Over the last few years, four friends have asked me to escort them home after a surgical procedure. My designated-adult resume includes two colonoscopies, one blepharoplasty, and one IVF egg retrieval. I take pride in this role. It must mean I’m a responsible, dependable person. Or that I have too much free time.

Regardless, it’s always been a simple favor, typically just requiring me to pick up the friend at the doctor’s office, order an Uber, and make sure they get into their apartment safely. Thanks to Capsule’s delivery service in my hometown of New York City, I’m not even on the hook to do a pharmacy run.

But recently, I volunteered to help one of my closest friends, Robin, recover from a deep-plane face and neck lift, which meant being by her side for an entire week. It also meant flying down to Palm Beach, Florida from New York City (on her dime) since that’s where her chosen physician, facial plastic surgeon Mark R. Murphy, MD, practices.

My nerves are pretty steely, but I was anxious about seeing Robin in the immediate aftermath of this major surgery. Would it be gross? Disturbing? Would she be in agony? I remember the Italian mother of a high school classmate of mine referring to the “sympathy pains” she could feel when one of her kids was sick or hurt. She wasn’t being melodramatic. According to an article in Nature Reviews Psychology, seeing others in pain often recruits the same brain systems as feeling pain ourselves, and can be distressing, especially for highly empathetic people.

Lucky for Robin, my allegiance to her as a friend and my curiosity trumped my fear—and my empathy. I wanted to be there for her, of course, but I also wondered how witnessing her recovery at such close range would impact my own temptation (one way or the other) to eventually go under the knife. On that front, I’ve long been in the “maybe someday” camp—I’m just not there yet. And at 55, I’m eight years older than Robin.

In the days leading up to the surgery, I burrowed into an Instagram rabbit hole of facelift journeys. There are plenty to choose from, but like all things on social media, I couldn’t be sure how much of what I was watching was real. Once the algorithm kicked in, I was served an infinite scroll of videos from women who’d had facelifts all over the world, from Beverly Hills to Istanbul.

I also joined an Instagram Broadcast Channel called The Aesthetic Authority created by actor-DJ-trainer Emily Wagner, who’d had a lineup of procedures—it’s never just a facelift, I discovered—similar to the one Robin had planned. She was chronicling every step of her recovery and what I saw wigged me out a little—specifically, the facial swelling. I wasn’t alone. Emily, who approached the healing process like she was hosting a comedy roast of her own face, told me one of her friends temporarily muted her on social media to avoid seeing the no-holds-barred reveal unfurl.

Nevertheless, I remained committed to my caretaking duties and was shocked by how many surprises were still in store after all of my research. Here are the 10 no one tells you (or certainly didn’t tell me).

1. You Need to Budget Beyond the Base Cost—the Extras Add Up.

Facelift price tags range wildly. Steven Levine, MD, the New York City surgeon who performed perhaps the most famous facelift in history last year (yes, Kris Jenner’s) is now reportedly commanding $400,000. That number also happens to be the median cost of buying a home in America. More—way more—realistically, an experienced, sought-after plastic surgeon in the US will charge $40-50,000 for a facelift (including anesthesia and OR fees, but without common add-on procedures, such as a brow lift, lip lift, blepharoplasty, and fat transfer). If you travel to a cosmetic tourism destination, such as South Korea or Turkey, you can expect to pay more like $20-35,000 for a facelift—but the price savings comes with a whole other set of considerations and risk management.

And even if you don’t hop on an international flight, there are many ancillary costs to factor in. Before she ever got near an OR, my very thorough friend did 13 consultations with doctors in New York, Florida, Texas and Los Angeles, plus Zoom consultations with surgeons in South Korea and Turkey. And while that’s excessive, Julie, another woman I know in her late 40s who recently had a facelift, did four. At $250 to $1,000 a pop, those meetings can add up fast. (The fee gets applied to the surgery, if you decide to move forward).

