After Your Procedure

We are committed to helping you look and feel great as quickly as possible after a procedure. Here’s what to expect, depending on your treatment.

Post Operative Visits

If you had general anesthesia, your first post-operative visit is typically the day after surgery, with your next visit at one week from surgery. For procedures done under local anesthesia and/or oral Valium, your first post-operative visit will be one week after surgery.

You will been seen one week post-procedure for suture removal, and additional visits will be scheduled as necessary for up to 18 months.

Recovery

You should plan for one to two weeks of private time to recover. We recommend not scheduling any social or professional engagements. This doesn’t mean you will be housebound; though if you choose to be, that is fine!

Most people return to work in about a week after eyelid surgery. After rhinoplasty or CO2 laser skin resurfacing, plan on returning in about 10 days. If you have a facelift, please give yourself two weeks before returning to work. It is always best to plan for more time away and return earlier if your recovery is going better than expected.

Exercise

It is important to stay active during your recovery but not to over do it. As a general guideline, you are encouraged to walk immediately, but do not work up a sweat for at least two weeks following your procedure. Avoid lifting anything more than 10 pounds. Starting post-operative day 15, you may increase lifting to 20 pounds and add non-impact aerobic exercise, such as Stairmaster, stationary bike or elliptical. Starting day 21 you may jog and swim. If you had a facelift, it is important that you avoid lifting or sharply turning your head and neck for six weeks. Once you return for your six week postoperative visit, assuming all is healing well, you will be cleared for unrestricted activity. Regardless of these guidelines, listen to your body. If it hurts stop!

Makeup application

In most cases, makeup may be applied to incisions 48 hours after suture removal. For skin that has been treated with a CO2 laser, most patients are ready for make-up 10 days after the procedure. We offer aloe-based, hypoallergenic makeup that we custom match to your natural skin coloring. Our aestheticians are trained in the art of camouflage makeup and are here to assist you during your recovery.

Sun avoidance

Sun avoidance is essential to prevent additional skin injury and to reduce the risk of scar darkening (hyperpigmentation). In the case of skin that has been treated with a CO2 laser, you MUST diligently avoid the sun, and starting two weeks after your procedure, protect your skin with a broad-spectrum, hypoallergenic, SPF 30 or greater sun block, such as Elite Sunblock by Marietta Derm Essentials, until your skin is no longer pink.

Emotional expectations

During the first two to four weeks following surgery, a generalized sense of melancholy is quite common. Since you were feeling well before surgery and now you are uncomfortable, have incisions that need to heal, are swollen and are generally not yet looking or feeling your best, many patients question their decision to have had aesthetic surgery. Let me reassure you that this is quite normal and as you begin to feel better physically, your emotional state will also improve.

Don’t expect family and friends to comment on your aesthetic improvements. As a rule, people are busy with their own lives and aren’t necessarily tuned in to the details of your appearance or to the fact that you may need reassurance that you made the right decision to have aesthetic facial surgery. Remember that you did the surgery for your own personal reasons, and it is you alone who must appreciate the aesthetic improvements and feel satisfied with the results.

Non-Surgical Procedures

If you were treated with either Botox® or injectable fillers, we will provide you with written post-treatment instructions at the time of your visit. If you received Botox®, you may notice small bumps under the skin at the injection sites, which are caused by the fluid injected. These usually dissipate within an hour. Botox starts to work two to three days after injection and becomes more effective up to about 10 days after injection.

Dr. Yellin encourages you to return for a post-Botox® injection check-up at about two weeks after injection. If a touch-up is necessary, there is never a charge. We want you to be satisfied and get the full, intended Botox effect. Muscle relaxation and the aesthetic benefits from Botox® usually last about three to five months. To maintain the benefit, retreatment is necessary.

If you received injectable fillers, you should expect some bruising and swelling. The amount of bruising and swelling is not easy to predict, nor is it possible to give you an exact timeframe for its resolution. In general, the more fair skinned (redheads are the most sensitive), the more bruising you will experience. Older individuals with thinner skin are also more susceptible. Bruising is also injection-site, product and technique (needle vs. cannula) dependent. However, in most cases you will look presentable with make-up immediately, and the final, ideal result will be appreciated one to two weeks following injection.

