Should I Use Hear or Ice to Get Swelling Down Now? I Was Using Ice First 2 Weeks.

Question

I am 6 weeks out and still have swelling under my chin, in my cheeks (near my ears) and above my eyes (under my brows) after having a chin lift, brow lift and half facelift... Should I use heat or ice now?

Peter Lee, MD, FACS · Answer

It is understandable that you want to do something to accelerate your healing and the dissipation of the swelling in your face and neck that you perceive.  There can be a temporary loss of sensation in the skin flaps after a facelift, so one must be careful with extremes of heat or cold applied to areas of insensate skin.  

	However, beyond that general precaution, the most truthful answer is that the more dissection that is done within the face, and the deeper the anatomic level of that dissection, the longer the postoperative swelling will last, and the slower it will be to leave.  What is really required from you is patience, rather than the application of heat or cold.

Jed H. Horowitz, MD, FACS · Answer

Throughout the #facelift #healing process you should be seen frequently by your doctor and one of their registered nurses to ensure you are following instructions properly and your recovery is going well. The healing process in general can take up to one month for the majority of swelling to subside, incisions to close, sutures to come out, and for bruising to completely go away. Ice can certainly help reduce the swelling.#Recovery time from a #facelift varies from person to person, but patients can generally expect to be presentable within three weeks from surgery. Patients should expect swelling, bruising, and discoloration of the skin during this phase of recovery (swelling normally goes down after 48 hours; most bruising will go away within two weeks). The marks from a facelift can easily hidden with “camouflage” make-up which you can learn how to apply.The scars from a facelift mature within six to twelve months from the surgery date. It is during this time that the rejuvenating effects of the facelift will become apparent and the real result will be seen.If you have certain concerns about the procedures and #healing process, it is recommended to call your board-certified surgeon or their medical staff and discuss those #concerns.

Young R. Cho, MD, PhD · Answer

Thank you for your question for sharing your concerns with us. Swelling and firmness in the tissues will return to normal as time passes by. Between the first and second week, much of your swelling and bruising will dissipate. It may take more than a month or two for your tissues to fully soften and any residual swelling to resolve. Lymphatic massage maybe an option to help clear the swelling and firmness at a faster pace.  At six weeks, heat may make swelling worse and ice may not have very much impact but won't hurt to try.  Just avoid prolonged icing or heating as this may also cause inflammation.  I would make sure that you continue to follow up with your plastic surgeon during this period of time.

Jeffrey J. Roth, MD, FACS · Answer

Ice is usually used for swelling, especially in the early post operative course.  Each surgeon will have a different protocol, (ice/heat/message/compression/elevasion etc;).  Best to talk to your surgeon and see what his particular protocol is.

Vincent N. Zubowicz, MD · Answer

When the capillaries are leaky in the first 24 hours eyes can be of some benefit in reducing swelling. After this it really doesn't have any effect.

Anil R. Shah, MD · Answer

Initial swelling is improved by ice. Ice helps constrict blood vessels which decreases swelling. Ice is typically applied on and off for the first 20 minutes for the first 72 hours. After the first few days, ice is no longer effective in improving swelling. The body needs to "drain" the area with swelling and lymphatics need to be established so that edema can be removed. Warm compresses can encourage lymphatic formation but we generally do not recommend this. Gentle massage, sleeping in an upright position, and appropriate compression garments can help improve swelling as well.

James M. Ridgway, MD, FACS · Answer

During the first few days after surgery cool compresses are very helpful. During the ensuing days warm compresses are more helpful. At this point your patience is very important as many patients observe persistent swelling for up to 3 months. In the end, it all resolves.

	Be healthy and be well,

	James M. Ridgway, MD, FACS

Ryan Neinstein, MD, FRCSC · Answer

Staying upright as much as you can will help the most. Temperature changes at this point wont have much effect. Just need the tincture of time for the swelling to come down

Larry S. Nichter, MD, MS, FACS · Answer

Ice is very effective in the first 72 hours to minimize and prevent swelling, however after that period of time in my experienced it does not make it go away quicker. In other words there is no need to use it after that time period.

Ronald Schuster, MD · Answer

I like ice for the first week and then warm, but not hot, compresses thereafter. I think that the heat helps to dilate and open up the little vessels which can help to remove the trapped fluid. Together with gentle pressure, or massage helps the swelling to go away quicker. Also, even more important is to avoid salt as it will cause you to retain fluid.

Michael I. Echavez, MD · Answer

Ice can be helpful with swelling after surgery, but really only helps the first few days. At 6 weeks after surgery, ice will not make a significant difference. I would not apply heat to the area initially or now. Unfortunately, it is just a matter of giving it more time for the swelling to resolve, and this can take several months.

Should I Use Hear or Ice to Get Swelling Down Now? I Was Using Ice First 2 Weeks.

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