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Our facelift philosophy at The Maercks Institute

It’s possible to get the more attractive, youthful face you want without sacrificing your natural good looks. When you choose Dr. Maercks for your facelift, you can rest assured that you’re getting focused and individually tailored care. Dr. Maercks believes in enhancing your organic beauty. 

He does not conform to mainstream plastic aesthetics, but is instead dedicated to the beautiful, natural human form. He will optimize your facial structure by highlighting your unique beauty through bespoke designed interventions. This means you get the more youthful appearance you want, but you will still look like yourself. 

What is a facelift?

When performing a facelift, a plastic surgeon should address the entire face, including areas surrounding the jowls, cheeks, and neck. A good facelift tightens the underlying layer of muscle (called the SMAS) and removes any excess skin from the area to tighten it up. This procedure can be combined with other corrective procedures such as eyelid and/or brow rejuvenation, fat transfer to create youthful contours, and sometimes chin, nose, and/or jawline surgery. 

What happens to the face with age

As the face ages, it goes through three transformations that are often visible to the naked eye. These transformations are known as deflation, descent, and radial expansion.

  • Descent: Inferior displacement of the soft tissues of the face
  • Deflation: Facial fat is lost over time
  • Radial expansion: Facial tissue is loosened

Are there different kinds of facelifts?

SMAS facelift

There are many different facelift techniques, and there are even more opinions on what works best. In the commoditized world of plastic surgery, many practices focus on a quick and inexpensive solution ranging from the “skin-only facelift” to the abbreviated “SMAS” (Superficial Muscular Aponeurotic System, i.e., deep structure) facelift. 

Mini facelift

In a mini facelift, the lower half of the face — the jawline and jowls — are tightened, but the neck is not typically addressed. Small incisions are used to slightly pull the facial skin upwards. Shorter incisions are used (the scar stops at the earlobe), and typically only local anesthesia is used. This technique is popular due to its results and minimal recovery time. 

MACS facelift

More than 80% of facelifts performed today in the U.S. are MACS (Minimal Access Cranial Suspension) lifts. This technique is a simplified technique that uses several loops of suture to squeeze and lift the SMAS in a vertical direction. Dr. Maercks does not offer MACS facelifts because of the strange, stretched, and abnormally “pulled up” skin that can result from it. A common finding years after a MACS facelift and other vertical lift techniques is what is known as “joker lines”. Joker lines result from the lower face next to the mouth descending while the skin at the hairline is high in its vertical position. The result is a strange, drooping-then-ascending crease — much like a joker. Another issue with vertical techniques is that they are very limited in capability of correcting neck laxity, which is usually the primary reason for seeking a facelift.

Direct SMAS facelift

Direct SMAS approaches — such as the extended SMAS lift popularized by Stuzin — offer more control of the vectors and shape of the face. When performed by a talented plastic surgeon, these techniques tend to deliver much more natural and supported results. Dr. Maercks used these techniques early in his practice with great results.

Deep plane facelift: Dr. Maercks’s technique of choice

Although Dr. Maercks previously utilized the Direct SMAS facelift technique, he has since moved to a different concept known as a “deep plane facelift” or the “composite facelift”. He has chosen to do this for several reasons. 

The principles of Dr. Maercks’ facelifting technique were elucidated by an Australian plastic surgeon named Brian Mendelson. Dr. Mendelson’s anatomic studies revealed a natural space overlying the major muscle we chew with: the masseter. This space is a safe plane of dissection that allows the facial nerve branches to be clearly visualized and avoided. The idea of working near facial nerves can scare off surgeons from this technique; however, experienced craniofacial surgeons such as Dr. Maercks and Mendelson consider this technique much safer than blind suture placement of all other techniques that can be associated with facial nerve damage.

The major advantage of this technique is that the face is fully mobilized as a composite block instead of delaminating into several layers. The ligaments that support the face are moved at their base, which provides a much stronger, and therefore lasting, support. These ligaments are like tree trunks that branch out further and further as they reach more superficially into the face.

Moving the face under the skin is like cutting the thin end branches right below the leaves of the tree — i.e., not much support. Moving the SMAS under the skin is like grabbing the thicker branches below these twigs, lending stronger support. A deep plane facelift is essentially moving the whole tree without disrupting any branches. The face retains its natural support system and has much less healing and recovery. The vectors and shape of the face can be managed in a customized and natural manner.

While deep plane facelifts of the past were more aggressive and had significant complications associated with them, the modern deep plane facelift avoids many of the dangers of a conventional facelift, and conveys many advantages.

The deep plane facelift that Dr. Maercks uses avoids the thinning and delamination of the face, which can result in the scarred or stretched appearance so often associated with a bad facelift. One of the other advantages are that the deep ligaments are re-suspended, and there is no tension on the skin. This results in superior treatment of the central face and an extremely natural-looking, supported face.

