How to go from 50+ to looking 20+ with plastic surgery rejuvenation.

[weewee]

Here is a stark reminder from 2018/2019 that ANY FACIAL procedure that causes profound SWELLING may then deswell and cause profound SAGGING. If you want longevity, you must have zero swelling postop and that can only be achieved with postop prednisolone (UK)/prednisone(US).

I learned the hard way with a record 5 full face fat grafts causing profound swelling then sagging and one VR facelift that caused profound swelling then sagging. After 6 bouts of swelling, 6 fab faces, then several months of deswelling, sagging face misery and depression, I finally worked out how vital it is to only get facial fat graft or facelift with steroids. The surgeons won't tell you as they may want your repeat business for endless fat grafts or revision facelifts.

I took 4 days of 20 mg of pred after my 2nd facelift in 2022, never swelled and the lift has held for over 2 years now. Don't figure it out after 3 or 4 facelifts. Be smart. No steroids= no facelift. Swelling=sagging.

Manchester Star Clinic, Dr Marando's office is now saying he does not prescribe steroids as it interferes with healing. Check directly with Dr Marando at consult as he did prescribe for a friend and she looked great at 8 months. Turkey's Dr Mehmet Comert told a British man at consult he does not prescribe steroids as it hampers healing but will if swelling doesn't subside.

Why is it forcing ladies to fly to the US and pay $50,000-$120,000 to Karam, Nayak or Jacono to get pred after a facelift as they do prescribe pred and understand the importance of minimising swelling? Jacono is dual board certified in plastic surgery and ENT/head and neck. In ENT (ears, nose and throat surgery) steroids are often prescribed so he has familiarity with steroids.

Alternately fly to Canada and see Dr Cory Torgerson. He prescribed 40 mg pred for 2 weeks for a recent smas FL patient and charged $15k with tax or £8782 so is affordably priced, does smas and gives steroids postop!

Patients can't be expected to buy pred themselves from Indiamart online as they won't be confident in dosage. It is such a crying shame and a big injustice in plastic surgery forcing many ladies into their 2nd revisions or even 4th revisions like Katie Price, all the while making predominantly male plastic surgeons super rich doing primary and revision deep plane facelifts. No postop steroids= potential repeat customer or pay another surgeon for a facelift too and the cycle continues. Break the cycle. Have only one VR facelift ever in your life with one week of postop pred. The challenge is obtaining pred externally from a private doctor or online.

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I had called few DR in states and they don't prescribe any med. You mention Indiamart, they need to buy a quantity. Any other place? Thank you for all those info.

Btw, you only took 4 days of 20mg? postop? No preop? And you mention the dr in Canada prescribed 40mg for 2 weeks. Thx

 

[MissOrange]

Thanks so much Miss Orange. So we have to source our own steroids? I don't understand why surgeons say it interferes with healing? This is frustrating! I'm also confused why so many surgeons say fillers are evil...

Hi @6098Sophia, see how unjust it is. In the UK Dr Dominic Bray prescribes postop steroids for his £70,000 deep plane face and neck lift but starting at 20 mg and tapers down so this is far too small a dose for the enormous tissue disruption and swelling that comes with invasive deep plane. Does that mean the top US, Canadian and UK surgeons who do prescribe are smarter? Prednisolone on a private or NHS prescription is only £9! Indiamart sells for £28. It would be much safer if private GPs and surgeons would give the option to their patients as to whether they wanted to try pred for postop swelling for a week. What ever happened to shared patient management? Who wants to wait until the neck swelling interferes with breathing and one needs emergency IV pred?

How can it interfere with healing when given for only one week? If someone has an autoimmune condition like rheumatoid arthritis and takes it daily, then yes chronic use more than 6 weeks may slow down healing but not 1-2 weeks and at doses 40 mg or less. I feel like they were not the top in their medical school to not know this.

Radiesse fillers are fine in my opinion and lasted 6-9 months. It kept me looking good in my 40s. Lip fillers never lasted more than 1-2 months though. Botox only lasted 6 weeks.

