Facial rejuvenation surgery folds in four chapters as follow. These four chapters will be developed in this long page with several videos and photos explanationss and exemples. You can read this all or go directly to a specific part from the top the page


Photo after facelift and fat transfer on a 45 Lady: all the goals of facial rejuvenation were reached
Facelift specialist cosmetic surgeon Philippe Chout results
Facelift specialist cosmetic surgeon doctor Philippe Chout results Facelift specialist plastic surgeon Dr Philippe Chout results

This 45 Lady benefited from a facelift plus a blehparoplasty to rejuvenate the eyelids and a fat transfer to the cheekbones. This picture shows a close-up view on the scar quality, and unconspicuous location, the earlobe shape and position has been preserved, the jawline definition obtained is excellent. Dr Philppe Chout plastic surgeon specialist of facelift with natural results.


The Facelift also called Rhytidectomy or Facelifting, is the face & neck lift.

A facelift is by definition a surgical procedure that tightens loose skin, remove wrinkles and sagging skin on the face. The Facelift procedure known also as face and neck lift or Rhytidectomy is a very wellknown and efficient facial rejuvenation surgical procedure. The purpose of the facelift is rejuvenation by the reduction of face and neck sagging (ptosis) that is frequent after 40 years of age. This operation will improve the lower half of the face but do not addresse the upper half , the eyebrows, cheekbones and eyelids. The ideal age for a first Facelift vary between 40 and 60 years of age. This cosmetic surgery procedure treats the damages caused by the aging process.

Anaesthesia types for the facelift and neck lift are either general anaesthesia or intravenous sedation plus local. This procedure can be performed under intravenous sedation plus local anaesthetic or under general anaesthesia, which requires one or two nights hospitalisation according to Doctor Chout Philippe, Board certified plastic surgeon.

The results of a Facelift go far beyond what can be expected from Botox injections, or Hyaluronic acid injections, Laser or Facepeels. Nevertheless thay are not expensive treatments and they are easy to perform as a day case, walk-in treatment at Doctor Philippe Chout's office in Paris. It is therefore common for patients to start with these lifgt cosmetic procedures, become gradually familiar with the Doctor, later go ahead for suergery or and wait until they are not sufficient to hide the actual age.

The different facelift surgery techniques.

The surgeon begins the incision in the area of the temple hair, just above and in front of the ear, hidden on its natural border ( see pictures below). Next it continues under and behind the earlobe , hidden in the crease and follows the back of the ear where it stops. Sometimes ending and blending into the hairline and hair bearing scalp behind the ear. The skin is gently lifted up as the surgeon repositions and tightens the underlying muscle and connective tissue. Some fat may be removed to the jowls and lower face , or added to the upper cheeks cheekbones and tear through, as well as excess skin is removed. In all cases, the incisions are placed where they will fall in a natural crease of the skin for camouflage. After trimming the excess skin, the surgeon closes the incisions with fine sutures and metal clips. This will permit precise surgery and avoid shaving hair in the incision sites.

Facelift improves the wrinkles jowls, cheeks, deepened nasolabial folds, jowls, neck folds and turkey’s neck. The Facelift treat a skin and fat excess but do not change the actual quality of the skin itself. It will have no effect on the lower neck wrinkles, on crow’s-feet, on bulging lower eyelids, nor on smaller wrinkles around the mouth, which can benefit from other specific treatments. Incisions are made into the hair-bearing scalp above and in front of the ear; in the pre- auricular area; behind the ear and then back into the hairline. Sometimes a small incision is made under the chin. Drains may be placed on each side of the face, under the detached skin. They are very helpful to allow the liquid out and reduce the swelling.

The Total duration of the Facelift operation is between two and four hours.
The total length of the Hospital stay is 24 hours if you reside in Paris, otherwise it is 48 hours (two nights at the clinic). Doctor Philippe Chout shall ask you to stay in Paris another 7 to 21 days according to the extent of your procedure. A five 3 days stay is sufficient for a mini-lift. A 12 days is usual for facelift wiht upper and lower blepharoplasty, but 21 days is required if it is a full face lift.

