Facelift

Over the course of a lifetime, the face changes as the skin ages and the muscles and connective tissue lose tone. In addition to genetic factors, the main causes of skin aging are sun exposure and general lifestyle.

 

Slackening of the muscles in the face and neck is just as responsible for a tired-looking expression as the sagging of fatty tissue. The formation of deep folds around the nose and mouth, frown lines on the forehead, and wrinkles around the cheeks and eyes can all contribute to this undesirable impression. The resulting appearance often no longer matches how the person actually feels inside.

A Natural-Looking Facelift Takes Years Off

A facelift removes excess tissue and tightens the soft tissue of the face (SMAS lift), repositioning it closer to its original location, while the remaining skin is re-tensioned for renewed elasticity. This generally takes several years off the face, resulting in a fresher, more rested appearance. For Dr. med. Christian Metz, it is essential that your face retains its characteristic features and natural look, without appearing mask-like.

A Lift Tailored to You

Every facelift is individually tailored by Dr. med. Christian Metz. A range of surgical techniques is available for your personalized facelift. Depending on your age and skin condition, a temple lift may be sufficient. If wrinkles are concentrated around the cheeks or the center of the face, a midface lift is the right choice. In a classic facelift, the temples, cheeks, and neck are treated together in a single procedure.

Deep Plane Facelift

The deep plane facelift is one of the more advanced and comprehensive facelift techniques. It works within deeper tissue layers to lift sagging structures in the midface, cheeks, and lower face as a single, connected unit. This technique is particularly well suited when the face appears not just lax but noticeably sunken following weight loss. The goal is a natural result without an overly tightened or "pulled" appearance. At the same time, the technique demands especially precise specialist planning and experience, since the surgeon is working within deeper tissue layers. Recovery time is therefore comparable to that of a classic facelift.

Surgical Information on Facelifts at the Practice of Dr. med. Christian Metz in Munich

Which Surgical Methods and Techniques Does Dr. Christian Metz Use?

We perform what is known as SMAS lifting (Superficial Musculo-Aponeurotic System), referring to the thin layer of connective tissue (SMAS) that lies beneath the skin. This layer is lifted and tightened during the facelift procedure. Depending on your needs, a temple lift, midface lift, or classic lift addressing the temples, cheeks, and neck may be indicated. We are also happy to explain the minilift, thread lift, volume lift, and so-called small facelift, and to advise you on the surgical options available.

What Does the Procedure Involve in Detail?

The procedure varies depending on the type of facelift chosen. After administering general anesthesia or twilight sedation with local anesthesia, the incisions are made. In a classic facelift, these are placed either in front of or within the temple hairline. They typically continue along the edge of the ear, around the earlobe, and back into the hairline, depending on whether the neck is also being treated. The skin and the underlying connective tissue layer (SMAS) are then released, and the muscles and fatty tissue are lifted, repositioned, and tightened. Any excess skin (usually 1–2 cm) is removed as needed. If the facelift is combined with a volume lift, fat — with or without stem cell enrichment — previously harvested from another area of the body, or PRP (platelet-rich plasma), is also introduced into specific areas of the face. The incisions are then sutured. Antibiotic dressings placed in the hair help prevent wound infection.

Thread lift: In a thread lift, self-dissolving threads with small barbs are drawn into the tissue, where they anchor in place and lift sagging areas of skin. No incision is made.

Volume lift: Fat is harvested, potentially enriched with stem cells, and introduced into the desired areas of the face. This can also be done using fillers (hyaluronic acid).

Minilift: The incision is made only in front of the ear. The cheeks, and to a lesser extent the neck, are tightened using the same method as in a facelift (SMAS). This can also be effectively combined with a vampire lift, in which, in addition to the skin tightening, blood drawn beforehand is processed and the resulting PRP (platelet-rich plasma) is injected into the skin.

Do I Need to Stay at a Clinic for a Facelift?

A classic facelift is performed under local anesthesia with twilight sedation or under general anesthesia. It can be carried out on an outpatient basis or with a hospital stay of one to two nights. A midface lift addressing the cheeks and center of the face can be performed as an outpatient procedure or with one overnight stay. A temple lift is generally performed on an outpatient basis. A thread lift is always performed as an outpatient procedure. We will clarify these details together during your consultation.

What Type of Anesthesia Is Required?

