Facelift & Neck Lift

Shopping List

• Prescriptions. Sent to your pharmacy at least 2 weeks before surgery. See “Two weeks before surgery.”
• Tylenol (acetaminophen). For mild pain, in place of your prescription pain medication, never together with it.
• MiraLAX (stool softener). Narcotic pain medication causes constipation.
• Hypochlorous acid (HOCl) spray. Your antiseptic before and after surgery.
• Cool compress supplies. Frozen peas in small sandwich bags work well. Make several.
• Q-tips, hydrogen peroxide, and Vaseline. For cleaning and protecting your incisions.
• Arnica tablets. Start them the day after surgery.
• Fresh pineapple or cold-pressed pineapple juice. Eat the center core too. Its bromelain helps reduce swelling.
• Wedge pillow or recliner. You will sleep on your back with your upper body elevated.
• Button-up or zip-up shirts and a large hat. Nothing that pulls over your head or sits tight on your neck.

Two Weeks Before Surgery

• Pick up your prescriptions well ahead of surgery. We send them to your pharmacy at least 2 weeks in advance. Open the bag well ahead of your surgery and make sure nothing is missing. Call us right away if your antibiotics or pain medication are missing.

• Starting 2 weeks before surgery, avoid aspirin, ibuprofen, naproxen, alcohol, and blood-thinning supplements. Check with your prescribing doctor before stopping any prescription blood thinner.

The Night Before & Day of Surgery

• Take two showers: one the night before surgery and one the morning of surgery. Each time, wash your hair well, shampooing twice, and use antibacterial soap on your face and body.
• Nothing to eat or drink after midnight the night before surgery, or anesthesia will cancel your surgery. Hydrate well before midnight. If you must take a vital prescription medication, take it with a small sip of water.
• Prepare your recovery area at home with fluids, appropriate foods, and assistance. Set out pillows, blankets, your medications, and your cool compresses.
• Review your arrival time and the location of the surgery center. Please do not be late.
• Wear loose, comfortable clothing that buttons or zips in the front.
• Arrive without makeup, lotions, skin products, sunblock, deodorant, or hair products.
• Remove jewelry and piercings. Do not wear contact lenses; wear your glasses instead.
• Remove hair extensions, weaves, braids, and lash extensions if possible. They can harbor bacteria.
• Arrange for a responsible adult to drive you home and stay with you initially. You will not be released to an Uber or taxi.

The First Week

• Relax. Rest your mind and your body. Too much activity or anxiety raises your blood pressure and can cause bleeding. Sleep, rest, and recover.
• Sleep on your back with your upper body elevated about 45° (recliner, wedge pillow, or several pillows).
• Use cool compresses or frozen peas wrapped in cloth for 15–20 minutes about every hour while awake for the first 3 days.
• Never place ice or frozen materials directly on the skin. Numb skin can get frostbite.
• Rest, hydrate, and walk gently and regularly to promote circulation. Rise slowly and have assistance at first; you may feel weak. When you are resting, move your legs and ankles regularly and take occasional deep breaths.
• Avoid bending, straining, or lifting.
• For the first 2 weeks, move your face, neck, and upper body as one unit. Do not turn your head from side to side; turn your shoulders and whole upper body instead. Turning your head puts shearing forces on the healing skin flap.
• You may shower 48 hours after surgery. If you have a drain, wait until 48 hours after it is removed, so the drain site has sealed. Use lukewarm water and gentle pressure. Do not let the spray hit your incisions directly; let the water run over them gently. Do not rub your incisions; fresh incisions can open if handled roughly. Be careful of falling.

• Avoid hot showers and baths. Heat causes more swelling and can make you lightheaded.

Medications

• Start your antibiotics the evening of surgery, once your nausea has passed and you can keep food down. Take them as prescribed until finished, and tell us if you have any reaction.
• Use your prescribed pain medication, or Tylenol if pain is mild. Do not take the two together; most prescription pain medications already contain Tylenol. Take it with food to reduce nausea. Good pain control helps keep your blood pressure down.
• Do not exceed 4,000 mg of Tylenol (acetaminophen) in 24 hours.
• Take only as much narcotic pain medication as you need. It causes nausea and constipation.
• Use your nausea medication as needed, if prescribed.
• Begin a stool softener when you start narcotic pain medication. Do not strain during bowel movements. Do not wait until you are constipated. Hydration and gentle walking help.
• Start your Medrol steroid dose pack the day after surgery: 6 pills on the first day, then 5, 4, 3, 2, and 1 on the days that follow, until finished. If your pharmacy gives you the pills loose in a bottle, follow the same schedule.
• If you have a side effect from any medication, stop taking it and let us know right away so we can substitute it.

Nutrition and Hydration

• Eat as tolerated, in small bites. Soft foods are easier at first.
• Dark green leafy vegetables can help with bruising. Pineapple, especially the center core, contains bromelain, which helps reduce swelling.
• Continue the Naderi Anti-Bleeding, Anti-Bruising Diet for 2 more weeks after surgery.
• Protein shakes and milkshakes give you hydration and protein. This is not the time to diet or restrict calories.
• Drink 6 to 8 glasses of water or sports drinks a day.
• Avoid spicy and sour foods for 3 weeks. They stimulate your saliva glands and can lead to a sialocele, a collection of saliva under the skin.

