FACE LIFT SURGERY

Different cervical-facials lifts can correct the signs of facial-aging: the face lift corrects the sagging of the neck and the loosening of the cheeks, the mid face lift corrects the sagging of the middle third part of the face and the medial part of the cheeks, finally, the temporal and forehead facelift corrects the sagging of the forehead and eyebrows.
Among these three possibilities, the neck and face lift surgery is the most frequently performed. This cosmetic surgery can correct the sagging of the face from the temporal part to the cheeks.
The corrective procedure may be local in the case of a face and neck mini-lifting, or more extensive such as a classic face lift. Doctor Jean-Charles BAYOL uses the mini-facelift technics which gives great satisfaction to patients with simple postoperative follow-ups.

The objective of this cosmetic surgical procedure is to reposition the muscles and skin of the face and neck to correct their progressive collapse due to the aging process (Figure 1).

Figure 1: Head and neck loosening due to the aging process

The goal of this procedure is to give to your face the appearance it had ten years ago. The purpose is not to change or transform the patient’s appearance (changing the eye expression or apply too important volumetric changes to cheekbone and lips, as we sometimes see it in the media).

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he muscular and aponeurotic subcutaneous system of the cheek and neck is repositioned; the skin is then reapplied without tension. The face lift on the skin but also on the muscles will give a natural result with simple postoperative follow-up due to the detachment of only a small extent of the skin, hence the term mini-facelift.

Sometimes, loss of volume and relief especially on the cheeks, forehead and dark circles, can be corrected during the same procedure by re-injection of autologous fat also called lipostructure.

If deep wrinkles will be reduced by the face lift, superficial wrinkles will not be corrected. They may benefit from other treatments more or less related to one another such as botulinum toxin, hyaluronic acid and resurfacing (laser, peels, dermabrasion).

In the same way, the eyelids and the eye will not be altered by a face and neck lifting. A cosmetic eyelid surgery (blepharoplasty) may be carried out during the same surgical procedure.

Most scars are hidden in the hair, only the scar in front of the ear may be visible but stays very discreet.

Regarding men, the facelift pushes back the bearded skin part of the cheek, and brings it in immediate contact with the ear.

A face lift can be done when the first signs of aging appear (around 40-45 years old). You should know that the earlier you take action the simpler the procedure will be, with a better result that will last longer.

Doctor Jean-Charles BAYOL always meets each patient twice before surgery at Laclinic-Montreux, or at the Beauty Suite in Lausanne, (near Geneva and Neuchâtel by train). The first consultation is to listen to you and understand what bothers you and what you want to correct, but also to examine you and offer you a personalized solution. The second consultation is to answer your questions, renegotiate the terms of the surgical procedure and organize the date of the surgery.

It is strongly recommended that you reduce smoking at least one month prior the procedure in order to minimize the risk of scarring complications.

Refrain from taking aspirin 15 days before the surgery because it provokes excessive bleeding.

Homeopathic treatment is systematically prescribed to reduce bleeding, swelling and postoperative bruising.

The face and neck lift can be performed under general or conscious anesthesia (local sedation) in the operating room. This kind of local anesthesia is carried out more and more frequently, it is a local anesthetic reinforced by tranquilizers intravenously administrated.

At Laclinic in Montreux, one day of hospitalization is usually sufficient. You will check-in in the morning, the surgical procedure will take place during the day, a nurse will monitor you all night long, then you can check-out the following morning. When it comes to mini-facelift, the procedure can be done as an outpatient surgery.

The cosmetic surgeon adapts his technique to each patient in order to have the best result. The different stages of the procedure are:

•    The Scar is hidden in the hair and around the ear. Regarding “modern” facelifts, incisions are often shorter in the hair than the incisions of conventional facelifts (Figure 2).

Figure 2: The different incisions of the cervical-facial lifting

From the incisions, the surgeon performs a dissection under the skin. The importance of this detachment depends on the loosening of the skin and subcutaneous structures. The detachment of the “modern” facelifts is less extensive than conventional facelifts detachment (Figure 3). Therefore, the postoperative follow-ups are much simpler with less swelling.

Figure 3: different detachments of the cervical-facial lifting

These incisions and these limited detachments match the new facelift techniques which is sometimes called mini-facelift.

-The Musculo-aponeurotic structures under the skin are repositioned to correct the sagging without changing the facial expression (fig 4).

