Post Operative Notes from Dr. Lev

Face Lift • Forehead Lift • Eye Lifts

Every operation, no matter how minor, is accompanied by swelling. The amount varies from person to person and it is difficult to predict. Swelling or inflammation is a natural body reaction. It is due to the new tissue fluids brought into the surgery area to promote healing.

Swelling may become greater after the first or second day. It is generally worse in the mornings when you wake up, especially along the eyelids and the jaw line. This is not serious or an indication that something is wrong with your operation. It is normal. In most patients, 80 to 90 percent of swelling will be gone in 3-4 weeks. The rest could take 9 to 12 months and sometimes more.

To obtain a satisfactory recovery, follow these instructions carefully:

  • Stay upright as much as possible (sitting, standing or walking around.)
  • Do not bend over or lift heavy objects for ten days.
  • Avoid hitting or bumping your face and neck. It is advisable not to pick up small children, play ball or contact sports for one month.
  • Sleep with the head of the bed elevated for one week. To accomplish this, place two or three pillows under the mattress at the head of the bed.
  • Apply cold pads on the eyelids for 2 days, as much as you can.
  • Avoid sunning the face for two months.
  • Avoid using a hair dryer for two weeks.
  • Avoid "pull-over clothing" during the first two weeks. Wear clothes that fasten either in the front or the back.
  • No swimming, strenuous athletic activity or exercises that involve turning the head for one month.
  • Try to keep the face and neck stiff. Do not move the face and neck excessively. Try to turn the head, neck and shoulders as a unit for two weeks.
  • Avoid excessive use of face and neck muscles for 10 days. No chewing gum or chewing hard foods. Avoid talking too much, yawning with the mouth widely opened, grinning and smiling.

Daily Post-Operative Care

  • Twenty four hours after the bandage and drains are removed you must take a shower every day during the first week. Shampoo your hair with a shampoo. Don't be afraid to get the sutures around the eyes wet when showering.
  • Hair cannot be tinted or colored for three weeks.
  • Make-up may be worn on the face from five days after surgery. But, not over the incisions for 10 days.
  • Smoking is known to delay healing. When you smoke the blood supply to the skin is reduced. To minimize possible complications such as skin loss, lack of healing and bad scarring, smokers must refrain from using tobacco four weeks before and four weeks after surgery.

Convalescent Period

  • The entire face and neck will be swollen. This will start reducing after the second day. About 80% will be gone in 3-4 weeks. The rest will take 9 to 12 months and in a few cases more. Swelling will be asymmetric and changeable. The face will temporarily look deformed and irregular. Be patient with the healing process.
  • Bruising, black and blue, although generally localized, may be distributed throughout the face and neck. Usually it lasts 1-2 weeks. The color may be purple, green or yellow.
  • Numbness is customary around ears, cheeks and under the chin. The feeling or sensation will return slowly over several months.
  • Dimpling of cheeks and neck occurs. You could feel small "lumps" and skin irregularities. They usually disappear within 4-6 weeks.
  • Pain on the neck and around the ears, especially when touched, may persist for several weeks.
  • A feeling of tightness behind the ears and upper neck will last a few weeks. The neck may feel firm. It will eventually soften. This tightness usually peaks during the second or third week.
  • The convalescence period varies from person to person. Although most bruising disappears in a few weeks, residual swelling may last for months. Your appearance generally will be presentable in 3- 6 weeks, but healing continues for up to one year or more. Months after surgery, you may suddenly experience some swelling in certain areas. Healing is not completed as long as there is swelling and sensitivity in some areas. Thus the final appearance has not been achieved. Be patient. The healing process takes time and each patient's time frame is unique to that individual.

Tummy Tuck Patients

After Your Surgery

For the first few days, your abdomen will probably be swollen and you're likely to feel some pain and discomfort which can be controlled by medication. Some people return to work after three weeks, while others take four to six weeks. It all depends on the individual patient. Listen to your body. Everyone heals at their own pace.

Your scars may actually appear to worsen during the first three to six months as they heal, but this is normal. Expect it to take nine months to a year before your scars flatten out and lighten in color. While they'll never disappear completely, abdominal scars will not show under most clothing, even under a bathing suit.

You must stay at least three weeks in Costa Rica following a tummy tuck. There's a 50/50 chance that you will have to go home with the drain still in if you are still draining more than 30 cc's in a 24 hour period. Everybody drains differently and that is why it's difficult to tell for sure if three weeks will be long enough to allow you to go home without the drain still in place. You have a better chance the longer you can stay in Costa Rica postop.

It seems that the patients who end up having to keep the drain in longer than usual are the patients who've had previous abdominal surgeries, or patients who've lost a great deal of weight (more than 50 pounds.)

Obviously, the best choice for tummy tuck patients, if you can arrange it, is to stay in Costa Rica for three full weeks postop so Dr. Lev can continue to see you until he can safely remove the drain and send you on your way.

Complications

Thousands of abdominoplasties are performed successfully each year. Nevertheless, there are always risks associated with surgery and specific complications associated with this procedure.

Post-operative complications such as infection and blood clots are rare, but can occur. Infection can be treated with drainage and antibiotics, but will prolong your hospital stay.You can minimize the risk of blood clots by moving around as soon after the surgery as possible.

Poor healing, which results in conspicuous scars, may necessitate a second operation. Smokers MUST stop smoking at least one month prior to surgery, as smoking is very likely to increase the risk of complications and delay healing. If Dr. Lev knows you are a smoker and have not stopped smoking at least one month prior to the surgery, he will not perform the surgery.