51 Yr Old Lower Face/Neck Lift, Upper Blepharoplasty, Lower Lid TCA Peel- Dr. Harley - Asheville, NC

I first noticed signs of lower face aging at 49....

I first noticed signs of lower face aging at 49. Now at 51, I have significant neck banding and laxity (with a weird "crater" thing in the middle of my neck) with lower face jowling and have decided to look into getting a lower face and neck lift. I did hours of research and had consults with several local plastic surgeons, but nothing felt right. One wanted to do a lot of filler (Bellafill) along with a lower lift, another wanted to to do the lower lift without a corset platysmaplasty because he "didn't like chin scars." What?!! Loose/lax platysma muscles are my main problem, so that was a big "no" to that guy. Thankfully, I came across Dr. David Harley who practices in Asheville, NC. After reviewing his training, credentials (double board certified, by the American Board of Facial Plastic and Reconstructive Surgery and the American Board of Otolaryngology!), patient reviews and his incredible before and after photos, I knew he was the surgeon for me. Added bonuses are he uses local sedation and only does facial work. I filled out an intake form and sent in my photos (yuck!). Dr. Harley called me a few weeks later, answered all my questions and it was decided I was a candidate for his Biltmore Lift (lower face/neck lift) and surgery was scheduled for November 2. I flew into Asheville on November 1 and had my in-person consult with Dr. Harley. He was very personable, answered all my questions and was up front about realistic expectations for outcomes. During this consultation, I elected to also get an upper blepharoplasty and a 30% TCA peel to my lower lids. Needless to say, at this point I was very confident in proceeding with Dr. Harley.
The next morning I arrived at his office at 6:15 am and was greeted by Dr. Harley and his wonderful nurse Kelly. I signed all the consent forms, took the cocktail of pills (Valium & ATX), pictures were taken and then I was escorted to a big comfy chair. By this time I was really relaxed. I remember him injecting my face. It didn't hurt, just felts like little sticks and then I was out. Next thing I remember is getting into the car and going back to the hotel. That afternoon I slept most of the day. The only pain I had was bilateral lower jaw pain, bottom mandible... that was pretty uncomfortable until I took the pain meds.
The next morning I went back to Dr. Harley's and the compression wrap and drain were removed (did not hurt). I returned to the hotel and pretty much just took it easy and iced all day. I will continue to update as I continue to heal.
As an aside, I want to thank those who have posted reviews and so generously shared their experience, especially with pictures ... all have been very helpful to me and I'm sure to many others.
Also, my "before picks" are from the cheeks down because I wasn't sure if I wanted to publish full face pics. However, since I had a blepharoplasty, my post procedure pics will be full face.

"Before" Pics

I finally am able to post pictures from my phone. Here are the painful "befores." The neck is a lot of real estate around the face and I think the laxity and banding in that area really aged my appearance Also present is lower face jowling.

Update with pictures

The last several days have flown by. I have continued to take it easy, mainly watching movies and reading. My energy level is definitely diminished, however, I have gotten out several times for walks (only had a rental car the day I arrived) and that has been enough activity for me. I am in awe of the gals who have gone out sightseeing and been more active during their recovery... that most certainly has not been in my stamina zone. I have had some post procedure discomfort, nothing terrible. At first it was mainly bilateral lower jaw pain and lateral neck aching starting below my ears. Once the compression head wrap was removed PO Day 1, the lower jaw pain disappeared. I have continued to have lateral neck discomfort, along with a tight feeling under my chin, but that has easily been controlled by medication, first two days with Hydrocodone, now just with Tylenol. My incisions are healing well. My "sideburn" incisions look great, very fine, perfect suturing by Dr. Harley! The incisions in front of my ears, below my chin and lateral upper lids are covered with silicone tape, but as far as I can tell, look very good. The incisions behind my ears and in the back are not as good, kind of bumpy and a source of discomfort. I believe that is not uncommon so I am trying to be patient while I heal. Not surprising to me, despite doing the pre-procedure Arnica montana, eating pineapples and blueberries (ad nauseem, I might add), bromelein, low Na diet, hydrating and icing/using cool packs, I still managed to swell and bruise impressively. My cheeks were swollen by PO day 1, then I developed swelling around my ears, my lateral neck and under the chin. I iced religiously the first three days, which I think minimized swelling, now I ice just for comfort. I have discoloration/ bruising behind my ears that extend somewhat down my neck and scattered light yellow areas in various places on my face, neck and chest, subtle, but can be seen in some of the photos I am going to post... not pretty, but not terrible either. The upper blepharoplasty and lower lid TCA peel have been a total breeze. My upper lids are a pretty shade of purple, but lightening in color already. I have had no pain, minimal dry eye and no vision problems. I already love how my upper lids look! My lower lids are a kind of pinky/light brown from the peel, no discomfort, keeping aquaphor on the area around the clock, slight peeling just started today. I was initially going to have a full face peel, but weanied out... now kind of wishing I had done it. I am going to keep on cruising until this Wednesday when I get my stitches out (YAY!), then fly home on Thursday.

Chin incision

Forgot to show pics under the chin, also included one showing yellow bruising.

