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is imperative that patients refrain from ingesting any medications or other substances
that could potentially be the cause of surgical complications. A list of medications
should be reviewed and discontinued at least two weeks prior to operation. Patients
are seen just prior to their surgery date for a general physical examination to
ensure that no underlying medical problems exist that may interfere with the safety
of their surgery. Specifically, any infections that arise prior to operation,
however seemingly trivial, should be reported to our office. Even an otherwise
innocent infection can result in a surgical wound infection, and must be treated
prior to surgery. If you have hypertension, this must be under very good control
with your medications prior to surgery; you should plan to take your blood pressure
medication right up to the time of your operation. Cigarette
smoking must be discontinued for one month prior to operation. Serious wound healing
complications can occur in patients who are exposed to smoke, even passively. Prophylactic
antibiotics are prescribed prior to and for a few days after surgery to reduce
the risk of surgical wound infection. A prescription for pain medication is also
written, so that you have your pain pills when you return home from the operation. Preoperative
photographs are taken so that you can see the improvement from your surgery afterwards.
We generally take postoperative photographs at 3 - 6 months after your procedure. You
will be asked to sign a surgical consent, which enumerates the risks of the procedure
in detail. These risks have been explained here, but are also discussed at the
consultation.
You will need to arrange for
an escort to drive you to and from our Surgical
center. Patients cannot operate motor vehicles
after surgery, and we will not place recently
sedated patients into taxis for transport home.
We can arrange for medical transportation in the
event that you cannot find an escort. It is mandatory
to have someone stay with you for at least 24
hours after surgery, for your comfort and safety.
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Facelifts are very individualized procedures. Patients are under a local anesthetic
with intravenous sedation. You will not feel the injections of local anesthetic,
and you will be very drowsy throughout the procedure. Continuous monitoring of
your vital signs is carried out throughout the operation. Incisions are
marked prior to taking you to the operating room. Your hair is gathered in rubber
bands to keep it out of the incision lines. Minimal amounts of hair are clipped
to provide exposure to do your surgery. The procedure usually takes about
three to four hours, depending on the extent of your particular procedure. Incisions
are made around the ear and usually just beneath the chin to tighten muscles in
the central neck area. Dr. Parker does a very thorough operation, and almost always
tightens not only the skin, but also a layer of muscle and fascia just beneath
the skin to give the best result with the greatest longevity. Fat pads are repositioned
and secured. Excess skin is removed and the skin is then stitched with very fine
suture material. Metal clips are sometimes used in scalp portions of the incision.
A small drainage tube is placed just beneath the skin and is connected to a suction
bulb to drain any small amounts of blood in the first 24 – 48 hours. A non-constricting
bulky dressing is applied for comfort and to minimize swelling and bruising. |
Following the surgery the patient’s face is wrapped in a garment to help
prevent any excess bleeding which is worn for a few days. The patient will be
kept overnight in the hospital for observation. The sutures are removed from around
the ears at three to four days.
Remember that any surgical procedure
requires a certain period of recovery. The body needs time to adjust to its new,
younger look. Therefore, depending on the patient’s skin type and underlying
health, it is possible (and normal) for the face to remain swollen and black and
blue for up to two to three weeks. This doesn’t mean one has to stay home
and hide from the public. Makeup can be worn to cover visible areas of bruising.
However, the full effect of the surgery may not be accurately seen until that
time.
You will need to have an escort to drive you
home from the operation and to stay with you for
the first 24 hours. You will also need someone
to drive you to your first visit one day following
your procedure. In the first day or so, it is
best to do as little talking, chewing, or other
movement of the face as possible in order to minimize
swelling and reduce the risk of bleeding and/or
bruising. You should maintain head elevation of
at least 30 degrees from horizontal to keep the
swelling down. There is usually only minimal discomfort
following a facelift, and this is controlled with
the pain medication that is prescribed. You will
be advised to take an antibiotic for the five
days around the day of your procedure.
The dressings will be removed on the first or second day
after your surgery, and the drainage tube will be taken out. On the fourth or
fifth day, most of the stitches will be removed. A couple of key stitches are
left in until the ninth to tenth day. Though you will be up and around
in a day or two, you should plan to rest as much as possible for the first week.
Most people take 10 –14 days off of work to recover. You should avoid vigorous
activity, including sex, for two weeks after surgery (though walking and stretching
are fine), avoid alcohol, steam baths, and saunas for four weeks after surgery.
Sun exposure should be limited for the first several months. The face will be
numb for weeks to months, and so heating pads and sun lamps are to be absolutely
avoided. You should avoid bending over for three weeks. |
