Q&A
Frequently asked questions
Frequently asked questions
I work 2 days a week in the Velthuis clinic in Amsterdam and 2 in Rotterdam. You can make an appointment with me by filling in the contact form. My assistants will then contact you to plan a date and time for the consultation.
A consultation can usually take place within one month. I have a waiting list of about 1-2 months for operations, although this may differ depending on what procedure is required. The weeks just before holidays are always busier.
Yes.
The operations are performed in the new operating complex of the Velthuis clinic in either Rotterdam or Amsterdam.
The operations I do are generally not painful, although it is true that there may be some discomfort in the form of swelling or a feeling of tightness. Usually paracetamol should be sufficient to cover that. Incidentally a stronger medication is needed, such as ibuprofen. Even when pain is not a common occurrence, not everything can be avoided (so please let us know if you have any discomfort so we can treat it for you).
Because it takes a year for scars to completely settle and the healing to be fully completed, it doesn't matter in which season a procedure is performed. It is mainly someone’s personal planning that determines when an operation is most convenient.
Make sure that you get the prescribed medication one week before the procedure at the latest. Please be aware, some medications must be started a few days before the procedure!
Generally no, so keep taking them as usual. Even if you have to be sober on the day of the procedure, you will have to take your normal medication with a sip of water. However, some medication, such as blood thinners, should be stopped a week before the procedure. This should always happen with the permission of the doctor who prescribed it to you, so you should check with them beforehand.
There are three different methods of anesthesia in operations on the face.
This time varies per person and per operation. If you easily bruise, it usually takes 2 weeks before they disappear. On the other side of the spectrum I’ve had people being presentable and ready to start working again 3 days after a facelift. People that can work from home and that do not have much face to face client contact or social contacts can of course return to work earlier than people that rely on close contact to do their job. Average downtime following procedures are:
You look at yourself in a very different way compared to how you look at others. When you look at yourself, you notice details such as wrinkles and folds, puffiness or "your mother's neck". When looking at others, you mainly notice someone’s appearance: you will see whether someone is happy or angry, tired or in balance. Others won’t notice you have less wrinkles, a smaller nose or that your bags under your eyes have disappeared. What they will see is that you look better, less tired and that you radiate more openness and confidence. Everyone will see, but nobody will know.
Usually, the operated area swells a bit in the first 3 days, after which it will slowly come down again. Cooling helps against the swelling and will keep it under control. This is thus especially useful in the first 3 days. Some people feel it still brings comfort at later stages of the healing process, which is also fine. It is important however that you never use ice directly on the skin, but always put something in between such as a clean cloth or a tea towel, as not to harm the skin.
Scars go through a number of phases while they heal. Redness and firmness are present in the first 4-6 months, after which they will slowly but surely fade. If it bothers you, you can camouflage your scar with make-up after the stitches are removed. Once a scar has faded to the color of the surrounding skin, it is usually no longer noticeable or visible. On average however, it takes one year for a scar to fully settle. During this period, it is vulnerable to damage from UV light, such as from sunlight or tanning beds. It is wise to protect your scar from the sun by clothing or by covering it with a sunblock (factor 50).
This can vary enormously per person. It depends, among other things, on age, genetics of skin quality, whether you smoke and on whether you spend a lot of time in the sun, etc. It also differs per procedure. For example, most people only need one upper eyelid correction to avoid skin excess there for the rest of their lives. For a facelift, it generally will take 10 to 15 years before skin laxity reaches similar levels as before the operation. It is important to realize that the natural aging process obviously continues as usual, also after surgery (which also applies to the people around you by the way).
Many people come to me with the question whether they already need a facelift or not. Usually they notice that at some point other solutions, such as botox and fillers, simply no longer have any effect. When people turn 40 the ageing process seems to accelerate. Skin excess starts to become apparent and you may find yourself standing in front of the mirror pulling your skin tight to see what it looks like. Once skin laxity has appeared, a facelift is really the only structural solution. With a facelift, the tissues are placed back to where they come from and the surplus is removed. It is a reset of your face.
I am adamant that prevention is better than having to solve a problem once it has occurred. This also counts for your face. If you operate with this principle in mind, so before things get out of hand, you can achieve a lot with a relatively small procedure without ending up drastically changing your appearance. However, if the tissues have dropped and your skin quality has deteriorated noticeably due to age, sun and / or smoke damage, it is often much more difficult to obtain a more nuanced and natural result. Realistically, a modest facelift from the age of 45 is favorable. The effects of such an operation at that age will also last a lot longer.
The S refers to the shape of the scar and doesn't say much about the technique. I am not a fan of it, because the S scar is placed on the edge of your hairline on your cheek and in the temple zone and is therefore visible. I prefer to position my incisions where they end up being inconspicuous.
