FACE AND NECK LIFT
Aesthetic surgery:
This document has been conceived under the authority of the French Society of plastic Reconstructive and Aesthetic Surgery (SOFCPRE).
DEFINITION
There are now several types of facelifts that improve the misfortunes caused by the aging face and neck, or on a localized or a more extended.
The face- and neck-lift is the most frequent procedure; this means surgical correction of aging of the neck and also the face from the forehead to the jowls.
This cosmetic procedure is not reimbursed by health insurance.
OBJECTIVES
The aim of the operation is to remedy the sagging and laxity of the skin and muscles of the face (forehead, eyebrows, cheeks, jowls, and the oval facial outline) and the neck.
The aim here is not only to transform the form and aspect of the face. On the contrary, restoring the different anatomical structures of the face and neck (the skin, the muscles and the fat) enables the patient to look as he or she did some years earlier.
PRINCIPLES
The muscles are tightened, to correct slackness. The skin is then draped as required over the new curves, without excessive stretching. This dual action gives a natural appearance (as the skin is not over-stretched), which lasts (since the muscular base is strong). The healing process is generally uneventful (the skin is less bruised because it is less traumatized, because the tension and separation are limited.) Excess fat, if present can be treated by liposuction.
On the other hand, if the face appears emaciated, this can be corrected at the same time by re-injection of autologous fat (lipostructure).
In this way the face and the neck are "rebuilt" or "restructured".
In contrast, expression lines, wrinkles of the crow's feet or peri-oral wrinkles are not changed.
The wrinkles are improved by the tension applied to the skin without ever completely disappear.
The aspect of the eyelids is not corrected by a face and neck lift isolated.
The incisions necessary for the procedure are hidden almost entirely in the hair (at the temples and the nape of the neck) and around the ears. The scar is thus almost entirely concealed.
A face lift can be carried out as soon as signs of aging appear and the patient feels a real need for their correction, generally around the age of 40 or 45.
This procedure can be carried out at the same time as another facial cosmetic procedure: eyelid aesthetic surgery (blepharoplasty), forehead lift (endoscopic forehead lift). It can be completed by other treatments: (laserabrasion, dermabrasion, chemical peels, medical treatment of wrinkles and skin folds, and Botox injections).
BEFORE THE OPERATION
Prior to the operation a thorough examination will be carried out as prescribed.
You will see an anaesthesiologist in consultation at the latest 48 hours before the procedure.
No aspirin-based medication should be taken over the 10 days preceding the operation.
Stop smoking is strongly recommended at least one month before and one month after the intervention (smoking can cause a delayed healing).
You must wash your hair the day before the operation and make-up must be thoroughly removed.
You must fast (neither eat nor drink) for 6 hours before the operation.
HOSPITAL STAY AND TYPE OF ANAESTHESIA
Type of anaesthesia:
A face-lift can be carried out under general anaesthesia or local anaesthesia with sedation ("twilight" anaesthesia).
The type of anaesthesia will be chosen after discussion between yourself, the surgeon and the anaesthesiologist.
Hospital stay
A 24-48 hour hospital stay is usual.
THE PROCEDURE
Each surgeon has adopted his or her own specific technique that he or she adapts in order to obtain the best results in each case. We can however give some basic points:
The incision is almost completely hidden in the hair, or around the ears.
Once these incisions are made, the skin is detached to a greater or lesser extent in each case, according to the degree of sagging of the skin.
The muscle layer is then carefully and precisely tightened to correct laxity, without affecting the normal expression of the fac
If there are localized fat deposits, which can form on the neck, the chin, the jowls or the cheeks, a liposuction is performed during the operation.
The skin is then re-draped in a natural manner, excess skin removed, and stitches placed without excess tension.
Finally a dressing is placed around the head, framing the face.
The procedure lasts from two to three hours depending on the surgeon and the individual corrections required.
AFTER THE OPERATION
You will be able to go home on the first or second day after the operation.
For the first few days you are advised to rest and avoid physical strain.
During this period you should not be surprised by, or worried by, the following:
-
d’un œdème (gonflement) qui peut être plus accentué le deuxième jour que le premier,
-
edema (swelling) which can be worse on the second day than the first,
-
bruising around the neck and chin,
-
a sensation of painful tightness especially behind the ears, and around the neck.
This bruising and swelling generally disappears in the two weeks following surgery.
After one month all signs of swelling have usually practically disappeared. The zones from which the skin was detached may feel slightly hardened; this is perceptible to the touch, but not visible. The ears will not regain normal sensitivity for one or two months.
