Facial Plastic Surgery: Recovery

A facelift, or rhytidectomy, is a surgical procedure that improves visible signs of aging in the face and neck. This elective procedure is done to help improve the youthfulness of the face that may have been damaged due to sun discoloration, smoking, weight loss, genetics, and/or the aging process.

Being fully prepared for the recovery process after major facial plastic surgery is important and can help the healing process and reduce the risk of complications.

Surgery Follow-Up

The 2020 pandemic spurred significant changes to facelift surgery follow-up care. Plastic surgeons are recommending dissolvable sutures and unsutured superficial dressings in order to reduce the number of hospital and/or office visits after your surgery.

Despite the need to reduce postoperative visits, you can expect the following appointments during the first week. All subsequent visits will be at the discretion of the surgeon:

• The day after surgery, your surgeon will likely remove your drainage tube, apply antibiotic ointment to your incisions, and place new bandages on your face.
• About a week after surgery, your healthcare provider will remove your stitches and assess the wound.

Week 2:

• Most patients return to work by week 2.
• Resume light activities such as walking.

Week 3:

• Return to work if you haven't.
• Resume full activities such as weight lifting and exercising.

Recovery Timeline

Facelift surgery recovery isn't cookie cutter. Your recovery will be dictated by your surgeon, the amount of work that is done, and your body's healing abilities. You can expect the following during the healing process.

Week 1:

• Most pain from the procedure will be experienced in the first 24 to 48 hours after your surgery. Expect to take prescribed pain medication during this time period.
• Sleep upright as swelling will occur and this will help decrease swelling and increase comfort.
• No driving while on narcotic pain medication.
• Two to three days after your facelift, you may be able to switch from wearing bandages to wearing an elasticized facial sling.
• Ice your face and neck as much as possible during the first 72 hours. After 72 hours, either ice or heat is permitted.
• Avoid bending or lifting heavy things for one week. Besides aggravating swelling, this may raise the blood pressure and start a hemorrhage.
• Avoid hitting or bumping your face, head, and neck. It is wise not to pick up small children and/or pets. You should sleep alone for one week after your operation to avoid this possibility.

Week 2:

• Swelling and bruising continue and some can also experience some numbness, tingling and tightness.
• Return to work as long as your job is not physically demanding.
• You will start to feel more like yourself during week 2.
• Can resume driving.
• Do not smoke for at least two weeks after your surgery as smoking significantly delays healing and increases the risk of complications.

Week 3:

• You may continue to have swelling and bruising.
• You can exercise including more vigorous activities such as running and lifting.

It's important to follow all instructions from your surgeon to promote optimal healing and minimize the risk of complications:

• Follow wound care instructions as directed by your surgeon.
• Do not pick at crusting scabs that develop on your wound.
• Follow instructions on when you can begin using shampoo and soaps and what kinds you can use.
• Wear clothes that fasten in the front (rather than clothes that are pulled over the head).
• Avoid excessive pressure or motion on and around the incisions.
• Avoid using makeup until cleared by your surgeon.
• Prioritize getting enough sleep at night, at least seven to eight hours, to promote healing.
• Avoid vigorous or aerobic activity or sports until cleared by your surgeon.
• Avoid direct sun exposure to the incision for three weeks and use a sunscreen of SPF 30 or higher thereafter.
• Avoid coloring, bleaching, or perming hair for at least six weeks.
• Eat a healthy diet and drinking plenty of fluids.
• Maintain a positive attitude and learn how to cope with and manage stress.

Coping With Recovery

It's very normal to second guess having the facelift procedure during the recovery process. It's important to remember that your face will look worse and you will feel worse before it gets better. Recovery after facial plastic surgery takes time.

One of the biggest challenges during the postoperative time is pain management. You will be sent home with a prescription of narcotic pain medicine.

Pain Management

During the first week, you can expect to use narcotic pain killers to help manage your postoperative pain as well as over-the-counter (OTC) pain medications such as Tylenol and Advil. Let's take a closer look at what you can expect your pain management regimen to look like.

Over-the-Counter Pain Medications

Over-the-counter (OTC) pain medications such as non-steroidal anti-inflammatory drugs (NSAIDs), which include Advil (ibuprofen), can be used in combination with other pain relievers.

Tylenol (acetaminophen) is also commonly prescribed after surgery. It's important to remember proper dosages and timing of OTC medications as accidental overdose is possible. Make sure to let the medical team know if you have a history of kidney, liver, or heart problems as these can be affected by these drugs.

Prescription Pain Medications

For more intense pain and during the first few days after surgery, you will be prescribed an opioid drug such as Percocet, Vicodin, or Oxycontin to help ease your pain. It’s important to note that these are highly addictive and should be taken only as directed.

You may experience the following side effects while taking prescription pain medication:

• Fatigue
• Hypotension
• Bradycardia (slow heartbeat)
• Nausea
• Constipation
• Skin rash
• Bradypnea (slow breathing)

It is recommended that all unused prescription pain medication should be disposed of properly or returned to the pharmacy.

Non-Medical Approaches

Complementary therapies such as aromatherapy, meditation, and/or guided imagery can be helpful during the recovery process. It's important to remember that these alternative approaches should not replace needed pain medication but rather should act in conjunction with your healthcare provider's pain management regimen.

While you may want to attempt recovery with little to no medication it is also important to remember to listen to your body. Untreated pain can cause numerous physical complications and should not be ignored.

Healthcare providers recommend trying distraction—listening to your favorite music, playing board games or card games. This may ease anxiety or stress as a means to get your mind off the pain.

Another approach is the use of guided imagery. This involves, closing your eyes, breathing very deeply, and picturing yourself in an ideal location or a “happy place.” Over time, you should be able to feel positive emotions from where you are, leaving you calmer and more in control.

Emotional Challenges

Recovery from surgery can also be emotionally challenging. Studies have found that patients might experience the following emotions:

• Upset
• Depressed
• Nervous
• Irritable
• Angry
• Sad

Experiencing the aforementioned emotions is normal. Having a loved one to open up to can be helpful or talking to a professional counselor can help as well. It's important to let your healthcare provider know if you are having emotional and mental difficulties after the surgery as this is important for the healing process.

Wound Care

Keeping the area clean and dry, and be sure to care for your wound and drain according to the instructions you received in the hospital. The drain will be removed and the initial surgical dressing will be changed by the surgeon in the office

After the initial dressing has been changed, you will be instructed to wash the surgical incisions gently with a mild, non-fragrant soap and water three times a day.

After cleansing the area, the remainder of the cleaning process is surgeon specific. For example, some may instruct you to clean the incisions with a 50% solution of 3% hydrogen peroxide and a Q-tip. Mix the hydrogen peroxide with an equal amount of warm tap water.

The incisions should then be constantly covered with the antibiotic ointment prescribed. If you do not have antibiotic ointment, a thin coat of Vaseline works well. Ultimately, the incisions should not be allowed to become dry or crust over.

It's important to follow the specific instructions from your surgeon to care for the surgical incisions following facial plastic surgery.

A Word From Verywell

Despite the complexities and challenges with facelift surgery, it continues to be one of the most popular plastic and cosmetic surgeries in the United States. Taking care of yourself during the healing process and understanding that often times you will look worse before you look better is important.

Bruising and swelling are normal postoperative complications that you should expect to experience during the recovery process.