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Facelift surgery brings dramatic changes to the neck and jowl area and helps to completely reverse the effects of aging and gravity on this visible facial area. While the euphoria of the final result is what many patients understandably think about, there are some expected after surgery events that happen that can be disturbing if one is not aware. These are frequent sources of phone calls and questions and, while only temporary, are part of the process to get to the final result.

Pain after a facelift is usually quite minimal. The little pain that it creates is directly around the ears, where most of the incisions are made. The combination of the ear incisions and a pressure dressing the night after surgery makes for the ear discomfort. It gets better once the head dressing is removed the next day. When neck muscle work (platysmal tightening) is done with a facelift, there may be some soreness in the center of the neck and a slight temporary feeling of ‘difficulty’ with swallowing.

The reason there is so little pain after a facelift is that much of the skin will be numb. Undermining of the skin, which is a fundamental part of a facelift, makes the skin numb as the tiny little nerves to the skin will be cut in this process. Those skin nerves will grow back and normal feeling will return, but it will take months to do so. The feeling gradually returns  from the sides of the face and neck towards the ears.

Tightness of the face and neck is to be expected right after facelift surgery. I tell my patients that if it doesn’t feel tight right after, you won’t have a good long-term result. The tightness will be felt on the side of the face and neck and may make turning your head side to side a little difficult. Eventually that tight feeling will go away after a few weeks.

Some bruising and swelling always occurs but it does vary a great deal between different patients.  Most of the bruising will settle low in the neck due to gravity and may take a few days to see fully. Often it takes a good 10 to 14 days to go away completely. The swelling will occur mainly in the sides of the face and will make one’s face a little round or full initially. This will go down significantly in a week or so.

Many facelift patients suffer a little ‘depression’ in the first week after surgery. It can be quite a shock to see your face, the one you have known all your life, to be bruised, swollen, and look different. Such an appearance creates some initial uncertainty about whether you should have done the surgery. This will pass as one starts to improve by the second week after surgery.

Dr. Barry Eppley

Indianapolis, Indiana

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