Sometimes, you can observe for several weeks after the surgery discomfort, tension on the tissues, an uncomfortable feeling of weight that can last for several weeks or months.
The scars are hidden by the hair both in front and at the back of the head. The only zone where they are visible, in front of the ears, where them can be temporarily masked by make-up or concealed by the hair.
So, we can say that you are presentable:
-
on the seventh day for close friends and family,
-
on the twelfth day for friends,
-
after three weeks for people uninformed about the operation.
THE RESULT
After two or three months one can have a good idea of the final result. The scars, however will still be slightly pink and hard to the touch, and will not fade until the sixth month after the operation.
Through progress over the years and techniques of great precision we usually achieve a result giving an impression of considerable rejuvenation that nevertheless looks quite natural. The face does not have a ‘surgical’ appearance and has regained the features that it had eight to twelve years before. The general impression is relaxed and refreshed.
The physical improvement is accompanied by a general rule of a psychological well-being.
The goal of this surgery is to make an improvement and not to achieve perfection. If your wishes are realistic, the result should give you great satisfaction.
In the long term, a face- and neck-lift has beaten the ravages of time, but aging does continue, and a second similar procedure can be envisaged after about ten years.
DISAPPOINTING RESULTS
These can be essentially:
-
edema (swelling) which can persist in certain zones three months after the procedure, and which needs to be treated by massage,
-
partial relapse of sagging skin (ptosis) particularly of the neck, when this was a major problem before surgery,
-
visible scars, or hair loss around the temples (alopecia), which can require revision surgery after six months to a year.
POSSIBLE COMPLICATIONS
A face-lift, although essentially an aesthetic procedure, is nevertheless an operation, and this implies that the risks inherent to any surgery apply here.
We must distinguish here between risks related to the anaesthesia and those related to the surgery.
-
For the anaesthesia, the anaesthesiologist will explain the risks during the preoperative consultation. You must be aware that anaesthesia can cause unpredictable reactions, which can be difficult to control: the presence of an experienced anaesthesiologist, in a surgical context, means that the risks are statistically practically negligible.
In fact techniques, products and monitoring methods have progressed considerably over the last twenty years, giving optimal safety, especially when the operation is not an emergency and the patient is in good general health.
-
Concerning surgery: by choosing a competent, qualified Plastic Surgeon, used to performing this procedure, you limit the risks, without however eliminating them completely.
Fortunately, real complications are rare following a face- and neck-lift, which has been carried out correctly. In fact practically all the operations go well and patients are completely satisfied with the result.
In spite of the fact that complications are so rare you must be aware of the following possible problems:
-
A hematoma: this must be rapidly drained.
-
Skin death (necrosis): this delays the healing process. (This risk is highly increased by smoking habit).
-
Infection: This is extremely rare.
-
Nerve damage: in particular damage to a branch of the facial nerve, this can lead to paresis, or facial paralysis. This is rare and the after-effects usually disappear in a few months.
-
Abnormal scars, either hypertrophic or keloidal: they are impossible to foresee, and their development is unpredictable. They can threaten the aesthetic result and require specific local treatment over a long period.
All things considered, the risks must not be overestimated, but you must be conscious that an operation, even a minor one, always has some degree of unforeseeable unknown factors.
You can be assured that if you are operated on by a qualified Plastic Surgeon, he will have the experience and skill required to avoid these complications, or to treat them successfully if necessary.
These are the facts that we wish to bring to your attention, to complement what you were told during the consultation.
Our advice is for you to keep this document and to read it and think it over carefully after your consultation.
Once you have done this you will perhaps have further queries, or require additional information.
We are at your disposal should you wish to ask questions during your next consultation, or by telephone, or even on the day of the operation, when we will meet in any case, before the anaesthesia.
"Copyright", © "All Rights Reserved" SOFCPRE, any reproduction, even partial, of these texts is prohibited without permission from the French Society of Plastic Reconstructive and Aesthetic Surgery. A copy or reproduction by any means whatsoever, including photocopying, photography, screen capture, copy, paste, recording or otherwise, constitutes an infringement punishable under the Act of March 11, 1957 on the protection of copyright.
Authorization for reproduction of March 10, 2009, for: MCEI (www.chirurgiens-plasticiens.info).
This factsheet has been designed under the auspices of the French Society of Plastic Reconstructive and Aesthetic Surgery (SOF.CPRE) as a complement to your first consultation; to try to answer any questions you can ask yourself if you intend to use a surgical lipo-filling.
The purpose of this paper is to bring you all the information necessary and essential for you to make your decision with full knowledge of the facts. So is it advisable to read with the greatest attention.