HOME / Facelift

Facelift

Overview

Procedure time

2 to 5 hours

Overnight stay

0 - 1 night

Anaesthetic

General

Final results

6 to 9 months

A facelift is a procedure that tightens and lifts the skin and muscles of the face. The medical name for a facelift is a rhytidectomy. This gives the face a more youthful appearance. It is one of the most commonly requested procedures by both men and women. Often, it can be combined with other procedures such as a neck lift or brow lift, to rejuvenate the overall facial appearance. This facelift overview page will be able to give you an idea of what the procedure involves.

What can a facelift achieve?

A facelift (rhytidectomy) can give you a more youthful, rejuvenated appearance. As we age, our skin gradually loses its elasticity and our facial muscles slacken. This creates the appearance of wrinkled, sagging skin, especially on the face. Lifestyle factors such as sun exposure and stress can also contribute to these changes. This can affect your confidence and make you look older than you feel. Thus, a facelift aims to restore the vitality in your appearance. 
By lifting and pulling back the skin and soft tissues of your face, a facelift can:

  • Smooth the skin on your face.
  • Reduce the appearance of fine lines and wrinkles.
  • Reduce flabby or sagging skin around the face.
  • Restore definition in your face.
  • Give you a more youthful appearance.

Facelift technique

The facelift procedure involves raising and repositioning the soft tissues of the face. Your surgeon will do this by firstly making an incision on both sides of the face, in front of the ears. They will then remove excess skin and fat and then tighten the muscles and soft tissues. Finally, they will lift and pull back the skin before closing the incision.
Your surgeon will perform your facelift using one of several techniques. The most common techniques are the following:
SMAS facelift
In this method, the surgeon makes a deep incision that goes below a layer of tissue called the Superficial Musculoaponeurotic System (SMAS). By making a deep incision, the surgeon can improve more severe facial sagging and problem areas, and achieve long-lasting results.
Minimal Access Cranial Suspension (MACS) facelift
With this method, the surgeon will make smaller incisions that do not go as deep as a SMAS facelift. This technique may be best for you if you only have mild problem areas, as you will have smaller scars and a shorter recovery period.

Candidates

Why choose to have a facelift?

Ageing is a natural process and gradually signs of this will show on your face. However, often lifestyle factors can lead to premature wrinkles and lines, leaving some people unhappy about their appearance. If this is the case, you may be considering a facelift. To know if a facelift procedure is right for you, think about your main concerns you have and what you wish to change. You may be suited for a facelift if:

  • The appearance of your face is making you look older than you feel.
  • Your face is showing visible signs of ageing, such as fine lines and wrinkles.
  • You want to restore a youthful, more fresh appearance.
  • You want to redefine your face by reducing loose, sagging skin.

Who are the best candidates for a facelift?

Some patients are more suited than others to a facelift procedure. This depends on a variety of factors. The ideal candidates for a facelift will have the following features:
Good skin elasticity & strong bone structure
It is best if your skin still has some natural elasticity and suppleness as it will be able to conform to its new, improved contours. Well-defined bone structure also contributes to satisfying results. However, if you have less distinctive features, you may wish to consider facial implants.
Good general health
It is important to be in good general health before your surgery. This may mean stopping smoking before surgery or losing weight before the procedure. This will reduce the risk of complications and help you achieve better results from the surgery.
Loose skin, wrinkles & deep creases
A facelift is an excellent way to reduce flabby or sagging skin, reduce wrinkles, and smooth out deep creases.

What a facelift will not resolve

A facelift will only smooth and tighten the skin of the lower half of your face. However, often the surgeon can combine a facelift with the following procedures to address other concerns you may have:

  • Brow lift – this can reduce wrinkles on the forehead.
  • Blepharoplasty – this can correct sagging of the eyelids.
  • Neck lift – this tightens and lifts the skin of the neck.

Your surgeon can perform these procedures at the same time as your facelift. Discuss with your surgeon your concerns so that they can suggest the best approach for you to achieve your goals.

Procedure

How is a facelift procedure performed?

There are a number of different techniques your surgeon can use for a facelift procedure. You will have met with your surgeon for a consultation prior to the surgery to discuss the different options, and what technique would be most suitable for you to achieve your goals. A facelift can take anything between 2 to 5 hours. This also depends on whether you have additional procedures, such as a neck lift, performed at the same time. Below is an overview on what will happen on the day of your facelift procedure.

