Facial Plastic Surgery Patient Guide

A patient guide to healing from facial plastic surgery

After more than thirty years of exclusively enhancing the natural faces of our patients, the Smith Cosmetic Surgery & Medical Aesthetic Center team have garnered decades worth of experience. We get to celebrate the amazing results that help our patients shine and support the emotional weight of such a big decision as our patients navigate the recovery process.


Because our practice is rooted in the truth, we believe it’s important to address the realities of healing from cosmetic facial surgery. We are completely confident in the skills of Denver’s most trusted facial plastic surgeon, Dr. Brent Smith, and the natural results that so many patients have already experienced.

Our mission is to set the right expectation with every patient as they prepare for the stages of recovery that come with cosmetic surgery of the face — the part of our body that we closely associate with our humanness, our personality, the window to our soul. Remember, we are here for you every step of the way. We know every stage of healing, acknowledge every emotion, and will answer any question you have.

Our very own practice manager Lorayn Bowers had the mini facelift at age 47. Her direct experience is invaluable to our patients and informs our guide. Lorayn wrote a first-hand account of her healing entitled, A Patient’s Journal, which can be found on the Smith Cosmetic Surgery & Medical Center website.

Now buckle up. Let’s dig into the realities of what each week of healing will look like.  As important as the surgical procedure itself, pre-operative preparation, and planning for what’s ahead will help you navigate through each twist and turn and come out on the other side a whole new you.

Surgery: Setting Your Expectations

Post-operative scarring is a concern for many when considering facial plastic surgery.  Dr. Smith takes great pride in closing his incisions so that the resulting scar is nearly invisible when healed.  Dr. Smith accomplishes this by placing incisions along the relaxed skin tension lines, at a natural boundary or along a skinfold. The relaxed skin tension lines run perpendicular to the underlying contraction of the muscles.

You can find your “relaxed skin tension lines” by looking at your natural wrinkles or pinching the skin between two fingers to determine the natural crease of the skin.

This spot puts the least amount of tension on your scar and provides the best camouflage post-op. Skin folds and shadows can also hide incisions, and we take all of these aspects into consideration during surgical planning.

Rest assured: You are in no better hands. Dr. Smith’s three decades of experience and excellent surgical technique include critical precautions to prevent infection and stress, which will promote better healing and less scarring.

While specialization in the face, longevity in the industry and proven results should put you at ease, the best advice we can give you is to trust your decision and trust the process. Healing is a process.  Dr. Smith states that When one understands that healing is a process rather than an event, the patient will realize that their initial appearance is far from their final result”.

Pro tip: Hypoxia, or reduced blood and tissue oxygen, increases your risk of infection and complications, while prolonging healing. Because smoking decreases blood flow in the arteries, which impairs wound healing, we strongly recommend that patients stop smoking prior to surgery and during the recovery phase.

Stages of Healing

While the healing process occurs at a different rate for each individual, the built-in miracle of healing — the body’s innate ability to repair itself — can be broken down into four phases: hemostasis, inflammation, proliferation or rebuilding, and remodeling.

Stage 1: Hemostasis (immediate)

The first stage of healing is called hemostasis, when the body naturally stops bleeding at the surgical site. Following any trauma to the tissues and resultant bleeding, your blood vessels constrict to slow the flow of blood. Amazingly this occurs within minutes.

Additionally, blood platelets are attracted to the incision site and begin to “clump” to form a blood clot. You are essentially scabbing up like you would with any other “wound,” as blood brings in fresh oxygen and nutrients for healing.

Within the first 24 to 72 hours a thin cell layer bridges around your sutured wound. As the cells migrate to cover and close the wound, the skin actually makes more of itself through a process called re-epithelialization. “It’s truly a miracle that our body has the ability to restore a wound to a condition that may be entirely imperceptible,” says Dr. Smith.

Pro tip: Infection is the greatest threat to successful wound healing. For this reason, we place patients on antibiotics prior to surgery and continue this during the immediate healing phase. While this does not completely negate the risk for infection, it does make the risk minimal.

Stage 2: Inflammation (6-8 hours post-op)

After bleeding has stopped, the immune system undergoes a series of cellular reactions to begin the healing process and rapidly restore the integrity of the tissues. These cellular reactions result in inflammation, which will cause your face to become warm, red, and somewhat swollen. This is a natural, beneficial inflammatory response that’s required for the healing to progress normally.

Within the first 6 to 8 hours following surgery white blood cells are attracted to the wound to cleanse, sterilize and clear the area of debris. During the first three or four days, these cells also manufacture various growth factors that accelerate healing and allow the body to reconstruct new blood vessels, muscle cells and other tissues.

Pro tip: Keep your incision site dry for the first three days, except for cleansing with half-strength hydrogen peroxide and applying a moisturizing antibacterial ointment as outlined in your post-operative booklet. Keep your head elevated to improve lymphatic drainage, decrease swelling and reduce tension on the incision.

Stage 3: Proliferation (3-10 days post-op)

You’ve just had the muscles — not just skin — of your face manipulated and contoured during a surgical procedure. This ongoing tissue-reconstruction process may begin anywhere between day 3 to day 10 following surgery. Once your white blood cells have cleaned and sterilized your incision site, oxygen-rich red blood cells naturally migrate to your face, creating an ideal environment for rebuilding tissue.

During proliferation new blood vessels are created while damaged blood vessels are repaired. You’ll also produce collagen, elastin, and fibrin to provide a stronger foundation and support for healing and rebuilding going forward.

