For years, my role as a designated adult after surgical procedures has become a recurring, albeit unofficial, part of my social circle. My resume boasts experience with two colonoscopies, a blepharoplasty, and an IVF egg retrieval. This volunteer work, while possibly indicative of responsibility or an abundance of free time, typically involved simple tasks: picking up a friend, arranging transportation, and ensuring their safe arrival home. In New York City, thanks to services like Capsule, even pharmacy runs are no longer a concern. However, my recent experience volunteering to assist my close friend, Robin, through her deep-plane facelift and neck lift recovery demanded a far more immersive commitment, transforming a simple favor into a week-long caretaking mission. This entailed flying to Palm Beach, Florida, at her expense, to be by her side during her recovery under the care of facial plastic surgeon Dr. Mark R. Murphy.
The prospect of witnessing the immediate aftermath of such a significant surgery understandably brought a wave of anxiety. The potential for discomfort, visual distress, and the unknown emotional toll weighed on my mind. This echoes a concept akin to "sympathy pains," where observing another’s suffering can activate similar neural pathways in the observer, as detailed in Nature Reviews Psychology. Fortunately, my loyalty to Robin and a profound curiosity about the surgical recovery process outweighed my apprehension. Furthermore, this experience presented a unique opportunity to observe firsthand the realities of cosmetic surgery, potentially influencing my own long-held stance in the "maybe someday" camp regarding such procedures. At 55, eight years Robin’s senior, this personal reflection added another layer to my involvement.
In the days leading up to Robin’s surgery, I delved into the world of social media, specifically Instagram, to research facelift journeys. The platform offers an overwhelming array of visual documentation, from before-and-after transformations to detailed recovery vlogs, spanning global destinations like Beverly Hills and Istanbul. However, the curated nature of social media often blurs the line between authentic experience and idealized presentation. I also joined an Instagram Broadcast Channel, "The Aesthetic Authority," curated by actor-influencer Emily Wagner, who candidly documented her own extensive cosmetic procedures. Wagner’s raw and often humorous account of her recovery, particularly the visible swelling, resonated with me, confirming that my initial unease was shared by others. She even mentioned a friend who temporarily muted her account to avoid the unflinching visual progression of her healing.
Despite these initial apprehensions, I remained committed to my role as Robin’s caregiver. What followed was a revealing immersion into the less-discussed aspects of surgical recovery, highlighting ten critical points that are often overlooked or not explicitly communicated to patients and their support systems.
The Financial Realities Beyond the Sticker Price
The cost of a facelift can vary dramatically, with top surgeons like Dr. Steven Levine, known for performing Kris Jenner’s highly publicized procedure, reportedly commanding fees upwards of $400,000. For a more typical, yet still significant, investment, experienced and sought-after plastic surgeons in the United States often charge between $40,000 and $50,000 for a standard facelift. This figure generally includes anesthesia and operating room fees but typically excludes common add-on procedures such as brow lifts, lip lifts, blepharoplasties, and fat transfers. For those considering cosmetic tourism, destinations like South Korea or Turkey may offer facelifts in the range of $20,000 to $35,000, though this often necessitates careful consideration of additional travel, accommodation, and potential risks associated with international medical care.
Beyond the surgeon’s fee, ancillary costs can substantially increase the overall expenditure. Robin’s meticulous approach involved thirteen consultations with surgeons across New York, Florida, Texas, and Los Angeles, in addition to virtual consultations with practitioners in South Korea and Turkey. While this number is exceptionally high, another acquaintance, Julie, underwent four consultations before her facelift. Consultation fees can range from $250 to $1,000, a sum that is often credited toward the surgery if the patient proceeds with that surgeon.
Robin ultimately selected Dr. Murphy based on a combination of factors: his natural aesthetic results, his 25 years of experience, his interpersonal skills, his pricing, and his well-defined recovery protocol. "I met with a wide range of surgeons, including some of the now-famous ones such as Dr. Ben Talei and Dr. Steven Levine, who charge top dollar," Robin shared. "I liked Dr. Talei a lot, but his price point was too hard for me to justify, although I tried. Dr. Levine was also extremely expensive, and the consultation was about 15 minutes, which was a bit unacceptable to me given the price tag. For something this major involving my face, I needed more time and personal connection than that. A lot of people only focus on the before-and-afters, but I wasn’t doing this unless I felt completely confident and comfortable with not just the results but the person behind them. With Dr. Murphy, everything just clicked. It was a very clear yes."
