Facelift – naturally rejuvenated, without looking “lifted”

Over the years, the face loses its firmness: the cheeks sag, the jawline softens, and wrinkles form on the neck. Creams and injectables reach their limits here, because the cause lies in the deeper tissue layers. That is exactly where a modern facelift comes in.

Why the face is my focus

For many years, my particular clinical and scientific focus was craniofacial surgery. In this field, complex abnormalities of the bones and soft tissues of the skull and face are corrected – such as congenital malformations, the consequences of accidents, or reconstruction after tumor surgery. Professor Mühlbauer entrusted me with the position of senior physician in charge of this subdepartment.

This work requires very detailed knowledge of facial anatomy: of the course of nerves, blood vessels and connective tissue layers. It is precisely this knowledge that is the best foundation for aesthetic procedures on the face – from the mini lift to the classic deep plane facelift, from midface and neck lifts to the forehead lift.

The deep plane SMAS technique

With older lifting methods, it was mainly the skin that was tightened. The result often looked taut or “mask-like” and did not last long, because skin gives way under tension.

With the deep plane SMAS technique, I reposition the deeper tissue layers and lift sagging areas back into harmonious proportions without putting the skin under tension. SMAS stands for “superficial musculoaponeurotic system” – a layer of connective tissue that supports the face like a net. If it is released at the right place and repositioned, the skin follows without tension.

• A natural facial expression instead of taut skin
• Your facial expressions are preserved
• Cheeks, jawline and neck are treated together
• Scars are hidden in natural skin folds and in the hairline

Who a facelift may be suitable for

A facelift can make sense when deep wrinkles, sagging areas of the face and lost contours shape your appearance – such as jowls, a blurred jawline or pronounced nasolabial folds. What matters is not your age, but the findings, your general state of health and your expectations.

Not every concern requires surgery. Sometimes eyelid correction, a neck lift or a wrinkle treatment is sufficient. That, too, is part of an honest consultation.

Which variant is right? An overview

“Facelift” is an umbrella term. The word covers procedures of very different extent:

• Skin tightening with a short incision (often called an “S-lift”): The incision runs in front of and around the ear; mainly the skin and subcutaneous tissue are tightened. Suitable for mild sagging, often possible under local anesthesia, with a short recovery – but the effect is more limited.
• SMAS and deep plane lift: In addition to the skin, the supporting layer of connective tissue and muscle is lifted. This is the approach when the cheeks, jawline and neck have all sagged together.
• Midface lift: Through an incision just below the eyelashes, the sagging cheek tissue is lifted – often together with lower eyelid correction.
• Neck, forehead and brow lift: complement the facelift or are used on their own – more on this under Neck and brow lift.

Terms such as “mini,” “midi” or “maxi lift” are not uniformly defined. What matters is not the name, but which layer is tightened, where, and to what extent.

Can be combined well

A facelift tightens and repositions – it does not replace volume. It can therefore be usefully complemented, for example with your own fat for hollowed areas, with eyelid surgery or with injectables for fine lines.

Preparation: what matters before the procedure

• Photos from your younger years help us define the goal together.
• Preliminary examinations such as a blood count and, if necessary, an ECG – through your family doctor or with us.
• Blood thinners (for example, painkillers containing acetylsalicylic acid) should only be stopped about two weeks beforehand after consulting a doctor.
• Avoid nicotine and alcohol for at least two weeks before and after the operation if possible – this significantly reduces the risk of healing problems.

When a facelift is not the right approach

In the case of serious acute illness, the procedure is postponed. Caution is advised if you tend to form raised, thick scars – and if your expectations of the operation go beyond your appearance, such as solving personal problems. We talk about this openly, too.

The process: from consultation to aftercare

1. Consultation and examination We discuss your wishes, I examine your skin, tissue and facial proportions and explain what can be achieved.
2. Planning We decide on the approach – for example, whether the neck or midface should also be treated – and clarify anesthesia, preparation and medication.
3. Informed consent You receive detailed information about the procedure, risks and alternatives and have sufficient time to think it over.
4. Operation For a classic facelift, I recommend an inpatient stay of one to two nights.
5. Aftercare We see each other regularly during the first weeks. Individual healing times can vary; you are usually socially presentable again after 10 to 14 days.

After the operation

Swelling and bruising are normal in the first few days and subside gradually. Cooling, sleeping with your upper body raised and physical rest support healing. You should avoid sports, saunas and intense sun for a few weeks – we discuss the exact timing at your follow-up appointments.

The final result becomes apparent after a few months, once even slight swelling has completely subsided. The natural aging process continues, but a well-performed facelift has an effect for many years.

Risks discussed openly

Every operation carries risks. With a facelift, these include, among others, secondary bleeding and bruising, wound healing problems, conspicuous scars, temporary numbness or altered sensation and – rarely – injury to facial nerves. Smoking, certain medications and pre-existing conditions increase the risk. Mastery of complex surgical techniques and precise anatomical knowledge are therefore the most important prerequisites. In the informed consent discussion, we go through every point individually.

Facelift: the process step by step
Preparation, the day of surgery and healing – with illustrations

Frequently asked questions