Enbloc facelift

Personal analysis

Often people come to me because they feel their face doesn’t reflects anymore how they feel inside. When we communicate, we subconsciously react to what others radiate. We respond to a face as a whole, where we see a friendly, persuasive or charismatic person, a sad or tired person, long before we can tell what specific features account for this intuitive impression.

This is important to realise, as it clarifies why optimising this impression requires a holistic approach. Adjusting only one part of the face can easily create an unbalanced and thus an unnatural appearance, which others will notice instantly. They will start to wonder what it is that makes them feel something is wrong, which will completely distract from the conversation you are having.

So when optimising the face one should be careful not to disturb the balance of the face. This is why a personal analysis is so important, as it will make clear what the best choices are for your face.

From what age are facelifts performed?

Age related changes often only become noticeable when laxity of skin starts to become a factor. Tissues drop down over years (like jowls or bands in the neck) and thus give a more tired or worn appearance. This process usually accelerates between 40 and 50 years of age, which is when facelift surgery starts to be beneficial.

The longer I’ve been doing this, the more I realise prevention is better than renovation. The longer you wait, the more difficult it is to surgically optimise your face in a natural way. This is the reason why I take the Enbloc facelift into consideration from the age of 45. In some people skin laxity only occurs at a much later age. But one thing is sure: once the skin shows laxity, the best option is a structural solution by facelift surgery.

The Enbloc facelift

The Enbloc facelift is the ideal technique to correct a face in a natural way.

In my experience most frequently used facelift techniques either do not have sufficient effect (S-lift, MACS lift) or are too drastic (Deep plane facelift). With these techniques people are often not presentable for weeks or even longer, after which it is not uncommon for them to look tight and operated.

The Enbloc facelift technique was developed to improve on this. The goals were:

1. to achieve the most natural effect possible:

• by taking everyone’s personal appearance as the starting point instead of unrealistic beauty ideals,
• by respecting the balance in the face, optimizing the cheeks as well as the jawline and the neck,
• by respecting the limits of normality, so that you do not “become someone else”, but rather the most optimal version of yourself that you feel most comfortable with.

2. to minimize the impact of the process:

• by making the operation possible under sedation or even local anaesthetic (general anaesthesia is really not necessary),
• by making scars as small as possible (up to half of what is common in other techniques),
• by making the wound surfaces as small as possible (up to a third of what is common in other techniques),
• by operating with the least possible risk (i.e. far away from the muscles and nerves),
• by using soluble sutures, which results in the shortest and most pleasant recovery time.

The scars

One of the main reasons why the impact of this operation is so minimal are the relatively short incisions I use. The scar starts just above the ear at the front and then continues behind the entrance of the ear down and around the earlobe, and then stops after 2cm behind the ear. It falls into the folds of the skin and behind the auricle, making it virtually invisible in the long term.

All the steps of the Enbloc facelift treatment

All the phases of a correction via the Enbloc facelift are explained in more detail below. My recommendation would be that you read this information carefully and contact me if any questions arise. I wish you a good recovery!

The preparation

• You should not take medication that thin the blood as this increases the risk of bleeding. Non-steroidal anti-inflammatory drugs such as aspirin, Brufen, Ibuprofen and Nurofen should therefore be stopped two weeks before surgery and should not be used up until two weeks after the procedure.
• Ask us in advance if you have any doubts about the safety of your current medication regarding the operation.
• If you smoke, it is strongly recommended that you quit two weeks before to at least one week after the surgery. Smoking restricts blood flow, which may prevent proper wound healing.
• Make sure someone is able to pick you up after your surgery, because you can't drive home (besides the fact that you won’t be insured) if you’ve just undergone surgery.
• We advise you to shop for your groceries in advance, so that you don’t have to do this for the first days after the operation.
• It is wise to arrange for some help at home for the first few days after surgery.
• If you also have your eyelids corrected, please make sure to collect the prescribed eye drops and gel before the surgery date.