Video before/after Beauty Design Surgery: rhinoplasty, lips reduction , chin augmentation, model lift. From artificial back to natural Beauty

This 39 years old Lady, had un-natural looking lips, and a gaunt facial appearance with heavy features, premature ageing, several descending lines and a lack of harmony in the mouth-lips-nose-cheeks-complex. She benefited from a Beauty Design surgery, I combined in one single operation a lips reduction, a facelift, a rhinoplasty, a fat transfer. An attractive and youthfull facial appearance and the gaze


The male facelift : the procedure for facial rejuvenation of gentlemen involves a different technique
Male facelift and neck surgery specialist surgeon Dr. Philippe Chout Male face and neck lift surgery by Dr. Philippe Chout

A 52 years old gentleman beofre and the day after a lower face and neck lift, combined a rhinoplasty. Observe the limited extend of bruising thanks to a non-invasive technique and preoperative infiltration with diluted adrenalinated saline. The neck and jawline have been thourougly rejuvenated .

For Men : the Face and neck lift Technique is different for the gentlemen.

FOR MEN, the incision is aligned in front of the ear to accommodate the natural beard lines. The Male haircut style must be taken into consideration as well.The Male's skin is thicker and there are hair bulb to be preserved during the dissection, that is done in a deeper plan. The desired jawline definition is square and sharp. Sometomes a chin implant will help to build these features. The male facelift surgery is different from the female surgery. Dr Philippe Chout has a long experience and a specific technique for gentlemen facial surgery

Usually people age fifty do not want to become somebody else..

They do not want other people to spot easily thtat cosmetic surgery was done. The challenge for the surgeon is to get a thorough rejuvenation, to take 10 to 15 years off teh facial appearance, while preserving the identity and personality.The combination of surgical techniques, and medicine treatments such as facepeels is very effective when appropriately selected and performed. There will always be a period of time two to four weeks before the rejuvenation looks good.


Face and neck lift on a 50 years old Lady

Here the patient is rejuvenated by 12 years thanks to the combination of the face and neck lift and the rhinoplasty. The neck, cheeks and gaze look natural. The light pinkness of the skin is related to the use of Dr. Chout's skin resurfacing medical creamss. Interestingly this video is also showing the early stages of the recovery, at day 1 and day 2, with the maximum swelling and bruising.


Recovery after the facelift operation.

A moderately compressive dressing is applied which will be left in place for 24 -48 hours. Dr. Philippe Chout will remove the dressing and drains himself the day after the operation. Nurses give the first shampoo before the end of the second day, with subsequent daily shampoos by the patient herself with a baby shampoo by Johnson & Johnson (like Mixa baby). This daily shampoo is extremely important to prevent infections. After the shampoo , blow dry (not too hot) then apply the antiseptic solution given to you , using a sterile gauze. Betabdine red vial, Hexomdeine, Eosine after day 10. Sutures are removed on the 7th day and scalp clips on the 12th day approximately.
A face lift requires one night stay in the hospital and wearing a compressive dressing around your head for 24 to 48 hours. Swelling (tumescence due to oedema) and bruising (blue face) is usual after this operation to an extend depending on each individuals .The duration of this inconvenience that requires to hide from public appearance vary between eight days to three weeks. It may sometimes be quite impressive.

The use of Arnica cream and arnica 9 CH pills from 5 days before to 5 days after the operation is very helpful. The use of Helichrysum italicum* Hélichrysse , immortelle as well. Painkillers will be prescribed to the patient adn taken orally for five days. Work can be resumed after two to three weeks, depending on public exposure at work, and on your requirements.Usually, the patient’s face is presentable between the 10th and the 21st day after an average face- lift, with the final result visible after a minimum of three months. Some individual have a tendency to bruise easily and may have a longer recovery time.

First hair coloration or first hair-set cannot occur before the 21st day after surgery. It is advisable to have any coloration done before surgery. The patient should bring a scarf and large sunglasses to be worn when leaving the clinic. In the case of a mini neck lift, or a soft lifting the same incisions are made, but with a reduced sub-cutaneous detachment, thus resulting in simpler and shorter postoperative after-effects but also a less dramatic effect.

Usual side effects after a facelift (face or neck lift)

Some usual and transitory after-effects which can be of concern to the patient : Primary swelling (oedema) and bruising will result in a very round swollen face, which is normal as an after-effect of lifting. These will regress downward over the next two weeks, i.e. at Day 10 the residual oedema is located around the lower cheeks and the neck. This secondary oedema regresses more slowly, over the next few months, and is variable depending on the time of the day. It can be asymmetrical, with no prognostic significance.

