Facelift

Table of contents:

The Medical Team performs three different types of facelifts, each with their own indication: a simple facelift, a neck lift and a mid-face lift. If no jaw reduction or chin correction is performed, the facelift can be performed at the same time as the rest of your Facial Feminization Surgery take place. 

Indications

Indication for a simple facelift

  • Existing sagging skin (cheeks).
  • After Jaw and Chin Recontouring in Older Patients—After jaw and chin recontouring in older patients, previously unseen sagging skin may occur. This is because the volume of the jaw and chin has decreased and the swelling after this surgery can be enormous. In a young patient with good and elastic skin, the skin will recover from all that stretching. As you get older, the skin will not be able to fully adapt to the new jaw shape. This is why many older FFS patients (late 30s and older) may need a facelift. It is best not to have a facelift at the same time as a jaw and chin recontouring because the result will not be optimal. We recommend that you leave at least 4 months between the two surgeries. A facelift helps enormously to reveal the newly shaped jaw and chin, resulting in a very feminine facial shape.
  • Can be combined with a neck lift and mid-facelift if necessary (see instructions below).

Indication neck lift

  • Excess skin on the neck.
  • Almost always performed in combination with a facelift.

Indication mid-face lift

  • Drooping corners of the mouth.
  • After a Substantial Lip Lift—Often indicated after a lip lift. A lip lift does not lift the corners of the mouth, and without a mid-face lift, the patient’s mouth may look a little sad.
  • Younger Patients—Can also be very helpful in patients under 40 who do not yet need a full facelift. A subperiosteal midfacelift is a very effective way to lift the cheeks and corners of the mouth. As a side effect, it will also slightly lift the cheeks.

How do you prepare for a facelift?

If you are a smoker, you should stop smoking three weeks before surgery and wait until three weeks after surgery before starting again. Smoking significantly reduces the blood supply to the skin and can lead to serious problems with wound healing.

Procedures

Simple facelift procedure

For a facelift, Dr. Bart van de Ven uses the MACS-lift technique, a technique developed by Dr. Patrick Tonnard and Dr. Alexis Verpaele. A MACS-lift stands for 'Minimal Access Cranial Suspension' lift. 'Minimal access' means a small incision, so a small scar. Because the skin and the underlying layer of the lower part of the face are lifted purely in a vertical direction during this procedure, no incision behind the ear is necessary. The MACS-lift is a very safe and fast way of facelifting with excellent and long-lasting results.

  • General anesthesia.
  • Incision—The incision is kept as small as possible and runs in front of the ear.
  • Undermining—The skin is undermined (loosened from the layers beneath it) in the area.
  • Three Sutures—Three sutures are placed to lift the tissues. These sutures dissolve after 6 months. This is enough time for the tissues to heal in their new position.
  • Excess skin on the neck—The excess skin is cut away and the skin is sewn closed.

Neck lift procedure

If a patient has too much loose skin in the neck, the MACS lift incision (in front of the ear) should be extended behind the ears. Only then can the excess neck skin be excised.

  • The same procedure as a simple facelift.
  • Incision Extension—The procedure is similar to the MACS lift, but the incision is extended behind the ears and into the hair to approximately 2 mm behind the hairline.
  • Extended undermining—The skin of the neck is undermined (loosened from the layers beneath it) in the area.
  • Additional loop suture—A suture is anchored to the strong bone membrane (periosteum) just behind the ear and runs up the neck and back, allowing the platysma muscle to be tightened.
  • Excess skin on the neck—The excess skin is cut away and the skin is closed.

Midface lift procedure

  • Under-eye Incision—Incisions are made just beneath the eyelashes of the lower eyelids and extend approximately 1,5 cm lateral to the corners of the eyes.
  • Mobilization —The cheeks are mobilized by a preparation just above the bone (subperiosteal).
  • Incision in the mouth—to make the cheeks more mobile, the bone membrane is cut in several places through an incision on the inside of the mouth.
  • Drill holes – Three small holes are drilled into the bone just below the eyes to anchor the sutures.
  • Permanent Loop Sutures—With a special instrument, 3 nylon sutures are pulled through the cheeks and tied through the drill holes. This will forcefully lift the cheeks and corners of the mouth.
  • Excess Skin Removed—The excess skin from the lower eyelids, resulting from the lifting, should be cut away and then the wounds closed.

Recovery

  • First Week—There will be some bruising and swelling in the neck and jawline and some bruising around the eyes.
  • Subsequent Weeks—After three weeks, the patient may resume social activities, with some makeup around the eyes if necessary to cover any remaining bruising.
  • Full recovery—After three to four weeks.