TEMPORAL LIFT. BROW LIFT & MIDFACE LIFT.



Introduction

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 you may loose 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 the harmony 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 other is rarelly used now. The two modern techniques 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 horizontal lines and vertical 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" gaze.

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 frown lines but it allows and excellent approach to the midface for lifting the external part of the eyebrows, the corner of the 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 no effect on a sagging the oval of the face, jowl, neck and chin (late fourties our fifties) that require a
proper face lift (rhytidectomy), 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. 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, no naso-labial 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 may be obvious though, and often 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 Lift technique
forehead and temporal brow 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 and midfacelift or with long incisions, extended undermining (yet heavier); as a consequence recovery would be longer. 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 »), 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 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 separately:
1-Excess skin or fat bulges in the upper and lower eyelids can be removed (upper or lower
blepharoplasty).
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 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, visible scar
- Transitory paresis, or a paralysis of the frontalis or supercilii muscles
- Impaired mimic or asymmetrical mimic, asymmetric eyebrows
- 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 gentle 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 depending on individuals. Usually a
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 patient
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.

 

Keywords: temporal lift specialist, temple lift, midface lift technique, brow lift, model lift, chiselled look, doe eyes, cat eyes caty catty eyes, brow and forehead rejuvenation, lifting temporal technique beauty design, keyhole brow lift, faceliftspecialist facelift and face lift.

 

 

 

 

 

Feel free to visit our before and after video testimonial gallery with video of facial rejuvenation procedures, brow-lift video, mid face lift


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Dr Philippe Chout AIHP, ACCAHP, MD

Specialist in Plastic and Cosmetic Surgery
Registered with the UK General Medical Council n° 4783516.
www.faceliftspecialistlondon.com
www.doctorchout.com

 

 

 

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