Understanding what actually happens during facial plastic surgery recovery is one of the most overlooked parts of the process. Dr. Jonathan Zelken shares an honest, patient-informed look at the real plastic surgery healing process, details that go well beyond simple swelling.

We often talk about the benefits of one type of facelift versus another, or one type of facial implant versus another, but almost nobody dwells on or educates patients about the aftermath of either facelift or facial implant surgery. A valued patient of mine, who had surgery with me a week or two ago, asked me as a favor to make a video about the post-operative experience. I asked him to be the presenter, but he felt a little shy about sharing his picture, so instead he gave me some pearls to pass along to a general audience about what it's actually like to undergo both a facelift and facial implant surgery.

Meet Patient X

We'll call him Patient X. He had jaw implant surgery using custom PEEK implants, along with shaving down of a previous genioplasty. In the past, other doctors had moved his chin forward by cutting and plating it in a forward position, but this was done slightly off to the right side, giving his chin a noticeable rightward cant. This time, Patient X consented to fat grafting, a facelift, custom facial implants, and a genioplasty revision to recut that bone.

At two weeks out from roughly 10 hours of surgery, he looks and feels great, with no real issues at this point. But there were a few things that surprised him, and that I learned from talking with him, that I want to share with you.

1. The Feeling of Food Stuck in Your Mouth

The first thing he told me is that it always feels like there's something in his mouth that needs to be cleared. When he woke up from surgery, Patient X had a numb tongue tip and a lot of heaviness in his lower face. He described feeling like there was food underneath his lip, in what's called the gingivobuccal sulcus, as well as in the back of his mouth. In fact, when I saw him on post-operative day one, I actually did see small bits of food there, because with the numbness, he couldn't always tell whether it was food or suture material.

That area can also be temporarily numb, which adds to the sensation of not being able to clear your mouth. If you have stitches placed there, I typically use ones that dissolve over four to six weeks, the same type I use in buccal fat pad surgery, and the tail ends of those stitches can stick up a bit, almost like blades of grass. You can imagine feeling that with your tongue and mistaking it for food, which can understandably get annoying. If it becomes a real nuisance after two or three weeks, we can trim the stitches shorter or remove them altogether; they're designed to dissolve on their own, but we're happy to help sooner if needed.

2. Heaviness and Swelling That Can Feel Alarming

The other thing he noticed was heaviness in the back of his jaw angles. We always talk about swelling playing tricks on you because when you look in the mirror, your face looks a lot more swollen than what the implants are actually contributing. You come in expecting a certain result, and suddenly your face looks twice as big as you expected. That can be a little troubling for patients, and I've seen it happen even in my own practice. But if you trust the process and give it time, even a month or two makes a significant difference, and by six months it will have gone down considerably. Along with that swollen appearance comes an actual sensation of heaviness, not just a visual change.

3. Less Pain Than Expected — With One Exception

Aside from that, the pain he experienced was less than most people would expect. He has a history of orthognathic surgery himself, so he had something to compare it to, and he said this really wasn't a painful operation. His mouth was swollen and he spoke a little differently, but the pain itself wasn't bad. He also had a facelift done at the same time as the jaw reshaping, and the facelift portion was relatively painless on its own. I think when you combine jaw or orthognathic-style surgery with facial surgery, your brain gets a little confused about what's actually causing the discomfort you're feeling, and where.

The one area that was uncomfortable was where his neck skin had been suspended and tightened; most of my facelift patients describe a similar sensation, especially when extending the neck, like when he took a pillow out from under his head at night. Even so, by two weeks he wasn't taking any narcotic pain medication at all, and he was already comfortable after just one week despite roughly 10 hours of fairly extensive facial plastic surgery.

The Bottom Line

In the end, Patient X gave me a few genuine surprises to pass along about facial plastic surgery recovery:

  • Jaw implant surgery isn't nearly as uncomfortable as you might expect.
  • It can feel heavy and full afterward, and that fullness can temporarily affect your speech.
  • Perhaps most surprisingly, you may feel the stitches inside your mouth, and it can genuinely feel like food stuck in certain places, which can be a bit of a nuisance.

If you've had a similar experience, or have more to add to the list of expected and unexpected post-operative outcomes, share it in the comments below, I'd be glad to explore this topic further in future videos. In the meantime, thank you to Patient X for asking me to make this video about an important and underreported topic.

Schedule a consultation at Dr. Zelken's Newport Beach office to learn more about what to expect during facial plastic surgery recovery and the plastic surgery healing process.