Dr. Gujrati’s Q&A

Dr. Gujrati is proud to offer plastic and reconstructive surgery to patients throughout San Jose, Palo Alto, Saratoga, Santa Clara, Sunnyvale, Los Gatos, Milpitas and the surrounding areas. Please read below to find Dr. Gujrati’s answers to some commonly asked questions by our patients.

Q: Downtime for Full Facelift?

I often read that it takes 10 days to recover from a face lift but I don’t know if that includes upper and lower blephs plus browlift, which people often have at the same time. I’d like to know how long to budget in a general way even as you need to add the disclaimer that everyone is different, we all heal at different rates. If it helps I am a 45 woman basically in good health, some asthma and allergies, of Caucasian and African-American descent.

A: Facelift Recovery Downtime

This depends on both the patient’s ability to heal and the surgical technique utilized. Our technique and approach is what most people commonly refer to as a SMAS facelift, in which the muscle layer under the skin is also tightened. This approach gives very long-lasting results, however when we manipulate and tighten this tissue, there is bound to be some minimal but noticeable swelling. Sutures are removed one week after surgery, and at that point the swelling starts to diminish, and on average most people have very little if any swelling left at 2 weeks. But some people heal faster than others. Patients should expect to feel some lumps and bumps for at least 3-4 weeks (and possibly months) after surgery but they will all resolve over time. There are radiofrequency devices (i.e., Accent RF) that can help minimize lumps / bumps and other irregularities to a significant degree.  Keep in mind, however, although you may feel these lumps and bumps, no one else notices them and you will already be looking rejuvenated and refreshed.

Q: When Should Facelift Sutures Be Removed?

How Many Days Post Op from a Facelift Should Sutures in Front of Ears Be Removed, for the best possible chance of limited scarring? Thank you

A: Facial Cosmetic Suture Removal Principals

For the best cosmetic results, sutures are removed anywhere between 5-10 days. If left in too long, they can leave marks on the skin, but if taken out too skin the incision may not be strong enough to hold itself. The range is variable based on surgeon’s different preferences and based on the fact that we may use different types of sutures and techniques. In my facelifts, because we are tightening the SMAS underneath the skin, the skin incisions themselves are not left under much tension. I will use permanent sutures (Nylon or Prolene as opposed to absorbable) because they are generally less reactive and leave less redness in the skin. For these reasons, I remove sutures 7 days after surgery. Absorbable sutures are acceptable, but may be taken out sooner or later.

Q: Is the Position of Earlobes Changed After Face and Neck Lift?

I had a face & neck lift in August 2010. The position of my earlobes has changed. I cannot wear my earrings because my right ear pierce is further away from my face than my left ear. The earrings do not hang right and look odd.

My right earlobe is very stretched and is attached to my neck, it is still sore after 8 months. My left ear is a little stretched. I have very little feeling in my face at the sides of my cheeks and around my earlobes. I have scars completely around my earlobes.

A: Earlobes should not change, but can

In most facelift techniques, the earlobe should appear natural and remains at about the position it was at prior to surgery. Most Facial Plastic Surgeons will agree that the goal is to get the neck and cheek skin tightened and elevated, but to not leave that tightness pulling down on the ear lobe, thereby changing its position or appearance. However, if that principal is not kept in mind, the earlobe can be drawn into a different position when a patient heals from a facelift. This is commonly referred to as a “Pixie Ear” and would require revision surgery.

Q: How Long Until Swelling Is 100% Gone After Face Lift?

I am 54 yo lady. I have done my face lift, eyes & neck in October last year and already 3 months now. All going good. I am satisfied and happy with the results. Just I still have a bit swollen/puffy on my cheeks (bottom). My question is: For how long does swollen will be gone and normal again?… Thanks for answer. Mrs HO Australia.

A: Swelling vs. Normal Tissue

This depends on both the patient’s ability to heal and the surgical technique utilized. Our technique and approach is what most people commonly refer to as a SMAS facelift, in which the muscle layer under the skin is also tightened. This approach gives very long-lasting results, however when we manipulate and tighten this tissue, there is bound to be some minimal but noticeable swelling. Sutures are removed one week after surgery, and at that point the swelling starts to diminish, and, on average, most people have very little visible swelling left at 2-3 weeks after the procedure. But some people heal faster than others. Patients should expect to feel some lumps and bumps for at least 3-4 weeks after surgery, if not longer, but they will all resolve over time. Keep in mind however, although you may feel these lumps and bumps, no one else notices them and you will already be looking rejuvenated and refreshed. But also keep in mind that in facial rejuvenation, we are elevating tissues that have started to sag from gravity. The swelling some patients notice long after their procedure can often be accounted for by normal structures of the face and neck (glands, etc.) or by tissue the was elevated into an area of hollowing with the purpose of giving that full, youthful appearance.

Q: Why Has my Vision Deteriorated After Eyelid Surgery?

I had an incision at the top of each eyelid and the muscle was reattached to open the lid further. 6 months later my vision is awful. My optometrist thinks that the change in eyelid position has caused the corneas to change shape and they continue to do so. I have had multiple lens changes both in type and prescription. I wore gas perms with only minor changes for 40 years. I now have a toric lens in the left eye that does not work and none in the right in hopes it will stabilize. Any ideas?

A: Not typical to last 6 months

It is fairly common to have temporary vision changes after blepharoplasty (eyelid surgery), especially if both the upper and lower lids are operated on at the same time. As with any surgery, swelling occurs during the healing process. When that swelling occurs in the eyelids, some slight and minor pressure is placed on the eye itself. The orbital bone (commonly known as the “eye socket”) is a tight space, so when the swelling from eyelid surgery pushes back on the eye, the eye itself temporarily changes in shape. It actually becomes shorter, which directly affects the focal distance of your vision. As the swelling starts to go down, the eye will return to its normal shape and your focus will recover as well.

Another issue that can affect contact wearers is increased dryness of the eyes after blepharoplasty which can severely affect the patient’s ability to tolerate wearing lenses and maintaining clear vision with them in.