Toronto, ON

Facelift: Post-Operative Care Instructions

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By Jerome Edelstein, MD

The healing time for a given procedure varies between different patients. The following represents the general recovery you might expect following your face / neck lift. Individual patients may experience variations from this course.

When you awake from your facelift surgery, you will be in the recovery room. Dr. Fialkov does not use any dressings for the most part, only polysporin ointment. Dr. Fialkov may elect to insert a soft drain under the skin. The drain will help remove any fluids that may accumulate under the skin, and is usually removed on the 1st or 2nd post-op day. Dr. Fialkov encourages all face-necklift patients, whether having undergone a necklift, mini facelift or full facelift, to stay overnight to recover. You must have a driver who will be responsible for taking you home (taxis are not acceptable).

Pain and Discomfort After Face lifts

You may feel some pain and discomfort, but this is generally well controlled by pain medications. Most patients experience a moderate degree of discomfort for up to one week. Your cheeks, scalp, and neck can be very numb (numbness can last several weeks).

Nausea and Vomiting

A few patients react to the anesthetic after surgery with nausea and vomiting. This usually lasts less than 24 hours and should be treated with lots of fluids, Gravol and rest.


Maximum swelling occurs for about 3-5 days. A few patients may even have eyes that are almost swollen completely closed. Most of the swelling will be gone in 7 days. Your lips, mouth, cheeks, and back of your neck may feel tight for the first few days.


Most bruising resolves in 10-14 days. Some light skin discolouration can last several weeks.

Treatment of Swelling

Swelling will be maximal during the first 3 to 5 days. During this period we recommend that you keep your head elevated above your shoulders as much as possible, and to sleep on several pillows (this will increase drainage of the swelling by gravity).

Sleep on your back as much as possible. Do not bend your neck forwards (bringing your chin close to your chest) when you are lying back on a pillow. This can interfere with blood flow to the skin.

Soft, conforming ice packs (or frozen peas) can be used for 20 minutes at a time to help soothe and reduce swelling. You can do this up to 4 times per day. There is no added benefit to cold compresses after day 5 or 6.

Going out in Public

It will generally be 10 to 14 days before the swelling and bruising has resolved enough that you will want to go out in public. This is when you will really start to see the rejuvenative effects of the surgery. Be patient during the first two weeks. After this time, camouflage make-up can be worn.


Rest quietly at home for the first week. This is very important, as any straining, such as fast walking, running, bending over, coughing, or lifting heavy objects, will increase blood flow to the face, which may result in increased bleeding, bruising, or a blood collection under the skin (hematoma). Remember NO ASPIRIN / ANTI-INFLAMMATORIES (eg Advil) for at least one week, and NO SMOKING for at least two weeks.

Dr. Fialkov encourages walking starting immediately post-op, but walk slowly and avoid strenuous exercises. Walking will help reduce swelling and minimizes the risk of deep clots in your leg veins. During the first 24 hours, someone should be there to assist you when you get up.

For the first 2 to 3 days, eat a soft diet and drink fluids to rest your jaw as much as possible. The skin must stick to its new position and excessive talking disrupts it from its new location.

Eat and read from a high table surface to prevent bending your chin down. Keep your chin elevated as much as possible.

Driving should be avoided for the first 3 to 5 days until the swelling begins to settle (the swelling can make your vision blurry).

You may return to normal activities after 2 weeks. Strenuous activity should be avoided for 4 weeks (eg. cardio, weight training, tennis etc).

Avoid pull-over tops for 2 weeks. Be careful when you’re outside in cold weather – you can develop frostbite if you don’t wrap up in a scarf and hat (your cheeks and earlobes will be numb so you can’t feel how cold it is).

Incision Care

You may begin to shampoo your hair and cleanse your incisions after the drains are removed, usually the second or third day after the surgery.

Hair should be shampooed every day until all sutures are removed. Don’t forget to shampoo where the incisions are in the scalp as well, but don’t rub too hard. Take great care using a hairdryer or curling iron not to burn your scalp, ear or cheeks, as these will be very numb. You can gently brush out your hair.

All the incisions should be cleansed with soap and water once or twice a day (any mild soap will do – for example, Dove or Ivory). Make sure you cleanse the incisions within the hair as well. Remove all crusts. If the crust doesn’t come off with soap, use a Q-tip soaked in 3% hydrogen peroxide to gently remove the crust. A thin layer of Polysporin ointment should be applied along the incisions in front of the ear (you don’t have to put Polysporin on the hair incisions because it becomes fairly mucky after a while).


Drains are used to remove any excess fluid or blood, preventing accumulations under the skin. Drains are usually removed within 2 to 3 days. Occasionally, they need to be left in longer.

If the drains are going to remain in longer than overnight, before you are discharged home the nurse will show you how to empty your drains, but here are a few reminders:

Remove the cap. Hold the bulb upright and measure the amount of blood and fluid in the bulb by reading the measurement levels. Record the amount (see below).

Turn the bulb upside down and squeeze out the blood and fluid into a garbage, toilet, or sink.

Turn the bulb upright again, squeeze the bulb so it crumples and expels all the air, then while holding it tightly squeezed replace the cap. Release the bulb, it should stay collapsed. (The bulb should not quickly re-expand or there is an air-leak)

Measure and empty your drains every 12 hours.You may have to do this more often if the bulb becomes full before the 12 hours are up.

Record the Drainage in following format:

DATE TIME DRAIN SITE (if more than 1 drain) AMOUNT (in cc’s)


NO make-up should be used for the first 10 days. When you resume applying make-up, avoid heavy, dark brands as the incisions and scars may collect the pigment.

You may have your hair styled and/or permed after 2 weeks, and you can wear your hair as you see fit.

Avoid hair colouring for 6 weeks to avoid pigmenting the scar.


Sutures in front of the ear will be removed after 5 to 7 days. Remaining sutures will be removed by 2 weeks.

Long-Term Results After A Facelift

As mentioned previously, most of the swelling will be gone in 1 to 2 weeks, but some improvement will occur over a further 8 to 12 week period.

Once the incisions have healed, Polysporin should not be applied anymore. You can gently massage some scar cream such as Dermatix into your incisions.

Avoid direct sunlight to the incision line as this may result in pigmentation changes. This is particularly true during the first year after the surgery. Never expose the incision to sunlight without sunblock – use SPF 30 or greater.

Scars will initially be red and a little raised, but over 3-6 months they usually get lighter in colour and flatten out.

Sensation will begin to return to your skin and ears by 8 weeks.

The improved appearance from your face and neck lift will last for many years. Over time, aging changes will reappear, but you will always look younger, more rejuvenated than if you had not had the surgery in the first place. Most of our facelift patients are very happy with the quality of their cosmetic enhancement.


The quality of your face lifting may be compromised if you fail to return for any scheduled post-op visits, or follow the pre- and post-operative instructions.

Don’t hesitate to report any unusual or concerning changes. If you are unable to contact Dr. Fialkov and you have an urgent post-operative concern, contact the Plastic Surgeon on call through the hospital paging system, or, proceed to your local emergency department.

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