Post-operative care mandates a minimum of 18 to 24 hours with a private nurse, costing between $100 and $200 per hour, to ensure patient safety, medication adherence, and proper post-operative management, including meticulous icing. Dr. Murphy’s protocol for icing involves a full ice mask applied for 20 minutes on, 20 minutes off during the initial 18 hours, with smaller ice packs for targeted areas if needed. This schedule gradually reduces to 20 minutes on, 40 minutes off during waking hours on day two, and typically ceases by day three.
For patients not residing in close proximity to the surgical facility, overnight stays in nearby hotels are often necessary. Robin booked her hotel for three nights and engaged her nurse for 39 hours. She ultimately extended her hotel stay by an additional night, incurring a total cost of $6,400 for accommodation and nursing care. "I was a very scared patient, so I wanted the first 48 hours of aftercare to be meticulous," Robin stated. "My nurse iced me like clockwork. It’s not something I could have done as consistently by myself, and it’s too much to put on a friend."
The Role of Ancillary Recovery Treatments
Recovery add-ons can significantly escalate costs. While Robin adopted a minimalist approach focused on rest and adherence to instructions, Emily Wagner invested in ten hyperbaric oxygen therapy sessions at a cost of $2,500, believing it accelerated her healing. However, medical professionals advise a cautious approach to such supplementary treatments. Dr. Eunice Park, a facial plastic surgeon in New York, emphasizes a "less is more" philosophy for the initial recovery period, prioritizing incision protection, inflammation minimization, and the re-establishment of blood supply.
While some limited studies suggest hyperbaric oxygen therapy may aid in faster healing, both Dr. Murphy and Dr. Park consider it on a case-by-case basis, primarily for complications like poorly healing incisions, rather than as a routine recommendation. Hyperbaric oxygen therapy carries potential risks, including ear or sinus trauma from pressure changes, oxygen toxicity, temporary vision changes, and infection exposure. Surgeons often recommend carefully timed lymphatic massage, performed in their offices, to assist with swelling and fluid drainage.
The Emotional Rollercoaster: Pre- and Post-Operative Anxiety
Plastic surgeons often find themselves acting as informal psychiatrists, navigating the significant emotional landscape of their patients. Dr. Murphy highlights that "the emotional roller coaster is real—and honestly, it’s more than half the battle for many patients." He attributes much of this anxiety to misinformation readily available online. "We spend significant time explaining what to expect; there will be ups and downs. That’s vital. I also give patients my personal cell number to call or text with questions or concerns—and many use it. But even just knowing they have that safety net dramatically reduces anxiety."
Robin, an admitted anxious over-analyzer, found solace in my extended presence beyond the standard 72-hour post-operative recommendation. My responsibilities included managing medications (oral steroids, antibiotics, pain relief, and anti-anxiety prescriptions), applying ointment to sutures daily, and providing transportation to her initial five post-operative appointments, as driving is prohibited in the first week. Beyond practicalities, I offered crucial reality checks. When Robin began to express concern about appearing alien-like, with her head seemingly shaped like an inverted pear due to asymmetrical swelling, I reassured her that this would even out and that she already looked remarkably youthful.
"It was so helpful to have a friend to distract me—we chatted a lot and watched a ton of Schitt’s Creek," Robin recounted. "And whenever I started worrying that I’d never look ‘normal’ again, Michele reminded me I was only a few days out of a major surgery and that I needed to wait a reasonable amount of time before spiraling." Anecdotal evidence suggests younger patients, typically in their 40s, may experience more pronounced emotional distress, potentially questioning their decision for elective surgery. Conversely, older patients, often more resigned to the effects of aging, tend to approach the procedure with a "let’s get this done" attitude.
The Swelling and Bruising Timeline
Facial edema, or swelling, typically peaks around day three post-surgery. While the immediate post-operative appearance might be manageable, significant puffiness and swelling are common by the second day. This occurs as blood vessels, temporarily more permeable to facilitate healing fluids, begin to constrict. Subsequently, the body’s lymphatic system gradually begins to drain excess fluid, leading to a reduction in swelling.
Upon my first visit, 48 hours after Robin’s surgery, her appearance was less alarming than I had anticipated, with minimal bruising. However, her face was noticeably taut and shiny, a phenomenon often described as looking like a "Cabbage Patch doll." By 72 hours, the swelling began to subside, though not always uniformly. Mild bruising transitioned to a yellow hue and largely disappeared by day seven or eight.
A Temporary Loss of Dignity and the "Frankenstein Phase"
The initial days post-surgery can involve a temporary relinquishing of personal autonomy. Robin reported needing assistance from her nurse for basic tasks like using the bathroom and showering during the first two nights. She was able to feed herself, primarily with soft foods like pudding, yogurt, and protein shakes, using a baby spoon due to limited mouth opening. The use of straws is also generally discouraged post-operatively.
