DRESSINGS:
The bulky dressing placed at the time of surgery puts some pressure on the areas operated on and helps soak up any external drainage of normally occurring serum and blood. If the dressing is too tight or causes pain, please call us at (480) 464-8000. You may be instructed to cut part way or completely through the portion of the dressing under the chin. This will usually relieve the discomfort. Removing the entire dressing will not cause any problems, in the unlikely event that this seems to be necessary. We remove the bulky dressing the morning after surgery and replace it with a very light one, which you will remove the following day. After that, there are no more dressings.

POSITION:
Keeping your head elevated as much as possible will help to reduce postoperative swelling. If you can, sleep on two or three pillows to keep your head above the level of your heart.

DRAINS:
On each side of your face, a small drain may be placed under the skin and brought out through a small incision made in the temple. These drains evacuate the fluid that accumulates after surgery and enable you to heal faster. When the drain is first put in place, the bulb at the end of each tube will be compressed to create gentle suction. As the fluid collects in the bulb, it will expand.

DRAIN CARE:
Secure the bulb of the drain to the dressing on your head with a safety pin. The evening of surgery, you should empty the bulb by opening the plug at the top and pouring out the contents. Do not attempt to remove the bulb from the tubing. Squeeze the bulb to recompress it, and put the plug back into the hole at the top in order to maintain the vacuum. Do this whenever the bulb fills or expands 50% or more.

If the bulb fills rapidly after emptying it, or you need to empty it more than three times daily, please call us at (480) 464-8000. The doctor or a nurse will usually remove the drain the day after surgery, but occasionally they are left for 2-3 days. Removing them feels a little strange but is not painful. You may shower and shampoo your hair the days after the drains are removed.

YOU CAN EXPECT:
Patients can expect moderate discomfort and should take pain medication at first sign of discomfort. Moderate swelling with black and blue discoloration and blood shot eyes are normal.

BLEEDING:
Small amounts of oozing and bleeding after surgery are normal. The bulky dressing may be stained and the size of the stain may enlarge after you go home -- this is normal. If serious bleeding occurs, apply pressure and call us. Swelling and discomfort caused by bleeding under the skin flaps is very uncommon, but if it does occur, it requires attention and evaluation by your surgeon. Call us at (480) 464-8000 immediately.

DIET:
You should begin with a soft diet that requires little or no chewing. Be sure to get enough liquids. Avoid very hot foods or liquids.

SUTURES:
The sutures in front of your ears will be removed 4-6 days after surgery. If you have had an incision made under your chin, those sutures also will be removed 4-6 days after surgery. The staples within the hair and the sutures behind the ear are removed 9-12 days after surgery.

SMOKING:
Avoid smoking for 2 weeks after your operation to prevent coughing and possible bleeding.

ALCOHOL:
Avoid alcohol for 4 days after surgery.

SUNSCREEN AND MAKEUP:
It is imperative that your scars be protected from the sun for a good 6 months after surgery. Use a sunscreen with a skin-protection factor (SPF) of at least 15 at all times. It should be applied before your makeup. You may begin applying makeup 2 days after your sutures are removed. Speak to our nursing staff or the front office about scheduling a skin care appointment several weeks after surgery. We provide this service to help you maximize the benefits of your "new look."

SKIN CARE:
All the skin of the face and neck may feel dry and chapped after facial surgery. We recommend that you make frequent and liberal use of a good moisturizer without fragrances in it.

HAIR CARE:
After a facelift, most patients experience a temporary change in the texture and manageability of their hair. Your hair is reacting to the "shock" of surgery and will recover naturally within 6 weeks. If you color or perm your hair, plan to have it done before surgery or wait until 6 weeks afterward for the best results. Your hair will be a little "lifeless" during that period of time.

SHAMPOO:
Forty-eight hours after surgery or 24 hours after the drains have been removed, you may wash your hair. You may prefer to have your hairdresser wash it for you. In either case, a hair dryer, if used at all, should be kept on the lowest heat setting, as your scalp may be partially numb.

ACTIVITY:
Avoid sports and strenuous activity for 6 weeks.

SPECIFIC "AS YOU HEAL" INFORMATION

NUMBNESS:
When the skin is separated from the underlying tissues during surgery, small sensory nerves are cut. Varying degrees of numbness will be present after surgery and will improve gradually as the nerves reconnect to the skin. This process can take from 2 months for face, neck, and cheeks to 9-12 months for the forehead and scalp.

TIGHTNESS:
Frequently there is a tight feeling in the neck after a facelift. During surgery, not only the skin, but the underlying muscles are tightened to create a better and longer lasting result. Additionally, the swelling will move downward in the first week and the neck will feel even tighter. Do not be alarmed! You will not choke, and the sensation will decrease during the first month.

HEALING OF SENSORY NERVES:
As the nerves regenerate, itching, burning, tingling, and shooting sensations will occur. Ice, moisturizers, and gentle massaging are helpful during this phase of the healing process.


FIRMNESS UNDER SKIN:
Some degree of firmness or lumpiness under the skin is normal after surgery and will resolve with time. Local massage will speed resolution of this problem, which normally takes 2-4 months to disappear completely.

ASYMMETRIC SWELLING:
Do not be alarmed if one side of your face is slightly more swollen or numb than the other. This is common and usually disappears within a few weeks.

EYE SYMPTOMS:
Your eyelids may feel tight even if they have not been operated on, because of the swelling that occurs in the entire face. Your vision may also be blurred from the ointment that is placed in them for protection during surgery. Eye drops and ice packs will feel particularly soothing for the first few days after surgery.

ACTIVITIES:
Most patients who have had facelifts feel reasonably normal within 3-4 days after surgery even though they are swollen. If you wish to do light office work, you may. Do not, however, do any heavy activities or aerobic exercise for at least 6 weeks after surgery! Strenuous activities can cause bleeding and swelling for a longer period than is necessary.