You may visit your surgeon as many times as you wish to have all of your questions answered. At your final preoperative visit, your final questions will be answered and you will confirm that you have understood the procedure to be performed, that this material has been explained to you, that you have read and understood these information sheets, and that you accept the risks by signing the informed consent forms. You will be given prescriptions for pain pills and antibiotics along with instructions for their use. Certain laboratory tests will also be required within two weeks of surgery. If you are over the age of 50, you will have to obtain a cardiogram at your doctor’s office or any licensed laboratory. You may have blood drawn by our office nurse during your final preoperative visit, or, if you prefer, at your family doctor’s office or any laboratory (e.g. Kaiser Hospital, etc.). All patients will be asked to stop smoking at least a month prior to surgery in an effort to maximize your body’s ability to heal the incisions following the operation.

Patients should shampoo their hair the morning of or the night prior to surgery. Absolutely nothing may be taken by mouth after midnight prior to the day of surgery (except medications prescribed by your family doctor, but please mention these to the anesthesiologist in advance.)

Ordinarily, your anesthesiologist will call you the night before surgery to discuss the anesthetic care plan with you. But if you miss the call or your anesthesiologist does not call you, do not worry as you will be able to discuss your anesthesia and have all your questions answered in the morning, at the Laguna Hills Surgery Center, prior to your procedure. It is absolutely imperative that you make arrangements in advance to have someone drive you to the surgery center on the day of your operation. Patients spend the first night with a nurse, either at the Ayers Hotel adjacent to the surgical facility or at their home (depending on demands placed by children, pets, etc).

Please wear loose fitting clothing, which will be easy to get off and on after the operation. Someone must drive you to the surgical facility on the day of your operation, and back for your first post-operative visit. Wear no makeup to the surgical facility on the day of surgery, and do not apply facial moisturizers.

All patients anticipating an elective surgical procedure are to stop taking any medication containing anti-inflammatory agents (Aspirin®, Advil®, Motrin®, etc.) as these interfere with the body’s clotting mechanism and can result in dangerous blood loss and excessive bruising.

A facelift is an elective, cosmetic surgical operation in which the loose muscles of the face and neck are tightened and the skin redraped and the excess trimmed. If excess neck fat is present, it will be suctioned as part of this procedure.

Occasionally, the patient and surgeon may decide that in order to obtain the desired optimal result, additional ancillary procedures such as a midface lift, tear trough microfat grafting, eyelid surgery, a brow lift, skin resurfacing, or a chin implant may be required. These additional procedures will be discussed separately as they are not an actual part of the face or neck lift operation. If desired, your surgeon will go over these additional procedures with you.

A straight forward face or neck lift operation requires approximately two and a half hours. Of course, if additional procedures are requested or if you have an exceedingly full neck, a longer time will be required. The surgery will usually be performed under a light general anesthesia or deep sedation. An anesthesiologist will be present to administer the medications and assist in monitoring all patients to ensure their safety.

At the completion of the operation, drainage tubes are placed beneath the neck skin to minimize swelling and bruising. These tubes are connected to a bulb; it will be necessary for the nurse to empty the drainage fluid a few times during the first night. In the morning, she will drive you to the office for your first post operative visit. The drains will be removed in the office and a light wrap applied. Your family or other designated adult will pick you up from the office after this visit and home care instructions will be given.

After surgery the patient can expect swelling of the face and eyelids and severe discoloration. Occasionally, the whites of the eyes will become temporarily bloodshot-this could last for many weeks, but always resolves spontaneously. If the eyes swell shut, or if the eyelashes stick together, your caretaker may clean the lashes with Q-tips and hydrogen peroxide.

The discoloration will be most noticeable on the second and third days, and diminishes anywhere from one to six weeks after surgery. This, again, depends upon the type of skin, age, and healing ability of the patient. Most patients, with perhaps light makeup, can resume everyday tasks approximately two to three weeks after surgery.

You will return to the office daily for the first few days for Oxymist® treatments, which expedite healing, and skin care as required. All suture lines should be cleaned gently with Q-tips and hydrogen peroxide a few times each day. Vaseline ointment should then be applied to the suture lines to inhibit further crust formation. You may shower by the second or third day. You may begin walking as soon as you feel able, but all lifting, straining and other vigorous activity is to be avoided until all bruises have faded. The best rule of thumb is to avoid any activity that causes you discomfort and to enjoy those that do not. Most patients are pleasantly surprised to discover the relatively mild degree of post-operative discomfort. The patient is requested to call the office if the discomfort is not readily quelled by the pain pills, or if significant bleeding appears around the incisions. Some drainage, particularly behind the ears, is normal for a few weeks. Sutures will be removed four to ten days post-operatively.

