Face-lift

Q: After a face-lift, will someone be able to have a natural-looking smile?
Yes, of course. In fact ultimately, the smile should not change at all. Something that can change the smile would be swelling or bruising around certain nerves of the face. Having said that, the smile can look uneven for the first or even several weeks after surgery, if not longer. The nerves that affect the smile very rarely get injured directly but are so sensitive that even a small amount of indirect swelling or inflammation around the nerves can cause a weakness after surgery

After face-lift surgery, very often people will have a little bit of an uneven smile. They may not even notice it, but the surgeon usually would be able to evaluate this. The inflammation and swelling ultimately subsides and the smile returns to baseline.This period is the time for patience and reassurance from your surgeon and a conservative approach.

Q: Is there any chance of a face-lift leaving scars or any noticeable after-effects where people would be able to tell that you’d had one?

A: One of the funny things about plastic surgery is that sometimes people think it is like Star Trek or it's magic and the scars just disappear. They say, "Well I came to a plastic surgeon so that I wouldn’t get a scar."

There are always scars. The key is to hide them in certain spots (usually anatomical landmarks) where you can really minimize their appearance.

Now having said that, sometimes it takes another plastic surgeon to know where the scars are hidden. Sometimes only another doctor is going to know where to look and the average person will not see them at all.

“Undetectable” is not a reality, but camouflage is something that you should expect from a good plastic surgeon. Something that we consider is the “stigmata” of a face-lift. The stigmata is actually more of a tell-tale sign of a face-lift than the actual incisions. Usually we discover two things in the stigmata. One is something called ‘Pixie-ear deformity’ for pixie or elf. That appearance happens when the earlobe looks as if it is being pulled downward. This usually is caused by the scar being placed in the wrong position. Over years, the earlobe will drop down resulting in this appearance.

The other sign that can be seen is when sideburns begin very high. You sometimes see this on patients that have had 2 or 3 face-lifts. The sideburn or temporal hairline can begin almost at the top of the ear. This is another tell-tale sign of a face-lift. So therefore, hair loss and ear deformity are probably the two main signs that can become obvious before seeing any scars.

After surgery, a “turban” dressing should be applied.

In most cases you may remove the dressing 48 hours after surgery by simply unwrapping the bandage.

After the dressing is removed, you will find sutures near your ears. Gently cleanse these areas to keep them free of crusts. You may now shower and gently wash your hair with a mild shampoo. You will need to shampoo regularly to remove ointment in your hair. You may comb your hair with a wide tooth comb and allow it to air dry, or you may use a blow dryer on a low, cool setting.

You will find it helpful to sleep with your head elevated on 2 pillows. This will help minimize the swelling. You can expect swelling and bruising to be maximal 48-72 hours after surgery and will resolve itself within time. Do not ice your face. If you have had eyelid surgery as well, only ice the eye area.

You should visit your doctor's office approximately 5-7 days after surgery, if you have had eyelid surgery as well, your first visit should be 3-4 days after surgery. The sutures may be removed at this visit or may remain in longer; your doctor will make this decision upon seeing you on your first visit.

You may begin to cover the bruised areas after the sutures are removed.

Care must be taken to avoid sun exposure to the treated area. You should not intentionally go in the sun for 3 weeks after surgery. You should us SPF 30. The sunscreen should contain Zinc Oxide or Titanium Dioxide as these are physical UVA and UVB sunblocks and will not irritate your skin.

Do not wear earrings until all the sutures have been removed. Do not wear dangling or heavy earrings until full sensation returns to your earlobes, which is approximately 6 weeks after surgery.

Physical activity, exercise and sexual activity should be avoided for 2 weeks following surgery.

Use your pain medication and antibiotics as directed.

Call your doctor's office and speak with a nurse if you have any questions regarding your surgery.

Medications to Avoid - Please do not take Aspirin or any NSAIDs for two weeks before and two weeks after surgery. You may take Tylenol. Inform your doctor of all medications you are taking prior to your surgery.

Do not drink an excessive amount of alcohol for 48 hours before and after surgery.

If you are a smoker, you must not smoke for 3 weeks prior to and 3 weeks after surgery.

Eating - You should not eat or drink anything after midnight on the day of your surgery. You may, however brush your teeth. If you take medications on a daily basis and have discussed continued use of these medications you may take these with a small amount of water.

Hygiene - You may take a shower and wash your hair on the morning of your surgery. Go to the office without make-up and perfume.

Escort and Sedation - Arrange for an escort to accompany you. You must have someone escort you home after your surgery. This is for personal safety as well as convenience. Usually a private duty nurse can be arranged for you if you choose.

Clothing - Please wear loose comfortable clothing the day of your surgery. Wear a button down or zippered front closure shirt the day of surgery. Avoid clothing that must be pulled over your head. Bring a scarf to cover the bandage.

Contact Lenses - cannot be worn the day of surgery.