Ultimately, Robin chose Dr. Murphy based on a constellation of factors: his natural aesthetic, his 25 years of experience, his bedside manner (a big one), his pricing, and his recovery plan. "I met with a wide range of surgeons, including some of the now-famous ones such as Dr. Ben Talei [Denise Richards’ plastic surgeon] and Dr. Steven Levine, who charge top dollar,” says Robin, who writes the no-BS, all-transparency beauty Substack Charlotte’s Book. “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-surgery, all reputable surgeons require you to have a nurse for a minimum of 18-24 hours (at $100-$200 per hour) to ensure that you're safe, comfortable, taking crucial medication, and doing the proper icing. For Dr. Murphy’s patients, that means 20 minutes on, 20 minutes off for the first 18 hours using a full ice mask (smaller ice packs are used for more targeted areas, if needed). On day two, the icing schedule is 20 minutes on, 40 minutes off during waking hours and by day three, icing can typically be stopped.

Unless you live around the corner from the surgical suite or hospital, you’ll probably be spending a couple of nights in a nearby hotel. Robin checked into hers the day before her surgery. She originally booked the room for three nights and her nurse for 39 hours, but ended up adding an additional night for a grand total cost of $6,400. (I subbed in for 12 hours before the third post-surgery sleepover, while her nurse was at work.) “I was a very scared patient, so I wanted the first 48 hours of aftercare to be meticulous,” says Robin, who tacked on the extra night because she didn’t feel quite ready to move locations. “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.”

Recovery add-ons can ratchet things up, too, depending on how zealous you are. Robin took a super minimalistic approach and focused purely on getting as much rest as she could and, she says, “not effing anything up.” Emily sprung for 10 hyperbaric oxygen therapy sessions, which she did every other day following her surgery. At $2,500 for the package, that added some serious coin to the tab—but, Emily told me, “I believe it sped up my healing.”

But all the recovery bells and whistles—many not exactly proven—don’t necessarily mean better results. “Social media makes recovery look like a checklist of biohacks, but my philosophy is less is more, especially in the first two weeks,” says New York facial plastic surgeon Eunice Park, MD. “The priority is protecting incisions, minimizing inflammation, and allowing tissues to re-establish blood supply.”

While you can find some small studies that show faster healing with hyperbaric oxygen therapy, both Dr. Murphy and Dr. Park only consider it on a case-by-case basis— for example, when incisions are not healing properly—not as a blanket recommendation. It is still a medical treatment with risks, such as ear or sinus trauma caused by pressure changes, oxygen toxicity that can provoke seizures (rare, but documented), temporary vision changes and exposure to infection; Remember, people go hyperbaric chambers to heal all kinds of wounds. One thing they do often recommend is carefully timed lymphatic massage, done at their offices, to help with swelling. We’re not talking about full-on lymphatic drainage facials— just some gentle manipulation done by the surgeon themselves to get things moving.

2. You Will Probably Freak Out—Before and After.

Plastic surgeons may as well be board-certified in psychiatry because they have to play shrink alongside surgeon. “The emotional roller coaster is real—and honestly, it’s more than half the battle for many patients,” says Dr. Murphy, who cites misleading information patients find online as one common fear-heightening factor. “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.”

By her own admission, Robin is an anxious over-analyzer so she was happy I bunked with her well beyond the advised minimum of 72 hours post-surgery. My job was grocery shopping, tracking meds (an oral steroid and antibiotic, plus pain and anti-anxiety prescriptions), applying ointment to her sutures once a day, and bringing her to her first five post-op appointments (driving week one is a no-no.) But I also provided some much-needed reality checks, like when she began obsessing over looking like an alien, her head shaped like an inverted pear. This was around day five or six when her upper face swelling wasn’t going down at the same rate as her lower face. I assured her that it would even out (it did) and that she already looked amazing, like a bouncy-faced 30-something-year-old (she did).

"It was so helpful to have a friend to distract me—we chatted a lot and watched a ton of Schitt’s Creek,” says Robin. “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.” Anecdotally, I’ve heard younger patients (in their 40s) tend to melt down emotionally more than older ones (in their 50s, 60s and beyond), the theory being that they’re more apt to question whether they really should have had an elective surgery. Older patients are more fed up with their faces, and have usually been thinking about this for a long time. Their attitude: LFG!

