46 and Ready for a Lift - New York, NY

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I have really appreciated the information shared...

I have really appreciated the information shared on this site... it has helped me so much as I was thinking through the decision to go for it. I want to give back to the community -- and, yes, I'd love your support through my journey!

A couple of weeks ago I interviewed my doc and set a date. I travel a lot for work and my "window of opportunity" this year isn't until April, so I still have a while to wait. Trying not to obsess too much in the interim (and not succeeding too well).

Here are a couple of current pictures showing what I want to fix.

Not exactly ready for my closeup, Mr. DeMille

I got copies today of my professional pre-op photos (which my PS requires) and I was surprised by a few things.

(1) They are in B&W. I guess that makes sense; the doc isn't going to do my makeup, after all, and B&W shows texture better than color. I think the contrast may also have been enhanced to show more detail.

(2) The sagginess of cheeks and neck doesn't look as bad in these pictures as it does in the ones I took (or in recent candid snapshots), because the photographer had massive lights shining straight at my face instead of the overhead lighting we normally inhabit. Fewer shadows = less obvious droopiness. I guess RuPaul is right and it's all about the lighting.

(3) But OMG the texture of my skin in these high-res B&W photos is appalling. Thank goodness for makeup.

(4) And perhaps the most useful thing I learned: the photographer had me do a "big toothy grimace" for the camera... and my smile is more lopsided than I realized. Not that I see this as a problem, but it's something I want to make note of now and not freak about asymmetry later, since I wasn't symmetrical to start with!

P.S. Waiting for my hair to hurry up and grow. I have worn a pixie for years but that does NOT seem like a good option for the recovery phase! Maybe by the time the surgery is done and I'm ready to go back to work my hair will be in some kind of decent shape and people will attribute any change in appearance to my hair being past the awkward-growing-out phase.

Pre-op phone consultation with nurse

Called today for my pre-op phone consultation with the surgical nurse. Mostly the purpose of this seemed to be confirming that I read and had understood all the materials they had provided me and giving me a chance to ask questions.

What I learned was...

(1) At 2 weeks before the surgery, really cut out absolutely all vitamins and supplements (other than the Arnica Montana and Bromelain) as well as alcohol, aspirin, ibuprofen, naproxen, etc. (a long list); maintain through 2 weeks post.

(2) One week before the surgery, start taking Arnica Montana and Bromelain 3x a day; continue through 2 weeks post.

(3) An Ambien or Tylenol PM is OK the night before the surgery if I am nervous and cannot sleep.

(4) It will be OK to take Diflucan (which, given the antibiotics, I am glad to hear).

(5) I will have drains for 48 hours which my private nurse will remove. But all the sutures and/or clips will stay in a full week; the first post-op appointment will be scheduled for one week after the surgery.

(6) The doc wants patients to keep the face muscles and skin very still to the extent possible -- minimize talking, laughing, smiling, chewing but also not washing the face, not applying moisturizer, not massaging the scalp while shampooing, etc. -- for the first 2 weeks. Gentle rinsing with warm water is beneficial after 48 hours but the strong instruction is don't move the facial muscles or disturb the facial skin any more than absolutely necessary during those first 2 weeks. The nurse said this really makes a big difference for optimal healing.

Less than a month to go

I filled my prescriptions yesterday... there is Ondansetron (Zofran) for nausea on the day of surgery, Hydrocodone-Acetaminophen (Vicodin) for pain, Diazepam (Valium) for anxiety, and Cephalexin antibiotic. The nurse told me that patients often find the Valium more useful than the Vicodin after surgery because the pain as such isn't the major issue, it's more the sensations of tightness or numbness and the overall emotional aftereffects in the first week or so.

Anyway I am excited about the date getting closer, a little nervous of course. I am trying to get myself into good habits now, for example trying not to cross my legs when seated. That is surprisingly difficult!

Final check-in done

I've now had my blood work and EKG done, and I went for my final consult with the PS. Re-confirmed with the PS exactly what will be done - short scar SMAS, including the stitching of the neck muscles under the chin, and also we will do a TCA peel under the eyes to reduce fine lines. Reassured me the procedure is totally routine. I wish the day would hurry up and get here already!

(Naturally, now that I am moving into the period where it's imperative NOT to get a cold, my throat has begun to feel a bit scratchy. Making me anxious since I really do not have a lot of schedule flexibility and absolutely do not want to postpone!! I will just try to get a lot of sleep the next few days and hope it goes away.)

Here are a last couple of "before" photos of what I want my neck not to look like...

day of

I am now ensconced in my recovery hotel with expert nurse. One interesting point is she wants me propped at 45 degrees not upright... Says too upright contribute to pooling / swelling under chin. More tomorrow!

rest of what happened yesterday (day of)

So here I am! Amazingly I was really not nervous before the surgery yesterday. I was supposed to be there at 6:30 am but I totally did not want to be late and I go there about 6:10 (fortunately craxy taxi diver managed to avoid causing an accident but it was a close call... wouldn't THAT have been perfect). When the nurses arrived at 6:30 they had me strip down and get into a gown and compression hose, take a final pee, and then got me into the operating suite (I was not catheterized thank goodness). The anesthesiologist go the IV into my arm, started the sedation, and that's the last I remember until waking up in recovery. I was woozy but not in pain, no nausea. They had a drink a fair bit of ginger ale (juice also an option but I love ginger ale) and then god me dressed and the duty nurse and my husband accompanied me to the hotel.

No face bra (yet - may come 2nd week, bleah). Just bandages. The way they have the drain set up it's a single drain that apparently runs the width of my neck under the skin and comes out behind the right ear. That is tended and is making my neck look lumpy and causing bruises. But, I hope, preventing hematomas etc.

