Facelift surgery is the cosmetic procedure that restores more natural, harmonious facial contours. With ageing the face changes. It loses volume, the facial muscles slacken, and the skin wrinkles and becomes lax. Surgery to refine facial contours is surgery of rejuvenation and enhancement. The aim is to tighten the facial muscles, redrape the skin that has become lax, and restore lost volume. It can be performed in both women and men. There are many procedures that rejuvenate and enhance, and they can be combined with one another. A facelift may concern different parts of the face (temples, neck, …). We speak of a full facelift (cervico-facial facelift) or a partial lift (neck lift, …) depending on whether it involves all or part of the face. It may sometimes be necessary to combine it with another surgical procedure: eyelid surgery (blepharoplasty), nose surgery (rhinoplasty) or lip surgery, for example. A 'standard' operation does not exist in cosmetic surgery because every person is unique and therefore requires a specific, personalised procedure. From your first consultation, Le Docteur Lionel Sallaz will take the time to listen to your wishes and motivations. He will examine you carefully to ensure the operation is appropriate and will explain it precisely. He will assess your skin tone and elasticity, the amount of fat loss (fat atrophy), muscle laxity, bony contours, the nose, eyelids, smile, … This is where the surgeon’s expertise is crucial. Le Docteur Lionel Sallaz will inform you as fully and honestly as possible about this procedure, explaining what it can genuinely offer you and what it cannot correct.
Anaesthesia – Hospitalisation The surgical procedure will be carried out under general anaesthesia in the clinic’s operating theatre, in a state-of-the-art environment authorised to perform cosmetic surgery procedures by the Haute Autorité Sanitaire (HAS). It will take place during a short hospital stay (most often as day-case surgery).
Procedure Liposuction of the neck may sometimes be combined if there is a double chin. The incisions (future scars) are concealed in the hair (at the temple and behind the ear) and in the crease just in front of the ear. The skin is then undermined to a greater or lesser extent over the temples, cheeks or neck, as required. The facial muscles are then tightened (by muscular sutures) to re-elevate the parts of the face that have descended (cheekbones, …). This is the key step of the facelift and must be precise and meticulous, as it is what truly lifts the face and ensures the quality of the result. The elevated skin is then redraped without tension, the excess removed, and the sutures placed. Fat grafting, also called lipostructure® according to S. Coleman, lipofilling or liposeeding, is sometimes added if needed (the surgeon will discuss this with you at your first consultation). It consists of a true autologous graft of fat cells by re-injecting fat taken from your own body. In practice, liposuction of a part of the body is performed with atraumatic micro-cannulae to collect a small amount of fat. This fat is then centrifuged to separate the intact graftable fat cells from the other, non-graftable cells. The microparticles of centrifuged fat can then be re-injected into the desired area using a very meticulous, precise technique. This is therefore a genuine graft of living cells. With a good technique, and if the graft takes well, the effect can be considered stable over time. Its value in the facelift is to enhance the results by softening and shaping the facial contours and improving skin quality (a more radiant complexion). A conforming dressing is then applied and, after the procedure, you will be monitored in the recovery room until you have recovered satisfactorily, before being taken back to your hospital room until discharge from the clinic. Post-operative recovery is most often straightforward and not very painful. Patients generally report discomfort over the first few days, such as tightness behind the ears and a pulling sensation in the neck, which gradually lessens. Facial oedema (swelling) is normal and will settle progressively. It varies from one patient to another. Bruising is sometimes present, but a haematoma may occur and slow normal progress. It will be prevented and treated if necessary. To limit this risk, no medication containing aspirin derivatives should be taken in the ten days before and after the procedure. A homeopathic treatment is prescribed to limit it as much as possible. For the first few days, you should avoid bending your head forwards and keep it held high, which will promote good healing by smoothing the neck.
Follow-up Le Docteur Lionel Sallaz will look after you in the clinic for the duration of your hospital stay. Then, after you leave the clinic, follow-up will take place at his practice for post-operative consultations. You will be given medical recommendations for your home care until your check-up consultation at his practice a few days later, in order to obtain the most natural and harmonious result possible. A few days of rest to recover is advisable, and sport can be resumed after several weeks. Ideally, allow a period of convalescence in calm surroundings, avoiding too much talking and any strenuous effort. After 3–4 months you can have a good idea of the final result, but the scars are still a little pink and firm and only fade towards the 6th month. Thanks to the progress made and great technical meticulousness, a pleasing rejuvenating effect is most often obtained, yet remains very natural. The face does not look operated on and has approximately regained the features it had a few years earlier, giving an overall rested, relaxed and refreshed appearance. This physical improvement is generally accompanied by improved psychological well-being.
Risks and complications
They are rare; nevertheless, although carried out for essentially aesthetic reasons, a facelift remains a genuine surgical procedure, which entails the risks associated with any medical act, however small. To minimise operative risks as far as possible, you will always be seen at a pre-operative consultation by an anaesthetist experienced in this type of procedure. To minimise the risk of infection, patients must take pre-operative antiseptic showers at home. To limit the risk of haematoma, no medication containing aspirin derivatives should be taken in the ten days before and after the procedure. Smoking is a risk factor for poor wound healing. Smoking should therefore be stopped weeks before the operation to reduce the risks of poor healing (= skin necrosis). Injury to the facial nerve (the nerve that enables the facial muscles to produce expression) is exceptional. It causes an unsightly facial asymmetry (= paralysis) but usually resolves spontaneously within a few weeks. It is, however, the risk that must be prevented as far as possible by the most impeccable surgical practice.
Overall, the risks should not be overstated, but simply recognised: any surgical procedure, even one that appears simple, always carries an element of uncertainty. Choosing a qualified plastic surgeon ensures that he or she has the training and expertise required to avoid these complications, or to treat them effectively if they occur.