Facelift and Necklift

Why opt for a facelift and a neck lift

As we age, the skin and the underlying muscles begin to relax, which leads to a loss of skin tone and elasticity. So if one takes into account the effect of the sun and the loss of fat volume (lipodystrophy), aging accelerates. A facelift can partially reverse these changes, especially in the neck area and the line of the lower jaw. This operation can be combined with fat removal from the area of the neck, blepharoplasty, brow lift, and even with the injection of fat which could help the face acquire a more bright appearance.

The operation in brief

After a thorough clinical examination and assessment of your face/neck problems, either a full face facelift or a mini lift, or a MACS Lift through a smaller incision can be selected, always based on the individual needs of each patient.

Full-Facelift

A total facelift involves the removal of skin and fat from the underlying muscles in an area that extends from the cheeks, to the jaw line and to the base of the neck. The incision used extends both in front of and behind the ear, extending sometimes into the scalp, and sometimes along the line of sideburns, instead of into the hair itself. Then, the underlying anatomical muscle layer (SMAS-superficial  musculoaponeurotic system) is tightened and suspended at fixed points on the face, which is the most important stage in surgery, as this suspension is what will give longevity to your facelift. Then, the excess skin from the area of ​​the face and neck is removed and with careful suturing the skin is repositioned removing any wrinkles in the area of ​​the nasopharynx, cheeks, lower jaw, and neck.

Short Scar Facelift

Short Scar Facelift involves a smaller incision made in front of and not behind the ear. Although this operation is similar to the total facelift, a lesser extent of skin lift is achieved, improving mainly the line of the lower jaw and to a lesser extent the neck area. It can be performed under local anesthesia and does not require hospitalization.

MACS Lift | Minimal Access Cranial Suspension Lift

The MACS Lift is nothing more than a variation of the Short Scar Facelift or mini-lift where the SMAS layer is suspended on solid anatomical points of the skull (such as the deep temporal fascia) with strong sutures, thus increasing the longevity of the lifting effect on the face and neck. It can be performed under local anesthesia and does not require hospitalization.

Incisions

Incisions in the facial area heal quite satisfactorily and, although during the first two months they appear slightly pink, they then fade to white. The quality of scars in most patients will be extremely good in the long run, but some may develop hypertrophic or keloid scars. The way your other wounds have healed in the past may be an indication of the wound healing process.

Medication 

In our clinic, a complete medical history is always taken before each surgery. As a precaution, over-the-counter medicines or herbal products should not be taken before and for 3 days after surgery. It is also considered necessary to avoid taking non-steroid, anti-inflammatory drugs such as aspirin (salospir), ibuprofen (Nurofen), diclofenac, and any other anticoagulant or antiplatelet drug.

Smoking

If you are a smoker you should try to stop smoking for at least 6 weeks before and 1 week after the surgery as this will dramatically reduce the chances of postoperative complications and help achieve the best possible result. Facelift surgery is rather affected by smoking-related problems.

Facelift Recovery

Duration of the procedure

Depending on the technique used, the procedure may take 2.5 to 4.5 hours.

Hospitalization/Duration

Hospitalization is only required for a total facelift and in that case, you will only be required to stay in the hospital for one or two nights.

Wound dressing and suture removal

Immediately after the operation, the sides of the patient’s face will be covered with a relatively voluminous bandage, which the patient must keep for one day. This is removed after the patient is discharged from the hospital and replaced by a special elastic face/head corset, which may need to remain for two to eight days, depending on the type of surgery. Incisions and the result will be checked on the second and seventh postoperative day. However, if you need any clarification or there is something that worries you, doctors are always at your disposal. Your next appointments will be after one, three, six, and twelve months respectively and during said appointments postoperative photos will be taken. For these visits, there will of course be no extra charge for any follow-up related to your surgery.

Drainages

It only concerns total facelift. It is common to place a small surgical drain under the skin to remove any unwanted fluid/blood collection, which is usually removed before the patient leaves the hospital the next day.

Absence from work

Although recovery time varies from patient to patient, patients should be given at least two weeks to recover. Most patients start feeling very comfortable from the very first week post-surgery and, although they think they can return to work, we would suggest not to rush. During the first week, there will be some slight swelling and a few bruises, most of which will subside by the end of the second week.

Refraining from exercising

Patients are usually able to go brisk walking within three to five days and swimming in 10 to 14 days (if they have fully recovered). However, strenuous exercise should be avoided for at least four weeks.

Post-op instructions

From day one to day four, you should ideally avoid any activity. You should not take care of small children or do household chores without help.

From day 5 to day 14 you can start exercising more, as for instance go walking for a longer period of time, go shopping, etc. If all wounds seem to have been healed by day 10, it is rather unlikely that you increasing your level of activity could cause any issues. You should only resume your activities if you feel healthy.

From the third to the sixth week you will be able to return to your work and after the sixth week, you will be able to resume your normal activities.

Driving

Patients who have undergone breast reduction should ideally avoid driving until they are completely free of any discomfort or restriction, in order to be able to make a sudden movement, such as braking, freely and without any pain. This parameter is proposed so that patients can secure coverage from their insurance company in case of an accident. Thus, it may take up to two weeks for them to fully recover. There are of course patients who feel able to drive after 4-5 days, but always at their own risk.

Postoperative follow-up

Your wounds will be checked and the bandage will be changed on the second, fifth, and seventh-day post-surgery. Afterward, follow-up examinations will be performed after one, three, and six months and after one year. However, if you need any clarification or there is something that worries you, doctors are always at your disposal. For these visits, there will of course be no extra charge for any follow-up related to your surgery.

Possible complications from facelift surgery

A facelift is a routine operation and is completely successful for the vast majority of our patients, which is a result of the large number of cases that doctors have in their belt. However, as with any surgery, it is very important to understand that there is a possibility of complications. Possible complications are listed below:

Skin loss

Its appearance is extremely unusual and occurs when the blood supply to the skin is insufficient. The risk increases if the skin is removed to a large extent (and therefore this is always avoided), as well as when patients are heavy smokers.

Paraesthesia/Altered skin sensations

It is quite common after surgery to have a feeling of numbness in the treated area, however, sensation returns to the vast majority of patients within one to two months.

Paraesthesia/Altered ear sensations

It is very unusual, but it can happen if a sensory nerve of the skin of the ear is disturbed.

Minor asymmetry

Although the same surgery is performed on both sides of the face and neck, there is a small risk of a minor asymmetry between the two sides. Similarly, the earlobe may change position slightly.

Scars

The quality of the scars varies among patients.

Wound disruption

Although uncommon, it can lead to delayed wound healing and poor scarring.

Hematoma

There is a very small chance of hematoma forming under the skin, which, if said hematoma is large enough, could result in the patient be brought back to the operating room for its removal. However, hematomas usually occur within the first 24 hours after surgery and affect about 1% of patients.

Inflammation

It is quite an uncommon phenomenon, but if it occurs, antibiotics will be required.

Nerve injury

Injury to the facial nerve is very rare but could lead to paralysis of the facial muscles. The most commonly affected areas are the eyebrows and the corners of the mouth. If facial nerve damage occurs, it will be healed on its own in the vast majority of patients, after two to three months. However, some cases of permanent damage have been reported in the literature, so this should be taken into consideration before the patient undergoes this surgery. Our excellent knowledge of the anatomy of the face in combination with the large number of similar surgeries performed is the main tool in our toolkit that helps us almost eliminate the risk of facial nerve damage.