Why Dr. Maercks favors the deep plane facelift technique

Dr. Maercks typically selects the deep plane facelift technique over other methods such as the mini facelift or others. He chooses the deep plane technique to restore a supported youthful appearance when there is extensive neck and/or facial laxity that cannot be addressed non-surgically. When a surgical facelift is needed, Dr. Maercks leverages the power of fat transfer to re-build youthful volume around the eyes, lips, temples, and forehead. He also commonly performs a browpexy and four-lid blepharoplasty to ensure the entire face is harmoniously rejuvenated. To achieve a beautiful neckline, he incorporates a platysmas kite flap that lifts and supports the neck. The sum of these procedures produces the natural-looking MAERCKS lift (Musculo-Aponeurotic Elevation and Retention Check Kite Suspension lift).

Facelift for descending skin

Over time, the underlying tissues and the skin of the face will descend. This change is often noticeable first in the mid-face where the cheek starts to descend, and creates two different effects: either a hollow spot forms as fat of the cheek descends, or jowls appear as the tissues of the face descend down and forward. The muscle that starts in the lower face and continues to run down the neck is referred to as the platysma. As the body ages and this muscle descends, jowls are often the result. 

A jowl is the muscle’s front end as it sags. If the muscle sags in the neck, it may create bands around the front. A facelift should elevate the cheek back to its original position. This restores fullness to the spot between the lower eyelid and the cheek. Many facelifts fail to account for this change, while we believe it is a huge part of restoring the natural, youthful look and feel of a face. A thorough facelift will re-position this muscle to its natural position in order to remove jowls. Along with the facelift, fat transfers may be used to further lift and balance the cheeks and create a younger appearance.

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Facelift for deflation

Patients who notice hollowness in some areas as the skin ages may be noticing deflation. Deflation is usually due to the descent of facial fat or a noticeable loss of fat volume. Most patients notice this problem first in the area directly underneath the cheek. In order to correct for deflation, a facelift should account for these hollow areas created by a shift in fat volume from aging. During the procedure, volume is replenished by re-positioning the deep tissues of the face, either by an autologous fat transfer or simple re-positioning of the fat.

Facelift for radial expansion

Radial expansion is noticeable as an outward push in some facial areas that is common during aging. This creates a loss of the definition of the jawline, and is most noticeable in the jawbone’s lower border and the jowls. Radial expansion is a result of facial-retaining ligaments weakening over time. These tissues separate from deeper tissues as they become weaker and may be a very difficult problem to correct, even with surgery. During a facelift to correct radial expansion, deep tissues are elevated and secured in order to recreate the original, youthful-looking jawline.

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Facelift for neck sagging

The neck is one of the first places patients notice the effects of aging, as it often begins to sag over time. Muscle descent, increasing skin laxity, and inflation are all causes of neck sagging, and should be addressed accordingly by your plastic surgeon during a facelift. These changes are caused as the platysma muscle loosens over time. This causes a fullness right around the jaw, which may create jowls and require a platysmaplasty (tightening of this muscle). When fat accumulates right under the chin, the neck may need to be sculpted during a facelift in order to maintain a natural, youthful appearance. Taking too much fat out of this area may leave the neck looking skeletonized and make structures of the neck visible. When the neck loses elasticity and becomes lax, there may be extra skin over the neck. 

A facelift can tighten the skin and muscle and remove the excess skin, but does not address the issue of skin laxity and how to fix it. This may require certain non-invasive skin tightening procedures after a facelift. This is a common cause for the dissatisfaction some patients have with the neck area after the procedure. Patients should note that a mini facelift does not address sagging neck skin. 

Composite Facelift Procedure

Composite Facelift With Dr. Rian Maercks

Facelift or Aesthetic Facial Balancing?

Over time and as the body ages, the face’s layers may loosen and separate. These layers include muscle, fat, and skin. A successful facelift will fully rejuvenate the neck and the face by properly addressing these issues when necessary. Neck laxity is the main determinate as to whether Dr. Maercks will recommend a formal facelift, a mini facelift, or recommend one of his customized Aesthetic Facial Balancing techniques to deliver a naturally lifted appearance without surgery.

FAQ

How much does a facelift cost in Miami?

As with most cosmetic surgeries, the cost of the procedure depends entirely on the patient and the nature of the surgery. The cost of a facelift at The Maercks Institute in Miami is typically $15,000 to $50,000, depending on if the patient will be receiving additional procedures along with the facelift. All fees include anesthesia and operating room costs, but please note that this number is a general estimate and may be different for every patient.

What is a non-surgical facelift?

There are many non-surgical options available at The Maercks Institute in Miami, such as Aesthetic Facial Balancing that deliver beautiful facial transformations that resemble facelift results, but that don’t require surgery. This is often more affordable and takes much less recovery time. Dr. Maercks usually opts for non-surgical measures such as these for patients who do not have significant neck findings. Significant neck laxity is a good indication to jump ahead to a surgical facelift.

What is a mini facelift?

