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Introduction
The following is a list of general instructions for your care following your surgery. Please read them carefully several times as most of your questions should be answered here. Instructions for your care will also be reviewed the morning after surgery. Carefully following these instructions should help you get the best results from your surgery.

After Surgery
The night following surgery it is important for you to have someone with you—this is a must!  It is also important for you to keep your head elevated the evening after surgery as well as for the first two weeks following surgery. This can be done by either sleeping in a recliner tilted at 45 degrees, or sleeping with two pillows underneath the head. Avoid rolling onto your face. Sleeping on your back for the first two weeks after surgery helps to ensure this.

Diet

Most people can resume a normal diet the evening of surgery. If you feel queasy or nauseated, start with clear liquids or soup. Advance your diet as tolerated to a regular diet. You may experience some constipation as a result of the pain medication. Over the counter laxatives such as Milk of Magnesia or stool softener is recommended. If this is not sufficient, then dulcolax or a glycerin suppository may be necessary. This can be purchased over the counter at your pharmacy. 

Activity

It is usually a good idea to avoid strenuous activity or exercise for the first 2 weeks after surgery. Walking and light activities are recommended instead. Be sure to walk at least 300 yards daily. This can be broken up in multiple short trips.  It is OK and recommended that you walk more than the minimum of 300 yards.  This will help prevent Deep Vein Thrombosis (DVT’s/Blood Clots) and Pulmonary Embolisms (PE’s). Exercise can usually be gradually initiated beginning 3-4 weeks after surgery.  Heavy lifting (over 10 lbs. – the approximate weight of a gallon of milk) should be avoided until 3 weeks after surgery. Driving should be avoided if you are taking narcotic pain medications or if there is still significant pain from the surgery. Driving while either of these conditions are present could result in an unsafe driving situation. No head turning activities or exercises for 4 weeks. Hair coloring should be delayed for 4 weeks after surgery. No “pull-over” clothing for 2 weeks. Avoid hard chewing foods for 2 weeks.  Avoid yawning or wide mouth opening for 2 weeks.

Wound Care

You may shower the second day following surgery and should shower every day following this. Be sure to use a mild soap such as Dove Sensitive Skin. Be sure to report immediately any signs of bleeding that persist after ten minutes of direct pressure, infection, redness, fever, unusual drainage, or pain. Stitches and staples will be removed at the 1 week point except for one stitch, which will remain in the ear lobe until day 10 to 14.

What to expect

Swelling will vary both patient-to-patient, as well as, side-to-side. Swelling may actually increase the first 3 to 4 days before subsiding. Most of your swelling should resolve over the first 2 to 3 weeks. Do expect, however, to have minor fluctuations in the remaining swelling over the course of the next 2 to 3 months. Things to do to minimize this swelling include keeping your head elevated as much as possible over the first 2 to 3 weeks; avoid bending over, or heavy lifting for the first 3 weeks, and avoiding prolonged sun exposure for the first 2 to 3 months.  Bruising will vary, like swelling, from person to person, as well as, side-to-side. Most bruising and discoloration should resolve over the first 2 weeks. Make up, with Dr. Bernacki’s permission, can be applied 10 days to 2 weeks after surgery. Most of your face will be numb following surgery. This is normal and will subside over the coming weeks to months. Unusual sensations, pins and needles, and occasionally mild discomfort may occur as these nerves regenerate over time.

Pain Control

Take the narcotic pain medicine as instructed and needed. Take your pain medication with food.  This can be with as little as a few crackers.  This will help prevent nausea. Do not drive until you are no longer taking the narcotics and are free of significant pain. AVOID ASPIRIN, or anti-inflammatory medications (Motrin, Aleve, etc.) for 2-3 days after surgery, as these may increase the risk of bleeding immediately after surgery. Tylenol is safe immediately after surgery and may be alternated with (or used in place of) prescribed pain medication. Dr. Bernacki will not refill any prescriptions. When your prescription  medications are gone switch to the above recommended over the counter medications. In some cases, antibiotics may be prescribed.

Emergencies

Normal surgical pain and swelling should begin to gradually decrease 2-3 days after surgery. If you suspect infection at the surgical site, contact your provider as soon as possible to determine the appropriate treatment course. Signs of bleeding: sudden increased swelling/mass-effect at the surgical site, drainage of blood from the wound, or severe bruising around the surgical site. Sudden onset (or increase) in pain can be a sign of bleeding as well. Drainage of a small or moderate amount of blood-tinged fluid, from the incisions or drain sites, is not uncommon and is usually not indicative of active bleeding. If there appears to be active bleeding, direct pressure on the site can be helpful. If you suspect significant bleeding following surgery, contact your provider to determine appropriate treatment. 

Wound healing problems can manifest as separation of the skin edges or an open wound at the surgical site. This can be caused by a variety of factors and is usually a problem that can be managed by dressing. changes and wound care. Keep the area clean and place a gauze dressing. Contact your provider to discuss need for further evaluation and treatment recommendations. If there is a problem, please call our office 614.682.5095. Most issues are easily addressed and do not require significant intervention.

The most common emergencies that might need attention are:

  • Nausea that lasts 4 hours or more and does not respond to medication
  • Bleeding that is persistent and uncontrolled
  • Sudden enlargement and/or pain of one side with bruising
  • High fever(101.5) lasting more than a few hours and not responding to medication
  • Shortness of breath
  • Chest pain that is considerably worse on one side
  • Leg swelling

If you feel the situation is urgent, call 911 and/or proceed directly to the closest emergency room.

Please call us as well.

Follow-Up

Follow-up is typically in 7-10 days and should be scheduled by calling our office at 614.682.5095 if it has

not already been arranged.

Finally

The healing time for facelift surgery is often less than expected and the results are worth the wait. While swelling should be completely gone after 4 to 6 weeks, your healing will continue for the entire first year. I will follow you through this entire process, but be patient.