Your facelift recovery may vary depending on the individualized surgical plan developed by Dr. Paul Howard. Dr. Howard & his staff will provide you with one of our signature “facelift kits.” The contents include post-operative suture ointment (Aquaphor), peroxide, cotton swabs, cotton rounds, baby shampoo, straws, sunglasses, designer scarf, eye drops (if the patient also had an ancillary blepharoplasty), post-operative suture cleaning instructions, and staff cell phone numbers for after-hours questions.
Your safety and comfort are our number one priority. We perform procedures in our on-site state of the art surgery center which has the most modern equipment available and a superbly trained staff. Dr. Howard and his plastic fantastic staff believe facial plastic surgery is a highly individualized process. They are devoted to providing the most personalized care to help see you through the entire process.
If you are from out-of-town, Dr. Paul Howard and his plastic fantastic staff are available to assist you with your accommodations during your stay in Birmingham, Alabama. Depending on your specific facial rejuvenation procedures, Dr. Howard may require you to stay in the Birmingham area for up to a week.
Dressings – The dressing placed at the end of surgery puts some pressure on the areas operated on and helps soak-up any external drainage of normally occurring serum and blood. You are not allowed to remove this dressing the first night. It MUST stay in place until we remove the entire dressing the morning after surgery and replace it with a lighter one. You will be asked to wear this lighter dressing for the next week to keep swelling from accumulating. The purpose of this dressing is to mildly compress the skin to keep swelling from incresing. Failure to wear these dressings can result in more swelling which will prolong your recovery. Patient compliance is vital in order for us to help you heal faster.
Position - Keeping your head elevated as much as possible will help to reduce post-operative swelling. If you can, sleep on two or three pillows to keep your head about the level of your heart.
Drains - Many facelift procedures do not require drains, but if it is necessary a small drain may be placed under the skin and brought out through a small incision. These drains evacuate the fluid that accumulates after surgery and enable you to heal faster.
Drain Care - The drains will be hidden by Dr. Howard inside of your head dressing. You should not need to do anything with these drains. If they should fall out of the head dressing, gently put them back in, upward into an opening of the dressing. Be sure not to force the drain back in, or not to push the drain in directly around the ear area. If you prefer, you may use a safety pin to secure the drain to the head dressing so long as you do not puncture the drain or drain tubing. Dr. Howard will remove these drains the day after your surgery. Removing them feels a little strange, but it not painful. You may shower and shampoo your hair after your drains are removed, but only with the Baby Shampoo provided.
Bleeding - Small amounts of oozing and bleeding after surgery is normal. The 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 Dr. Howard.
Sutures - The sutures around your ears will be removed 4-6 days after surgery. If you have had an incision under your chin, those sutures will also be removed 4-6 days after surgery. Incisions around the eyes for a blepharoplasty are removed 3-4 days aft surgery. Dr. Howard requests you keep this sutures clean with the provided peroxide and cotton swabs, and apply a thick coating of the Aquaphor healing ointment to keep them moist.
Ice Packs – Cold or ice packs help to reduce swelling, bruising, and pain. Use frozen peas in the package or crushed ice and put the ice into a zip-lock bag. This should help, not hurt. If the ice feels too uncomfortable, don’t use it as often. Cotton rounds soaked in a bowl of ice water then placed around the eyes are very soothing and also help to reduce swelling. Be sure to discard used cotton rounds and replace with clean ones.
Sunscreen and Make-up – 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 of at least 35 SPF at all times. It should be applied before your make-up. You may begin applying makeup 2 days after your sutures are removed. On the long term, if fresh scars are exposed to the sun, they will tend to become darker and take longer to fade. Take extra care and precautions if the area operated on is slightly numb – you might not “feel” a sunburn developing!
Skin care – All of the skin on the face and neck may feel dry and chapped after facial surgery of any kind. We recommend that you make frequent use of a good fragrance free moisturizer. Dr. Howard prefers Eucerin Products sold at the local drug stores.
