Many patients considering a facelift procedure are most concerned about the facelift recovery time. Thankfully, with continued improvement in surgical techniques and recovery regimens, the period of facelift recovery is getting shorter and shorter. Below is a rough guideline of what to expect when recovering from a facelift under the care of Dr. Thomassen in Fort Lauderdale.
Day 0 – The day of the procedure
Recovery Room
On this day, you have your procedure. Facelifts are performed with oral sedation or IV sedation depending on your particular situation. With oral sedation, you may fall asleep for a short period of time during the procedure but otherwise you are awake. At the end, you are walked back to the preop area. You are given something light to drink and eat and you then get dressed. You are able to go home immediately with someone to take you. You will be comfortable since the local anesthesia will still have an effect.
If you undergo the procedure under IV sedation, you will not remember anything of the procedure or likely of even going into the operating room. You will wake up in the recovery room. You will be comfortable and only feel some tightness from the procedure and the dressing. You will be given something light to eat and drink. We will transport you in a wheelchair to the car that will take you home.
You will have instructions printed out and explained to your care person before you leave. You will also have a time for the follow up appointment the next day.
Home Accommodations
When you get home you should have a comfortable set up waiting for you. This includes a bed with a back support that keeps you 15 to 30 degrees elevated. This can be done with a few pillows, a wedge pillow, or a recliner. You will sleep on your back in this slightly elevated position and avoid sleeping on your side or stomach.
You will be given “chucks” or disposable paddings that you use on your pillows where you rest your head so you keep these clean if there some mild spotting on the dressings .
What to eat
As you become more alert once the anesthesia wears away, you will become hungry. It is recommended you have something light to eat the first day. This includes a soup without cream or any other light meal. The reason is you may get nauseous from the anesthetics and a light meal will make it more tolerable. Also, your muscles of mastication will be tight due to the procedure and chewing will be uncomfortable the first night.
How to manage pain
After a few hours you may feel a headache or pain associated with the incisions. At this point you may start the pain medication prescribed. Be aware that this medication contains a mild narcotic that can cause nausea, vomiting, itching, and constipation. Some patients are more susceptible to the side effects than others. For this reason, Dr. Thomassen recommends taking the oral dissolving Zofran tablet, an anti-nausea medication, before taking your first dose of pain medication. If you have no experience with these narcotic medications, you should also consider starting with half a pill to see how you react.
Some patients experience headaches related to caffeine withdrawal. Since the normal first cup of coffee the day of surgery is missed, the withdrawal symptoms can start in the evening. For patients that drink coffee daily, it is fine to have a dilute cup of coffee after the procedure to ward off these coffee-related headaches.
Do not under any circumstances use ice on the face. This will reduce blood flow to the thin skin flaps that were elevated as part of the facelift and may compromise healing.
What other medications to take
In addition to the pain medications, and Zofran oral dissolving tablets, you will be given prescriptions for an antibiotic. Read carefully how often to take them. Usually it is prescribed to be taken four times a day. This means morning, noon, afternoon and evening. You do not need to wake up in the night to take them. In patients with a penicillin allergy, they may be given a different antibiotic that is taken 3 times a day. You can start your first dose after you have had something to eat at home and are comfortable.
You can continue the homeopathic medications to reduce swelling and bruising like Arnica and Bromelein as indicated.
What to look out for in the first 24 hours
You should feel comfortable overall although tightness and some swelling is to be expected. If you feel tightness and swelling on one side more pronounced than the other side, this may represent a hematoma or bleeding under the skin. This may or may not be accompanied by bruising. You should call Dr. Thomassen right away if you experience this.
Most importantly, if any concerns arise at any time you should call Dr. Thomassen first. It is best to call at the time something arises and not wait until the morning.
POD 1 (Postoperative Day 1)
Hopefully you will have had a restful first night. Because of the snug compression and drains, most patients do not experience a very restful night. Thankfully all this is removed on this day and you should have normal sleep nights from now on.
Dr. Thomassen will see you for your first postoperative appointment in the mid-morning or early afternoon. You will need someone to drive you for this visit. During this appointment the dressings and drains are removed. Rarely are the drains kept in place for an additional day. This does occur occasionally if more bleeding than usual is noted.
The drain removal process is painless. Afterwards, a thinner compression garment is placed that is much more comfortable. You should have very little pain from now on.
You are given instructions for how to proceed to care for yourself over the next week. The recovery regimen is simple and detailed below. For the rest of this day, you proceed as you did the first day: rest with your head elevated, eat light simple meals, and take medications as prescribed.
POD 2 through POD 6
On POD 2 you may start showering. Take your garment off and launder it if necessary. You can wash your hair with shampoo and your face with soap. You will feel the suture line near your scalp and ears and therefore be very gentle in these areas. You can pat these areas dry gently afterwards.
An antibiotic ointment like Bacitracin or Neosporin or a wound gel like Aquaphor is recommended to be placed on the incisions after the shower. This will help the incisions heal faster.
After your shower and apply the ointments, you should place the garment back on. The garment is worn throughout this first week. It is intended to help reduce swelling in the midface and neck. However, you can remove it if going out of your home for any amount of time. Sleeping with it is recommended.
You should not drive during this week. However, you are allowed to drive to your 2nd follow up appointment on POD 7.
Some patients may experience significant swelling. You should see a gradual improvement in swelling and bruising as the days go by. If you feel it is not improving, call Dr. Thomassen. In some cases, starting a steroid during this week significantly improves swelling and shortens recovery.
For the rest of the week, you continue with the prior instructions: rest with the your head elevated, eat normal meals, and take medications as prescribed.
POD 7 (1 week after surgery) thru POD 14
You can drive to your 2nd follow up appointment if you feel comfortable. You should avoid any aggressive movements like turning your neck suddenly.
At this point in your recovery the incisions should be healing well. Dr. Thomassen usually removes the sutures during this visit. It is normal to leave a few in place if an area does not look sufficiently healed.
You will no longer need to wear the compression garment after the first week. You are allowed to perform most sedentary activities like office work and walking. You are able to sleep how you would normally without head elevation. You should be done with any medications from surgery and be back on your usual regimen.
POD 14 (2 weeks after surgery) thru POD 21
You should be fully healed and all swelling and bruising resolved. You should have the results you expected and be happy with your recovery. You will have an appointment with Dr. Thomassen this week to remove any remaining sutures.
You will be instructed on how to use a silicone scar cream on the incisions to hasten their resolution.
Dr. Thomassen will clear you for more than just sedentary activities depending on your recovery.
POD 21 (3 weeks after surgery)
You will be fully healed with no bruising or swelling. You will have a follow up with Dr. Thomassen to address any remaining concerns. You should be cleared for all activities.
In Summary
Healing following a facelift does not have to be a prolonged, arduous experience. With Dr. Thomassen, it should be a comfortable experience lasting between 2-3 weeks.
You can learn more about facelift recovery at the American Society of Plastic Surgeons website.