1. Consent

You will need to give your consent for the operation in the form of writing. You will do this before the surgery. This ensures that you have had enough time to obtain information about the facelift procedure, including the benefits, risks, and complications involved. Before you sign the consent form, you should also make sure that you have asked your surgeon any questions you have regarding the procedure. Once you have done this, your surgeon will demonstrate where he will be making the incisions by drawing lines on the treatment area.

2. Anaesthesia

You will be walked to the anaesthetic room where you will meet your anaesthetist. This is the doctor who will be responsible for giving you your anaesthetic. Your surgeon will have discussed with you what type of anaesthetic you will have during your operation. This will either be a general or a local anaesthetic. A general anaesthetic will put you safely to sleep throughout the entire procedure. A local anaesthetic will numb the treatment area, and the anaesthetist will also give you a sedative medication at the same time. This will help to keep you relaxed throughout the operation.

3. Incisions

In the operating theatre, your surgeon will prepare you for the operation by cleaning the treatment area and draping over a sterile sheet. Your surgeon will then make an incision. The incisions will vary slightly in size and location according to the technique used. The general technique involves the surgeon separating your skin from the underlying tissue, before removing the excess fat and tightening the tissues. The surgeon will then use stitches to fixate the lifted tissue to its new position. Afterwards, they may reposition the excess fat to enhance the contours of the face. If there is not enough excess fat, the surgeon can also retrieve fat using liposuction. The different areas your surgeon may perform the facelift include the following:

Mini facelift

If you are only just beginning to show signs of ageing, you may not need a full facelift surgery. A mini facelift may be an ideal alternative for you. This technique involves the surgeon making small incisions in front or behind the ear. Depending on the degree of lift you need, the surgeon may also make a small incision along the hairline. They will then insert a stitch just under the skin and into the underlying fibrous tissue. The surgeon will use this stitch to lift the cheeks, jowls and the upper neck.

Mid Facelift

Whilst the above techniques mainly focus on sagging around the jowls and jawline, a mid facelift can address laxity and flattening of the skin in the middle segment of the face. This includes the cheek area below the eyelids and next to the nose. The surgeon will make small incisions in the hairline and either the mouth or lower eyelid. The surgeon can then tighten the muscles and reposition the fatty tissue upwards. This restores volume in the cheeks to create a natural, youthful contour to the face. This technique is ideal for patients who want to achieve a subtle but noticeable lift and fullness to their cheeks.

Full facelift

A full facelift is more suitable for older patients looking for a more dramatic final result. The full facelift targets the cheeks, jowls, temples and upper neck. Often, it does not include the brow area or neck area and a brow lift or neck lift may need to be added on. Your surgeon will discuss if you are a candidate for a full facelift or a mini facelift.
There are also different techniques that the surgeon may use which include the following:

SMAS facelift

This is the traditional facelift technique, and involves the manipulation of the Superficial Musculo Aponeurotic System (SMAS). This is a  deep layer of tissue that contains muscles and support structures of the face. In this technique, the incision is made along the hairline, past the front of your ears to below the earlobe, and behind the ears. The incision is deep and extends under the SMAS layer. The surgeon is able to elevate and tighten the tissue of the SMAS, and uses stitches to fixate it to its new position. Although it is a longer procedure with a longer recovery time, this technique produces long-lasting results. It is also more suitable for men and women who have more severe sagging of facial skin.

Minimal Access Cranial Suspension (MACS) facelift

With this technique, the surgeon will make a smaller incision that does not extend to the ear. The incision is more superficial and does not go under the SMAS layer. This technique is less extensive than the SMAS technique, so is better suited to correcting milder laxity of facial skin. The advantages of this method is smaller scars and a shorter recovery time.

4. Closing of incisions

The surgeon will lift and pull back the remaining skin and stitch it to its new position. They will use absorbable and non-absorbable sutures to close the incision. Afterwards, they will apply a light dressing to your face to help minimise bruising and swelling. These bandages will come off after a couple days. You may also have a small drainage tube placed under the skin behind your ear to drain any fluid.

5. Return to the ward

At the end of the surgery, the nurses will move you to a recovery room. Here, you will gradually wake up from your anaesthetic under close supervision.

