My facelift story, including my experience under the knife

My PS Dr. Joseph O'Connell in Westport CT kindly reviewed my story and pointed out one thing I may not have made clear. He told me ONLY to ice the incisions for my upper and lower blephs (which I did). In his e-mail to me on my story, he pointed out that icing the other FL incisions can actually cause harm. He also clarified why he his patients don't experience nausea and vomiting post-operatively (and reminded me of some measures I'd forgotten about). Here's what he said: "One of the things that I do is pharmacologically block all five known receptors that the body has for nausea. That's why you took the Emend and Ondansetron and you probably didn't realize that I had given you Benadryl and Dexamathasone and you probably remember the scope patch. It's also one reason I like Propofol rather than an inhalational agent. I suspect that most other docs don't block all 5 but I have a rate of postoperative nausea/vomiting that's almost zero." This is so important I really wanted to share this as something for others to discuss with their PSs prior to surgery.

My mother was a beauty well into her 70s, and even at the age of 80, people were still stopping her on the street to tell her how lovely she was. My sister is the same way. At the age of 70, she still turns heads. Unfortunately I must have inherited the aging genes from the other side of the family. By the age of 64, my once-firm jaw line and neck were sagging and I’d developed small pouchy jowls. My mouth was flanked with deep grooves and the corners were turned down in a perpetual scowl. As if that wasn’t bad enough, my upper eyelids were so saggy and crepey that they were overhanging the corners of my eyes and starting to obscure my peripheral vision. To see clearly, I had to elevate my eyebrows in an exaggerated manner that must have suggested to others that I was perpetually startled. That’s when I began to seriously consider a facelift.
I have a rule whenever I need any type of “important” work done. I research extensively to find “the best”, then meet with them to determine whether their skills are compatible with my needs and whether I have a sense of comfort that they can TRULY do the job. I followed the same process to select a facelift surgeon. Living in Northwestern Connecticut, I ruled out surgeons in the downtown New York and Boston metro areas (too far for me to travel back and forth for follow-up visits and treatments) but considered everyone in between with sterling credentials and an outstanding reputation. I also focused my search on plastic surgeons with an emphasis on cosmetic rather than reconstructive procedures, because facelifts require specialized artistry. During my research, one name kept coming up over and over: Dr. Joseph O’Connell in Westport, CT. In early 2012 I met with Dr. O’Connell for a preliminary consultation.
I was positively impressed by Dr. O’Connell’s practice from the time I stepped through the door. His waiting area is paneled in a rich wood, and the furniture is upholstered in beautiful fabrics in soothing and tasteful shades of aqua, cream, and taupe. Everything here says “class act.” I was warmly greeted by a member of Dr. O’Connell’s staff and made to feel welcome.
My boyfriend and I were shown to a consultation room right on time and Dr. O’Connell introduced himself. From the moment we met, I liked Dr. O’Connell. He listened very carefully to my questions and answered each one in a detailed and respectful manner. He took his time to examine my face and evaluate which procedures would be most helpful to me. He also told me very honestly which ones wouldn’t be worth my while (specifically, a brow lift and rhinoplasty). By the end of the consultation, I really felt that I would be placing myself in the hands of an extremely skilled and caring surgeon who would help me achieve the best possible results for me.
I waited more than a year to actually move forward with planning the surgery, mainly due to my concern about the pain and downtime from the procedure. In April 2013, I contacted Dr. O’Connell to request a final “decision making” meeting and he graciously agreed to let me come in for an additional consultation. During that meeting, he once again listened to my questions and answered them patiently and respectfully. When I asked how much pain I should expect, he said “Very little if I do my job properly.” We agreed on a plan which included upper and lower blephs, liposuction removal of fat from my neck and grafting of the fat into my cheeks, and a full facelift. Dr. O’Connell also explained his preference for using local anesthesia and sedation instead of a general anesthetic to avoid post-surgical complications. I mentioned to Dr. O’Connell that I’d had violent vomiting after a colonoscopy performed under sedation . Dr. O’Connell said that, to be on the safe side, he would give me anti-emetic medications because vomiting could trigger bleeding – not a good thing after a facelift. We scheduled my surgery for the next month.
Two weeks before the surgery, my boyfriend and I had a formal “pre-surgical” consultation with Dr. O’Connell. During this consultation Dr. O’Connell explained in more detail how the surgery would be performed, what I should do to support an effective recovery (icing of incisions for first few hours, sleeping with head elevated, not bending, straining or overexerting for 3 weeks, etc.). He also told my boyfriend what he should be prepared to do during the initial stages of my recovery, which included emptying the small drainage sacs that would be collecting fluid from tubes embedded in my incisions, in order to prevent fluid buildup. He also provided me with directions for the two weeks prior to surgery, which included a list of foods to be avoided (including all alcohol) and instructions to take Vitamin C daily. Finally, he gave me prescriptions for a variety of medications, which included 1 powerful anti-emetic tablet to be taken 2 hours before surgery, pain pills if needed after surgery, anti-emetic tablets to be taken after surgery if I experienced nausea, and antibiotic ointment for my eyes. He also told me to get liquid tears so I could keep my eyes moist.
