After Facial Cosmetic Surgery
The following instructions apply to patients who have undergone facelift procedures and based on Dr. Lalhs experience with many facelift operations. Since no two patients are ever exactly alike in their surgical needs, type of surgery performed, or rate of healing, we may elect to individualize the following guidelines for each patient. In such instances, we will so instruct you. Otherwise, we urge you to follow the advice below very carefully in order to accelerate your healing and maximize your surgical outcome. Since you have just undergone a major surgical procedure, use good common sense. Use your best judgment and do not ignore signs from your body of overdoing. The handout will attempt to answer every question that may arise regarding the dos and donts after surgery. You and your family should read them several times so that you will become thoroughly familiar with them. Attempt to follow them faithfully. Those who do so generally have the smoothest postoperative course.
Dressing The bulky dressing placed at the time of facelift surgery puts some pressure on the areas operated on and helps soak up any external drainage of normally occurring serum and blood. It is to remain in place until the following day and should not be adjusted or removed by anyone except Dr. Lalh. The day after surgery, we will replace your dressing with a very light facial wrap and provide you with a special facelift garment (chin sling). Typically this will be worn constantly during the day and night for the first week and during sleep for another two weeks.
Position Keeping your head elevated as much as possible will help reduce postoperative facelift swelling. If you can, sleep on two or three pillows to keep your head above the level of your heart for 1-2 weeks following your surgery. To accomplish this, place two or three pillows under the head of the mattress and one or two on top of the mattress. Try not to roll onto your face. Some patients find a reclining chair placed at a 45-degree angle to be more comfortable than a bed.
STAY VERTICAL IMPORTANT! Sit, stand and walk around as much as is comfortable beginning on your second postoperative day. Of course you should rest when you become tired, but keep your upper body as upright as possible.
AVOID TURNING YOUR HEAD or bending your neck. When you must turn, move your shoulders and head as one unit or as though you had a stiff neck. This protects the soft tissues of the face, allowing them to heal quickly, smoothly, and securely to the facial skeleton. This will result in longer lasting facelift.
AVOID BENDING OVER OR LIFTING heavy things for one week. In addition to aggravating swelling, bending and lifting may elevate blood pressure and start bleeding. If you have little children, bend at the knees or sit on the floor and let them climb onto your lap.
Every operation, no matter how minor, is accompanied by swelling of the surrounding tissues. The amount varies from person to person, but it always seems more dramatic in the face. Do not be concerned if you have more or less than others who have undergone the same operation. The swelling is usually the greatest on the second or third day after your operation. It is usually more pronounced along the jaw line. Your face and neck will remain swollen with varying amounts of discoloration for several days. Pressure around the ears may persist for several weeks. A feeling of tightness behind the ears and upper neck will last for a short time. The tightness peaks during the third week. Dimpling of the cheeks sometimes occurs, but disappears within 2-3 weeks. The most important thing to remember is that such swelling ALWAYS subsides.
HAVE ICE PACKS READY Place ice packs (ice in Ziploc baggies or packages of frozen peas) to the face, neck, eyes, and jaw line for 20-30 minutes each hour for at least 48-hours following surgery to minimize swelling and discoloration. If you do not have ice packs, try using a bag of frozen peas wrapped in a thin towel. Never place ice packs directly to skin, as it can cause serious tissue damage.
It is not unusual to have varying amounts of discoloration about the face. Like the swelling, it may become more pronounced, especially in the neck, after the first day or so. Again, do not be concerned if you have more or less than others who have undergone the same operation. Remember this is normal and temporary. It usually lasts no more than two weeks, all the while decreasing in intensity. You can camouflage the discoloration to some extent by using special cover-up makeup – several specific products are available for this purpose. Do not apply makeup over the incisions themselves until two (2) days after the sutures have been removed, however, you may bring makeup to the line of the incisions. Our skin care specialists can help you in determining the correct cover-up cosmetics for you. Remember, there is no medication that will cause it to disappear rapidly – only the natural course of time.
There is usually little pain following a facelift, but you may experience a deep bruised sensation as a result of the swelling. Patients often comment, my face feels heavy. As is usually the case with such things, this seems worse at night when you are tired. For the first 24 hours, take the prescribed pain medication given to you and rest as much as possible in an elevated position (See Position and Swelling). On postoperative days #2-3, most patients feel ready to start moving about and do not need prescription-strength pain relievers. If you do not experience sufficient relief, take Extra-Strength Tylenol according to the package instructions. Under no circumstances should ASPIRIN or medication containing Aspirin or Salicylates be taken (See comprehensive list of medications to be avoided, which you received in your preoperative surgical packet). If you are not sufficiently relieved of pain, try alternating doses of Extra-Strength Tylenol and the pain medication prescribed by Dr. Lalh. If the pain is severe, notify Dr. Lalh so that appropriate steps can be taken.