Your consultation

What should I expect from my facelift consultation?

Your facelift consultation is an opportunity for you to meet with your surgeon to discuss the procedure and what you would like to achieve from it. This will last 15 minutes to an hour. You will talk with your surgeon about your concerns, and they will assess your face and the problem areas. They can then discuss with you the best surgical approach to the problems you have expressed. If appropriate, they may suggest procedures for other parts of the face such as the eyelids or brows. Often, these can be performed at the same time as a facelift. Your surgeon will also discuss with you the potential risks and complications that come with a facelift procedure. It is important to be aware of these so that you can make an informed decision on whether or not you wish to go ahead with the procedure.
To assess your suitability for surgery, your surgeon may ask you about the following:

  • Any current medical conditions you have.
  • Your past medical history.
  • Any previous surgeries you have had.
  • What medications you are currently taking (including over-the-counter and herbal remedies).
  • Your intake of alcohol.
  • Your smoking history.
  • Whether or not you have any allergies.

During your facelift consultation, we recommend that you are as open as possible with your surgeon. Be honest about your expectations and your desired outcome. Your surgeon is there to listen carefully to you, and to help you achieve the goals you want. This also means letting you know if your expectations are not realistic. In this case, they may suggest better alternatives for you.

What questions should you ask during your facelift consultation?

You can ask your surgeon any questions you have about the procedure during your facelift consultation. We want you to be confident with your decision to have a facelift, so make sure you express any queries you might have. There is no such thing as a silly question! The following are some examples of questions that you may consider asking:

  • Will a facelift correct the concerns I have expressed?
  • What scars will I be left with?
  • What other options are available for me?
  • Will I benefit from a neck lift/browlift/eyelid surgery too?
  • Do you have any before and after pictures of previous facelift procedures you have performed?
  • Will I be in pain after the surgery?
  • How soon after a facelift can I return to work?
Risks & complications

What are the main facelift risks and complications?

With any surgery, there are risks and complications that can occur. It is really important for you to be aware of what these are so that you can feel fully confident in choosing to go ahead with surgery. Below, we have listed the main facelift risks and complications. You should read these through carefully and take a while to think about them. Your surgeon will also give you a two-week “cooling-off” period after discussing the facelift risks and any of your concerns during your consultation. This will give you time to decide if you are happy to proceed with the surgery.

Bruising & Bleeding

Some bruising of the treated area is common after surgery. This should resolve over the first couple of weeks. You may also experience slight bleeding from the incision site. This typically occurs right after surgery but may occur a few weeks later. However, if you notice significant bruising, pain, and facial swelling, inform your surgeon immediately. It is possible that you may have a haematoma, which is a solid collection of blood under the skin. These usually occur within 24 hours of surgery and require medical attention to treat. You may be more at risk if you are male, have high blood pressure, or take certain medications.

Tissue necrosis

A facelift surgery involves cutting into the skin and the underlying tissues of the face. Therefore, although uncommon, some areas of the skin or tissue can lose its blood supply during the operation. This can result in these areas of the tissue to necrose, or die, after the surgery. As this will affect the results, you may need to have another operation to treat this. Smokers are at higher risk of this complication, so we advise you to stop smoking at least 6 weeks before the surgery.

Infection

Although every effort is made to minimise the risk of infection during surgery, it is still possible for an infection to occur in the treated area. Therefore, it is important that you are aware of the signs of infection. Make your surgeon aware if you notice any of the following signs:

  1. Feeling feverish with a temperature over 38° C.
  2. Redness at the incision line that is spreading after the first 48 hours.
  3. Yellow pus-like or foul-smelling fluid seeping from the incision.
  4. Increased pain or discomfort that your pain medication does not resolve.

Scarring

Unfortunately, it is not possible to avoid scarring where the surgeon has made incisions. The size and location of the scars will vary according to the technique used. Make sure you have discussed with your surgeon what scarring you can expect. Most scars will be minimal and your surgeon will make them as discreet as possible. Remember that scars will also fade with time. How much they fade will depend on the healing ability of your skin. Your surgeon can also give you some tips on how you should care for your wounds, to minimise the scarring you are left with.

Skin discolouration

Sometimes the skin where the surgeon has operated on can change colour slightly after the surgery. This should settle over a few months. You should be able to easily cover this with makeup if it concerns you.

