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Getting Back to Normal


• A small amount of blood or drainage from your incisions is normal.


• Empty the drains when they are about a third full. You may need to do this several times. However, sometimes the drainage is so minimal you don’t have to empty them at all. The bulbs should stay collapsed. If the drain bulb is not collapsed, it is not maintaining suction and therefore is not working. It is easy to empty the drain by removing the plug and squeezing out the blood, and then replacing the plug.


• Use ice packs over the eyelids and face to help reduce swelling during the first 24 hours. Crushed ice in a Ziploc bag or a bag of frozen peas work well. Wrap the ice in a cotton towel so it’s not too cold on the skin. You can apply it intermittently for 20 minutes or so each time (20 minutes on, 20 minutes off). Don’t wake yourself up to do it and don’t feel you have to adhere strictly to this schedule. It’s not mandatory, but simply an extra measure that can provide comfort and reduce swelling.


• Sleep with your head elevated using two or three pillows, or in a recliner to help reduce swelling. Some patients use a foam wedge in bed to elevate their upper body. Avoid positioning the pillows behind your head in such a way as to cause your neck to be flexed forward. Elevation is most important for the first several days after surgery. Then it becomes more important that you sleep comfortably, so you can reduce the amount of elevation. You should not sleep on your side or on your tummy for at least a couple of weeks after surgery. This restriction can be difficult for people who are not used to sleeping on their back. Sleeping may be uncomfortable for about 2 weeks after surgery.


• You may bathe and shower the day after surgery, after your follow-up appointment. All of the incisions can get wet. Go ahead and shower, using soap and water. Shampoo your hair. Your hair was shampooed after surgery in the operating room, but there will still be some dried blood to remove.


• Bruising is usually most apparent on the neck and chest. Because of gravity, the bruising can sometimes cover much of the upper chest. This is normal. Use a scarf to cover as necessary. The bruising may take up to 1 month to dissipate.


• Makeup may be used to cover facial bruising. However, if laser skin resurfacing has been performed, you will need to wait until the skin is completely healed before applying makeup, usually a week to 10 days.


• Avoid any strenuous activities that may increase your blood pressure for 1 week. Such exercise would increase your facial swelling.


• To promote optimal healing, eat a well-balanced diet and take plenty of fluids. You should be getting up to urinate every 3 hours or so. This frequency confirms that you are adequately hydrated.


• Do not take aspirin for 2 weeks after surgery. You can take NSAIDs such as ibuprofen and naproxen as early as 3 days after surgery. Don’t take Arnica or anything else that is supposed to reduce bleeding or accelerate healing. They don’t work.


• Avoid smoking for 2 weeks before surgery and 2 weeks after surgery.


• The suture below the chin is usually removed 3 to 5 days after surgery. The facelift and forehead lift (if performed) sutures are removed 10 to 14 days after surgery.


• Numbness around the ears is normal.


• Take the antibiotics as prescribed—typically three doses after surgery. You don’t need to take them before surgery.


• Take the painkillers as necessary. Normally, a facelift is not a very painful procedure. Most patients report an uncomfortable tightness. Judicious use of the painkillers helps avoid side effects such as nausea, sedation, and constipation. Try to take just one painkiller at a time and don’t take them more frequently than every 4 hours.


• Apply Neosporin ointment lightly to exposed incisions or where there is any crusting. Leave the Steri-Strips on until they are removed in the office, usually 3 or 4 days after surgery. Use the ophthalmic ointment directly in your eyes at night to keep the corneas lubricated until you can fully close your eyes. Use artificial tears during the day. Tears are used during the day because they don’t blur your vision as much, but they need to be inserted more frequently than ointment. Don’t worry about dried blood along the incision lines; these crusts will come off as you wash.


• Anticipate at least 2 weeks before returning to work, and about a month before you start getting comfortable with your appearance in public. A good way to judge your time off work is to look at postoperative photographs of other patients at various times after surgery and decide what might be acceptable in your work environment.


• You can color your hair when the incisions are healed, usually 2 or 3 weeks after surgery. There’s no reason in coloring your hair at an earlier time anyway.


• After a facelift and laser resurfacing, protect the incisions and facial skin with sunblock at least until the redness has subsided. Scars heal best if they are not exposed to ultraviolet light, which may cause them to hyperpigment. Of course, sunblock also reduces future photoaging.