Ice After Facelift

You appear to have a normal amount of swelling at the 4 day postoperative point. Ice is most helpful in the first 2-3 days after surgery but it is okay to continue using it if you want. As many of the others have mentioned it is important to protect your skin from the ice pack so as to not harm the skin.

It isn't uncommon to have asymmetric bruising. This usually resolves during the first 10-14 days after surgery. Sleeping with your head elevated at least 30 degrees can help with the swelling, especially in the first few weeks.

Web reference: http://www.drlamperti.com/facial-plastic-surgery/facelift-midface-lift

Web reference: http://www.michaelelammd.com

From the pictures it seems that you have normal amount of swelling after a Facelift and upper eyelid surgery.

Ice usually helps with swelling in the first 48 to 72 hours (do not use directly on the skin since after a Facelift the nerves are severed and you have no sensation over the skin). After that period of time icing does not change much of the swelling.

You may use black and blue ointment or any product with Arnica and Bromelin.

Sleep with your head elevated.

It takes about 4 weeks on average for a significant amount of the swelling to go away.

Web reference: http://www.seattlefacial.com/photogallery/facelift_photos.html

These are issues you need to speak to your facelift surgeon about as everyone has different protocols; generally I like warm compresses starting 3-4 days after surgery.

Web reference: http://www.facialplastics.info/facelift.html

Cooling using ice (never directly on skin) helps prevent swelling for the first 3-4 days until it peaks but in my experience does not make it go away. Here are the recovery tips I give my patient for the first 7-10 days:

RECOVERY TIPS:
Limiting bruising by preventative means is a good idea after all surgeries especially those involving the face and neck (e.g. facelift).
This is what I recommend to my patients:
1. Head elevation at all times - I recommend a minimum of 30 degrees elevation and suggest they sleep in a  a recliner chair if  available
2. Stay away from supplements and medicines if you are able that cause bruising.
These include NSAID's like asprin, ibuprofen, and naprosyn, blood thinners and so on.
The list for supplements to stay away from is huge - we generally give out a list of the most common 200 supplements to avoid  (e.g. Fish Oil, alpha omega 3 fats, Vitamin E, etc)
3.  Normal or Low-Normal Blood Pressure. - If you are blessed with this great, otherwise make sure your BP is well controlled
4. No early lifting or bending down
5. Icing as directed by your MD during the first 3 days

The use of ice and elevation are very helpful to reduce the swelling after facelift and blepharoplasty procedures.  I think that the effects of ice on swelling diminish after about five days.  However, many of my patients like to continue the ice after five days because it gives them some relief as they are healing.  

Judging by your photos, it looks like you have a normal amount of swelling.  We found that ice and elevation helps.  Please do not place ice directly on the skin.  Have a cloth barrier between the cold and the skin.  Sitting in a recliner with the head up is helpful.  3 pillows will also do nicely.  You want about 30 or 45 degrees of elevation.  This all will help keep the swelling down and the pain away.  It is also OK to call your surgeon with questions. 

Web reference: http://www.jjrothmd.com/procedures/facelift-necklift

We use ice for the first 24-48 hours and then we begin to alternate warm moist heat and ice, done 4 times per day for about 5 minutes, making sure the warm towels are not too hot to avoid burning the skin.