High Hopes- Bangkok, Thailand

Six months today since my surgery and there’s only one way to describe how I’m feeling - relieved!

Relieved because
- most of the feeling is back and the swelling has gone - pretty much back to 'normal'. I’ve not had any sharp ‘pings’ which I read are indicative of nerves reconnecting - but, I also read that this doesn't always happen and the nerves are healing anyway (which seems to be my experience).
- I was very fortunate with my choice of surgeon, Dr Komwit, in Bangkok. His skill achieved 3 important results for me as I approach my 62nd birthday: jowls gone, neck and jaw line tightened with loose skin gone, reduced lines around my eyes. I had every confidence in him and really appreciated his calm, gentle and professional approach.
- nothing went wrong. In retrospect, I realise that complications are a big risk and traveling overseas for surgery makeS this and/or revisions much harder. Naively, I didn’t give it a thought at the time :) This makes choice of Dr and hospital critically important. I got the very best of care at Bumrungrad Hospital - fabulously large, quiet room/suite, immediate responses to calls for assistance, all pre-surgery mark-ups cleaned from my face, even my hair washed (in bed!) the morning after surgery.

Things I didn’t know then…..but do know now (which might be helpful to others) - this is big surgery and I certainly needed 2 weeks ‘down time’ post surgery and months afterwards to get totally back to normal. I really don’t know how people manage to go back to work in a week or so - it was a month before I could even go to a brief work meeting (I work part time).
- I wouldn’t contemplate doing this without a general anaesthetic. Four and a half hours of surgery with local anaesthesia would have be unbearable (in my humble opinion).
- for me, it was the right choice to travel to Bangkok for the surgery. More important than the cost, it maintained my privacy and forced me to rest. The combo of a week in Bangkok and a week in Hua Hin worked perfectly for me. I did not need any extra support or anyone to organise things for me. I was easily able to ‘look after’ myself and walk the 5mins to Bumrungrad for follow up visits. (By the way, I really don’t understand the concept of cosmetic surgery ‘holidays’……. if you have facial surgery, you’re unlikely to feel up to doing much more than rest……and would need to be pretty tough to sight-see, shop etc!)
I was very ill-prepared which, in some ways, that was a good thing: I may not have had the courage to go ahead if I’d know how long the healing process took, the side effects - and what could go wrong.
- 3 months after my surgery, I was ready to travel to France for a month (including a week of cycling), then Singapore (for work) and then San Francisco for work and a wedding. All went fine except I noticed swelling at the end of each long and hot cycling day.
- there were SO many side effects. The initial things were obvious and expected e.g. swelling, bruising, not being able to chew/eat solid food, stitches. After that, I had a very tight neck for many weeks, wasn’t able to sleep on my side (or wear earrings) until about 3 months, it was uncomfortable to wear glasses for ages, and I had swelling (sometimes extreme) from salt (and exercise) until very recently. If I’d taken the salt issue more seriously from the beginning I believe I would've had a lot less discomfort in the early weeks.
- I put on weight due to not being able to exercise. This was quite hard for me - I could go for walks, of course, but cycling was impossible (I couldn’t turn my neck fully) and I’ve only just this week got back to lap swimming. I found the sedentary life hard in terms of boredom and emotional well being.
- with my Dr located overseas (even though he answered a couple of my email questions promptly), the Realself site was invaluable for reassurance re some of my healing questions and the support of members - thanks again to all!

Bottom line - was it worth it? Even though no-one noticed (apart from a few general comments re my hair and skin looking great) I feel better about my appearance......so, YES!

This has been longest 3 months. Through all the doubts, discomfort, swelling, and general ups and downs it’s been a steep learning curve. Thanks (hugely) to all the words of wisdom and experience on this site, I held 3 months as a goal. Someone said that one of the ‘difficulties’ with facelift surgery is that it’s not instant gratification - you look and feel a lot worse before you feel and look better. You really do need a huge amount of patience and resilience.

Now that I’m here, I look back and all I can say is that I went into this bravely but naively. What I thought were the big things - like getting through the surgery, the scars healing, worrying about looking markedly different, post surgery problems - all passed uneventfully. The ‘little’ unexpected things have been tough……the ongoing swelling (less now and greatly helped by low salt diet), the numbness (still there but receding), forcing myself to rest, discomfort wearing glasses and earrings (only just ok now), sleeping on my side (at last I can), low energy and reduced physical activity, feeling self conscious (needlessly), having a haircut (ouch! - my hairdresser didn’t know/didn’t notice, maybe I should've told her?!), driving (limited neck mobility), sore eyes etc.

Feeling good now, and looking forward to going to France on Monday for 3 weeks. If I knew then what I know now, would I have done it? Tentatively, yes….I’ll know for sure when I get to 6 months!

As the feeling and mobility is returns, I am even more aware of the discomfort of the ongoing swelling.

It took me all of 8 weeks to really understand the salt thing. I’m quite savvy re food - I love to cook, I eat healthy, I’m not overweight. I read so many times on this site about the link between salt and swelling and I thought I was reducing salt by not adding it and not eating obviously salted foods like nuts (except at 6 weeks when I totally forgot and had a major swelling incident after eating salted caramel ice-cream). But, duh, what I didn’t realise is how much ‘hidden salt’ there is in foods - especially many favourites I was eating regularly - cheese, smoked salmon, capers - even bread and milk. It’s easy, easy, easy to get to 1500mg a day.

I only finally got it when I read this fantastic response on Realself from Dr George Commons to “How long until swelling is 100% gone after a facelift?”

“Swelling is quick to dissipate 60 % in the first 2 weeks but then the long wait begins.   Avoiding salt and sleeping with head elevated helps.  Occasionally I recommend diuretics for a boost in swelling reduction.   By 3 months most have 80% of swelling gone.  Buy 6 months 85 to 90 % is gone.  The last 10% can take most of a full year.  There are huge differences in people.  I have been amazed at how some swell so little and some so much.   A GREAT TRICK is to go on a very low salt diet starting 2 weeks prior to surgery.  Try to not go over 1500 mg per day.  Read all labels. It is not easy.  Once you have a load of Sodium aboard it takes 4 or 5 days to get rid of it.  Remember the cause of swelling.  Surgery disturbs your little lymphatics.  There are zillions of these little vessels.  Enough to stretch to the moon in one person.  Until they reconnect and function, the surgically damaged tissue will hold fluid because of poor lymphatic drainage.  When lymphs reconnect, swelling dissipates.  You will be fine.  Sodium is your enemy in the interim”.

For the last couple of weeks I’ve waged reduced salt drastically (plus drinking lots more water). The result is much less tightness and feeling less swollen and, even though probably not visible, it does make a difference and certainly feels better.

Hope this helps others too….