Treatment Provider

John Michael Thomassen, MD
Board Certified Plastic Surgeon
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24 days post SMAS Facelift

My swelling did go down, but it is still there and I am still swollen and numb around the sides of my face, ears and chin. I also have lumps in various areas. One is right along the line of my chin, some in my cheeks (almost feels like pimples or cysts or something) and some under my chin. I have a pretty prominent scar in my chin as well. When I last went to see my doc he said wait it out and see. I told him that I was not happy with my chin line yet and he said that he would do lipo if necessary. It may be only swelling at this point. It is really difficult to tell.

I have been able to go out and even back to work. To date, no-one (ok, one person) has said anything at all. I know there is a difference though. I have been taking pictures the whole way. Some days it is good, some days bad. It seems to look good, then bad, then good, then bad. It has been 24 days for me now and I am healing, slowing but surely. I am keeping ice on it (daily) and oftentimes sleep with ice packs on my face. I still find it difficult to sleep, and I am sure that is contributing to the slow healing. I will see my doctor again in a week or so, and touch base with him on what he thinks. He has promised I will get the results I want, and I choose to trust in his expertise. Will keep you posted.

I just had a lower facelift on February 19. I had...

I just had a lower facelift on February 19. I had a problem with the lower face sag (I turn 50 tomorrow and I am sure it had to do with periomenopause). I had the surgery done with local. I did quite a bit of research beforehand, and heard both good and bad about the surgery/recovery. It really helped me to read about the reality, and I wanted to write about this daily during my recovery, but it was a real struggle and I needed all of my energy to heal. I saw someone posted on here about their upcoming surgery and that prompted me to respond to them and then write about it here as well.

The Surgery
During the surgery there were a lot of shots to numb the pain. I did feel those, but it was bearable. I was given a 10mg valium before hand (it did not do much, but they do not really affect me). Overall, I felt very little pain. Some things that might be disturbing to some include how I could hear the snip of the scissors as they cut my skin, and the buzz of the cauterizer as it worked to close blood vessels. As the doctor cuts, the PA holds your skin off your face with forceps. It is sort of a pressure, but not pain. I guess I am a little weird, but it was all very interesting to me. I know it sounds horrible, but was not so bad. I thought I would be uncomfortable lying on a table so long while awake, but I did not feel any discomfort. The doctor and PA both constantly asked how I was doing, and the moment I felt any pain, they gave me another local. Honestly, I was joking with the doc and PA during (I would not recommend this..let them focus). Part of the reason I did that was to alleviate my own anxiety, and it did help. They played music during the procedure, and that was nice and distracting. I would highly recommend that since you will not be able to wear headphones.
Coming Home
After all was said and done, they wrapped me up, attached a couple of drains (I called them blood bags) and sent me home. One of my blood bags kept backing up and I had to squeeze the tubing to push it into the bag. I thought about calling the doctor about this, but looked it up online and found that they can sometimes get clogged with debris, etc. and to just try to push it through. Probably not a good idea to do yourself, but that was my experience. The pain did not set in immediately, but I took a painkiller anyway to combat what I knew was coming. I got home from surgery at about 3:30 pm and I had taken one painkiller during surgery as well. By the end of the day I think I had taken 3, and then woke up on and off through the night and had to take more. It was hard to sleep (get yourself one of those pillows to prop yourself up in bed), and there was a good deal of pain after (especially in the drain areas). I took the prescribed vicodin frequently (every four hours or so) over the next few days, but it is hard on the stomach. I threw up in the car the next day when I had to go back to get the drains removed. Once the drains were out the pain was more bearable, but it was still bad. I would recommend getting off the narcotic drug as soon as possible, since the vomiting only compounds the pain. Use mostly acetaminophen if possible, and see if your doc can prescribe a sleep aid and maybe some Xanax.
Daily Notes
I started taking Arnika Forte (for the bruising), and an antibiotic two days prior to the procedure. I think the Arnika Forte did help with the bruising. There were ups and downs throughout the first few weeks, but the first week was the most difficult as far as pain and swelling goes. I looked like Stewey from Family Guy (football head) because I swelled up so much around the sides of my face. The good thing about it is that I was so numb, I could not really feel any pain after about four days or so. I wore my compression garment every day because I really want a nice chin line. On the second and third day I had a lot of swelling behind my ears, and it looked very bluish. I immediately thought hematoma, and called my doctor, but he determined it was just normal swelling and bruising. I then developed some swelling under one eye (not bruising..just fluid). I kept ice compresses on throughout the day each day until it subsided. It was around my ears and chin that the swelling has been the worst. At one point, my chin was so swollen, it felt like it would burst. The skin around my chin and ears was hard like a rock for several days. It has gradually subsided over the two weeks since the surgery.

It has been about 2weeks now and I had most of my stitches taken out after week 1, and the rest 5 days later. There was some leakage behind my ears (still is actually) and numbness especially around my ears and in my chin. There is still a good bit of swelling in my chin which is worrisome to me because I especially want that nice chinline, but the sagging is much better. Most of the pain is gone (barring an occasional twitch from a nerve) and my facial line is much better than before. Although not perfect yet, and none of my friends have seen me (they will see me at my birthday party tomorrow, and none of them know I have had this done..I await the comments), so far my boyfriend and son say it has taken 10 years off of me. I don't know about you, but that is worth the pain, lol. P.S. Right after you look like a mutant and your face is swollen. I had alot of bruising on my neck (kinda looked like a serial killer got at me and didn't finish the job). It has subsided over the last couple of weeks. There were some hard times, and more ahead during the healing process. I think my doc feels that I am healing rather slowly, but in comparison to some of the horror stories I have read online, I feel pretty lucky with the whole thing. I can tell you, I went into this thing pretty scared, but I hated the sagging enough to go through with it. I feel like you do have to be pretty brave to do this. I really like my doctor, and had a great deal of trust in him, so that helps alot. I think that is one of the most important parts of getting this procedure. Find a doc you feel comfortable with, and then do your research. Find real reviews from real people. That is where you will get your best information.
Tips
Make sure you have icebags handy and someone to take care of you. Have plenty of soups and a straw for drinking. Get all of your meds filled ahead of time, and have plenty of re-freezable ice packets handy. Have two compression garments if you are going to wear one, because the first stretches out and can get really gross. For the couple of weeks following, you might be comforted by the cloth face masks or facial cloths moistened with water. I put a little hat under the compression garment so the velcro would not pull my hair out. Make sure you have someone who can take care of you. You will not be able to take care of yourself for a week or so. Have acetaminophen on hand for the first couple of weeks, and ibuprofen for after that. Don't take the ibuprofen till the doc says it is ok. Above all, relax, meditate, perform deep breathing techniques, and get as much rest as possible to help with healing.

Adding pics: I am not ready yet, but will add pics soon.

Provider Review

Board Certified Plastic Surgeon
2800 East Commercial Blvd., Fort Lauderdale, Florida
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Dr. Thomassen is really awesome. He listens to you and seems interested in what you have to say. I feel like he has real artistic talent, and a love for what he does. That is very important. He was very quick to follow up with any of my concerns and I know I can trust him to make certain I obtain optimal results. His PA also seemed to enjoy performing surgery, and was very knowledgeable. They are a great team. All of the people he works with are very nice and helpful as well.