Facelift/necklift aftercare: ice or no ice? Bandages or no bandages?

Question

Getting different aftercare instructions from the dr's i am interviewing for basically the same procedures. One says no ice so bloodflow is enhanced for healing, no big mummy headwraps. Another dr 's after care protocol is ice constantly, bandages and drains... just another area I need guidance.

Waleed Ezzat, MD, FACS · Answer

Hi, and thank you for your question. It’s understandable that you would feel confused after getting seemingly contradictory advice from various surgeons. At the end of the day, every plastic surgeon is going to have his or her own set of guidelines for each procedure, so it’s important that you follow their particular advice once you choose someone for your facelift. If you have questions along the way, don’t hesitate to give their office a call. Good luck with your upcoming facelift!
-Dr. E.

Philip Solomon, MD, FRCS · Answer

Surgeons have different post procedure followup and care. My typical post facelift protocol involves a 24 hour compressive bandage which is changed to a lighter compression garment.  Patients are advised to wear the garment as much as tolerated for 3 weeks.  I do not routinely use drains but do use tissue glue to reduce seroma and hematoma.formation.  I do give a dose of tranexemic acid during surgery as long as its not contraindicated.

Amir Nakhdjevani, MBBS, MRCS, FRCS(Plast) · Answer

Thank you for your question.  Every surgeon will have they own protocol on different surgeries.  The best advise is to ask to speak with past patient to see how their recovery was and results are from following different recovery protocols.  There is no right or wrong approach and every surgeon may have a valid reason for their preference.  Which every surgeon you choose, please do follow their protocol instructions.  All The Best

James Chan, MD · Answer

There are a number of opinions and options for post-facelift care.  The best thing to do is to follow the instructions of the surgeon you choose.  There are likely reasons that these recommendations are made, and it is better to discuss personally.

Christopher J. Davidson, MD, FACS · Answer

Thank you for your question.  Post operative instructions do vary from one plastic surgeon to another.  That being said, I do recommend 1 day with a head dressing and a simple drain overnight.  I see my patients 1 day after face/necklift surgery for an assessment.  Best to seek care with a board certified plastic surgeon.  Best of luck.

Shim Ching, MD · Answer

Dear Alohacyn1,I can understand your need for guidance with this.  As all surgeons employ different techniques and have different beliefs about surgery, your postoperative care will vary.  Whichever surgeon you choose, you should follow his or her guidelines carefully as the techniques that were used will dictate what needs to be done after surgery.In my practice, fat grafting is an essential component of facial rejuvenation.  We believe fat survival may be influenced detrimentally by icing, so this is not recommended.  Wrapping the head and face is not recommended as well as I find it does not help with swelling.  In summary, it's best to follow the advice of the surgeon you choose.Aloha,Shim Ching, MD

Arnold Almonte, DO · Answer

Surgeons differ in opinion regarding post op use of ice and bandages. Arguments on both sides are reasonable and valid. Ask your specific surgeon why he or she advocates their protocol. I have my patients leave the operating room in a bulky dressing that gets changed the next day and converted to a lighter, more elastic face wrap to be worn for about a week. An ice pack is used in the first 24- hours, cooling, not freezing the tissue helps, I believe. Good luck!

Jeffrey M. Darrow, MD · Answer

Each surgeon has their own post operative protocol for their facelift patients.  It doesn't mean one is right and the others wrong, it's just a personal preference.  These preferences are not fixed in stone either and may change as dictated by the individual patients.  I personally use drains, especially if I need to elevate most of the neck skin, and a light compressive head dressing overnight and remove them in the morning when I see the patient.  This is not uncomfortable and is well tolerated by patients and can help decrease swelling right after surgery.  If you have a good rapport with your surgeon, trust that advice.  Best wishes.

Daniel Barrett, MD · Answer

Dear alohacyn1,every plastic surgeon has his own postoperative protocol which he recommends to his patients. I would suggest you to discuss this with your plastic surgeon.Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Ivo Gwanmesia, FRCS(Plast) · Answer

Thank you for your question.Aftercare protocols really do vary from doctor to doctor. In my Practice, I keep the patients in softwool for the first 24 hours, then the next morning, the bandage is removed with any drains that may have been inserted. I get the nurses to wash the patient's face and hair and then the patients are put in a facial garment for a week all the time. After a week, I see the patients in clinic where I remove all the stitches, and then advice them to wear the garment at night time for a further 5 weeks.This works well for my patients. I do not use ice as such. The best thing to do is to stick with the protocol that your surgeon gives you, as he would have had a lot of experience with his own protocol.Hope that helps.Kind regards.

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