Two weeks later and the night before my surgery, my boyfriend and I drove from northwestern Connecticut to the Delamar Hotel in Stamford, CT to be close to the hospital in Bridgeport CT where my surgery was to be performed. (BTW, the Delamar is gorgeous and Dr. O’Connell’s patients receive a preferential rate.) The plan was for us to stay at the Delamar the night before surgery to make it to the hospital bright and early, and also stay the night after the surgery to be close to Dr. O’Connell for my first follow-up visit.
The morning of the surgery we arrived at the hospital in Bridgeport CT around 7:30 a.m. to check in for my 9:30 a.m. surgery. To my surprise, I had absolutely NO nervousness or trepidation, which I chalked up to having complete confidence in Dr. O’Connell and the result he would achieve. The first thing I did upon arrival was to stop at a water fountain to take the anti-emetic pill prescribed by Dr. O’Connell. From there, we proceeded to surgical admitting, where the check-in process was completed quickly and efficiently. A short while later and about an hour before the actual start of my surgery, I was moved into a surgical waiting area. After changing into a Johnny, I had an IV expertly and painlessly inserted in my hand by one of the nurses on duty (who, as it turned out, had beautiful eyelids done by Dr. O’Connell some time previously). The nurses began a saline drip infused with another anti-nausea medication.
I then met with the anesthesiologist, Dr. Packman, who carefully explained the protocols that would be used in my case. Due to my age (65), the expected duration of my surgery (roughly 6 to 7 hours in all) and various other medical issues, Dr. Packman once again explained that Dr. O’Connell would perform some of my surgery using local anesthesia supplemented with IV sedatives and Propofol. He reiterated that this approach is preferred by Dr. O’Connell because it results in fewer post-surgical complications and, as I now know, allows the patient to feel much less “wiped out” after surgery. He also told me that patients typically have one of 3 experiences under Propofol: they don’t know what’s going on at all, they know what’s going on but don’t care, or they know what’s going on and kind of like it. As it turned out, I would fall into all 3 categories at various points during my surgery.
After Dr. Packman left, the nurses gave me yet another anti-nausea medication, this one orally.
Around 9:00 a.m. and 30 minutes before the start of surgery, Dr. O’Connell came by. Using a marking pen, he traced out where he would be altering my facial contours and the areas around my eyes. Even from the way Dr. O’Connell drew on my skin, I could tell I was in the hands of an artist.
Dr. O’Connell left to get ready, and I was wheeled into the operating room at 9:30 a.m. Everyone was extremely pleasant and I felt very relaxed and optimistic. A short while later, Dr. O’Connell entered the room and the surgery began.
I don’t recall the actual start of the surgery but at some point I had a urinary catheter inserted and also a small breathing tube. At this point, I must have been at the stage that the anesthesiologist had called “being totally out of it and unaware”. Sometime later I did become aware that Dr. O’Connell was working around my eyes, and he explained to me that he was performing the upper and lower blephs. I was able to communicate with him about what I was experiencing, which was mainly a little tugging sensation. However, at one point I told Dr. O’Connell I could feel a tiny twinge of discomfort and he immediately injected additional local anesthetic. (This must have been the stage the anesthesiologist described as being “somewhat aware but not caring” because knowing I was being operated on didn’t bother me in the slightest, nor did the twinge.)
I continued to drift in and out of awareness as Dr. O’Connell proceeded. I remember him telling me he was beginning the facelift and I drifted away. Then I remember him performing the liposuction under my chin, and again I drifted away. The last thing I remember was being aware of him working around my ears, but my only sensation was a sort of pleasant one, almost as if I was being massaged. (This must have been the stage the anesthesiologist described as “being aware and sort of liking it”. I now realize that Dr. O’Connell must have been suturing the incisions around my ears.) The next thing I knew I was sitting up in the recovery area with my head swathed in soft cotton and with a wide elastic bandage wrapped over my head and under my chin. Some people report that the bandages made them feel claustrophobic. In my case, they felt pleasantly comforting. My total time in surgery was somewhere around 7 hours.
In the recovery area, I was surprised to discover I didn’t have any real pain! And thankfully no nausea! The only thing I was aware of was a slightly uncomfortable sensation of swelling and tightness in my cheeks and neck, and a bit of soreness above and below my eyes from the bleph incisions. After an hour, the nurse asked if wanted something to eat or drink and I said yes. They brought me jello and ginger ale. Consuming this turned out to be a little challenging because only the right side of my face and mouth “worked”. Dr. O’Connell stopped in to say that everything had gone very well, and that I had regained movement on the right side of my face first because my right side is dominant. He said the left side would regain movement in a few hours, which it did.
After about 1-1/2 hours in the recovery room, I dressed, put on a headscarf, and was wheeled down to the exit. My boyfriend picked me up in the car and we drove back to the Delamar Hotel, where we arrived around 6:30. I sat up in bed while my boyfriend ordered room service, which for me consisted of soup and risotto, because vigorous chewing is discouraged for the first few days. At this point I was feeling a tiny bit “wobbly” and my vision was a little blurry, but otherwise I was feeling generally OK. And still there was no pain! For the next 4 hours or so, my boyfriend helped me put frozen peas on my eyes to reduce swelling and bruising. He also put the prescribed antibiotic ointment and artificial tears in my eyes and monitored the drainage containers on either side of my head, which had only collected a small amount of fluid. Around 11:30 p.m. I took a “precautionary” pain pill and slept well.