Two weeks later...

Healing has been going well. Flying back on Thursday went smoothly... it was so nice to be home! At two weeks post procedure(s), I am feeling almost normal. I bruised more than most, as compared to other Dr. Harley patients, but truth be told, I wasn't surprised. I usually respond to "insults" with lots of color. The left side of my face has had more swelling and bruising as compared to my right (see pics). I have been very good about sleeping perfectly upright, so not sure why, maybe left side being the drain site? Who knows. Again, feeling pretty good... the only places that feel "different" are the areas on my face in front of my ear incisions (below my cheek bones, above my lower jaw) and at my chin incision. Those areas feel weird, partially numb with fullness/tightness, but seem to be getting better every day. Apparently, the firmness is related to the sutures under the skin that are holding the deep tissues together (please keep holding that all together!!!). I also have some lumps/scabs along the incisions behind my ears. Per post op instruction, I have been massaging them... sounds gross but some areas actually have made a "crunch" noise. I keep doing it because it is probably breaking up things that need to be smoothed out. I am not sure what the incisions in front of my ears look like right this moment as they are still covered with silicone tape that was applied two days ago (all looked clean and approximated at that time). Dr. Harley's post procedure incisional protocol now is using silicone gel tape as much as possible for the first eight weeks, changing the tapes out every 3-5 days. I have kept them covered 24/7, except for replacing the tape when needed. I am using is Mepitac brand silicone tape, 3/4" width, good product. I cut it to length, then cut it in half for each side of my face.
I have to say, the recovery from Dr. Harley's neck and lower face lift has been easier than I thought, even with my extra bruising. Honestly, what has been a TOTAL breeze are the upper bleph and lower lid 30% TCA peel. I am not kidding when I say I have had zero discomfort from either procedure... and I love the results. I think my upper lids look great (thank you Dr. H) and the incisions, even at just two weeks, are indicernible when I have my eyes open (lids down can see them a little, see pics). I have silicone tape on the incisions that extend from the outer corners of my eyes. After the 30% TCA peel, my lower lid skin is so smooth, no trace of the fine lines I had pre-procedure. The lower lid skin was a little pink right after I peeled, but now there is no detectable discoloration. I keep holding my breath because I worry that the below the eye wrinkles will show up again full force one morning... hasn't happened so far! I am going to be good and protect/take care of that skin, along with the rest of my face from here on out. I'll update in another week or so to show incisions when they are not covered by silicone tape. Maybe even apply some make up. I haven't put on any since my procedures and cannot wait... kind of forgotten what I look like with a little mascara. I also need to figure out how to do side by side pics for pre & post procedure comparison.

Incisions and Healing 2 1/2 weeks

Glad to report at just over 2 weeks post procedure, I am feeling almost back to normal. I started exercising (mild cardio on my elliptical hybrid) at the 2 weeks, without issue (post op instruction recommend avoidance of strenuous activity until the 4 week mark).. Appearance wise, my face is also getting close to normal. I still have a small amount of swelling, firmness, and bruising in my lateral cheeks, but each day the areas get better. At the time of my last post, I wasn't sure what my ear, chin and outer upper eye lid incisions looked like because I have been keeping them covered 24/7 with Mepitac tape per post procedure instruction. I hadn't seen the incisions for 5 days (the tape stays on WELL!), and let me tell you, I think Dr. Harley is right on with the silicone gel taping because I think they look great. They are still slightly discolored, but the edges are perfectly approximated. They are well placed, following my "side burn" hair line and down right in front of my ears (THANK YOU Dr. Harley!) Even this early in the healing process I can hardly see the incisions that are right in front of my tragus(s). My chin incision looks great, too... it is FLAT and you cannot see it unless I stretch my head/neck way up, which of course don't do normally. I honestly almost forgot to take the chin tape off last night because it really is that inconspicuous. My upper bleph incisions are still slightly discolored, but not bad. In fact, the discoloration of all of my face incisions is such that they are easily camouflaged with just regular foundation, no specialty or heavy duty concealer needed. I will say that my upper lid incisions became a little irritated after I wore eye make up this past weekend, so I may hold off another week before I do that again. The lids weren't irritated when I applied and wore the make up, it was only after I removed it. Even though I was gentle, I think the removal of the make up was part, if not mostly, to blame. I am attaching some incision pics, all without make up and hair tucked behind my ears. I apologize for the poor quality. I took the pictures after I removed the tape, which happened to be at night time, which challenged my already lacking photo taking skills. I really am pleased with the placement and healing of the incisions so far... totally surpassing my expectations!
Asheville Facial Plastic Surgeon

Dr. Harley is an exceptionally skilled surgeon. I could not have had a better experience than I did with him and his wonderful staff.

5 out of 5 stars Overall rating
5 out of 5 stars Doctor's bedside manner
5 out of 5 stars Answered my questions
5 out of 5 stars After care follow-up
5 out of 5 stars Time spent with me
5 out of 5 stars Phone or email responsiveness
5 out of 5 stars Staff professionalism & courtesy
5 out of 5 stars Payment process
5 out of 5 stars Wait times
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