Sara:
Although I didn't suffer from facial paralysis and it's concomitant issues, in the weeks and months immediately following my surgery (and later radiation treatments) I was told, repeatedly, about how 'good' I looked. I smiled and said: "thanks" - a lot.
I agree with Lori and Debbi that when folks know you've undergone brain surgery, they do expect you to look like 'death warmed over' and when you don't, they say, reflexively, that you look 'good'. I concur that in this situation, 'good' is a relative term. I also lost a lot of weight prior to my surgery so I suppose, in a sense, I did look better. In any case, I don't allow people's comments , especially the insensitive kind, to affect me, much. As you realize when you get to my age: 'life is too short'.
Prior to my diagnosis, my wife and I knew a youngish lady (in our church) who had AN surgery before we began attending and had suffered severe facial paralysis and the facial distortion that often accompanies it. I never, ever mentioned her appearance to her or anyone else. I thought she was brave to soldier on with this condition and didn't need me to tell her what she already knew about her appearance. I apply this to the obese or anyone who's appearance is not what we consider 'normal'. My contention is that they have a mirror and know full well what they look like. I've always made it a rule never to comment on another person's appearance, no matter what the situation. This rule has served me well and probably saved me some embarrassment and other folks some hurt over the years. If a person looks well after an illness, I just say I'm happy to see them. If they don't look so good, I say the same thing, and mean it. I wish more folks would resist the urge to tell someone who isn't looking too well, how 'good' they look. It's gratutious and mostly unnecessary because we usually know it's false. Sometimes, the less said, the better.
Jim