Dr Bart van de Ven performs three types of facelift that each have their indication: a simple facelift, a necklift and a midfacelift. If no jaw reduction or chin recontouring is performed, it can be done in the same operation as the rest of your facial feminization surgery.
Indication simple facelift
- Existing sagging skin (jawls)
- After a jaw and chin recontouring in older patients— After a jaw and chin recontouring in older patients may appear a previously not existing sagging skin. This is because the volume of the jaw and chin has been reduced and the swelling after this type of surgery can be massive. In a young patient with good elastic skin, the skin recuperates from all that stretching. If you are older, the skin will not completely readapt to the new jaw shape. That is why a lot of older FFS patients (late 30’s and older) may need a facelift. A facelift is best not performed at the same time as a jaw and chin recontouring because the result is suboptimal. We recommend at least 4 months between the two operations. The facelift helps enormously to show off the newly formed jaw and chin, resulting in a very female shape of the face.
- Can be combined with a necklift and midfacelift if needed (see indications below)
- Excess skin in the neck
- Almost always performed in combination with a facelift
- Drooping corners of the mouth
- After a substantial liplift—It is often indicated when a substantial lip lift is done. A lip lift doesn’t lift the corners of the mouth and without a midface lift the mouth of the patient can become a bit sad.
- Younger patients who don’t need a complete facelift yet—It also can be very helpful in patients under 40 years of age who don’t need a complete facelift yet. A subperiosteal midfacelift ist a very effective way of lifting the cheeks and the corners of the mouth. As a side effect it will also lift the jawls a bit.
Procedure simple facelift
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 short incision, so a short scar. As the skin and underlying layer of the lower part of the face are purely lifted in a vertical direction during this procedure there is no need for an incision behind the ear. The MACS-lift is a very save and fast way of facelifting with excellent and long-lasting results.
- General anesthesia
- Incision—The incision is kept as short a possible and runs in front of the ear.
- Undermining—The skin is undermined (made loose from the layers below it) in the area
- Three loop sutures—Three sutures are placed to lift the tissues. These sutures absorb in 6 months. This is enough time for the tissues to heal in their new position.
- Excess neck skin removed—The excess of skin is excised and the skin closed.
The dark red line in front of the ear indicates the incision line, the red area demarcated by the blue line indicates the area that is undermined (made loose from the layers below it), the three loops indicate the three sutures that are placed to lift the tissues
Video of the procedure made by the developers of the MACS-lift technique Dr Verpaele and Dr Tonnard:
If a patient has too much loose skin in the neck, the incision of the MACS-lift (in front of the ear) needs to be extended behind the ears. Only then the surplus of neck skin can be excised.
- Same procedure as simple facelift +
- Extension Incision—The procedure is as in a MACS-lift, but the incision is extended behind the ears and in the hair about 2mm behind the hairline.
- Extension Undermining—The skin of the neck is undermined (made loose from the layers below it) in the area
- Extra loop suture—A suture is anchored to the strong bone membrane (periosteum) just behind the ear and runs into the neck and back, so the platysma muscle can be tightened.
- Excess neck skin removed—The excess of skin is excised and the skin closed.
- Incision under the eyes—Incisions are made just under the eyelashes of the lower lids and continued until about 1,5cm lateral to the corners of the eyes.
- Mobilisation—The cheeks will be mobilised by a preparation just over the bone (subperiosteal)
- Incision in the mouth—To make the cheeks more mobile the bone membrane is incised on several places through an incision on the inside of the mouth.
- Burring holes—Three small holes are burred in the bone just under 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 bur holes. This will forcefully lift the cheeks and corners of the mouth.
- Excess skin removed—Finally the skin surplus of the lower eyelids that is a result of the lifting needs to be excised and the wounds are closed.
Recovery of a facelift
- Hospitalization— Patients leave the clinic the day after surgery.
- Plastic tubes— plastic tubes leading under your skin will be removed the next day.
- Swelling—You can minimize swelling and bruising by applying our cooling machine. You should rest or sleep in a semi-seated position: lying completely flat (or bending over) is not advised as this might cause the swelling in your face to increase. You should count on not being as socially active as normal for about two to three weeks. The swelling starts to subside on the third day, and is usually hardly visible after a week to ten days. You can go out (for shopping, etc.) from the first day after the operation.
- Pain—If you need a painkiller, only use products that do not contain aspirin (acetylsalicylic acid). Because of the deep stitches your jaw might hurt when you open your mouth wide. That annoying feeling will soon pass in the course of the first week.
- Food—You should eat soft foods in the first few days after the operation.
- Hematoma—You should not experience a severe swelling of the cheek, combined with a feeling of tightness and increasing pain. This might indicate post-surgical bleeding. If this happens, you might need to undergo further operation to remove the accumulated blood. But this only happens in less than one per cent of cases. If you notice these symptoms, you must immediately contact Dr Bart van de Ven.
- Stitches—All the stitches will be removed after a week.
Complications of a facelift
- Temporary paresis of the facial nerve— In 1% of patients the facial nerve can be stuck in the suture. This results in a temporary partial paresis of the facial nerve. The effect is an eye that cannot be closed completely or one corner of the mouth hanging down a bit. The problem is always temporary but takes 3-6 months to resolve completely, which is quite stressful for the patient.
FAQs before surgery
That is a very difficult one. It depends very much upon your healing and we can’t give you any guarantee about how long it takes before you look good enough for a photoshoot.
It could be 4 months, but it could also be a year. Of course it also depends on the amount of work that has been done.
If you want you can send us good pictures together with your ideas so we can send you a financial and operative proposal. To receive a proposal, please fill in the proposal request online
and pay the proposal fee of 50 euro through Paypal.
Of course you are always welcome for a consultation.
You should count on not being as socially active as normal for about two to three weeks. The swelling starts to subside on the third day, and is usually hardly visible after a week to ten days. You can go out (for shopping, etc.) from the first day after the operation.
The swelling after a jaw angle reduction can be massive. That is why a facelift is best not performed at the same time as a jaw recontouring. The results will be suboptimal. We recommend at least 4 months between the two operations. The facelift helps enormously to show off the newly formed jaw and chin, resulting in a very female shape of the face.
As smoking counteracts wound healing we strongly advise against smoking during the 3 weeks before surgery until 3 weeks after surgery. Smoking dramatically increases the risk for skin necrosis and should be avoided at all times.
FAQs after surgery
You still have another question? Feel free to ask! We will answer your question and if generally applicable add it to the FAQ of this page.