After Your Procedure
Post Operative Visits
If you had general anesthesia, your first post-operative visit is the day after surgery, with your next visit 7-12 days post surgery. For procedures done in the office with local anesthesia with or without Xanax, your first post-operative visit will be 7-12 days post surgery.
Additional visits will be scheduled as necessary for up to 18 months. All pre and post operative visits for aesthetic procedures are included in your initial surgical fee.
We are committed to helping you look and feel great as quickly as possible after your procedure(s). A general overview of your post-operative experience can be found below. During your pre-operative visit, we will review your post-operative care and what to expect in detail, with the information customized to the procedure(s) you will have.
After Procedure Care
Additional Procedure Information
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.
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!
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 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.
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.
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 & 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.
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.
Pain & 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 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 & 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 homeopathic Arnica Montana and Bromelain (available at health food stores) to reduce both bruising and swelling.
Itching is a normal part of healing. If it bothers you, you may take an over-the-counter antihistamine. We recommend non-sedating Zytrec® (Cetirizine) 10 mg in the morning and Benedryl® (diphenhydramine) 25-50 mg at night. With procedures such as laser skin resurfacing you may be prescribed an antihistamine such as Atarax (hydroxyzine).
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. Skin lines continue to relax up to 30 days post injection.
Dr. Yellin encourages you to return for a post-Botox® or post-Dysport® injection check-up at two to three weeks after injection. This is particularly true if you are a first time patient in the practice. About 5% of patients may require additional Botox® or Disport® to get their optimum result. If a touch-up is necessary, there is never a charge and for future treatments, you will get a custom treatment combining your initial treatment dose plus any touch-up injections that were performed. . We want you to be satisfied and get the full, intended aesthetic improvement. Muscle relaxation and the aesthetic benefits from Botox® or Dysport® usually last about three to five months. To maintain the benefit, retreatment is necessary.
If you had the Injecta-Lift procedure or had targeted 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; with the final, ideal result appreciated six to eight weeks following injection.
Dr. Yellin encourages you to return for a post-injection check-up six to eight weeks following filler injections to assess balance and volume. If you have a partial syringe of filler remaining from the injection session, we will label and save it. It can be used anytime if it is not expired, at no additional fee. If, however, no product remains and you need additional volume, you will need to purchase the appropriate product. Many of the injectable filler results will last 18 to 30 months routinely, and in some cases for many more years, before a touch-up is required. Therefore, it is critical to make sure that your filler results are aesthetically optimized since the results will last for a long time.
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.
If you are recovering from a blepharoplasty (cosmetic eyelid surgery) there are no bandages. For upper eyelid surgery or lower eyelid skin removal, sutures are removed at 10 days from surgery. If fat is removed from the lower lid, this will have been done from the inside of the eyelid and no sutures are used. 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 the 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 20+ years and the benefits of upper eyelid surgery generally last 25+ years.
CO2 Laser Resurfacing
Following CO2 laser skin resurfacing, your skin will peel for about seven to ten days. During this time, it is imperative to soak your skin with the Dakins solution provided, which you will dilute according to our instructions, using saturated gauze pads placed on the skin for five to ten minutes every three hours while awake. This is followed by a generous layer of the provided Vaniply cream (apply it like you are icing a cake), which is actually a non-petrolatum based protective ointment. After the initial seven to ten days, your skin is typically pink/red, smooth, and intact.
Most patients are ready for camouflage make-up after their 10 day post-operative visit and can plan on returning to work. The redness associated with CO2 laser skin resurfacing typically resolves fully by four months if you have naturally black or brown hair and brown eyes, in about six months for those with naturally blonde hair and blue eyes and nine-twelve months for those who are naturally red-headed with blue or green eyes. Until your skin is no longer pink/red, you must be diligently sun protective and sun avoidant to prevent the formation of unwanted hyperpigmentation of the skin. It takes about 18 months for full collagen development which provides the long term benefits of CO2 laser skin resurfacing, with results that can last for 15+ years.
Following a face lift (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 10 days after surgery. During this time, you should remove the elastic support only for meals and your daily shower.
During the initial healing phase, after the first 24 hours from surgery, you should shower and clean the incisions around your ears, along the hairline behind your ears and under your chin with cetaphil or another gentle cleanser. Peroxide should only be used if their is a small amount of bleeding or dried blood that needs to be removed. Regular use of peroxide inhibits healing and should be avoided. after your shower and 2-3 times more per day, re-apply Aquaphor® ointment to all incisions. When re-applying the elastic support, protect your ears and under your chin with either a gauze pad or feminine napkin, which can stick to the elastic support making it easier to put on. The elastic support should be snug but not strangulating and it should feel smooth without rippling of the elastic fabric under your chin. Sutures are removed 10-12 days after surgery. The benefits from a facelift often last up to 20 years.
Following your rhinoplasty, you will be seen in the office the day after surgery. The inside of your nose will be cleaned and we will review how to care for your nose. 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 7-10 day 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. The only exception to this is if you have a nostril narrowing procedure, in which case sutures will removed at day 7-10. 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.
Following an endoscopic brow lift (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 location that Dr. Yellin uses surgical staples as they have been shown to have a lower complication rate than sutures in hair bearing skin. 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 brow lift such as a mid-forehead brow lift, lateral brow lift, or a pre-trichial 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.
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.
Follow Your Instructions
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.