Intestinal distress, either constipation from pain medication or diarrhea from antibiotics, is another potential side effect. Robin experienced significant gut upset due to the antibiotic regimen, describing her digestive system as "pretty destroyed" for several days.
The surgical incisions and sutures, while necessary for healing, can lead to what might be termed a "Frankenstein phase." A deep-plane facelift and neck lift involve extensive incisions, extending from the temples down around the ears and into the hairline at the base of the neck. Robin’s procedure involved approximately 400 sutures and an additional 30 staples in her scalp from a concurrent temporal brow lift. Witnessing these sutures and staples can be visually striking, even when the surgery was elective. Many patients also utilize drains or surgical nets to manage fluid accumulation, though Dr. Murphy primarily relies on sutures and staples.
Robin opted to avoid looking at her reflection for several days, even delaying the insertion of her contact lenses until day six. She continued to shield her eyes when passing mirrors for some time, a behavior that is not uncommon. Some patients reportedly tape cardboard over their mirrors before surgery to mitigate the visual impact of their post-operative appearance.
The Surprising Absence of Pain and the Sensation of Tightness
Contrary to initial fears, Robin, like many other patients, reported that the recovery was not characterized by significant pain. Dr. Murphy explains this phenomenon: "For a deep-plane facelift, we lift the skin and SMAS (Superficial Musculoaponeurotic System) together in natural anatomical planes and reposition the platysma [a muscle stretching from the upper chest to lower face] at a structural level rather than pulling on the skin." The temporary numbness resulting from the stretching of small sensory nerves during the skin elevation further contributes to the lack of pain sensation, particularly around the cheeks, ears, and neck. Patients often describe a sensation of "tightness and pressure," with the neck being the most commonly reported area of discomfort.
Robin described the sensation as akin to wearing an "extremely tight chin strap." The numbness can also create a detached feeling when performing routine tasks like washing one’s face or hair, as if performing them on someone else. Nerve regeneration is a slow process, averaging about a millimeter per day, meaning the return of sensation can take weeks to months.
While pain is minimal, the use of opioid pain medication, such as oxycodone, and sedatives like diazepam (Valium) for anxiety is common. Robin utilized the full spectrum of prescribed medications, including a refill of Valium, for two weeks to manage her anxiety and ensure comfortable sleep.
The Six-Week Hiatus: Hair Color and Exercise Restrictions
Post-operative recovery includes a significant period where certain activities are restricted. Hair coloring is prohibited for six weeks due to the chemical nature of dyes and the potential for them to interact with incisions in the hairline, potentially "tattooing" scars with color. Dr. Murphy advises patients to cease hair coloring two weeks prior to surgery.
While light walking is encouraged within the first week, more strenuous exercise is generally prohibited for at least six weeks. The increased blood pressure and physical exertion associated with exercise can lead to swelling, bleeding, and the risk of tearing newly formed tissues. Activities like yoga, particularly inversions, require additional recovery time due to the strain on the neck.
The Body’s Remarkable Healing Capacity
As a health journalist, I am accustomed to the body’s inherent drive toward homeostasis. Witnessing this process unfold so rapidly after a seven-hour surgical procedure was remarkable. Robin’s swelling progressively subsided, bruises (which were surprisingly minimal) vanished, and within a week, all staples were removed, and sutures no longer required daily ointment application. By day ten, all remaining sutures had been dissolved, leaving virtually no trace, akin to disappearing ink.
The healing trajectory was impressive. Dr. Murphy explained that the face, with its exceptionally rich blood supply, is biologically primed for rapid healing. "The body prioritizes the head and neck, so oxygen, nutrients, and healing factors reach those tissues efficiently, supporting collagen production and rapid repair," he stated. He noted that many patients, particularly those in their 40s who tend to heal more quickly, feel comfortable resuming social activities within seven to ten days.
Beyond Youth: The Psychological Impact of Facelifts
A significant realization during this experience was that a facelift is not solely about achieving a more youthful appearance. It is often about reclaiming one’s sense of self. As we age, the disparity between our internal perception of vitality and the reflection in the mirror can create a disconnect. This can also influence how others perceive us. Beauty journalist Valerie Monroe noted how the area around her mouth seemed to convey disdain, an emotion she felt was incongruent with her actual disposition.
Robin echoed this sentiment: "My jowling and heavy brow made me look angry even when I wasn’t. I felt my mood had shifted so much as a result of that. Post-facelift, I genuinely feel happier." This alignment between internal feeling and external appearance can lead to improved well-being. Multiple studies, including those published in Psychology Today, report enhanced well-being and life satisfaction in patients over a year after undergoing a facelift. This positive feedback loop can foster increased confidence, which in turn elicits more positive social interactions.
