Each patient’s experience is different and it is important to have realistic expectations with regards to the outcome of your surgery and the risks associated with surgery.
Discuss any concerns with Dr Oates and his team of medical professionals.
A large turban-like bandage will be on your head to under your chin when you wake up following the facelift which will be removed a day after the procedure when the drain is removed. Hair is to be washed before the bandage is put on but you can expect some matting and hair to be stuck down when the bandage is removed.
Swelling and bruising
Some swelling and bruising is to be expected depending on the extent of the facelift, often extending down the neck. Bruising goes through a range of colours including purple, green and yellow. After a week you may be reasonably presentable, however most of our patients don’t feel ready to go back to work for two weeks as a minimum. For 6-8 weeks some swelling may be persistent but will go down.
The incision line
Keep incision lines clean is integral so wash them gently 3-4 times a day using cotton wall balls and salt water. Oozing and crusting around the incision lines are to be expected within the first 48 hours after a face lift. Until there is no crusting around incision lines, a thin layer of vaseline is good to keep the site moist.
Wearing shirts that button up from the front will be easier to wear and will avoid catching when pulling shirts over your head.
We recommend dedicating some face washers and towels to cleaning the incisions as these will likely become soiled.
Non-dissolving sutures are removed at around 7 days and if you have been keeping up with the recommended cleaning steps, dissolving stitches will drop off at roughly the same time.
Pain is not a significant feature of facelift surgery for most patients. While there is some discomfort from ‘tightness’ most noticeable under the chin, rarely is the experience described as painful.
It is sometimes reported that cheeks and ears become numb which is a regular part of face lift healing which will return to normal after some weeks. As healing progresses you may experience a feeling similar to insects crawling on the skin which is nothing to be concerned about.
Blood collection under the skin
Haematoma, a collection of blood below the skin, is a potential facelift complication as a large amount of skin may have been elevated off of the deeper facial structures. It is rare and occurs in around 1% of surgeries 1-2 days after surgery.
Mild haematoma can be aspirated in theatre with a needle. Larger haematomas may need to be removed in theatre.
Later fluid accumulation is a seroma and is a collection of tissue fluid treated simply with aspiration via a needle. Multiple aspirations may be needed for it to settle completely.
Whenever skin is cut there is the possibility of infection, however, this is unusual during a face lift and antibiotics are given pre-emptively to minimise the risk.
Smokers, diabetics and people that have had facial radiations are at an increased risk of superficial or full thickness skin loss, most frequently found in the hairless spot behind the ear. This can leave a more noticeable, pale scar so please inform Dr Oates if you are a smoker or diabetic.
A scar will always left with any skin incision but facelift surgery should have the scar hidden where they are less noticeable and finer.
Scars in front of the ears are often hidden in the natural crease of this spot. Behind the ears scars are hidden deep in the ear crease and into the hairline to hide them.
Some people do have an increased risk of abnormal scarring so if you have any history of hypertrophic or keloid scarring you should let Dr Oates know before the procedure.
People with darker skin are at greater risk of keloid scarring
Rarely, abnormal scarring occurs without a predisposition for this. Scars can be treated with an injection into the scar.
Scar maturation takes place over 6-12 months but in the first 6-12 weeks scars are pinker and may feel thick. This is regular and a gentle massage will see them settle down quickly for most. By 6 months post-surgery you should expect flat and fine lines from any scars.
Alteration of the hairline
Keeping a normal hairline is vital to the success of a more subtle facelift. With Deep Plane face lifts a lot of skin can be elevated and it is necessary to have an incision inside the hairline running to the temple region. You can expect this to fade so only you will notice when looking for it and others won’t notice.
Numb skin is a common outcome from making incisions and elevating skin. In face lift this includes the ears and the skin in front which will resolve itself over a period of weeks.
Because one side of the face is completed before the second side is started the face can appear asymmetrical shortly after surgery is carried out due to the delay in swelling in one side.
Another aspect of a face lift which can be expected is uneven swelling from one side to the other based on sleeping habits and has no impact on the resulting outcome.
Some lumpiness of the skin may be noticed after the face lift due to little pockets of increased swelling under the skin and is expected in the first 6-8 weeks. To settle this you can gently massage the skin.
Occasionally long-term asymmetry can result from pre-existing asymmmetry and the facial bone structure. When noticed in pre-operative consultations improvements and corrections can be made but asymmetry shouldn’t be expected when it did not exist previously.
Modern facial techniques address the deeper tissue layers, not just the skin, meaning a more natural and longer-lasting result is achieved from the face lift.
Deeper tissue adjustment brings surgeons closer to the facial nerves that control movement of the face. Very, very rarely this nerve can be damaged but it has been recorded. Nerves are known to spontaneously recover but it is possible for facial nerve damage to be permanent.