grade oxygen inside a pressurised chamber, at a pressure higher than normal air. Under pressure, far more oxygen than usual dissolves directly into the bloodstream, and that oxygen-rich blood can reach tissues whose normal blood supply has been disrupted.
It is not a new or fringe treatment. HBOT has been used in hospital medicine for decades, for things like non-healing wounds, certain infections, and compromised skin grafts and flaps. Established medicine, in other words. What is newer is its use as a recovery aid after cosmetic surgery, and that is where the evidence is less settled than the marketing around it sometimes suggests.
A practical point matters here. Genuine medical hyperbaric therapy uses a hard-shell chamber that reaches the pressures actually studied. The soft, inflatable chambers found in some wellness settings do not reach those pressures and cannot dissolve oxygen into the blood in the same way. If you are going to do this, it should be in a properly equipped, medically supervised facility.
Why it might help healing
The reasoning behind HBOT is genuinely sound. It is worth understanding, because it explains both the interest and the caution.
Surgery temporarily disrupts the tiny blood vessels that supply oxygen to skin and tissue. Healing then depends on oxygen reaching those recovering tissues, and when oxygen runs low, healing slows. By dissolving extra oxygen into the blood, HBOT can, in principle, support tissue that is short of it. In wound-care medicine, higher tissue oxygen is linked to several things that matter after surgery. The formation of new blood vessels. More organised collagen. Better resistance to infection, and less swelling. Each of those steps counts after facial surgery.
So the mechanism is plausible. Plausible, though, is not the same as proven. It does not by itself show that the therapy changes outcomes after an elective facelift or rhinoplasty, and it is important to hold those two ideas apart.
What the evidence shows in facelift surgery
Here is where honesty matters more than enthusiasm.
In one small case-control study of twenty facelift patients, published in 2023, those who received hyperbaric oxygen healed noticeably faster than those who did not, with a reported average wound healing time of roughly thirteen days against roughly thirty-seven days in the comparison group. That sounds dramatic. And it is encouraging. But a study of twenty people is a long way from proof, the groups were small, and it was not a large randomised trial. An earlier study reported less bruising in the first week after facelift and eyelid surgery in patients who had the therapy. Again, useful to know, but not the final word.
When researchers have looked across many different types of surgery, the overall picture is more muted, with no clear reduction in complications across the board. The facelift-specific results look more favourable than that broad average, which is partly why interest is growing. The honest summary is this. The early, procedure-specific findings are promising. The studies are small. And large trials are still needed.
What the evidence shows in rhinoplasty
Rhinoplasty has a particular feature that makes the rationale for HBOT interesting. Cartilage, which is central to nose surgery, has one of the poorest blood supplies of any tissue in the body. When cartilage is reshaped or grafted, that limited supply is stretched further.
Cartilage struggles when its blood supply is stretched. Because HBOT delivers oxygen through the blood plasma rather than relying on an intact network of small vessels, the theory is that it may help nourish cartilage and recovering tissue during the early weeks. The same plausible benefits around swelling, infection resistance and ordered scar formation apply. There is also interest in whether it supports the return of normal sensation at the nasal tip, which some patients find slow to recover. These are reasonable ideas grounded in how the nose heals. But they are not yet backed by large rhinoplasty trials. Rationale, not proof.
A note on fat grafting
Some facial surgery includes fat grafting, and you may read claims that HBOT improves how well grafted fat survives. The biological argument is plausible, since new fat needs a fresh blood supply to take. I would simply note that the published evidence here is limited and that one prominent study in this area was later retracted, so I am cautious about putting weight on it. It is an area of interest. Not an established benefit.
Who I tend to consider it for
HBOT is more likely to be worth discussing for some patients than others, generally those whose healing has a smaller margin for error.
That includes people who have smoked, where tissue oxygenation is already impaired. Stopping nicotine entirely still matters far more than any therapy, by a wide margin. It includes patients with conditions such as diabetes that affect healing, those having revision surgery where scar tissue has reduced the blood supply, and those undergoing longer combined procedures or surgery involving thin skin or significant cartilage work. For a straightforward procedure in a fit, healthy non-smoker, the case is weaker, and I will say so. Not everyone needs it. The point is that this is a considered, individual decision, not a blanket recommendation for everyone.
What a course involves
If we decide together that HBOT is worth including, a typical course runs over the first few weeks after surgery, with a series of sessions each lasting roughly an hour. My usual approach is a programme across the four to six weeks following surgery, which gives enough cumulative exposure to support the slower phases of healing, not just the initial swelling.
