Instructions after a Rhytidectomy (Facelift) Surgery
What Can I Expect After Rhytidectomy (Facelift) Surgery?
There will be a mild to moderate amount of pain and discomfort associated with the surgery. This should be easily controlled with oral medications. Tylenol with codeine (or equivalent if allergy to codeine exists) is generally always sufficient for pain control.
The discomfort and pain should begin to decrease within 48 hours after surgery and a significant increase in pain after this period should prompt you to call the office. Severe pain is rare; if you experience this, please contact us immediately.
Bruising and swelling are to be expected after the surgery. These symptoms will peak within the first 36 to 48 hours after surgery, and will gradually subside over the next 10 to 14 days. To minimize the swelling, you should sleep with your head elevated for a couple of weeks after the surgery.
It is not unusual to have some slight drainage for the first 48 hours after surgery. A bulky cotton compression dressing with drains will cover your scalp and face for 1to 2 days after surgery. It serves to help prevent blood collections under the skin. Prior to leaving for home on the day of surgery, you (or someone looking after you) should feel comfortable emptying and resetting the drains.
During your first postoperative visit, the bulky dressing and, usually the drains, will be removed. You will then be placed in a supportive elastic face garment that is to be worn continuously, unless showering, for the first 7 to 10 days. After this time, it should be worn at night only for the next 3 weeks.
It is of utmost importance to tell Dr. Verret ahead of time if you have ever been on Accutane, received radiation therapy to the head or neck, taken steroids or immunosuppressive agents. Immunosuppressed patients (HIV positive, chemotherapy, diabetes, etc.) and patients with certain autoimmune disorders may not be good candidates for this procedure as the risks of poor healing and infection leading to permanent scarring and poor esthetic results may be much higher. It is mandatory that you inform Dr. Verret if you have any of these conditions before surgery.
Things To Remember After Rhytidectomy (Facelift) Surgery
- Make arrangements to have someone drive you to, and from, your surgery. You will likely need someone to assist you in driving for at least a week after surgery.
- If you live more than 30 miles from our office, you should plan on staying in Plano with friends, family or in a hotel for 2-3 days following surgery.
- Arrive for your surgery in loose, comfortable clothing. Your top should button or zip rather than pull over your head.
- Having someone stay with you on at least the first night after your surgery is highly recommended.
- Be sure to fill your prescriptions before your surgery since it means one less thing for you to worry about afterwards. Take the vitamins and antibiotics until your supply is exhausted; the prescriptions need not be refilled.
- If you are a smoker, you should not smoke for at least 2 weeks prior to surgery and 2 weeks after surgery. Smoking and chewing tobacco inhibit your circulation and can significantly compromise your surgical outcome.
- Do not take any aspirin or any anti-inflammatory compounds for 2 weeks before and 2 weeks after your surgery unless you first discuss it with your surgeon.
- Sleep with your head elevated 40 degrees for two weeks; an additional pillow or two under your mattress may help, if necessary.
- Apply iced compresses made of washcloths (not an ice bag) to your eyes as much as possible during the first three days after surgery.
- Stay up (sitting, standing, walking around) as much as possible after you return home – this promotes a decrease in facial swelling. Of course, you should rest when you tire.
- Avoid bending or lifting heavy things for one week. Besides aggravating swelling, this may raise your blood pressure and start bleeding. No lifting over 5 pounds the first week, 25 pounds the second week.
- Avoid straining at stool, which also raises your blood pressure. If you feel you need a laxative, consult your local pharmacist as most stool softeners do not require a prescription.
- Avoid hitting and bumping your face and eyes. It is wise not to pick up small children, and you should sleep alone for one or two weeks after your operation.
- Avoid sunning the face for 1 year. Whenever you go out in the sun, use at least an SPF 15 sunscreen.
- Don’t tweeze your eyebrows for two weeks.
- You may have your hair washed at a salon or wash it gently yourself 24 hours after your surgery. Do not use the usual heat type hair dryer; use the cap type or blow dryer set on cool setting.
- Go over your suture lines 2 to 3 times a day with hydrogen peroxide on a Q-Tip, but avoid getting any in your eyes. Then put a very small amount of Lacrilube on a Q-Tip and apply it to suture lines at the outer corners of the eyes.
- Take only prescribed medication or Tylenol, never aspirin or other NSAIDS, as they promote bleeding.
- Report any excessive bleeding that persists after holding pressure for 15-20 minutes.
- Different types of sutures were used. Dissolvable sutures will generally disappear on their own within 5 to 7 days. Permanent sutures should be removed within 5 to 7 days after surgery. Staples in the hair will be removed over the next 1 to 2 weeks.
- You may shower or bathe the day after surgery, but do not let the spray directly strike your face. Do not be afraid to get your suture lines wet.