Hair Care – After a face lift, 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 a few 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 may be a little “lifeless” during that period of time. Please take effort to keep your hair out of the incisions around the ear. Hair acts as a foreign body when it interferes with the healing of the incisions. This interference causes the incisions to not be able to heal, often creating a raw area on the surface of the skin around the incision.
Shampoo – Twenty-four hours after surgery and once the drains have been removed, you may wash your hair but only with baby shampoo. 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. Also, be sure to not direct the hair dryer directly on your incisions.
Activity – Obviously this is not the time to clean out the garage. Walking (not jogging or running!) is permitted as long as your incisions are protected from the sun. Do not lean over to pick up items, instead squat down without facing your face towards the ground to keep gravity from contributing to the swelling. No heavy lifting is permitted for two weeks following your facial surgery. Lite house-keeping is permitted. If you cook over a stove be sure to protect your face from the heat.
Most patients who have had facelifts feel reasonably normal with 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 3 weeks after surgery. Strenuous activities can cause bleeding and swelling for a longer period than is necessary.
Alcohol– Alcohol dilates the blood vessels and could increase post-operative bleeding. Please don’t drink if you are taking prescription pain pills,as the combination of pain pills and alcohol can be dangerous. Dr. Howard recommends his patients refrain from alcoholic beverages, including wine, beginning two weeks prior to surgery until approximately two weeks post surgery. Alcohol consumption can cause more bruising and swelling.
Tobacco Use – Exposure to both first-hand and second-hand tobacco has been found to inhibit the body’s ability to heal following facial surgery procedures. Smoking causes constriction (narrowing) of small blood vessels in the skin which may have a direct negative effect on your surgery. In any operation that involves undermining of the skin, survival of the skin depends on blood flow through those small blood vessels. Reduction of that blood flow can cause reduced or slower healing, blistering of the skin, or in the worse cases, actual loss of tissue. Please stop smoking at least 6 weeks prior to your scheduled surgery, and make arrangements to recuperate in a smoke-free environment. Second-hand smoke has been found to delay recovery and healing of surgical incisions.
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 to 6 months to complete heal.
Tightness – Frequently, there is a tight feeling in the neck after a face lift. During surgery, not only 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 in a week or two.
Healing of Sensory Nerves – As the nerves regenerate, itching, burning, tingling, and shooting sensations will occur. Ice, moisturizers, and gentle massage are helpful during this phase of the healing process.
Firmness under the 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 issue. Dr. Howard will direct you when and how to massage after your facelift surgery.
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 as all the swelling and bruising decreases. Often times, patients discover they may favor sleeping on one side more than the other which contributes to the asymmetric swelling.
Eye Symptoms – You 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 following surgery.
If you also have eyelid surgery, you will be required to ice youe eyes around the clock for the first 72 hours. Swelling from eyelid surgery will cause your eyes to become dry during the healing process. Symptoms of dry eye are: sratchy, running eyes. If your eyes are over tearing, that means your eyes are actually DRY! Your body is over responding by over-producing tears which will irritate your eyes and cause them to swell. You will be given an over-the-counter day-time hydrating eyedrops and an over-the-counter nighttime hydrating eye ointment that goes inside of the eyes to coat them through the night as you sleep. Failure to keep your eyes hydrated will cause your swelling to linger longer and delay your healing significantly. Please take us seriously about using these eyedrops during your recovery.
If you are a stomach sleeper, take measures to keep yourself from rolling over on your face while you sleep. Gravity has a sense of humor and will pull swelling more to one side of your face if you sleep on your side. Sleeping on your side after facelift and/or eyelid surgery will put pressure on incisions causing you to swell and delay the healing process. Take measures to sleep elevated such as in a recliner or with lots of pillow, including pillows on your sides. Many patients recommend sleeping with a "u-shaped" travel pillow that wraps around the neck.