3. It Gets Worse Before It Gets Better.

Facial edema (aka swelling) peaks around day three. You wake up the morning after surgery looking decent, all things considered. Then things get worse. The next day you’ll be very puffy and swollen. Then, after about three days, the blood vessels that had become more permeable immediately after surgery to bring healing fluids to the face tighten back up again. After that, the body’s lymphatic system gradually begins to drain the extra fluid, helping the swelling to go down.

When I first saw Robin, 48 hours after her surgery, she wasn’t as bloodied and bruised as I thought she’d be, but her face looked very full, taut and shiny, like a Cabbage Patch doll who’d done her skin slugging routine with Vaseline. After 72 hours, the swelling abated a little more each day (though not always uniformly), and the mild bruising began turning yellow, fading away entirely by day seven or eight.

4. Dignity Goes Out the Door for a Few Days

Robin reported that the first two nights, her nurse had to help her to the bathroom, pull down her sweats and underwear for her… and flush the toilet. Not mad I missed that part. She also helped her shower for the first time, carefully washing her hair to avoid the incisions and combing out the matted knots. Robin was able to feed herself (mostly pudding, yogurt, and vegan protein shakes) with one of those smooth, silicone-coated baby spoons because she couldn’t open her mouth very wide. (And straws are another post-op no-no.)

Another fair warning: There can be bouts of constipation from the pain medication or diarrhea—the form of intestinal distress Robin experienced—if you’re taking an antibiotic. “I have a sensitive stomach so for a few days, my gut was pretty destroyed from the antibiotics,” she says.

5. There Is a Frankenstein Phase.

Jacob Elordi may have made visible mending look cute on the big screen. In real life, not so much. A deep-plane face and neck lift (they almost always happen in tandem) requires cutting from about temple height all the way down, around and into the ears and further down the hairline toward the base of the neck. And where there are incisions, there are sutures—approximately 400 of them in Robin’s case. The temporal brow lift (which is commonly coupled with a facelift) meant Robin also had about 30 staples in her scalp.

It’s very weird seeing your friend’s face pieced together like that, especially when she hasn’t gone through the windshield of a car. This was, after all, a choice, and there were definitely a few moments when I thought, Why subject yourself to this? The suturing and staples were the most gruesome part for me, because I could really "see" how intense that surgery was—it almost looked like a face transplant. (Many facelift patients have drains or surgical nets post-surgery to minimize the risk of fluid pooling under the skin, but Dr. Murphy only uses sutures and staples.)

Robin refused to look. Though she was allowed to put her contacts in on day three, she waited until day six to give herself sight back. Then, for a few more days, she continued to shield her eyes Clydesdale-style every time she passed a mirror. This is not uncommon. Robin’s nurse said some people who recoup at home tape cardboard over all their mirrors before leaving the house for surgery.

6. It Doesn’t Actually Hurt.

It’s hard to believe, but Robin (and other women I’ve spoken to) said the recovery isn’t painful. Dr. Murphy backs this up: “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,” he explains. The pain-free recovery is also thanks to temporary numbness. “When we elevate the skin, the small sensory nerves are stretched, so patients can’t feel much in the areas we operate on—especially around the cheeks, ears, and neck,” says Dr. Murphy. “Most patients describe tightness and pressure, not true pain. I know that sounds like semantics, but the most common complaint by far is tightness in the neck.”

Robin said it felt like she was wearing an extremely tight chin strap. The numbness on the sides of the face, ears and sometimes the scalp, can make washing your face or hair feel like you’re doing it to someone else. Nerves regenerate slowly, at about a millimeter a day, so regaining feeling can take weeks to months as they heal and reconnect.

Of course pain tolerance (and patience) are highly individual. Many patients use an opioid medication, such as oxycodone, to deal with the discomfort, though some are fine with just extra-strength Tylenol. In addition, a sedative such as diazepam (Valium) is often prescribed to reduce anxiety. Robin unabashedly opted for the full spectrum of pharmaceutical support—taking the entire seven-day script of oxycodone and one refill of Valium (for a total of two weeks) to ease her anxiety and make her comfortable enough to sleep.