Nerve injury

If, during your surgery, the nerves in your face are injured, you may lose some feeling or movement in your face. For most cases, this is temporary. However, rarely, more long-term loss of sensation or movement can occur. At Avrupamed, we work with surgeons who are highly skilled and qualified. This means that you will be at less risk of this occurring.

Hair loss & hairline distortion

Hair loss can occur at the site of or around the incisions. This may be temporary, and the hair may grow back. However, it can also lead to a permanent reduction of hair growth. It is also possible for the hairline to become distorted after a facelift surgery, depending on where the surgeon makes the incisions. In men, as a facelift procedure involves trimming, lifting and tightening the skin under the beard area, it is possible that your beard may grow closer to your ears. Generally, this will only be noticeable to you, and should not make a large difference.

Aesthetic

After a cosmetic surgery, there is always the possibility that you find you are unhappy with the results of your procedure. There is also a risk that after a facelift, your facial features will look asymmetrical. For example, the position of your earlobe may be slightly higher up than the other side. Most of the time, this will not be noticeable to anyone other than yourself. To ensure you are not displeased with the results, we recommend that you talk openly with your surgeon during your consultation about your desired outcomes, and make sure they understand your expectations.

General surgical complications

All surgeries carry some common risks. These include the development of a blood clot, nausea and vomiting, and postoperative pain. As the surgery involves the use of an anaesthetic agent, it is also possible that you may develop anaesthetic complications.

Preparing for your treatment

How can I prepare for a facelift?

Preparation is key for a smooth and speedy recovery. Doing some household chores and planning ahead will make your life easier for after the surgery when you will need to take things slow as your wounds heal. Below are some simple facelift preparation tips that can help you make a smooth recovery:

Household work

You might want to do certain tasks like cleaning the house, taking the bins out, or doing the laundry, before the day of your operation. This way, you won’t have to do these chores when you get home from the surgery. Coming home to a clean and tidy house is sure to make you feel more comfortable and at ease.

Shopping

It’s good to stock up on some key food items that can be kept in your cupboard or the fridge. You may not feel like leaving the house for a couple days after the surgery, so this will save you from having to go to the supermarkets when you return home. We would also recommend that you buy some frozen ready-meals. Alternatively, you can cook your own meals ahead of your surgery and keep them in the freezer. You can then easily defrost these on days you don’t feel like cooking.

Children and pets

Looking after pets and young children can often be a handful! After a surgical procedure such a facelift, it is understandable to be tired and lack your usual energy. Asking friends or family to mind your child or pets can, therefore, help lift some of the stress involved with this! As another option, you might wish to get a babysitter or nanny to help you with your little ones for a short time as you recover.

Driving

After the surgery, you will not be able to drive as the effects of the anaesthesia wear off. Therefore, make sure you have organised for someone to pick you up and drive you home. We recommend asking a friend or family member, rather than a taxi service, as you will feel more at ease having someone familiar with you in hospital after your surgery.

Diet

A healthy diet is an important factor in helping you to heal and recover after a facelift. Eat lots of healthy green vegetables, fresh fruit, and high-protein foods such as chicken, fish and legumes. Drink plenty of fluids – water is best. Tea and coffee are high in caffeine, so we advise you to keep those to a minimum. Also, try to avoid foods that are high in sugar and salt as much as possible.

Clothing

Make sure you have clothing that fastens in the front or the back. Clothes that have to be pulled over your head will make contact with the treated area of your face and might cause friction against your wounds. Loose clothing such as jogging bottoms will be comfortable for you to relax at home in during your recovery.

Sleeping

Your face might feel delicate the first few days after surgery so you may find it uncomfortable sleeping face down. You may, therefore, want to have some extra pillows prepared for after your surgery so you can sleep propped up, on your back. Resting in an inclined position on pillows also has the benefit of reducing swelling around the treated area.
Your Avrupamed surgeon may be able to give you further facelift preparation tips as well as more specific information on your surgery, on the day of your consultation. Make sure you follow their instrcutions to achieve the best results from surgery.

Aftercare

What can I expect after a facelift?

Knowing what to expect after a facelift surgery can help to make you feel more comfortable and at ease on the day of the surgery. Your surgeon will discuss the details of the facelift aftercare process during your consultation. They will provide you with information on how best to take care of yourself during your recovery. This includes advising you on:

  • When you can go back to work.
  • How long you must wait before resuming exercise.
  • How you should wash and care for your wounds.

