Hyperbaric Oxygen Therapy (HBOT) in Aesthetic Surgery: What the Evidence Shows

Article
Dr Nur's profile photo
DrNur Ozyilmaz, MD
Founder · NUMA

Summary of HBOT in Aesthetic Surgery Recovery

Regulatory and clinical background

Hyperbaric oxygen therapy is recognised by the FDA and the Undersea and Hyperbaric Medical Society (UHMS) for indications relevant to surgical recovery, including compromised grafts and flaps, burns, refractory infections, radiation injuries, and tissue necrosis 1. HBOT has been used clinically since the 1950s, with a long-established role in complex wound healing and complication reduction 2 3.

Broader relevance to aesthetic surgery

Beyond managing complications, HBOT may enhance routine post-surgical recovery by improving tissue oxygenation, reducing swelling and inflammation, and supporting collagen synthesis and angiogenesis, even in patients without overt complications 2 4 3 5.

Case Strategy

1. Standard care: For uncomplicated aesthetic procedures, 5–10 HBOT sessions are commonly used to reduce swelling and bruising and to support early wound healing. Protocols are typically adapted to the procedure type and individual patient factors 6 7.

2. Comprehensive recovery: More intensive recovery programmes often involve 10–20 sessions to support angiogenesis, collagen production, and tissue regeneration during the postoperative healing phase 2 4 3.

3. Complicated post-surgical cases: In cases of delayed healing, tissue ischemia, or higher-risk surgery, extended HBOT courses may be used and tailored to the patient’s clinical progress and recovery goals 7 8.

Evidence Base

A 2025 systematic review and meta-analysis examined whether HBOT improves recovery after aesthetic surgery. The review analysed 11 clinical studies involving 734 patients, of whom 416 received HBOT as part of their surgical recovery 9.

Types of Procedures Included

The studies covered a wide range of aesthetic surgeries, most commonly:

  • Abdominoplasty
  • Breast procedures (reduction and reconstruction)
  • Facelift and facial surgery
  • Liposuction
  • Hair transplantation
  • Blepharoplasty

9 6 8

How HBOT Was Used

Across studies:

  • Most patients received HBOT postoperatively
  • Typical protocols involved 100% oxygen at 2.0–3.0 ATA
  • Sessions lasted 45–120 minutes, usually once daily
  • The number of sessions ranged from 3 to 39, with most studies reporting around 10 sessions

9 6

Key Findings

1. Faster healing

Across procedures, HBOT was associated with significantly shorter healing times. The pooled average healing time was approximately 11 days 9. In facelift surgery specifically, one controlled study reported healing times almost three times faster in the HBOT group compared with controls 6.

2. Fewer complications

Patients receiving HBOT experienced lower rates of postoperative complications, including infection, wound breakdown, tissue ischemia, and poor-quality or hypertrophic scarring 9 7 8. In abdominoplasty, one large cohort study showed complication rates falling from approximately 33% to under 9% when HBOT was incorporated into postoperative care 8.

3. Improved patient satisfaction

Where patient-reported outcomes were assessed, early satisfaction was significantly higher in patients receiving HBOT. Patients reported less swelling, faster recovery, and improved early cosmetic results, and many indicated they would recommend HBOT as part of their recovery 9 6.

4. Strong safety profile

Across all included studies, no serious HBOT-related adverse effects were reported. No cases of oxygen toxicity were documented, and HBOT was generally well tolerated, even when initiated soon after surgery 9 7.

Why HBOT May Help After Surgery

Several biological mechanisms may explain the observed benefits of HBOT in surgical recovery, including increased tissue oxygenation, reduced inflammation and oedema, enhanced angiogenesis, improved collagen deposition and wound repair, and reduced risk of ischemia in vulnerable tissues 2 4 3 5.

Important Limitations

Many of the included studies were small or observational, and HBOT protocols were not standardised. Further high-quality randomised controlled trials are still needed to define optimal protocols and patient selection 9.

What This Means in Practice

The current evidence suggests that HBOT may be a useful adjunct for patients seeking faster and smoother recovery, for procedures associated with higher risks of swelling or tissue compromise, and for extensive or combined aesthetic surgeries 9 8.

Bottom Line

Current evidence supports HBOT as a safe and effective adjunct in aesthetic surgery recovery. When used appropriately, it may accelerate healing, reduce postoperative complications, and improve early recovery and functional outcomes. HBOT is not a replacement for skilled surgery or standard postoperative care, but it appears to meaningfully enhance recovery outcomes when integrated into a well-managed post-surgical recovery plan 9.

If you found this overview helpful and would like to explore surgical recovery and the physiological mechanisms involved in more depth, you can read our in-depth evidence review here.

References

Footnotes

  1. Mayer R, Hamilton-Farrell MR, van der Kleij AJ, et al. Hyperbaric oxygen and radiotherapy. Strahlenther Onkol. 2005;181(2):113–123. ↩
  2. Hopf HW, Gibson JJ, Angeles AP, et al. Hyperoxia and angiogenesis. Wound Repair Regen. 2005;13:558–564. ↩ ↩2 ↩3 ↩4
  3. Thom SR, Bhopale VM, Velazquez OC, et al. Stem cell mobilization by hyperbaric oxygen. Am J Physiol Heart Circ Physiol. 2006;290:H1378–H1386. ↩ ↩2 ↩3 ↩4
  4. Peña-Villalobos I, Casanova-Maldonado I, Lois P, et al. Hyperbaric oxygen increases stem cell proliferation and angiogenesis. Front Physiol. 2018;9:995. ↩ ↩2 ↩3
  5. Hachmo Y, Hadanny A, Mendelovic S, et al. The effect of hyperbaric oxygen therapy on the pathophysiology of skin aging. Aging (Albany NY). 2021;13:24500–24510. ↩ ↩2
  6. Neel OF, Mousa AH, Al-Terkawi RA, et al. Assessing the efficacy of hyperbaric oxygen therapy on facelift outcomes. Aesthet Surg J Open Forum. 2023;5. ↩ ↩2 ↩3 ↩4 ↩5
  7. Simman R, Bach K. Role of hyperbaric oxygen therapy in cosmetic and reconstructive surgery in ischemic soft tissue wounds. Eplasty. 2022;22. ↩ ↩2 ↩3 ↩4
  8. Friedman T, Menashe S, Landau G, et al. Hyperbaric oxygen preconditioning can reduce postabdominoplasty complications. Plast Reconstr Surg Glob Open. 2019;7(10). ↩ ↩2 ↩3 ↩4 ↩5
  9. Mortada H, González JE, Husseiny YM, et al. Efficacy of hyperbaric oxygen therapy as an adjunct in aesthetic surgery: a systematic review and meta-analysis of postoperative outcomes and complications. Aesthet Plast Surg. 2025;49(9):2498–2512. ↩ ↩2 ↩3 ↩4 ↩5 ↩6 ↩7 ↩8 ↩9 ↩10