So I had not much pain -- really only the very top tips of ears -- maybe 3 on scale of 10. Took my Vicodin, antibiotics, Bromelain. The most difficult think is trying not to talk or laugh and not to do things for myself. Oh, and keeping my head pointed straight ahead and tilted back at 45 degree angle along with torso. Watching old "comfort TV" (I brought DVDs) helps stay still but does not help the head position. Getting up to walk laps in the hotel hallway is a relief.

I didn't sleep all that well despite Vicodin and Ambien. Plan to take a nap later today. More later when I can give proper report on day 2. Meanwhile I should take a walk and then get my head back into proper position (hard to do while typing!).


ps please excuse, typing semi-recumbent not helping!!

day 2

feeling more tightness in the neck today and definitely aware of the drain. But still in the "discomfort" realm rather than "pain". I feel like my face and jawline look pretty good, a little worried about appearance of my neck which I hope is just swelling and issues caused by the drain, and the horizontal banding I'm seeing now will go away!! the bruising is much less than I'd feared (so far but of course it's only day 2).

definitely feel more lucid and amble to walk much better. still an effort not to talk too much, laugh, push myself too hard. Will be very happy to get the drain out and have a shower.

more day 2 pix

Day 3 adventures

I think I am in full "balloon face" mode now. My face and ears look and feel very much more swollen than yesterday.

The good news is, I got a decent night's sleep last night and the drains are out. The bad news is, I got VERY VERY woozy after my first shower. With help of my nurse everything was OK but it was kind of scary. I think I need to eat more... I have had basically no appetite, but the body needs fuel to heal of course. Originally the plan was for me to be on my own by this afternoon but I arranged for 24 hours more nursing supervision. Will just feel safer that way.

I'll post more pix when I can but for now just imagine a Bobble Head. Thank goodness the nurses have seen it all before, and though my ears feel like two bricks tied to the side of my head the experts tell me the swelling is not bad at all and will go down soon. Everyone says day 3 and 4 are the worst, right??

Day 3 report - made it through and starting day 4

Thanks everyone for the words of encouragement!! It is so much appreciated!!

Here are some of my balloon-head pictures. As I know others have experienced, my face and neck *feel* much more swollen than they seem to look (not that I would say it looks good or anything). The numbness probably makes that feel even worse... you know how when the dentist numbs you and it feels like your lip is the size of a cantaloupe? I guess it's like that, my cheeks / neck / jaw feel about 5 times normal size but only look twice normal size, ha ha.

I am actually surprised that there is not more bruising. Developing bruises (just from brushing against the corner of a desk, etc.) is one of my best skills, so I give major credit to my doc and the Bromelain that it's not worse than it is.

Today I am definitely going to pay close attention to my blood pressure; I always tend to run low (typical 110 over 65) but I do NOT want a repeat of yesterday's scary dizziness. Maybe I should get a bp cuff of my own to use once the nurses are off duty starting this afternoon.

day 4 swell-o-rama

I thought I looked like a bobble head yesterday but that's nothing on today! The nurses tell me it is all normal and will start to go down tomorrow and I sure hope so. I can see why Day 4 is the day when people start wondering "why did I ever do this?"

I am heartened by everyone else who has been through this and come out with beautiful results... I hope I will get there too!!

Day 5 part 1

My emotional rollercoaster is dipping today for sure. I slept well last night, thank goodness, but when I woke up and found my face still felt like a giant heavy mask and that the swelling under my chin didn't look any better than last night (why did I think it would magically go away overnight?) I really got hit with a case of "oh no why did I do this to myself things will never be normal again" etc. etc.

My husband is being a sweetheart. He doesn't understand why I felt I needed to do this but is being supportive... on the other hand I can tell he is freaked out by how I look now, and last night when he came to visit he said he really never wants me to do anything like this again. (I suppose that's better than "hey honey, do X and Y next, OK?")

Maybe some of my low mood is the fact this is my first morning waking up on my own since my nurses went off duty yesterday afternoon. Actually I should point out that last night the nurse who helped me through my "whoa-low-blood-pressure-don't-pass-out-on-me-girl" first shower dropped by to check on me. She was here in the recovery hotel with another patient and when she went off duty she came by my room to see how I was. She assured me the swelling was much better ("I can see your cheekbones now") and that the swelling under the chin was not a hematoma or anything scary but just a part of the healing process.

My plan for today is to take a (careful) shower, watch some "comfort TV", and maybe (MAYBE) check work email for no more than 1 hour. I was thinking I might try to take a very short walk (just up and down the block) but if it is still raining this afternoon I will stick to pacing in the hotel room!

Day 5 part 2

So it did pretty much rain all day, no walking the block for me. But I did take my careful shower and pace around the room a bit. Maybe a sign that I am feeling better is that I caught myself trying to turn my head a couple of times (and chided myself: no head turning! Turn whole torso only!). Tomorrow it is supposed to be nice out so maybe I will try my "walk the block" then. Originally I was thinking I would walk to my doc's office for my appointment Thursday afternoon to get my sutures out -- it is only half a mile -- but now I am thinking maybe it would be smarter to get a cab than to walk by myself.

I did *not* check work email and not feeling too guilty about that! But I did chat with one of my three girlfriends who is "in the know" and that was nice. Husband came by tonight and we had (soft easily chewable) dinner together. The next couple nights he is away on business... and then Friday I go home for a week's recuperation there.

I think *maybe* the swelling is starting to subside in my cheeks. My face is starting to look a bit less like a balloon, although it has acquired a lovely yellow bruise color. The neck and under the chin (and the left ear... why??) still feel and look super swollen. But, early days, yes?

Thank you so much to everyone for your kind words of encouragement. You really really helped me get through the day without a crying jag, which would have done no one any good. Karma points to you all!!!

Day 6 update

I counted surgery day as Day 1, so that makes today Day 6. So then tomorrow is lucky number 7? :)

Today my face seems to be more face-shaped (yay!) and my neck a teeny bit less swollen but the swelling under the chin is still freaking me out. My right ear (the less swollen one) is starting to feel slightly more like an actual part of my anatomy, though the left one still feels more like a brick tied on to my head.