As part of your facelift aftercare, your surgeon will also organise a follow-up appointment with you. This often takes place within two weeks of your surgery. During this appointment, your surgeon will check your wounds to see how they are healing, remove any non-dissolvable stitches, and remove or replace any dressings if necessary. They will also address any complications.

How will I feel after surgery?

If you were put to sleep with a general anaesthetic, you will gradually wake up following surgery under close supervision. You will have dressings around your face and you may also have drainage tubes in place. The nurses will often remove any drainage tubes before you go home. The bandages will normally stay in place for one or two days. If local anaesthetic was used, you may feel a change in sensation in the treated area of the face. This will eventually wear off. The treatment area may also feel slightly tight and tender. Your surgeon or the nurses in the recovery room will offer you painkillers which you can take if necessary.

Is there anything I need to do in the first 24 hours?

It is important that you have a responsible adult to stay with you for at least 24 hours after the surgery. This is because after a general anaesthetic you will feel tired and groggy. The anaesthetic can also affect your memory and concentration for a few hours to up to 2 days. It is good to have someone there to help you if at any point you feel dizzy or unsteady as you get up to go home. We, therefore, recommend you ask a friend or relative in advance. You can also ask them to drive you home after the surgery, as you will not be able to drive yourself.

How much time do I need to take off work?

The recovery period may depend on which surgical technique your surgeon uses and how extensive your facelift procedure is. In general, you will need to take around 2 weeks off work. You may need longer if your job is more active.  You should therefore listen to the exact time frames that your surgeon provides you. Whether you have an office job or a physical job, make sure that you do not lift anything heavy for at least 4 weeks.

When can I return to exercise and sport?

You should avoid any strenuous activity and contact sports for at least 4 to 6 weeks after your facelift surgery. However, you should be fine to resume some light physical activity after two weeks. Start off gently, with light aerobic activity such as walking on a treadmill. Do not do any exercise during the first week, as this can increase the amount of swelling and bruising.

What other points should I consider?

Swelling & Bruising

This is common around the treated area for the first couple of weeks after a facelift surgery. Generally, this will be at its worst 3 to 4 days after the operation, and will then gradually begin to settle. Sleeping and resting with your head propped up with pillows for the first 10 to 14 days can also help to reduce any swelling. 

Scarring

For the first few weeks, scars typically appear pink and raised. They will eventually fade to faint white lines. Avoid too much sun exposure to the treatment area as this can cause permanent darkening of the area.

Saunas and heat

Avoid anything that may promote facial flushing for 4 to 6 weeks. This includes saunas, steam rooms, and steam face masks.

Compression bandage

Your surgeon may advise that you wear a compression bandage around your face for the first inital weeks post-operatively. The length of time you will need to wear this bandage will depend on your individual surgeon’s specific advice.

Final results

There will of course be a noticeable difference to your face immediately after surgery, but it is important to remember that you may not be able to appreciate the final cosmetic results until 6 to 9 months after surgery. This is because often there is some residual swelling, some scarring may take longer to fade, and it may take a while for the area to fully heal. Immediately after the surgery, the skin on your face may at first look and feel too tight. This will gradually settle within 6 weeks. As long as you follow your surgeon’s facelift aftercare advice, after some weeks you will gradually feel more like yourself, and be able to appreciate a rejuvenated and youthful look.

FAQs

What are some common facelift FAQs?

We have compiled some of the most common facelift FAQs about the procedure below. It is useful to read them through as there may be some questions that you had not thought about. On the other hand, if you still have further questions don’t worry! Your surgeon will be happy to answer them during your consultation.

Do I need a GP referral for cosmetic surgery?

Generally, you do not need a GP referral to see a cosmetic surgeon for an initial consultation. However, if you decide you want to go ahead with the procedure, your surgeon will require more detailed information on your medical history. In this case, they may contact your GP for this information, with your permission.

When can I shower and wash my hair after surgery?

Your surgeon will give you specific advice on how to wash and bathe after the surgery.  In general, you may shower and wash your hair 48 hours after a facelift surgery. Use a mild shampoo and be particularly careful around the treatment area. You can also blow dry your hair on a cool setting. Be gentle when brushing or combing your hair so that you do not catch your comb in the suture lines. You must follow your surgeon’s specific advice.

