Facelift, or rhytidectomy, is a surgery that treats the physical signs of aging in the face and neck. If you are considering facelift surgery, it is important to speak to your surgeon about what to expect in terms of pain and recovery.
Overall, many studies have demonstrated that facelift in general is not painful and well-tolerated.
The severity and duration of pain after facelift can vary for every individual as they are dependent on a host of personal factors, such as baseline health history, medication use, reaction to anesthesia, pain tolerance, and the extent of the surgery performed.
Facelift recovery: The first few days after surgery
As with most surgeries, pain after facelift tends to be more severe in the first couple days after surgery.
For the first day or two, you should expect some tightness, pressure, and occasional pain around your neck and face.
These symptoms are common, but your surgeon should give you detailed instructions on what to expect and how to manage this discomfort.
Pain medications to take after facelift surgery
Typically, a recovery pain regimen consists of taking over-the-counter pain medications, such as acetaminophen (brand name, Tylenol), on an “around the clock” basis to stay on top of the discomfort. Acetaminophen is a safe and easily accessible medication and is highly effective for post-surgical pain. Another category of pain medication, non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (brand name, Advil or Motrin) and naproxen (brand name, Naprosyn or Aleve), is also effective for combating post-surgical pain.
However, because NSAIDs slightly increase the risk of bleeding in patients who recently undergo surgery, some surgeons do not advocate taking NSAIDs right away. Speak with your surgeon first on whether or not you should take NSAIDs for pain and when you can do so safely.
As with any medication you consume, it is important to follow the instructions printed on the bottle or from your pharmacist. Pay close attention to how frequently you should take these medications, whether they can be taken together, and what the maximum dose per day should be.
The final category of pain medications is narcotic or opioid medications, such as oxycodone, tramadol (brand name, Ultram), or hydrocodone-acetaminophen (brand name, Norco). There are a variety of opioid-containing medications on the market, and some of them even contain acetaminophen; be sure to take note of the maximum daily dose to avoid side effects. Narcotic medications require prescription by your doctor and are usually an adjunct to over-the-counter medications.
This means that you should only take them if you do not experience adequate relief of pain after taking over-the-counter drugs. The strength of the narcotic medication is determined by the dose and the chemical property of each opioid medication. In addition, each opioid medication can carry different side effects, such as bloating, constipation, nausea, vomiting, drowsiness, and the risk of addiction. Because facelift is in general not a very painful procedure, studies showed that most patients required little to no narcotic medications at all. Nonetheless, narcotic medications are helpful for post-surgical pain and are commonly prescribed by surgeons.
In addition to pain, during the day or surgery and sometimes the day after surgery, you will feel fatigued, nauseous, or in general “out of it.” Keep in mind that the effects of anesthesia may linger in your body for hours after surgery. Besides good pain control, it is important to rest and take it easy during this time. Support from family members and friends is crucial, as they can help you cope with recovery at home or manage your medications to stay on top of pain.
After approximately 2 to 4 days after surgery, most people will no longer require prescription medications. After about a week, most people find the discomfort manageable enough without having to take any pain medications. During this time, you may still have a lot of swelling and bruising in certain parts of your face and neck which can cause tightness, tingling, or generalized discomfort. Cold compresses or ice packs can be useful for areas of swelling or tightness, while heat packs can help reduce bruising or mitigate the discomfort caused by swelling.
Keep in mind that the treatment of pain after a facelift surgery is a unique and personal experience. Every individual goes through this journey differently. For example, while narcotic pain medications work well for some people, they can cause bloating, nausea, constipation, or other abdominal symptoms in others which often outweigh the discomfort from surgery itself. Therefore, it is important to listen to your body, stay informed of different pain medication options, and find the right pain regimen for you.
About the Author: Dr. Edwin Williams
Dr. Edwin Williams is a double board-certified facial plastic surgeon who founded The Williams Center in 1993. He has performed over 10,000 facial plastic surgery procedures and has pioneered the deep plane facelift. He served on the Board of Directors for the American Academy of Facial Plastic Surgery for over a decade, and served as President from 2015-2016. In 2016, 2017, 2018 and 2019, Dr. Williams earned the Castle Connelly Top Doctors award in New York Facial Plastic Surgery.
Dr. Edwin F. Williams III attended Cornell University in Ithaca, New York where he received a Bachelor of Science degree in 1982. He began medical school at the State University of Buffalo School of Medicine and received his Doctor of Medicine in 1986.
Dr. Williams is actively involved in teaching facial plastic and reconstruction surgery to the residents of the Albany Medical Center and is former Chief of the Section of Facial and Plastic Reconstruction Surgery at Albany Medical Center where he received an academic appointment of Clinical Professor, Department of Surgery.