Thinking about a facelift, but concerned about taking time off work. When can I go in public without looking like a freak (or like I just had facelift surgery!)?
Doctor Answers 175
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All the Best,
A. Dean Jabs M.D., Ph.D.
Board Certified Plastic Surgeon
Bethesda MD/McLean VA
Facelift Recovery - Choose your Plastic Surgeon Wisely View Many, Many Photos
For very high profile patients and / or people who don't want people to know they have had surgery, I often recommend a change in hairstyle immediately before surgery. Starting to wear eyeglasses or changing your current eyeglass frame can also make a change a bit less obvious.
Great plastic surgery won't have people asking "who is your plastic surgeon?" Instead, they will ask if you've lost weight, been on vacation, started yoga, or something else that may be responsible for you looking so wonderful.
Follow your plastic surgeons orders very closely before and after surgery
Most importantly, choose your plastic surgeon wisely. Take your time, seek out multiple consultations if you desire and be sure you are very comfortable with our surgeon's ability to perform extraordinary surgery, their philosophy, training, education, attention to detail and commitment to safety. Also ask about what happens AFTER surgery. Post op appointments should be scheduled prior to surgery, and you should be seen often. You should have an immediateNurse practitioner or nurse who can answer questions and see you in person even when your surgeon is in surgery with another patients.
The following are a few things that can distinguish some surgeons from others
1) Graduating from a top tier medical school at the top of their class.
2) Membership in Alpha Omega Alpha. THis is the medical honors society. Alpha Omega Alpha is to medicine what Phi Beta Kappa is to undergraduate colleges.
3) Formal surgical training from prestigious medical universities. The minimum number of years of surgical training for plastic surgeons to be bord certified in five years. Some physicians have as many as ten years of formal surgical training. There simply is no substitute for stelar academic and practical surgical training. A Fellowship training in addition to residency provides additional surgical training and experience.
4) Very experienced surgeons with meticulous surgical technique and natural looking outcomes will have photgraphic evidence of their work. Patients should be able to view many photos of the surgery of interest, photgraphed from three different perspectives all with similar lighting, distance from the camera and cropping
The elite experience extends beyond the surgeon to the facility, and the surgical team. You should be able to see the surgical theater and know who else will be in the OR with you during surgery. The Joint Commission (JCAHO) is an organization that provides certification to hospital OR's. The Joint Commission and AAAASF are two of the organizations that can provide certification to surgical suites. Some plastic surgeons elect to have their surgery centers dually certified.
The anesthesia experience is critical to a safe and comfortable surgical experience. A board certified anesthesiologist can administer general or MAC anesthesia. My preference is to have a board-certified anesthesiologist at the bedside of my patients for the duration of surgery.
Plastic surgeons who cater to high profile individuals who place a high value on privacy will have a private first floor entrance and exit so patients never need to be in a public lobby or elevator for pre-operative or post operative visits.
How to Minimize "Looking Like A Freak" After Facelift Surgery
Of all concerns about facelift surgery, the concern of looking abnormal following the procedure and about how long it will take to look normal again are often the biggest. Appearance problems are primarily due to bruising, swelling, puckering and stretching of the skin. Those surgeons who do everything they can to speed recovery and educate their patients on their own part in the recovery process are doing a great service for their clients in this regard.
WHAT THE SURGEON DOES TO SPEED RECOVERY:
1. Respecting surgical anatomy to minimize trauma: There are subtle anatomical planes that only the most experienced surgeons consistently recognize and respect and consistently work within. By staying within these planes, less trauma and therefore less bleeding/swelling occurs.
2. Compression dressings vs tissue glue: Both work well at reducing the potential space between skin and underlying tissues, which ensures that little blood can accumulate that would otherwise increase bruising and swelling. Placing a good dressing that applies even pressure is both a skill and an art.
3. Minimize bleeding: A surgeon who takes his/her time to be meticulous at finding and stopping every small point of bleeding will produce less bruising.
4. Adequate drainage: No matter how meticulous the surgeon is at stopping any point of bleeding, there will still be some amount of bleeding that occurs under the skin following the surgery. The surgeon that places drains to remove this blood that would otherwise accumulate and create more swelling and bruising, can make a big difference in the recovery time.
5. Tighten deeper structures so the there is little tension on the skin: Tension on the skin can be minimized from the start by elevating, tightening and supporting the deeper structures first. There is then minimal tension and distortion on the skin.
