NON ENDOSCOPIC TEMPORAL LIFT
Aesthetic surgery:
This document has been conceived under the authority of the French Society of Plastic Reconstructive and Aesthetic Surgery (SOFCPRE).
DEFINITION
The temporal lift improves the stigma of aging in the temple region. This region lies between the frontal and head and neck regions, which can also benefit from a facelift. The temporal lift can be performed in isolation although, in practice, is often associated with eyelid surgery (blepharoplasty).
This surgery for aesthetic reasons cannot be supported by the Health Insurance.
AIMS
This procedure will treat the collapse of the lateral eyebrow, smooth out the crow's feet and tighten the skin of the external eye. It is not intended to alter the features but to replace the anatomical structures, especially the tail of the eyebrow, in the position that had several years ago.
PRINCIPLES
In this region, the sagging of tissues is mainly of skin.
The temporal lift is performed through a scar:
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Either in the hair (intracapillary scar) but at the cost of a recession in the hairline,
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In flush with the hairline (precapillary scar) but with the risk of some scar visibility.
If the scar in the hair, the temporal skin is ascended by pulling on the deeper layers.
This gesture is more efficient and avoids any traction on the scalp limiting the risk of alopecia (hair loss) and a significant recession of the hairline.
In case of a precapillary scar, chosen when the hairline is already quite recessed and / or the quantity of skin to remove is large, the detachment is subcutaneous. Only the hairless skin (without hair) is removed and the hairline slightly advanced.
The temporal lift can restore a smoother distance between the eyelashes and tail of the eyebrow.
When eyelid surgery is associated, the temporal lift reduces the skin resection and the length of the scar at the upper eyelid.
The procedure, performed as well in women than in men, may be made from 40 years. However, it is sometimes done much earlier, when the disgraces are constitutional (hereditary factors) and not related to aging, as initially low eyebrows.
This technique can be associated with eyelid surgery, as already mentioned, but also with other techniques of plastic surgery (brow or face and neck lift, lipostructure).
In the long term, aging continues to do his work and the face continues to suffer the ravages of time. A maintenance treatment of the face with specific treatments for the skin (laser, pulsed lamps...) and injections (botulinum toxin, fillers) helps maintain the results longer. A new intervention, often more moderate may sometimes be necessary.
BEFORE THE OPERATION
The motivations and demands of patients have been analyzed. A careful study of the temporal region, its reports and a comprehensive study of the gaze have been made.
A preoperative assessment is normally conducted as required.
The anaesthesiologist will be seen in consultation at the latest 48 hours before surgery.
No medication containing aspirin should be taken within 10 days prior to surgery.
It is practical washing the hair the night before surgery and a thorough make-up cleansing the day of surgery.
It is essential to fast (not eat or drink) 6 hours before surgery.
TYPE OF ANAESTHESIA AND HOSPITAL STAY
Type of anaesthesia
The temporal lift can be performed under general anaesthesia or under local aesthesia combined with intravenous tranquilizers ("vigil" anaesthesia).
The choice between these different techniques will be the result of a discussion between you, the anaesthetist and your surgeon.
Hospital stay
The procedure can be performed in "ambulatory", that is to say, with a same-day discharge after a few hours of surveillance.
However, in some cases, a short hospital stay may be preferable. The admission is so in the morning (or even the day in the afternoon) and leaving the hospital is allowed the following day.
THE PROCEDURE
Each surgeon adopts his/her own technique that he/she adapts to each case in order to obtain the best results.
However, we can retain some common basic principles:
In case of intracapillary scar, the incision of approximately 4 to 6 cm is completely hidden in the hair a few inches behind and parallel to the hairline.
In case of precapillary scar, the length of the incision depends on the amount of skin removed.
From the incision, separations are performed in very specific anatomical planes whose extent depends amongst other of the tissue laxity of each case.
It then proceeds to the restoration of tissue tension.
The rise of the tail of the eyebrow and the relocation of the skin are appreciated by taking care to keep his facial expression.
The operation can last between 40 minutes and one hour for both sides.
AFTER THE OPERATION: POSTOPERATIVE CARE AND FOLLOW-UP
The discharge may be either the evening or the day after surgery when other interventions have been performed in the same operation.
The first days you need to rest up and avoid any exertion.
During these early days, the patient must not be surprised or worried of:
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a small skin bulge at the upper part of the temporal scar,
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edema (swelling) that may be more pronounced the third day that the first,
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ecchymoses (bruises) in the region,
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a painful sensation of tension in the temples.
In case of intracapillary scars, they are not visible with styled hair. The sutures or staples placed at the scalp are removed at the 8th postoperative day.
In case of precapillary scars, they are visible but will have hidden from the 4th month post-operatively by the regrowth of hair through them. They can of course make up the first month.
Basically the patients are:
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the seventh day, presentable to their intimates,
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about the twelfth day presentable to their friends,
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but to appear before the people you don’t want them to know the operation, it is necessary to wait three weeks.
THE RESULT
After two to three months, we can have a good idea of the final result.
The physical improvement is accompanied by a general psychological well being.
If in the next few years, an indication of a face and neck lift was raised, a new intervention in the temporal is not necessary. Injections of botulinum toxin at regularly spaced fibres of the orbital orbicularis muscle can maintain the result longer, in reducing the lowering effect of this muscle on the tail of the eyebrow. For cons, the process of skin aging continues and maintenance of the latter by medical and cosmetic procedures is quite recommended.
DISAPPOINTING RESULTS
It may be essentially a reproduction of the partial relaxation of tissues (ptosis), especially the lateral eyebrow, which may require a re-tightening under local anaesthesia.
POSSIBLE COMPLICATIONS
The temporal lift although carried out for mainly aesthetic reasons, none the less is a real surgery, which involves the risks associated with any medical procedure however small it may be.
We must distinguish here between risks related to the anaesthesia and those related to the surgery.
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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.
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Concerning surgery: by choosing a competent, qualified Plastic Surgeon, used to performing this procedure, you limit the risks, without however eliminating them completely.
Fortunately, the postoperative course is generally simple after a temporal lift performed in the rules, and real complications are rare.
In practice, the vast majority of operations go without any problem and the patients are satisfied with their results.
However, despite their rarity, you still know the possible complications:
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A hematoma requiring prompt evacuation.
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Localized alopecia is rare and usually temporary
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The infection is exceptional when the procedure is performed under normal conditions of asepsis.
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Nerve damage, especially the injury or stretching of the temporal branch of the facial nerve may cause paresis, but recovery occurs, usually within a few months.
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.