Timing varies, but treatment usually begins within the first few days after surgery, once the early acute phase has settled. None of this is fixed. Every plan is individual. It is tailored to your procedure, your healing and your circumstances, and it is always optional. It is an addition to good surgery and standard aftercare, never a replacement for them, and it carries its own cost, which we will set out clearly in advance.
Safety and side effects
Used in an appropriate clinical setting, HBOT has a strong safety record. The main absolute reason it cannot be used is an untreated collapsed lung, and there are a few other cautions, including certain lung conditions, that are checked before you start.
The common side effects are mild and temporary. Nothing dramatic. A sensation of pressure in the ears, similar to a plane descending. It is managed with simple equalising techniques. Brief changes to vision that settle over days to weeks. Some tiredness after a session. Serious problems are rare and are linked to improper or excessively high-pressure use, which is another reason to attend a supervised medical facility rather than an unregulated one.
Being honest about the evidence
I want to be plain about where this stands, because you deserve that.
The evidence for hyperbaric oxygen therapy in routine cosmetic facial surgery is still developing. The supportive studies are small, large randomised trials have not yet been done, and broad reviews across all surgery types have not shown a clear benefit. What we do have is a sound biological mechanism, a good safety profile, some encouraging procedure-specific results, and consistent reports from experienced surgeons. My own clinical impression, across my patients, is that it can be a helpful support to recovery. That is the honest basis on which I recommend it. Nothing more, and nothing less. It is a reasoned choice, not a proven certainty, and I would never present it as one.
How this fits into your recovery
The foundations of a good recovery have not changed. They never do. A careful operation, not smoking, following your aftercare, keeping your head elevated, resting properly, and giving healing the time it needs all matter more than any single therapy. You can read more in my guides to preparing for plastic surgery and to bruising after facial surgery.
Hyperbaric oxygen therapy, where it suits you, sits on top of those foundations as an optional extra, not in place of them. If you would like to talk through whether it makes sense for your procedure, that is a conversation worth having in person. Face to face, properly. You are welcome to contact us to arrange a consultation at our Sydney clinics in Bondi Junction and Manly.
Frequently asked questions
What is hyperbaric oxygen therapy?
Hyperbaric oxygen therapy, or HBOT, involves breathing pure medical-grade oxygen inside a pressurised chamber at a pressure higher than normal air. Under pressure, far more oxygen than usual dissolves into the blood, which can then reach tissues whose normal blood supply has been disrupted. It has been used in hospital medicine for decades for conditions such as non-healing wounds and compromised skin grafts, and is now also used as an optional recovery aid after some cosmetic surgery.
Does hyperbaric oxygen therapy help recovery after facial surgery?
It may, but the evidence is still limited. Small studies in facelift patients have reported faster wound healing and less early bruising, and the biological mechanism is sound. However, these studies are small, large randomised trials have not yet been done, and broad reviews across all surgery types have not shown a clear benefit. Dr Turner offers HBOT as an optional recovery adjunct based on this developing evidence and his clinical impression, not as a guaranteed or proven result.
Is hyperbaric oxygen therapy safe?
In an appropriate, medically supervised setting, HBOT has a strong safety record. The main reason it cannot be used is an untreated collapsed lung, and a few other conditions are checked beforehand. Common side effects are mild and temporary, such as ear pressure like that felt on a descending plane, brief vision changes that settle over days to weeks, and some tiredness after a session. Serious problems are rare and are linked to improper or unsupervised use.
How many HBOT sessions are needed after surgery?
There is no fixed number, and it depends on your procedure and how you heal. Dr Turner’s usual approach is a programme of sessions across the four to six weeks following surgery, each lasting around an hour, generally starting within the first few days once the early swelling has settled. The plan is tailored to you, and the therapy is always optional rather than a required part of surgery.
Is hyperbaric oxygen therapy available in Sydney?
Yes. Medical-grade hyperbaric oxygen therapy is available in Sydney through properly equipped, medically supervised facilities. It is important to use a hard-shell clinical chamber rather than a soft inflatable one, because only a clinical chamber reaches the pressures used in the research. If you are considering HBOT as part of your recovery, Dr Turner can advise whether it is appropriate for your procedure and how to arrange it.
About Your Surgeon
Dr Scott J Turner is an AHPRA-registered Specialist Plastic Surgeon (FRACS) consulting in Sydney (Manly and Bondi Junction), Brisbane and Canberra. His practice focuses on facial aesthetic surgery, rhinoplasty and cosmetic breast surgery, performed at accredited private hospitals in Sydney. Dr Turner emphasises individual patient assessment, surgical planning and clear information on risks, recovery and costs, holds Fellowship of the Royal Australasian College of Surgeons.