Can I wear makeup after surgery?

You should not wear makeup until your surgeon gives you approval to do this. Usually, it is possible to start wearing makeup again 2 weeks after your procedure. You can then use camouflage cosmetic products if you wish to cover any bruising you may have.

When will I feel comfortable attending major events after surgery?

It is normal to feel a little self-conscious when you are in public due to the swelling, redness and bruising around the treated area after a facelift. However, the vast majority of bruising and swelling should have settled by around 4 weeks. By this time, most people feel comfortable enough to be seen by friends and colleagues. Full recovery, however, takes several months. We, therefore, advise that you plan ahead. If you have a major event coming up such as a wedding or birthday, plan your surgery 2 to 3 months before it.

How long will my results last for?

A facelift is not a permanent solution. No cosmetic procedure can stop the effects of time and aging. Genetic factors and environmental factors such as sun exposure and smoking can also speed up the natural aging process and reverse the effects of a facelift. However, the results achieved from a facelift surgery are long-lasting. This will also depend on the type of procedure you have, the technique used, and the quality of your tissue. The effects of a full facelift can remain for over a decade. This means that most patients only undergo one facelift in their lifetime. There are some precautions you can take to limit the effects of environmental factors. These include using sunscreen, wearing sunglasses and a hat when outside, moisturising regularly and staying healthy and hydrated.

What are the effects of smoking, drugs, and alcohol on surgery?

Smoking and drinking too much alcohol can increase your risk to a number of complications from surgery. This is why we advise you to cut back on alcohol and stop smoking well in advance of the operation. Six weeks is the least we advise you to be smoke-free before your surgery.

Booking Procedure

1st Step / Treatment Plan and Deposit Payment (Flight Ticket)

Avrupamed medical consultants will reach you to give detailed information about your treatment after you contact us. Following your decision on having the treatment, you will need to send pictures of your treatment areas for assessment. Our doctors will prepare a treatment plan accordingly and you will fill in the medical history form to determine your current health status. Once your medical history form is approved, deposit payment or flight ticket will be made to fix the price and to schedule your treatment.

2nd Step / Bookings

After your deposit payment or sending your flight details, your patient service coordinator will contact you to assist flight bookings according to the availability of your doctor. As soon as you send us flight tickets, your PS will arrange your airport transfers and hotel booking and send you the medical travel itinerary 2 weeks prior to your arrival.

3rd Step / Procedure

On your arrival to Turkey, your transfer will welcome you at the airport for your hotel. In accompany with your personal host you will leave for hospital. After your consultation with your doctor and making the necessary arrangements your procedure will be performed. Your last check up will be arranged one day before your departure. Private transfer will pick you up from your hotel to airport for your flight. Thank you for choosing us!

Medical Park Hospitals

Getting into the act in the Turkish hospital business since 1995, Medical Park Hospitals Group serves patients in 29 hospitals located in 17 cities. It is, now, the pioneering actor of the sector with closed area of 718 thousand and 965 square meters, 211 operating rooms, 5 thousand 240 beds and more than 16.000 employees.

Enabling all patients, irrespective of socioeconomic status, access healthcare services at international standards based on the principle "healthcare for all", Medical Park not only closely monitors all advanced technologies and therapeutic methods worldwide, but it also aims to serve as a model which supports science and innovative practices.

Gathering specialists, patient-oriented service approach and multi-disciplinary work in one roof, Medical Park Group of Hospitals provides quality diagnostic and therapeutic services in all hospitals, including four accredited by Joint Commission International (JCI).

Medical Park continues adding new members to the chain in accordance with the principle "it is every people's right to live healthy and have equal access to healthcare services and it takes firm steps to spread all regions of Turkey and to increase healthcare standards based on advanced technology, with no sacrifice from medical ethics.Continuously setting higher service standards and combining ease of access, experience and volume with patient oriented treatment approach, our Group aims to create a totally new vision in the healthcare sector with the brand"VM Medical Park". Carrying the hospital business adapted to changing life style, VM Medical Park makes all diagnostic and therapeutic modalities, which are recently used worldwide, innovative medical technologies and experienced physician staff meet in a contemporary hospital environment. Our efficient, sustainable and dynamic operation system, which is based on team work, opens door to a healthy future.