7. You Can’t Color Your Hair (or Exercise) for Six Weeks Post-Op.

You might want to add root-concealing powder and headscarves to your pre-surgery cart because you’ll have to wait six weeks before you touch that gray regrowth. “Hair dye is a chemical, and the hair acts like a sieve,” explains Dr. Murphy. “If you have incisions near hair-bearing areas, which we often do to hide scars in the hairline, the dye could theoretically get into the wound and ‘tattoo’ the scar. Instead of a fine white line, you might have a fine colored line.” (Dr. Murphy also advises patients to stop coloring their hair two weeks pre-op.)

While light walking is recommended after the first week or so, you’ll need to press pause on other workouts: The increased blood pressure and physical exertion can trigger swelling, bleeding, and risk tearing a platysmal band. Dr. Murphy told Robin she couldn’t do anything strenuous for at least six weeks. And yogis should wait several more before doing headstands or any inversions—too much neck strain.

8. The Body Has Mind-Blowing Healing Powers.

As a health journalist, I’m aware that the body is always trying to return to homeostasis. Seeing it happen so rapidly after a seven-hour surgery is wild. Day by day, Robin’s swelling subsided, the bruises (of which she had surprisingly few) vanished, and in less than a week, all of her staples came out and her sutures no longer needed to be slathered with ointment. By day 10, all of the remaining sutures were gone, hardly leaving a trace… like disappearing ink.

To be clear, getting a facelift is no picnic. The first three to five days are challenging, emotionally and physically. Robin was fearful that she might do something to compromise the results. She walked robotically and rather than risk turning her head from the neck, she’d rotate her entire upper body from the waist. Her shoulders were hiked up to her ears. Dr. Murphy eventually got her to relax by assuring her that she wouldn’t ruin anything and that the excess tension might actually be causing more strain.

From my point of view, the trajectory of healing was remarkable.“Even though a facelift is a significant procedure, biologically the face is designed to heal quickly because it has an exceptionally rich blood supply,” explains Dr. Murphy. “The body prioritizes the head and neck, so oxygen, nutrients, and healing factors reach those tissues efficiently, supporting collagen production and rapid repair. Many patients, especially those in their 40s who tend to heal more quickly, feel comfortable being seen socially within seven to 10 days.”

9. It’s Not Just About Looking Younger.

A major epiphany for me was realizing that a facelift isn’t simply about getting a snatched jawline—it’s often about feeling like yourself again. As we age, gradual changes in facial structure can create a disconnect between our internal sense of self—how young/vibrant/amazing we feel—and the face we see in the mirror. It can also cause other people to view us differently than we view ourselves, as beauty journalist Valerie Monroe wrote in Allure, saying the area around her mouth seemed to have set itself into something that looked exactly like disdain—the emotion she says she’s least likely to succumb to.

Robin can relate: “My jowling and heavy brow made me look angry even when I wasn’t,” she says. “I felt my mood had shifted so much as a result of that. Post-facelift, I genuinely feel happier.”

Closing the gap between perception and reality does have a major psychological upside. Multiple studies report an improved sense of well-being and overall life satisfaction when measured more than a year after getting a facelift. Those changes crank up the flywheel of positive feedback: As you feel better about your appearance you project more confidence, which in turn elicits more positive social responses.

After attending all of Robin’s post-op check-ins and watching her progress unfold, I was intrigued by what scalpel-assisted time travel could look like for me. So before leaving Florida, I did my own consultation with Dr. Murphy. He first asked what I was dissatisfied with before telling me what his trained eye saw and what my surgery might involve. Then we stood in front of a mirror and Dr. Murphy gently hooked his thumbs under my jawbone to tighten my neck skin while using his other fingers to create backward tension on either side of my head, roughly approximating what a lift would look like. This is the same maneuver I perform in the mirror almost daily, only Dr. Murphy can do it with a lot more accuracy. The result was appealing. In the end, he suggested the procedures Robin had—deep-plane face and neck lift, temporal brow lift and fat transfer. Plus, an under-eye (my most hated area) skin pinch and potentially, a lip lift to shorten the space between the bottom of my nose and my upper lip, an area that gravity widens slightly over time. The lengthy list is not surprising given my age, but yowza!

Will I do it? I’m still not there yet—at least mentally—but let’s just say I’ve migrated over to the “probably someday” camp. Now, I need to retrain my algorithm to serve me something other than facelift recovery content long enough to make that decision.

A Few More Things Nobody Tells You:

Train yourself to sleep on your back.

