What to expect
You will wake up from surgery with a large cotton dressing surrounding your face. This will stay in place until the following morning. All face and forehead surgery necessitates that you stay with us overnight. We will remove the bandage and send you home around 8AM the next morning. Someone must be there to take you home.Upon discharge, we will apply a chin strap with cotton underneath. We will show you how to appropriately wear this. You must wear the chin strap continuously for the first two weeks after surgery except while eating and showering/cleaning incisions. The strap helps fight the forces of gravity immediately after surgery and helps improve any swelling. After 48 hours, you can remove the strap and cotton and follow the below instructions for washing your hair and cleaning incisions. After drying off, replace the strap. You do not need to wear the cotton underneath the strap. Most patients instead prefer to wear a soft towel or scarf underneath the strap. The third and fourth week after surgery, you only need to wear the strap around the house and at night while you sleep.
Swelling will peak at 2-3 days. The swelling and bruising will evolve over the next week but will have greatly subsided by 2 weeks. Remember that all of this subsides with time and has no bearing on results. Swelling and bruising around the eyes is variable from patient to patient.
The discomfort should be managed well with the pain and anxiety medicine provided. Often the most common complaint is not pain but rather the tightness. We would like for you to sleep upright on your back and avoid turning on your side so that there is no inadvertent trauma during sleeping. Some people use a recliner; others use multiple pillows in bed. You can also place pillows on either side of your head to keep from rolling on your side.
You can shower the second day after surgery. It may take several washings before the water runs clear. You must use baby shampoo for the first week and can only apply conditioner to the ends of the hair to avoid the incisions. Clean your incision(s) once daily with peroxide for the first two days after removing the chin strap. Apply antibiotic ointment with a q tip lightly along the sutures lines every morning and before bed. Use an antibacterial soap like Dial to wash your face during the first week. Use a mild soap like Cetaphil or Neutrogena to wash the face lightly daily afterwards. No scrubbing. You can use light makeup and moisturizer after the first week. Normal makeup can resume after 2 weeks. Only touch the incisions if your hands are clean. Do not allow pets to touch the face or forehead.
The sutures will be removed on days 4-5 and again at the end of the first week. You will receive a card noting your appointment times upon discharge from the surgery center. After suture removal, tape will be applied. The tape should be worn continuously until the second week after surgery. The third and fourth week you will tape your own incisions before you sleep. We will show you how to tape the incisions appropriately. It is difficult to keep the tape adherent with beard growth. You must do your best. Be patient and follow up diligently.
Restrictions
- no excessive bending over or stooping
- the above increase pressure in the face which can cause bleeding and worsen swelling.
- no lifting greater than 15 lbs for the first two weeks. Strenuous exercise can be resumed after 5-6 weeks. Light contact sports at 6-8 weeks.
- avoid the sun completely while bruising is present. You must further protect yourself and minimize sun exposure for the next year after surgery or until scars completely heal.
- no nicotine or tobacco for two weeks afterwards.
- no medicines that can promote swelling, bleeding for two weeks afterwards.
- do not wear any glasses that may irritate the incisions behind the ear. If you must wear glasses (i.e. if blepharoplasty was also performed), wear them higher on the head so they don’t rub the incision.
- do not shave for the first week. Then it is ok to shave carefully around the incision lines.
- do not allow pets to touch the face or incisions for the first week. Only touch your face with hands that have been washed with antibacterial soap.
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