The 4th Dimension

General risks for any surgery include bleeding and infection.

• Infection is very rare unless there is a general reduction in immunity. Smoking increases this risk. It is explicitly expected that you do NOT SMOKE for at least 6 weeks before the procedure and for at least 2 weeks after the procedure.
• Bleeding is also very rare. However, the risk is significantly increased if you are in a high-risk group (smokers, poorly controlled high blood pressure, use of blood thinners, and other medications that thin the blood). In such cases, it is always advised to first schedule a preoperative consultation with the treating specialists and to wait with a neck-face lift until you are out of the high-risk area.
• If a large hematoma occurs immediately after the procedure, an additional procedure may sometimes be necessary to close a leaking blood vessel. To address this quickly and adequately, one overnight stay is recommended. This way, such an inconvenience, if it occurs, never leads to a permanent reduction in the final result. Although some bruising can occur, within 2 to 4 weeks after surgery, the person is almost always presentable again.
• Dehiscence is the separation of the skin edges at the scar site. Specifically for neck-face lifts, it should be emphasized that the risk of this is greatly increased if the person has not stopped smoking in time. The result can be an unsightly separating wound, especially behind the ear, which can take several weeks to fully close. Wound care is not difficult (shower 1-2 times a day, dress the wound with greasy gauze – Unitulle – twice a day). The result is usually a somewhat widened and retracted scar. From 9 months after surgery, a scar correction can be performed. This is also done without additional costs in the mentioned circumstances. It is better to prevent this by completely stopping smoking at least 6 weeks before surgery.
• If you are taking medication or have had other issues after previous surgeries, you should always report this during the preoperative consultation to take it into account if necessary.
• For procedures performed on both sides, such as a neck-face lift, absolute symmetry cannot be guaranteed. Usually, there was no absolute symmetry before the procedure either, as the two halves of the face are never exactly the same.
• The scar in front of the ear fades so quickly that after 2 weeks, only a minimal line remains, which lies in a natural crease at the front edge of the ear. However, behind the ear, the skin is tougher and thicker, so the scar will remain stiff, thicker, red, and wide for longer. This is normal and not a risk in itself. However, it can cause prolonged discomfort if you do not consider your hairstyle. During this period, tightly pulled-up hair is not advisable. With slightly longer hair directly behind the ear, you can camouflage the scar. Post-treatment with silicone-containing scar cream is recommended.
• Note: Neck-face lifts in men generally cause more immediate postoperative discomfort because:

• Men generally do not like to use facial camouflage to cover the scars during the first 3 months when the scar may still be somewhat red.
• With a technique introduced in the Netherlands by Dr. Jeroen Stevens, this surgery is possible for men. The scar can be completely hidden in the groove behind the ear.
• Some risks that theoretically exist but are very rare include temporary fluid accumulation, which can sometimes be removed with a puncture (a small needle) if the swelling becomes too uncomfortable. The risk of facial nerve damage is extremely low with the technique used by Dr. Stevens (lateral SMASectomy) and has not occurred in his practice to date. If this happens, such discomfort is generally temporary (6 to 9 months).
• Changes in sensation occur with any procedure where the skin is lifted and tightened (abdominoplasty, forehead lift, etc.). Usually, it involves a small area in front of the ear or near the earlobe where the skin may feel temporarily dull.
• Changes in skin sensation: After any procedure involving an incision in the skin, the sensation of that skin often feels temporarily different. Often dull, sometimes (temporarily) more sensitive, tingling, stinging, or burning. Although it almost always eventually feels nearly normal again, it can take longer than you would like (sometimes 3-6 months to sometimes 1 1/2 years). Sometimes the sensation can be really bothersome. Desensitization exercises may then be applicable.