Over the past year, I've noticed a growing trend on social media: patients are being encouraged to undergo hyperbaric oxygen therapy (HBOT) before or after cosmetic facelift surgery. Some practices even market a series of HBOT sessions as an essential part of recovery.
Naturally, many of my patients have asked whether they should be doing the same.
The short answer is:
For an uncomplicated facelift, the current medical evidence does not support routine prophylactic hyperbaric oxygen therapy.
That doesn't mean HBOT has no role in plastic surgery—it absolutely does. But it's important to distinguish between treating complications and trying to improve normal healing.
What Is Hyperbaric Oxygen Therapy?
Hyperbaric oxygen therapy involves breathing nearly 100% oxygen inside a pressurized chamber. Under these conditions, oxygen dissolves into the bloodstream at much higher concentrations than normal, allowing more oxygen to reach tissues.
Researchers have shown that HBOT can:
- Increase tissue oxygenation
- Reduce tissue swelling (edema)
- Promote new blood vessel formation
- Enhance collagen production
- Support the body's immune response
These effects make HBOT an excellent treatment for certain medical conditions.
The question is whether these theoretical benefits translate into better outcomes after an otherwise healthy cosmetic facelift.
What Does the Research Actually Show?
When you look past the marketing and examine the published medical literature, the answer becomes much less exciting.
Two major systematic reviews published in 2025 evaluated the available evidence for HBOT in aesthetic surgery. Both reached essentially the same conclusion:
There is currently insufficient evidence to recommend routine HBOT after cosmetic surgery.
One review analyzed more than 700 patients undergoing aesthetic procedures. However, most of the surgeries involved abdominoplasty and breast surgery—not facelifts. In addition, HBOT was generally used after surgery rather than as a preventive treatment, and the quality of the studies varied considerably.
Another systematic review screened nearly 600 published articles but found only 15 studies of sufficient quality to include. The authors concluded that HBOT may have value in selected situations, but the available evidence is too limited to justify its routine use or its additional cost.
Simply put, we do not currently have high-quality studies demonstrating that prophylactic HBOT improves facelift healing, reduces complications, or produces better cosmetic results.
Why Doesn't More Oxygen Automatically Mean Better Healing?
This is probably the most misunderstood concept.
Healthy tissues already receive the oxygen they need to heal normally.
Hyperbaric oxygen therapy does not appear to make normal wounds heal faster simply because more oxygen is available.
Instead, HBOT seems to help when tissues are struggling because of poor blood flow or injury. In other words, it helps abnormal healing move closer to normal healing.
One of the classic principles described in the plastic surgery literature is:
Hyperbaric oxygen does not accelerate normal wound healing—it helps compromised wounds heal more like normal wounds.
That distinction is incredibly important.
If your facelift is healing exactly as expected, there is little evidence that additional oxygen changes the outcome.
When Does HBOT Make Sense?
Although I do not routinely recommend HBOT after an uncomplicated facelift, there are situations where it can become a valuable treatment.
These include:
- Skin flap compromise
- Areas of threatened skin necrosis
- Significant wound-healing problems
- Radiation-related tissue injury
- Compromised grafts or flaps
- Certain severe infections
- Filler-related vascular occlusion
These are well-recognized indications where HBOT has demonstrated benefit and is supported by organizations such as the Undersea and Hyperbaric Medical Society.
In these circumstances, HBOT serves as an adjunctive treatment—meaning it complements other appropriate medical or surgical management.
Is HBOT Safe?
For most healthy patients, HBOT is generally considered safe when administered by experienced providers.
However, it is not completely risk-free.
Potential side effects include:
- Ear pressure or barotrauma
- Temporary vision changes
- Sinus discomfort
- Claustrophobia
- Rare oxygen toxicity or lung injury
There is also the practical consideration of time and cost. Treatment protocols often involve multiple sessions over several days or weeks, and prophylactic cosmetic use is generally not covered by insurance. A patient could end up spending hundreds or even thousands of dollars, not to mention time, on treatments that really are not changing the surgical outcome.
My Approach
As a plastic surgeon, my goal is to recommend treatments that have been proven to improve patient outcomes—not simply treatments that are popular on social media.
Hyperbaric oxygen therapy is a remarkable medical tool, and I absolutely consider it when managing certain postoperative complications.
However, for patients experiencing normal recovery after a facelift, I do not routinely recommend prophylactic HBOT because the current scientific evidence does not demonstrate a meaningful benefit.
Medicine evolves continuously, and future high-quality clinical trials may change our understanding. If strong evidence eventually shows that routine HBOT improves facelift recovery or results, I will gladly incorporate it into my practice.
Until then, I believe patients deserve recommendations based on evidence rather than enthusiasm.
The Bottom Line
Hyperbaric oxygen therapy has an important place in reconstructive and wound-healing medicine.
For routine cosmetic facelift recovery, however, today's evidence does not support its widespread preventive use.
The best way to achieve an excellent facelift result remains meticulous surgical technique, careful patient selection, thoughtful postoperative care, and close follow-up throughout the healing process—not simply adding more treatments because they sound promising.
