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What is the recovery after facelift surgery? The truth revealed…

On this page Dr. Julian De Silva talks candidly about a common question that many patients ask.

The truth is that recovery after facelift does differ on you as an individual, no two patients have an identical experience. The truth is that recovery after facelift and neck lift surgery does depend on several factors.

On average for facelift surgery, 90% of my patients are back to normal in two weeks. The truth is that this recovery after facelift surgery does depend on the individual person and does depend on several factors.

1) What do we mean by recovery? Some parts of the recovery are quicker than others. What can I expect 1-week after surgery?

2) What are the individual factors that influence recovery?

3) What can ­you do to speed up your recovery?

1) What do we mean by recovery? What can I expect 1-week after surgery?

  • Bruising & Swelling. After 1-week 80% of the bruising and swelling will have gone, by 2-weeks a further 80% of the bruising and swelling will have gone. Occasionally there can be a marked bruise that can take 6-weeks to go, though it can be covered with make up after 1-week. Occasionally swelling can persist for several weeks, though usually there is pre-existing medical condition.
  • Sensory Change. There is numbness around the ears and chin in the recovery period, this continues to improve over the first 6 weeks although occasionally it can take 6-12 months to disappear completely.
  • Pain. In terms of pain, there is surprisingly little pain, and usually only for a few days after surgery that is relieved by oral analgesia.
  • Incisions. What about the incisions. This depends on the surgical technique, placement of the incisions and skin closure technique play an important role, incisions that are visible can be covered with cosmetics and make-up from 2-weeks, the final result from any scars is 6-12 months later. Please see the area below on hiding facelift incision scars
  • Activities. Reading, computer work, these kind of low level activities can be started after a few days as they are not the same as lifting and strenuous activities that influence blood pressure and increase swelling.
  • Social activities. Most can be restarted after 2-weeks, there will be some residual bruising and swelling, generally this can be covered up with makeup. For an important social event such as a wedding should allow 6-weeks.
  • Exercise. As a general rule 3-4 weeks is advised for most aerobic and anaerobic exercise.

2) What are the factors that influence your recovery?

  • You. If you have any medical conditions like diabetes or high blood pressure, these should be well controlled before rhinoplasty as they effect healing. Environmental factors such as smoking that delay healing, Dr. De Silva insists all patients stop smoking before surgery to improve healing and reduce the risks of surgery. Your constitution influences the speed of recovery, two people having identical surgery will not heal in the same time, we all heal differently. Mental attitude, cosmetic surgery can be an emotional experience, and having a positive mental attitude goes a long way towards a fast recovery.
  • Your Surgery. Not all facelift surgery is the same, whether the surgery is principally on the face, the neck, whether a deep plane technique has been used, all of these effect healing. Having additional procedures such as eyelid surgery, fat transfer and others at the same time as the surgery will effect the recovery. Depending on how much surgery was required influences the amount of bleeding and bruising during the surgery.
  • Your Surgeon. Different surgical techniques influence the recovery period. Dr. De Silva performs meticulous surgery that limits trauma to the tissues of the face, and where appropriate innovative techniques such as deep plane technique and 3D telescopes to speed up the recovery process. Other innovations that can be used to reduce bleeding, such as the use of tissue glue in a patient with known bleeding issues.

3) What are things you can do to speed up your recovery?

  • Before surgery. Dr. De Silva provides all patients with detailed instructions on medications and other treatments that can influence bleeding and should be avoided before surgery. In addition there are herbal medications that should be taken to reduce bleeding, Arnica.
  • After surgery. Icing the face and neck area for the first three days, in the form of ice in a zip lock bag, frozen peas or gel mask all have a beneficial effect on reducing swelling when applied to the face for ten minutes every hour during waking hours. There are other factors such as resting and taking things easy during the daytime that will maintain a relatively low and stable blood pressure.
  • Head Elevation. Sleeping with you head elevated reduces the effect of gravity on the face and reduces swelling of the face and neck areas.
  • Sun exposure. You should avoid sun exposure, wear hats and high sun protection factor sunscreen for a minimum of 6-months after facelift surgery.
  • Surgeon’s advice. It is important to follow your surgeons’ pre and post-operative instructions in order to heal properly and minimize prolonged recovery.

How can the facelift incision be hidden?

Meticulous surgical technique.

  • Surgeon’s technique. Surgeon’s use different techniques to complete a facelift and neck lifting procedure. Meticulous care and attention is required to hide the facelift incisions.
  • Location of the incision. The incision and thus the scar in front of the ear can be hidden in women by placing the visible portion of the incision inside the ear canal or opening behind the little lump in front of you rear called the Tragus. In men, this is not ideal as it means the beard hair will grow up to the ear which is not ideal long-term, Dr. De Silva will often use a natural crease that lies in front of the ear to mask this incision and maintain a normal area of beard growth.
  • Multiple-layered meticulous closure. Multiple layered skin closure ensures that there are deep stitches to support the soft tissues once the superficial skin stitches are removed, this is key to avoid unattractive widened scars, it does take additional time to complete the procedure and is more challenging for the surgeon. Dr. De Silva always closes the incisions with multiple layers to give the best possible final result.
  • Beveled incision. In hair bearing skin the use of a beveled incisions in the hairline enables hair to grow through the scar after surgery, hiding the scar in hair bearing skin.
  • Deep Lifting of SMAS layer. Lifting the deep tissues beneath the skin (SMAS or Deep Muscle Tightening) before skin closure is essential to give a natural looking result and avoiding tension on the skin on closing the incision are all important aspects of the surgery.
  • Stitches. There are different methods that can be used to close the skin. Dr. De Silva avoids the use of staples in skin areas as the best healing is from the use of fine sutures in non-hair bearing skin, this takes additional time and meticulous care to complete. Dr. De Silva does not compromise time for giving the best final result.

What can you do to improve facelift scars after surgery?

  • Keep your incisions clean after surgery.
  • Avoid exercise during your recovery period for 3-4 weeks.
  • Maintain a healthy diet, including adequate protein and high anti-oxidant containing foods.
  • Daily supplemental vitamin C (anti-oxidant) improves recovery.
  • All surgical scars are red to pink for 6-12 months after surgery, most scars are white after this time period. When the scars are pink they can be effectively covered with make up or concealer or hair.

Facelift scar 6-weeks after surgery

Facelift scar 6-weeks after surgery - photo

  • Avoidance of sun exposure is important after facelift surgery. The use of hats and a high quality sun block of SPF 30 is important for 12-months after surgery to avoid redness and darkening of the incision sites.
  • After 4-6 weeks, gentle massage of the scar twice a day will help soften the scar by aiding remodeling of the scar.
  • Follow your surgeon’s instructions & advice.
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