Many patients asked what they should expect in the first few days following a facelift. My answer is always that it varies from patient to patient but it is generally easier to recover from than one would think.
First of all it is important to note that recovery will depend on the specific technique and the manner in which the technique is employed. A SMAS flap facelift permits a powerful and at the same time very natural repositioning of the malar (cheek) fat pad to its anatomic position. When this is done precisely and under direct vision with careful elevation of skin flap swelling and bruising are minimized. Because the SMAS flap technique transfers the repositioning to the SMAS and away from the skin, one avoids the over-pulled look that is otherwise seen in the skin. I make this point because it seem as if many patients recently have become pre-occupied with “mini facelifts” or “short scar facelifts” in a what I believe is a an effort to minimized their recovery – but in my opinion these techniques do not have an advantage over a SMAS flap facelift when performed well and at the same time may not provide as powerful or natural results. With that said onto recovery.
I will discuss the recovery in several categories:
Pain: Patients always report that there is less pain with a facelift than they expected. Most patients only take pain medications for 1-3 days.
Swelling: With a direct vision technique that is gentle on the tissues and with proper coordination with the anesthesia, swelling does not have to be significant. A low salt, low refined carbohydrate diets before and after surgery goes a long way to reduce swelling. Recovery nurses who see patients from many different doctors frequently comment that they are surprised at the difference technique and diet can make in terms of swelling. This is true for bruising too. So swelling is present. It is generally minimal and last only about 72 to 94 hours. Patients do not have to have the “pumpkin-head” swelling that one might have seen on the internet or reality TV programs.
Bruising: When blood pressure is controlled and nausea and hacking are controlled and good technique with precise hemostasis is used, patients generally do not have a lot of bruising with a facelift. Avoiding red wine, fish oils, and other supplements and OTC/RX medications in advance also helps reduce bruising. A small drain for two days removes most extra red blood cells that might lead to bruising. Most patents have a very thin line of light bruise, if any at all, in the mid to lower neck where a small amount of RBCs collect that can’t be captured by the drain. Bruising in the cheeks and upper neck is rare.