After Facial Procedures

Facelift:

1)  Since you have just undergone a major surgical procedure, use good common sense.  Use your best judgment and do not ignore signs from your body that you are overdoing.

2)  Following surgery, there may be a large bulky dressing around your head.  You may remove the dressing after 48 hours.

3)  Your head should be elevated on at least two (2) pillows during sleep for the first fourteen (14) days in order to keep your head higher than your heart to help reduce swelling.  Do not sleep face down, but rather on your back or side.  Apply ice packs (frozen peas in a ziploc bag) 20 minutes on then 20 minutes off for the first 48 hours to minimize swelling.  After the first 48 hours, moist heat should be applied.

4)  You may be up and around the day following surgery, however, some natural fatigue may persist for two to three days due to the normal effects of the anesthesia and surgical procedure.

5)  Avoid excessive exercise, straining, lifting or bending activities for at least one to two weeks.  When you move, stand, or change positions, do so deliberately and carefully for the first seven (7) days.  In turning your head, move the head and shoulders deliberately as a single unit.

6)  You may eat a normal diet the day following the surgery.  In moderation, talking and smiling are perfectly acceptable.

7)  You may gently shampoo your hair 48 hours after surgery, but do not use conditioners or gels.  Baby shampoo is stonlgly recommended.  Avoid any strong rubbing or combing trauma to the incision in the hair and around the ear.  Do not blow dry your hair for seven (7) days and postpone any permanent waves or hair coloring for three to four weeks following surgery.

8)  You may gently cleanse the incision lines daily with hydrogen peroxide and cotton or Q-tips.  Apply Vaseline ointment twice daily to the incision lines in order to avoid excessive crusting to the incision and to help reduce redness.  Do not apply any other ointments or medications to any other areas unless prescribed.

9)  Some sutures will be removed around the fifth to seventh postoperative day.

10) Your earlobes and portions of the face that have been lifted and repositioned will be slightly numb for several weeks; sensation will then return as healing progresses.  Do not wear heavy or tight earrings for six weeks.

11) Some facial swelling, neck swelling and bruising are normally present after facelifts, but the degree of each varies widely from patient to patient.  Do not be concerned if you have more or less than others who have undergone the same operation.

  1. The entire face will be swollen for 1 to 2 weeks, but swelling will start resolving 72 hours after surgery.  Swelling will usually be symmetric over the face but can be irregular.
  2. Bruising, although generally localized, may be distributed throughout the face and will last for 1 to 2 weeks.  The color may be purple or yellow.
  3. Dimpling of the cheeks sometimes occurs but disappears within 2 to 3 weeks.
  4. Pain around the ears, especially on pressure, may persist for several weeks.A feeling of tightness behind the ears and upper neck will last for a short time. The tightness peaks during the third week.

12) It is acceptable to do some light walking 72 hours after surgery.  Jogging and light non-contact exercise should not be resumed for three (3) weeks, and strenuous sports require six (6) weeks of healing before being safely resumed.

13) Do not take any aspirin or medication containing aspirin for two (2) weeks and then only on the advice of your personal physician.  Other routinely used medications may be taken as necessary.

14) Excessive exposure to sun (including suntanning parlors) in the first three (3) weeks after surgery may result in prolonged facial swelling and injury to the skin and should be avoided.  Thereafter, you should always protect your skin with a strong sunscreen in order to decrease the inevitable aging effects of the sun on your skin.  We offer a superb sunscreen product along with a full line of maintenance skincare products.

15) Any unexplained development of pain, facial swelling or fever should be reported to us immediately.

16) It is very important to your well-being that you follow completely all instructions given to you by this office and that we check your progress regularly following surgery.

The convalescence period varies.  Although most bruising disappears in several weeks, residual swelling may last for months.  Your appearance is generally presentable in 3 to 5 weeks, but healing continues for up to one (1) year.  The most sensitive areas are normally the cheekbones and around the ears, but you may experience tightness in the neck or cheeks as well.  Tissue healing may be influenced by many factors.

Months after surgery you may suddenly experience some swelling in a certain area.  Remember that the more extensive the surgery the longer the convalescence period, but the more impressive and longer lasting the result will be after your procedures.  Healing is not complete as long as you have swelling and sensitive areas, and thus the final appearance has not been achieved.


Endoscopic Browlift:

1)  The head dressing, if used, may be removed at 48 hours.