The TCA peel under my eyes is actually starting to slough skin, which is progress. Actually I also noticed the front of my chin (not underneath) is starting to shed some skin flakes though there was no peel there. Maybe just from the swelling and the lack of moisturizer? My strict orders from the doc are to do absolutely nothing to my face other than keep a thin layer of Aquaphor on the TCA peel areas under the eyes.

I took a walk around the block today and that felt good. Maybe I will actually brave the walk to the doctor's office tomorrow instead of taking a 2-minute cab ride. I am glad I'll see the doc tomorrow to get stitches out and ask him my long list of questions! Not just about the swelling and such but also when will it be OK for me to start smiling and laughing and generally having facial expression again? :)

Day 6 photos

Eventful Day 7

Today was my post-op appointment to have sutures removed and generally have the doc check me out. I walked to and from the doc's office -- about a mile all told, which should by rights be nothing but still felt like an accomplishment!

I went in with a very long written list of questions so I'll start with what I learned:

1. Is all this swelling under my chin and on my neck normal? Is it going to just stretch everything out so I am back to turkey wattle? What's with the lumps behind my ears, are they from the drain? -- ANSWER: normal swelling. Unfortunately everybody is different about how long it takes to subside, so we can't say when it will go away, but everything looks totally fine. No, it will not stretch back out into a new turkey wattle. The fact that one side (for me, the left) is more swollen than the other is very common. The weird lumps and bumps on the neck are mostly due to the short-scar procedure rather than the drain, and will settle down and flatten out over time.

2. I've had a bit more pain around my ears the last 8 hours. Is that because the nerves are starting to heal, or is something wrong? ANSWER: yes, the nerves are healing; no, there is nothing wrong.

3. Is it possible to sleep too much or should I just nap when I feel like it? ANSWER: sleep all you want. Sleep is healing.

4. I should still be trying not to move my face much for the next week, right? No smiling, animated expressions, etc? ANSWER: keeping your face as still as possible through the next week will give you the best result. Similarly don't floss your teeth, yawn widely, etc. for another couple of weeks. If it feels OK to you it is now fine to turn your head about 45 degrees to left or right, but no more than that, and if you can keep looking straight ahead for another week so much the better. And keep sleeping propped up and no bending over!

5. Do I really have to wear the compression stockings for another week? ANSWER: not necessarily if you are up and moving around, but it doesn't hurt.

6. When can I wash my face? Can I use my Clarisonic again? ANSWER: you can wash your face gently with Cetaphil if you feel the need, but it is actually better still to do nothing in week 2. Wait until at *least* 2 weeks after surgery to use a Clarisonic and if it doesn't feel right, stop immediately. Basic rule -- if something doesn't feel right, stop.

7. Do I need to have my head supported when reclining / sitting? Or is sitting up (e.g. at a desk chair, working at a computer) all right? ANSWER: It's all right to sit up, but you may be more comfortable for a while yet with more support. Don't push yourself.

8. I normally watch what I eat very carefully. For this first week after surgery I set that aside and just ate what I could to make 3-4 meals/snacks a day (not just soup, scrambled eggs, and applesauce but Ensure, yogurt, peanut butter, ice cream, chocolate... I fear I will be one of the few people who actually gains weight in the first week post surgery). Is it OK for me to go back to my normal calorie intake now, headed into the second week? ANSWER: yes, but make sure you eat extra protein.

9. Is it reasonable to target about half my normal exercise level as a goal in the second week? ANSWER: sure, give it a try, but listen to your body.

10. Do I have to wear a face bra now? ANSWER: it should help with the swelling. Here it is -- wear it as much as you can when you are not out and about, take it off if it starts to drive you nuts.

11. How should I care for the incisions? ANSWER: Up till now we wanted you to just leave them alone. Now that we're taking the stitches out, it can't hurt and might help to put on a thin layer of Bacitracin morning and night.

12. I go home tomorrow... what precautions should I take with my pets? ANSWER: Pet hair and dander can cause infections of the wounds. Keep pets away from your face. Wash your hands well after touching your pets, their toys, etc. Use a clean pillowcase each night. Keep your face bra clean.

13. What should I have asked that I'm not asking? ANSWER: Can't think of anything but call any time.

Anyhow, the nurse took out the clips in my scalp, the sutures in front of my ears and under my chin. The ones behind my ears are dissolvable and may take a while to finally dissolve. Wish my hair was longer!!

The nurse also checked out the TCA peel under my eyes and carefully removed the last of the dead skin so I guess I am all done with that. Whew. It was not a deep peel so that went quicker than what many others have experienced.

Both nurse and doc say my result will be very good. (Of course what are they going to say, unless they saw a big problem that definitely needed fixing right away... but I will try to take them at "face value". By the way this whole experience makes me realize that movie "Face Off" was far more ridiculous than I ever could have guessed, even though I did in fact guess it was massively ridiculous.)

I do feel like the swelling under the chin is a teeny bit better than yesterday and the bruising a bit less noticeable. Little baby steps.

Next official appointment with the doc won't happen for about a month, though they welcome me to come in or call any time.

Oh I almost forgot the important but *really gross* thing I learned today (discovered all by myself, not at the doctor's office). Since the first day I had been feeling my ears were clogged but assumed that was just numbness & swelling. Well this evening I had kind of an itch in my left ear canal -- not near the incisions -- and (sorry, but here it comes) I pulled out a plug of dried blood about the size of a black-eyed pea. EWWW. I checked, as you might imagine, to make sure there was no new bleeding and there wasn't -- the thing must have been left over from the surgery itself or the day 1-2 ickiness. Now it's gone I can hear again in my left ear -- hallelujah! There may however be an evil twin lurking in my right ear... will rinse with some ear drops when I get home tomorrow. Sorry for the yucky story but I hope it might help someone else.