Dr. Yellin encourages you to return for a post-injection check-up about 3 weeks after injection to assess balance and volume. If you have product remaining from the injection session, and you need additional volume there is never a charge. If, however, no product remains and you need additional volume, you will need to purchase the appropriate product. Many of the injectable products will last between 18 and 30 months. Therefore, it is critical to make sure that you are aesthetically optimized.

Surgical Procedures

If you had a surgical procedure, discomfort during the initial healing phase of recovery is normal and expected. However, significant pain after aesthetic facial surgery is unusual.

Pain and discomfort

Most patients rate their pain level as a two or three out of 10. Discomfort usually dissipates by post-operative day three or four, but may persist up to a week following the procedure.

Many patients report that they had almost no pain at all and never needed to take a pain relieving medication. However, recovery is a personal experience and there are no awards given for those who tough it out. Pain increases your blood pressure, which can increase your risk of bleeding. So if you need pain relief, take the recommended medication. For mild discomfort, acetaminophen (Tylenol) is recommended. For more significant discomfort, the prescribed pain medication should provide relief. Realize that any prescribed pain medication contains a narcotic plus acetaminophen. The narcotic can cause nausea, so it is important to eat something when taking this medication to reduce this effect and in some cases you may find it necessary to take the anti-nausea medication you have also been prescribed. Additionally, narcotics can cause constipation so if you are using this medication, we recommend using a stool softener such as Dulcolax® or Colace® and drinking plenty of water. Since the prescribed pain medication also contains acetaminophen, you cannot double up this medicine with Tylenol; it is not safe for your liver.

Numbness

Numbness affecting the operative area(s) is a common consequence following facial aesthetic surgery. As a normal part of your procedure, superficial sensory nerves are injured. It takes several months for the nerves to repair themselves and for normal feeling to return.

Swelling and bruising

Swelling and bruising are also a natural consequence of any facial aesthetic surgical procedure. If you are fortunate to have minimum bruising and swelling early in your recovery, do not be surprised if several days later, you appear more bruised and swollen. These changes typically start improving three to five days after surgery, with the majority of bruising being resolved in about two weeks. However, swelling goes away more gradually and may last 6 to 12 weeks. We recommend Arnica Montana and Bromelain (available at health food stores) to reduce both bruising and swelling.

Itching

Itching is a normal part of healing. If it bothers you, you may take an over-the-counter antihistamine. We recommend Zytrec® (Cetirizine) 10 mg in the morning and Benedryl® (diphenhydramine) 25-50 mg at night.

Healing timeline

As with any soft tissue surgical procedure, a wound gains about 10% strength per week of recovery. Therefore, it takes about 10 weeks for the skin to have full strength. Final scar healing is usually completed by 12 months. During healing, your scars will soften, flatten and lighten, and skin redness associated with normal healing will resolve. Patients generally start to appreciate their aesthetic improvements soon after surgery, but it may take six months before you feel your best. However, it is important to keep in mind that final aesthetic contours from facial rejuvenation surgery are appreciated at 12 months from surgery and for rhinoplasty, the final result may take up to 18 months to reveal itself.

Surgery site / incision care

Twenty four hours after surgery, start washing the operative site(s) twice a day (with the exception of rhinoplasty) with a mild soap such as Cetaphil® or Basis®. You may shower and wash your hair with baby shampoo. You should keep all of your incisions clean and free of dried blood with soap and water and then apply a layer of Aquaphor® to keep the incisions protected. Use peroxide on your incisions only if there is active bleeding or to help remove dried blood. Regular use of peroxide is not advised as it has been shown to inhibit healing.

Cold compresses such as crushed ice in a plastic bag or frozen peas should be applied to the operative site(s) 20 minutes on then 20 minutes off so as not to create thermal injury to the skin. At a minimum this should be continued for the first 48-72 hours after surgery while awake. Cold compresses will reduce bruising and swelling which will help you look your best more quickly and provide pain relief.

Sleep and nutrition

To further reduce swelling, plan on sleeping with your head elevated for the first week after surgery. If this is too uncomfortable, get comfortable and sleep. Sleep is very important while you are healing.

