Face-lift Chronicles: the Final Entry

It's now nearly two months after surgery. I’m still numb on the sides of my face, and the cut marks on my upper eyelids are plainly visible. I expect all of this to fade in time. Two-to-six months to heal completely is a realistic goal—don’t expect less unless you happen to be 25 years old.

After all is said and done, would I do it again in 10 years? I doubt it. However, knowing what I know now about the pain and worry, would I do it the first time? Yes. It was an incredible adventure. And the results have made a real impact on my life. I’m no longer “invisible”—and every woman over the age of 45 knows what I mean (I’ve been told men experience the same things). This really was a result of the surgery—I did research before I went in, noting how often 1. Men looked at my face and didn’t look away, 2. People smiled back on the street, and 3. Attractive women defended their man/territory when I was around before the operation. As an anthropologist and student of sociology, I’m not fooling myself; human females will continue to look for males who will provide them with healthy offspring and are able to protect and provide for them—human males look for healthy, attractive breeders. In American society, where we are constantly bombarded with images of “perfect” people, both male and female, looks count. As a society, we really need to grow up so we can grow old.

As a friend said, “Someone [in our group of friends] has to be the leader,” and it was me—to all those around me considering cosmetic surgery, I hope I’ve brought a little bit of reality to the situation. It’s certainly not a walk in the park, and the MDs—who want to get their hands on you for their own reasons—soft-pedal a lot of the problems and dangers you might face. In their defense, they also can’t predict how people heal (or don’t). And sometimes the work is just plain sloppy: besides the two inches of suture thread I removed myself from my left eyelid, I have noticeable sutures on my right eyelid and may have some stitches behind my left ear and on the back of my head that should have been, but weren’t, removed. Getting an appointment at my hospital is difficult at best—I’m scheduled for September 16 unless I go to the emergency room—pretty typical of HMOs. And all this for voluntary surgery; I’ll be avoiding any type of surgery from now on.

So, in closing, I say you better have a REALLY GOOD REASON to have cosmetic surgery. It’s expensive, it hurts, and it may not change your life in the ways you expect. If you honestly feel you’re being held back at work because of your looks, perhaps you need to search for employment where you feel valued (or figure out why you don’t feel valued). If you haven’t met Mr. Right or Ms. Right, looking better is not going to make the pool of available appropriate mates any bigger. Another friend said it was about aesthetics: making the most of what you’ve got for yourself rather than others; to look as good on the outside as you feel on the inside. That’s as good a reason as any—after all, you’re the one who looks at yourself in the mirror every morning; you might as well love it, with or without surgery.

Face-lift Chronicles: Uh oh/39-42 Days Post-surgery

On Friday, July 24, I couldn’t help but wonder why the area above my left eyelid remained swollen and dark. I pulled the lid up to the brow bone and discovered between one and four black plastic sutures still embedded in the skin! These were supposed to be removed the first week. Some were almost invisible; the skin had covered them. I called the advice nurse who told me to make an appointment at Plastic Surgery the following Monday. I called on Monday and was told to go to Emergency on Wednesday, as the clinic wasn’t open until then, and there was no room for an appointment. Frustrated, I was determined to see if those little black lines really WERE sutures and not wee tiny fine veins--though I didn’t have them on the other eyelid. I worked on the most visible one, and managed to get under it with a pair of very fine tweezers with points. It was definitely thin black plastic. Yes, it hurt, but not as bad as I thought it would. I started to pull. And pull. And pull. All of the fine black lines were a single suture. I held my eyelid taut and pulled. The suture turned out to be two inches long, laced under about ½ inch of my eyelid (the entire dark and swollen part). I iced it immediately, and put on a topical antibiotic. It was definitely still infected, but not much. My body was taking care of itself very well (Thank you, body!). The eyelid has been responding well—I can feel a difference already.
If any of the three doctors who examined me after the sutures were removed had taken a good look at the troubled area, they would have seen the sutures and saved me weeks of problems. The lesson here: we are our own best physicians; no one knows our bodies as we do, and our health and welfare is first and foremost in our own hands. Not to say modern medicine isn’t full of miracles—it is. But MDs are human, in spite of their best efforts. Take care of yourselves!