Observing Robin’s recovery and her subsequent satisfaction piqued my own interest. Before leaving Florida, I consulted with Dr. Murphy. He began by asking about my personal dissatisfactions before offering his professional assessment and outlining potential surgical options. In front of a mirror, he demonstrated the effects of a lift by gently manipulating my jawline and scalp, an approximation of the results I see in my daily mirror checks but executed with surgical precision. The outcome was appealing. Dr. Murphy suggested procedures similar to Robin’s, including a deep-plane facelift and neck lift, temporal brow lift, and fat transfer. He also proposed an under-eye skin pinch and potentially a lip lift to address age-related changes in these areas. The comprehensive nature of the proposed procedures, while not unexpected given my age, was notable.
While I have not yet mentally committed to undergoing such procedures, my perspective has shifted from "maybe someday" to "probably someday." The next step involves re-training my social media algorithms to provide a broader range of content, allowing for a more balanced decision-making process.
Additional Insights from the Recovery Journey
Optimizing Sleep Post-Surgery
Adequate sleep is paramount for recovery, and achieving it can be challenging for individuals who typically sleep on their sides or stomachs. Dr. Murphy advises patients to maintain an elevated head position, initially sleeping upright for the first 48-72 hours, then gradually reclining to a 20-30 degree angle, and a 60-70 degree angle for watching television. This positioning facilitates fluid drainage. Robin utilized a pillow-wedge set to support her back and knees, finding it helpful, though she noted that sleeping on one’s back exclusively for an extended period, without the ability to rotate, was difficult. She reported that even when medically cleared to sleep on her side after a week or two, the residual numbness in her ears and face made it feel "super weird," and she avoided side sleeping for a full two months.
The Alternative to General Anesthesia
Modern plastic surgery frequently employs IV sedation combined with local anesthetic, bypassing the need for general anesthesia. This approach utilizes lidocaine and longer-acting agents to ensure the patient does not feel the procedure, while also incorporating a vasoconstrictive agent to minimize blood flow. This is crucial for operating on delicate facial structures and also leads to less post-operative grogginess and nausea compared to general anesthesia. Patients are often advised to take anti-nausea medication proactively, even if they do not feel queasy, as post-operative vomiting can be a significant complication. Robin adhered to this recommendation religiously for three days.
The Role of Significant Others in Recovery
While the intention of a significant other to provide care is commendable, their presence during the initial recovery phase can sometimes add undue stress. Whether they fully support the decision for cosmetic surgery or not, partners may struggle with the visual changes, become overly anxious, or exhibit smothering concern, none of which are conducive to a smooth recovery.
Pre-Surgery Health: Maintaining a Robust Weight
It is advisable to be at a stable, healthy weight before undergoing surgery. Attempting to lose significant weight immediately before surgery, either to maximize skin tightening results or in anticipation of reduced appetite, is generally not recommended. Many patients experience appetite suppression due to medications, increased sleep, and jaw tightness, leading to unintentional weight loss. Robin, already slim, lost approximately five pounds, underscoring the importance of ensuring adequate protein intake to support muscle mass and healing.
GLP-1 Medications and Surgical Guidelines
The use of GLP-1 medications, such as Ozempic and Wegovy, in the pre-surgical context is an evolving area. In 2023, the American Society of Anesthesiologists suggested discontinuing weekly injections one week prior to surgery due to concerns about delayed gastric emptying and aspiration risk. A 2024 multi-society update clarified that most patients can continue these medications with appropriate risk assessment. However, some surgeons still advise a hiatus of one to two weeks. Dr. Park emphasizes close coordination with anesthesiologists and individualized patient plans based on symptoms, dosage escalation, and procedure length.
The Ten-Year Horizon of Results
While the immediate results of a facelift can be dramatic, gravity and the natural aging process are relentless. Surgeons often describe facelifts as resetting the clock rather than stopping it. New research published in Facial Plastic Surgery & Aesthetic Medicine tracked revision facelifts and found that patients who underwent a deep-plane lift typically sought a second procedure after an average of 10.9 years. Those who had their primary surgery at or before age 53 waited an average of 12.4 years for a revision, compared to 9.3 years for older patients. This indicates that the longevity of results is influenced by factors such as age at the time of the initial procedure and ongoing aging processes.
For further insights into Robin Shobin’s facelift experience, her Substack, Charlotte’s Book, provides a comprehensive account.