Day 8

I'm home now from the recovery hotel. For me I think it was good to be away that first week, but it sure is nice to be home. I think a week of rest and healing at home will really help me ease back into a normal routine and prepare for the "real world".

I'm wearing the face bra as much as possible since I got it yesterday. It does look weird but it feels supportive and I have less fear that I'll bump an ear in a bad way or something. And maybe it is even helping with the swelling? Whether it's that or just the passage of time, I'll take it. I feel like I can start to see my chin emerging once more. Still swollen under chin and lumpy around the neck, still yellow bruises, still sort of flaky skin around the lower face but overall a little better I think. Patience (says The Impatient One)!

Day 9

Last night I did find the face bra uncomfortable when I woke in the wee hours, so I had to take it off to get back to sleep. But it does make me feel more secure that I won't do something horrible to an ear by turning my head in my sleep. So I will try to keep wearing it as much as possible at nights for a while and during the day while I'm home. One thing I realized -- no need to fasten it too snug behind the neck!!

My energy is definitely improving... for sure not back to 100%, but today I helped the Mr. run errands and did not feel shaky or anything. My pedometer has me at over 6000 steps for the day so far... not bad, considering. I felt a little silly in my scarf, hat, and sunglasses getup but I guess I did see people wearing sillier things.

Small daily improvements continue. Swelling a little less, I think. Right ear feeling a smidge less clogged. Left side of the face still quite yellow but oh well. Too early for any makeup on the face, but I have been using the black & blue bruise I got on my arm from the IV as a test case. (That is much more typical of how I normally bruise, and I had expected my whole face to come out that way.... big hat tip to the doc that I did not!) I had a reasonably decent result by starting with Bobbi Brown Foundation Stick and then patting Becca Ultimate Coverage Complexion Crème over that. If that got the awful black & blue to a somewhat less noticeable yellow, maybe it can hide the scars and any remaining yellow on my face and neck when the time comes.

Day 11

No huge changes in the past couple of days... kind of incrementally inching along. Sometimes I worry that I have traded a droopy neck for a swollen neck and double chin... but then I remind myself it is still early days, I should not expect to see the final result yet, and the swelling really does seem to be going down (though slower than my impatient self would like). Besides, I definitely feel those developing jowls are gone and the cheeks are back where they ought to be instead of drooping down... so I need to trust my doc that the droopy neck will be gone too once it's all healed up.

Yesterday I saw a friend who knew about my procedure beforehand and had been skeptical (not quite trying to talk me out of it, but sorta feeling like she *should* try to talk me out of it). She was very encouraging, commented on how little bruising there is, said by next week definitely I will be ready to face the world. It was great to hang with a friend for a couple hours... only bad thing was having to try to keep my face still, not talk too much, and not smile or laugh! :)

I'm still feeling clogged in the right ear so I am going to have the nurse check me out Wednesday morning... besides having them look at the clogged ear (which the nurse said on the phone today it's very common to have temporarily, from swelling and/or dried blood that normally works its own way out) I might as well just generally get another overall status assessment and a chance to ask more questions in person this week.

Last night was the first night I slept my normal sleep pattern... asleep by 11 and up with the alarm at the normal weekday time of 6:30, without any long period of wakefulness in the middle of the night (and actually without the face bra making me uncomfortable all night). By morning I had kind of scooted down so that my head was only "somewhat" elevated... have to work on improving that elevation strategy. (Ha, maybe that was why I slept better!) Seat belt? Velcro on my butt?

Trying to get myself back in the direction of my normal routine I went to the gym first thing with the Mr., but I did only treadmill "strolling" at 2.5 mph for 30 minutes followed by standing stretches that did not involve any bending from the waist. Then after shower & breakfast I worked on some various light projects around the house... by lunchtime I was tired so I took a 40 minute nap, but my energy's been pretty good in the afternoon.

I put on sunscreen today before running an errand and oh boy is my skin peely (everywhere *except* where I had the peel)! My doc says it is OK to start washing the face with Cetaphil during week 2 but "less is always better" so I actually have not washed my face since the surgery. I think tomorrow I may have to give it a gentle try.

I finally figured out how to take a picture of the backs of my ears, so thought I would share how that is going. Dissolving sutures back there -- not sure how long they will take to finally dissolve! I wish I could make my hair grow about 2 inches this week... hoping once I lay off the Bacitracin and can actually use styling products it will at least do a bit more to conceal things.

Day 11 continued

Day 13

No really big visible changes in the last couple of days but since I am here at the almost-2-week mark and I did go in for a checkup today with the nurse I thought I would post a status update.

First thing I have to say is that when the docs say "presentable" at 2 weeks but also "you'll still be healing and you will not see final results for several weeks more," that is exactly what they mean. I do think I have reached "presentable" in that the bruising is pretty much gone, and I don't think anyone who's not looking closely would notice anything amiss other than I'm looking kinda washed out with no makeup and no hairstyle... for example, I have not felt especially self conscious running anonymous errands like going to the drugstore. However, being the impatient type, I was hoping (especially since I am on the younger end of the spectrum for the procedure and generally fit and in good health) that "presentable" at 2 weeks would mean "basically completely healed and back to normal with my awesome new look."

Well... no.

So for any of you reading this and contemplating the procedure: really, it will *not* be all over and done with after 2 weeks. Even though you see pictures of folks here on RealSelf who look absolutely fantastic at 2 weeks, most of them come right out and say they still feel swollen, tired, etc., and are still healing. Somehow I did not really internalize that part into my own expectations because they look so great!

