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.


