Pre-Operative Planning: Complete Checklist

A facelift is a transformative procedure that can rejuvenate your appearance and restore facial harmony. However, the success of a facelift does not depend only on the surgeon’s skill during surgery. Meticulous pre-operative planning is fundamental to optimize results, minimize risks, and ensure a positive experience.

This article offers a complete checklist to help you prepare properly for your facelift. We will cover everything from the initial consultation and necessary exams to skin care and precautions to be taken before the procedure.

1. Detailed Initial Consultation: The First Step to Success

The initial consultation is the foundation of the entire process. It is the moment to establish open and honest communication with the surgeon, discuss your expectations, and understand the possibilities and limitations of the procedure.

1.1. Choosing the Ideal Plastic Surgeon

Verify credentials: Ensure the surgeon is a member of the Brazilian Society of Plastic Surgery (SBCP) or other renowned international associations (ASPS, ISAPS).
Evaluate experience: Look for a surgeon with vast experience in facelifts and a portfolio of consistent and natural results.
Trust and empathy: Choose a surgeon you feel comfortable discussing your concerns with and who demonstrates genuine interest in your needs.

1.2. Exposing your Expectations and Goals

Communicate clearly: Explain in detail what you hope to achieve with the facelift.
Be realistic: Understand that a facelift can improve appearance but cannot stop the aging process or transform you into another person.
Photos as reference: Bring photos from when you were younger to show the surgeon the result you wish to achieve.

1.3. Evaluation of Your Facial Anatomy

Skin analysis: The surgeon will evaluate your skin’s elasticity, texture, and quality to determine the most suitable technique.
Bone structure: Analysis of your facial bone structure will help define the surgical plan and predict results.
Fat presence: Facial fat distribution will be evaluated to determine the need for fat grafting or other complementary techniques.

1.4. Complete Medical and Medication History

Inform everything: Be transparent about your medical history, including pre-existing diseases, allergies, and previous surgeries.
Medications: List all medications you use, including vitamins, supplements, and herbal remedies.
Habits: Inform about your smoking habits, alcohol consumption, and drug use.

1.5. Detailed Physical Examination

Blood pressure: Verification of blood pressure to identify possible cardiovascular risks.
Thyroid evaluation: Thyroid examination to rule out problems that may affect healing.
Neurological exam: Evaluation of facial nerves to identify possible pre-existing dysfunctions.

2. Indispensable Exams: Ensuring Procedure Safety

After the initial consultation, the surgeon will request a series of exams to assess your general health and identify possible contraindications for the facelift.

2.1. Blood Tests

Complete blood count: Evaluates blood cells and detects anemias or infections.
Coagulogram: Evaluates blood clotting capacity, essential to prevent excessive bleeding.
Glycemia: Measures blood sugar levels, important for diabetic patients.
Kidney and liver function: Evaluates kidney and liver function, organs responsible for metabolizing medications.

2.2. Cardiological Evaluation

Electrocardiogram (ECG): Evaluates heart’s electrical activity, identifying possible arrhythmias or other changes.
Surgical risk: In some cases, an opinion from a cardiologist may be necessary to assess surgical risk.

2.3. Imaging Exams (Optional)

Facial ultrasound: Allows evaluating muscle structure and presence of fibrosis resulting from previous aesthetic procedures, such as biostimulator application.
CT scan: In specific cases, may be requested to assess facial bone structure.

3. Essential Skin Care: Preparing the Ground for Surgery

The quality of your skin plays a fundamental role in the facelift result. Adopting a skin care routine before surgery can optimize healing and improve final appearance.

3.1. Avoid Excessive Sun Exposure

Daily sun protection: Use sunscreen with SPF 30 or higher daily, even on cloudy days.
Avoid tanning: Do not expose yourself to sun or tanning beds for at least 4 weeks before surgery.

3.2. Adequate Hydration

Drink water: Keep hydrated by drinking at least 2 liters of water per day.
Moisturizers: Use moisturizers recommended by your surgeon to keep skin soft and flexible.

3.3. Specific Products

Retinoids: In some cases, the surgeon may recommend using retinoids to improve skin quality.
Hyaluronic acid: Using products with hyaluronic acid can help hydrate skin and improve healing.

4. Discontinuation of Medications and Supplements: Minimizing Bleeding Risks

Some medications and supplements can increase the risk of bleeding during and after surgery. It is crucial to inform your surgeon about all products you use and follow their guidelines on discontinuing use.