Bruising of various shapes and coloration, often asymmetrical will eventually disappear completely within 10 to 21 days in most cases. Arnican mask, arnica pills, massage and lymphatic drainage improves the oedema rapidly and prevents the formation of adhesions.

Postoperatively, scars will be pink-coloured and itchy between the 4th and the 20th week, and partial make-up will be applied. They eventually become thin and barely visible, although their final aspect cannot be predicted. Keloid scars can occur in 5% of cases.

It is common to feel slightly numb and tight in the area that has been treated. This numbness or sometimes a sensation of tension will disappear spontaneouly. These may persist several months before disappearing spontaneously. Sensitivity in detached areas will be restored progressively after the third month..

Rarely, a short of baby-blues, a mild depression is sometimes seen , even with good evolution of healing and good results, escpecially if the patienet had a past history of mood disorders or a pecuiliar psychological profile tha twould have gone un-noticed. The patient selections is crucial for facial surgery.
/"> Psychopathology aspects of cosmetic surgery.

The Risks and possible Complications of a Facelift

The serious complications of the face-lift are very rare, but they can require further treatment :
- Haemorrhaging and bleeding, which may in some cases, necessitate an operation and an adapted medical therapy as well as, exceptionally, a blood transfusion.
- Infection is a very rare complication because an antibiotic treatment is always given intravenously ad orally.
- Infection may be caused by a lack of hygiene. The prescribed shampoo must imperatively be done daily for 14 days) ;or an untreated haematoma,
- Scar disunion related to cutaneous necrosis, mostly seen in smokers. These complication could require frequent consultations and dressings to monitor the delayd healing ( gelonet - betadine -eosine - for several weeks...
- A permanent injury to a branch of the facial nerve, resulting in paralysis (palsy) or paresis of a muscular group affecting facial expression.
This may occur if the facelift was done under the Smas plane which is not advisable. The Smas layer must be tucked from above, not from below!
- Non permanent facial nerve palsy can be seen in relation with local anaesthetic drugs.
- Parotid fistula, Local alopecia: loosing hair locally next to the scars. This rare event may require a sacar revision or sometimes transplant of a few hairs.
- Localized scalp hypoesthesia (loss of sensitivity) or and earlobe anaesthesia, chronic pain.
- Cutaneous adhesions and protracted residual oedema are improved by prompt and frequent massage,
- Large elevated and pink scars. May evolve into Keloid scars after six months.
- Psychological complications on patients with a past mental history. Dr Philippe Chout has a psychological clearance process.
- Basically Dr. Philippe Chout and his team have a heavy selection policy, to select physicallly and mentally healthy patients.
- Patients should also remember the exceptionnal, but sometimes lethal or invalidating complications of anaesthesia, on patients with a poor health ,
cardiovascular, respiratory or immune - allergic complications like anaphylaxy shock which may evolve independently.

Face and neck lift on a 54 years old Lady

This patient was rejuvenated by 15 years ! The neck, cheeks and gaze look natural. The light pinkness of the skin is related to the current use of Dr. Chout's skin resurfacing medical creams. Interestingly this video is also showing the early stages of the recovery, at day 1 and day 2, with the maximum possible swelling and bruising. Plastic surgery video tutorial by Dr. Philippe Chout, qualified plastic surgeon.


A face and neck lift and lipo on a 57 years old Lady.

57 year old Lady with a fat neck and jowls, loose skin to the lower face and lower eyelids. The operation itself, a face and neck lift, lower blepharoplasty is displayed here (we warn you about the graphic content). Early recovery at day 8, and 3 months is shown. Very good and fast recovery.

Video testimonial. Face and neck lift upper and lower eyelids blepharoplasty.

Older Arabic Lady with a very loose skin to the neck and jowls , and a fat excess to the neck . The operation, a face and neck lift, upper and lower blepharoplasty is displayed here. Early recovery at day 8, and 3 months. Very good jawline improvement.

Considering a Facelift operation

Study the cost, advantages and disavantages of the face and neck lift surgery.

