Facelift

The cervicofacial lift (commonly referred to as a facelift) is a surgical procedure designed to correct skin sagging and tissue laxity of the face and neck. It is suited to patients who wish to restore firmness and more defined contours while maintaining a natural and harmonious facial appearance.

Common motivations: loss of jawline definition, marked nasolabial folds, jowls, sagging neck skin and muscles. The goal is to improve facial harmony without altering identity. This information is intended for general guidance and does not replace an individual medical consultation.

Main surgical approaches

Different techniques exist, chosen based on age, skin quality, degree of muscular laxity, and expectations following a clinical examination.

Skin-only lift

• Description: primarily skin tightening.
• Specifics: less invasive technique but provides limited results when deep laxity is significant.
• Limitations: risk of earlier recurrence with significant laxity.

SMAS lift (Superficial Musculo-Aponeurotic System)

• Description: treatment of the superficial muscular layer (SMAS) combined with skin tightening.
• Specifics: provides more lasting action on volumes and contours.
• Limitations: technique requiring expertise and more extensive dissection.

Deep plane lift

• Description: undermining and tightening of deeper planes, beneath the SMAS.
• Specifics: indicated when tissue descent is significant; aims for natural harmonisation.
• Limitations: more technical procedure, potentially associated with a more pronounced recovery.

Mini-lift or limited lift (MACS lift)

• Description: shorter scars, targeted tightening (mid-facial areas).
• Specifics: suited to moderate signs of ageing; recovery is often shorter.
• Limitations: limited efficacy on the neck or markedly pronounced jowls.

Neck treatment (platysmaplasty, liposuction)

• Description: specific management of the neck muscles (platysmal bands) and/or fat excess.
• Specifics: often combined with cervicofacial lift for a harmonious neck result.
• Limitations: may require additional procedures depending on the examination.

Pre-operative Consultation

Process of a consultation with the surgeon

• Medical history: past medical history, current medications, surgical history, smoking, expectations and motivations.
• Clinical examination: skin analysis, volumes, facial features, pre-operative photographs.
• Technical choice: discussion of adapted options (type of lift, associated neck procedures, possible liposuction).
• Anaesthesia information: an anaesthesiologist consultation is mandatory before surgery.
• Quote and documents: provision of a written quote, information document, and informed consent to sign if you decide to proceed.
• Reflection period: reminder of the mandatory 15-day period between the initial consultation and the procedure for any aesthetic surgery.
• Questions and clarifications: time to answer questions regarding post-operative course, risks, and follow-up.

Procedure

• Anaesthesia: general or deep sedation combined with local anaesthesia depending on the extent of the procedure and the patient's medical condition.
• Duration: generally between 2 and 4 hours, variable depending on the associated procedures (neck treatment, liposuction, etc.).
• Hospitalisation: day surgery (same-day discharge) or one night's hospitalisation depending on the protocol and anaesthesia.
• Surgical steps (summary):
• Pre-operative markings.
• Incisions concealed around the ear and sometimes behind the ear or under the chin for the neck.
• Dissection of the chosen planes (skin, SMAS, deep).
• Tissue tightening and repositioning; neck procedure if necessary (platysmaplasty, liposuction).
• Suture and possible drain placement.
• Safety and traceability: complete medical record, pre-operative photographs, operative report, signed consent, peri- and post-operative monitoring.
• Prescriptions: analgesics, care instructions, estimated time off work.

Post-operative Recovery

• Pain: generally moderate and controlled by oral medication.
• Swelling and bruising: present in the first days/week, decreasing progressively; may persist for several weeks.
• Dressings and drains: dressings during the first days; drains, if placed, are removed within a few days.
• Care: local hygiene, analgesics, possible antibiotic prophylaxis depending on the case. Compression wear (bandage or collar) depending on technique.
• Resumption of activity:
• Return home the same day or after 24 hours depending on hospitalisation.
• Return to work: generally 10 to 15 days depending on professional activity and degree of bruising/swelling.
• Physical activities: progressive resumption after 4 to 6 weeks, avoiding strenuous effort and prolonged sun exposure on scars.
• Medical monitoring: check-up appointments at D7–D15, 1 month, 3 months, 6 months, and depending on progress. Monitoring for any complications.

Results and Limitations

• Progressive result: appearance improves week by week and month by month; swelling and scars fade progressively.
• Timeline: appearance close to definitive generally after several months; contour refinement may continue up to 12 months.
• Individual variability: the result depends on skin quality, age, degree of laxity, and lifestyle (smoking, sun exposure, weight fluctuations).
• Durability: a facelift corrects existing laxity but skin and tissues continue to age; appropriate medical follow-up and care help optimise the longevity of the result.

Risks and Complications

Complications remain rare but must be known and will be detailed at the consultation.

• General risks: infection, haematoma sometimes requiring re-intervention, delayed healing.
• Specific complications:
• Facial nerve palsy (often transient but sometimes prolonged) affecting a motor branch.
• Sensory disturbances (numbness) around the ears and the operated area.
• Asymmetries, irregularities, localised over- or under-correction.
• Skin necrosis (rare), more frequent in smokers or with poor vascularity.
• Visible or hypertrophic scars.
• Management: close monitoring and appropriate treatment if necessary; these risks will be explained and quantified during the consultation.

Alternatives to surgery or complementary procedures

• Injections (hyaluronic acid, botulinum toxin): can improve certain volumes, firm/model without surgery but do not address significant skin excess.
• Aesthetic medicine (peels, laser, radiofrequency, ultrasound): useful to improve skin quality, elastin and collagen; limited for correcting major laxity.
• Thread lifts: intermediate solution with moderate and temporary results, suited to mild laxity.
• Combined care: surgery can be supplemented by non-surgical procedures to optimise skin texture and scar quality. Each alternative has limitations: they do not always replace a facelift when laxity is advanced. The choice is discussed at the consultation.

Frequently Asked Questions

How long is the hospital stay after a cervicofacial lift? Depending on anaesthesia and the procedure performed, surgery may be on a day-surgery basis (same-day discharge) or require one night's hospitalisation. This is defined during the consultation and anaesthesiologist appointment.

Are the scars visible? Scars are placed to be discreet (around the ear, natural fold, sometimes behind the ear or under the chin). They fade over time but may remain perceptible; their evolution varies with skin type and post-operative care.

Does smoking affect the result? Smoking increases the risk of complications (poor healing, necrosis) and can affect result quality. It is strongly recommended to stop smoking before and after surgery.

Can a facelift be combined with other procedures? Yes. It is common to combine neck liposuction, platysmaplasty, or non-surgical aesthetic procedures to improve harmony. These combinations are discussed at the consultation.