50 Yr Female, Facelift, Neck Lift and Upper Bleph

I am 50 yrs old, 5 ft tall and 110 pds. I am having a facelift, including neck Lift & upper bleph. I have been having face filler and botox for the past 8 years.
Why I am Having This Done Now
- I have come to the point where I don't want to invest any more $$ for filler, time to get to the office to have it down, etc... to address the early jowls and marionette type lines. I am ready for a more permanent solution through a facelift. I estimated I would have to spend $700 to $1000 a year in filler for the fillers if I didn't get a facelift and I just don't want to spend the time or money to do this.
- By having it done now, I feel it would be a less noticeable, more seamless change to others than if I waited till I got much older
- The thought of deferring this surgery for a few years makes me ill to my stomach as I know that during this time it would affect my self-confidence every time I looked in the mirror, did my videos, etc..
- I feel I will heal better after the surgery being younger and doing it before I hit menopause
I have been on RS since Feb 2016 and have learned a lot from other people's sharings and photos. For that I am grateful! Thank-you to the RS community ! I hope in sharing my experience I can help others as well.
I noticed over the past two years, that my face was started to square off unattractively. When I was younger, I had a more prominent pointy chin. This was starting to get lost.
Most people think I am 10 years younger than I am. But I have seen the signs of aging on myself because I know my face. Deciding to get plastic surgery is such a personal decision.
In the past six months I also began to notice the following:
1) more of a draping of my upper eyelids on both eyes, which is why I wanted to get the upper bleph. The eye lid skin also appears to be getting more crepey. Ugh!
2) Some signs of turkey waddling under my chin on my neck that was affecting my side profile and especially more noticeable in certain angles like when I looked down slightly like when I am working on my computer. Ugh! How did this happen??
These signs were becoming more and more noticeable in photos in various angles. In addition I started making videos for my practice in the past year so I really get a chance to see these facial signs!
These are my goals for this face lift/neck left/ upper bleph surgery. I thought by writing it out it would be very clear to me why I am doing this and for me to share this with my PS.
1) Tighten the overall skin laxity in the lower part of my face
2) Eliminate the lower jowls that are forming thus removing the weight from this area making appear heavy. These are especially noticeable when they are shadowed.
3) Tighten my chin area subtly as a result
4) Have my face shape look less square and more of the natural shape when I was younger with a pointy chin
5) Improve my jawline, making it more tight and defined for a better front and side view
6) Eliminate the early waddling under my neck for a better, tighter front on view and side view
7) Have the neck area in general tighter, more youthful looking and so my lower face doesn't look pudgy
8) Remove the draping of the upper eyelids for a more alert, energetic look and better eye profile from the side
I had four other consultations with board certified plastic surgeons. I decided to go with Dr. William Portuese in Seattle, WA because of the 124 reviews on RS with 4.7 rating out of 5, and the amount of experience he has had with facial plastic surgery. His credentials including education are solid. He was the only PS that I went to for a consult that had an entire album of his before and afters in the waiting room. He had a very relaxed, non-rushed manner about him as some of the other consults, the PSs seemed to want to get me in and out of the consults. So not pleasant!
My spouse does not think I need to have this done but he is supporting my decision because he knows how important it is to me. He will be my caretaker following the surgery. I am not telling anyone else I am having this done.
I know this surgery with Dr. Portuese is expensive; however, he does have great experience, reviews and credentials. I may have considered going outside the country to a PS with great reviews on RS to save on costs but my spouse was not comfortable with this.
I feel good and confident about my decision especially after reviewing these pre-op photos I posted! I am psychologically ready. I have done substantial research and feel prepared in this way as well.

My pre-op consult is scheduled for the first week of Oct 2016. I paid the $500 deposit & will play the entire remaining amount 2 weeks before surgery. I'm going to be meeting with the nurse practitioner & PS. I have a list of questions I have been compiling.

I had my pre-op exam on 10/4/16. My surgery was scheduled for 10/31/16 Monday at 11:30 am, the day of Halloween! I would definitely be having a mask for Halloween! Ha!

During the pre-op exam, Dr. Porteuse met with me for about 10-15 minutes then I saw the nurse. The Dr. answered only questions specifically related to the surgery and asked me to pose my other questions to the nurse Angela about pre & post treatment care. He said the mid face lift, neck lift and upper bleph surgery should take 2.5 hours.