Fees will be discussed freely in advance by the office staff. You will receive assistance with financing if desired. Naturally, additional fees will be required if the patient desires ancillary procedures such as forehead, eyelid, chin or nasal surgery at the same time. In compliance with suggestions adopted by the American Society of Plastic Surgeons, it is customary for the patient to pay all fees for cosmetic surgery prior to the desired operation. This insures that the patient is sincere in her motivation and can afford the surgery, thus creating a better patient/physician relationship. A non-refundable deposit will be required to secure your desired surgery date. The remainder of the fees must be paid prior to the surgery, usually at the time of the preoperative visit, but no later than one week before surgery. Additional fees are also required for laboratory tests, surgical facility fees, the anesthesiologist, and if necessary, mammography. If additional surgical procedures become necessary, additional facility, laboratory, anesthesia, implant costs and professional fees will be incurred. The surgical facility and anesthesiologist fees quoted will be based on our best faith estimate; the final fee may vary as these fees are based on surgical time, and it is not always possible to predict exactly how long a procedure will take to complete.

It is important that you understand that the patient is responsible for all costs associated with all secondary surgical procedures or for the treatment of any complications that may arise as a result of this elective surgery.

Every activity in life, whether driving automobiles or having surgery, is associated with risk. The following inherent risks must be understood and assumed by the patient if we are to proceed with this surgery. Although complications and bad results are uncommon from this type of operation, they do sometimes occur. Your doctor cannot guarantee a favorable result from any operation you are considering, but every effort will be made to provide you with the best result possible.

Some of the possible complications from this operation include: blistering or sloughing of the skin with the possibility of permanently noticeable scarring, infection, bleeding, unequal discoloration and swelling of the face, abnormal contour, nerve damage causing temporary or permanent loss of feeling in the face and weakness of portions or all of the face, personality changes and mental difficulties following the operation which may occur even when the operation has been a success, and allergic or other adverse reactions to one or more of the medications used during or after the operation.

Some of the complications associated with this operation can cause the need for further or touch-up surgery, which will result in additional fees to the patient. Some of the complications can cause prolonged healing, unsightly and painful scars, deformity and inconvenience. Some unsightly scars or asymmetry caused by nerve damage cannot be improved by further surgery.

Complications, particularly blistering and skin loss around the ears, without question are seen much more frequently in smokers, and you are urged not to smoke for at least a month prior and after your surgery to minimize the likelihood of such complications. (And if you can stop for that long, why not do your body a favor and quit this nasty habit permanently!)

There are also other, very rare, potential complications from this operation in addition to the ones that have been mentioned, but it is not possible to advise you of every conceivable complication.

Complications after any type of cosmetic surgery are relatively rare and most patients end up with a very satisfactory result. The purpose of this information is not to frighten you, but to insure that your decision to have this operation is not made in ignorance of the potential risks of cosmetic operations on the face.

The surgical scars are permanent; however, the incisions are placed so that they are barely discernable on normal visual observation, barring complications, which may result in thick and/or painful, disfiguring scars. If this problem occurs, treatment by excision or steroid injections may be indicated, but it may be impossible to improve an unsightly scar.

Cosmetics and moisturizers may be applied over the skin of the face, up to the edge of the surgical incisions, two days after the operation. The office aesthetician will not only be able to assist you with makeup application to help hide bruising, but also to give you guidance regarding skin care after you have healed.

Coiffure procedures may usually be carried out after the drainage tubes have been removed and the wounds have stopped draining. Care must be employed when drying the hair during the first few months while you do not have normal sensation; the low heat setting should be used for the first two months to avoid inadvertent damage to the skin or hair.

The head must be kept dry initially. By the second or third day, the patient will be encouraged to begin showering and shampooing normally, but care must be taken not to tug on the drainage tubes or to rub the incisions hard.

Social activity should be limited for as long as you feel uncomfortable with the degree of swelling and bruising that you have. Light activities such as walking may be begun as soon after surgery as the patient desires. Strenuous exercises may be resumed when it is physically comfortable to do so, usually in a few weeks when all visible swelling and bruising have subsided.