Facelift, Browlift and Endoscopic Browlift

Common Questions

What can I expect postoperatively?
It is important that you be sufficiently prepared for your postoperative recovery period, as well. The day of surgery, for instance, you will feel sleepy from the anesthesia. Most likely, you will have no discomfort due to the long-acting local anesthesia that was used. When this wears off, most patients describe some discomfort, usually around the scalp, ears, and neck, which is easily alleviated by analgesic pills and cool compresses, prepared as follows:

Your vision may be slightly blurry due to swelling and protective ointment used during the surgery. Slight bruising and swelling are an important part of the body's normal healing process, and are most apparent around the eyelids, earlobes, and neck. This will rapidly resolve over seven to ten days. Not infrequently, the cheeks will have a slight chipmunk appearance. This, too, is short lived, resolving over several days. Notify our office if swelling appears excessive.

You should be prepared for some degree of temporary asymmetry. Swelling and bruising naturally occur and resolve faster on one side of the face then the other. This is due to differences with blood and lymph supply.

Your face and neck may feel firm, tight, and shiny during the swelling period. Elevate your head on one or two pillows or you can make a neck pillow following the instructions given on the next page.

In closing facial incisions, specialized plastic surgery stitches are used. Some are absorbable and dissolve in seven to fourteen days. Removable sutures are also taken out in seven to fourteen days, depending on your individual healing process. Despite what you may have heard to the contrary, scarring is usually minimized the longer your stitches are left in place.

The facial area may have slight firmness and bumpiness until the deeper swelling resolves. This is especially true where extensive, deeper fat layer removal or muscle tightening is performed.

Mood changes are common during the first several days to weeks after any surgery. Typically, periods of excitement and elation alternate with depression and fatigue. The slightly weak, tired feeling during your early recovery period will gradually resolve over the next few days to weeks. On the average, you should allow two weeks recovery time before socializing or working. Most patients report feeling totally "back to myself" in four to six weeks and feel their new, fresh, youthful appearance was well worth it.

How do you heal?
Contrary to popular opinion "scar" is a good word to your body because scarring is part of the healing process. To the patient, however, the idea of scarring is frightening. We attempt to minimize scarring by treating your incisions in a way that allows proper healing while camouflaging the incision sites. Most plastic surgery scars are very inconspicuous.

Your incision lines heal in four phases, as follows:

Phase I: Days 1 through 14. Characterized by slight oozing and crusting; bruising and soreness resolve in 7 to 10 days; ice compresses are helpful. (See care instructions below.)

Phase II: Weeks 2 through 6. Formation of early supportive scar tissue, pink to light red; itchiness and tenderness are common; some thickening of incision site. (See care instructions below.)

Phase III: Six weeks to six months. Scars lose their redness, itchiness, and tenderness; areas flatten and begin to blend.

Phase IV: Six months to 24 months. Scars become softer, looser, smoother, and less noticeable.

The following is a step-by-step guide to the healing process:
Stitches are used to support your incision site while it heals during the first several days to several weeks after surgery. Plastic surgical stitches are very fine and rarely leave stitch marks. Deeper stitches add strength to your incision line closure and will absorb over a period of six to eight weeks. In all likelihood you will not even be aware of this process.

Occasionally some minor irritation develops and a tiny bump may be felt under the skin as you wash. This is nothing to be alarmed about, as it is usually temporary and resolves in time.

Stitches used on or near the surface of the skin are removed in our office one to three weeks after surgery. A topical anesthetic may be utilized, and no pain is involved.

Your incision lines will be protected by dressings for a day or two after surgery. These dressings also absorb the normal, slight oozing of blood-tinged fluid from the surgical site. If this oozing persists, it can usually be stopped by applying continuous pressure on the area with a clean, dry cloth for ten minutes.

Elastic compression garments can be helpful in decreasing the formation of scar tissue following burns, injuries, or extensive reconstructive surgery. Depending on your specific procedure, the doctor may recommend that you be fitted for such a garment. If so, our office can provide you with a prescription and the location of a supplier.

You may notice some crusting of the incisions for a few days. This crusting can be softened with Vaseline, antibiotic ointment, or the doctor's special ointment which our office can provide. Your stitch lines will seal very rapidly—usually within 24-36 hours. At this point, the softened crusts can be washed away gently with mild soap and water. Avoid irritating soaps, powders, and oils until the area is completely healed.

As your incision lines heal, new blood vessels and nerves grow in the area. This can result in slight itchiness. Gentle washing of the incision line, followed by the application of Vaseline, antibiotic ointment, or our special ointment, will help decrease irritation.

Intermittent swelling can also occur in the first few weeks, and consequently lumps may develop under the skin. Once your stitches have been removed, you can treat any lumpiness with gentle pressure. Press the tip of your index finger gently over the area for ten seconds once an hour. Do not press hard enough to cause pain. It should feel like you are pushing a putty pea into a small pancake. This technique has been successful in decreasing scar swelling in burn patients.

If excess redness or swelling continues along the incision line, the doctor can give you a prescription for light cortisone ointment or an injection of dilute cortisone.

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