I like using an elastic support strap after a facelift/necklift.My patients have a fluffy cotton bandage on for the first 24 hours, then we switch to a much smaller version of of a fluffy cotton head wrap for the next 24 hours.After that I just have them wear the elastic support strap without any additional cotton padding. I use an elastic strap that is similar to what most other surgeons use. It goes under the chin along the neck and then extends vertically over the cheeks with two velcro pieces that rest on the top of the head (one directly on the top and the other further back closer to where the strap on a baseball cap would sit).I like for patients to wear this support strap as much as possible in the first week, but I encourage them to take some breaks from wearing it so that it does not become annoying or irritating on the skin. In week 2 after surgery I like for patients to wear the support strap when they are sitting around the house, watching TV, sleeping, etc. However, they can go without it when in public. After 2 weeks it becomes more optional. I encourage patients to wear it occasionally when awake and encourage them to wear it when sleeping for another 2 or 3 weeks. Some patients really feel a great deal of added security from the support strap and choose to wear it even longer.In week 1 the support strap is helpful for keeping swelling down.In weeks 1 and 2 it is also important for keeping the skin that has been elevated in contact with the deeper layers so that everything heals in place as planned.The body continues to heal and the tissues strengthen underneath the surface for another month or so before things are really healed in place, so that is why I have found that continuing to wear the strap occasionally for a few more weeks has been helpful for most patients.The key is that there should never be excessive tension or pressure with the support strap. It should only counteract the force of gravity and weight of the skin to gently keep things in position.
An elastic chin strap is commonly used in the first week after a facelift, but the duration and timing of use will vary from Surgeon to Surgeon. The purpose of the strap is to provide mild compression between the skin and underlying tissue during the early postoperative period. I instruct my patients to use it for the better part of the first week. If the patient is experiencing irritation or difficulty with the garment, I will have them discontinue its use sooner.
