This fact sheet was developed under the aegis of the French Society of Plastic Reconstructive and Aesthetic Surgery (SOF.CPRE) as an addition to your initial consultation, to try to answer all the questions you can ask yourself if you plan to use surgery baldness. The purpose of this document is to provide you with all the necessary and essential elements of information to help you make your decision with full knowledge of the facts. Also you is it advisable to read with the greatest attention.

 

 

 

• DEFINITION OBJECTIVES AND PRINCIPLES

Today there are several types of facelifts that can improve the discomfort caused by aging of the face and neck, either locally or more extensively.

The cervicofacial lift is the most common type of facelift, which is the surgical correction of aging in the neck and face, from the temples to the jowls.

This surgery for aesthetic purposes cannot be covered by !'Assurance Maladie.

The operation aims to treat sagging and slackening of the skin and muscles of the face (temples and eyebrows, cheeks, jowls, oval of the face) and neck but also the insufficiency or excess of fatty tissue.

 

The objective of such an operation is not to change the shape or appearance of the face. On the contrary, simply reshaping the different anatomical structures of the face and neck (skin, muscle, fat) allows the surgeon to regain the appearance that was his or her own a few years ago. 

These sometimes major physical alterations, as well as the psychic suffering induced, give a therapeutic purpose to this restorative surgical act.

The muscles are put back in tension, in order to correct their relaxation. The skin is then redraped on demand on the new curves, without excessive traction. This double action makes it possible to obtain a natural result (because the skin is not overly pulled), long-lasting (because the muscular plane is solid), and generally fairly simple post-operative results (the skin 'marks' less because it is less traumatised, due to the limited tension and detachment). Any excess fat can be treated by liposuction.

Conversely, if the face is emaciated, this aspect can be corrected at the same time by re-injection of autologous fat (lipostructure). Thus the face and the neck are in a way

"rebuilt", "restructured".

On the other hand, expression lines, crow's-feet wrinkles or perioral wrinkles are not modified.

Deep wrinkles are improved by the tension exerted on the skin without ever disappearing completely.

The appearance of the eyelids is not corrected by an isolated cervicofacial lift.

The necessary skin incisions are mostly hidden under the hairy paw or in the hair (at the temples and nape of the neck) and around the ear. The scar is thus almost completely hidden.

 The cervico-facial lift can be performed as soon as the signs of ageing appear (sagging of the cheeks, neck, deterioration of facial lines) and a motivated request for correction is made, generally from the age of 40 or 45.

This operation can be combined with another facial aesthetic surgery procedure: aesthetic surgery of the eyelids (blepharoplasty), correction of sagging of the lateral part of the eyebrow and correction of crow's feet (temporal lift), correction of sagging and wrinkles of the forehead (conventional or endoscopic forehead lift), use of notched sutures. It can also be complemented by medical-surgical therapies (laserbrasion, dermabrasion, peeling, hyaluronic acid injections, botulinum toxin injections, PRP).

During your discussions with the surgeon, it will be important to point out all the imperfections you wish to see improved or disappeared. Having fully understood your request, he will become your guide in the evaluation of the future result and the techniques to be used.

He will be able to possibly advise you against the operation or to propose alternatives.

 

• BEFORE THE OPERATION

A routine pre-operative check-up is performed as prescribed.

The anaesthetist will be seen in consultation at the latest 48 hours before the operation.

No medication containing aspirin must be taken in the 3 weeks prior to the operation. Hair must be washed the day before and the morning of the operation and make-up must be carefully removed on the day of the operation.

It is essential to fast (do not eat or drink anything) 6 hours before the operation

 

• TYPE OF ANESTHESIA AND CONDITIONS OF INTERVENTION

Type of anaesthesia: The cervicofacial lift can be performed under general anaesthesia or under deep local anaesthesia with intravenous tranquillisers ("vigil" anaesthesia).

The choice between these different techniques will be discussed between you, the anaesthetist and the surgeon.

 

Hospitalization: Hospitalization for 24 to 48 hours is usually necessary.

 

• INTERVENTION

Each surgeon adopts a technique that is specific to him and that he adapts to each case to obtain the best results. However, there are some common basic principles:

The incision is largely hidden in the hair and around the ear.

From the incisions, a detachment is made under the skin; the extent of the detachment depends on the individual case, especially on the extent of tissue slackening.

The musculo-aponeurotic plane is then tightened in an extremely precise and dosed manner, in order to correct the deep sagging, while preserving the face's natural expression.

In case of localized fat overload, a liposuction or lipectomy with scissors is performed at the same time: it can act on the neck, chin, jowls and cheeks. On the other hand, in case of volume loss, an addition of fat of the patient (lipostructure) will often be necessary.

effective in hamonizing the final result.

The naturally redraped skin follows the shape created by muscle mobilization, lipostructure or liposuction. Excess skin is removed and sutures are made without tension.

At the end of the operation, most surgeons make a dressing that goes around the head.

The facelift in men has some special features (thicker skin, displacement of hairy areas, thinner hair masking less discreetly scars) which your surgeon will maintain.

Depending on the surgeon, the importance of the corrections to be made and any associated procedures, the operation can last from two to four hours.

AFTER THE INTERVENTION: THE OPERATING SUITES

 

You can be discharged either the day after or the day after the operation.