You will take an oral antibiotic for 7-10 days following your surgery. All antibiotics should be taken with food or liquids to prevent nausea and promote proper absorption of the medication (do not consume milk or dairy products when taking your antibiotic as they can inactivate many medications). Take your antibiotic as instructed by your physician until the medication is completely gone. Do not forget to take your antibiotic and do not stop taking it because you feel better.
Parts of the face, neck, and ears sometimes feel weak or numb after the facelift operation these feelings are temporary and, if they occur, generally last less than 6 weeks. In some cases, this sensation may last as long as six months, but this is an extremely rare occurrence.
Tightness of the Face
The skin of the face may feel tight following surgery and you may feel that it interferes with your smile this is temporary and will disappear within a few weeks. Keeping the head of you bed elevated and following the recommendations outlined in the Position and Swelling section of this handout will shorten the duration of this sensation.
Thinning of the Hair
There may be transient thinning of the hair in areas adjacent to the suture lines in the temple and behind the ear. Should this occur, do not be concerned as the hair almost always grows back to its normal thickness and distribution, ultimately covering the incision lines and scars.
Upon arriving home from surgery, begin with clear liquids until fully awake then begin regular food intake with soft foods. AVOID GUM OR FOODS THAT ARE HARD TO CHEW. Soups, mashed potatoes, stewed chicken, ground beef, or any easily chewable food is permissible. Steaks, French bread, etc. should be avoided for at least one week. AVOID STRAINING DURING ELIMINATION. If you need a laxative, we recommend Correctol (your pharmacist will give it to you without a prescription). Proper diet, plenty of water, and walking are strongly recommended to avoid constipation.
You may take a bath or shower on the first day following surgery. If you have dressings on your face, try to keep them dry. After the dressings have been discontinued, you may gently wash your face with warm water and a mild soap, and pat dry. Do not rub with a towel or washcloth, as the treated areas are very delicate until healed. You may use a mild, non-irritating soap such as baby shampoo, Neutrogena, Dove, or Cetaphil. Pat dry with a clean towel.
Hair Care You may gently shampoo your hair 3 days after surgery, but use no conditioner or gels for one week. Avoid bending your head over. Baby shampoo is strongly recommended. Avoid any strong rubbing or combing trauma to the incision in the hair and around the ear. Be careful that you do not catch your stitches on your comb when combing or brushing your hair. Do not blow dry for five days and postpone any planned permanent waves or hair coloring for 4-6 weeks following surgery. After a facelift, often patients experience a temporary change in the texture and manageability of their hair. Your hair is reacting to the shock of facelift surgery and will recover naturally within 6 weeks.
All the skin of the face and neck may feel dry and chapped after facelift surgery. We recommend that you make frequent and liberal use of a good moisturizer without fragrances in it. Do not use Retin-A or any alpha hydroxy acids for one month after surgery. A skin care program is recommended at that time to maintain a healthy complexion. Skin creams will be tailored to your specific needs. This can be scheduled through our office after your procedure.
Do not TWEEZE YOUR EYEBROWS for one week following surgery
Sunscreen and Makeup
It is imperative that your scars be protected from the sun for a good 6 months after facelift surgery. Use a sunscreen with a Sun Protection Factor (SPF) of at least 15 at all times. If should be applied before your makeup. You may begin applying makeup 2 days after your sutures are removed. We will be happy to assist you in the use of a sunblock and special cover-up makeup. We provide this service to help you maximize the benefits of your new look.
The sutures in front of the ears will be removed 4-6 days after your facelift surgery. If you have had an incision made under your chin, those sutures also will be removed 4-6 days after facelift surgery. The staples within the hair and the sutures behind the ear are removed 9-12 days after facelift surgery.
Remember that whenever an incision is made in the skin, healing results in the formation of a scar. Dr. Lalhs goal is for these scars to be almost invisible. After all stitches have been removed, the incision lines will appear a deep pink color. There will be varying amounts of swelling in and around the incision lines themselves. With the passage of time, the pink will become pale and fade to white, the firmness of the scar will soften, and the scars will become almost invisible. Each individual varies with respect to healing, but it takes approximately one year for these changes to occur in most scars. Vitamin E oil and makeup can be applied to reduce the scars in front of your ears after incision lines are well healed.
