Doctor Philippe Chout

Qualified Plastic Surgeon





BEAUTIFICATION and REJUVENATION SURGERY OF THE UPPER FACE


FACIAL REJUVENATION SURGERY : FACELIFT, TEMPORAL LIFT, BLEPHAROPLASTY


Facial Beautification rejuvenation surgery folds in three chapters as follow. These three 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 of the page. How to become more pretty ?

1 - REJUVENATION / BEAUTIFICATION OF THE UPPER FACE : THE TEMPORAL BROW AND MIDFACE LIFT

2- FAT TRANSFER LIPOFILLING

3 - EYELIDS REJUVENATION SURGERY : THE BLEPHAROPLASTY


The spectacular effects of a Temporal Lift combined to a fat transfer to cheekbones, tear through and nasolabial folds.
best facial beautification specialist Dr Philippe Chout london uk how to become prettier top facial beautification and rejuvenation specialist cosmetic surgeon Dr Philippe Chout


The spectacular effects of a Temporal Lift combined to a fat transfer to cheekbones, tear through and nasolabial folds. This is Dr. Philippe Chout's favorite combination. Operation under sedation as a day case, total duration two hours. Cost on application. Dr. Chout's reasoning is the following : this lady in her early forties do not have any jowls. The jawline and neck are perfect and the face would not be improved by a mini-faelift ! Her actual problem is the loss of volume to tear through area and he sagging eyebrows that give the impresssion of a tired face or skin excess to the uppper eyelids... But it is a common mistake to perform a blepharoplasty and a mini-facelifft in this situation. Patients then do not end-up looking any younger or prettier ! And they come to see me finally, often too late. They 'd better trust me in the first place...



UPPER FACE BEAUTIFICATION TEMPORAL BROW AND MIDFACE LIFT


The Facelift does not address tha sagging eyebrows nor the skin excess to the eyelids, or a sad gaze and hollwed eyes. Some women complain that there are aging before they have even been pretty...

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.

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Video before after a facelift surgery, rhinoplasty, lips reduction and fat transfer.

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 and personality revelation were obtained. The patient became much more attractive and prettier



Video before after a short scar temporal model lift surgery, rhinoplasty and fat transfer.


The combination of a temporal lift (brows and midface) with fat transfer has a very beautifying effect. Il you find yourself more beautyful wit a pony tail , and a little smile that pusches the cheeks up, then you may be a suitable candidate for a temporal lift.


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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.

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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


Review Beauty Design facial beautification surgery results by Dr. Philippe Chout.


Result of a facial Beauty Design surgery performed by Dr. Chout video The Beauty Design surgery concept was created by Doctor Philippe Chout in 2002. A facial surgery is a Beauty Design when it combines three or more surgical proceduures in the same operation, with the goal to Beautify the face before the age of 40. Beauty Design surgery may include a facelift or not. The temporal lift that addresses the upper half or the face is more suitable. It is unusual for a Beauty Design to include a Facelit though, but the followwing case displayed in a before/ after video does. In all the cases, the Beauty Design operation is a bespoke combination of surgical procedures with the goal of facial Beautification. The goal is to reveal/create the Beauty and the Harmony for Younger women at the beginning of their lives. The Beauty Design candidate do not want to maintain their previous facial appearance. They just want to become themselves. A heavy psychological selection process involving meeting a psychologist for clearances always necessary.


Video before / after rhinoplasty,nose reshaping surgery, chin augmentation temporal model lift.

Doctor Philippe Chout aesthetic plastic surgety on a 30 years old Lady, rhinoplasty, chin augmentation, temporal model lift




BLEPHAROPLASTY THE EYELIDS REJUVENATION SURGERY


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.


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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