For the first 10 days, it is necessary to rest as much as possible and avoid any violent effort.

 

During these first days, the patient should neither be surprised nor worried:

an oedema (swelling) which may be more pronounced on the day of surgery.

second day than the first,

bruises in the neck and chin area,

a painful or unpleasant feeling of tension, especially behind the ears and around the neck.

These bruises and swellings disappear on average within 2 weeks after surgery.

At the end of the first month, the swelling has usually almost disappeared. However, there is still a slight induration of the detached areas, which is more palpable than visible. The ears and cheeks do not regain their normal sensitivity until a few months later.

Sometimes, for several weeks or even months after the operation, a feeling of discomfort, tissue tension and a slightly unpleasant feeling of heaviness can be observed, which eventually disappears.

The scars are hidden back and forth by the chewing muscles. The only slightly visible area, in front of the earlobe, can be temporarily masked by hair or make-up.

 

Schematically we are:

on the fifth or sixth day, presentable to the intimate ones,

around the twelfth day, presentable to his friends,

but in order to appear in front of the people you want them to ignore, it is necessary to allow three to four weeks, in the absence of incidents.

 

• THE RESULT

After one to three months, we can have a good idea of the final result. But the scars are still a little pinkish and indurated and do not fade until around the sixth month.

Thanks to the progress made both in the treatment before and after the operation and in medical and surgical techniques, an appreciable rejuvenation effect is obtained, which however remains very natural: the face does not look like a "normal" face.

He is now "surgical" and has regained approximately the features he had eight or twelve years ago, giving him a rested, relaxed and refreshed appearance overall.

This physical improvement is generally accompanied by psychological well-being.

The aim of this surgery is to bring about improvement and not to achieve perfection. If your wishes are realistic, the result should give you great satisfaction.

In the long term, the cervicofacial lift has made it possible to fight against the ravages of time, but aging continues to take its toll and a new facelift type operation may be envisaged after about ten years.

Current techniques allow the procedure to be repeated if necessary beyond this time frame. However, this percussive pers must be part of a facial maintenance by lighter complementary techniques that will delay a new intervention all the better as they will have been performed regularly.

 

• FAULTS OF THE RESULT

It can be essentially:

oedema (swelling) that persists in certain areas beyond the third month and may require massage,

Partial reproduction of sagging tissue, especially under the chin, when the ptosis was significant prior to the procedure,

excessively visible scars or localized hair loss in the temple area (alopecia) that may require remote surgical retouching (six months to a year).

 

• POSSIBLE COMPLICATIONS

The cervico-facial lift, although performed for essentially aesthetic reasons, is nonetheless a real surgical procedure, which implies the risks inherent to any medical procedure, however minimal it may be.

In particular, this procedure is subject to the risks associated with living tissue, the reactions of which are never entirely predictable.

A distinction must be made between complications related to anaesthesia and those related to the surgical procedure.

As far as anaesthesia is concerned, during the consultation, the anaesthetist will inform the patient himself/herself of the anaesthetic risks. It is important to know that anaesthesia induces reactions in the organism that are sometimes unpredictable and more or less easy to control: the fact of having recourse to a perfectly competent anaesthetist, working in a truly surgical context, means that the risks incurred have become statistically very low.

In fact, techniques, anaesthetic products and monitoring methods have made great progress in the last thirty years, offering optimal safety, especially when the operation is performed outside the emergency room and in a healthy person.

As far as surgery is concerned: by choosing a qualified and competent Plastic Surgeon, trained for this type of intervention, you limit these risks to the maximum, without however completely eliminating them.

Fortunately, the after-effects of surgery are generally simple after a cervicofacial lift performed properly, and real complications are rare.

In practice, the vast majority of operations are trouble-free and patients are satisfied with their results.

 

However, despite their rarity, you should be informed of possible complications:

A haematoma that may require rapid evacuation.

Suffering or even localized skin necrosis, due to delayed healing (the risk is greatly increased by tobacco intoxication).

Infection is exceptional.

Nervous lesions: the lesion of a branch of the nerffacial nerve, likely to lead to paresis, or even facial paralysis, is exceptional and the after-effects disappear most often in a few months. Even more rarely, paralysis of the spinal nerve (nerve of the elevation of the shoulder) may occur.

Alterations in sensitivity such as a decrease in sensitivity but also painful phenomena can sometimes be observed, or even persist, especially near the scars around the ears, even if sensitivity usually returns to normal within 3 to 12 months. These disorders are linked to an alteration of the superficial cervical plexus.

Abnormal, hypertrophic or even chemoid scars of unpredictable appearance and evolution can compromise the aesthetic aspect of the result and require specific local treatments, sometimes prolonged.

 

In total there should not overstate the risks, but just be aware that surgery, even seemingly simple, still a small share of hazards. The use of a qualified Plastic Surgeon ensures that it has the training and knowledge required to avoid these complications, or effectively treat if jurisdiction.

          

These are the pieces of information that we wanted to bring you in addition to the consultation. We recommend that you keep this document, read it again after the consultation and reflect "a clear head." This reflection may raise new questions for which you wait for additional information. We are available to talk during the next consultation, or by phone, or even on the day of surgery when we meet in any way before anesthesia.