WEARING GLASSES AND CONTACT LENSES. Eyeglasses may be worn as soon as the bandages are removed. Wear glasses over the facial wrap. Contact lenses may be inserted the day after surgery, if no eyelid surgery was performed. If additional procedures were performed at the time of your facelift, check with Dr. Lalh at your one-day postoperative visit.
NO PULLOVER CLOTHING. For 1 week following surgery, you should wear clothing that fastens either in the front or at the back rather than the type that must be pulled over the head.
You may be up and around the day following surgery, however, some natural fatigue may persist for two to three days due to the normal effects of the anesthesia and surgical procedure. Walking is the encouraged choice of exercise during the first two weeks after surgery. Avoid excessive exercise, staining, lifting, or bending activities for at least 4 weeks. This will help minimize swelling. Use common sense for other daily activities. If in question of your normal exercise program, ask Dr. Lalh before you resume activities.
DO NOT SMOKE & AVOID ALCOHOL CONSUMPTION for 8 weeks. Both of these activities significantly slow the healing process.
Reasons To Call The Doctor
If, at any time following surgery, you develop:
- Temperature elevation (fever greater than 101.5 degrees)
- Sudden swelling or discoloration
- Hemorrhage (bleeding)
- Discharge from the wound edges or other evidence of infection
- Development of any drug reaction
You should contact Dr. Lalh by calling him at Renew Oral & Facial Surgical Centre Phone Number 780-439-4399. This is his cell phone number, which is answered 24-hours a day, seven days a week.
POSTOPERATIVE DAILY CARE
Your To Do List:
Day of Surgery:
- Rest for entire day after surgery. Remember to sleep in an elevated position.
- Take your medication given to you at your preoperative visit.
- HAVE ICE PACKS READY Place ice packs (ice in Ziploc baggies or packages of frozen peas) to the face, neck, eyes, and jaw line for 20-30 minutes each hour.
- Begin clear liquids. You may have some crackers to take with your pain medication to help prevent nausea. If you feel like having something more substantial, use common sense and do not have anything heavy (as a normal meal). Avoid dairy and citric fruit juices.
Postoperative Week #1: (Beginning the day after surgery)
- Clean the suture lines located around the front and back of the ears, and the surgical staples located in the hair-bearing incisions with a hydrogen peroxide / water mix (equal parts 50/50) and Q-tips 6 times a day. Rinse the incision areas with warm water before applying a small amount of Neosporin to the suture lines following the cleaning process.
- Apply Neosporin ointment sparingly twice daily to the incision lines in order to avoid excessive crusting to the incision and to accelerate the reduction of incision redness. However, limit the Neosporin ointment to only incision lines and do not place on the rest of the face as this can sometimes contribute to infection. Do not apply any other ointments or medications unless we prescribe it. DO NOT apply Vaseline to the staple or suture lines. DO NOT pull ear forward while cleaning behind ear.
- On your second day, you are encouraged to be up and around the house with our usual activities except those specifically outlined previously (no bending, no heavy lifting, etc.). No strenuous activity.
Postoperative Week #2:
- Blow dryer may be used on low setting only with a diffuser.
- Wash face with a mild soap (Cetaphil or Neutrogena) twice daily.
- Continue cleaning, as described above, if crusts along incisions are still present.
- May apply base makeup to face, except areas of continued crusting.
- Tweezing eyebrows is permitted.
MEN: May shave with electric razor only, except areas of continued crusting.
Postoperative Week #3:
- May use a vegetable color rinse (Roux) in hair if desired.
- Restart normal skin care regimen at this time, if applicable.
- Use a SPF 15 sunscreen over healing incisions if sun exposure is expected.
Postoperative Week #4:
- May use makeup at this time.
- May resume regular physical activities.
- May use a curling iron. Be careful not to burn areas of scalp that may still be numb.
Postoperative Week #6:
- May color hair and have a permanent if desired.
Of foremost importance, BE PATIENT during the healing process. Remember, there is no such thing as a bad question. If you still have questions after reading the materials we have provided, please feel free to call the office and speak with Dr. Lalh and his staff.
Rhytidectomy (Facelift) Typical Postoperative Time Table
- Day 1:Surgery
- Day 3-5:Remove eye stitches (if applicable)
- Day 5-7:Remove ear stitches
- Day 7-10:Remove stitches behind ear
- Day 10-14:Remove staples