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

The temporal lift helps to improve the stigmas of aging in the temple area. This region is located between the frontal and cervico-facial regions, which can also benefit from a facelift. The temporal lift, which can be performed alone, is, in practice, often associated with eyelid surgery (blepharoplasty).

This aesthetic surgery cannot be covered by the Health Insurance.

 

This procedure treats the sagging of the lateral part of the eyebrow, unfolds the crow's feet and slightly tightens the skin of the external part of the eyelids.

 

It is not intended to modify the features but to restore the anatomical structures, in particular the tail of the eyebrow to the position it was in a few years ago.

These physical alterations as well as the psychological suffering induced, give a therapeutic finality to this repairing surgical act.

Tissue sagging is essentially cutaneous in this region.

The temporal lift is performed by means of a sitting scar:

either in the hair (intra-capillary scar) but at the cost of a receding hairline,

either flush with the hairline (pre-capillary scar) but with the risk of some scar visibility.

In the case of a scar in the hair, the temporal skin is lifted by exerting traction on the deep planes. The gesture is thus more efficient and avoids any traction on the scalp limiting the risk of alopecia (hair loss) and a significant receding of the hair implantation line.

In case of a pre-capillary scar, chosen because the hairline is already far enough back and/or the amount of skin to be removed is important, the removal is subcutaneous.  Only the hairless skin (without hair) is removed and the hairline is slightly advanced.

The temporal lift makes it possible to restore a more harmonious distance between the eyelashes and the tail of the eyebrow.

When eyelid surgery is combined, the temporal lift allows to reduce the skin resection and the length of the scar on the upper eyelid.

The procedure, performed on both men and women, can be performed from the age of 40. However, it is sometimes performed much earlier, when the disruptions are constitutional (hereditary factors) and not age-related, such as initially low eyebrows.

This technique can be associated with eyelid surgery, as we have already mentioned, but also with another cosmetic surgery procedure (frontal or cervico-facial lift, lipostructure).

 

In the long term, ageing continues to do its work and the face continues to suffer the ravages of time. A facial maintenance with specific treatments of the epidermis (laser, pulsed lamps ... ) and with injections (botulinum toxin, fillers) helps to maintain the result longer. A new intervention, often more moderate, may sometimes be necessary.

 

• BEFORE THE OPERATION

The patient's motivations and requests will have been analysed. An attentive study of the temporal region, its relations and more widely of the gaze will have been made...

A usual pre-operative check-up is carried out in accordance with the prescriptions.

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

No medication containing aspirin must be taken during the 10 days preceding the operation.

However, in some cases, a short hospital stay may be preferable. In this case, admission is in the morning (or sometimes the day before in the afternoon) and discharge is permitted the following day.

 

• TYPE OF ANESTHESIA AND CONDITIONS OF INTERVENTION

Type of anesthesia: Usually the procedure is done under general anesthesia. However, in some cases, a local anesthetic depth by tranquilizers administered intravenously (anesthesia "vigil") may suffice.

The choice between these techniques is the result of a discussion between you, the surgeon and the anesthetist.

 

Terms of hospitalization: The intervention can be done in "outpatient", that is to say, day hospitalization with an output on the same day after a few hours of monitoring. However, as appropriate, a shorter hospital stay may be preferable. The input is then carried out in the morning (or sometimes the day before in the afternoon) and the output is allowed the next day or two.

 

• 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:

In the case of an intra-capillary scar, the incision of about 4 to 6 cm is completely hidden in the hair a few centimetres behind and parallel to the hairline. In the case of a pre-capillary scar, the length of the incision depends on the amount of skin removed.

From the incision, hair is removed in very precise anatomical planes, the extent of which depends, among other things, on the laxity of the tissue in each case.

The tissues are then re-tensioned.

The rise of the tail of the eyebrow and the re-draping of the skin are appreciated, taking care to preserve the expression of the face.

The procedure can last between 40 minutes and an hour for both sides.

AFTER THE INTERVENTION: THE OPERATING SUITES

 

Discharge may take place either in the evening or the day after the operation when other operations have been performed at the same time.

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

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

of a small skin bulge at the upper part of the temporal scar,

edema (swelling), which may be more pronounced on the third day than on the first,

of bruises in the region.

a painful feeling of tension in the temples

In case of intra-capillary scars, these are not visible when the hair is combed. Sutures or staples placed in the scalp are removed on the 8th day after surgery.

In case of pre-capillary scars, these are visible but will be faded from the 4th month post-operatively by the regrowth of hair through them. They can of course be made up for the first few months.

 

Schematically we are:

on the seventh day, presentable for the intimate ones,

around the twelfth day, presentable to his friends,

but in order to appear in front of the people we want them to ignore, we need to allow three weeks

 

• THE RESULT

After two to three months, we can have a good idea of the final result.

Physical improvement is usually accompanied by psychological improvement.

If, within a few years, the indication for a cervicofacial lift was given, a new operation at the temporal level would not be necessary. Regular, spaced injections of botulinum toxin into the orbital fibres of the orbicular muscle allow the result to be maintained for a longer period of time by reducing the lowering effect of this muscle on the tail of the eyebrow. On the other hand, the aging process of the skin continues and the maintenance of the skin by medical and cosmetic procedures is highly recommended.

 

• FAULTS OF THE RESULT

This can essentially be a partial reproduction of tissue sagging (ptosis), particularly of the lateral part of the eyebrow, which may require re-tensioning under local anaesthesia.

 

• POSSIBLE COMPLICATIONS

Although the temporal lift is performed for aesthetic reasons, it is nevertheless a real surgical procedure, which implies the risks inherent to any medical procedure, however minimal it may be.

This procedure is subject to the risks associated with living tissue, whose reactions 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 himself inform the patient of the anaesthetic risks. It is important to know that anaesthesia induces unpredictable reactions in the organism, which are more or less easy to control: the fact of having recourse to a perfectly competent anaesthetist, practising in a truly surgical context, means that the risks incurred have become statistically very low.

Indeed, it is important to know that techniques, anaesthetic products and monitoring methods have made huge 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 operation, you limit these risks as much as possible, without however completely eliminating them.

Fortunately, the after-effects of surgery are generally simple after a temporal lift performed properly, and real complications are quite 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 the following

possible complications:

A hematoma requiring rapid evacuation.

Localized alopecia is rare and most often tempo raire.

Infection is exceptional when the procedure is performed under normal aseptic conditions.

Nerve damage, particularly injury or stretching of the temporal branch of the facial nerve, which may result in paresis, may occur but recovery usually occurs within a few months.

All in all, the risks should not be overestimated, but it is important to be aware that even apparently simple surgery always involves a small number of risks.

The recourse to a qualified Plastic Surgeon assures you that he or she has the training and competence required to avoid these complications, or to treat them effectively if necessary.

          

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.