Face-lift Chronicles: 28 Days Post-surgery

July 12 – 15 Nearly one month after the surgery
My face is considerably less swollen, and I’m beginning to see a difference, especially when I compare my before picture and a current one. My former undereye circles are WAY better, though my neck and jawline seems about the same (I didn’t need much there). My former “deputy dawgs”—the loose skin on the cheeks—is mostly gone. I look like myself, but better. Definitely better. I’ve never looked at my face so much in my life. I was trying on a scarf in a shop, and looked into a tiny slice of mirror—I finally had that “ah ha” moment that so many others have told me about. I could see that I looked different, and pretty darn good. Of course, it didn’t live up to my fantasies of having the face of an airbrushed teen model in the cosmetic ads—but that’s just what it was: a fantasy, like having the “perfect” marriage, career etc. My right eyelid is almost normal, and the left is still continuing to catch up to it. I fear that I may not be able to raise that eyelid all the way again. I wondered if this was a by-product of the surgery, but when I took a good look at my “before” picture, I see the eye was not as open as the other. Things we don’t notice about ourselves! I’m visiting Dr. Leon for a checkup on July 15—30 days after—to see if I’m progressing normally or if something else has to be done.
On the 15, one month after the surgery, I voiced my concern over the swollen eye again, and was told that I needed to give it time to heal from the prior infection. Neither doctor in the room looked closely at it. I’m happy with the rest of the work, however—I’m still getting “pings’—those sharp shooting pains that last a few seconds to tell me my nerves are reconnecting. I think it’s a good thing I have “dead zones”-as feeling increases on the sides of my face (from the inside out, which is normal), I’m beginning to feel the healing muscles that were cut—feels like a bruise deep under the skin. Not bad except when I press on it. Sutures remain itchy—it looks like I have lice. I have to be careful about that in public.

The Face-Lift Chronicles: 12 Days Post-Surgery

Friday, twelve days after the surgery
I think the Arnica Montana really saved me from a lot of bruising. The sides of my face were bright yellow for three days, but I never had the black-blue-red spectrum to deal with, and no pooling under the eyes.
I had  a dream about a former boss, who (in the dream) is my boyfriend and terribly sweet and affectionate. I liked him in real life, too--maybe more than I thought at the time.  It also starred a couple of family members I haven’t seen much of in the last few years who came to me for advice about another relative we’re all concerned about. It felt pretty good. What’s with all the romance and familial affection, though? I’d be embarrassed if I had any sense.
I opened my door to the most wonderful sight. Friend Nick had sent me a couple dozen wonderful roses. They’re on my dining room table right now.

I’m still swollen on the sides of my face and neck. Dr. Chung said it would take anywhere from two weeks to two months for the underlying muscle sutures to heal—the muscles are folded in on themselves, sewn together and cut. I also have “dead zones” in front of and in back of my ears—all this was expected. Now comes the waiting, for my skin to relax into the new contours that have been rebuilt for it. It’s only painful if I touch the sutures—plenty of scabs that have to fall off, but the cuts around my ears are virtually undetectable. I suspect they won’t even show with my hair pulled back thanks to the precise cuts very close to the back of the ear and the careful cutting around the front and into the hairline both front and back. I wasn’t shaved at all. I don’t know how they did it.

 

The Face Chronicles: More on the Second Week

Wednesday, back to the hospital for the hand-off. Lovely Dr. Chung is moving to New York City on Friday, and I was being passed on to the handsomely boyish Dr. Leon (no pain, believe me). The left eye was still droopy, and there was some concern over a possible infection beneath the skin. The Drs. changed antibiotics (which I had been taking since the operation), and the eye responded by the end of the day. Whew.
What I used in addition to the prescriptions:
Boiron homeopathic pellets (available in most health food stores and now in Longs/CVS pharmacies:
•    Arnica Montana 30, for trauma, bruises, muscle soreness. 5 pellets under the tongue 3X/day
•    Staphysagria 30, for healing of surgical wounds, same dosage. Dosages continued for two weeks (two bottles of each, about $8 per bottle)
To keep the intestines working properly under the antibiotics regimen:
•    Culturelle probiotics ($24 at most pharmacies). This was a winner in a recent sampling to see if probiotic products actually contained what they claimed. I twisted open the capsule and shook out half over applesauce (anything would do) about ½-2 hours after I took an antibiotic.  It worked amazingly well—never had a moment’s discomfort. I never used more than ½ capsule, but always after the antibiotic.
On the 2nd-4th days after surgery, I took a packet a day of Dr. Dahl’s Cold Chaser (www.coldchaser.com), which contained:
•    30,000 IU Vitamin A from fish liver oil
•    2,000 mg Vitamin C
•    1,200 IU Vitamin D from fish liver oil
•    30 mg Zinc from 150 mg Zinc Monometionine
•    10mg Rose hips
•    500 mg Citrus Bioflavinoids
I’ve used this locally developed formula many times to ward off colds—it REALLY works, especially in conjunction with Zicam products—available in most drug stores.
The absolute best (and cheapest) aid I had in healing was ICE. I had a pad that went around the back of my head and neck, two smaller ones up the sides, and a packet of frozen peas across the eyes. Have two sets of everything, especially for the first four days. It’s the best investment you’ll make (the aforementioned Walgreens has a good assortment, all $10 or less), and the most effective at pain relief, and keeping swelling and bruising to a minimum.