Before undergoing a facelift you need to do in depth research, read about the procedures, watch as much images as you can. Yuu must be critical about what you see , because at the end of the day what you see is what you get. It is recommended to see before /after VIDEOS rather than just PHOTOS, or to see an actual result in the flesh. You must attend at least two consultations with Dr. Philippe Chout who shall give you his advices and recommendations. If you are contemplating cosmetic aesthetic surgery you need to review info about the risks, the cost and prices. At home, before the consultation you need to research and benefit from the written information given here by Dr. Philippe Chout, plastic surgoen. Reading recent informations is required because many new valuable techniques are up and coming.

Dr Philippe Chout facial aesthetic surgery expert reviews the out of fashion procedures. Your Physician will tell the news about recent and modern cosmetic surgery procedures.
It is also advisable to watch before after videos and photos. The videos are a much more valuable source of information, and the best manner to pictures the information and reviews. Patients will share the experiences of previous Doctor Philippe Chout’’s clients. It is a convenient manner to get the insiders knowledge of the evaluation of services by previous clients and customers. You will take your time at home before and after consultations to read the the pros and cons of each aesthetic surgery procedure, and compare with non-invasive treatments available. It is worth it to compare medicine and surgery and find out the most effective and value for money. The patient will apparaise the cost and evaluation of services.

How to avoid the unatural results, the fake-look ?

Many patients do not want to be just refreshed like ironed and pulled woth a fish-moouth.
They don't watn to look done but want to be truly rejuvenated.

Then often they travel abroad to Paris to benefit from natural Beauty results. watch out and review the surgeon's results on videos ++++ Believe only what you actually see ! Your Surgeon should be able to show you past histories , with the different stages of the recovery including the bruising, the swelling, the stitches removal, the final scars. Doctor Chout will always give you this possibility on top of the oral and writtten adundant information. So Many American or British surgeons perform unatural looking facelift after which the Ladies, although rejuvenated, are not attractive after the operation ! Many patients look overdone and fake after a facelift in America ! Too many celebrities who where good looking lost their identity and personality. Pulled ears, overly round cheeks, duck mouth, are commonplace in Hollywood.

Do I need a Temporal Lift as well or instead of a facelift ?

If your eyebroaws have fallen and give the impression of a skin excess to the upper eyelids. Maybe. If you like the appearance obatained when you pull your hair up, or when you pull on the temples, you may benefit from a Temporal Lift. Have a look at the specific effect and ideal indicatio nof a temporal lift: raise the eyebrows and the cheekbones up. The combination of a temporal (upper and midface -) lift with a fat transfet has sometimes a striking beautifying effect.

The benefits and advantages of having a Facelift surgery done .

- Looking much younger
- Looking rested and relaxed
- Feeling rejuvenated and fresher
- Increased self-confidence and self-esteem
- Becoming more noticeable , less invible.
- Better appearance at diner party when bending forward to eat
- Ability to wear clothes with lower necklines
- No longer the need to hide behind a scarf / high-necked top
- Easier application of make-up
- Better appearance on pictures and photography.

Conclusion summarizing the facelift and lower face rejuvenation surgery.

In conclusion, the purpose of the face and neck lift is to improve the facial oval and to reduce muscular and cutaneous sagging of the neck and cheeks. It attenuates deepened nasolabial folds and « bitterness » wrinkles to the corner of the mouth. A face lift can remove a decade or twelve years to from the apparent age, but it will never restore the exact face as it was before because not only do skin and muscles alter with age, but the bone structures and teeth as well which (cheekbones, jaw-line) which is Impossible to change. Its effects are maintained for 10 years, nevertheless a face-lift may be performed two times in the course of a lifetime. The facelift is for th elower half of the face, and has no effect onf the upper half.

The temporal lift is for the upper half and has no effect on the lower half. The combination of both an upper and lower face lift is called a full facelift.




The Facelift does not address the sagging eyebrows nor the skin excess , wrinkles or folds to upper or lower the eyelids. This is done by either a blepharoplasty , a fat transfer or a temporal midface lift

The fat or skin excess to the eyelids , or hollowness is treated by blepharoplasty , laser skin ressurfacing and fat transfer to the tear through or fat removal. The sagging eyebrows or eyes corner togetherr with sagging upper cheeks are treated by the temporal and midface lift. Interstingly the temporal lift has the ability to lift-up the cheekbones and external part of the eyes slant thus giving the Doe eyes. This operation is used for Beautification of young ladies in their thirties. Together with fat transfer its beautifying effect can be quite spectacular.

