Midfacelift

MIDFACELIFT SURGERY

Although healing time is generally less with midface suspension procedures (there is less muscle tightening involved so there is less bruising), overall the preparation and aftercare is about the same as for a traditional facelift. For specific information on midface lift procedures (how they differ from a facelift, etc.), go to FAQ Facelift where you will find answers to the most commonly asked questions. Patients undergoing midfacelift, which is performed endoscopically so that the incisions are smaller, follow the same preoperative and postoperative instructions as traditional facelift.

BEFORE MIDFACELIFT SURGERY

At your preoperative appointment our nurse will provide all the instructions for you to follow before and after surgery. On the business day prior to the operation we ask you to call to confirm your arrival time for surgery. Upon arrival for your surgery, you will talk with a nurse (who will start an IV), discuss anesthesia (local anesthesia with IV sedation keeps you asleep and comfortable) and meet with your doctor before going to the operating room. A facelift takes about three hours depending on the structure and amount of excess tissue prior to surgery. If you are having a combination of procedures your surgery will take longer. Recovery time from the anesthetic takes about an hour and you will be discharged about five to six hours from the time of admission.

AFTER MIDFACELIFT SURGERY

When you wake up from surgery you will notice a soft, bulky head wrap dressing. Attached to your head dressing are “balls” or drains. These drains collect excess drainage and help prevent infection. Following your facelift, the nurses will ask assist you to meet the discharge criteria: to drink liquids, walk with a steady gait, void, manage your discomfort, and monitor and empty the drains. For patients who have a combination of procedures such as an eye tuck, your vision may be cloudy from the ointment we place in your eyes at the time of surgery. The nurses will review all instructions you will need for care following your facelift.
You will be asked to come to our office (not the Surgery Center) the following day after surgery for a dressing change and drain removal. Although most patients describe drain removal as discomfort rather than pain, you are encouraged to take your pain medication about an hour prior to drain removal. You will be asked to return in four to five days for suture removal.

POSTOPERATIVE MIDFACELIFT INSTRUCTIONS

Wound care

Keep dressing dry and intact the evening after surgery. Notify your doctor if the dressings become loose or fall off. It is easy to monitor the drainage. Our nurse will show you how at the time of discharge.
Following dressing removal the morning after surgery, an elastic (ace) wrap will be applied. We will again instruct you on suture care. Cleaning the suture with a Q-tip dipped in hydrogen peroxide and then applying the antibiotic ointment twice a day is an essential part of the healing process. Sutures that have been kept lubricated with ointment are less painful to remove. Keep elastic wrap in place at all times other than suture care.

Medications

•     Most patients complain of discomfort more than pain. Do not drive or drink alcohol while taking pain medication. Taking pain medication with food helps minimize nausea sometimes associated with pain medications.
•     Start your antibiotic when you get home. It is not uncommon to have a low-grade fever for 24 hours following surgery.
•     Start swelling medication when you arrive home. Take with food.
•     Take Vitamin C (ascorbic acid) that helps promote healing, for two weeks following surgery.

Diet

Advance diet from liquids to soft food.

Activity

Rest for entire day after surgery. Sleep with head of the bed elevated or use two to three pillows for one week after surgery. Absolutely no bending, lifting or straining. If you have little children, bend at the knees or sit on the floor and let them climb on to your lap. No driving for one week following surgery. Two weeks off work is recommended.
After 24 hours, keep incisions dry except for cleaning and ointment. Bathing is ok as long as you don’t get your incisions/hair wet. You are encouraged to shower and wash your hair twice: the evening before and morning of suture removal (usually postop day four or five).
After suture removal steristrips, which must remain dry and in place for four days are applied. Bruising can be camouflaged at one week postoperatively with make-up. Always protect your face from the sun. At this point, a hat and sunglasses are a good idea. Following surgery, our staff will tell you when it is ok to apply sunscreen, cosmetics or facial creams. Avoid unprotected prolonged sun exposure for three months following rhytidectomy to prevent pigmentation of incision lines.

Appointments

Your head dressing and drains will be removed the morning after surgery. Sutures will be removed four to five days following your surgery. You will need transportation to and from these appointments. Your next appointment will be for removal of remaining clips and sutures on or around postoperative day seven.

Please Remember!

Swelling, bruising and disrupted sleep are very normal postoperative symptoms and will decrease as the healing process occurs. Assistance with daily activities the first two to three days after surgery is strongly recommended.

Final Result

Following rhytidectomy, it takes time for the swelling to subside and for the skin to heal. Most patients return to work two weeks following surgery, however three weeks is ideal, depending on the degree of privacy one is trying to maintain. At three weeks postoperatively, swelling and bruising may be apparent to you but not to many of your coworkers and closest friends.
Final results following facelift are not apparent for one full year following surgery. After three months, the changes are ever so subtle, although still important. Being perfectionists about our work, you may tell us you are pleased long before the one year anniversary. However, we request that you follow-up with us at that time for postoperative photographs and so that we can enjoy your final result.