This revolutionary facelift technique was developed in 1999 by Tonnard and Verpaele in the Coupure Centre for Plastic Surgery in order to lift a patient’s aged face in a simple and natural manner and with minimal effects and risks for the patient. Tonnard and Verpaele have since published dozens of articles in international scientific journals about this procedure. They have had a reputation as pioneers in the field of surgical facial rejuvenation for years now. Just search for “MACS-lift” on Google to see for yourself just how popular their technique is all over the world.

What is a MACS-lift?

Tonnard and Verpaele have earned worldwide renown with their technique, which they teach to others via scientific articles and books, as well as hundreds of lectures at international conventions. MACS-lift stands for “Minimal Access Cranial Suspension lift,” i.e. a facelift that only produces a small scar and involves the vertical suspension of the sagging tissue.

The primary benefits of the MACS-lift are:

  • Natural results with preservation of your own facial features
  • Safer because the classic side-effects of a facelift are avoided
  • A short and inconspicuous scar
  • Quick recovery
  • Excellent sustainability of the results

In summary, the MACS-lift involves making a small incision along the front of the ear to clear a bit of skin and return the sagging facial tissues to their original position in a vertical direction. To do so, two strong yet soluble threads are woven into the tissues to achieve a sustainable vertical lift. This is the secret of the invisible scars: all tension is subcutaneous, while the skin itself is hardly under any strain. This makes it possible to correct a sagging neck, chin or cheeks with removal of only a small amount of skin.

Is it possible to combine the procedure with other techniques?

A MACS-lift can be performed on its own or in combination with other procedures, such as a liposculpture of the chin, a lipofilling, a laser resurfacing or peeling to correct the grooves around the mouth and/or eyes, an upper and/or lower blepharoplasty, a temporal lift (eyebrow lift) or a liplift. Every candidate for this procedure is personally analysed and no two operations are ever the same. Tonnard and Verpaele use pictures of patients in their twenties in order to achieve a natural rejuvenation of the face.


Via an incision along the front of the ear and the lower edge of the sideburns, the skin is cleared. Near the tendon of the masseter muscle, just above the cheekbone, two soluble threads are firmly attached. These are woven into the sagging tissue of the face. As a result, the facial tissues are not detached from the underlying muscles, which is a major difference compared to classic facelifts and makes the whole procedure a lot safer.

By tightening the two threads, the neck is made firmer again, the angle underneath the chin is restored, the cheeks are corrected, the corners of the mouth are lifted and the grooves next to the nose and lips (nasolabial fold) made smoother. Finally, the skin itself is tightened and a small quantity is removed. Tubes are temporarily installed to drain fluids from the wound. The procedure concludes with the careful stitching of the skin.

Combination of different techniques

It is quite common to perform other techniques (more extensive surgery on the neck, lipofilling, blepharoplasty, laser/peeling, temporal lift, lip lift, etcetera) alongside the MACS-lift.

Another popular technique at the moment is called “Centrofacial Rejuvenation.” It is a combination of various techniques used on the centre of the face, i.e. around the eyelids and the mouth. The strength of this technique lies in the fact that the eyes and the mouth are the source of a face’s emotional expressions. When these features are changed, it is possible to realise a remarkable and natural-looking rejuvenation of the facial features, just like when the patient was young.


You will be allowed to sleep it off for a few hours in our recovery room before you return to your own room. A special cooling mask (Hilotherm) will be applied to your face, which will quite comfortably cool down your face to a temperature of 16-18° C. This is clearly a less aggressive method than cooling with ice. Swelling and bruising of the area are reduced as a result.

At home, it is advisable to take it as easy as possible. You should not lie completely flat (or bend over too far), because that will increase the swelling in your face. The best way to rest is by raising the back support of your bed up to an angle of 20-30° or by placing an extra pillow beneath your shoulders.

You should avoid extreme heat and temperature fluctuations: no saunas, sports, tanning beds or walks outside in the cold before going back inside to warm up, etcetera.

When it comes to painkillers, only use products that do not contain any aspirin (acetylsalicylic acid). Paracetamol can be used in combination with an NSAID (anti-inflammatory medication), which your doctor will prescribe.

As a result of the deep stitches, you will mainly feel discomfort in your jaws when you open your mouth wide. This discomfort will quickly disappear over the course of the first week. It is advisable to only eat soft foods during the first few days after the procedure.

It is not uncommon to experience significant swelling and bruising of the area during the first few days after the procedure. Swelling will mainly occur beneath the ears, but it will always go away eventually.

The plastic tubes will be taken out on the day after the procedure. Your hair will be washed and your face will be cleaned, so you will feel good when it is time to go home.

After one week, all stitches will be removed in the Coupure Centre.

You should account for a period of two to three weeks during which you cannot engage in your usual social activities. If the MACS-lift is combined with other techniques, this period may be slightly longer. The swelling will start to go down from the third day and after seven to ten days, it will usually be gone almost entirely. You may go outside (to go shopping, for example) on the day after your procedure.


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