result in a "windswept" look. The MACS lift has been successfully used for to correct complication after thread-lift with APTOS. Complications The most common complication is bleeding which usually requires a return to the operating room. Less common, but potentially serious, complications may include damage to the facial nerves and necrosis of the skin flaps or infection. Although the facial plastic surgeon attempts to prevent and minimise the risk of complications, a rhytidectomy can have complications. As a risk to every operation, complications can be derived as a reaction to the anesthetics. Hematoma is the most seen complication after rhytidectomy. Arterial bleeding can cause the most dangerous hematomas, as they can lead to dyspnea. Almost all of the hematomas occur within the first 24 hours after the rhytidectomy. Nerve injury can be sustained during rhytidectomy. This kind of injury can be temporary or permanent and harm can be done to either sensory or motor nerves of the face. As a sensory nerve, the great auricular nerve is the most common nerve to get injured at a facelift procedure. The most injured motor nerve is the facial nerve. Skin necrosis can occur after a facelift operation. Smoking increases the risk of skin necrosis 12-fold. Scarring is considered a complication of facelift surgery. Hypertrophic scars can appear. A facelift requires skin incisions; however, the incisions in front of and behind the ear are usually inconspicuous. Hair loss in the portions of the incision within the hair-bearing scalp can rarely occur. A distortion of the hairline—and facial hair in men—can result after a rhytidectomy. There is a high incidence of alopecia after rhytidectomy. The permanent hair loss is mostly seen at the incision site in the temporal areas. In men, the sideburns can be pulled backwards and upwards, resulting in an unnatural appearance if appropriate techniques are not employed to address this issue. Achieving a natural appearance following surgery in men can be more challenging due to their hair-bearing preauricular skin. In both men and women, one of the signs of having had a facelift can be an earlobe which is pulled forwards and/or distorted. If too much skin is removed, or a more vertical vector not employed, the face can assume a pulled-back, "windswept" appearance. This appearance can also be due to changes in bone structure that generally happen with age.[2] One of the most often overlooked (or not discussed) areas of