After Surgery: Deep Brain Stimulation
Practical guidance on wound care, activity restrictions, what to expect before programming begins, and when to call your team.
What's Normal After Surgery
Expected Symptoms
- Soreness at incision sites (scalp and chest), bruising, and fatigue
- Swelling or bruising around the eyes — may take 1–2+ weeks to improve
- A cool compress (wrapped in a cloth, never directly on an incision) can ease swelling around the eyes — ask your team first
Microlesion Effect — a Common Question
You may notice temporary improvement in tremor or Parkinson's symptoms before DBS is turned on. This happens from temporary brain swelling near the target. Symptoms often return as the swelling resolves — this is expected and does not mean the surgery didn't work. Programming will address your symptoms once healing is complete.
Incision Care
Keep Incisions Clean & Dry
- Do not apply ointments or creams unless your surgeon specifically tells you to
- No soaking (bath, pool, hot tub) until cleared — commonly at least 2 weeks
- Do not scratch your incision
Showering:
- Keep the dressing clean and dry for the first 48 hours
- After 48 hours you may remove the dressing and shower — let water run gently over the incision; do not scrub
- Baby shampoo is preferred for gently washing your head and the incision; rinse well and pat dry with a clean towel
- Leave the incision open to air after washing (unless told otherwise)
Watch Closely for Infection
Call your team if you notice any of the following:
- Fever, spreading redness, warmth, or worsening swelling
- Drainage from any incision
- Wound opening or increasing pain at the incision site
Stitches & staples: Your scalp incisions are usually closed with stitches that need to be removed at your follow-up visit, about 2 weeks after surgery. Your chest incision is usually closed with dissolvable stitches under the skin that do not need to be removed. In some cases staples are used instead and will also be removed at that visit. You will have a post-operative appointment with your neurosurgery team in 1–2 weeks for a wound check and removal — please contact the office to confirm your appointment.
Activity & Lifting
These restrictions protect the leads, extension wire, and chest generator during healing. Your team will personalize the timeline based on your surgery and recovery.
✕ Avoid
- Heavy lifting (anything heavier than a gallon of milk), especially the first 4–6 weeks
- Strenuous upper-body exercise
- Repetitive bending or twisting
- Anything that puts strong tension across the neck/chest where the extension wire runs
- Extreme overhead reaching on the side of the chest generator until cleared
✓ Do
- Walk daily as tolerated — increase gradually
- Rest with your head supported on a pillow; some patients find sleeping slightly propped up more comfortable in the first few nights
- Use soft pillows to avoid pressure over your wounds
- Keep movements slow and controlled
Driving: Do not drive while taking opioid pain medication or if you feel foggy or dizzy. Return to driving depends on recovery — ask your team when it's safe.
Return to work: Timing depends on your recovery. Many patients return after initial healing and once programming begins. Your team will help you plan.
Pain Control & Medication
Important: You should resume your Parkinson's or tremor medications immediately after surgery, exactly as instructed by your DBS team. Do not change doses on your own.
Pain medication guidance
✓ You may take
Acetaminophen (Tylenol) 500–650 mg every 4–6 hours as needed for pain or headaches. Use prescribed pain medication only as directed — most patients do not need it for more than a few days.
✕ Do not take without clearance
Aspirin, ibuprofen (Advil), naproxen (Aleve), meloxicam, or any NSAIDs for at least 1 week. No blood thinners (Coumadin/warfarin, Plavix, Eliquis, Xarelto, Brilinta) unless instructed by your neurosurgical team.
Constipation is common — especially with opioids. Stay hydrated, eat fiber, and use stool softener or laxative as your team recommends.
What to Expect After Implant
DBS is usually not turned on immediately. Programming begins once healing is complete — typically 4–6 weeks after surgery.
Healing Phase (weeks 1–4)
DBS is off. Focus on wound healing, rest, and following activity restrictions. The microlesion effect may provide some temporary benefit.
Programming Begins (~4–6 weeks)
Your team starts turning on the system and adjusting settings. Programming is iterative — it may take multiple visits over weeks to months to optimize benefit.
Ongoing Optimization
Keep every follow-up appointment for wound checks and programming. Your team will also monitor battery and device function long-term.
When to Call or Go to the ER
Know When to Act
- Fever, spreading redness, warmth, worsening swelling, or drainage from any incision
- New or worsening severe headache and neck stiffness, increasing confusion, persistent vomiting
- New hardware concerns: rapidly worsening symptoms that feel "sudden," or concern that something shifted