Anxiety is standing in my way!

Question

The only thing holding me back from making my neck lift/lower face lift appointment is anxiety about my neck feeling too tight and my head being bandaged. I normally suffer from claustrophobia. Is an anti-anxiety drug the answer or am I just a poor candidate for this kind of plastic surgery? I'm 60 years old and I'm not afraid of the work - more afraid of how I'm going to feel afterwards with a compression garment on my neck! How can I work through this fear?

Jason Emer, MD · Answer

For unique cases where a variety of modalities could be used to treat the condition, I would suggest an in-person or virtual consultation to develop a custom and effective treatment plan.  It is difficult to precisely define the best option without collecting the same information. I suggest reaching out to an expert for a consultation with surgical and non-surgical methods to get a comprehensive option. Best, Dr. Emer.

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

Hi, Thank you for your question and I completely understand your concerns. Throughout my career I have performed many facelifts and have always found the patients worst experience is coping with the drains and bandages. I therefore pioneered my own technique whereby the procedure is performed under local anaesthetic, so no overnight stays and you are awake throughout, also due to my technique so is no need for any drains, bandages or compression garments. You are able to walk out of the clinic and go straight back to the comfort of your own home.  My technique is called the Concept Facelift and it has amazing results with the same longevity as a traditional facelift however the recovery is only 1 to 2 weeks rather than the usual 4-8 weeks. It is definitely beneficial to see a board certified surgeon and find out about different techniques along with ready different reviews.Good luck in the future and try not to worry, it will all be worth it!Amir

Toby Mayer, MD · Answer

Once the patient hears what is involved and that the dressing will not be tight and their face is fully open that is enough for most. However, if needed I have supplemented the surgery with anti anxiety meds for a few days.

William Portuese, MD · Answer

There are some medications can help with the anxiety  in the immediate postoperative period. In our practice, we do not use any head wraps or bandages whatsoever. We use JP drains which are left in place for 24 hours after the surgery to remove the blood out from underneath the skin.  The drains minimize the amount of bruising in the neck.The neck muscles do feel rather tight for the first week or two after the procedure.

Samir Shureih, MD · Answer

It is normal to be anxious before surgery. It is the fear of the unknown. Normal human reaction.How ever if patients are prone to anxiety attacks and are extremely anxious, then controlling the anxiety prior to surgery is best. You do not want to have anxiety attacks while healing.You need an in person consult with frank discussion of the surgery and what to expect in details then both doctor and patient can make informed decision

Francis R. Palmer, III, MD (retired) · Answer

Hi, I have performed many facial shaping procedures and facelifts over the past 30 years.  I am sorry to hear that you are suffering such anxiety over a possible lower facelift because of the perceived post op dressing.  It's best that you meet and discuss this with an experienced Facelift Surgeons but if you are indeed a good candidate for a lower facelift as described below, there are many ways to "tailor" your facelift experience in order to make it as easy as possible.  I've always believed that these procedures should be done with the utmost level of safety and comfort.  There's just no reason for you to be anxious or suffer.   I would add that in my experience and humble opinion, it's probably best that you have a general anesthetic (not a local anesthetic) and stick with the less invasive minimally invasive type SMAS facelift for numerous reasons:  Far less surgery time, which means far less bruising, swelling and recovery time.  Most importantly, theres no need for drains or a compression pressure dressing that are used in the more invasive type facelifts.  Even with all that, I would highly suggest anti-anxiety medication during your post op course when it's critical to keep your blood pressure at a normal level (anxiety can greatly increase the blood pressure leading to bleeding, swelling, bruising and hematoma in the more invasive type facelifts).   Following my beauty principles, women look the most feminine, youthful and attractive with heart shaped faces.  Heart shaped faces have cheeks that are full and round in the front.  Cheek augmentation with a dermal filler or using cheek implants for a permanent enhancement will create full, round cheeks that will feminize the entire face.
 If you have "jowls” these are sagging facial tissues and an indication for some form of a SMAS facelift.  The underlying SMAS layer, of the face, must be dissected, lifted, trimmed and re-sutured (not merely folded or suspended with threads or sutures that will not last).  The excess skin is then removed and the facelift incisions closed.
My most popular facelift is the minimally invasive, short incision facelift that has all the benefits of more invasive facelifts (traditional, mid-face, deep plane, cheek lift and subperiosteal facelifts) but with these added benefits:
very small incisions and no incisions extend or are placed within the hair.
minimal tissue dissection = less bruising and swelling = rapid recovery ( several days instead of weeks or months with the more invasive type facelifts mentioned)
can be performed in 90 minutes or less, with or without general anesthesia
no incisions within the hair = no hair loss
excess fat can be removed
excess skin removed
cheeks, chin and jaw line can be augmented with dermal fillers (I prefer Restylane Lyft) or facial implants
most patients fly back home to parts all over the world in as little as 3 days post-op
I combine facial shaping with every facelift procedure.  When jowls are present, these should be done in concert and not alone or separately in order to create a naturally, more attractive face.
Hope this helps.

Jon A. Perlman, MD (retired) · Answer

You can be free of any drains and only briefly have a mildly compressive head wrap on after face and necklift surgery.  I have been using fibrin glue for more than 15 years and a tight compressive dressing is not required.  If the benefits of the face and necklift are not sufficiently enticing to proceed with your surgery then perhaps you are best off leaving well enough alone.  Review photos of other patients and meet with plastic surgeons until you find a board-certified plastic surgeon who gives you a sense of confidence and caring.  Once you are in the hands of a doctor you trust your anxiety level should be reduced and antianxiety medications used judiciously only if necessary .  Best wishes and good luck in making your decision,Jon A Perlman M.D., FACSDiplomate, American Board of Plastic SurgeryMember, American Society for Aesthetic Plastic Surgery (ASAPS)ABC-TV Extreme Makeover SurgeonBeverly Hills, CaliforniaIG: jonperlmanmd

Ronald V. DeMars, MD (Retired) · Answer

I see a few patients a year with the same worries as you have. Anti-anxiety meds are fine to take, but most experience surgeons realize that tight bandages play no role in good results and prolong facial swelling. Our bandages are not tight and we allow the patients to remove them the next day if they are bothered and at 48 hours postop in any case. With that understanding they all seem to tolerate the bandages. Have a frank discussion with your surgeon at the initial consultation to make sure he is willing to work with you.

Anxiety is standing in my way!

Answers (8)

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