With a fuse form incision, we cut off the skin excess that exists on the superior eyelid. The orbicular muscle is only separated, in order to take off the fat bags, if they exist. We only cut the muscles when the superior eyelids are severely fallen down.

In the case of fat bags in the inferior eyelids, the incision is made close to the eyelashes, without cutting them off.

On the first 24 hours, the edema is severe; the face seems the one of a little monster. It stays so for approximately a week and it is advisable to take advantage of a trip of your husband/wife.

What type of anesthesia is it indicated?

If the anesthesia is to be general, you have to stay in the hospital or clinic overnight. If the anesthesia is local plus sedation, two hours after the surgery you may go back home.

Your doctor must know if you have already had any allergies, mainly allergy to local anesthetics. Topic anesthesia with ointments is not sufficient for this procedure.

How long does the surgery last?

We take approximately 3 hours to do the face, associated to blefaroplasty. If we include the nose, we take one hour more.

There is a whole sequence of preparations, before and after the surgery.

The first step is to cut the hair. Don’t bother; this area will disappear with the cut off part of scalp.

Next, you take a rigorous and relaxing bath, when you should deeply wash your scalp. The hair will be fixed in a proper way, to facilitate the incision on the scalp.

You stay approximately 5 hours hospitalized, in the case of local anesthesia and 24 hours if the anesthesia is to be general.

What happens after the surgery?

As we said, we get the aspect of a real little “monster”, for approximately one week, because of the edema.

The eyes get reddish and the eyelids very swollen, as it happens after an eye trauma.

The head gets “light” (as the patients say) on the first days.

The stitches on the eyelids and around the ear can be taken off after the 6th day; the ones on the scalp, only after 15 days.

What cares should I take after the surgery?

Avoid exposure to the direct sun for 3 months. You also should avoid reading and watching television during the first week.

After 24 hours, take everyday baths, wash deeply your scalp and maintain the operated area completely clean. On the first week try to stay in a not too light environment. Use cold dressings (criodressings) 5 times a day, on the operated areas. Use ophthalmic ointment on the eyes, every night, on the first week.

You should use oral antibiotics and anti-inflammatory pills for the first week after the surgery.

Follow-up consultations, for revaluation, should be done with your surgeon, twice a week, on the first 15 days, once a month, on the first 3 months, after 6 months and after a year.

Is it paintfull?

Most of the patients submitting to this surgery have few complaints. They feel some discomfort on the first week, but they usually resist very well. The biggest trouble is when we take off the eyelid stitches.

Note: There is the possibility to use special glues instead of stitches but there are some inconvenient: allergy to the product, possible opening of the lesion and, mainly, the high cost.

What type of scars may I have?

The possibility of a hypertrophyc scar or keloid (thick scar) on the face or scalp is very remote because those are very irrigated regions. Smokers that didn’t stop smoking 30 days before the surgery may have bald areas, close to the scar. If this occurs, it is possible, 3 months later, to cut off the bald area or to implant hair on it, with micro-grafts.

The scar is peculiar for each patient: normal, dark, whitish, thick, shrunk, etc.

What may go wrong?

The wish to change for the better must be the proposition of each client. I always tell them: “If you think something will go wrong, please don’t submit to an operation, don’t come to me.” Our mind is strongly capable of commanding us. However, if you wish to get better than you already are, trying to repair your imperfections, so, go ahead.
A real fact that happened with a famous physician of my hometown: his client, before submitting to an abdomen plastic surgery, and without commenting anything with him, left a farewell letter to her family where she said she was sure not to come back alive from the hospital. Indeed, in the anesthesia induction the patient had a cardiac arrest, before the beginning of the surgery. The physician was still scrubbing his hands before getting into the surgical theater, when he knew about this fact.

Still now there is no explanation for what succeeded. This patient had made all her pre-surgery tests –all normal- with no contraindication to any type of anesthesia, local, epidural or general. The surgeon was so troubled that he stayed more than one year without operating anyone, and only returning to his regular activities, after a long psychiatric and psychological treatment.

In synthesis, this client must have had a strong wish to die and she succeeded. When we cross a street, there is no assurance that we succeed arriving safely on the other side. However, we should always think positively; if we don’t, we are not psychologically prepared to submit to a surgical treatment.

It is absolutely necessary to talk to your doctor about your wishes and your fears. All your questions must be answered, all your doubts cleared.

As complication, an haematoma (blood pool) may appear in some area. If it is drained in 48 hours, it should go back and have a satisfactory evolution.

The follow-up is as important as the operation itself. In this case, if the haematoma is not drained, it can contribute to the formation of pus and infection, causing tissue destruction. If there appears heat, redness, pain, it is obligatory to communicate your doctor, immediately.

Temporary facial palsy may also appear. With physiotherapy it may disappear in the period of one month.

To avoid anything wrong, be a faithful allay of your doctor. Confidence is of fundamental importance.

In how much time I may resume my normal activities?

In any surgical treatment, the whole process of cicatrisation takes one year. However, after a week, with the help of a make up to hide the hyperhaemia (reddish scar zone) you can present yourself in public.

There is a visible edema for about 3 months. Six months later, the swelling is not apparent anymore, but it lasts for about a year.

Depending on your work, you can resume it in 48 hours. The scars will be less apparent after 3 months.

Sumary

Cervical lifting is a very effective procedure. Nowadays there is a tendency to do it in a more natural way. When too much skin is taken off, the resulting face is artificial and we call it “cat’s face”.

We do the possible to avoid the appearing of scars, by hiding them in the scalp or minimizing the ear scar, making it follow the ear lobe. It gets very discrete, almost imperceptible.

Considering the type of life each one takes, and the fact that gravity do harms the face, this operation can be repeated each 10 years, to get a more persistent good effect.

The maintenance of our self-esteem is essential for a better life.

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