Facelift

A/Prof Mark Gianoutsos performs face and neck lift surgery (meloplasty/rhytidectomy) from Prince of Wales Private Hospital in Randwick, offering both a traditional long-incision technique for patients with significant skin laxity and a short-incision MACS lift variation for younger patients who prefer no scars behind the ears. Both approaches address sagging jowls, crepey neck skin, double chin, and turkey neck through repositioning of the skin, deeper SMAS layer, and platysma muscle. The facelift is frequently combined with brow lift, eyelid surgery, chin surgery, rhinoplasty, and structural fat grafting in a single operative session at the Randwick private hospital.

Facelift surgery at A/Prof Mark Gianoutsos's Randwick practice at Prince of Wales Private Hospital in Sydney addresses the hallmarks of facial ageing through surgical repositioning of the skin, the underlying SMAS (superficial musculoaponeurotic system) fibromuscular layer, and the platysma muscle of the neck. Two distinct facelift approaches are offered, with technique selection driven by the degree of skin laxity, the patient's age and tissue characteristics, and their preference regarding scar placement. The traditional long-incision facelift (meloplasty/rhytidectomy) uses incisions placed above the ear along the hairline, within the anterior helical crease and tragus, continuing around the earlobe and into the postauricular hairline. Through this access, the SMAS is elevated, repositioned along a more youthful anatomical vector, and secured — with excess skin conservatively redraped and trimmed. A subperiosteal approach is available for patients requiring deeper plane elevation. Platysmal bands in the neck are addressed through platysmaplasty, restoring a clean cervicomental angle and eliminating the turkey-neck appearance. For younger patients presenting with early to moderate facial laxity who wish to avoid the posterior incision of the traditional approach, A/Prof Gianoutsos offers the MACS lift (Minimal Access Cranial Suspension) — a short-incision variant that repositions facial soft tissue through purse-string suspension sutures placed via a limited incision in front of and above the ear, with no extension behind the ear and therefore no postauricular scar. This technique is particularly suited to patients in their forties and early fifties who are beginning to notice jowl formation and mild neck laxity. Both techniques address sagging jowls, crepey neck skin, double chin, and the general gravitational descent of the lower face. Common adjunct procedures performed in the same operative session include brow lift (addressing drooping brows and forehead lines), upper and lower blepharoplasty (eyelid surgery), chin surgery (genioplasty), rhinoplasty, and structural fat grafting to restore volume loss in the temples, cheeks, and perioral area. Recovery after facelift at the Randwick practice involves wearing a chin strap for one to two weeks. Return to normal activities is typically expected at three to four weeks, with improved neck definition consolidating at six weeks. Hospital stay is 48 hours for extensive procedures and day-only or overnight for less involved cases at Prince of Wales Private Hospital. Sydney patients benefit from A/Prof Gianoutsos's surgical training under Professor G. Ian Taylor in Melbourne — one of the most distinguished plastic surgery educators in Australia — combined with his NYU fellowship in reconstructive plastic surgery.