Cheek Augmentation Recovery: What To Expect

Initial Recovery: Anesthesia
After you are awakened and brought into the recovery room, the recovery nurse will monitor your vital stats until you are ready to be released.  This is dependent upon the individual but may take up to two hours or more.  You will feel quite tender and possibly confused as the anesthesia wears off.  If you feel any discomfort you may want to ask for a pain reliever which you will more than likely have been asked to bring with you.  You may even feel emotional or upset, this will depend upon your body's reaction to anesthesia.  You may also experience rigors or shivering.  This may feel uncontrollable and is usually from the medications, more than likely epinephrine that is used as a vasoconstrictor, and the cold saline which will have been introduced into your system for the last few hours, and still may be.  The fact that the operating room is usually very chilly, surely does not help matters in this regard.  The recovery nurse usually has wrapped you in a warm blanket but if not, request one.  It certainly makes things more tolerable.  You may even be lucky enough to have heating lamps!  Some surgical theaters are more like the dollar theater rather than IMAX, so ask first.

Some patients feel nothing different than waking up from a good night's rest.  Although if you have had General you may feel a little sick, hopefully your surgeon gave you something to lessen this.  Although I was prescribed Zofran, I forgot to take it and got sick as soon as I got into recovery. Your prescribed medication should alleviate any pain or discomfort.  However, if you believe your pain to be out of the ordinary once you get home, call your surgeon or the on call staff immediately.  You will be driven home by your spouse, significant other or friend as you will not be able to see, much less drive yourself home.

Incision Care
Please keep your incisions/suture line dry if they are extra-oral.  Your surgeon may have placed Steri-Strips on top of your incision line and sutures or you may have has internal sutures but externally may have had tissue glue to bind your incision edges.  Either way your surgeon will give you specific care instructions at your pre-operative appointment or sent home with you the day of your surgery.  It is best to learn before so that your spouse, friend or caretaker will understand and assist you instead of having to learn the last minute.  Also take care in not getting creams or lotions, nor topical arnica into the incision.  These can cause inflammation.

For intra-oral incisions, keep your mouth clean!  You may be asked to use Listerine several times a day and stay on a liquid diet until the incisions are healed.  This is common, so expect it just in case.  Do not tongue your incisions, or feel them with your fingers.  If you must touch your incision line for applying medications (although rare), only touch them with a clean, gloved finger.  Disposable latex or vinyl gloves can be bought at your local drugstore.

Suture Removal
You may have your incision sites checked and your stitches removed in approximately 10 days if they are non-resorbable.  Suture removal may be painful, especially if the wound edges are snipped with the surgical scissors accidentally.  It is generally a quick process and nothing to worry about although know that there may be some discomfort associated with the removal process.  It may feel like a tugging sensation or slight stinging.

However, if you have intra-oral sutures, it is unlikely you will have them removed.  They will eventually dissolve and fall out. 

Monitor Your Temperature
Take your temperature regularly.  An elevated temperature could mean an infection.  Take those antibiotics ON TIME and don't forget if you are a female taking birth control that some antibiotics can interfere so in the event that you do have relations, use another form of protection as well. Although you should not be doing any type of activity such as this because it can raise your blood pressure. Your surgeon will let you know when you are released for normal activity.

Soreness & Pain Factor
Pain tolerances depend upon the individual but you will feel tender, stiff and sore for a few says and will more than likely not want to move too much.  This will subside.  Be sure to take your required medications and follow the precise instructions provided to you by your surgeon.  Common pain medications may be Vicodin, Vicodin ES, Percocet, etc.  There is no reason to suffer, so please take your medications regularly instead of waiting to feel pain before taking a pain reliever.  The less pain you have, the better your experience and the faster you will make a full recovery.

Swelling (Edema)
As with all surgeries, swelling will be an issue.  Swelling is a normal reaction to an injury and is categorized as a natural inflammatory action.  Fluids high in white blood cells and hemoglobin will accumulate at the treatment site to treat the injury. 
You may be swollen for up to 3 to 5 months, although this could be very slight and only noticed by you.  Swelling is not necessarily a bad thing, however severe swelling can be a problem. Let your surgeon know if you feel your swelling is not normal. 

