What You Should Know About Facelifts

What to Know About FaceliftsExcerpted from Dr. Peter Adamson’s book Fabulous Faces (available on Amazon.com) and edited for our blog.

Surgery is a big deal, especially facial plastic surgery. It’s one thing to go under the knife because you have a serious illness and no other options. It’s another to voluntarily submit to a facelift. You’ll have many questions, and many of them should be answered below.

Will it hurt? Most facelift patients say that they feel little or no pain. But you’ll feel miserable the morning after. Everything around your head will feel tender. It’s not stung-by-a-hornet, rock-on-the-foot pain, but it’s no walk in the park either. In fact, you won’t feel like walking in the park for a few days. An over-the-counter medication that isn’t aspirin-based (e.g., Tylenol) should suffice. If you’re “discomfortable” and need something stronger than Tylenol, prescription pain medication is available.

Will I feel sick? You may be mildly nauseated from the anesthesia, which can take a day or two to leave your system. However, it’s by no means a certainty. Not everyone who has a facelift experiences postoperative nausea. You may also feel weak, have occasional palpitations, get dizzy, and even break out in cold sweats. Beyond that, your temperature may be above normal (38.5 degrees Celsius or 100 degrees Fahrenheit). That’s enough to make you a little feverish. Treat all of this with a lot of fluids (but no alcohol) and Tylenol (preferably extra-strength). The nausea, if present at all, will usually pass within a few hours.

What about swelling and bruising? Count on it. Almost everyone comes out of a facelift with a swollen face. Some patients have very little, others more. In some cases, the facial features are distorted by the swelling. But it subsides quickly, especially if you keep your head elevated during the night and use a lot of cold compresses during the day.

Bruising usually doesn’t appear until a day or two after surgery. Then it usually follows a progression over two to three weeks. The bruises start out a scary blue/purple color and fade to green, then yellow.

Here’s a tip: Wait until day five after surgery, and then put warm compresses on the bruised areas. Use cold compresses for swelling on days one to five, and then warm compresses for bruising after day five.

Will there be scars? Yes, but nobody will notice. You can’t make an incision in the skin without leaving scars, but those scars are almost imperceptible. Incisions for facelifts are usually made in areas that aren’t readily noticeable, mainly around the ears and into the hairline. Complete healing can take anywhere from a few months to a year.

What are the risks? Complications from facelifts can include excessive bleeding, infection, and poor healing. These are rare. Rarer complications include bad reactions to the anesthesia, leading to lung and heart trouble. There’s a remote chance of blood clots that can travel to the heart or brain, causing heart attack or stroke. Neurological reactions to either the anesthesia or the surgery could lead to nerve damage. A thorough medical pre-screening will reduce the risk of such complications.

How long will I be off work? You can usually go back to work in two weeks. However, if you’re worried about your “coming out,” take three weeks to be sure. With “mini” lifts, the healing is about one week faster.

Will I be in the hospital? Some facelifts are performed in hospitals. You might stay overnight or be sent home the same day. Many surgeries are performed in private clinics. In accredited clinics, the operating rooms are equipped in the same way as found in hospitals.

What kind of anesthetic will I have? For most facelifts, expect either a general anesthetic or a local, “twilight,” or neuroleptic anesthesic. Much of this decision is based upon the surgeon’s experience, the medical facilities, the length and type of your procedure, and your wishes. An anesthesiologist will administer a combination of drugs and constantly monitor your progress throughout the surgery. These drugs take time to wear off, so you may feel a little disoriented or nauseated afterward.

Will people know I’ve “had work”? Not unless you tell them. Most facelift patients report getting compliments on how young and fresh they look, followed by questions on what brought about this transformation. These include questions about weight loss, a new exercise regimen, or a change in wardrobe or hairstyle.


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