Brows are like curtains of the gaze
and face. When they are opened the gaze is intense, bright , the
face seems cheefful and attractive.When they aren't , the face looks
sad, tired, dull. Ageing lowers ghe brows and therefore the upper
eyelids give a sad appearance.
Eyebrows movements give either the
expression of being indifferent, doubtful, focused, preoccupied,
sorry, sad, angry. Sometimes if you use you eyebrows excessively
your youthful looks to early by acquirieng deep forehead furrows,
and frown lines. This may give the appearance of a premature ageing
although montionless forehead doesn't look young either...
From an aesthetic (artistic) point
of view the ideal location and shape of the eyebrows are ruled by
position and proportions of the whole face. It is striking how pulling
up the eyebrows may alter (improve or not) the gaze.
From a technical point of view
the brow lift with a scalp long incision going from one ear to the
for brow treatment are :
1- The Keyhole endoscopic technique
where the surgeon uses and endsocope with a camera and the short
incision open temporal lift. The endoscopic forehead lift is very
good for frown lines permanent removal ( forehead
lines above the nose), but this is not a very good technique for
lifting the midface nor the corner of the eyes. It allows to lift
the middle part of the eyebrows , although this may give a "surprised"
2- The temporal lift with short
incisions above the ears long like the last finger (they do not go
to the top of the head). The temporal lift do not allow access to
lines but it allows and excellent approach to the midface for lifting
the external part
eyes (cat eyes) the cheeks. Its results are longer lasting than the
keyhole endoscopic brow lift. For midface lift without frown lines
treatment, the temporal lift incision is preferred by Dr Chout.
The principle of the temporal lift
The principle is to make
a short incision ( long like the last finger) in the hair above the ear, parallel to the hair line but 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 to reposition .
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 the midface elements :
- 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)
Surgery will be performed most often
under neuroleptanalgesia, that is to say but under intravenous sedation
plus local anaesthetic as a day case procedure. Sometimes it is performed under
general anaesthesia if this is your preferenceand will require 24-hour hospitalisation
and five to seven days off social appearance,
which is a short recovery.The temporal lift (midthirties , early fourties) has
the oval of the face, jowl, neck and chin (late fourties our fifties)
proper face lift (rhytidectomy), nor on crow’s-feet wrinkles
that can be treated by muscle relaxing injections (e.g. botox).
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. A woman who love the appearance of her face and gaze
when she does pull her hair up, will certainly like the permanent
effect of a temporal lift.
The Temporal Model lift
technique done by Dr Philippe Chout quite
often achieves the Model look (chiselled look)
as defined by Dr. Chout is the very photogenic combination
of high and full cheekbones, cat or doe eyes, no tearthrough hollows,
folds, prominent cheekbones, slim
lower cheeks. It is obtained by the combination of a temporal lift
and a fat transfer to the cheeks midface and tear through area (SOOF).
Because no treatment of the frown lines is then required, the
incision is short, detachment is less extensive, and the results
quite spectacular, Again a fat transfer to the
cheekbone area and nasolabial folds will give a more
dramatic result. This excellent procedure can add some tension to
the cheekbones and result in a more attractive gaze, as when one’s hair and
temple is pulled back and up. It is usually possible
to show in public very soon after the operation (one week).
A video exemple of a Temporal Model lift by Dr Chout (combined here with a rhinoplasty, a chin implant, a fat transfer to the cheeks and tearthrough and a skin resurfacing .
Forehead & Brow Lifttechnique
forehead and temporal brow lift
the same time is quite a different and heavier procedure.
It can be done by a keyhole procedure and is then
called endoscopic forehead and midfacelift or with
long incisions, extended undermining (yet heavier); as a consequence
This is a heavy procedure rarelly used nowaday. It is possible
to correct permanentlythe forehead’s horizontal wrinkles,
and vertical glabellas wrinkles (« lion’s wrinkles »),
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 and undermining of the whole
frontal skin in
order to diminish the activity of frontalis and supercilii
muscles by trimming them from inside thus resulting
in a snantly. oother brow and forehead.
Alternatively it would also possible to work only on
frontal area (forehead) with an endoscopic
approach, and shorter according to the Doctors choice.
Possible additional Procedures A number of additional procedures could be performed
at the same time alongside the temporal lift,
upon the patient’s request, they would be charged
1-Excess skin or fat bulges in the upper and lower
eyelids can be removed (upper or lower
2-Fat transfer to the cheekbone and nasolabial folds
or to the chin to give a chiselled look.
3- Skin improvement with creams based on retinoic
acid or peeling.
4-The position of the external canthus can be modified
and lifted (canthopexy or canthoplasty). This
can help to give the Doe eyes, which is a very feminine
and attractive feature.
Complications Complications are very the unusual
evolutions that require further treatment.The possible complications
of the temporal lift are
- 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, visible
- Transitory paresis, or a paralysis of the frontalis
or supercilii muscles
- Impaired mimic or asymmetrical mimic, asymmetric
- Local alopecia, loos of hair local anaesthesia
of the scalp, persistent asymmetry, itchiness
- Psychological disorders (depression, psychosis)
- Cardiovascular, immunoallergic or respiratory
complications of anaesthesia.
Usual evolution and Recovery
The operation being performed under
sedation, patients usually go back home the same day. They will shamppo
daily with a
baby shampoo (Johnson) and apply an antiseptic solution on their
incisions. It is not a painfull procedure although
painkillrs may be required for a few days.The incisions are hidden
because no hair is cut or removed when performing a temporal lift.
Recovery time and after-effects
are simple and short and of various duration
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).
In conclusion, The Temporal lift is a simple and
effective procedure that will give the
a brighter and rejuvenated gaze and a younger
mid-face appearance, with no visible
scars, or barely visible scars and rather short
recovery. Its rejuvenation effect and
Beautyfication effect is sometimes spectacular.
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Feel free to visit our before
and after video testimonial gallery with video of facial rejuvenation
procedures, brow-lift video, mid face lift