6. Clearly Educate the patient about what they can do to speed recover.
WHAT THE PATIENT DOES TO SPEED RECOVERY: (primarily steps taken to minimize bruising and swelling)
1. Steps to minimize bruising:
a. Do not take any medications (unless OKed by your surgeon) that might increase bleeding tendencies: Every surgeon who does a lot of facelifts will have a list of medications and supplements that are known to increase bleeding tendencies
b. Take a natural supplement named "Arnica" -- which is safe and is known for it's anti-bruising properties
2. Steps to control blood pressure: Ensuring normal blood pressure will reduce swelling and bruising. The patient can do the following to normalize blood pressure during the critical week or two following facelift surgery:
a. Keep your head elevated: This, for obvious reasons will reduce pressure and swelling.
b. Take your blood pressure medication. Make sure you're blood pressure is controlled by an adequate dose of your medication.
c. Limit strenuous physical activity. Although walking around in encouraged within a day or two following surgery, anything that you need to strain at or that causes you to huff and puff and sweat should be postponed for at least two weeks following surgery
d. Do things that relax you: Your surgeon can even prescribe anti-anxiety/sedative medication during this period if you are overly anxious.
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Going out after facelift
I usually tell my patients that if they are going to be in a “high profile” situation – such as a wedding – to allow themselves a full six weeks for healing prior to the event. Otherwise, my patients seem to feel comfortable with their appearance at about two weeks.
Face lift recovery
Recovery from a facelift can vary tremendously , but in general you can look socially acceptable after seven to ten days. You will not feel totally normal for six weeks. Back to work ( depending on what you do, i.e. no heavy lifting) is about two weeks.It's easier for a woman because they can wear make-up.
Wishing you the best,
Tal Raine MD FACS
Facelift recovery is not as bad as you think
- Two weeks for most of bruising to resolve and all sutures removed.
- One month of no heavy lifting and straining.
- Most of the swelling is gone in the first month, but residual swelling can take a few more months to settle. The less active one is after surgery, the faster the swelling seems to resolve.
- Patient's usually do not have pain, but more of a "tight" sensation that relaxes somewhat over the coming months.
Recovery from facelift takes many forms
Recovery from a facelift takes many forms. Physical recovery. Social Recovery. Recovery of sensation. Because it is your face, the interruption in social activities is often the hardest part of the recovery.
Most patients have only mild pain after a facelift and it is usually gone in one or two days. I give only Tylenol #3 since stronger medications are not needed.
I allow patients to drive after 4 days if they are off pain meds. Before this, some mild neck stiffness may make driving safely more difficult since you may not turn your head as far to look for cars.
Swelling and Bruising:
Recovery from a facelift involves bruising (usually down low along the neck) and swelling which increases some each day for the first 4 days after surgery. On the 5th day after surgery this begins to improve rapidly and usually by the 7th or 8th day after surgery makeup can be applied. Patients often tell me with a scarf and some sun glasses they can run quick errands. At this stage they would not necessarily want to run into a close friend if they are trying to be discrete.
Dinner With Friends:
For a patient to sit down to dinner with friends and not be asked any questions, I believe it takes about two weeks. Occasionally a very dark bruise may not be completely gone but can be effectively covered with makeup. About 80 % of the swelling is gone so the remainder is hard to detect. Sometimes a slight change is hairstyle can be used to help explain away any differences a close friend might notice.
I ask patients to wait on exercise and heavy lifting until 3 weeks after surgery. Otherwise I don't limit their activities
Mild facial numbness seems to always go away completely but takes about 9 months. Fortunately this does not bother most patients especially once they realize its temporary.
Facelifts are variable
There is not a standard facelift since there are different techniques and aspects to this generic procedure. Ingeneral, most bruising should be minimal enough to cover with make up 7-10 days post-op. Swelling is more variable. The more that is done higher up ( forehead, eyes, cheeks) the longer the swelling should last compared to lower face and neck. Most of the time, I tell patients they can go out in public within 7-10 days since all stitches shold be out by then and they can wear camouflage make-up.
Length of recovery after facelift surgery
The length of your recovery is directly related to the extensiveness of the procedure performed. For a traditional facelift, which involves manipulation of the fatty/muscle layer below the skin, as well as generous lifting and tightening of the skin, most patients are able to go in public 2 weeks after surgery, but camouflage makeup is almost always required. After three weeks, the vast majority of patients have experienced resolution of enough bruising and swelling to feel comfortable in public.
Hope this helps. All the best.
What Do You Consider a "Freak"?
The answer is not that easy. The biggest problem after any type of surgery is the amount of bruising and swelling that occurs. While certain things can be done to minimize bruising and swelling, there is no way to predict what may happen. While patients can go out into public in 2-3 days after facelift surgery, there will be stitches in place and likely some amount of bruising and swelling. For most patients, 2 week is enough time to recover. At this point, make up may be necessary to cover some bruises and in men, it may be needed to cover the incisions in front of the ear. At one month, most, if not all bruising and swelling should be resolved. The incisions may still be red and require makeup for coverage for several more weeks, if not months. For my patients who say that they don't want anyone to know they had anything done, I advise one month with the caveat that makeup on the incision lines may be necessary.
These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.