Why Do Some Doctors Say to Expect Feeling Depressed After a Full Face and Brow Lift?

Feelings of fatigue and sadness are not uncommon after any plastic surgery procedure. The reasons for these feelings are varied. First of all, a great deal of planning, anticipation and anxiety (stress) proceeds cosmetic surgery, especially when the procedure could impact ones self image and confidence for a long period of time. After the procedure there is often an 'emotional release' or let down, causing many patients to feel feel tired and spent afterwards. Downtime following the procedure is accompanied a period of swelling and bruising that can also trigger a spell of the 'blues', the symptoms of which are not too dissimilar from any other form of depression. Finally, in some circumstances feelings of sadness and loneliness occur because the patient feels 'judged' and doesn't receive the anticipated emotional support of friends or family. Fortunately most feelings of sadness resolve quickly as the body heals and the patient is able to return to normal life and activities. To minimize the risk of post-operative depression, patients should possess a realistic understanding of the time required for the healing process. They should also avoid surgery during periods of extreme stress such as death, divorce, job loss or family crisis. 

It is not surprising that some patients feel depressed after major surgery such as a facelift. Some factors that may affect mood are:

Lack of energy owing to the healing processCurtailment of normal activities during “downtime”Distress over how the face looks while it is still healingReaction to anesthesiaChanges in sleep and appetite in the postsurgical period.A facelift represents a major life change and, like all life changes, it takes some adjustment. I always try to prepare my patients for the possibility of feeling not quite like themselves in the first two to three postoperative weeks. Knowing ahead of time that depression may become an issue allows them to prepare emotionally, just as they prepare themselves physically, for surgery. I'm glad that wasn't your experience.

Great question.  Although many patients seem to sail through the postoperative period without even a hint of depression, the downtime can be difficult for some to cope with emotionally.  Although everyone knows and expects that there will be swelling, bruising, and general downtime with cosmetic facial surgery, sometimes it doesn't completely sink in until the patient sees him or herself in the mirror.  There may be feelings of doubt or even guilt for spending money on themselves.  The good news is that with patience and encouragement from your surgeon and family members, these feelings generally resolve quickly, and patients quickly becomes excited and happy with how they look.  Here's some info on facelift recovery:

It is very common after having a big life event to get a little down.  There is ramping up of excitement, then the event, and then the after effects.  With facial surgery there is also getting used to a face in the mirror that is different than what you are used to.  Also aesthetic surgery sometimes makes people look worse before they look better.  Please do talk to your plastic surgeon's office.  They see this stuff all the time.  They should be able to help.

    Most patients have some pain or discomfort after facelift.  Though depression may not be observed in the majority of patients, there are some patients in which the postsurgical changes and the healing process produce changes in mood.  Kenneth Hughes, MD Los Angeles, CA

Doctors who perform facelifts and understand the process and pay attention to their patients know that some can get the blues in the first month or two after a facelift.

its not a deep depression but a very mild sense of blues.

i talk with a lot of other facelift surgeons and we all have had a patient or two that reports this.  It is rare and it is not really related to the patients appreciation for the results.  It is also temporary.

i often tell my patients about this in advance and this seems to prevent the phenomenon.

Plastic Surgery affects each person differently. Some get depressed afterwards others do not.

One of the things I ask people in a pre-op visit is "Who will take care of you?" Then I say, "You want to have somebody who's really going to take care of you, who won't say to you when you first get home: "What the heck did you do that for?" Get somebody who's going to be really supportive and caring and who will be warm, because you're really going to need that.
The emotional stages the patient is going through affects the caretaker too. At the end of the first week the support person may be tired and need to go back to work.

Cosmetic Surgery affects each person differently. The most common reaction is to be depressed on the third or fourth day. However, some patients say, "Well, not me. I don't feel depressed." But three weeks later, they may have a crying jag while driving to work."
"Sometimes near the end of the second week they've begun to feel good. And there's a day in there when they realize that they look magnificent."


"Patients experience feedback, both positive and negative. Some people tell me that they're a bit irritated because people are now paying them more attention than they did before." And I say to them, "Isn't that why you had the surgery? Because you wanted to be more attractive?" And they reply, "Yes, but why didn't they like me the way I was?" But eventually people start to really enjoy the extra attention.
Recovery from cosmetic surgery for most people follows a necessary and predictable course. At Pacific Center for Plastic Surgery, we believe that being knowledgeable about the normal recovery process will reassure you and make it less stressful. These transient emotional and physical reactions to cosmetic surgery will pass easily when you are prepared about what to expect. The last part of the recovery process is the fun part - get ready for all the compliments!

First clinical depression is common.  It is estimated that 30% of the population suffers from depression at sometime.  I personally think this might be even higher among patients having cosmetic surgery.  Times of stress seems to bring out depression.  Think of your ability to function without experiencing depression as a capacity.  Surgery can stress this capacity.  Healing from surgery is very unstructured time.  I think this lack of structure also contributes to these feelings.  The important thing is to understand that these feels do happen and usually the depression is relatively short live.  In individuals with a known risk of depression, we generally ask them to talk to there psychotherapist about the need for additional support while they recover from surgery.  Occasionally depression after surgery is severe enough that intervention is required.  The thoughtful surgeon talks about these issues before surgery to help prepare their patients just in case this does become an issue.

There could be several reasons for depression of listlessness after surgery:

 

1) Downtime

2) Effects from Anesthesia

3) Stress about the surgery

4) Improper Family or Friend Support

5) Concerns whether you made the correct decision.

 

To alleviate these concerns, it is important to choose a skilled and experienced surgeon and staff who can prepare you properly, walk you through the postoperative care, and deliver the results that you are seeking.

Thanks for such an open question!  I do in fact discuss this with my patients.  I can sum this up very quickly I believe--- downtime.  Our patients tend to be very dynamic and have very busy and fulfilling lives.  We temporarily request and require a significant lifestyle change for a very brief time after surgery.  In addition, our patients are sometimes having significant changes in sleep, activity level and diet due to the normal stressors of surgery.

I really stress balance in all aspects of our lives for our patients.  We work together to get back into the swing of things as quickly as possible.

I am so glad you didn't experience anything like this.  It is certainly very common.  Being prepared and knowing that it can be "normal" is 90% of the battle.

Thanks again for such a great question.

Dr. Todd Hobgood