The next morning, I awoke and had breakfast, then dressed and walked with a little support to the car for the ride to Dr. O’Connell’s office. At this point, I was still aware of the sensation of swelling and tightness in my face and neck, and my eyelids were a little sore, but I still had no real “pain”. At Dr. O’Connell’s office, he removed the drains from my incisions and removed the bandages! Even though my face was very swollen with some bruising, and there were bruises around my eyes, I could already see how dramatically the surgery had corrected my problems! I once again had a clean jaw line, a firm neck, no jowls, and best of all, eyelids! Dr.O’Connell applied fresh bandages and sent me home.
I mainly spent the next week resting. On Day 3 after the surgery, Dr. O’Connell told me I could remove my own bandages, so I did. This felt a little scary because I was half afraid that my jowls would immediately reappear and my neck would sag without any support, but thankfully they stayed where they were supposed to. I was also able to take a shower and wash my hair, taking care not to disturb any of the incision areas. Immediately afterwards, I draped myself in a scarf, donned Jackie O sunglasses, and had my boyfriend take me to the grocery store so I could show him what to buy. By this point, I was able to walk around without difficulty or discomfort, but took care to not bend, lift, strain or overexert. My near vision was still blurry (partly because of the antiobiotic ointment we were applying) but distance vision was OK.
Over the next few days I continued to experience increased swelling and tightness in my face and neck, and increased buising on the side of my neck and below my eyes, which peaked around Day 7. However, I felt essentially “normal” except for being a little tired. Even though Dr. O’Connell had prescribed pain medication, I really didn’t need it and just relied on Tylenol for the most part after Day 3. An unexpected side effect of the surgery (for me) was that I was also retaining a significant amount of fluid (about 10 pounds worth, according to the scale) which is evidently the body’s way reaction to what it perceives as an “insult.” During this time, on Day 5, Dr. O’Connell said I should remove the long “whisker” sutures from my upper eyelids myself, and they pulled out neatly with a bit of persistence.
Toward the end of post-op week 1, I have to admit that I did start to feel a little discouraged, because I wondered if my face would REALLY return to a normal appearance or whether I would ever lose the fluid I was retaining. I had read that feeling a bit “blue” was a very common emotional reaction to the surgery at this point. However, around Day 8 I could see the swelling and bruising begin to subside, my weight started to come down, and I began to once again feel excited and optimistic about the results. On Day 8 I also returned to Dr. O’Connell so he would remove the remaining sutures under my eyes, behind my ears, and at the base of my scalp. At this point my bruising was turning to intense shades of yellow, but the swelling was coming down nicely.
The next week saw gradual but steady improvement in the swelling and bruising, as well as my feelings of strength and physical “normalcy”. By Day 10, I felt pretty much back to normal and was very comfortable driving and going out into public wearing sunglasses with my hair arranged to cover the incisions around my ears and the remaining bruises on my neck. I knew I must not look THAT bad when a cute young checker at the supermarket looked at me carefully, then told me in a lowered voice that he REALLY liked my new hair cut. LOL. Same haircut, different face.
Today is now 28 days after surgery and I feel better about my appearance than I have in years. My boyfriend tells me I look 20 years younger. I think this may be a slight exaggeration, though when I compare my face now to pictures taken 15 years ago, I now realize that my eyelids were beginning to sag even then. Before the surgery, I told Dr. O’Connell that I didn’t expect to repeat the procedures ever again. But now, I know that the results were so worthwhile compared to the minor discomfort and inconvenience, that I would definitely consider a touchup if and when the time comes, hopefully in the skilled and caring hands of Dr. O’Connell.
Update: The “after” pictures I posted were taken by Dr. O’Connell 42 days after surgery. I’m told that the final results can take up to 6 months to emerge, but I am amazed at how dramatic the transformation has been. My family and friends are all extremely impressed with my results and especially how natural they are, which is a hallmark of Dr. O’Connell’s work. Thank you, Dr. O’Connell, for your amazing skills and for helping me be the “best me” possible.

I've been contemplating having a face lift for several years but hesitated due to my apprehension about the discomfort and downtime. A little over a year ago I had an initial consultation with Dr. O'Connell and was extremely impressed with him and his office staff. Dr. O'Connell carefully and respectfully listened to my concerns and objectives for having the surgery, and gave me honest and constructive guidance on which procedures would and would not be beneficial. About 8 weeks ago I finally decided to go ahead with surgery and had my pre-surgical consultations with Dr. O'Connell. We agreed that the surgery would include a full facelift, upper and lower eyelid lifts, necklift with liposuction and fat transfer/grafts to the cheeks. Due to my age (65), we agreed that the surgery would be performed at Bridgeport Hospital in Bridgeport, CT.