Steroids to reduce swelling after facelift? My doctor said they can have serious side effects. What is your opinion?

I am a big proponent of using a Medrol Dosepak for postop
swelling. This will definitely help with the postop edema.
Also, I use
Arnica Montana orally to decrease swelling and inflammation. This can be taken
as four pills sublingual (under the tongue) twice a day. I recommend this to
all my surgical patients.  (Note: It will
also help any other ache or pain . . .).  Also, reduce
your salt intake . . . this will reduce your postop water retention (swelling).
Also, I have
all my facelift patients have lymphatic massage . . . which is very mild,
GENTLE and will reduce the swelling.
All of these
in combination will help your overall postop recovery and result.  
Good luck!
 

Thank you for the question. All surgeons have specific prescriptions that they like to use before and after surgical procedures. Medrol (methylprednisolone) is one that is commonly used after face and neck lift to reduce soft tissue swelling. I use this in my practice also. The medication is given as a "dose pack" which is a 6 day taper. The dose is not really high, but there can be side effects. We don't recommend this for patients with diabetes or a history of stomach ulcers, for example. Please consult with your surgeon to see if this would be helpful in your case. Take care and best of luck!

I have been using a short course of steroids--- IV Decadron during surgery and a Medrol dose pack post operatively on most of my facelifts and rhinoplasties. In my experience, a short course of steroids does more to prevent swelling than elevation, ice and everything else put together. I haven't performed a double blind study, but I have performed over 3,000 Rhinoplasties and 1,000 facelifts in the last 34 years--it makes a difference. Never had a serious reaction except some patients get a little hyper and can't sleep, so we decrease the dose and taper it more rapidly.
In your case, one week post op, it's too late to start. Don't worry about your swelling, everyone swells, the final outcome will be the same.

Hello.  Thank you for your question.  I would suggest following the recommendations of your primary surgeon, as they know your case and medical history, and should be making recommendations in your best interest based on their experience.  Swelling is absolutely expected following facelift, and can vary from one patient to another.  The swelling usually reaches it's peak around postoperative day 3 or 4, and will then diminish fairly quickly over the following 2 weeks, with some mild residual swelling that will diminish more gradually over several months.  For most patients, the visibly apparent swelling that others will notice typically resolves in about 10 - 14 days, such that patients may feel comfortable getting back out in public.  I do not routinely prescribe steroids after facelift.  Earlier in my career, I would prescribe a Medrol dose pack after facelift surgery.  However, I stopped doing that several years ago and saw no significant difference in recovery for my patients.  Therefore, I see no advantage to prescribing steroids, in general, as steroids do have the potential for undesirable side effects, especially in older patients.  Having said that, in a case of excessive swelling in a patient with no contraindication to steroids, I would not hesitate to prescribe a short course, such as a Medrol dose pack, in hopes that it might potentially speed up resolution of the soft tissue swelling.  I hope this information is helpful.  I wish you the best in your recovery and achieving your aesthetic goals.

Thanks for your interest. Twenty four years ago I enjoyed having a fellow from Kuwait who was training with me for a year-and we organized what became an unpublished study that provided copious quantities of valuable information. We blinded patients in three procedures-facelift, blepharoplasty and rhinoplasty. 1/2 of these patients randomly were either given the equivalent of a Medrol dose pack (steroids) or given nothing. All were instructed in routine postop care specially aligned to reduce swelling-episodic ice and head of bed elevation. A year later with 60 facelift patients, 85 blepharoplasty patients and 275 rhinoplasty patients- our beloved nurse, myself and my boy scientist fellow - were unable to discern any statistically significant difference between the 2 groups in the 4 weeks following surgery. So, cutting to the chase-you have an operation which results in swelling and bruising sometimes-throw some ice on the affected area(20 minutes on and 3 hours off)-do this for the first 10 days with head elevation-get a great result and avoid a short course of steroids!Seems simple and oh did I mention-I love my job!!!.

A short term course of steroids like a 5 day Merrill Dosepak avoids the many side effects of long term steroids.  Avascular necrosis of the hip is a rare side effect that has been reported even with relatively short steroid courses but with a Medrol Dosepak extremely rare or nonexistent.  For unusual swelling, and other conditions like a severe allergic reaction to adhesive it can be quite useful.  Studies with other facial surgeries have shown no demonstrable benefits in swelling once the steroid course has been completed.  In your case steroids would unlikely give more than very temporary benefits.

Swelling and tightness post facelift surgery is expected and normal.  The majority os facial swelling occurs in the initial 2 weeks and usually complete resolution by 6 - 8 weeks.   Steroid medication is rarely recommended as there is a risk of significant side effects. Best wishes

It is quite normal to expect some swelling after a
facelift.  Most of it subsides in a few
days.  In my facelift practice I do not
prescribe steroids routinely, as it has not been shown to improve long term
results.  A surgeon relies on impeccable technique
and proper preoperative preparation and proper aftercare to minimize the
swelling.  Discuss pros and cons of
steroid use with your plastic surgeon.  

There normally would be some expected swelling still present a week after a face and neck lift.  The degree of swelling can vary by individual though.  Medrol may be used by some surgeons to reduce swelling, but it is true that steroids can cause negative effects in some people.  I normally do not find that oral steroids are needed after a face and neck lift, as swelling does usually resolve completely over time.  I would recommend following the advice of your particular surgeon.  

I used to give perioperative steroids to the facelift patients.It does seems to reduce swelling during early post op butthen swelling will return delaying recovery. Therefore I do not recommend them routinely to my patients. You are veryearly in your recovery and expect you to be looking bettersoon. Complete healing takes about 6-12 months but most swelling resolves in the first few weeks. Best wishes.