Video before after Beautification surgery by Temporal lift with fat transfer

This 33 years old woman was embarrassed by her gaunt aappearance, a lack of volume to tear through, lack of chin projection and nose's bump. Beautification (beauty design surgery ) by Temporal lift with fat transfer to the tear through area and cheekbones, rhinoplasty, chin implant.


Video before after rhinoplasty, temporal lift of cheeks and eyes, fat transfer.

This 30 years old Lady had a long and protruding nose, a gaunt facial appearance related to a lack of fat volume under the eyes, and cheekbones. She benefited from a reduction rhinoplasty, a fat transfer to the under eyes tear through and cheekbones area, a temporal lift with an incision only in the hair above the eyebrows. A natural and youthful appearance of the midface, the nose and the gaze were obtained. Dr Philippe Chout facial beautification surgery specialist

Before the Temporal Lift or full forehead and brow lift.

You must be aware that this surgery will be performed most often under neuroleptanalgesia, that is to say intravenous sedation plus local anaesthetic as a day case procedure. Sometimes it is performed under general anaesthesia and will require 24-hour hospitalisation at least. The temporal and brow lift is an upper and mid face lift that suits the needs of the late thirties and mid forties Ladies. The principle of the temporal lift ( lift of the temple +/- forehead) is to make a more or less extended incision in the hair above the ear, behind the anterior hairline, and to detach (undermine) in depth the anterior portion of the forehead and temple skin, eyebrow area and malar cheekbone skin areas. Then this area will be pulled and deep stitches will be placed. The incision and the scar are therefore hidden in the hair and not visible. It is then possible to lift them and put stitches in depth therefore treating and adjusting as required:

- Sag of the external end of the eyebrow
- Sag of the upper part of the cheek and cheekbone fat
- Marked nasolabial folds
- Low position of the external part of the eyes (with, if required, a small incision: canthoplasty)
- Shape of the eyes and gaze (doe eyes or catty eyes)

The temporal lifting has no effect on a sagging the oval of the face, jowl, neck and chin that require a face lift, nor on crow’s-feet wrinkles that can be treated by muscle relaxing injections (e.g. botox). It does not treat a skin excess to the lower eyelid. It has some effect on the nasolabial folds, especially when a fat transfer is done at the same time (charged separately). The temporal lifting is the proper procedure to correct a sad face for a patient as young as 30 –40 years old, and to provide improved, rejuvenated looks without revealing surgery as incisions are hidden in or at the border of the hair bearing scalp above the ear, sometimes going further down in front of the ear. Some swelling and bruising will be noticeable for a few weeks. The pain and tension following the operation are helped by painkillers. Recovery time and after-effects are simple and of various duration depending on individuals. Usually two week-off social life is enough. The small clamps staples in the hair-bearing scalp are removed on the 8th day. Swelling of the upper part of the face and eyelids due to postoperative oedema and ecchymosed will decrease gradually over the first 10 days, then the residual oedema will disappear in the next few months. It is usual the first weeks to have a bulge in front of the hairline: this will disappear spontaneously. Loss of hair is a rare event. Sensitivity, and subtle motility of the scalp around the incision will return within a few months (with a possible pruriginous stage).

Forehead plus Temporal Lift at the same time is quite a different and heavier procedure.
It can be done by a keyhole procedure and is then called endoscopic forehead lift or with long Incisions, extended undermining; as a consequence recovery would be longer. It is possible to correct the forehead’s horizontal wrinkles, and vertical glabellas wrinkles (« lion’s wrinkles »), by performing a forehead lift in association with the temporal lift. This one-stage procedure, called a fronto-temporal lift, consists in combining incisions described above, followed by detachment of the frontal skin in order to diminish the activity of frontalis and supercilii muscles, thus resulting in a smoother brow. Alternatively it would also possible to work only on frontal area (forehead) with an endoscopic approach, and shorter according to the Doctors choice.