My own experience at 2 weeks is.... I still have considerable swelling under my chin and through my neck, I still have some pain (manageable with Tylenol) that randomly comes and goes near the incisions at the bottoms of my ears, I still have scabs under my chin and inside the tragus of my ears. I knew I would still have numbness, so while I'm listing where I am at... what's numb for me is the lower half of my right ear (the one that *didn't* swell too bad), under my jaw and chin, and about 2" at each side of my lower face, in front of my ears.

None of that means I am unhappy or discouraged, though.

Compared to a week ago I have made huge progress both in how my healing face looks and in how I feel. I am back to my normal sleep schedule. I feel able to go through a normal day at home unassisted (a week ago I was nervous about taking a shower!) and I had no hesitation today about taking a 2 mile walk around the city by myself today. In fact, I noticed myself several times speeding up to my normal brisk pace and had to consciously remind myself to slow down and not push too hard (whereas a week ago I was nervous about walking half a mile). I am confident I'll be able to go back to work next week without problems.

And as to how the results will finally look, I've compared where I am at now to pre-surgery and I can definitely see my cheeks back up where they should be instead of sagging. Though the swelling (darn it) is there under my chin, the looseness and droopiness is gone... and I will keep the faith that the swelling will not subside to leave a brand new wattle but instead will yield the smooth neck and jaw that I've seen others enjoy down the road. One other interesting thing I noticed is that the shape of my face from the front is much more oval. It had been starting to get fairly square around the jaw pre-surgery -- which obviously was nothing to do with my actual jawbone, must have been the jowls forming. They're gone, and I like the oval shape.

And the news from the nurse today was all good. I had my usual list of long Q&A so here they are:

1. How low should I keep my sodium to help the swelling go away, and for how long? ANSWER: Low sodium can help, but it's not going to make the swelling you have under the chin and in the neck -- which is totally normal -- vanish right away. That will take a few weeks. If you stay under 1500 mg of sodium a day, that's great, but trying to cut back to 1000 (for example) is not going to make it un-swell faster. If you eat a LOT of salt, over 2000 mg a day, it could make you puff up though. Or... it might not. It depends on your personal reaction to sodium. Everyone's different.

2. How about eating a high protein diet... will that help me heal faster? ANSWER: it's a good idea to get plenty of protein while you are healing, but that also will not make you magically heal at a superhuman rate.

3. How long should I keep putting Bacitracin on the incisions? ANSWER: until the scabs are totally gone.

4. How long should I continue to be super careful about washing my hands after playing with my pets? ANSWER: until all the scabs are totally gone.

5. How long should I continue to avoid bending at the waist? ANSWER: at least another week. And as always, pay attention to how you feel... you do not want any feeling of pressure in your face. (Side note: with all the squatting instead of bending, I have actually noticed that my glutes and thighs are getting a little extra work. Hey, it all helps.)

6. How long should I continue to sleep elevated? ANSWER: for a few more weeks yet. Let's talk when you come see the doctor at the one month mark. You can start sleeping elevated on your side if it is comfortable. (Side note: I do not think it would be, with how my ears feel.)

7. Can I start using hair styling products and a warm hair dryer? ANSWER: yes. (hooray!)

8. Can I start having a glass of wine once in a while? ANSWER: yes. (again hooray!)

Friday is my official past-the-2-week day, so that's the day I plan to venture back into the world of hairstyle and makeup. We'll see how that goes!

Day 15 - emotional rollercoaster again

OK gals, I'm asking for your support and reassurance once again!!

Today was my big day to try hairstyle and makeup. I was hoping this would feel like a "breakthrough" for me but honestly it has left me a little shaken. The hair's all good -- well as good as my hair gets anyway, but it's nice to use my normal styling products and get a bit of shape. The thing that has freaked me is the makeup.

Moving my face in the ways I normally do to put on makeup (you know the silly faces we make in the mirror while doing eyeliner, lipstick, etc.) felt really strange; the new tightness in my face made it feel all wrong.

And I normally do not wear much in the way of base -- just concealer under eyes and on any blemishes -- but I thought I should try the camouflage base. Yikes! This left me looking super "made up" and I didn't like it at all. The only place I feel like the camo helped at ALL is on the scar under the chin. The rest of it I think just looks awful. I may wash my face and try again later today with only concealing that and just my normal everywhere else. Thank goodness I also have the weekend to practice!

But the thing that freaked me out most was trying to smile.

Until now I have been following the PS instruction to keep my face as motionless as possible for optimal healing. Can you forget how to smile in 2 weeks? Or am I just too afraid to smile properly? Or have I actually obliterated my old smile? The smile I saw in the mirror looked so fake and halfhearted and not me at all. I can't even post the pic I got of that, it's ghastly.

Since I have been given permission to have facial expressions again I think I need to genuinely allow myself to be expressive for a few hours and then check it out again.

Those of you who are further down your journey -- did you have this kind of experience? Please tell me it came out OK!!!

Day 15 - calming down a bit :)

Thanks as always to those who have reminded me it is early days yet, I am still healing, all those things my rational mind knows but my emotions freak out over nonetheless! You gals are lifesavers, really. I am so grateful to you!

Besides watching some comfort TV and getting a mani-pedi, I actually practiced smiling and being expressive this afternoon (how weird is that?), I took a "shopping therapy" trip to Sephora to buy new lip gloss and perfume, and I redid my makeup without the awful heavy camouflage stuff. Ladies, based on my experience today I would say if you don't have an awful black-and-blue bruise to hide, go with your normal makeup and you will feel much better! I think I probably do still have some redness and "off color" at the sides of my face, but I think it looks a lot better with just my normal dusting of Bare Essentials powder.

I also did some "before and now" comparisons to cheer myself up. I won't say before and after, because I know I won't see the real "after" for another several weeks. I still think my smile is not as broad as it was before and I think that's just the healing and being out of practice... I will keep the faith that it will come more easily in the days ahead.

Once again major karma points to everyone for being there to help me get on a more even keel!!