The Face-Lift Chronicles: 15-20 days after Surgery

I’ve been walking and driving to the store for several days now; I always wear a hat to disguise my swollen lids without having to wear sunglasses, which irritate the upper ear sutures. I drove over an hour to my daughter’s house, and swam in the pool. Closing the eyes all the way felt strange, as my eyelids are still very swollen, especially the left one, where the infection was. The following Friday, I went to a 4th of July celebration with some friends—my “debut”.  The next day, I went to a party with a bunch of old friends. Everyone was very kind, and I do think I look pretty good for only two weeks. The eye is still dragging, and there’s no feeling on the sides of my face, but every day is a slight improvement. I’m still taking a lot of naps, but there’s no pain—at least there wouldn’t be if I didn’t try to sleep in “face-plant” position, which is a little rough on the ears. I put earrings in my pierced ears for the first time—had to work the lobes a little bit, but the holes were still there. I used to have a line running from the hole in each lobe to the bottom—the result of years of heavy earrings. It now runs nearly sideways. Another thing they don’t tell you: hair loss. After the surgery I began shedding like an alley cat; the only thing that slows it down is extra B vitamins. Ugh.

The Face Lift Chronicles: The Second Week

On Monday, exactly one week after the operation, I woke up with a spring in my step, and took a 20-minute walk--it was too much, too soon. I had to take an ibuprophen, ice the back of my throbbing head and take a two-hour nap. I enjoyed closing my eyes in the morning and listening to a CD I made. In the afternoon, I drove to the drugstore and bought more of my homeopathic medicines. It felt great to be outside. Driving was much easier than walking, though I’m still not a pretty picture: yellowish, swollen, wrinkled and red around the eyes.
I watched two movies: Bottle Shock, which I suppose was meant to ride on the coattails of that other wine movie set in San Luis Obispo (I enjoyed both, flawed though they were), and the Illusionist, which I had seen in the theater and fell in love with all over again. Jessica Biel is way pretty, though I think Edward Norton’s voice is a little high—he can bring on the passion, though, and that was what counted. I seem to be obsessing over period films with dark lighting.
Tuesday, I thought I’d take it easy. Got up at 8, washed my face, and went promptly back to bed to sleep until 10. I AM enjoying my dreams. This one was about living in the same house with my mother, and wanting my boyfriend (a beautiful J. Eagle look-alike, a lover from many years ago in Pennsylvania) to spend the night. A romance novel dream; I'd be embarrassed if I knew any better. It felt great, especially the fact I had confidence that I would just tell my mother he was going to sleep over, not beg for her approval-- though I fretted that I was getting male-pattern baldness (a tonsure, no less). I checked when I woke up—still OK. But the stress from the operation on my body is causing me to shed like a cat in a heat wave. I need to check out various hair-loss remedies, though the only ones I've seen are either ineffective or only work on real male pattern baldness. Time for more vitamin B.