Eat nutritiously. Your body needs calories to heal. Avoid excessively hot liquids, milk (cultured milk products are fine), very spicy or salty foods and any food that requires a widely open mouth, a strong bite force or excessive chewing.

Blepharoplasty

If you are recovering from a blepharoplasty (cosmetic eyelid surgery) there are no bandages. All sutures are absorbable. If fat was removed from the lower lid, this will have been done from the inside of the lid. Expect your eyelids to be swollen for approximately four to six weeks.. Your vision can be temporarily blurry due to swelling of a thin cell layer covering your eye itself. Visual clarity usually returns to normal within about two weeks following surgery. The scars generally heal very well and are difficult to find at one year following the procedure. The benefits of lower lid surgery generally last 15-20 years and the benefits of upper eyelid surgery procedure generally last 25+ years.

CO2 Laser Resurfacing

Following CO2 laser skin resurfacing, your skin will peel for about seven days. During this time, it is imperative to soak your skin with a diluted vinegar solution saturated on a gauze pad for five to 10 minutes every two hours (while awake) and then apply the petrolatum based medicine we provided you. After the first week, your skin is typically pink/red and smooth.

Most patients are ready for camouflage make-up on post-operative day 10, and you can plan on returning to work at that time. The redness associated with CO2 laser skin resurfacing typically resolves fully by three to six months following the procedure, with an average time to heal of about four months. Aesthetic benefits from this procedure generally last about 10 years.

Facelift

Following a facelift (lower face and neck lift), you will have a cotton fluffy dressing around your face. This will be removed the next morning and replaced with an elastic support that you will wear continuously for the first week after surgery. During this initial week of healing, you should remove the elastic support only for meals and your daily shower. At these times it is recommended to clean your incisions around your ears, along the hairline behind your ears and under your chin and re-apply Aquaphor® ointment. When re-applying the elastic support, protect your ears and under your chin with either a gauze pad or feminine napkin (it has adhesive on one side which you will stick to the elastic support and makes putting it on much easier). The elastic support should be snug but not strangulating and it should feel smooth under your chin with no rippling of the elastic fabric. Sutures are removed 7 days after surgery. The benefits from a facelift often last up to 20 years.

Rhinoplasty

If you had a rhinoplasty, you will have a plastic splint on your nose that must be kept dry or else it is at risk of coming off. In the event it does come off, you can hold it in place with paper surgical tape that can be purchased at the drug store. Typically, your nasal splint will be removed in the office at your one-week post-operative visit. While you need to keep the outside of your nose dry, you must keep the inside moist. Use peroxide to remove any dried blood from the incisions. All external sutures are absorbable and do not need removal. To maintain a moist environment, use saline spray and Aquaphor® ointment inside your nose regularly for at least six weeks following surgery. Rhinoplasty provides a lifelong aesthetic benefit. However, the nose changes as we age, much like other facial features.

Browlift

Following an endoscopic browlift (five small incisions are made, the brow is elevated, but no skin is removed), you will have surgical staples in your hair. These will be removed 7-10 days following surgery. This is the only area on the face that Dr. Yellin uses surgical staples as they have been shown to have a lower complication rate than sutures in this area. The new position of your brow will have been secured with two absorbable triangular plates under the skin. Initially, you will feel and may see the outline of these absorbable plates. However, after several months these plates will dissolve and you will be left with no foreign material in your face. If you have a skin removal browlift such as a pretrichial operation (the incision follows your frontal hairline, the brow is lifted and skin is removed), only sutures will be used to close your incision and no absorbable plates are necessary. Sutures are removed 7-10 days after surgery. Aesthetic brow surgery benefits typically last approximately 10 years.

Facial Implants

Dr. Yellin uses only FDA approved facial implants. Initial soreness at the operative site is common since the implant will have been placed underneath the bone lining (periosteum). However, within a few weeks, the implant will feel natural and with time you may even forget that it is there. The implants are made of solid materials and include silicone, ePTFE and Medpor® and will last a lifetime.

It is important that you follow all of our post–operative instructions and that you do not take medical advice from family or friends without clearing it with us first. Finally, know that if you have any questions or concerns we are a phone call away, 770-425-7575.