Facelift Recovery

Your recovery from a facelift will depend a great deal on the plastic surgeon you select. Start by looking at many, many before and after photos (A link to my facelift gallery is attached)  for evidence of the results a plastic surgeon has achieved. Often, the plastic surgeons with the most expertise and the most beautiful long-lasting results will also have the skills to make the initial recovery shorter with less swelling and bruising.

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.

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.

Pain:

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.

Driving:

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.

Exercise:

I ask patients to wait on exercise and heavy lifting until 3 weeks after surgery. Otherwise I don't limit their activities

Numbness:

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.

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.

When it comes to healing everyone recovers at there own pace. Generally after a full face lift I tell my patients that they will be ready to be seen in public in approx. 14 days. That being said many people are comfortable being seen in 5 days. Things that may help in your recovery are : 1. good pre-op condition 2. healthy diet 3. arnica, bromelain and steroids for swelling and bruising and inflammation. Hope this helps.

Dr C

Going out public after a facelift.    The great majority of my patients do not bruise due to the surgical technique that I use.  Usually my patients can be seen quite well usually within a week of the surgery.  And at two weeks, they are amazingly well.  Final results are seen about three to six months after.

It is usual to be able to return to a job with light duties such as a desk job after two weeks.  You will still feel sore and stiff but should be able to manage without difficulty.  If you have a brow lift or lower eyelid surgery at the same time, add a week to this.  Winter is easier than summer as clothing and makeup suit the camouflage of bruising and healing wounds.  Wound infection rates are lower in winter also.
I recommend that people who lift heavy loads or have a vigorous job take four weeks off.  
Gentle exercise can start at three weeks and heavy exercise at six weeks.  

Avoiding blood thinners pre-operatively reduces your post op bruising and risk of a blood collection in the cheek.

If you have an important event (such as your daughter's wedding), give yourself a 2 month recovery to feel confident.

It depends on the person, but usually after 2-3 weeks you can be seen in public without being too self conscience about your appearance. You will still have some bruising and swelling but it should be minimal. You should be fully healed in 1-3 months after the surgery.

Typically, a facelift will take about 2 weeks before you're ready to be seen in public with minimal makeup.  However, there are ways to reduce the recovery time.

 

Before surgery, you should be in as good overall health as possible.  Bleeding is one of the big concerns with facelift, so not taking blood thinners, controlling any high blood pressure you may have, and avoiding aspirin will help with your overall health.

 

During surgery, your plastic surgeon should use the appropriated surgical techniques that give you the results that you want, with as little surgical dissection as possible.  The more surgery you have, and the longer your procedure, generally the more swelling you'll have, resulting in a longer recovery time.

 

After surgery, it's important to allow your body to heal, and to follow instructions for post-surgical care.  These include, but limited to, elevating your face, icing the areas of swelling, avoiding blood thinners, taking care of your incisions, possibly taking homeopathic medications and creams to help reduce swelling, and possibly eating more nutritious food with more protein, to get the best results.

 

I know, a long-winded response, but accelerating facelift recovery is possible with great pre-surgery planning.

 

Best Wishes on Your Recovery!

Roy Kim, MD

It takes several weeks for the residual swelling and bruising to clear in some facelift patients.  Each patient is different, but at my Austin, Texas area plastic surgery practice I usually recommend that patients take about 2 weeks off from work.  Some minor bruising and swelling might still persist for a week or two longer in some patients, but in general most areas can be covered with makeup at that point and look acceptable.  You can drive once you are not taking narcotics; this is usually in a few days in most patients.  Facelifts are not particularly painful but like any surgery it take a while before you start to feel normal again.  Best of Luck, Dr. Kerr

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