I asked him about fat grafts to the face because I saw on RS so many females were getting that during facelifts for volume. He was not a proponent of facial fat grafts and did not perform them because of that.

I asked if he had any other recommendations to enhance my face. He said he would NOT recommend a brow lift because my eyebrows were in a good position. That's what I thought anyway. He said I did not have to be worried about volume loss, that my face was fine the way it is now.

I hadn't received the pre-op instructions yet so I had a list of questions for the nurse.

Nurse Angela spent about 30-45 minutes with me explaining everything in detail, which I truly appreciated. I was given a detailed written packet for pre and post treatment care for which I was grateful for. I was surprised though it didn't say not to drink alcohol, avoid caffeine or follow a low sodium diet 2 weeks prior to the surgery. I also was given dates and times for my following 3 appointments. Very organized !

I was informed to do the following the day of surgery:
- I would be under general anesthesia (g.a.) and completely asleep. I was glad about that but I concerned with the side affects of g.a. like nausea, dizziness, prolonged grogginess
- Wear a bra or a camisole during the surgery but needed to make sure the straps could slide down my shoulders and stay down.
- I would be wearing a surgical gown but not a hair cap.
- I could keep my pants, socks and shoes on during the surgery. I was relieved I wasn't going to be stark naked during the surgery under the surgery gown!
- Bring a minimal amount of things and no valuables with me to keep in the locker.
- Bring a zip up top and no tops that go over the head.
- No makeup, remove all jewelry, no moisturizer on face & do not use any hair products with alcohol on the day of surgery
- No food, gum, mints after 12:00 am the night before
- I could have some water up to 3 hours before the surgery. (I actually drank I think too much water about 12 ozs 3 hours before the surgery but the anesthesiologists said that was ok and it shouldn't cause vomiting during the surgery.)
- To bring my filled scripts for pain killer Hydrocodene, antibiotic Azithromycin and anti nausea Ondansetron with me on the day of surgery.
- I asked the Nurse for a script of Valtryx because I get cold sores when I have bad colds or deeply stressed, like one time a year, just in case I needed it.
- There would be a warming blanked during the surgery as I expressed to the Nurse my concern that I get cold easily. The last time I had anesthetic during my C-section, I got very strong cold shivers.
- There would be a compression machine during the surgery for the lower legs that gently squeezed them to keep the circulation going
- I needed to have a caretaker for 48 hours after the surgery & someone had to pick me up from recovery.
- After recovery, I was going to be taken by wheelchair to the close by elevator for my caretaker to pick me up.
- Both the Dr and nurse said that most of the clients don't experience nausea with vomiting after the FL. The Dr said that only about 5% of the clients ever did that and the nurse said it only happened rarely and with people who tend to get motion sickness. I had concerns of vomiting from the anesthesia and busting my sutures. I did research on how to vomit correctly after the PS just in case. Ugh! This turned out to be a non-issue after the surgery for me. Thank-goodness!
- A list of supplements to stop taking was provided 2 wks before. I am big into supplements, herbs and spices so this was a big change for me to stop temporarily but I obliged.
- There would be a drainage tube for one day and the Dr does not use compression garments.
- No icing after in case the skin gets frost bite
- I can take a shower and wash my hair after the drains were removed the day after surgery.
- Ducolax stool softener
- Benedryl in case the incisions got really itchy about healing

For the following three weeks, I prepared and ordered supplies mostly from Amazon & items like the following:
- organic baby food that was non-GMO, no salt and organic
- a special gentle natural type baby shampoo and baby conditioner
- a food chopper
- made sure I had enough pillows to be at least at a 30 degree angle when sleeping

Paid Caretaker
My spouse and I agreed to have a caretaker for the 1st 24 hours that the Dr.'s office recommended. My spouse was uncomfortable with doing the drainage work every 40 minutes when I got home and emptying the drains. I don't blame him. I also thought it would be better for my husband not to see me right after the surgery in case I was really out of it. I knew he would worry.

The caretaker would pick me up from recovery, take me to the apartment, stay overnight and then take me to my appointment the next day to remove the drainage pipes. My husband would be staying in a hotel that night just a block away. She wasn't a nurse but someone who was familiar the Dr's specific protocol for post treatment care and usually did elder care. I found her to be organized, careful and a very nice person.