24 HOURS POST SURGERY
- Facial Dressing: A dressing is placed around the head and neck to provide moderate compression. Keep this dressing dry. Your surgeon will remove the dressing at your post-op day 1 appointment.
- Head Elevation: Sleep on your back with your head elevated about 30-40 degrees (2-3 pillows). Do not sleep on your side. Keep your head elevated to minimize swelling. Continue this for 2-4 weeks depending on swelling.
- Physical Activity: You may be up and moving around the house on the day of surgery and thereafter. However, avoid all strenuous activity. Getting up and moving around helps prevent blood clots from developing.
- Facial Movement: Keep facial/jaw movement to a minimum. Chewing, talking, and laughing should be minimized. Avoid turning your head and if you must turn, move the shoulders and head as one unit.
- Post-Operative Day 1 Appointment: You must have a responsible adult drive you to your first office visit post-surgery. At this visit your surgeon will remove your dressing, a few of the skin sutures, and check the progress of your healing.
- Breathing: Take deep breaths often when you get home and for the first 24 hours after surgery. This helps to expand the base of your lungs.
- Aquecool™ Device: Your surgeon will show you how to put on the Aquecool™ masque the day after your surgery in our office. The Aquecool™ device is a special cooling device that assists with significantly reducing swelling and discomfort after a facelift/necklift. Keep the masque on and connect it to the Aquecool™ machine when you return home. Begin using the machine and use as much as possible to maximize its benefit. If the Aquecool™ masque becomes uncomfortable you can reposition the masque or even take small breaks from using the device. It is advised to use the Aquecool™ device for 3 days and then return the machine. Ensure you return the machine in a timely fashion as the Aquecool™ rental company or late fees may apply.
- Head Sling: Wear your head sling during all times for the first week except for when you are using the cooling masque. You may take it off to shower. Then wear it only at bedtime for the second week.
- Antibiotic: Start your antibiotic the night of your surgery and take all tablets as prescribed and until finished.
- Pain Medication: You will be prescribed a pain medication for post-operative pain control. If your discomfort after surgery is not strong you are welcomed to take Tylenol in place of the prescribed medication. Do not take Tylenol with the pain medication, often the medication you are prescribed will have Tylenol in it. Do not exceed 4,000 mg of Tylenol in any 24-hour period. Take medication with food to minimize risk of nausea.
- Constipation: Sometimes decreased physical activity as well as pain medications may lead to constipation. Any over the counter stool softener such as Metamucil or Colace can be used. Start laxatives with the narcotic pain medications to prevent constipation from occurring.
- Nausea: Some pain medication may make you feel nausea. It is best to eat something small 20 minutes before taking pain medication. Keep hydrated with small sips of noncaffeinated beverages (ginger ale, Sprite, Gatorade).
- Medication to Avoid: Avoid medications containing aspirin or ibuprofen (Advil, Motrin, Naproxen, etc.) for two weeks before and after surgery. These medications may increase bleeding.
- Substances to Avoid: Avoid alcohol, nicotine, and caffeine, for these will dramatically slow the healing process.
- Diet: A light low-fat diet is best after surgery. Soft foods will be best to decrease excessive chewing that would lead to more swelling and discomfort. You may start a regular diet after your surgery as long as you are not feeling nauseous or vomiting.
- Hydration: Stay hydrated by drinking 8 -10 glasses of water a day. Avoid alcohol for 48 hours and while you are still having to take pain medications.
- Movement is Important: Make sure you are up and walking around immediately after your surgery. When lying down in bed or on the couch, make sure you are moving your legs and ankles.
- Glasses: You may wear sunglasses and eyeglasses as soon as the bandages are removed. Wear glasses over your head sling. Contact lenses may be inserted the day after surgery, unless you have had eyelid surgery in combination with you facelift/neck lift.
- Driving: Do NOT operate a vehicle or make important decisions until you have been off pain medications for 24 hours. Use good judgment.
- Return to work: Returning to work depends on the amount of physical activity and public contact your job involves and also the amount of swelling and discoloration you develop; the average patient may return to work or go out socially 1-2 weeks after surgery. There is some individual variation regarding the time one returns to work • Physical Activity: Avoid bending, lifting, straining and aerobic activities for 2-3 weeks or until you have been cleared by your surgeon. Avoid hitting or bumping your face and neck.
- Exercise: Exercise may not be resumed for 3-4 weeks post-op or as further instructed by your surgeon. When cleared, you must start easy and build back up to your previous exercise levels. Resuming exercise may worsen swelling.
- Travel: Airline travel is restricted until 1 week postop. You will notice increased swelling with airline travel, and this can happen 6-8 weeks out from surgery.
