Facial rejuvenation with a face and neck lift
The face and neck lift has to be a complete rejuvenation treatment focused on ensuring that there is no repetition of the mistakes of the past, namely drawn expressionless features and a frozen face. The exact opposite in fact of real facial rejuvenation.
The facelift must be a gentle and subtle intervention. The fashion at the moment is currently in mini lifts (soft lift or French lift) carried out earlier than a real face lift (most often between the ages of 40 and 50 years) delivering excellent results against the beginning of aging of the face. Once face folds, wrinkles, furrows and skin ptosis have developed, however, there is no other solution than to consider a real facelift.
There is not one facelift but many facelifts. Each facelift must be unique and adapted to the individual’s face and, especially, to their facial expressions. A facelift can affect many different anatomical regions of the face, neck and head:
- The forehead, were we perform a forehead lift or, more often, botulinum toxin injections (botox).
- The eyebrows which sag with age and accentuate a tired aspect of the face by weighing on the upper eyelids, were we perform a temporal or eyebrow or mannequin lift, most often under local anesthesia, with a small scar hidden in the hair.
- The eyelids, which have excess skin or pockets of fat, were we perform an upper or lower blepharoplasty (upper or lower eyelids) which consists in opening the eyes and removing the excess skin and bags under them.
- The dark circles which are difficult to treat but can be improved by injections of fat (lipofilling) or hyaluronic acid.
- The cheek that is empty or drooping. It can be raised using a mid-facelift or concentric malar lift. It can also be re-inflated if it is empty with a silicone prosthesis or lipomodelling.
- Wrinkles and furrows (upper lip, bitterness folds, lion’s wrinkle, nasolabial folds etc.) are treated with injections or lipofilling.
- The upper lip is made plumper and more sensual by injections of hyaluronic acid, the placement of a silicone implant (permalip) or reassembled using a lifting of the upper lip.
- The “sad mouth” in the form of an inverted U is treated without a scar by sectioning the DAO (depressor anguli oris) muscle.
- The neck, jowls, cervical cords and ptosis of the cheek tissues is treated by a cervico facial face lift.
- All of these procedures can be combined with one another.
Cervico-facial face lift in practice
Objective of the facelift: tighten sagging skin, restore the facial contours and revitalize the facial muscles.
Duration of the facelift: 1h30 to 4h depending on the technique
Anesthesia: local for a small facelift (mini-lift), sedation or, more often, general.
Duration of hospitalization: leave the same evening or the next day
Time off work: 7 to 15 days (for the swelling and bruising). At least a week while the bruises fade and the threads are removed.
Pain: very little, the facelift is not a painful procedure
Duration of effectiveness: 10 to 15 years depending on the quality of the skin and exposure to toxic substances (sun, tobacco, etc.)
From what age: 35 for a mini-lift and 45 for a facelift but there is no age limit and no ideal age for a facelift.
Scars: the scar is hidden in front of the ear in the folds, behind the ear, and then in the hair.
Operative technique: adapted to each case (subcutaneous facelift, SMAS, plication, flaps, subperiosteal, etc.). The main principle of modern facelifts is to tighten the skin AND the underlying muscles, not just the skin.
Complications: mainly hematoma and skin pain, less than 5% of cases and favored by aspirin and smoking.
Price of a cervico facial face lift: very variable because of the procedures to be performed, fees from 6000 euros for a mini or soft lift, 8000 euros for a classic face lift or even more in case of associated treatments.
Frequently asked questions about a cervico facial face lift (face and neck)
WHAT ARE THE POSTOPERATIVE EFFECTS OF A CERVICO FACIAL FACE LIFT?
After a facial procedure such as a facelift, the postoperative recovery is generally very simple. There is always swelling that will be present. If the facelift only concerns the face and its oval (the jowls), which is also called a mini facelift or soft facelift, then the swelling will last an average of 10 days. If the facelift is more concerned with the neck area (“the real facelift”) then the swelling will be greater and longer, on average 14 to 21 days.
There are also bruises that go through many different colors: blue, green, purple and yellow. The duration is the same as for swelling.
The pain is very moderate, most often taking a simple pain reliever like paracetamol is sufficient. It is worth knowing that at first the ear lobes can feel less sensitive or “asleep” and there can be an asymmetry at the corner of the mouth for the first few days (a branch of the facial nerve is affected by swelling) and, finally, there is always a scar which is going to be visible because it will be a little inflamed, i.e. red, for the first 3 months.
WHAT SHOULD YOU KNOW BEFORE UNDERGOING A CERVICO FACIAL FACE LIFT?
The decision to undergo an operation must of course be carefully considered and the morphological indication must be ideal. There is no particular medical contraindication apart from not taking aspirin or anticoagulants and stopping smoking which affects scarring and can even lead to local necrosis. Age is of no concern because everything depends on the quality of the skin, the tissues and the sagging. It can happen that sometimes a facelift is carried out at the age of 30 in certain special cases!