4.1. Anticoagulants and Antiplatelet Agents

AAS (Aspirin): Stop use at least 14 days before surgery.
Warfarin: Adjust dose or replace with another anticoagulant under medical supervision.
Clopidogrel (Plavix): Stop use at least 7 days before surgery.

4.2. Non-Steroidal Anti-Inflammatory Drugs (NSAIDs)

Ibuprofen, naproxen, diclofenac: Stop use at least 7 days before surgery.

4.3. Supplements and Herbal Remedies

Ginkgo biloba, ginseng, garlic, vitamin E: Stop use at least 14 days before surgery.

5. Quit Smoking: Essential for Successful Healing

Smoking is one of healing’s biggest enemies. Nicotine and other substances present in cigarettes compromise blood circulation, increasing risk of complications such as skin necrosis and hypertrophic scars.

5.1. Total Smoking Cessation

30 days before: Stop smoking at least 30 days before surgery.
After surgery: Stay away from cigarettes for at least 30 days after procedure to ensure proper healing.

5.2. Alternatives to Deal with Withdrawal

Nicotine patches: Consult your doctor about using nicotine patches or gums to control withdrawal.
Psychological support: Seek psychological support to deal with anxiety and stress related to smoking cessation.

6. Nutrition and Hydration: Nutrition for Good Recovery

Balanced nutrition and adequate hydration are fundamental to provide your body with necessary nutrients for successful recovery.

6.1. Nutrient-Rich Diet

Proteins: Consume protein-rich foods (lean meats, eggs, legumes) to aid in tissue repair.
Vitamins and minerals: Include fruits, vegetables, and greens in your diet to ensure adequate intake of essential vitamins and minerals.
Anti-inflammatory foods: Prioritize foods with anti-inflammatory properties, such as fish rich in omega-3, red fruits, and olive oil.

6.2. Avoid Processed Foods

Ultra-processed: Reduce or avoid consumption of processed foods, rich in sugar, saturated fats, and sodium, which can harm healing.

6.3. Constant Hydration

Water: Drink at least 2 liters of water per day to keep skin hydrated and facilitate toxin elimination.

7. Expectation Alignment: Visualizing Desired Result

It is crucial to have realistic expectations about facelift results. The procedure can significantly improve your appearance but cannot perform miracles.

7.1. Open Discussion with Surgeon

Expectations: Communicate your expectations and listen attentively to surgeon’s explanations about what is achievable with facelift.
Photos: Analyze before and after photos of other patients to have a realistic idea of results.
Limitations: Understand procedure limitations and be prepared for possible touch-ups or complementary procedures.

7.2. Result Visualization

Simulation software: Use 3D simulation software to visualize facelift result on your own face.
Mirror: Observe yourself in mirror and identify areas that bother you most and that you would like to improve.

8. Practical Preparations: Facilitating your Recovery

In addition to health and skin care, it is important to organize some practical details to facilitate your recovery after facelift.

8.1. Arrange Help

Companion: Have a companion to take you home after surgery and to assist you in first days of recovery.
Domestic help: If possible, hire help to perform domestic tasks and take care of you.

8.2. Prepare your Home

Bed: Prepare a comfortable place to rest, with extra pillows to elevate head.
Food: Stock fridge with healthy and easy-to-prepare foods.
Medications: Organize medications prescribed by your surgeon and leave them in an easily accessible place.

8.3. Organize your Work and Commitments

Leave: Schedule a period of leave from work and social commitments to dedicate to recovery.
Communication: Notify family, friends, and coworkers about your surgery and need for rest.

Frequently Asked Questions (FAQ)

1. What is the importance of pre-operative planning for a facelift?

Pre-operative planning is crucial to personalize the procedure, minimize risks, and optimize results, ensuring that the patient’s expectations are aligned with surgical possibilities.

2. What exams are indispensable before a facelift?

Blood tests (complete blood count, coagulogram), cardiological evaluation, and in some cases, imaging exams (facial ultrasound) are essential to assess the patient’s general health and identify possible contraindications.

3. How long before surgery should I stop using anticoagulant medications?

The use of anticoagulants should be stopped at least 14 days before surgery, under medical guidance, to minimize the risk of bleeding.

4. What skin care should I have before a facelift?

Avoid excessive sun exposure, hydrate the skin, and use products recommended by the surgeon to optimize skin quality and facilitate healing.