Day 18 - survived first day back at work

I did feel self conscious (of course) but the only comment I got was from a (very!) observant person who asked if I had twisted my neck or something because I was moving more stiffly than normal... I said I have just been working on my posture! Holding phone to my ear not comfortable, but actually wearing the headset wasn't too bad. I was "aware" of the new sensations but felt like I was mostly able to just be normal animated self when talking.

I pretty much got into the groove, actually, and did my normal "start a brand new project at 6pm" bad habit. Around 7pm I felt like my neck suddenly inflated into Cinderella's pumpkin and I decided it was time to go home! The swelling *is* actually a little worse this evening than it was this morning, but not the "10 times worse" that it feels like.

Possibly I should have taken a Tylenol even though I had no pain just as anti-inflammatory. Possibly I should have been drinking even more fluid through the day. DEFINITELY it is the case that I need to take everyone's good advice to heart and be patient, remember that swelling is part of the healing journey, and it will get better as the weeks go by. Thank you all for reminding me! :)

Three weeks (plus 2 days)

I’ve made it through my first week back at work, which was the 3rd week post-surgery. Here’s the progress:

Scabs: All gone; the ones in my hair were the last to go, but they’re finally gone. Which means I am no longer putting Bacitracin on anything, just trying to get the last remnants of it *off* (I may try Westy53’s Neutrogena Makeup Remover trick on the creases behind ears, where there is a residue I’m glad no one can see… I doubt it does any harm, but it’s just gross). It also means I can play with my pets and generally hang out in my pet-hair-dusted apartment without resorting to protective draping and obsessive hand-washing.

Scars: The scar in front of my right ear is almost invisible. Not so the left – I feel like it looks worse in person than the photo indicates – but at least my hair on that side seems to do a better job of concealment. Under the chin it’s hard to say but who sees that anyway? I can’t move my head that far back to give anyone a view. I know what damage the sun can do, so to foster best possible scar healing I am being scrupulous about sunscreen and have bought some wide-brimmed summer hats… found some with attached scarf so the ears get even more coverage and the hat won’t blow off in the breeze. Oh, and my doc said OK to wear earrings after 3 weeks so I will start (mostly just to reduce my self-consciousness about that since I *always* wear earrings), but just keep to tiny studs for a while.

Itching / tingling / numbness / sensitivity: about as expected. No biggie. I take the itching and tingling and even the occasional nerve zinger all as good signs. Tops of ears are less sensitive than they were. Numbness not a lot changed; possibly the boundaries of numbness have receded about a quarter to a half inch from the high-water mark… still numb along the sides of my face, under chin, and the lower half of my right ear. Sometimes the scalp incisions feel “tight” and sometimes behind an ear it feels like I have an annoying bit of hair stuck back there – but it’s actually the new scar tissue (not hair) that I am feeling. All manageable. Really not taking any Tylenol at this point unless I feel super swollen.

Mobility: after a week back at work, generally being my normal expressive self, my face feels much more mobile -- actually I am glad that I did not redo Botox on my forehead yet, so my eyebrows have more range of motion during this period. The part of the face that’s not numb does not feel weirdly tight. Putting on makeup and doing my “putting-on-makeup faces” no longer feels bizarre. Smile still not quite what it was, but maybe that is OK (thank you, everyone, for the kind words after my freakout on that!)…it does look like me, just not exactly like the “giant toothy grin” me. (Maybe like a younger me! I will have to go back and check my smile in younger photos.) After the couple comments I got about “did I hurt my neck” I have been practicing moving my neck within the 45 degree range to either side of straight ahead that my doc recommended. But I’m not pushing it, as I don’t want to loosen anything prematurely while it is still healing. Looking upwards is the biggest restriction: I don’t think my chin comfortably goes up more than about 30 degrees. But that’s where I wanted it tightened, so I’m not complaining. I will work on range of motion when the doc tells me I can, but if having a super mobile head contributes to development of a new turkey wattle, I’d rather not go back there. (And claiming a minor neck/back injury while on vacation seems to have put an end to people’s questions.)

Energy level: better all the time. Still not 100%. I definitely did push myself too hard my first couple days back at work... I really was not up to my normal 10-hour “all systems go” day. Tried to take it a bit easier the rest of the week and I'm definitely resting this weekend. My exercise goal last week, which I hit, was to average at least 8000 steps a day. My goal for the 4th week is to see if I can get back to my normal 10,000. But if I can only manage 9000, I’ll set 10,000 as my Week 5 goal.

The main thing that’s NOT proceeding as I would wish is the swelling. It’s really only a *microscopic* bit better than it was a week ago. I talked to the nurse about this and she assured me that’s normal, everyone is different and it will not leave me with a new turkey wattle; it should be almost completely gone by 6-8 weeks. She said like when from one day to the next you suddenly need a haircut, there will come a day I wake up and suddenly realize the swelling is gone. I only wish I could make that day come sooner! My doctor and his staff say it is a waiting game and there’s not much to be done but be patient. Other than my poor attempts to be patient I’m trying to focus on diet, elevation, and compression (just to make me feel like I’m doing something).

I posted a question here about sodium and protein, and the answers have been consistent with what my doc and his staff say: low sodium and high protein can’t hurt, as long as your diet is balanced and nutritive, but they’re not a silver bullet either. I appreciated the one doc here on RealSelf who said sodium can contribute to edema but it’s a different kind of edema than post-surgery swelling. Still, I’m aiming in general to stay below 1500mg sodium and above 60g protein until the 6-week mark at least.

I’m still sleeping propped up – not quite sitting, but maybe a 45 degree angle against an “arm-rest style” cushion. Sleep schedule is basically back to normal.

And I’m still wearing the face bra to sleep in and a fair portion of my time hanging around home (my husband, poor man, seems to be getting used to me looking like a character in a bad science fiction movie).

