Face and neck lift

Over the years, the deep structures of the face and neck undergo the combined effects of gravity, loss of skin elasticity and bone resorption.

A modern face and neck lift is no longer about “pulling the skin”, but about carefully repositioning the deep muscular layer (SMAS) and gently redraping the tissues. The aim: a rested face, a crisp jawline, a restored chin-neck angle and, above all, a completely natural result.

The protocol, step by step.

1. Step 1

   Consultation and 3D planning

   In-depth facial analysis, assessment of volumes and a personalised surgical plan by Dr Yousefpour.

2. Step 2

   The operation

   Performed under general anaesthesia or conscious sedation depending on the indication. Duration: 2.5 to 4 hours.

3. Step 3

   Immediate recovery

   A moderate pressure dressing; 7 to 10 days of rest recommended (temporary swelling and bruising).

4. Step 4

   Final result

   Noticeable natural rejuvenation from 4 to 6 weeks, with full tissue maturation between 3 and 6 months.

Dr Yousefpour’s approach: maxillofacial precision in the service of aesthetics

Facial aesthetic surgery requires complete command of bone volumes, muscle dynamics and the course of the facial nerves. Thanks to his extensive training in oral and maxillofacial surgery, Dr Yousefpour approaches each face with an overall three-dimensional architectural vision.

• Deep-layer (SMAS) tightening: support comes from the muscle layers, avoiding any frozen or “stretched” look.

• Near-invisible scars: tailored to follow the contours of the tragus and disappear into the hairline.

• Overall harmony: facial fat grafting (micro-fat transfer) or eyelid surgery can be combined to restore volume and the eyes at the same time.

Mini-lift, SMAS or deep plane: a tailored approach

There is no universal technique, but a precise indication adapted to your anatomy, the quality of your tissues and your goals. Dr Yousefpour is experienced in every surgical plane in order to offer the most lasting and natural strategy.

• Mini-lift (MACS lift): a short incision, mainly in front of the ear, with vertical suspension of the SMAS by anchored sutures. For early laxity of the jawline and jowls (40 to 50 years). Minimal scars and quick recovery, but no correction of markedly fallen cheeks or a very loose neck. Effect 5 to 7 years, 7 to 10 days off social activities.

• Classic SMAS lift (plication or resection): the skin is lifted, then the SMAS is tightened directly. For clear jowls and moderate laxity of the neck and cheeks (45 to 60 years). Effective, lasting treatment of the jawline, limited effect on the nasolabial folds and midface. Effect 8 to 10 years, 10 to 14 days off.

• Deep plane facelift: access beneath the SMAS with release of the zygomatic and mandibular ligaments; skin, muscle and fat are repositioned as a single unit, without skin tension. For marked midface descent, a hollow under the eye and a loose neck (50 and over). Lifted cheeks, softened marionette lines, a redefined neck angle and maximum longevity. Effect 10 to 15 years, 12 to 18 days off. It requires expert knowledge of the course of the facial nerve, Dr Yousefpour’s area of excellence.

• Dr Yousefpour’s view: “The choice of technique is not a matter of fashion, but of careful analysis of how your face is ageing. The aim is to restore the structures to where they were ten or fifteen years earlier, without surface tension and without distorting the dynamics of your smile.”

Combining a facelift with facial fat grafting

Tightening is not enough: light and fullness must also be restored. Ageing combines gravitational descent of the tissues with selective shrinkage of the deep fat compartments. A facelift alone cannot make up for volume loss in the temples, tear trough or cheeks, so Dr Yousefpour combines the structural lift with high-precision autologous fat grafting, using micro-fat and nano-fat.

• A lively result, never hollow: avoids a “skeletal” or overly tight look by restoring the natural curves of youth.

• 100 % natural and permanent: your own fat, harvested with an atraumatic micro-cannula (abdomen or inner knees); grafted cells that take become a permanent part of the tissue, with no risk of rejection.

• A dual action on structure and texture: correction of deep volumes and regeneration of the surface layers thanks to growth factors and mesenchymal stem cells (ADSCs).

• Micro-fat (volume restoration): purified fat with intact micro-lobules, injected deep with a blunt micro-cannula, for the cheeks, temples, tear trough, chin and marionette lines.

• Nano-fat (regeneration): emulsified, ultra-filtered fat rich in stem cells, injected superficially into the skin, for fine lines around the mouth, dark circles, skin texture and the décolleté.

Dr Yousefpour’s surgical protocol

• Atraumatic micro-harvesting: small volumes of fat taken at low pressure to preserve cell viability.

• Purification and emulsification: washing and filtering in a closed sterile circuit to separate active fat tissue from debris and oily fluid.

• Surgical repositioning: performing the lift (SMAS or deep plane) to re-tighten the muscle structures and the jawline.

• Three-dimensional micro-grafting: layered re-injection in micro-droplets to maximise revascularisation of the grafts and an even, lasting take.

• “True facial rejuvenation does not seek tension, but balance between the verticality of the deep structures and the softness of the original volumes.” — Dr Yousefpour

Recovery timeline and check-ups

The success of a facelift depends half on the precision of the surgery and half on the rigour of the aftercare. Dr Yousefpour and his team support you step by step throughout your recovery.

• Days 1 to 3: peak of swelling and bruising, complete rest with the head raised (2 pillows), gentle pressure dressing. Visit on day 1 or 2: removal of the first dressing and check for haematoma.

• Days 4 to 7: skin tension gradually eases, start of the prescribed gentle shampoos and local care of the incisions. Check on day 7: cleaning of the sutures and removal of the first stitches or temporal staples.

• Days 8 to 15: bruising clearly fades, concealing make-up and light social outings are possible. Check on day 12 to 14: removal of all remaining stitches.