Getting adequate shut-eye is crucial for recovery—and it’s not so easy if you’re typically a side or stomach sleeper. “The head always has to be the highest point. I have patients sleep pretty upright for the first 48–72 hours,” says Dr. Murphy. “Gradually, they can recline to a 20–30 degree angle at night, and then back up to 60–70 degrees when watching TV. By positioning the head back toward the spine, the fluid drains through the pathways that haven’t been manipulated.” Robin, typically a side and back sleeper, ordered a pillow-wedge set to place behind her back and under her knees. They helped, but sleeping on your back for weeks on end with no middle-of-the-night rotations is tough. “Even once you’re technically allowed to sleep on your side after a week or two, it feels super weird because of the ear and face numbness,” says Robin, who didn’t turn over for a full two months.

You don’t have to go under general anesthesia.

Today it’s common for plastic surgeons to forgo general anesthesia and opt instead for IV sedation and local anesthetic. “We use a mix of lidocaine and some longer-acting agents so you don’t feel what we’re doing— because even though you’re ‘asleep’ with IV sedation, the body still has this very primal response to pain,” says Dr. Murphy. “And just as important, there’s a vasoconstrictive agent [which restricts blood flow] in the IV mix too. The face has an enormous blood supply, and you don’t want that working against you when you’re trying to operate on delicate structures.”

Another bonus: You wake up much clearer-headed, with less grogginess and nausea that you feel after general anesthesia. Throwing up post-op is a nightmare. For this reason, you are advised to take anti-nausea medication even if you don’t feel queasy. Robin never felt nauseous, but took the medication religiously every 8 hours for three days—her nurse and I made sure of that.

Significant others should probably stay away.

In theory, it’s nice to have a mate who wants to take care of you; in practice, it can add undue stress. Whether they are in favor of you having a facelift or not, it’s hard for a romantic partner not to judge, get freaked out, or smother you with concern—none of which are helpful in the first few days of recovery.

Go into surgery robust, not too thin.

You want to be at a strong, healthy weight going into the surgery. Striving to get skinny to max out the amount of skin that can be hoisted, or because you know you won’t be able to exercise for several weeks, is a mistake. Most people lose weight during recovery because medications suppress appetite, they sleep a lot, and jaw tightness makes it damn hard to chew in the first week or two. Already slim, Robin dropped five or so pounds. The challenge is actually eating enough protein to maintain muscle mass and aid healing.

And what if you, like over 10% of American adults, are on a GLP-1 medication? Guidelines around the pre-surgical use of medications such as Ozempic, Wegovy, Zepbound, and Mounjaro are evolving. In 2023, the Association of Anesthesiologists (ASA) suggested stopping 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 before elective surgery with appropriate risk assessment. Some surgeons still advise at least a week, even two, off of a GLP-1 before surgery. “I coordinate closely with the anesthesiologist and individualize the plan based on symptoms (like reflux or nausea), whether the patient is in a dose-escalation phase [of their GLP-1 treatment], and the length of procedure,” says Dr. Park.

The final results only last a decade.

No matter how much money you spend or how optimal the results, gravity is an unstoppable force. “I tell patients to think of it as resetting the clock, not stopping it,” says Dr. Park. “Surgery restores anatomy at that moment, but you will continue to age based on collagen quality, bone remodeling, skin behavior, and environmental exposure.” New research backs that up. The authors of an article published this year in Facial Plastic Surgery & Aesthetic Medicine tracked 93 revision facelifts from a single-surgeon’s practice over a 30-year period. They found that patients who had a deep-plane lift returned for a second procedure after an average of 10.9 years. Those who had their first procedure at or before age 53 waited an average of 12.4 years before seeking a revision, compared to 9.3 years for those who were older at the time of their primary surgery.

To read more on Robin Shobin’s facelift experience, go to her Substack Charlotte’s Book.

Read more first-person accounts of aesthetic procedures:

• I Got Chin Filler for My “Weak” Chin
• Denise Richards Opens Up About Her Facelift
• I Went to South Korea for a Week of Cutting-Edge Skin Treatments
• I'm 98 and I've Had Three Facelifts—Here's What I Learned

Watch the cast of I Love Boosters share some secrets: