Q: Dr. Eppley, I had a SMAS facelift two weeks ago. I have swelling and numbness alongside stitches and jawline. Although the swelling is even on both sides the swelling feels dense, thick and kind of hardish. Is this normal? Also, I have these slight dents under my cheek bones that I believe is caused by where majority of swelling begins. Is this normal? I have good things to report about my recovery, bruising is gone, symmetry is good, no pain and it looks like I am going to get the result I am after.
A: Recovery from a facelift procedure is rarely as fast as any patient would like. The skin will be numb for weeks to months where the skin flaps were raised and along the suture lines. The swelling will go away much quicker but it is perfectly normal for the face to feel firm and still a bit swollen at just two weeks after surgery. Expect all swelling to be gone by six weeks after surgery. Some of the facial features that are outside the zone of the facelift, such as the cheeks, may appear different because of the swelling around it. Your facelift recovery sounds perfectly normal and you appear to even be a bit ahead of schedule for what many patients experience.
Dr. Barry Eppley
Q: Dr. Eppley, I had a facelift just one week ago. I expected to be a little swollen and bruised but not like this. I was told before surgery that I could return to work two weeks after the surgery. I was also told that by that time I would not be completely healed but that no one will notice that I would have had surgery. Based on the way I look now, I can’t see how this will be true in just another week. I am a bit panicky now because I can’t go to work remotely looking like this. I’d have to quit my job if I went in looking like the monster that I do now. Any suggestions or advice on how to make this swelling and bruising go away faster?
A: The amount of swelling and bruising after a facelift that any patient gets will vary and is most affected by the type of facelift that one has. Unless it is a very limited type, I would never tell a patient that they will comfortably be able to go back to work in just two weeks. Three weeks after a more complete facelift is more realistic. That is now water under the bridge so to speak so what can you do now? Largely the speed of the improvement you are going to get is by your won natural healing process. But the use of Arnica tablets and topical gel for the bruising, don’t sleep completely flat (head up) and taking some bromelain (for swelling) may be of help. You may also be surprised what another week of recovery will do. I suspect you will be much better by next week and with a little makeup you will be largely ‘undetected’ for having a facelift.
Dr. Barry Eppley
Q : I am scheduled for a facelift next week. My friend had hers last week. We both go to the same plastic surgeon who is well known. I was shocked today when I saw my friend. It appeared she had been beaten up and looked horrible. Granted it has only been six days but is this normal? When I asked the plastic surgeon about the swelling, he said my friend was still swollen. He does the SMAS lift and pulls the skin as tight as he can knowing that in 3 months it will look normal. Is this routine? I really want a natural look and now am not sure what to do. Please advise. Thanks.
A: Your concern is understandable and let me provide you with this analogy. Facelift results are a lot like getting a haircut. Sometimes in the beginning it looks bad right after, you think it looks good during the middle part of its growth cycle, and then dislike it again once it is too long or outgrown. That is analogous to a facelift because it is not a static result over time.
Meaning…if you have don’t do too much (conservative facelift) then your swelling will be more mild, recovery will be quicker, and your result will look more natural from the getgo…but the result may not last as long. If an aggressive facelift is done, one will have a lot of bruising and swelling (i.e., look awful) and look overdone in the beginning…but will relax into a more natural reesult much later and the results may last a little longer.
As you can see, the facelift operation is balance of how much recovery one can sustain for perhaps a longer lasting result. While everyone wants the best result possible that lasts the longest, the reality is that the initial and short-term recovery period from doing the most aggressive/extensive facelift is not for everyone. Unfortunately, plastic surgeons generally use whatever facelift technique that they prefer on everyone.