Saturday Morning Coffee Interview #2: The Evolution of Facial Surgery with Dr. Patrick Tonnard
Posted June 27, 2025 in Uncategorized | 6 minute read
An Interview with Dr. Patrick Tonnard and Dana Fox
Join me for our second installment of “Saturday Morning Coffee Interviews with Experts”
It’s 6 AM here in my kitchen, and my laptop screen is lighting up with Patrick’s familiar smile from Ghent, Belgium. This Saturday morning, I’m particularly excited because we’re diving into something that absolutely fascinates me as a marketer: the evolution of facial surgery and how Dr. Tonnard revolutionized the field with the MACS-lift technique.
“Dana,” Patrick begins, “when I started my career, facial surgery looked completely different from what we do today. It’s been quite a journey.”
The Pendulum Swing: A Marketing Lesson in Innovation
Patrick explains facial surgery’s history as a pendulum swinging between highly invasive and minimally invasive approaches—and honestly, it reminds me of every industry I’ve ever worked in.
“In the early days—we’re talking 1920s through 1960s—procedures were quite crude,”. “Surgeons focused mainly on removing skin, with little attention to what lay beneath. Patients often ended up with that tight, wind-swept look that screamed ‘I’ve had work done.'”
I can’t help but think of early website designs from the 1990s—technically functional but missing the sophistication we take for granted today.
The pendulum swung toward more invasive techniques in the 70s and 80s as surgeons discovered the importance of deeper facial structures. “We started working with the SMAS layer—the Superficial Musculo-Aponeurotic System,” Patrick explains. “Results looked more natural, but recovery was brutal, and risks were higher.”
Then came the 90s, and patients demanded faster recovery times. “Everyone wanted the ‘lunchtime facelift,'” Patrick chuckles. “Thread lifts, mini-lifts, procedures that promised rejuvenation with minimal downtime. The problem? Most delivered disappointing, short-lived results.”
The “Aha!” Moment That Changed Everything
This is where the story gets exciting, because it’s classic innovation narrative. Patrick and his partner Dr. Alexis Verpaele weren’t satisfied with the existing options. They asked themselves a simple but profound question: “What’s the minimum intervention required to achieve maximum aesthetic improvement?”
“We developed the MACS-lift in the early 2000s,” Patrick says, and I can hear the pride in his voice. “MACS stands for Minimal Access Cranial Suspension lift. We wanted to find that sweet spot on the pendulum—effective but not overly invasive.”
As he explains the technique, I’m struck by how elegant the solution is. The MACS-lift uses shorter incisions, requires less tissue undermining, and employs a system of purse-string sutures to create vertical suspension of sagging facial tissues.
“The key insight was vertical suspension,” Patrick emphasizes. “Traditional techniques pull tissues sideways, but we restore volume vertically—the natural direction of youthful facial contours.”
From a business perspective, the benefits are compelling: reduced operative time, less swelling and bruising, shorter recovery periods, and more natural-looking results. It’s a classic example of innovation that benefits both the provider and the customer.
The Deep Plane Dilemma: When Social Media Drives Surgery Trends
Our conversation takes an interesting turn when Patrick discusses the Deep Plane facelift—a technique that’s exploded in popularity thanks to social media marketing. As someone who’s navigated the murky waters of medical marketing for decades, this topic hits close to home.
“The Deep Plane facelift has been around for 30 years,” Patrick explains, “but social media has turned it into the latest trend. Many surgeons now promote it as the ‘gold standard.'”
I ask him directly: “Patrick, is it really the gold standard?”
His response is refreshingly honest: “Dana, our approach has always been guided by proportionality. The surgical intervention should match the patient’s needs. For moderate facial aging, Deep Plane often represents overtreatment. For severe aging or specific anatomical issues, it might be appropriate.”
This is exactly why I respect Patrick so much—he doesn’t follow trends or make sweeping marketing claims. While Deep Plane can produce impressive results, it’s significantly more invasive, requires 3-4 weeks recovery versus 7-10 days for the MACS-lift, carries increased risk of facial nerve injury, and has potential for more noticeable scarring.
“Rather than chasing social media trends,” Patrick continues, “we focus on thoughtful, individualized assessment of each patient’s unique needs.”
The Neck Dilemma: Deep vs. Superficial
Patrick gets animated when discussing neck rejuvenation—clearly another passion point. “The neck often betrays age before the face,” he tells me. “But here too, we see this debate between deep versus superficial approaches.”
He explains how deep neck reduction involves extensive work on muscle bands, direct fat removal, and sometimes partial removal of submandibular glands. “It’s comprehensive but requires longer recovery and carries more risk.”
Superficial techniques focus on skin redraping and limited liposuction. “Faster recovery, reduced complications, but potentially less dramatic results.”
Patrick’s approach? “Most patients benefit from a balanced technique tailored to their individual anatomy. A younger patient with good skin elasticity might achieve excellent results with superficial techniques, while someone with significant muscle banding needs more comprehensive work.”
The Game-Changer: Integrating Surgery with Regenerative Medicine
Patrick’s pioneering work with nanofat, introduced to the medical community in 2013, represents what he calls “the current position of the pendulum.”
“Nanofat is a dramatic leap in regenerative medicine,” Patrick explains with obvious enthusiasm. “We mechanically process harvested fat to eliminate larger fat cells while preserving the stromal vascular fraction—that’s the stem cells and growth factors.”
When I witnessed nanofat procedures firsthand in Patrick’s office, I was amazed by the long-term results. Patients continue improving for years after their procedures, with skin quality that simply can’t be achieved through surgery alone.
“By combining the structural improvements of the MACS-lift with the regenerative benefits of nanofat, we address all dimensions of facial aging,” Patrick tells me. “We’re repositioning descended tissues, restoring lost volume, and dramatically improving skin quality at the cellular level.”
Looking Ahead: The Future of Facial Rejuvenation
As our Saturday morning conversation winds down, I ask Patrick about the future. His response reinforces why I’ve enjoyed co-writing his upcoming book “To Cut or Not to Cut.”
“The pendulum will continue settling in the middle ground,” he predicts. “Techniques that provide meaningful, long-lasting results with reasonable recovery periods and acceptable risk profiles. The most promising innovations will involve further refinements in nanofat applications working with refined surgical techniques.”
Patrick’s ongoing research into nanofat continues yielding new applications—improving scars, treating pigmentation disorders, rejuvenating hands, even addressing hair loss. “The stem cell populations and growth factors in nanofat offer tremendous therapeutic potential we’re only beginning to understand.”
What won’t change, Patrick assures me, is their commitment to evidence-based practice, thorough patient education, and individualized treatment planning. “Despite the allure of trending techniques promoted on social media, sound surgical principles combined with scientifically validated regenerative approaches will always remain the foundation of exceptional results.”
As I close my laptop and finish my coffee, I’m reminded why these Saturday morning conversations have become such a highlight of my week. Patrick’s approach isn’t just about staying current with trends—it’s about thoughtful innovation that truly serves patients’ best interests.
