Cosmetic surgery is really four-dimensional surgery. Your face is three-dimensional and we alter these dimensions for you at surgery. But, unlike sculpting in stone or wood, there is a fourth dimension — the passage of time. You keep looking better as the months go by.

Healing — the three "phases" of Eve

At the end of the operation, your face is new and the stitches and "cosmetic clips" hold everything in place for healing to begin. Nature's healing glue is called scar tissue. And, like all glue, the "drying process" passes through phases.

Phase one, the earliest phase of healing, lasts about a week. We call it the "Wet Elmer's glue" phase. It's strong enough to hold you together but it won't take any abuse. We remove the sutures and clips at the end of this time.

Phase two, the gnarly phase, varies a lot and we can't predict how long it will last, but around three months. It has been called the "dried-library-paste-at-the-bottom-of-the-jar-when-you-were-in-second-grade" phase. You feel hard and tight and the scars are red. It is inevitable and a nuisance you must abide… but it's temporary.

Phase three, ("Finally!") we call the "spider web" phase. The swelling is gone, the scars have faded to white lines, your face is no longer tender and the scar, like a spider's web, is very strong.

When am I done?

With that as background, let's get practical and talk about some markers.

Marker #1. Day One after surgery - you come back to our office. Bandages off. Home to take a shower and wash your hair. Bruised and swollen but little if any, pain.

Marker #2. Two weeks. After a face lift, say, you look healed enough to be among strangers… with good make-up.

Marker #3. Three weeks. You look okay to be out among friends, again with good make-up. A perceptive person might ask if your face is a little swollen. Usually, though, your friends'; comments are positive. "Wow, you look great. Did your lose weight?" or "New hairdo?"

Marker #4. Four months. About now, perhaps sooner, your face begins to feel normal. You're in phase three of healing, the "spiderweb" phase.

How long will it last?

Now she looked ten years younger… and prettier. "how long before I look that old again?" Hard question because the answer depends on so much - such as when your next growth spurt will occur, what type of aging your face has, how old you looked when you first came in and which procedures we performed. As a rule of thumb, six to eight years. Often longer. Some improvements, like a more attractive nose, cheekbone implants or a chin augmentation are permanent.

Will I need a touch-up?

A surgical touchup is useful for about one of seven patients.

It is an adjustment which either wasn't done or couldn't be done at the time of the original surgery. It is usually covered as part of the original fee.

Can I keep up with the aging process?

We can help you try to keep up with the aging process. Cosmetic surgery can't really keep up with it because age brings some skin and padding changes we don't know how to fix yet. Yet, from time to time, we can perform certain procedures which can turn the clock back once again. While it might mean you have another face lift, more often we can accomplish a lot with smaller procedures.

One of the best of these is a new procedure we have developed. We call it the "brightening lift". It tightens the skin of the temple, lifts any drooping of the corner of the eyebrow and even lifts the cheek a little more. The recovery time is almost nothing. You comb your hair over the little dressing and you can be off to the movies an hour later. Best of all, there is hardly any scar to show for it.

Harvey W. Austin, MD
Box 1470
Berlin MD 21811
email: h.austin@mchsi.com