 

[MissOrange]

I had called few DR in states and they don't prescribe any med. You mention Indiamart, they need to buy a quantity. Any other place? Thank you for all those info.

Btw, you only took 4 days of 20mg? postop? No preop? And you mention the dr in Canada prescribed 40mg for 2 weeks. Thx

Hi @weewee, they do exist in the states. You have to keep searching for a surgeon who does prescribe postop with their facelifts and does not charge $50,000+. I am not aware of any other online site.

I took for 4 days postop from days 2-6 as I was trialling my leftover steroids I had prescribed to me by my NHS GP for an allergic rash to the AZD vaccine. As I had previously taken it for the rash, which btw instantly disappeared with 1 day of prednisolone, I knew it was fine for me as I had no side effects and had 4 days leftover. I only chanced upon this finding when a patient of Nick’s who has an autoimmune condition and takes daily pred had zero swelling and was in full makeup on day 4 having healed super fast! I was stunned and soon realised her secret. As this was my revision I did not want to risk it swelling then sagging in months to come. It was the most amazing discovery and I firmly believe explains why my facelift looks the same right after my revision and 2Y 1M after.

 

[weewee]

Hi @weewee, they do exist in the states. You have to keep searching for a surgeon who does prescribe postop with their facelifts and does not charge $50,000+. I am not aware of any other online site.

I took for 4 days postop from days 2-6 as I was trialling my leftover steroids I had prescribed to me by my NHS GP for an allergic rash to the AZD vaccine. As I had previously taken it for the rash, which btw instantly disappeared with 1 day of prednisolone, I knew it was fine for me as I had no side effects and had 4 days leftover. I only chanced upon this finding when a patient of Nick’s who has an autoimmune condition and takes daily pred had zero swelling and was in full makeup on day 4 having healed super fast! I was stunned and soon realised her secret. As this was my revision I did not want to risk it swelling then sagging in months to come. It was the most amazing discovery and I firmly believe explains why my facelift looks the same right after my revision and 2Y 1M after.

Thank you MissOrange. I called more in the East Coast Dr and none prescribed. Maybe over the price of 50k$. I might try to ask my family dr but then need some reason. Should I get 20 or 40mg? Yes Indiamart cost more then local but also they charged a lot for shipping, more then the med. Do you need to take it when doing Lipo? Just curious.

 

[MissOrange]

Thank you MissOrange. I called more in the East Coast Dr and none prescribed. Maybe over the price of 50k$. I might try to ask my family dr but then need some reason. Should I get 20 or 40mg? Yes Indiamart cost more then local but also they charged a lot for shipping, more then the med. Do you need to take it when doing Lipo? Just curious.

Hi @weewee, try UWH (confirmed gives postop steroids methyprednisolone for 5 days), Dr Danny Soares in Florida (also gives postop steroids), Dr Plovier in Brussels (gives steroids), surgeon in Scottsdale Arizona gives steroids, Jacono gives 2 rounds of steroids, Dr Karam gives IV dexamethasone intraop steroid, etc. Looks like a tapering dose of 24 mg (21 pills of 4 mg) of methylprednisolone is common in the US.

 

[weewee]

Yes, in here called Medrol something. Let me check out. Thank you so much for all the information.

May I ask where's UWH? Also checked Dr Danny, it's over 20K.

 

[MissOrange]

Yes, in here called Medrol something. Let me check out. Thank you so much for all the information.

May I ask where's UWH? Also checked Dr Danny, it's over 20K.

Yes a medrol pack is methylpred usually given postop. UWH is univ of wisconsin hospital.

 

[Intrata]

It seems some Korean clinics will give de-swelling shots, which may be steroids.

And would you do the steroid pills for Lipo @MissOrange?

 

[MissOrange]

It seems some Korean clinics will give de-swelling shots, which may be steroids.

And would you do the steroid pills for Lipo @MissOrange?

Hi @mingaling99, no I did not need steroid pills for lipo. Instead I wore tight compression day and night for months which worked just fine as I wanted the skin to adhere.