A mini facelift addresses the lower half of the face. It uses shorter incisions — which means a smaller scar — and requires less cost and recovery time. A mini facelift is best for those with mild to moderate jowling or sagging skin of the face. Results from a mini facelift last 7 to 15 years, depending on the patient.

What risks are associated with a facelift?

As with any surgery, there are risks associated with a facelift. However, these risks can be controlled and minimized by a proper home care routine, which we will provide you with. Although rare, there is a risk after a facelift for a hematoma, which is treated by draining in the doctor’s office. Facelifts are not typically performed on active smokers, because nicotine may reduce the skin’s blood flow and negate the results of the surgery.

How to prepare for a facelift

The first step on your way to a facelift is to have a consultation with Dr. Maercks at his Miami surgical center. Once he has determined that you’re a good candidate for a facelift, you’ll need to stop taking any anti-inflammatory medications at least two weeks before surgery. You’ll also need to avoid alcohol starting five days before surgery in order to decrease bruising and swelling.

How is a facelift performed?

As mentioned above, Dr. Maercks typically performs a facelift using the deep plane facelift technique. Typically, the patient is placed under anesthesia before the procedure begins. The incision is hidden in and around the ear. Fat is then re-distributed or sculpted from the neck, face, and jowls, and tissue is re-positioned as muscles are lifted and re-shaped. A more in-depth facelift may require an additional incision right under the neck.

The incisions are closed with either skin adhesives or sutures after the procedure is complete. Dr. Maercks may use any of the following techniques:

  • Soft tissue augmentation
  • Wrinkle reduction
  • Resurfacing techniques
  • Facial fat grafting

Why choose The Maercks Institute for your Miami facelift?

At The Maercks Institute in Miami, we’re proud of our focus on customizing each treatment to the individual patient. After a facelift or mini facelift from Dr. Maercks, patients never look stretched or pulled, and he uses a personalized signature technique to ensure that the effects of aging are minimized, yielding a natural-looking result. The goal is a balanced, natural-looking face and a well-defined, youthful neck. Not only is face surgery one of our main services; Dr. Maercks will also formulate the ideal treatment for your specific goals. As a board-certified cosmetic, plastic, and reconstructive surgery specialist with an artist’s eye, he will leverage your unique beauty and use experienced judgement, attention to detail, and artistic vision to accomplish beautiful, natural-looking results. Dr. Maercks’s undergraduate training in fine arts and philosophy created the framework through which he explores the world of plastic surgery, and he has been changing the lives of patients since opening his practice in 2009. He elevates the standard of patient care and safety through his work as medical director at The Maercks Institute, and his approach to both surgical and non-surgical aesthetic procedures have garnered him international recognition by surgeons and patients alike. If you’re interested in scheduling a consultation for a facelift in Miami, please contact our office today. 

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Recovery 

A facelift is an outpatient procedure, and most patients return home the day of surgery. We offer overnight stay with nursing care at The Maercks Institute in Miami for patients who prefer this convenience. The first night should be spent in bed, with activity at a minimal level. Patients can resume a normal diet.

Facial and neck swelling are reduced by keeping the head elevated, and patients should ice for the first night to control swelling. After surgery, your face will be wrapped in a bandage to minimize pain and keep the skin flat. Most patients can control pain with Tylenol, but additional pain medication may be given as required or needed.

You can expect to return to normal activity levels two weeks after a facelift. Within the first three weeks, close to 70% of expected swelling is resolved, although it may take 2 to 3 months for the swelling to go away completely. A mini facelift requires less recovery time than a traditional facelift. 

You will see Dr. Maercks the following day to remove the bandages. Some bruising on the neck is normal, and no bandage is typically necessary after the first morning. We offer in-office hair shampooing for the first morning. On day five after surgery, the stitches on the chin and ear are removed, and you will be able to resume regular hair washing and showering.

24 Hour post op Facelift!

24 Hour post up Facelift!

Results

The final desired results of any facelift may not be completely noticeable for several months after the procedure. Patients typically report looking and feeling ten years younger after their Miami facelift from Maercks, and results can last as long as a decade or more. Facial rejuvenation surgery has extremely high satisfaction results, and most patients love what they see.

We are also proud of the results our patients see after a facelift in regards to scarring. All incision marks are hidden in natural creases of the skin and behind the hair. All incisions are closed without tension in order to reduce scarring, and closure is always meticulous and tension-free in order to give you the best results after your procedure. We know you want the most natural-looking appearance possible after surgery, and Dr. Maercks does his best to hide the incisions where no one will see them.

Good candidates for a facelift

If you’re interested in undergoing a facelift in Miami, you may be an excellent candidate. The first step is to schedule a consultation to see if it’s the right procedure for your needs. Dr. Maercks may determine that a mini facelift or a non-surgical procedure is better for you. 

In general, those who make good candidates for a facelift are those who:

  • Are non-smokers in good health 
  • Have enough sagging/excess skin for the surgery to be beneficial  
  • Are in their 40s to 70s
  • Have realistic expectations for the procedure

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