Face Lift Chronicles: After the Cut--the First Week

Wednesday, two days after the operation, my daughter drove me in to
have the tape and stitches on my lower eyelids removed. That burned,
but not much. Dr. Chung did it in the conference room—something tells
me she could operate in a mud hut and it would come out all right. We
then went to a nearby Walgreens, tape, extremely gross bloody hair and
ears, puffy face and all (they wouldn't let me clean anything up before
the Dr. saw me). Yes, they stared at me, and I didn't give a flying
f?!k. I would have sold my grandma for baby shampoo. I do believe that
hair wash was the best of my entire life. Thank you, nurse Nikki—what a
blessing to have so much care.
I was still taped over the top lids. I can almost open my eyes. I had
my first full night's sleep last night (thanks to my old buddy
Temazepam), and I'm feeling, if not exactly perky, perkish. I need to
lay down and re-ice every few hours. I took pictures every day. I
really want to remember this.
After the stitches on my lower lids came out on Wednesday, I could
see better, and was able to start taking NSAIDS like ibuprophen, which
really helped with the swelling. I only needed to ice four times
Wednesday—Friday, twice on Saturday. The swelling and bruising went
down a little every day. I slept at least once each day, sometimes
twice.
Saturday night, I saw Baz Luhrman’s Moulin Rouge,
with Nicole Kidman and Ewan MacGregor: two of the most beautiful people
on the planet, in a gorgeous eyeful of a romance. I may become obsessed
with movies. Reading doesn’t seem to interest me, which has never
happened before. The first few days, the thought of eating appalled me
(now we know how models stay thin), but now my appetite is back,
especially for fruit and buttered popcorn.
On Sunday, good Dr. Chung came to my house in between stints on-call
and took out my upper-eye tape and stitches, forewarning me to take one
Tylenol and one ibuprophen an hour ahead—getting surface stitches out
stings a bit, and I had a good 200 to remove. Dr. Chung mentioned that
good sewing skills really come in handy to a plastic surgeon. I was
surprised to find I could take Tylenol and ibuprophen together, but it
usually isn’t advised because Tylenol is processed through the kidneys
and ibuprophen through the liver, so it’s easier on your body to
stagger them—however, I refused to take an Oxycodone (no more walking
into walls for me!), so I had the next best thing. When the tape came
off and the stitches out, I felt like a new woman, though I had some
trouble raising my left eyelid all the way. This worried me. I’m no
longer taking either Tylenol or ibupropen 24/7, though I do take a
4-hour dose late in the afternoon or evening, and an 8-hour naproxen
sodium before bed. Works well. I can’t believe it’s been less than a
week. I have to add what Dr. D'Amore told me before the operation: I
was a casual cigarette smoker for a few years, but haven't touched one
for more than a decade. He told me it didn't matter how long ago I
smoked or how much--it would impede my healing and make it slower. I
wish I knew that then.

Face Lift Chronicles: After the Cut, Days One-Three

I've never  had surgery before, least of all on my head. The first 20 hours were the worst, with the drains (long plastic tubes inserted by needle under your scalp) in the back of my head making me feel like I was trying to sleep on iron rods; the preferred form of oblivion came in a tiny cup: morphine. It was blue and tasted like apple juice--very thoughtful. I was able to exit two-four hours at a time. They kept me off oral fluids and food because I was on the table for 10 hours (!). That was the price I paid for getting this done in a teaching hospital. If you ever decide to do this, make sure you limit the amount of time you’ll be on the table—I was told three hours, but there you have it. A machine breathed for me the entire time. In a way, it's better you DON'T know what's going to happen.
This surgery is under full anesthetic, so I had a breathing tube down my throat for the entire 10 hours, and an oxygen tube in my nose for the whole time I remained in hospital. Thanks to being under for so long, the next two days after surgery I began to cough up rubbery phlegm from deep in my lungs. The nurses encouraged it—less chance of pneumonia.
Time seemed interminable when I began to come to. I was in hospital from 6AM Monday morning until about 2PM Tuesday. The operating room nurses and recovery room nurses were outstanding--right there on the dot whenever I could find the call button to summon them. When I went to "the floor", however, it was a different story. I could hear the nurse talking on the phone: "Oh yeah. Should I pick you up or what? That sounds good. OK. OK.", and after the fifth or sixth time I hit the call button (I was covered in ice water as the ice pack on my face had leaked and burst open), she came over to the bed and said, in a tightly controlled voice, "We're busy here." Hey, I couldn't see (thanks to tape on both upper and lower lids), but I sure could hear! Apparently the nursing shortage is forcing hospitals to hire people who formerly worked as telemarketers.
Oxycodone and ice became my BFFs. I was very stoned and had long involved conversations with my daughter/nurse after she came to pick me up. She said I seemed quite lucid. A friend sent me a news clip about wallabies in New Zealand (where most legal/pharmaceutical opium farming is done). Apparently they munch on the poppies and wander in circles for hours. Undoubtedly, they were looking for walls and doors to run into, which I found with unerring frequency in my own shuffle to the bathroom and back.
Friend Jan brought flowers by that night--when she picked up the car on Monday, she checked to see how it went, found out I was still on the table, and got very worried. She was relived to see me, puffy and alive, bless her heart.
Wednesday I felt a little better. I was able to open my eyes enough to see a slit of reality.  I felt like I had a pillow tied over my face and I looked like an overweight 15-year-old Japanese boy. I never slept more than two hours without rummaging through the freezer for cold peas. I have never felt so warmly about iced vegetables. That night, I had my first Oxycodone nightmare (not much of one--I was defending myself in slow motion from what turned out to be an empty closet--I was making stabbing motions with a sharpened pencil. How obvious!). Bye Bye Oxycodone, hello Tylenol Arthritis formula.
More anon....

