The process of facial aging

Facelift – when and how?


Operation technique

Recovery after surgery


Before information about facelift surgery, it is necessary to understand the physiological process that leads to consideration of the correction of changes.

With time passing by, there is a natural process of relaxation of the skin on the face and neck, as well as other regions of our body. Characteristic delicate wrinkle lines appear around the edges of the eyes. The present horizontal lines of the forehead skin that we notice in youth, deepen over time and become more visible as furrows. There are characteristic changes, unevenness and wrinkles around the chin, all the way to the formation of a conspicuous chin. On the front of the neck we notice vertical lines that make the folds easily noticeable on the skin.

Aging promjene na licu i vratu
Aging changes on the face and neck

All the changes described, as well as those not listed here, are governed by our heritage (genetics), habits acquired during life, the ubiquitous gravitational force, and also the inevitable consequences caused by solar radiation.

Facelift – cosmetic surgery of the face and neck tries to improve and help to minimize the progress of the described changes.


The growing population of middle-aged and elderly people contributes to the fact that facelift procedures are increasingly in demand among head and neck procedures. Facelift surgery is sometimes performed on patients in their 30s, but it should be noted that successful surgeries are also performed on patients in their 70s.

It should always be borne in mind that a facelift cannot stop the aging process nor can it reverse the biological clock. What it can do is help maintain a healthy and rejuvenated look to the face.


Several factors are very important. The basic precondition for success is good general health and knowledge of basic information about the procedure. A good understanding of the limitations of the facelift is a key assumption, and the psychological stability of the patient is very important.

There is no ideal facelift – the goal of the operation should be to improve the overall appearance of the face and neck. Important facts, such as skin type and elasticity, individual characteristics of healing process, features of bone structures of the head, as well as a realistic positive approach to surgery should be discussed during the consultation. It should certainly be clarified whether the overall effect can be even better with possible additional procedures on the chin and neck (eg liposuction and lipoplasty of the face and neck or implant placement ) in order to remove/add fat tissue or contour the bone skeleton.

If there are several zones on the face or neck that require separate correction, several separate procedures are considered to achieve the maximum effect (eyebrow or forehead lift, mid-face lift, rhinoplasty or blepharoplasty ).

During the preliminary consultation, a careful examination of the facial structure, assessment of skin quality, color and elasticity will be made. Before the operation, photo documentation is obligatory, and the operator will take a detailed general medical exam just as if you were in a hospital and preparing for any other surgical procedure. It additionally assesses your mental health and emotional attitude towards the surgery. It is of utmost importance to detect the existence of individual risks such as high blood pressure, propensity to scar, smoking or blood clotting disorders.


In Polyclinic, we usually perform last generation facelift, so-called MACS (Minimal Access Cranial Suspension) facelift or short-cut facelift which is suitable for most patients of both sexes, especially younger age, ie. in their 40s and 50s. This type of facelift guarantees minimal tissue trauma with less noticeable postoperative scars, and the operation of shorter duration. Postoperative recovery is significantly faster than with the classic technique, which is very acceptable for patients due to an earlier return to regular activities.

Classic technique (SMAS) of the operation begins with an incision (incision) in the scalp above the temple, in front and above the ear, and continues with an incision around the ear and finally returns to the scalp where the incision began. In some cases, it is also possible to correct minor deformities of the external ear , especially the ear lobule. This is followed by lifting the skin before repositioning and securing the deeper muscle and connective tissue (SMAS) tissue in the desired position. Excess adipose tissue is removed, along with excess skin. In men, the incision is planned to fit in the line of beard growth.

The incision design is placed where it will be closest to the already existing normal skin furrows and wrinkles. In this way, maximum camouflage of the scar is achieved. After removing the excess skin, the incision is closed with fine sutures and/or metal clips (staplers) that allow surgery without the need to cut the hair at the incision site.

MACS lift


Depending on the type and weight, the operation takes between 2 and 4 hours.

Most surgeons recommend performing a facelift under general anesthesia. If another type of anesthesia is chosen (a combination of light sedation, local anesthesia, and intravenous anesthesia), the patient may feel a slight discomfort. After the operation, a bandage is applied so that the incision site and the operated area are covered in detail to keep it clean and sterile. Despite the fact that most patients feel very little pain, pain medications (analgesics) are given by an operator or anesthesiologist.

After surgery, certain formation of a swelling and/or hematoma is inevitable, in which case instructions are given on applying cold compresses to keep swelling to a minimum. The bandage is removed after 1-2 days, and further dressings are arranged as needed. It is advisable to raise the headboard and avoid excessive physical activity. The surgeon should definitely be informed in case of discomfort in the head and neck area or other problems that may occur.

Although there is little risk with facelift surgery, they are sometimes unavoidable, similar to any other surgery.

In most cases, drainage of the operated area is placed at the end of the operation. It is removed during dressing on the second or third day after surgery. All stitches and staplers are usually removed 7 -12. day after surgery. During the early postoperative period, it is recommended to avoid physical activity. You should definitely gain and maintain the support of your friends and family, both after the operation and before your decision on the facelift.



Recovery typically takes 2-3 weeks, although some patients will be able to return to normal activities and return to work after two weeks. The scars from the incision are usually not noticeable, given the time it takes for the scar to “mature”. In any case, the scars are easily covered by placing them in natural skin furrows, hair or by applying various cosmetics in case of prolonged healing.

It should be borne in mind that successful surgery does not stop the natural aging process and that a slight relaxation of the skin is expected during the first few weeks.