If your neck is saggy then a formal facelift rather than a MACS lift is is appropriate. This involves an incision in front and behind the ear and into the scalp in the temple region and behind the ear. These scars are all very inapparent. The skin and the layer beneath the skin (SMAS – Subcutaneous MusculoAponeurotic System)  are undermined and tightened. The platysma muscle, a thin sheet beneath the neck skin, which is partly responsible for those vertical bands in the neck, is usually tightened in the midline via a short transverse incision under the chin.  If you have too much fat beneath the chin, this is removed. The operation takes a about 3.5 hours. 

You wake up with only your face showing through the bandages. The bandages are removed the next morning and you can shower immediately and wash your hair. Some swelling and bruising is normal so you will need to plan to stay “out of sight” for a couple of weeks! Most people say that the post-operative period is not very painful. I provide you with an elastic chin support which I like you to wear continuously for the first week and whenever you are at home for the next two weeks.

The main risk specific to this operation is to the branches of the facial nerve which is the nerve that works all the facial muscles. Careful attention to undermine the tissues at a plane superficial to the facial nerve branches ensures than the facial nerve is not injured. The great auricular nerve lies quite superficially below the earlobe. Again, careful attention to undermine superficially in this area avoids injuring this nerve. While not so important as the facial nerve, injury to the great auricular nerve results in a numb earlobe. Other risks are common to all operations.

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