The temporal lift can be associated with other procedures

A number of additional procedures could be performed at the same time alongside the temporal lift, upon the patient’s request:
• Excess skin or fat bulges in the upper and lower eyelids can be removed (upper and /or lower blepharoplasty). More skin can be removed if the temporal lift incision and therefore the scar are pushed lower, in front of the ear down to the earlobe and behind it, like in a facelift.
• Fat transfer to the cheekbone and nasolabial folds or to the chin to give a chiselled look
• Skin improvement with creams based on retinoic acid or face peel with TCA.
• When performing a fronto-temporal lift, protruding bony rim above the eyes can be reduced. These arches can be attenuated, and forehead rounded prominence can be improved by grinding and rasping;
• when the gaze is sagging or dropping with a low position of the external corner ,the position of the external corner (canthus ligament) can be modified and lifted up (canthopexy or canthoplasty). This can help to give the Doe eyes, which is a very feminine and attractive feature. This eyelift is charge on top of the cost of a basic temporal lift
• The combination of these two above mentioned procedures (canthopexy and bone remodeling) is called a Mask-lift. This heavy operation, which is rarely carried out, offers a spectacular improvement in looks, and after a delay of several months a radical change of personality, which is its main scope, and is also somewhat rejuvenating. Nevertheless, all these drastic changes, if done at the same time, would result in major changes in facial expression and physiognomy and will require an extensive psychological preparation...

The possible complications of the temporal lift are rare:

- Haemorrhaging, Haematomas and infection which may require an additional procedure and a specific medical therapy
- Skin necrosis, and pain are very rare events
- Poor scaring, adherences, fibrous scar, large or visible scar
- Transitory paresis, or a paralysis of the frontalis or supercilii muscles
- Impaired mimic or asymmetrical mimic, asymmetric eyebrows or eyes slant
- Local alopecia, loos of hair local anaesthesia of the scalp, persistent asymmetry, itchiness
- Psychological disorders (anxiety, depression, psychosis)
- Cardiovascular, immunoallergic or respiratory (sometimes lethal) complications of anaesthesia.

In conclusion, the Temporal brow lift is a simple ,reliable, adjustable and effective procedure. It will give the patient a brighter and rejuvenated gaze and a younger mid-face appearance, with no visible scars, or barely visible scars and usually a rather short recovery.



Cosmetic eyelid surgery, or blepharoplasty, is an operation to remove excess skin, fat and muscle from around the eyes to produce a more alert and youthful appearance.

1-review-dr-philippe-chout-blepharoplasty-eyelids-surgery-before-after-3.jpg 1-review-dr-philippe-chout-blepharoplasty-eyelids-surgery-before-after-2.jpg

Gaze rejuvenation surgery : blepharoplasty by doctor Philippe Chout cosmetic surgeon
 gaze rejuvenation cosmetic surgery by dr philippe chout  eyelids rejuvenation surgery by dr philippe Chout plastic surgeon

Blepharoplasty, Eyelids rejuvenation cosmetic surgery

The procedure can be performed on the upper and lower lids, at the same time or separately. As we age, the skin around our eyes loses its elasticity. You may develop loose folds of skin on the upper eyelids and deep creases on the lower lids. At the same time, your muscles in this area may also slacken so that any fat bulges forward and looks baggy. Cosmetic eye surgery can remove the excess skin, fat, or both, from around your eyes. Sometimes you can develop baggy eyes in your 20s before your skin changes. You can inherit this trait from your family. Cosmetic eye surgery may also improve your sight if saggy skin in the upper lids hangs over the eyelashes to obstruct vision. The surgery can also remove wrinkles, but only those in the skin that is cut away in the operation. It will not remove "crow's feet" and cannot change the colour of dark shadows under the eyes. It is important to discuss with your surgeon what you are hoping to gain from the operation, and the result you can realistically expect.

Cosmetic eyelids rejuvenation surgery,is performed in order to remove fat and skin excess to the eyelids is called upper and /or lower blepharoplasty. This procdure dan be done under a twilight anaesthesia as a day case , or under general anaesthetic. The cost and price of a blepharoplasty is between 2500 euro and 6000 euro, according to Dr. Philippe Chout.

 Eyelids cosmetic surgery, eye-bags removal, eyelids lift, or double lid surgery for asian eyes westernization are blephraoplasty operations as well. the external canthopexy ( canthoplasty ) is something different : the purpose is to lift the external corner of the eyes in order to give the doe eyes. It is a Beutification operation, not a rejuvenation. For information abuout canthopexy pleae, visit Doctor Chout's Temporal Lift andt the Beauty Design surgery pages.

