The following instructions are based on our experience with many custom facelift operations. These instructions will answer practically every question that may arise regarding what you should and should not do after surgery. You and your family should read through this information several times so that you become thoroughly familiar with it. It’s very important to follow these instructions faithfully to ensure the smoothest post-operative course.
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 to occur more in the face as there is looseness of the tissues in this area, and because even a small amount makes the features appear distorted.
The swelling often becomes a little greater the second day after your custom facelift. It may become more pronounced along the side of the neck, and is generally worse when you first arise in the morning (proof that it is better to stay elevated as much as possible).
The swelling itself is not serious, and is not an indication that something is wrong. It may even be uneven on one side compared to the other, but this is normal.
There is usually very little actual pain following a facelift, but you may experience a deep bruised sensation as a result of the swelling, and your face may seem heavy. The bandage you will wear the first night may seem quite snug under your chin. Rather than make you feel restricted, we hope it makes you feel secure. It will not restrict your breathing, but will help to minimize bruising and swelling. It will be removed by Dr. Funcik or the nurse the first morning after surgery.
Unfortunately, strong painkillers can cause sensations of lightheadedness—particularly in the immediate post-operative period and, consequently, seem to make recovery more tedious. Therefore, we generally recommend Extra Strength Tylenol for pain. You may take two pills every 4-6 hours, and we recommended that you take it as directed to keep it in your system in order to maximize the pain control. If the pain is severe, use the stronger medication that has been prescribed for you. Please eat something first.
Narcotics may cause nausea, vomiting, extra bruising, and discomfort. They may also cause depression, allergic reactions, and constipation. Do not take aspirin or any ibuprofen-type medicines until instructed to by Dr. Funcik. Many over-the-counter pain relievers contain combinations of these products.
Getting Out of Bed
We usually recommend that you remain in bed during the first 12 hours following surgery, after which you may sit in a chair, walk to the bathroom, or walk around your room. You should be as quiet as possible during this time. We discourage a great deal of talking and having too many visitors. The second day after surgery, you should be getting up and around more.
AVOID STRAINING AT THE STOOL. If you need a laxative, we recommend Correctol or Miralax (your pharmacist will give it to you without a prescription).
If you live in another city, you must stay in town. You may stay at a hotel, or with a friend nearby. You should plan to stay in town for at least seven days after surgery.
Removal of Dressings
In the operating room, a pressure dressing will be applied and two drains will be placed in the neck area to help decrease swelling. They will be removed the next morning by either Dr. Funcik or a nurse.
- Apply a liberal amount of Vaseline or Aquaphor to the suture lines around the front and back of the ears. Be sure to have a new, clean supply of the ointment. Do not attempt to put ointment in the suture lines in your hair—this is too messy.
- Beginning the second day after surgery, start showering twice a day for the first week. Let warm water run throughout your hair and face while showering. You may use Johnson’s Baby Shampoo or a suitable pH balanced shampoo that will not sting. Twice daily, clean the staple and suture lines with soap by using your fingertips, and rinse well. After the sutures are removed in seven days, you can use gauze or a clean washcloth. If you have eyelid surgery, do not be afraid to get the sutures around your eyes wet when showering.
- Report any signs of infection such as excessive swelling, redness, drainage, or new unusual pain near the ears.
As previously explained, your face and neck will remain swollen with varying amounts of discoloration for several days. After most of the swelling has subsided in two weeks, there will be days over the next 3-4 weeks when you may have some recurrence of the swelling. Do not be alarmed. This will subside within hours of getting up in the morning. These fluctuations of swelling are expected, and are temporary. The main thing to remember is that such swelling eventually subsides. You can help in several ways, as follows:
- STAY UP (sitting, standing, walking around) as much as possible on your second post-operative day. Of course, you should rest when you get tired.
- AVOID BENDING OVER OR LIFTING heavy things for two weeks. Besides aggravating swelling, this may raise the blood pressure and start hemorrhage.
- SLEEP WITH THE HEAD OF YOUR BED ELEVATED for 2-4 weeks after your operation. To accomplish this, place two pillows under the head of the mattress, or one or two on top of it. Try not to roll onto your face; therefore, it is necessary to sleep on your back for one month, if possible. Some patients find a reclining chair placed at a 30-45° angle to be more comfortable.
- SUPPORT THE SWOLLEN TISSUES with a chin sling applied according to the directions we will give you. Wear it constantly until one week has elapsed from the date of your operation. After this, it should be worn during sleep for the second week.
- AVOID EXCESSIVE TANNING on your face for 2-3 months. Ordinary exposure is not harmful, but please use an SPF 20 or greater sunscreen and wear a hat, if possible. Splotchy brown coloration may occur with sun exposure.
Your body temperature may rise to nearly 100° following the facelift. This rise is due to the healing process. Patients will often think they have an increased temperature because they feel warm, but in reality do not. To be sure, you should measure your temperature by mouth. Report any persistent temperature above 100°.
It is normal after a person has an anesthetic (or any type of operation) to feel weak, have palpitations, break out in cold sweats, or get dizzy. This gradually clears up in a few days without medication.
It is common for patients to have some difficulty sleeping in the post-operative period. Please let us know if you would like us to prescribe a sleeping pill for you. It should be remembered, however, that such drugs also tend to make some people feel lightheaded and weak, and should be taken only if needed.