Incision Care

• You will most likely need to be driven to the office the day after surgery to have your pressure wrap (and any drains) removed.
• If you have hemostatic net sutures, do not be alarmed by how they look. They are removed 2–3 days later and usually leave no lasting marks.
• Wear your Velcro chin strap as much as possible.
  • Do not let the strap pleat the skin or pull it forward. Adjust it to keep it in the proper position.
• Clean incisions gently 3–4 times a day with a Q-tip dipped in diluted hydrogen peroxide. Roll the Q-tip; do not scrub.
  • Mix half peroxide and half water in the cap, then discard the excess.
• Apply prescribed antibiotic ointment or Vaseline very gently 3–4 times a day.
• Continue your hypochlorous acid (HOCl) spray on your skin, scalp, and incisions 3 times a day. Do not get it into your eyes.
• If you have a drain, protect it from pulling out. Dr. Naderi will remove it when appropriate.
  • To “milk” the drain, hold the tubing close to the skin so it cannot pull out, then pinch and slide the drainage toward the bulb.
  • Empty the bulb when it is more than one-third full, and keep it squeezed flat to maintain suction.
• Do not pick or pull at incisions.

• Dr. Naderi typically removes sutures 1 week after surgery. Staples come out at about 10 days.
• Protect healing skin and incisions from direct sun exposure for 3 months. Wear a large hat.
• Avoid tight-necked shirts such as turtlenecks for 1 month.

Activity and Recovery

• Do not lift more than 20 pounds for the first month.
• No exercise for the first month. You may then gradually resume and build back slowly, with the goal of returning to full activity by about 3 months. Slow, leisurely walking is encouraged; do not power-walk.
• Most patients feel comfortable leaving the house, returning to work, and resuming light social activities such as shopping at about 3 to 4 weeks.
• Most patients avoid large social events, photographs, and interviews for 2–3 months.
• Do not drive while taking narcotic pain medication or while you feel impaired.

Your Recovery Timeline

• The day after surgery. You are driven to the office to have your pressure wrap, and any drains, removed.
• First 3 days. Cool compresses every hour while awake. Rest with your upper body elevated.
• 48 hours. You may shower, or 48 hours after your drain is removed if you have one.
• 2–3 days. Hemostatic net sutures, if you have them, are removed.
• 1 week. Dr. Naderi removes your sutures. Staples come out at about 10 days.
• 7–10 days. No flying until this point.
• 2 weeks. You may turn your head from side to side again.
• 3 weeks. You may eat spicy and sour foods again. Men may begin shaving carefully with a manual razor.
• 3 to 4 weeks. Most patients feel comfortable leaving the house, going back to work, and doing light social activities.
• 1 month. The 20-pound lifting limit ends, you may begin to ease back into exercise, and you may wear tight-necked shirts again.
• 2–3 months. Most patients feel ready for large social events and photographs.
• 3 months. The goal for returning to full activity. Sun and heat precautions continue until this point.
• 3 to 6 months. Most patients start to love their result.

What to Expect as You Heal

• This is a big surgery. The road to healing can be bumpy at times. You need the mental fortitude to see it all the way through.
• Swelling and bruising. Mild to severe swelling and bruising are normal. Your face may look unfamiliar to you at first. Swelling changes from day to day and is usually worse in the morning. Exercise, heat, sun, flying, and alcohol all make it worse.
• Tightness and numbness. Tightness, numbness, and mild itching are normal. Because your skin is numb, protect it from heat and cold.
• Lumps and bumps. These are common early on, as are firm areas under the skin.
• Fluid collections. Fluid sometimes collects under the skin. If it does, you may need a series of office visits so Dr. Naderi can aspirate it.
• Hyperbaric oxygen (HBO). Some patients may benefit from HBO therapy after surgery to support healing.
• Asymmetry. Nothing on the human face is perfectly symmetric, and the two sides never heal at the same pace. Mild to moderate asymmetries, including of your smile, are normal. Do not expect perfect symmetry.
• Incisions. Your incisions may be more noticeable at first. They usually improve with time but do not disappear completely.
• Hair. Some thinning or shedding can follow a facelift, as it can after any surgery with anesthesia, and it usually returns to normal. Hair loss within the incisions can also occur and usually gets better with time.
• Your emotions. Low mood, second thoughts, and “buyer’s remorse” are common in the first weeks, and they usually pass. This is a normal part of recovery, not a sign that something is wrong.
• Do not judge your result early. What you see in the first weeks is not your final result. Stay off the internet, do not study yourself in selfies, and do not ask others for their opinion. Avoid negative people.
• Be patient. Healing is a process. Dr. Naderi will follow your progress closely and guide you at every visit.

If you are ever unsure, Dr. Naderi and our team are always available. Take a few clear, well-lit photos and email them to Surgery@NaderiCenter.com. For anything more urgent, please call the office so we get your message quickly.

Do Not

• Do not rub, massage, or manipulate your scalp, face, or neck.
• Do not turn your head from side to side for the first 2 weeks. Move your face, neck, and upper body as one unit.
• Do not pull on your ears or bend them forward.
• Do not rest eyeglasses on your ears.
• Do not place ice or anything frozen directly on your skin.
• Do not pick, pull, or scratch at your incisions.
• Do not take aspirin, ibuprofen, naproxen, or other blood thinners until Dr. Naderi says it is safe.
• Do not use nicotine in any form while you heal. Your skin will die.
• Do not expect perfection.