2)  Your head should be elevated on at least two (2) pillows during sleep for the first fourteen (14) days in order to keep your head higher than your heart to help reduce swelling.  Do not sleep face down, but rather on your back or side.  Apply ice packs (frozen peas in a ziploc bag) 20 minutes on, then 20 minutes off, for the first 48 hours to minimize swelling.  After the first 48 hours, change to moist heat.

3)  Forehead swelling may prevent the upper eyelids from closing completely for several days.  Saline eyedrops such as Artificial Tears, can be used for dryness as often as needed.  Avoid ceiling fans or any direct air that could encourage dryness of the eyes.

4)  Numbness and tingling sensations in the forehead may last for several weeks.  You may also experience some tenderness in this region.

5)  As the small nerves grow back, bizarre symptoms of itching are often experienced.  These will eventually disappear.

6)  You may gently shampoo your hair 48 hours after surgery, but do not use conditioners or gels.  Baby shampoo is strongly recommended.  Avoid any strong rubbing or combing along the hair line.  Do not blow dry your hair for seven (7) days and postpone any permanent waves or hair coloring for three weeks following surgery.


Blepharoplasty (Eyelid surgery):

1)  No dressings are applied to the eyes following surgery.  It is important to continuously keep cold compresses on your eyes.  A bag of frozen peas works best.  Continue cold compresses over the eyelids for two (2) days, then switch to warm, moist heat.

2)  Apply Vaseline to incision lines to keep the wounds clean of crusting.

3)  Sleep with your head elevated for one (1) week.

4)  Apply sterile saline eye drops, such as Artificial Tears, to your eyes if they feel dry or irritated.

5)  Occasionally, a small area of swelling or reddish bumps are seen on or around incision lines; these disappear as healing progresses.

6)  Swelling, bruising, and redness of varying degrees may occur.  They last for approximately two (2) weeks.

7)  Sutures will be removed in approximately ten (10) days.

8)  Avoid bending over or lifting heavy objects for one (1) week.  No strenuous exercise for at least four (4) weeks.

9)  Do not apply any makeup to the eye for the first ten (10) days following surgery.

10) Do not wear contact lenses for ten (10) days.  Wear glasses, if necessary, being sure they do not pull on the incision line.

11) Do not pluck eyebrows for two (2) weeks following surgery.

12) Report any eye pain or change in your vision to the office.


Facial Resurfacing:

Medications:
Zovirax:  Take as directed.  Begin this two (2) days before surgery and complete all medication.
Keflex/Antibiotic: Take as directed.  Begin the day before surgery and complete all medication.
Pain Medication: Take as directed as needed for pain.  You are advised to take your pain medication for at least the first 48 hours.

Preoperative Skin Treatment:
1)  Glycolic Acid Facial Cleanser:  Use twice daily, in the morning and at night.
2)  Conditioning Gel:  Use in the morning and at night under moisturizer beginning two (2) weeks prior to surgery.
3)  Face Cream:  Use twice daily, in the morning and at night.

Postoperative  Care

Cleansing:

1)  If gel dressing is applied, it may be removed at 48 hours following your surgery by using lukewarm water while in the shower.  Allow the water to run directly over the face and the dressing will fall off.

2)  Soak the treated areas eight (8) times a day using one (1) tablespoon white vinegar in one (1) cup cool water.  Apply with a soft cloth and cleanse using a gentle circular motion.  This will serve as your cleanser.

3)  Vaseline is applied evenly in a thin layer after each cleansing.  Some patients find it helpful to bathe in the tub and continually apply a saturated cloth to the entire face.

4)  A moisturizer recommended by our office may also be used.

5)  Do not apply any creams, vitamin oils or other products to your skin without consulting with our office.

Weeks 2-3:

1)  Continue to cleanse with the mild cleanser as often as needed.

2)  Continue to apply the recommended moisturizer.

3)  We suggest that you do not expose your skin to direct sunlight.  For traveling purposes, please protect your face with sunglasses and/or a hat, as well as applying sunscreen products.  Please ask our office for instructions regarding sunblock.

Once the redness has resolved, most patients are allowed to begin using glycolic acid products to help maintain their result.

General Care for Laser Skin Resurfacing:

1)  Do not pick or rub to remove dead skin or scabs, as this may increase the risk of scarring.  Any scabs should be gently soaked off.

2)  Do not apply Neosporin or any other ointment, including Vitamin E, to the face.  This could increase the risk of infection.