Treatment for prolonged edema include increasing your fluid intake, preferably water, normal to low sodium intake, movement such as light walking, in some cases the prescribing of prednisone.  Diuretics are not advised and should be avoided unless specifically instructed.  This includes natural diuretics as well.

Bruising
Bruises may or may not be present after your surgery,  This depends entirely on the patient, the technique and the effectiveness of the epinephrine.  One thing is for sure, bruises will usually get better.  Perhaps you can ask your surgeon about Arnica Montana, or Bromelain or even Vitamin A and C to reduce swelling and discolorations and improve healing.  Cold compresses will reduce the chances of bruising and reduce swelling during the first 48 hours.  They can also assist in pain relief and swelling reduction thereafter however, please be careful that you do not injure your skin.  The ice may hurt at first but will feel better as your skin gets used to it.  Ice should not be placed directly on the skin as this can cause injury.

Warm, gentle compresses starting at the 48 hours post-op mark can assist in bruise removal by dilating the blood vessels to help the body remove blood and damaged tissue away from the treatment area.  However, warm compresses  should only be used after the 48 hour mark, and not before.  

Permanent bruising is a risk but very rare.  if this is the case and you have discolorations after several months post op, you may wish to seek Intense Pulsed Light treatments.  These treatments target the hemoglobin in the blood.  [Hemoglobin <he*mo*glo*bin> (noun) : an iron-containing respiratory pigment of red blood cells that functions primarily in the transport of oxygen from the lungs to the tissues of the body.] A highly advanced computer regulates the light pulse to a specific wavelength range, which in turn heats the visible, targeted blood vessel(s).  Thereby damaging or otherwise destroying the targeted lesion while sparing the surrounding healthy or normal tissue.  The penetration depth and degree of heat is highly controlled so that most complications contributed to these specific factors are not an issue with Pulsed Light Therapy.

Sleeping
Sleeping is going to be difficult at first.  It is important to sleep with at least 2 to 3 fluffy pillows under your upper back and head to keep yourself elevated.  This helps relieve pressure from your treatment area hence reducing swelling and pain.  Many patients opt to place a pillow under their knees to help keep them from rolling over during the night.  Some place pillows alongside them and create a sort of recovery nest.

Many surgeons offer their patients a prescription of Ativan or Valium to ease pre- and post-operative jitters, sore muscles and help put you to sleep.  I personally found valium very helpful in falling, and staying, asleep.  My back was a little sore due to sleeping upright for 10 days so the valium eased this as well.

Just be sure that you do get some sleep because your body can heal itself better while it is at rest. Besides sleeping is a good way to past the time during recovery.  Just be sure to have someone wake you up to take your meds, eat some healthy meals and drink your fluids.

Bathing
You may want to sponge bathe until you feel better.  You may need assistance if you are disoriented.  A shower chair helps, but be sure not to get an extra-oral incisions wet.   You also may have a support garment so don't remove this to shower, nor get it wet, unless your surgeon instructs.  Bottom line, ask your surgeon when he is okay about your taking a bath or shower.  Baths are easier but you may need assistance actually getting out of the tub.  

You should wash your hair beforehand and either braid it or keep it back in a ponytail if it is long enough.  This will keep your hair clean and out of the way when you are eating and taking medications, or if you get sick.  You may not be able to wash your hair for a while due to dizziness, pain or disorientation.  If you must wash your hair, please get a friend to assist you in the sink or with a hand held shower head.  Or if you wish, have your hairstylist wash your hair for you a week post op or more.

Activity
Even though you may not feel like it, your surgeon will more than likely advise you to walk and move around as soon as you are able.  If you do not and lie around you may develop clots and or hold fluid (swelling, edema) a lot longer.  

You will be instructed not to exercise or engage in strenuous activities for at least 3  weeks.   Raising your blood pressure can cause bleeding and you don't want that.  Don't lift anything over 5 lb. and try not to raise anything over your head until your surgeon releases you for activity.  Take your time in healing so that you give yourself the best healing environment possible.  