I often hear “I don't want a facelift, I’d prefer something small, like a mini-lift”. And I realise that a mini lift must sound very tempting. However, a mini-lift is only a term that was invented to respond exactly to that emotion. With a mini-lift, just a limited amount of skin is resected. Skin however is not firm enough to support and maintain the initial tightness and therefore relapses within a few months. This means you will have paid money and received a scar but are left without any significant effect. The mini lift is therefore a pointless operation that I do not perform.
A MACS lift is popular facelift technique in which a relatively small scar is combined with a relatively modest lift. For this reason many young plastic surgeons use it early on in their practice. In my view however, it has a few essential limitations. The operation is done through the same S-shaped scar as the S lift (see above), which is too visible for my liking. Besides that, in the MACS lift only the tissues of the cheeks and the jawline are lifted, without much effect on the neck. This not only limits its results, but also creates a discrepancy between the jawline and the neck angle, introducing a certain degree of unbalance to the lower half of the face and making it look unnatural. This is the reason that I only consider this operation in very limited cases, when there is no ageing visible in the neck.
The deep plane facelift is also known as the American facelift. It is an operation that has existed for a long time and has proven itself in many American celebrities. It is however a somewhat more aggressive technique, resulting in a longer downtime and more extensive scars to reach the effect. In addition, as the name suggests, the technique uses layers that are quite deep in the face. Those deeper layers are lifted upwards, while the skin is pulled backwards as a separate layer.
It is a technique that works, but in my opinion it is unnecessarily extensive and therefore risky. In addition, in the wrong hands there is a chance of you ending up with an unnatural tightening of the face which has given plastic surgery such a bad name, because the skin is corrected in a different direction than the deeper layers. This can easily create an unnatural appearance. For these reasons I abandoned this procedure.
The Enbloc neck facelift is designed to minimize scars and lift the skin of the cheek together with the underlying layer of firm tissue. Enbloc means jointly, as one layer. The jaw line has dropped and is therefore corrected upwards, in a natural direction and with a limited area of dissection. The angle of the neck is then corrected towards just behind the earlobe, so that it falls in line with the new jawline. This way you can achieve a balanced and therefore natural correction of the whole lower face, with minimal scars and minimal disruption of the underlying skin structures.
Rhinoplasty is an option for anyone looking to improve the shape and / or function of their nose. It is important that you think carefully in advance about what you don't like about your nose so that clear and realistic expectations can be set. Please remember that perfect really does not exist.
Rhinoplasty is an option for anyone looking to improve the shape and / or function of their nose. It is only important that you think carefully about what you do not like about your nose so that you can explain it to me properly. In addition, it is of course important that you have to be realistic in your expectations for an operation, in addition to being healthy. Perfect does not exist.
First of all, your aesthetic and functional concerns and wishes are clarified. Next I will closely assess and analyze your nose. Then I’ll take some standardized pictures that I will morph in such a way that you can get a realistic idea about a possible end result. The purpose of the procedure, the expectations and the potential complications will be discussed, so that you are well prepared and know what to expect. All the information is also provided on paper so you are able to go over it again at home.
No. You have to wait until you have stopped growing, otherwise results will be largely unpredictable. The minimum age therefore is 18 years.
On average operations on the nose are performed under general anesthetic. Minor corrections to the tip or the nasal bridge are sometimes done under local anesthetic, but this is exceptional. Typically, it is not a painful procedure, but sometimes people do experience some discomfort due to the swelling in the first days after surgery. Paracetamol is almost always enough to get through that first period with a reasonable level of comfort.
No, I stopped using nasal tamponades back in 2015. When the septum has to be corrected, I sometimes leave splints in the nose. The splints I use have tubes integrated in them, which means you’ll be able to breathe, albeit somewhat restricted. The splints come out after 1 week.
In 90% of the nose corrections I do I use the so-called preservation rhinoplasty technique, which is a closed rhinoplasty technique. The scars (so also the stitches) are placed inside the nostrils and are thus invisible. The sutures used for this are always self-absorbing and therefore do not have to be removed. In the few cases where it is still necessary to do “open” nose surgery, a small scar is made at the small skin bridge in between the two openings. This will fade over time.
The main limiting factor is the situation at the start. For example, if you have thick skin, this will always limit any attempt to create a tiny, elegant nose. Potential complications include bleeding, infection, bruising or even a perforation of the nasal septum, incomplete correction, scarring and the slight return of the original shape. As a whole, in about 5 to 10% of cases a (small) post-correction is necessary, depending on the technique used. We continue to remain in touch with each other after the procedure until the nose is healed and a realistic and satisfying result has been achieved.
The swelling of the operating area will increase during the first 3 days after surgery before it subsides again. After 2 weeks, 90% of the swelling should have disappeared.
After a few days most people can resume light daily chores. Particularly bending down and applying pressure will be uncomfortable in that phase. At the check-up 1 week after the procedure, the cast and if needed, the splints are removed. If the bones have been corrected, it is wise to postpone contact sports for 3 months. Recovery is a gradual process, but it takes a year for everything to completely settle down and your nose to feel as mobile and natural as before.