The Face Chronicles: Before and After

What an adventure! I’m writing this now so I’ll remember how PAINFUL the operation was, and how quickly the healing process is taking place. I’m taking pictures every day, and I’ve learned a lot.
First, you find out who your real friends are, and how much you can lay on their doorstep. I had to leave for the hospital for the operation at 5:30 AM on Monday, June 15, and neither of the people who volunteered to drive me wanted to get up that early. Yes, it hurt my feelings, as I would have done it for either of them in an instant. I had to spend a bit of time remembering that it’s not always about me, it doesn’t mean I’m being deserted, etc. Also, if it was for a cancer treatment or some “real” medical treatment, I think it would have gone differently. We all learned a bit about ourselves courtesy of this event. I did have one volunteer who was willing to make the sacrifice, even though he was working through the weekend into late Sunday night: Thank you, Jim—you are the world’s nicest guy. Another friend came up with the cleverest solution to the problem: I could drive myself in, and she would drive in later that day with her son and pick up my car. That’s what we went with. Darn creative, Jan!
I got to the hospital, met the incredibly perky anesthesiologist, Annie, who lives in Marin and showed me pictures of her view from Sausalito on her cell phone. She postponed the dose that would send me to my “happy place” until Dr. Chung (my adorable senior resident surgeon) marked me up with a pen, and the supervising surgeon Dr. D’Amore (he had to make that name up—so cute, just like him!),  came in and discussed her preliminary marks and drew on me again. Amazingly, a woman I had met just the week before at a party spotted me (marks, hairnet and all) came over to say hello—she’s a nurse at that hospital.
Once the happy juice hit at 8AM Monday, I didn’t come to until 1AM Tuesday morning. Then began my endless quest for oblivion, which would last about two hours until I woke up again. Let’s be frank. In a face-lift/upper and lower eyelid combination, your ears are basically removed and replaced on your head while “excess” skin is removed and the muscles underneath are stitched up. Skin and muscle are cut and moved from your lower eyelid and upper eyelid, fat is placed in a “better” position, and the brow muscle is stitched up through your brow. It’s like a car accident where you’ve gone through the windshield. You can’t see the muscle work, but you can feel it—it’s tight, like a heavy workout/pulled muscle. In addition to the incisions (which you can both see AND feel) across your upper eyelid and inside your lower eyelids, and around your ears from the hairline in front around and through the inside of the ear across the bottom up the back and into the hairline, there are these marvelous things called drains. They are long tubes attached to your head by needles, and you are laying on them and occasionally pulling on the tubes accidentally, ripping the needle a bit. No need to ask, “Why morphine”, but rather, “When morphine?” People actually do this voluntarily, more than once. More later….

The FACE Chronicles Or Oh My God, I’m Almost “Done”

THIS IS A RE-POST OF THE DRAMATIC TALE OF MY FACELIFT, DONE IN JUNE, 2009


It’s now S (for surgery) minus 12 days, and counting. On June 15, I will be getting a new face. Oddly, this wouldn’t have happened if I hadn’t approached a plastic surgeon at a nearby teaching hospital with a few questions about the safety and development of new procedures a few weeks ago; one look at me, and he dubbed me the “perfect candidate” (not sure whether this is good or bad).
It so happened that the senior resident at the hospital was specializing in cosmetic facial work, and looking for a few good faces to rearrange before she moved on to private practice. So on June 15, the resident, under the supervision of a local plastic surgeon of excellent reputation (I checked—hey, research is what I do), will be chatting over a table full of instruments and yours truly, out cold.
I’m trying not to think about it—I’ve never been one to welcome pain (Hi there! Come on in and take a seat. Coffee?). But I couldn’t say no to the adventure AND the opportunity to stock up on Glucerna (the equally yucky low-sugar version of Ensure), as I’ll not be able to open my mouth much for a few days after the operation. People could be anticipating this all over town.
I MIGHT run the pix of before, during and after on this blog. I don’t know yet.