The Enbloc facelift surgery

• Please come to the surgery without any jewelry, makeup on or contact lenses in.
• On the day of the operation, I’ll see you right before the operation and I will briefly go through the procedure with you again.
• Before we start I will make skin markings for the operative planning and I will take pictures for the record.
• The operation will be performed in a fully equipped operating room, adhering to the strictest medical rules and guidelines.
• The operation will usually be performed under local anaesthetic or under sedation anaesthesia. Both methods are generally well tolerated. Before we start, we’ll do a final safety check. The local anaesthetic is combined with medication to help you relax. In case of sedation, you’ll receive the medication via a drip, sending you asleep during the procedure.
• The incisions will be made at the most inconspicuous locations. Reality is that others won’t see them and they will fade over time. If the procedure is combined with an eyelid correction, an incision will also be made there (see the page for eyelid corrections).
• The operation takes between two and three hours, depending on what we agreed to do.
• The incisions are closed using resolvable sutures. You may experience some traction around the ears in the first weeks after the procedure.
• At the end of the procedure, a lightly compressing bandage is applied.

After the procedure

• After the operation you will be taken to our recovery room.
• Once the local anaesthetic has worn off (after 2-4 hours), you may experience some discomfort for a few hours. Paracetamol (2x500mg) is usually sufficient to counter that.
• The lightly compressing bandage is removed before you go home. You will receive a removable bandage that you can wear if you prefer during the first week. The bandage is optional, as medically spoken it is not needed due to the restricted wound surfaces.
• In the first three days your face will slowly swell up and sometimes some bruises arise. If you however do bruise, it will take on average 2 weeks for it to subside.
• Avoid bending over or lifting heavy goods in the first few days. During this period it might be wise to sleep with an extra pillow so that your head is slightly higher, which will minimise the swelling.
• It is recommended you wash your hair with cold running water on the day after the procedure. If you bend your head backwards, for example over the edge of the bath, the chance that the scars will get wet is smallest. After 48 hours the wounds typically will be waterproof and getting wet is less of a problem. It is however unwise to take a bath in the first week after the procedure.
• You’ll notice that you can quickly return to your daily routine, even when you will be somewhat limited due to the healing process. You will have to adjust your pace accordingly. If you don’t do this, the process will be more troubling than needed.
• We’ll make an appointment for a week after the operation to check the wound. From this moment onwards using make-up is possible again. You also don’t have to wear the bandage anymore after this appointment (if you still did).
• By this time the swelling and bruising, if any, have usually reduced to an acceptable level that allows social activities to resume. Sometimes, however, these side effects take longer to disappear completely. We therefore recommend that you do not plan very important social activities in the first 3 weeks after the procedure.
• We also recommend that you avoid any heavy physical activities in the first 2 weeks.
• You will notice a varying feeling of tightness around your ears, which often lasts from several weeks to sometimes months, but then fades away. Massaging scars with silicone scargel like Dermatrix can ease this feeling.
• Initially the scars will be slightly red compared to the surrounding area, this will last for approximately 3-4 months. This is especially visible around the earlobes. You can use makeup to camouflage this. The colour will fade after that.
• It is common for the lower half of both ears to feel numb in the first months after the procedure. This will disappear by itself. It is sometimes nice to use an airplane pillow during this period, so you can sleep well without putting any pressure on the ear.
• Because the swelling disappears within the first few months, the skin will thus give way for a few millimetres. That is a completely natural and inevitable process. After the swelling is completely gone, this will stop and the result will stabilize.
• It will take a year before the scars fully settle. During this period, they are vulnerable to damage from UV light, such as from sunlight or sun beds. We recommend that you protect the scars from the sun by covering them or applying them with a sunscreen (factor 50).
• Most people only need one Enbloc neck facelift in their life. Be aware that the aging process will of course continue as normal and that structures will slowly keep sagging even after repositioning. Because the people around you age at the same rate, the structural improvement of the facelift will keep you looking good compared to others. If people do return for a second time, it usually is about 10-15 years later.