Expectation vs. Reality: Recovering From A Facelift
Questions and concerns over the realities of recovering from a rhytidectomy (a.k.a. facelift) feature prominently into pre-operative conversations and research with surgeons, friends, family, social media, and the internet at large in the run-up to a procedure. If you are considering having a facelift, chances are you will have been looking through stories of the recovery process, before and after photos, and will have been wondering what to expect.
To give you a clearer picture of what recovery is actually like, we’re breaking down what can be expected from the healing process. As with any procedure, recovery and results will look different for everyone and plastic surgeons have their own recommendations for giving patients the best possible outcome. Here, we offer some honest insight into what it’s really like to recover from a facelift.
The First 48 Hours After a Facelift Are Key
Whether you go home the same day (with the help of a caretaker) or stay overnight for observation is up to your surgeon, but you can expect to have bandages and drains in the immediate aftermath of a facelift. “After the surgery, you will be wrapped in a large head dressing for compression, and most surgeons place two small drains to help remove any extra fluid,” says Melissa Doft, MD, a double board certified plastic and reconstructive surgeon in New York City.
It should come as no surprise that swelling, bruising, and discomfort are common in the aftermath of the procedure. Your surgeon will prescribe pain medication to help ease any aches, which is just one piece of the post-op protocol. “It is important to ice your face during the first 48 hours to help reduce swelling and bruising,” she says. “It is also important to make sure that you are comfortable.”
Ensuring comfort isn’t just for a more enjoyable recovery experience, it’s important for your health. “One of the most common complications after a facelift is a hematoma or blood collection,” Dr. Doft explains. “They often occur when your blood pressure rises and this is usually due to discomfort or pain.” As a result, your surgeon may require you to have a private-duty nurse monitor your blood pressure overnight. After that first night, the dressings and drains (which are very small and do not hurt to take out) will be removed.
Dressings and drains aren’t the only things that need to come out after surgery. Depending on the surgeon and type of facelift procedure, incisions will be closed with staples, stitches, or a combination of both. While it depends on the individual case and patient, Dr. Doft says sutures around the ears are typically removed five to seven days post-op, while the stitches in the scalp come out after 10 to 14 says.
Pain Management After a Facelift
The level of post-operative discomfort varies from person to person, but Dr. Doft notes that a facelift is not a particularly painful procedure over all. “The operation is not very painful, but it is a little uncomfortable being wrapped and staying propped up on pillows,” she shares. Valium can be helpful to manage this. You will likely have prescription pain medication to take for the first few days. After that, you should be able to switch to over-the-counter painkillers taken at regular intervals until you feel comfortable enough to take them as needed. “Pain is managed with pain medication like Tylenol, Celebrex, or Vicodin,” Dr. Doft says.
When it comes to areas of pain, Dr. Doft explains that tightness around the neck is the most common complaint she hears during recovery. “Many patients find that their neck feels tight initially, but the tightness will decrease over the first two weeks,” she says. Additionally, the ears may prove to be pesky. “They also find that their ears are sore during the first few days,” she notes. “I usually inject a long-acting numbing medicine during the operation to help decrease any discomfort.”
In addition to icing and sticking to your prescribed medication plan, there are some steps you can take to help reduce discomfort:
- Don’t Be Shy: Ask friends or family for help with any tasks that feel like they are too much for you in the aftermath of surgery.
- Sleep Smart: Keep yourself propped up, even while you’re sleeping, to help with swelling and bruising.
- Stay Active: While you shouldn’t over exert yourself, make sure you keep on moving within the limits set by your surgeon.
All of these factors will help with the swelling (more on that below), which, in turn, will keep you more comfortable.
Swelling is usually the main source of discomfort after a facelift, and the amount of swelling you experience will depend on how your body reacts to and heals from the procedure. Swelling often peaks three or four days post-op. You may find the swelling causes sensations of tingling, numbness, or tightness. As we mentioned, don’t resort to bed rest. Instead, relax in a seated position and take regular walks around your living space.
While some patients opt not to look at mirrors for the first week to avoid looking at the worst point of the recovery process, it is important to monitor how things are going. If you notice swelling is a lot worse on one side of your face or if you are finding it difficult to breathe, you should get in touch with your surgeon right away.
In order to thwart swelling and bruising, Dr. Doft recommends this pre-op protocol for her patients: “I always suggest that they take arnica and bromelain before and after the surgery,” she says. “I find that the combination is helpful in reducing bruising and swelling.” The duo isn’t meant to replace regular icing for the first 48 hours but rather to complement it.
When it comes to bruising, most resolve in the first seven to 10 days. The specific areas that bruise will depend on the type of facelift you have, and your general predisposition to bruising. Certain medications, vitamins, and supplements can make bruising worse, and you will likely be advised to stop taking them in the lead up to surgery. Some patients may experience bruising around their eyes, even though the area isn’t directly treated. It is generally due to the delicate area being disturbed during the procedure and will heal along the same timeline as the rest of your bruising. If you have a black eye that persists, follow up with your surgeon.
Resuming Normal Activities After a Facelift
After the initial 48 hours of downtime, you will likely be able to get up and move around more. It’s important to remain active (within reason). While surgeons may allow for light housework so long as you are feeling well enough, you should avoid heavy lifting and bending over for at least a week. At the end of the first week, you can plan to wear makeup again as desired.
At two weeks post-op, you’ll likely be comfortable enough to return to work and mix with friends and family again — particularly if you can adjust your hairstyle to cover any scarring. You may have lingering swelling for four to six weeks after the procedure, but it shouldn’t hinder your ability to go about your daily life. Most remaining activities can be resumed at one month post-op, Dr. Doft says.
Final Results After a Facelift
So, how long until you enjoy the final results of your facelift? “Most of the swelling will be gone after six weeks but you will continue to notice improvements for a year,” Dr. Doft says. Between three and six months, you should have a pretty good idea of what your outcome will be. It’s important to note that it often takes facelift patients several months to get used to seeing themselves with their new look, so be patient with yourself.
Any scarring will fade over the course of 12 months, at which point you can also decide if there are any other treatments or procedures you would like to consider to enhance the results. Generally speaking, you can expect the results from a facelift to last anywhere from a few years to more than decade, depending on the technique. Less invasive S-lifts (also known as mini-facelifts) average two to five years, while a full facelift can last 10 to 15 years.