5. Is it necessary to stop smoking before a facelift? How long before?

Yes, it is fundamental to stop smoking at least 30 days before surgery, as cigarettes compromise blood circulation and healing.

6. What are the main risks and complications of a facelift?

Hematoma, infection, sensitivity changes, nerve injury (rare), skin necrosis, and hypertrophic scars are possible complications. Adequate planning helps minimize these risks.

7. How to align my expectations with possible facelift results?

Discuss openly your expectations with the surgeon, analyze before and after photos of other patients, and understand the procedure’s limitations are important steps for realistic alignment.

What to Expect: Recovery Timeline

Recovery is a journey requiring patience and specific care in each phase. Knowing what to expect helps reduce anxiety and optimize results.

First 24-48 Hours

This is the most delicate period. It is normal to present:

Moderate to intense edema: swelling is maximum in this period
Ecchymosis: purple spots may appear and are natural part of healing
Controllable discomfort: pain is generally mild to moderate, controlled with prescribed painkillers
Need for absolute rest: avoid sudden movements and keep head elevated

First Week (Days 3-7)

From third day, you will start noticing progressive improvements:

Edema begins to decrease gradually
Ecchymosis change color (purple → green → yellow)
Stitches and dressings may be removed as per medical guidance
Light activities can be resumed with caution

Weeks 2-4

Important transition phase:

Gradual return to social and professional activities
Residual edema still present, but less noticeable
Result begins to define, although not yet definitive
Lymphatic drainage massages may be indicated

Months 1-3

Final result consolidates progressively:

Tissues settle into their definitive position
Scars mature and become less visible
Sensitivity returns gradually to normal
Final result visible between 3-6 months

“Patience is fundamental. Final result of a facial procedure can only be evaluated after 6 months, when all tissues have stabilized.” — Dr. Robério Brandão

Essential Questions in Consultation

A well-utilized consultation is fundamental for procedure success. Prepare yourself with right questions.

About Surgeon’s Experience

“How many procedures similar to my case have you performed?” — Case volume is experience indicator
“Can I see before and after photos of patients with characteristics similar to mine?” — Real results are best reference
“What is your specific training in facial surgery?” — Specialization makes difference in results

About Proposed Technique

“Why do you recommend this specific technique for my case?” — Understand clinical reasoning
“What are the alternatives and why is this best option?” — Compare approaches
“Where will scars be and how do they evolve over time?” — Realistic expectations

About Risks and Recovery

“What are most common risks and how are they managed?” — Transparency is essential
“How long will I be away from normal activities?” — Adequate planning
“What type of anesthesia will be used?” — Anesthetic safety
“What is post-operative follow-up protocol?” — Continuous support

Signs of Good Surgeon

Answers your doubts clearly and patiently
Shows real results from previous cases
Discusses risks transparently
Does not promise unrealistic results
Has adequate team and structure

Post-Operative Warning Signs

Knowing warning signs allows early identification of any complication and quick action.

When to Seek Surgeon Immediately

Some signs require urgent medical evaluation:

Active bleeding that does not cease with light compression for 10-15 minutes
Fever above 38°C, especially if accompanied by chills
Intense and sudden pain not controlled with prescribed medication
Abrupt asymmetry — much larger swelling on one side may indicate hematoma
Skin color change — paleness or darkening in specific areas
Purulent discharge with unpleasant odor

Normal Signs (Do Not Worry)

These symptoms are expected and do not require concern:

Moderate edema in first days, especially in morning
Ecchymosis (purple spots) that change color progressively
Temporary tingling or numbness in operated area
Pulling sensation as tissues heal
Small temporary asymmetries due to irregular edema
Difficulty smiling or moving face in first days

Safety Protocol

In case of doubt, follow this protocol:

Document — take photos and note symptoms
Contact — call surgeon’s team
Do not self-medicate — avoid non-prescribed medications
Keep calm — most complications are manageable

“In Modern Face, each patient receives a direct communication channel for emergencies. Safety is not luxury, is priority.” — Dr. Robério Brandão

Conclusion

A complete pre-operative planning is an investment in your safety and success of your facelift. By following this checklist, you will be prepared to make informed decisions, minimize risks, and optimize your results.

⚠️ Disclaimer

This content is educational and represents author’s technical opinion based on documented clinical experience. Surgical decisions must be individualized.

Author: Dr. Robério Brandão, CRM-CE 8596 Last update: January 2026