Figure 4: Stretching of the muscular structure under the skin

– A Liposuction can be performed at the beginning or at the end of the procedure in case of excess fat in the neck or cheeks.
-The Skin is naturally lifted (Figure 5), the excess skin is resected, sutures are performed without tension.
Lifting of the skin

Figure 5: Resection of excess skin

A Pressure dressing is made at the end of the procedure to limit swelling and will be removed the next day.

Depending on the cosmetic surgeon, the importance of corrections to be made and the associated techniques (blepharoplasty, central-facial lift, temporal facelift, lipofilling), the procedure can last from two to four hours.

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To limit the extent and duration of postoperative follow-ups you will be systematically accompanied by the physiotherapy department for post-operative care. This care will take place on the same day, in case of outpatient hospitalization, or the next day if you stay in hospital overnight. It will consist in gentle massage of the operated area and LED care will ensure a lymphatic drainage and ease the healing process. Several weeks after surgery, a LPG treatment may be undertaken.

The compression dressing made at the end of the surgical procedure is removed the next day. The scars will remain in the open air, local cares will be carried out for 15 days. Doctor Jean-Charles BAYOL does not prescribe wearing a compression garment (press-lift) anymore, because it appears more annoying than useful. If it has to be worn, it will be during the first three weeks following the procedure.

It is possible to make a first mild shampoo immediately after the surgery. However, you must wait a month to a month and a half to die your hair again.

Several control consultations will be carried out: 10 days, 1 month, 3 months, 6 months and 1 year after surgery.

During the first 10 days, there usually is a swelling (edema) that can sometimes be significant, bruises that can descend on the neck and the chest, and a painful tension feeling behind the ears and at the neck. These signs fade progressively in 15 days to 3 weeks. Their disappearance may be faster with postoperative physiotherapy, but you may consider to be socially “presentable” after three weeks.

Skin sensitivity reappears in a few weeks, The feeling of tension will gradually disappear within weeks.

We have to wait 3 to 6 months or even a year for the final result of the face lift to be seen. The evolution of the scars takes 1 to 2 years.
The result is a facial rejuvenation of approximately 10 years. It must remain a natural rejuvenation. This physical improvement has a real therapeutic purpose since it is often accompanied by a real psychological well being.
This cosmetic surgery cannot stop the aging process, a new face lift can be considered after 10 years (sometimes several years before).

The swelling (edema) may persist over 4 months.
In case of a significant loosening before surgery, a partial recurrence in the front of the neck may reappear. It does not bother the patient who is very satisfied with the result of the procedure.
Scars that are too visible can be retouched in a second time at least one year after the first surgery.

However the procedure is performed under local anesthesia or general anesthesia, complications due to anesthesia are exceptional. Cervical and facial lift is a real surgical procedure that must be performed in an operating room within a cosmetic surgery clinic such as Laclinic in Montreux near Lausanne.
Regarding the procedure, you must choose a competent, serious and qualified plastic and cosmetic surgeon, to perform the facelift.
The postoperative follow-ups are usually very simple and complications are rare. However, they can sometimes occur:
•    The hematoma: It can be triggered by high blood pressure. To prevent it, do not take medicine that stimulates bleeding at least 10 days before the facelift: aspirin, anti-inflammatory, oral anti-coagulants must be prohibited. When the hematoma occurs, it is quickly evacuated.

•    Localized skin necrosis: boosted by smoking, hence the importance of reducing your consumption before surgery.

•    The infection which is exceptional but possible, as well as Thromboembolic complications (phlebitis, pulmonary embolism).

•    Damage to the facial nerve: mild and transient paralysis may occur, they usually disappear within a few weeks. Very rarely, these paralyzes are more important but usually disappear after several months.

•    A lack of sensitivity of the ear: caused by a possible lesion of the sensory nerve of the ear (posterior auricular nerve). It disappears in a few months.

•    The Ear lobe can be pulled down and forward: this is due to excessive tension on the scar in front of the ear. Revision surgery can be done between 6 and 12 months after the first procedure in order to reposition the ear lobe.

•    Unpredictable scarring evolution: Hypertrophic and / or keloid scars.

•    Subjectivity: The intervention being motivated by aesthetic reasons, the results can only be subjectively assessed. It is therefore important to recognize that the results may not exactly match the expected results.

Cervical and facial lift has a real therapeutic purpose because in addition to physical improvement, it brings a psychological well being.

Doctor Jean-Charles BAYOL performs the mini face and neck lift at Laclinic in Montreux. 
This surgical procedure gives great satisfaction to patients with simple postoperative follow-ups.