 

[MissOrange]

A friend has alerted me to a comment a TPFer has made on one of Dr Mehmet Comert’s ladies IG that I recommended him and he will soon be a patient of Dr Comert. Can I repeat myself and say I emphatically do NOT recommend Mehmet Comert and even advised this much younger TPfer that he might die in Turkey as he has many medical comorbidities that would put him at high risk if he were to undertake a major elective operation with multiple procedures and would be better finding a hospital with an ICU. I do NOT recommend a Turkish surgeon whose British patient experienced anaesthesia induced psychosis requiring anti-psychotic drugs. Deep plane face and necklifts may leave a lot of dead space where haematomas may develop. Flying home with a haematoma may mean the NHS needs to drain. Another reason against the deep plane technique.

It makes me wonder if British patients refused surgery by sensible UK surgeons may now be turning to Turkey as they are more likely to perform aggressive deep plane face and neck lifts in patients in their 30s or upsell operations they may not require? After all a medical tourist then flies back to the NHS if anything goes wrong.

I have now seen the progression of one 66 year old British lady at 7, 8 and 12 months post her deep plane with Comert and her last comparison shows little to no change with her before. All her fat graft disappeared along with the swelling and lift to leave her with a face that only looks different as it has makeup on at 1 year vs the before. She also describes not being able to sleep for 2 months due to the swelling and tightness. Please do not be seduced by low prices. He does not prescribe oral steroids and only reserves steroids for emergency IV administration.

Chris West charges £12,495 for deep plane face and necklift which is the cheapest in the UK and operates out of Coppergate in York or Spire in Leeds, but remember a VR smas facelift is cheaper and better at £5495 as it is a superficial and not invasive procedure. I saw a beautiful VR result in a 51 yo at 1 year so can highly recommend Chris for VR but again source postop prednisolone or ask if he prescribes as rumour has it half the surgeons at Coppergate are for postop steroids and half against.

 

[Intrata]

Do you know for what reasons half the surgeons are against post-op steroids? Do they think there is some adverse effect?

 

[MissOrange]

Do you know for what reasons half the surgeons are against post-op steroids? Do they think there is some adverse effect?

The half against keep saying it may slow healing, ie physiological reasons. For me, it is the opposite. Without inflammation and swelling, I heal faster. It is a big debate in the US with half the surgeons giving medrol packs postop and half giving nothing.

 

[MissOrange]

Here are 3 facelift surgeons who advocate use of postop steroids after a facelift.

 

[MissOrange]

Medrol or methylpred is stronger than prednisolone/prednisone so 4 mg of medrol = 5 mg of pred.

The medrol pack starts with 24 mg for the first day which is the equivalent of 30 mg of pred.
The second day is 20 mg of medrol = 25 mg of pred, etc. Although tapering is normally only necessary if you take steroids for more than a few weeks but I guess the pack dosing is being extra cautious.

 

[MissOrange]

The debate should be when to start steroids, the day before, the morning of or right after surgery. Here I am moments after my 2 hour first VR facelift in 2021. Swelling has not started but will. Before it swells you can see your final results had you had no swelling. Pred takes 1-2 hours to kick in. For my first VR I had no pred as I had no knowledge. So based on swelling starting in the 3rd hour after surgical trauma, perhaps start right after the op? Again speak to your surgeon and let him know if you are taking postop steroids. If the surgery is prolonged, swelling may start during surgery and make it difficult for the surgeon to approximate tissue and skin in a swollen field. This means the skin closure won’t be as tight had there been no swelling as he will have to leave extra cms of skin to be able to close the swollen face. The extra cms of skin may end up as loose skin after you deswell. An argument could be made to start steroids before prolonged surgery or receive iv steroids during prolonged facial surgery. Which is probably why Dr Donald Wortham recommends starting the medrol pack prior to facelift surgery and Dr George Toledo MD gives IV decadron during facelift surgery followed by a medrol pack after.

When I see a facelift lady with a swollen alien face after facelift surgery, I can predict there is a strong possibility the face may sag after it fully deswells within the first year as swelling stretches the skin of the face.