Tightness of the Face
The skin of the face may feel tight for awhile, and you may feel that it interferes with your smile. This will disappear within a few weeks.
It is normal for an individual to go through a period of mild depression after cosmetic surgery, because no matter how much they wanted the operation beforehand and how much they were told about what to expect post-operatively, they are shocked when they see their face swollen and perhaps discolored. Be realistic and realize that this is a very temporary condition which will subside shortly. The best treatment consists of busying yourself with the details of post-operative care and trying to divert your attention to other thoughts.
Parts of the face, neck, and ears sometimes feel weak or numb after a facelift operation. This is perfectly normal, and will generally subside with time. Sometimes unusual sensations may occur when the feeling nerves are returning. This can range from hypersensitivity to actual pain at times. This will subside, and normal feeling will return. This occurs for several weeks to a few months following surgery. Avoid curling irons, or use them only with care during this period.
Thinning of the Hair
There may be transient thinning of the hair in areas adjacent to the suture lines in the temple, top of the head, or behind the ears. If this occurs, it is a temporary shock phase to the hair follicle. The new hair shaft will not be visible for 4-6 months, however.
If You Injure Your Face
Many individuals sustain accidental bumps to the face during the early post-operative period. Usually, you don’t need to be concerned unless the blow is hard, or if hemorrhage or considerable swelling ensures. Please inform us of any injury.
Arnica montana (for bruising and swelling, three pills three times a day) can be taken the day of surgery and continued up to two weeks if needed. Keflex can be restarted the day after surgery and until finished. After your surgery, you may resume your regular medications that day, unless otherwise instructed by Dr. Funcik. You can restart vitamins and minerals after two weeks. No blood thinners until cleared by Dr. Funcik.
WEARING GLASSES AND CONTACT LENSES: Eyeglasses may be worn as soon as the bandages are removed. Contact lenses may be inserted the day after surgery. If you had eyelid surgery, wait at least ten days after surgery and ask Dr. Funcik when it would be safe for you to try them. Be careful not to let your glasses dig or rub behind your ears.
HAIR AND BODY CARE: You may wash your hair with lukewarm water and baby shampoo in the shower and comb it out with a large-toothed comb two days after surgery. You may have your hair washed at a salon three weeks after your surgery, but do not use the usual type of heat hair dryer. Use a hand blow dryer on low setting. Be careful not to rest your neck on the rim of the washbowl in the area of the incisions. You may use conditioner on your hair after one week. Generally, hair coloring can resume at four weeks once the incisions are well healed. Please get Dr. Funcik’s approval. Use your fingertips to wash your face gently with a mild soap (Ivory or Neutrogena) using a gentle upward motion. Do not tweeze your eyebrows for two weeks. You may wear a wig as long as it does not directly fit over the stitches or staples.
HOUSEHOLD ACTIVITIES: You may be up and around the house, but no housecleaning.
PULLOVER CLOTHING: For two weeks, you should wear clothing that fastens either in the front or the back rather than the type that must be pulled over the head. Removing pullover garments may loosen the sutures near your earlobes.
ATHLETICS: No swimming, strenuous athletic activity, or exercises that involve turning your head are permissible for four weeks. You may begin light aerobics after two weeks, but no head- or neck-turning exercises for four weeks. You may begin walking one week after surgery. Do not weightlift for at least 2-3 weeks. Start with the lower body first.
KEEPING A STIFF FACE AND NECK: You should not move your face and neck excessively until the skin heals to the underlying tissues.
- Avoid excessive grinning and smiling.
- Do not bend your head forward or extend your neck backward.
- Do not turn your head without turning your neck and shoulders as one unit. When you must turn, do so as if you have had a crick in the neck for two weeks.
- Avoid gum or foods that are hard to chew. Soups, mashed potatoes, stewed chicken, hamburger steak, or any easily-chewable food is permissible. Steaks, French bread, etc. should not be eaten for at least two weeks.
- Avoid yawning with your mouth opened widely for two weeks.
RETURNING TO WORK AND RESUMING SOCIAL ACTIVITIES: When you should return 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 when these factors are minimal. You will have to play this by ear. You should try not to drive until the end of the second week.
Your First Week Post-Operative Office Visit
Don’t build up fear and anxiety about your first week post-operative visit to the office. Most of the skin sutures will be removed, and the progress of your healing will be checked. Removing sutures is quick and uncomplicated because it’s done with small, delicate instruments to minimize discomfort. There is also a special instrument designed to remove the small staples. This can be minimally uncomfortable because of swelling. Some patients prefer to take a pain pill before arriving at the office. You will probably feel much better after the first office visit. Ordinarily, all staples are removed within two weeks from the day of your surgery.
Remember the things you were told before your operation, namely:
When the bandages are first removed, your face will appear swollen and lumpy, and there will be varying amounts of discoloration. This swelling will subside to a very large extent within two weeks. However, it will take a minimum of 6-8 weeks for all the swelling to disappear and for your face to reach its final contour.
The discoloration will gradually disappear over a period of 10-24 days in most cases. We have yet to encounter a case where it persisted permanently.
- Temperature elevation above 100°
- Sudden swelling or discoloration
- Discharge from a wound or other evidence of infection
- Development of any drug reaction
Most of all, BE PATIENT during the healing process. If you have further questions, you are urged to call us. While it is better to call during office hours, we are available 24 hours each day. We are here when you need us.