What are the alternatives to bleapharoplasty?
No other treatment can properly reduce a skin excess and fat bulges or hollows. In some cases, wrinkles around the eyes may be reduced using botox injections, or by a forehead, or brow, lift. For more information ask your doctor for advice or see the separate fact sheets on facial resurfacing and Facelifts. Many creams, gels and beauty treatments claim to be able to tighten the skin around the eyes. However, there is no scientific proof that they work.

What happens before cosmetic eye surgery?

You will have a consultation with your surgeon before your operation, and with your Ophtalmologist as well. He or she will ask about your general health and discuss how to prepare for your operation. Your Ophtalmologist will examine: • Your eyelids • Your vision • Your tear film (a layer of tears covering the surface of your eye) • The front of the eye • Your retina - an area on the rear wall of your eyeball • Your whole face to see the condition of your skin • The position of your eyebrows and eyelids, which will be measured and pictured • A report will be written by the Ophtalmologist for the cosmetic surgeon

The Blepharoplasty Operation

The operation lasts one to two hours, under general anaesthetic or sedation plus local less if just the upper or lower lids are being done. It can be performed as a day case, which means that you can have the operation and go home the same day. However, you may need to stay one or two nights in hospital for observation. The surgery can be carried out under general anaesthetic or a local anaesthetic, in which case the area around your eyes will be numb but you will be awake although sedated. It can also be done under a general anaesthetic, which means that you will be asleep throughout the procedure and will feel no pain. Your surgeon may use either conventional or laser techniques.

For surgery on the upper eyelids, cuts are made: - Into the natural lines and creases in your eyelid, ending into the laughter lines at the corner of your eye For surgery on the lower eyelids, cuts are made: - just below your eyelashes, which means the scars will run along your eye's natural folds, hiding them naturaly - and sometime inside the corner of the eyes sometimes cutting the external ligament for a canthopexy or canthoplasty which purpose is to change the eyes slant and the whole gaze, in a doe eye shape.This would be charge a higher price than a plain blepharoplasty. Excess fat, muscle and loose skin are then removed, and the cut is closed using fine stitches. These are generally removed two days to a week after surgery. If only fat is being removed, the cut can be made on the inside of the lower eyelid, leaving no visible scar. This is called a transconjunctival blepharoplasty. You should remember the difference between: - Cosmetic blepharoplasty, i.e. eyelid rejuvenating surgery, which consists in the removal of excess skin or fat from the upper or lower eyelid; - Eye expression improvement surgery (canthoplasty or canthopexy ) which consists in changing the position of the eyebrow external part, the shape of the external part of the orbital rim, the location of the eye’s external canthus, and, if necessary, in removing excess skin or fat from the upper or lower eyelid. The scope of blepharoplasty is not to change the eye expression but to make it look younger.

Lower eyelid blepharoplasty/Upper and lower blepharoplasty

This is performed under general anaesthesia or neuroleptanalgesia, and requires overnight hospitalisation, as well as all tests as described above. The resection of fat deposits and wrinkles in the lower eyelid is made either internally, with no visible scar when there is no loose ski or externally when loose skin and lines are present. In that case, there is a small nearly invisible scar along the lower eyelashes; this also permits resection of excess skin, or correction of a bulging orbicularis muscle. There are no postoperative pains but rather discomfort. Suture threads are removed on the 5th operative day. The after-effects are the same to upper blepharoplasty. On the 10th day, both postoperative oedema and ecchymoses have significantly regressed, and one can show socially after two weeks, but final results are visible only after three months. Normally, work can be resumed after a week. For a few months, there may be a slight oedema, which can be sometimes asymmetrical, and can be attenuated by massage.

After the Operation
Immediately after the operation, your eyes may be covered with gauze pads. The surgeon will apply some sterile paper tape (steristrips) to support the eyelids after surgery, which is normally removed after three to five days. An ointment or eye drops will be applied to your eye area to prevent it from drying out. You will be given painkillers to help with any discomfort as the anaesthetic wears off. If the operation has been planned as a day case, most people go home once they have made a full recovery from the anaesthetic. If you have had a general anaesthetic you will need to arrange for a friend or relative to drive you home and stay with you for the next 24 hours (unless you stay at the hospital). Before you leave hospital, a nurse will give you some advice about how to care for the eye area and you will usually be given an eye ointment to use at home.