- Face Care: Do not tweeze eyebrows for one week. Wash your face gently with a mild soap or cleaner twice daily after the first week, using a gentle upward motion. Do not use any harsh chemicals or creams on your face until all incisions have healed and your surgeons has advised you can return to your normal skincare regiment.
- Smoking: Smoking should be strictly avoided as it interferes with the blood supply to the tissues and slows and hiders the healing process.
- You may shower and gently wash your hair 2 days after your facelift, avoiding the incision areas using a gentle shampoo such as Baby Shampoo. Never wash your hair the day of suture or staple removal.
- Hair Care: You may gently comb your hair with a large, toothed comb. Avoid aggressively tugging at hair knots or tangles. You may use a hair dryer to dry your hair only if it is set on the cool setting. No hair products (gel, mouse, hairspray, leave in conditioners, etc.) may be used for at least a week.
- Hot Tubs/Baths/Swimming Pools: No tub baths or jacuzzi until your incisions have healed, and approved by your surgeon, which is usually around 6 weeks.
HOW TO TAKE CARE OF YOUR INCISIONS
- Cleaning your incisions: Soak a cotton swab with hydrogen peroxide. Gently apply the cotton swab over your suture lines 3 times daily. Suture lines will be found in front of and behind your ears. Then using a dry cotton swab gently dry the hydrogen peroxide. Finally apply a small amount of Bacitracin ointment with the cotton swab to keep the incision sites moist.
- Crusting: Occasionally crusting will occur around the sutures. Do not try to remove this yourself. This is normal and will resolve. Showering daily will minimize crusting.
- Sun Exposure: Avoid sun exposure as much as possible. This will optimize scar healing and minimize swelling. During the first year it is crucial to use an SPF 30 or greater when outdoors. Even mild sunburn can cause permanent discoloration, worsen swelling, and irritate an incision that is healing.
- Suture Removal: Do not attempt to remove sutures or staples yourself. Your Surgeon will remove all staples and permanent sutures at your follow-up appointments.
- Makeup: Do not use make-up for the first four days. When you begin to apply makeup, avoid application directly on healing incisions for at least a week.
WHAT TO EXPECT
- Swelling and Discoloration: Swelling and bruising of the surrounding tissues can be expected. Swelling and bruising may worsen on the second and third day after surgery. It is not unusual for one side of the face to be more swollen than the other. This is temporary and will improve over the course of the next six weeks.
- Bleeding: Some mild bleeding is not unusual at the incision sites the first few days after surgery. If you try to do strenuous activity, increase your blood pressure by straining on the toilet, sneezing, heavy lifting or bending forward you will aggravate the bleeding and swelling.
- Numbness: It is more common to have numbness of the cheeks, ears, and under the chin area that may last 3-6 months. Tingling and other odd sensations around incision lines are all to be expected and normal.
- Lumpiness: You may feel some lumpiness in your cheeks and neck. This is normal and will resolve within a few weeks.
- Pain and Itching: Occasional sharp shooting pains or itching is normal and will resolve in a few weeks. Pain is subjective, but most patients describe a mild to moderate pain level after a facelift. Pain is worse at night and can be aggravated with stress.
- Weak or Dizzy: You may experience some weakness or dizziness. This may be more evident if you try to stand up too quickly. Take a minute to go from lying down to standing. The sensation of feeling lightheaded will get better in a few days. Make sure to drink plenty of fluids.
- Depression: You may experience a period of mild depression after cosmetic surgery. This is related to the shock of seeing your face swollen and discolored. Remember this is temporary and once the healing process is completed you will begin to enjoy the results of your surgery.
- Scars: After all stitches have been removed, the scars will appear a deep pink color. With time, the pink will fade and become white, the firmness of the scar will soften, and they will become less noticeable. Everyone’s healing process is different, but it takes approximately a year for these changes to occur and the scars to look their best. Once your surgeon advises you, you may apply a Silicone based scar gel to your scar for enhanced healing.
- Final Result: Expect to see your final results between 6-12 months as the healing process takes time.
WHEN TO CALL THE OFFICE (703) 481-0002, OR GO TO THE HOSPITAL
- Signs of Infection: Spreading redness, worsening swelling, increased drainage or drainage of pus, worsening pain, warmth at incision site and temperature over 101 degrees Fahrenheit.
- Difficulty breathing, swallowing, or speaking.
- Excessive Bleeding: Bleeding that persists after applying pressure for 20 minutes.
- Medication Reactions: If you develop hives, rashes or itching you may be having a medication allergic reaction.
- Other Emergency Situations: Shortness of breath or difficulty breathing, chest pain, lightheadedness that does not quickly resolve, severe vomiting, pain, or asymmetric swelling in your legs.