Pro tip: Take advantage of our in-house hyperbaric oxygen treatments to speed the recovery. Air in the chamber is three times higher than normal air pressure, which helps your lungs take up more oxygen. Highly oxygenated blood is carried throughout the body, where it fights infection and promotes the repair of damaged tissue through the growth of new blood vessels.

Stage 4: Remodeling (starts in Week 3)

Remodeling begins around your third week post-op when collagen deposition is at its peak. This slow maturation process can continue for years! As your wound contracts, swelling decreases and a pink scar begins to form. This will later contract, flatten and become whiter. However, around the 3- to 6-week period, the scar may feel raised and itchy. This is a natural and expected stage of the healing process.

Approximately three months after your facial plastic surgery, your skin and repaired tissues will have about 80% of their original tensile strength. Clearly, an immediate result is impossible. Healing is a weeks- even a year-long process in various ways.

Pro tip: Gradually increasing activity in your second week of recovery will improve circulation and just make you feel better. However, be careful not to overextend. Continue to rest and elevate the head whenever it feels good.  More strenuous activity can begin at week three and beyond.

More Tips for Healing from Facial Plastic Surgery

Hyperbaric Oxygen Therapy

To accelerate and promote the healing process, we offer and incorporate hyperbaric oxygen therapy during the early healing phases. This powerful therapy has been well documented to serve as an aid for patients who don’t heal well, and has proven beneficial for recovering from cosmetic facial surgery.

Patients simply rest inside our specially pressurized unit. In the presence of enriched oxygen, blood can take up more oxygen and nutrients to the healing tissues, which will more quickly promote the resolution of bruising.

Constriction: In This Case Tight Is Alright

There are plenty of things that happen while you’re healing from cosmetic facial surgery that may not feel quite right at the time. But most likely they are completely normal. Here’s some of what you can expect:

Your face and neck are “constricted” for the first couple of weeks. For example, it’s normal to not be able to open your mouth as wide or rotate or tilt your head like you’re used to. But why?

Because muscle has a memory and it was perfectly happy where it was before undergoing a mini lift. Muscles need time to get used to their new position on the face. That’s 100% normal, 100% of the time. Patience is key. We promise, you will return to how you felt before surgery — only more youthful and rejuvenated than ever.

Balanced Nutrition

A balanced diet, as well as vitamin supplementation, gives the body appropriate amino acids and building blocks to heal. Vitamins A and C are especially beneficial. Vitamin A assists with appropriate immune system function and for the growth of the overlying skin. Vitamin C is needed for collagen production, which supports the skin and increases its tensile strength.

Eating complex carbohydrates and protein will provide essential ingredients for the body to perform its healing function. Adequate protein ensures that the body does not break down muscle to obtain the protein required to heal and decrease the risk of infection. Additionally, good hydration is helpful to facilitate blood flow, which delivers oxygen and nutrients to recovering tissue.

Major Milestones

Each week of healing you’ll experience milestones that may seem small when you read about them but will feel like major achievements while you’re healing. Mark your calendars for these wonderful little moments:

1. Compression wrap is off: Dr. Smith cauterizes blood vessels during the procedure, but he can’t hit every one, and bleeding may occur. So, at the end of a cheek and neck lift, Dr. Smith applies a compression wrap to minimize post-operative bleeding. Your wrap can feel very snug, and having it removed the day after the procedure is a welcomed relief.

2. Stiches come out: Your second week-one milestone takes place on Day 7. Coming back to our office to have your stitches removed signifies forward progress and is the beginning of feeling “normal” again.

3. Physical activity returns: After about a week, you will start to feel like moving around more normally. The endorphins you produce when you are active feel great and will offer positive reinforcement. But listen to your body and don’t push it. You should be able to return to a full exercise routine around three to four weeks after your surgery.

4. Get out there: Two to three weeks following surgery, you will begin to treasure small outings: shopping, getting your nails done, or enjoying a dinner out. Gently reveal your rejuvenated look to the public. Don’t worry: They won’t suspect you’re healing.

5. Prepare for the compliments: At week five or six, go ahead and attend that function you’ve been looking forward to whether it’s a wedding, a graduation, a reunion, etc.  And prepare for all the compliments!


Caring for yourself while healing from cosmetic facial surgery is critical to your success. Make sure you’re ready with plenty of positive thoughts, feel-good remedies, and supportive people.

  1. Engage in positive self-talk. As thoughts of doubt inevitably creep in, continue to mentally support your decision to have surgery. A facelift is an important decision, so give it the respect it deserves. Talk to yourself the way you would a friend who is healing.
  2. Be a rule follower. Take pride in carefully following your post-operative guidelines. Remember, this experience is a new one: what you’re seeing on your face during this time is normal. You will not see the new you for ten days to two weeks, but hold on, she’s in there just waiting to be revealed.  Remember, trust the process.
  3. Find resources to lift your spirit. Watching too much “reality” TV or world news can feel defeating and lead directly to a soured mood. Instead, go for feel-good movies or peruse positive social media sites like Pinterest or Instagram. Take a bath. Read a page-turner. Listen to soothing music. Most importantly, reach out to friends and family who are loving and supportive.  And remember, Dr. Smith and the staff of professionals at Smith Cosmetic Surgery & Medical Aesthetic Center have been where you are and are ready to support your decision and encourage your progress every step of the way!