- Do not wear any eye make-up until after you are examined and told it is all right to do so. Do not wear contact lenses for the first 5 days after surgery. Putting contact lenses in your eye can cause strain on your healing face.
- Don’t go swimming, diving, water skiing, or participate in strenuous athletic activity for at least one month after surgery.
- Do not apply hair coloring until three weeks have elapsed following your operation.
- You may wear a wig or hairpiece as soon as you desire.
- You can expect to experience some numbness around your ear lobes, face and neck for several weeks after surgery. Tightness during mouth opening is not uncommon. Likewise, a feeling of tightness in your neck is also not unusual after surgery. This sensation is most pronounced in the first 1 to 2 days after surgery, while the bulky dressing is in place. This dressing may give rise to a slight sense of labored breathing or a mild difficulty with swallowing.
- It is not unusual during the healing phase, to note some irregularities under the skin. These small distortions will gradually subside and eventually resolve. Small bumps under the skin are present where sutures were placed to resuspend the muscles of the face and neck. The skin often feels stiff while it is healing. Although most of these things resolve over a period of several weeks, be prepared to wait at least 6 months for your facelift to completely heal inside and out.
- Do not wear makup until you have been told to do so. You will likely be able to wear makeup by the end of your second week postoperatively.
- Take a shower or bath before coming to your one week postoperative visit. You will not be able to shower or get your incision lines wet for 24 hours after your sutures are removed.
- It is not unusual after a person who has an anesthetic or any type of operation to feel weak, have heart palpitations, break out in “cold sweats”, or get dizzy. This gradually clears up in a few days without medication.
- When there is too much difficulty in sleeping in the post-operative period, we will prescribe a sedative. It should be remembered that such medication also tends to make some people feel light-headed and weak and should be taken only if needed.
- It is not unusual for patients to go through a period of mild depression after cosmetic surgery because, no matter how much they wanted the operation beforehand, and how much they were told to expect postoperatively, they are shocked when they see their face swollen, and perhaps, discolored. Be realistic and realize that this is a very temporary condition that will subside shortly. The best “treatment” consists of busying yourself with the details of post-operative care and try to divert your attention to other thoughts.
- There may be transient thinning of the hair in areas adjacent to the suture lines in the temple and behind the ear. Realize that this is temporary and this hair will regrow.
- You should wear clothing that fastens either in the front or the back rather than the type that must be pulled overt the head for one week.
- After all stitches have been removed, the scars will appear a deep, pink, color. There will be varying amounts of swelling in and around the scars themselves. With the passage of time, the pink will become white, the firmness of the scar will soften, and they will become less noticeable. Each individual varies with respect to healing, but it takes approximately one year for these scars to be mature. This does not mean they will be visible, just that it can take up to a year for the final appearance to become evident.
- For the first two weeks after surgery, use a gentle hair shampoo such as Johnson and Johnson baby shampoo and No More Tangles as a conditioner.
- If you choose to blow dry your hair or curling iron, be careful. Parts of your scalp may be numb and you may not be able to feel if it is too hot. If you blow dry your hair, use a hand dryer on a cool setting or be sure to put your hand where you are drying.
- During the first two weeks postoperative, do not turn your head. This will allow the deep sutures and skin to heal in the proper position without excess pulling or relaxation. If you wish to turn your head, keep your neck stiff and turn your shoulders, much like a person with a cervical spine collar would. At night, try to prop your head so that accidental head turning is minimized.
- Since head turning is discouraged, driving is discouraged for two weeks after surgery.
- You can expect to take at least 2 weeks to recover. Everyone has varying amounts of bruising and swelling but we would expect that you could put on makeup and return to public activities in two weeks.
- Do not drink with a straw.
Contact the Office Immediately After Rhytidectomy (Facelift) Surgery
If you notice any of the following, please contact the office immediately at 972-608-0100:
- repeated or violent vomiting.
- unusual bleeding or discharge from the incision.
- development of a temperature elevation exceeding 100.0 degrees.
- a significant progressive increase in pain which is not easily relieved by taking your prescribed medication.
If any of the above should occur after regular office hours, do not hesitate to call the office after hours and have Dr. Verret paged. For whatever reason, if you notice one of the above changes and cannot reach us at our office or through any of the alternate means, present yourself to the emergency department for evaluation.
Recovery Timetable After Rhytidectomy (Facelift) Surgery
Day 1 Return home. Use cool compresses or ice for 24 hours.
Days 2-3 Maximum bruising and swelling. Bulky dressing removed
Days 5-7 Stitches removed or dissolving. Bruising starting to go away.
Week 1 Wear elastic garment at all times except when showering.
Weeks 2-3 Wear elastic garment at night only. Swelling much improved. Some areas of the face and neck will feel quite stiff. Residual bruising can be covered by make-up.
Remember If you have any questions at any time, do not hesitate to call. We do not like surprises and would much rather hear about a small annoyance before it becomes a big problem.