WHAT IS THE PROCEDURE?
The first step is to consult a cosmetic surgeon. The operative indication will be placed on what it is possible to do and on what it is not possible to obtain as a result. The most important thing is to have confidence in your surgeon and to rely on word of mouth, which is still important in the field. It’s all about listening, the surgeon must listen to and understand the requests of his patients to offer the best solution for each case. Some will want a very natural result, others will want a more drawn out aspect (to be avoided in my opinion …).
The cosmetic surgeon will explain to the patient what to do before the operation (see the anesthesiologist, take a blood test, arnica) and how the day of the operation itself will unfold at the clinic (duration of the operation from 1 to 3 hours, outpatient or overnight hospital stay under surveillance, local anesthesia with sedation or general anesthesia) and, finally, the postoperative recovery process (no dressing, disinfection of scars, cream, swellings, compression stockings, ice). A price estimate will also be delivered which will indicate the amount of the surgeon’s fees as well as the costs of the clinic and anesthesia.
HOW DOES A CERVICO FACIAL FACE LIFT WORK?
The principle of the facelift is to restore tension to the relaxed elements of the face. It acts on the skin, fat, muscles and aponeuroses. The traction vector is important as well as the elements to be re-tensioned. In all cases it will be necessary to make a scar which will be hidden either in front of or behind the ear (or both) but which is easily camouflaged by the hair.
THE OPERATION IN DETAIL
You must arrive at the clinic on an empty stomach the morning of the surgery. It is necessary to take a shower the day before and also in the morning with a specific antiseptic soap which will have been prescribed to you. You should not have taken any aspirin or any other bleed-inducing medication before you arrive. You are dressed for the operation and taken to the operating room after you have received a light sedation to reduce the normal stress felt before the procedure. The anesthesiologist sets up the infusion and either performs a sedation (light anesthesia that allows you to remain conscious) or performs a general anesthesia but which nevertheless remains light. After antiseptic preparation of the skin, sterile operating drapes are put in place and the surgeon can begin his work. The first step is to infiltrate a product that will allow good tissue dissection and avoid bleeding. During the entire operation the anesthesiologist ensures that the blood pressure is as low as possible. Once the product begins to works, the skin can be cut. An incision is made through the hair, in front of the ear, inside the cartilage of the ear (tragus) or sometimes in front and then down to the earlobe. If only the face is being treated then we stop the anesthesia at this level otherwise it is necessary to extend behind the ear in the groove then in the hair or flush with it to access the neck.
The skin is gently lifted and the work begins, we can extract fat, tighten the muscles, tighten the aponeuroses, perform internal flaps or folds and even reinject the extracted fat. Some difficult facelifts may need to descend to the level of the bone. Then the skin is rested, the excess is cut and we can suture. In all cases, in my opinion, the watchword is to obtain a result because, of course, the lifting procedure must be beneficial but we must not pull too much on the tissue otherwise it shows that a lifting has been done and the results are the opposite of what we want to achieve.
WHAT IS THE EFFECT OF A CERVICO FACIAL FACE LIFT?
Mainly, when carrying out a facelift we look to:
- treat the sagging neck
- corriger les cordes platysmales qui forment 2 cordes verticales au niveau du cou jusqu’au menton
- remove excess fat under the chin (double chin)
- correct the oval of the face by putting it back under tension
- remove the jowls
- alleviate the bitterness folds at the sides of the mouth
- attenuate the nasolabial folds between the nose, the mouth and the cheek
- remonter la peau des joues vers le haut et l’extérieur (vecteur oblique externe)
- remonter les pommettes
- reshape the cheeks
- reshape the temporal fossa or hollow temples
- remove bags under the eyes
- tighten the skin of the lower eyelids
- reduce dark circles
- remove excess skin from the upper eyelids which makes you look tired
- shorten the upper lip
- raise the eyebrows
- smooth the forehead
But of course all this is not necessarily carried out during a single facelift, it must be performed à la carte according to the patient’s demands and what is indicated.
WHAT ARE THE ALTERNATIVES TO A CERVICO FACIAL FACE LIFT?
While waiting for a facelift to be indicated, other treatments including Botox injections or injections of filler or volumizer such as hyaluronic acid (Juvederm, Restylane, etc.) can be performed. This can help reduce expression lines, restore volume, or fill in furrows or hollows. It is also possible to use treatments such as a peeling or mesotherapy or even skin boosters which will improve the radiance and tone of the skin. Absorbable tensor threads can also be effective. Another possibility is to rejuvenate the eye area and undergo a blepharoplasty (eyelid surgery) which has the advantage of being carried out under local anesthesia and being painless. The principle is to remove a spindle of excess skin at the upper eyelid which does not change the patient’s looks and gives only very rare complications for a very remarkable benefit.