Mid Face lift and Trans-conjunctival lower lid fat redraping

When Rebecca had Right Mid Face lift and Trans-conjunctival lower lid fat redraping surgery she kept a surgery diary to help others.

Prior to surgery

Before surgery

Before surgery

November 2014 I met with my consultant plastic surgeon at my regular check up in facial palsy clinic. I had attended regular facial therapy for the previous 18 months using trophic electrical stimulation and neuro-muscular re-education. The aim was to improve the muscle tone with the stimulation and develop some more facial movement using neuro-muscular re-education. Both my therapist and I felt that we had achieved as much as possible with therapy despite the fact that the sEMG of my facial nerve was very positive.

At my consultation with my surgeon, I discussed the fact that in photos I feel that my face is aging differently on my FP side, to which he suggested that he could perform a Mid Face lift and Trans-conjunctival lower lid fat redraping procedure. This would not aid movement but would make my nose, mouth and under eye area appear more symmetrical at rest.

The risks and possible outcomes were discussed with me clearly. They included: swelling, bruising, bleeding, infection, numbness, nerve injury and relapse over time. The procedure would be on an inpatient basis and would necessitate a general anaesthetic.
I decided to agree for the surgery and fully expected to wait months. However, I received a phone call within the week to offer me a date in early December.

Day of Surgery (Monday 1 December 2014)

I went in to the hospital on the day of my surgery and was admitted but allowed to wait with my husband until the last minute which was great. I was allowed nothing to eat from midnight and only water to drink up until the morning of surgery at 6am. Other than the usual health checks on the day and a blood test/MRSA swabs a week beforehand, I was ready for surgery!

I went down to theatre at approx. midday and vaguely remember being in recovery and apologising for not being able to wake up properly! I was quite nauseous and very drowsy but not in much pain surprisingly.

I was taken back up to the ward by about 5pm where my husband was waiting. I was given pain relief and had an oxygen tube running under my nose for a couple of hours post surgery. I was also given a blood thinning injection since I would not be running about a lot. I was able to eat a little that night and drank lots of water, straws really helped at this point. I slept in a propped up position and the nurses checked my blood pressure and heart rate every couple of hours. I was able to get up and walk about within a couple of hours of surgery. My husband and daughter came to visit briefly but I was in and out of sleep, lovely to see them both though.

Day after surgery (Tuesday 2 December)

Day after surgery

Day after surgery

I was able to eat breakfast and have a shower this morning. I did get a very big shock when I looked in the mirror as my face was very swollen and puffy and if anything, looked more asymmetrical than before surgery. After calming down, I realised this was simply because of the swelling. I was told sleeping propped up would really help with this. A minor thing, but I would have appreciated being warned about how exaggerated my facial palsy would look post-surgery. My husband came to collect me and I was discharged with painkillers by lunchtime. Spent the rest of the day napping and drinking lots. Eating was a little difficult as I felt very stiff and couldn’t open my mouth fully. The pain was controlled by the ibuprofen and paracetamol and was not nearly as bad as I had imagined.

Day 3 (Wednesday 3 December)

On this day I was still very tired but the pain was manageable.

Day 4 (Thursday 4 December)

I noticed the stitches in my mouth are a little sore and the wound on my scalp held together with tiny staples is quite itchy today. I am also a little sore by my right nostril where I have stitches too. More energy today but easily tired.

Day 5 (Friday 5 December)

I have much more energy today and managed to wash my hair, which really helped. I am using a special mouthwash to keep my mouth stitches really clean and the dressing on my face is beginning to peel around the edges – very annoying, but I am going to dressings clinic on Monday to have my stitches, staples and dressing removed. The swelling on my face has reduced significantly and although it is early days I think I am going to be pleased with my results. I have been taking photos every day of my progress.

Day 6 (Saturday 6 December)

I went out for the first time today to walk the dog while my daughter had her piano lesson. The bruising is still quite evident but with a hat and my glasses I don’t think I scared anyone. I am much less swollen and no longer needing to take painkillers although I am still taking the ibuprofen to ease any remaining swelling. Very much looking forward to having all my dressings, staples and stitches removed on Monday.

Day 8 (Monday 8 December)

Today I went back to hospital and had my stitches, dressings and staples removed. All fine but a little painful having the staples pulled out. I am due to see my surgeon again at the end of January. My face feels quite numb but otherwise okay today. Movements, e.g. smiling are still very stiff and awkward feeling.

Day 9 (Tuesday 9 December)

I slept without my wedge pillow for the first time last night and awoke feeling very achy and swollen so maybe it needs to be used for a while. By the late afternoon I felt much better and am able to smile less stiffly now. Today is the first day I have felt like myself again and I wrapped some Christmas gifts and did some admin for my husband’s business. I am looking forward to going back to work next Monday but I am glad I have a few more days of rest as I don’t feel able to concentrate to plan lessons yet let alone speak in front of 30 ten years old all day.

1 January 2015 – 1 month post surgery!

I am almost entirely back to normal now. Just a little soreness near the eye socket and some numbness but nothing like I was expecting. I am really pleased with results, especially in the area under my eye which is quite different. I feel my nose and mouth are a little more symmetrical at rest.

24 January 2015

Before and after

6/7 week check up. My consultant is happy with my recovery so far and I am returning in 5 months to assess the results as he feels I do still have a small amount of swelling. The area in my scalp where I had stitches/staples is still a little tender and gets cold easily so I am wearing hats whenever I go outside but it is January so cold anyway! Other than that I am almost completely recovered with minimal patches of numbness around my eye and on a very small portion of my upper lip.

Please note: Patient experiences reflect the individual views of the patient. While our content is checked for medical accuracy, please remember that every patient’s experience is different.

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Last reviewed: 14-11-2016    ||    Next review due: 14-11-2018