• Weeks 3 to 6: gradual return to sport, start of scar massage and moisturising. Check at 1 month: assessment of symmetry, tone and suppleness.

• Months 3 to 6: residual swelling fully settles and the scars mature. Consultations at 3 and 6 months: photographic assessment and confirmation of the final result.

Essential post-operative instructions

• Position and rest: sleep on your back with the head raised to 30–45° for the first 10 days; avoid bending your head forward or lowering your upper body suddenly.

• Wound care: gently clean the areas in front of and behind the ear with a sterile gauze soaked in a mild antiseptic, without rubbing, and apply a thin layer of the prescribed healing ointment.

• Shampoo: first gentle, lukewarm shampoo once the team agrees (usually on day 3), without rubbing the sutures; dry with cool or lukewarm air (never hot).

• Sun protection: SPF 50+ on the scars every day for 12 months.

• Scar massage: from the 3rd week, with a silicone cream or repairing serum.

• Strictly avoid: smoking and vaping for 4 weeks; aspirin and ibuprofen without the surgeon’s advice; sport, heavy lifting and sudden neck movements for 3 to 4 weeks; sauna, steam room, long hot baths and direct sun for 6 weeks.

Frequently asked questions: indications and preparation

• Aesthetic medicine or a surgical facelift? Aesthetic medicine treats skin texture and moderate volume loss. With excess skin, clear jowls or loose muscle bands in the neck, injections only weigh down the lower face: only surgical repositioning of the deep layers redefines the jawline.

• Why stop smoking? Nicotine constricts the small blood vessels and deprives the skin of the oxygen it needs to heal. Stopping smoking and vaping completely is compulsory for at least 4 weeks before and 4 weeks after surgery.

• Does the hair need to be shaved? No. The incisions run through or along the hair-bearing areas (temples and nape), following the direction of the hair follicles.

Frequently asked questions: the operation and technique

• What anaesthesia? Usually general anaesthesia or conscious sedation with an anaesthetist; the pre-operative consultation determines the most comfortable and safest option.

• Why is the result natural? Tension is applied only to the SMAS and the neck muscles; the skin is simply redraped without pulling, which preserves the earlobes, the line of the mouth and the freshness of expression.

• Can other procedures be combined? Yes: eyelid surgery, autologous fat grafting (micro-fat and nano-fat) or liposuction under the chin to sculpt the chin-neck angle.

Frequently asked questions: recovery and results

• Is it painful? Not very. Patients mainly describe tightness or numbness of the neck and ears, relieved by paracetamol in the first days.

• How long is the time off? Swelling peaks between the 2nd and 4th day; by day 7 to 10 the bruises turn yellow and can be covered with foundation; by day 12 to 15 all stitches are removed and social or professional life can resume.

• What about the loss of sensation around the ears? It is usual, caused by stretching of the small sensory nerves, and recovers on its own between 3 and 9 months.

• How long do the benefits last? On average 8 to 12 years of visible rejuvenation; ageing continues, but from a restored base.

• When can the final result be judged? At 1 month, the jawline is redefined and 80 % of the swelling has gone; between 3 and 6 months, the result is stable and the scars fade.

Medical information: aims of the operation

The face and neck lift (with or without platysma plasty, facial fat grafting or eyelid surgery) treats laxity of the cheeks, jowls, jawline and neck by repositioning the deep structures (SMAS and platysma muscles), without artificial tension on the skin. The aim is a harmonious, natural improvement; absolute mathematical symmetry cannot be guaranteed, as every face has pre-existing asymmetries.

Risks and complications

Although performed according to rigorous protocols, every operation carries some risk:

• Haematoma: a collection of blood is possible in the first 24 to 48 hours, triggered by a rise in blood pressure, coughing or a sudden movement. A small haematoma resolves on its own; a large one requires prompt drainage in theatre.

• Altered sensation: numbness or a “cardboard” feeling of the cheeks, neck and earlobes, almost always temporary, recovering over 3 to 12 months.

• Motor nerve injury: temporary weakness of a branch of the facial nerve (for example a temporarily asymmetric corner of the mouth) usually recovers within a few weeks; permanent paralysis is exceptional.

• Skin compromise and necrosis: a crust or localised superficial skin loss, especially around the ears, strongly linked to smoking.

• Infection: exceptional on the face, treated with antibiotics and local care.

• Scars: risk of a red, thickened, widened or pigmented scar, which may warrant massage, silicone gels, local injections or revision under local anaesthesia.

• Scar alopecia: temporary or permanent hair loss along the incisions at the temples or nape.

• Residual asymmetry or incomplete result: persistent localised laxity may justify a minor touch-up later.

Patient commitments

• Report your full medical and surgical history, allergies and current treatments.

• Take no medicines containing aspirin or anti-inflammatories in the 10 days before surgery.

• Stop smoking and nicotine substitutes according to the recommended protocol.

• Follow the prescriptions, dressing schedule and check-up appointments carefully.

Costs and Belgian VAT

Under the Belgian VAT Code (art. 44, § 1, 2°), any procedure or part of a procedure with a purely aesthetic purpose is subject to 21 % VAT, charged in addition to the fees and any hospital costs.

Final healing takes 12 to 18 months: no definitive touch-up is undertaken before then. If revision surgery is needed, all costs (clinic, anaesthetist, consumables, theatre equipment and surgical fees) are paid in full by the patient; the initial procedure is not a package that includes possible further operations.

Informed consent

You receive an information and informed consent form before the operation. By signing it, you confirm that you have read and understood this information, received clear explanations from Dr Yousefpour and been able to ask all your questions, had enough time to reflect, accept the surgical and anaesthetic risks described, and understand that any touch-ups are entirely at your expense and that aesthetic services are subject to 21 % Belgian VAT.