Recovering from cosmetic eye surgery
You will initially be bruised and swollen. Once you are home, you may take further painkillers if you need to. You will put the prescribed teardrops four times a day in both eyes during eight days. Follow the hospital's advice. Applying a cold compress, such as an ice or a bag of frozen peas (both wrapped in a towel) can help to reduce the swelling and bruising. You should not apply ice directly to your skin as it can give you an "ice burn". There are some important things to remember while recovering from cosmetic eyelid surgery.

1. Keep your head higher than your body by lying propped up on pillows, and avoid bending over for a few days. This will help to reduce swelling and bruising.
2. Clean around your eyes and use any ointment that the hospital staff gave you as they instructed.1
3. Avoid wearing eye make-up until a couple of days after the stitches have been removed, or for as long as your surgeon tells you to.1
4. Avoid wearing contact lenses for three weeks (they may still feel uncomfortable for a while after that).
5. Avoid driving until your vision has returned to normal and your eyes have stopped watering.
6. Most people are able to read or watch television within a few days. People usually feel like returning to work after a week to 10 days.
7. No alcohol at all and no smoking or smoke for t four weeks.

Deciding on having a blepharoplasty

It's important not to rush into the decision to have a cosmetic operation. And, it's sensible to discuss the issue with your GP. Cosmetic eye surgery is a commonly performed and generally safe surgical procedure. For most people, the benefits in terms of improved appearance are greater than any disadvantages. However, in order to make a well-informed decision and give your consent, you need to be aware of the possible side effects and the risk of complications. Side effects are the unwanted but mostly temporary effects of a successful procedure. For example, feeling sick as a result of the general anaesthetic. Anyone having cosmetic eye surgery can also expect sometimes:
• Soreness around the eyes, which can be helped by taking painkillers
• Bruising and swelling for up to a month after the operation, which might make your eyes feel tight and difficult to close when going to sleep
• Sticky, dry and itchy eyes for the first week
• Watery eyes for a few weeks
• rarely double or blurred vision for a few days usually related to the oily ointment Vaseline)like – otherwise you should contact your hospital or a GP if this lasts longer than three to four days
• Sensitivity to light for a few weeks
• Tiny white heads along the line where the stitches were - your surgeon can remove these with a very fine needle
• Pink scars for three months, but eventually they become skin colour thus almost invisible

Complications are unexpected problems that can occur during or after the procedure.
Most people are not affected. The main possible complications of any operation are bleeding during or soon after the procedure, infection, or an unexpected reaction to the anaesthetic. Specific complications of cosmetic eye surgery are uncommon but can include:
A haematoma where a pool of blood collects under the skin around the eye, which may need to be drained in a second operation if it doesn't disappear on its own or if it is large
Swelling that pulls the lower lid away from the eye, which usually settles on its own after a couple of days, but occasionally another operation will be needed. Damage to the surface of the eyeball or the surrounding muscles.are extremely rare: Keratitis, conjunctivitis, acute glaucoma, an eye condition requiring treatment by an eye specialist.
Unusually red or raised scars (called keloid scars) which some people have an inherited tendency to form sunken appearance if too much fatty tissue is removed.
A difference in appearance of the two eyes - they may not be identical due to your natural and intrinsic asymetry.
Partial or complete blindness, as reported in books, is absolutely exceptional (0.02%) .
Haemorrhage, infection, diplopia, ectropion, subcutaneous cysts.
For information mainly of people with a disease, cardiovascular, neurological, respiratory or immunoallergic complications of anaesthesia sometimes lethal or invalidating which may evolve independently.
As for all cosmetic surgery, extra costs, which may become necessary due to complications, as well as days away from work, are to be incurred by the patient. The chance of complications is low though and depends on the exact type of procedure that is being performed and other factors such as your general health. Your surgeon will be able to explain how these risks apply to you.



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(©) copyright- All Rights Reserved - Dr Philippe Chout- tous les droits sont réservés- Article L335-2 et 335-3 modifié par loi française n°2016-731 du 03/06/ 2016 - art. 44 , et Article L215-1 - LPD