Other remedies I haven’t really been pursuing. As I understand it the bromelain is really for bruising, which is now gone, so I’m not bothering with that. And as soon as I realized that the Arnica was a 30c homeopathic dilution I lost interest in it. I haven’t been doing any massage because my doc doesn’t recommend it – for now I’ll trust in his instructions: “don’t disturb the area other than compression and elevation and ice if that feels better”. I have iced occasionally when things feel “super swell,” like after my first Monday back at work, but thankfully that hasn’t been often.

Some of you RealSelfers out there seemed to be doing a lot better with swelling at the 3-week point than I am. Others didn’t. For those of you reading this just embarking on the journey – I hope you follow the quicker path, but if at three weeks you are where I am, well, we all heal differently and just take comfort that it’s not unusual. I have sure been glad to hear from others that their swelling did diminish and the jawline tighten up over time.

At least the swelling does not seem to be taking up any more volume along my profile than the turkey wattle did before. That’s temporary comfort.

More next week!

Four weeks

OK, when will the day come that I wake up and all the swelling is gone?

Not yet, sadly. Looking at my photos I can barely see microscopic differences from a week ago... honestly the visible differences even from 2 weeks are very small. Looks to me like the neck profile is almost as voluminous as before surgery -- just made up of swelling instead of drooping. I still have that nagging dread that when the swelling finally goes down I will be left with the same old droop, but I tell myself to believe my doc and the experiences of RealSelfers who are further along than I -- and keep the faith that it will all smooth out and snap tight into place.

Most of the differences since last week are in how I feel: better energy (back to my 10,000 steps a day), somewhat less self-conscious, a little less numb (numbness receding on my cheeks, no numbness now in front of the chin scar, even starting to get tingling in lower part of my right ear).

However today in NYC it was suddenly quite warm and humid (80 degrees F compared to 60 the past couple weeks, with 80% humidity) and that sucker-punched me. Humid heat often makes me feel lousy, but it's not *that* hot today; I definitely found myself thinking I must be extra susceptible now.

I'm still sleeping propped up on my back with the face bra (and the silicon scar reduction strips... thanks, cemlaw!), keeping sodium under 1500mg and protein over 60g. I read that bromelain can help with swelling (not just bruising as I thought) so I'm starting back on that. I am going to ask my doc about lymphatic massage and whether it might be OK for me to take a diuretic when I feel especially swollen.

I have to give a presentation next week to a big auditorium full of people. I enjoy public speaking, but this is my first time "post." Wish me luck!

Five weeks

Week 5 has been a good week. My big presentation went well... when I was on the stage I was able to focus on the message and the audience and just be me (and not think about my face at all). The "inflated head" feeling is no longer kicking in like clockwork every day at 7pm... not to say it doesn't happen at all, just some days I've escaped it and overall it's less intense. I can hold a phone to my ear without issues (I am *aware* of it but it's not massively uncomfortable), and I feel much less self-conscious generally. The swelling under my chin and through the neck is a bit less, I think, and it definitely is starting to feel softer under the chin instead of balloon-tight like it still does lower on the neck, which I hope from others' posts means it is on its way to receding.

I saw my dermatologist on Friday to re-Botox my forehead and between brows. Last time I saw her was about 6 months ago, at which time I asked her recommendation on facelift surgeons; I was wondering if she would take one look at me and say "so you did it!" but I had to point it out. We compared to "before" pictures she had in my file and where she saw the biggest improvement was in the cheeks and jowls (neck still swollen of course). She had a look at the scars and could hardly even see the one under my chin with the concealer on it; said everything was healing well and I looked very natural. I'm thinking if a dermatologist who knows you were thinking about a facelift can't immediately tell you had it, then average folks won't think you look "done" either.

By the way I have settled on a sunscreen and concealer routine that's working for me. I use Neutrogena SPF 70 solid stick on the scars, then spray Neutrogena SPF 45 spray on my ears/sides of face/neck/under chin while shielding eyes and nose, then finally spray more on my hands and pat the central areas of the face. The Kat von D tattoo concealer is the one that's covering best and looking most natural for me. Just a tiny dab the size of a lentil on the back of my hand is enough to cover all three scars with a fine-tipped makeup brush, then I stipple it in and dust with my usual Bare Essentials powder to set. Holds all day. And I think I have come up with a plan for how to wear my hair as a "slightly longer pixie" which is also helping me feel more "me."

I go in for my 6-week checkup with the surgeon next week and will bring my usual long list of questions. I'm feeling very positive about results so far and how they will finally be... in part because yesterday I went looking for old pictures of myself to compare (a couple are included in the post).

The one thing I'm not seeing yet that I hope I will eventually see is a flat, smooth line along the jaw meeting a flat, smooth line along the neck at a sharp-ish angle. Some of you gals have achieved that and I hope I'll get there!! BUT, looking at old pix of myself I must admit that I have never in my life had that. Possibly the structure of my muscles and/or glands isn't compatible with that contour. I'll ask the doc when I see him next week. Even if that's just not going to happen, I am so pleased to have gotten rid of the neck wattle and the descending jowls! I am feeling more and more ready to head confidently into my next decade.

6 week checkup

The doc said everything looked great and although I am free to call or come in any time, there's no real need for further checkups. Of course I had my list of questions so...

1) As the swelling goes down will I achieve that lovely clean 90-degree angle between neck and jaw? ANSWER: no, because of the position of your hyoid bone. That can't be changed. (So that's why I never had that angle before... I didn't even know there was such a thing as a hyoid bone.) But things will continue to tighten somewhat as time goes on.

2) Can I start sleeping flat? ANSWER: yes. It's possible that this may make you feel a bit more swollen in the morning. Do what's most comfortable for you.

3) I have been keeping to only 45-degree turn of the neck. Should I start increasing my range of motion? ANSWER: yes, at this point you can work back towards 90-degree head turns without danger of affecting your results.