3)  Do not expose the skin directly to the sun for 2-3 months.  It is very important to keep the area protected from the sun for the next several months to avoid changes in skin pigmentation and to minimize redness.  For 3-4 weeks after surgery, a sunblock containing zinc oxide should be applied.

4)  If the skin around the mouth is tight, you may use a straw for drinking.

5)  Avoid strenuous exercise for two (2) weeks to avoid irritating the skin.

6)  Avoid drafts, fans, or air conditioners, as air blowing on treated areas may cause stinging and dryness.

7)  Mild to moderate redness is expected for 1-2 months and will fade gradually over 3-4 months.

8)  Oozing of fluid from the treated sites may occur for 3-7 days.

9)  Mild to moderate swelling is normal and may last for 3-7 days.  Swelling and/or blistering may be the most severe for 3-4 days after the procedure.

10) Pulling, drawing, and itching of the skin will increase as healing occurs.

11) Frequently, the face will appear to “break out” approximately three (3) weeks after surgery with pimple-like raised areas.  This is normal and is simply caused by clogged pores.  Please notify the office for further instruction if this occurs.

The doctors at Willow Bend Cosmetic Surgery will instruct you when it is appropriate to begin wearing makeup.  This usually falls between the 7th and the 10th postoperative day.  He strongly recommends consultation with our medical aesthetician approximately ten (10) days after surgery for a make-over as well as makeup and skin care tips and direction.


Rhinoplasty (Nasal Surgery):

1)  Keep your head elevated on at least two (2) pillows to help minimize swelling.

2)  Apply ice bags (frozen peas work best) to the eyes during the day for the first 48 hours.  Do not get the cast wet or put pressure on it.

3)  Slight bloody drainage is normal.  It is okay to remove and change the small drip pad under the nose as often as needed.  Always keep your nasal dressing dry.

4)  Do not rub or blot your nose with Kleenex or a handkerchief.

5)  Do not sniff or blow your nose.  Try not to sneeze, but if you do, sneeze through your mouth for the first two (2) weeks after surgery.

6)  Take the pain medication every 4-6 hours if needed.  If you have no pain, do not take the medication.

7)  The tip of the nose sometimes feels numb after surgery, but this feeling will gradually disappear.  Occasionally, the front teeth with feel “funny”, but this will also disappear.

8)  A liquid diet is best directly after the surgery.  Begin by taking liquids slowly and progress to soups or gelatin.  You can start a regular diet the next day.  Avoid foods that require excessive lip movement, like apples or corn on the cob, for at least two (2) weeks.

9)  While the cast is on, you can have the hair washed “beauty salon fashion.”  Do not get the cast wet.

10) You may clean the edges of your nostrils with a Q-tip dipped in hydrogen peroxide to remove crusts.  Do not advance the Q-tip into the nose.

11) Do not engage in any strenuous activity (bending, heavy lifting, etc.) for at least two (2) weeks after surgery.

12) Do not do anything that could result in a blow to your nose for eight (8) weeks after surgery.

13) After the cast is removed, do not allow anything to rest on your nose for eight (8) weeks.  Glasses should be taped to the forehead if needed.  (We will show you how.)

14) Protect your nose from excess exposure to the sun for eight (8) weeks after surgery.

15) Notify us of any excess pain, rise in temperature above 100 degrees or injury to your nose.


Nasal Surgery Expectations:

The cast will be removed approximately one (1) week after surgery.  At that time, the nose will appear swollen and turned up at the tip.  Ninety-five percent of the swelling will subside rapidly over the next few days as the nose begins to approximate its eventual shape.  However, it usually takes up to one (1) year for the last five percent of the swelling to disappear.  This will not be noticed and will not detract from the appearance of the nose.  The inside of the nose will also be swollen.  This will result in nasal blockage which will progressively decrease with time.
After the cast is removed, the nose can be washed gently with a sensitive-skin cleanser and makeup can be applied.  Moisturizing creams can be used if the nose is dry.

Sunscreen and a full line of skin care products may be purchased through our office at a very reasonable cost.


Facial Implants:

1)  A head garment may be applied following your surgery.  We will give you further instructions on the use of this garment.  If applied wear the garment as much as possible until your first postoperative appointment.

2)  Please keep surgical area dry if a dressing is applied.

3)  A softer diet requiring gentle chewing is allowed.

4)  Cold compresses may be applied 20 minutes on, then 20 minutes off for the first 48 hours.  After 48 hours, change to moist heat.

5)  Further instructions will be given at your first postoperative visit.

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