Please print out our Complication Symptoms & Preparation Info Sheet.

Scars & Keloid Prevention
If you have extra-oral incisions and would like help with keloid prevention and scar flattening some surgeons suggest silicone gel sheeting.  Some products are manufactured, such as those from BioDermis, or scar tapes such as made by Curad or Band-Aid.  

Please see our Scar Treatment Section For More Information.

Numbness & Loss of Sensitivity
There may be some loss of sensation at first.  This is usually caused by the swelling from the trauma cutting of your nerves ability to transmit pain or touch sensations.  This usually will subside within a few weeks but be aware that in rare cases, loss of sensation may be permanent.  You may also experience sharp pains, burning sensations, heat, tingling, prickling, etc. This is from nerve damage and the sensations of the returning function of the nerves will result in the physical descriptions above.  Motor nerve damage is rare, but numbness after is common and usually almost always returns.

What Will I Look & Feel Like? PLEASE READ!
If you have had cheek implants, you will notice your cheeks are swollen, firm and possibly bruised. Your tissue will soften up and your swelling will subside.  The firmness is from the swelling which is essentially fluid retention in your tissues.  This is a natural reaction to a wound of any sort, it is your body's way of repairing it self.   The cold compresses in the first 48 hours, or for comfort thereafter, will significantly lessen the swelling, as will keeping your torso elevated. 

If you have had injectables, the swelling may be less, however I have seen injections cause great swelling.  Bruising is commonly less, but of you develop bruising don't be alarmed.  Your cheeks may also be firm as well.

As far as what you will first look like... You may feel you look like a "pumpkin head", many patients on our message boards feel this way.  I personally liked my swelling but I didn't have implants, I had fat.  Marc, my fiancÚ, had implants and was swollen on one side more than the other for many months.  He had good days and bad days.  This will pass, remember your results aren't near being seen. Give it time.  Don't jump to conclusions just yet, you will probably not like them at first and think your cheeks are too big.  Please be patient. 

Visit our Facial Implant Message Board for support.

 


Complications: What to Look For & Do In the Event of a Complication

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RECOMMENDED!

Please contact your surgeon or the on-call physician immediately if you notice any of the following:

  • bleeding from your suture lines

  • pus or cloudy discharge from your incision areas

  • a foul odor from your incision areas

  • uncontrollable pain

  • blisters or implant extrusion (if applicable)

  • displacement or shifting of the implant (if applicable)

  • temperature over 100.5º F

  • inability to pass waste (both liquid and solid)

  • numbness of the legs (unless you had lipo as well)

  • uncontrollable dizziness not related to the pain relievers

  • deflation

Please contact your surgeon or the on-call physician AND go to the emergency room as soon as possible if you notice any of the following:

  • passing blood through urine, feces or spitting up blood that is not from your incisions

  • abrupt and severe swelling and discoloration (aside from normal swelling)

  • blackening of the skin (which is clearly NOT a bruise)

  • uncontrollable vomiting

  • loss of consciousness not related to sedatives

  • temperature over 105º F

  • convulsions

What to do in case of a complication:

  • #1 STAY CALM

  • Have your emergency numbers handy and contact, or have your caretaker contact, your surgeon or the on-call physician to let them know of your problem as soon as you can.

  • If you are going to the emergency room don't forget to tell your surgeon WHICH hospital

  • Bring all of your medications with you to the hospital

  • It may be cautionary to pack an overnight bag ahead of time "just in case"

  • If you are able, keep a written journal (and if possible photos) of your symptoms and complaints

Emergency Numbers:

Surgeon: _________________________________________________________________________
Emergency On-call Physician: _______________________________________________________
Hospital: _________________________________________________________________________
Pharmacy: _______________________________________________________________________
Parents: _________________________________________________________________________
Friend: __________________________________________________________________________
Other: ___________________________________________________________________________

  


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(Updated on 03/01/10)
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