4) What about yoga inversions? ANSWER: you can try them -- you won't damage anything but you might not feel comfortable for a while yet.

5) A friend said the Olay rotary scrubber brush was a bad idea... what's your opinion? ANSWER: I don't think it's a good idea. It could create a "shear" force. Just use a washcloth. Don't twist the skin.

6) What about silicone gels or strips to improve the scars? ANSWER: They won't hurt but I don't think they help much either. Younger patients like you actually will see more pinkness in the scars for a longer time. That's normal. The absolute most important thing for good healing of the scars is to protect them from the sun. Always sunscreen, and a broad-brimmed hat is also a very good idea.

So anyway... I know the changes will slow down; certainly not visible daily anymore, not really even weekly -- maybe monthly? (Time to put the microscope away...)

I am encouraged by the 3-month and 5-month and later check-ins from gals further down the path: thank you all for sharing! I'll let you know how it goes for me...

8 weeks

The visible changes from the last time I posted pictures, at five weeks, are not very noticeable... the scars continue to fade a bit, and under the jaw is tightening a smidge. The Week 8 photos have no makeup at all so you can see how the scars are doing.

But over the past week I've started to feel like I am moving from "Healing Phase" into "Renewed Normal." I've put away the face bra - no longer getting the "swelled head" feeling at the end of the day and no longer feel I need it for sleeping. I am sleeping on my side and making no particular effort to elevate my head... though I do still find it more comfortable to use the crescent pillow to keep from lying directly on my ear. Haven't felt swollen in the morning.

Best of all I got my hair cut for the first time since the procedure. My hairstylist knew what I was having done and she said if she hadn't known she might have wondered if I'd lost a little weight because my face looks slimmer. And she absolutely could not see my scars at all, even though I pointed right at them (I had concealer on them of course) and she was just a few inches from my ear. We were talking abut how I wanted to keep the hair in front of my ears a bit long and she genuinely couldn't see what I was trying to cover. So I'm really not worried about someone noticing them in daily life. I am grateful to Dr. Hidalgo for doing such a great job of placement and stitching.

Still a couple of inches of numbness on the sides of the face, right earlobe, and behind the chin scar, but it continues to recede slowly. Occasional tingly or itchy sensations. Things feel generally "tight" but of course that was the whole idea.

I'm sticking to the low sodium diet, and I haven't yet tried yoga... of course I know healing is still going on, but the "Renewed Normal" is a good place to be.

3 months

In the last month the healing has progressed a lot. I no longer have any skin numbness -- sensation has returned to the skin on the sides of my face, under the chin, and the lower right ear. But I still have a sense of numbness *under* the skin in those places, if that makes sense. No longer using the crescent pillow to protect my ear when sleeping... just normal pillows like before the procedure, sleeping on my side.

I went way off my eating plan yesterday and had far too much sodium (and too many calories) but it doesn't seem to have made me swell up today. Yay! (Now about those calories...)

My energy level is fully back to normal. I have gone back to restorative yoga class with no problem and I'm thinking about getting back to more active yoga with serious inversions and such.

The visible changes in the last month are subtle. I think things may continue to firm up slightly but I think as far as anyone else will see, what you see now is what you get. Looking back at some old pictures, I definitely feel Dr. H has given me at least 10 years back... maybe 15!

6 months: it just keeps getting better

The changes over the last 3 months are subtle, but I can see that I have more definition along the corner of the jaw near the ear and that things are a bit tighter along the throat and under the chin. In the past few weeks I've had new sensations of itchiness / tightness in those areas; I'm sure that's just the continued reconnection of nerve endings that are waking up to discover things are tighter than they used to be. The healing process does take a long time to fully complete!

Though I continue to cover the scars with makeup most days (they're slowly fading, but the one in front of the left ear is visible when you know where to look) I feel confident they are not detectible with makeup and even without makeup somebody would really have to be scrutinizing me closely to see them. I don't worry at all about going to the gym or running a quick errand with no makeup.

I am really happy with my results and hope they will stay with me for 10-15 years!

Just past the 1 year mark!

Like cemlaw said, it's hard to believe it has been a year already. And me soon to be 48!

At this point I have no numbness anymore but the scars in front of my ears still do itch sometimes. The scar in front of the left ear is still a little pink; I have lately started using a pencil concealer on it (the matte end of the Anastasia highlighter duo pencil) so I can get *just* the scar, and that seems to be working well. The scar in front of the right ear and beneath the chin are pretty much invisible. I really don't bother with concealer for them and hardly think about them. I go to exercise class with no makeup at all and no worries. Actually I think I am wearing less makeup these days than I ever have.

There's a feeling of tightness beneath the chin but I don't mind that at all -- I wish it were tighter! I never got quite the jawline I was hoping for and I have thought about going back for a consult... then I remember I promised my husband I wouldn't consider more surgery this decade, and I really don't want to go back under the knife. It is so much better than before, and when I look at pictures of my younger self I'm reminded I never *did* have that sculpted profile some of you ladies enjoy. Darn that hyoid bone!

However one thing I noticed in putting together these photos is that I have lost some roundness / fullness in my chin since my thirties. I don't want an implant but I am thinking I may ask my dermatologist about filler. That might even help the jawline, who knows?

To all of you who supported me through the process: thank you so much!

And to all of you considering the procedure: the full recovery does take several months, even if you are ready to be out and about after a couple of weeks. Hang in there. It's worth it!
New York Plastic Surgeon

Dr. Hidalgo is a gifted artist as well as a world-class surgeon. You can see from the sketches on his website and on the walls of his office that he has an excellent eye, incredible talent, and a fascination with the human face and form. He and his staff are welcoming, kind, and thoroughly professional. They listened carefully to my questions and answered in terms I could understand. I never felt in the least rushed. I am very pleased with my results and absolutely recommend Dr. Hidalgo!

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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