Depending on the facelift variant, an outpatient procedure under local anesthesia with twilight sedation, or general anesthesia, is the anesthesia of choice. For combined procedures, the surgeon generally opts for general anesthesia.

How Should I Prepare for a Facelift?

You must stop taking medications containing acetylsalicylic acid 14 days before the procedure. Blood thinners must also be paused, in consultation with your primary care physician. In addition, you should stop smoking 3–5 days beforehand and refrain from alcohol. Pre-existing conditions, current medications, and allergies must be disclosed to your doctor. Please also inform your doctor of any blood clotting disorders. If you have previously experienced problems with scar healing, this is also important information for your doctor. Depending on any pre-existing conditions, additional preliminary examinations may be required. For general anesthesia, the necessary examination takes place either with your primary care physician or at the clinic the day before surgery.

What Does Aftercare Involve?

You will wear a facial compression garment. For several days, you will cool the treated areas using cold compresses (a head wrap). The drain is removed after one to two days. For the first few days after a facelift, it is best to sleep with your upper body elevated. Sutures are removed after five to six days, and again after 14 days. Scar care is important for procedures involving incisions. After the sutures are removed, make-up can help conceal any remaining redness for a time.

What Are the Risks of a Facelift?

General surgical and anesthesia risks can occur in rare cases. These include wound healing complications, bleeding, or infections, which are treated with antibiotics. A sensation of numbness in the treated area may occur, though this usually resolves quickly. Dr. med. Metz will inform you in detail about these risks during a thorough consultation prior to surgery.

What Complications Can Occur?

Swelling occurs initially but generally subsides after about a week. Good cooling helps to reduce it. Bruising may also occur.

What Kind of Pain Should I Expect?

Initially, the cheeks or other areas of the face may feel somewhat numb. Pain is minimal. Any mild discomfort can be effectively managed with standard pain medication. Both effects subside quickly.

Will I Have Visible Scars?

The scars are partly hidden beneath the hairline and typically heal well, making them barely visible. Depending on the extent of the facelift, fine incisions around the ear may also be necessary; with proper scar healing, these too become nearly invisible over time.

When Can I Return to Work?

This varies depending on the type of facelift. For a classic facelift, you can expect to be unable to work for around one to two weeks. After a thread lift, you can return to work after 1–3 days.

When Will I Be Presentable in Public Again?

Once the swelling has subsided, most patients are presentable in public again after about two weeks. This depends on the extent of the facelift. Make-up can effectively conceal any remaining redness.

Are There Alternatives to Surgery?

A volume lift using fat transfer or autologous tissue is an alternative to a surgical facelift with incisions, provided your individual circumstances allow for it. Thread lifting is another alternative, though it is generally more suitable for younger patients, as it only tightens the skin. If wrinkle reduction is the primary concern, we often recommend a carefully administered Botox treatment or hyaluronic acid injections instead. We are happy to advise you on the options available for facial rejuvenation.

Is a Facelift Also Available for Men?

Yes, men can also undergo a facelift specifically tailored to their individual needs.

Why Isn't Skin Tightening Alone Enough?

It is often claimed that good results can be achieved with simple skin tightening alone. This is not the case, however, as it addresses only the skin. The muscles and fat pads are left untouched, and tightening the skin alone actually causes more volume loss than gain. It is essential that the connective tissue beneath the skin, where the muscles are attached, is also tightened. This results in a redistribution of volume, with only the remaining excess skin then being removed.

Will My Face Still Look Natural After a Facelift?

Our goal is rejuvenation while preserving your face's natural characteristics. We bring extensive experience to this. You are welcome to view before-and-after photos at our practice.

Can a Facelift Be Repeated?

Some patients have previously undergone a partial facial treatment, such as a cheek lift. In such cases, the untreated neck can sometimes disrupt the overall harmony of the result. A further treatment, such as a neck lift, can then be a good option.

What Is Recommended for a Double Chin?

A double chin is usually caused by an accumulation of fatty tissue under the chin. An SMAS neck lift tightens the band of tissue beneath the skin to which the neck muscle is attached, after which the skin itself is tightened. Excess fat is removed.

What Does the Procedure Cost?

A classic facelift starts at €9,000.

In Which Cases Does Health Insurance Cover the Procedure?

This procedure is not covered by statutory health insurance.