My Face Is Very Tight After Facelift
27 November 2021 onur
As the name implies.
This is facelift surgery.
“I knew my face would be tight but is this normal? How long will this last? Will my expression go back to normal? I trust my doctor, but I can’t control my anxiety.”
You will go through this process after your facelift.
If you don’t, then there is a problem.
Worry, fear and impatience are normal.
I go through this process with each of my patients. You experience it for the first time in your life and it will probably be the only time.
The basics first:
When human skin is stretched, it relaxes through a response called “stress relaxation”.
If we did not have such a skill, a pregnant woman’s belly cannot grow, and your body cannot expand when you gain weight.
In the most classical types of facelift, we used to stretch the skin and expect this stretched skin to make sure the soft tissues of the face recovered. Problems with these classical skin-based surgeries included the flattening of the face due to excessive tension on the skin, the deformation of the ear and hairline, and the enlargement of the scars under tension. However, perhaps the most important problem was the recurrence of tissue laxity in midface (under the eyes, under the neck, around the mouth) within months as soon as the skin was relaxed.
The feeling of tension in skin-based facelift surgeries typically disappears within 1-2 weeks. Patients are relieved and the ensuing 1 to 3 months will feel like a honeymoon. During the honeymoon, the face looks very good. The patient will be very happy, thinking, “The process was very easy and I got a superb result.” Unfortunately, this result deteriorates with the skin relaxing again. In some patients, the face may even return to the beginning.
We call it an early relapse when the signs of aging return to the preoperative level in less than a year. Different surgical techniques have varying rates of relapse. It was me who designed the scientific study that analyzed early relapses after different facelift techniques in the medical literature and defined the diagnostic criteria for early relapse for the first time in the literature. This subject constitutes one of my special academic interests. I have three different surgical techniques that I personally developed to prevent early relapse after facelift surgery: (1) Sub-SMAS reconstruction of the retaining ligaments, (2) Double level SMAS plication, and (3) Intermediate fixation in deep plane facelift.
If you have been operated by me, it means I performed a deep plane facelift using the advanced fixation techniques I mentioned above, not a classic subcutaneous facelift technique. In my surgical approach, the soft tissues of the face are fixed in blocks with permanent sutures to the underlying bone, muscular structures and connective tissue system of the face. For the first 6-8 weeks after the surgery, it is perfectly normal for you to feel as if there is a hidden mask inside your face. All connective tissues of the face heal in 6-8 weeks, just like bones, muscles and tendons. If you do not feel the tightness inside and the rigidity under the neck, around the mouth and at the sides of the nose during this period, the effect of that surgery will not last for 10-15 years. Undulations may form particularly in the lateral and upper parts of the face, and temporary folds at the temples and under the eyes may occur in patients whom we gave a vertical midface lift. These are completely normal and temporary. Advanced fixation techniques may temporarily weaken the facial nerves due to pressure. We see temporary muscle laziness in about 8% of the patients. Rarely, it takes more than 3 months for lymphatic edema under the eyes to resolve.
In addition, patients often say, “Doc, when I look at the mirror, it feels like I see someone else.”
The vast majority of patients who had deep plane facelift with advanced fixation techniques can blend into social life in 2 to 3 weeks by camouflaging with an untied hairstyle, make-up and accessories. In some patients, recovery may be delayed a little longer. As there are individual differences in the healing process, I have never seen the right and left halves of the same person’s face heal at the same rate.
In short, recovery requires a specific process.
Hearing about this process preoperatively and experiencing it postoperatively are two different things.
Even if you are well-informed, you may need the constant support of your doctor as well as a repeated explanation of certain things during the postoperative period. I don’t get bored. That’s the normal in my job.
I explain to my patients whose face has been tense for a long time that this is not a completely negative situation and that this early period of tension is highly beneficial in terms of the long-term effect of the surgery. Although some of my patients do not find these explanations convincing while they are in a postoperative “depression”, I would like you to know that until now, none of my patients have had their face permanently tense after the surgery, and I have not encountered a permanent surface deformity due to excessive skin tension in any of my patients.
On the contrary, I observed early relapses at a rate of 4.8% in the first 188 facelift surgeries I performed before I developed advanced fixation techniques. This rate was reduced to 0.44% through the ligament reconstruction technique. In other words, the problem in facelift surgery is not that the face is tense in the early postoperative period, but that it cannot maintain tension in the long run. I have presented the solutions I have produced for this major problem in many international congresses on different continents.
If you think that the tension of the face or the fixation power is set incorrectly, forget it right away, and go and brew a cup of tea or coffee for yourself instead.
Please feel free to contact me for your early concerns after facelift surgery (if I performed your surgery, of course).
Take good care…
… of yourself and your beauty.