
Dr De Silva’s signature VFR-7 technique, performed exclusively at his Harley Street clinic, combines facial-only expertise with over 20 years’ experience to deliver natural, long-lasting results.
A deep plane facelift is a highly specialised surgical technique that works beneath the surface of the skin, releasing and repositioning the deeper structural layers of the face. Unlike traditional approaches that simply tighten the skin, which can produce an over-pulled or unnatural appearance, the deep plane facelift lifts the underlying support structures together with the skin, creating results that look refreshed, balanced, and genuinely longer-lasting.
The procedure is considered one of the most advanced forms of facelift surgery available. Fewer than 5% of plastic surgeons worldwide are trained to perform it. Dr De Silva is among them. Over more than two decades of facial-only practice in London, he has developed his own signature approach, the Vertical Face Restore 7 technique, or VFR-7, which combines the principles of the deep plane facelift with the Golden Ratio and specialised methods to minimise discomfort and downtime.
The VFR-7 lifts both the cheeks and the underlying facial muscles, eliminating the need for additional fillers and delivering a sharper, more youthful appearance that preserves natural facial contours. It is particularly well suited to patients aged 40 to 60 experiencing jowling, midface descent, volume loss, or laxity in the jawline and neck.









4–6 Hours
Outpatient
Twilight Sedation
2 Weeks
1 Week
5–7 Days
6 Weeks
6 Weeks
2 Weeks
6–8 Weeks. Fully at 12 months
Browse the before and after galleries of our deep plane facelift patients.

Look like you feel. A youthful, natural appearance was restored with Dr. Julian De Silva’s signature Vertical Deep Plane Facelift Restore. For complete rejuvenation, this patient also underwent fat transfer for added volume, a chin implant, and blepharoplasty to refine the eyelids.

When you look in the mirror and don’t feel the age you see, it can affect your confidence and professional presence. This patient’s daughter said she looked 20 years younger the day after surgery. Here she is 6 weeks after her facelift and neck lift with Dr. Julian De Silva.

This wonderful patient had disliked her neck since her 20s and remains delighted years after surgery. Along with a deep plane facelift, she underwent a deep neck lift with deep fat and submandibular gland reduction, achieving a snatched jawline and neck definition even better than in her youth.

Look like you feel. A youthful, natural appearance was restored with Dr. Julian De Silva’s signature Vertical Deep Plane Facelift Restore. For complete rejuvenation, this patient also underwent fat transfer for added volume, a chin implant, and blepharoplasty to refine the eyelids.

When you look in the mirror and don’t feel the age you see, it can affect your confidence and professional presence. This patient’s daughter said she looked 20 years younger the day after surgery. Here she is 6 weeks after her facelift and neck lift with Dr. Julian De Silva.

This wonderful patient had disliked her neck since her 20s and remains delighted years after surgery. Along with a deep plane facelift, she underwent a deep neck lift with deep fat and submandibular gland reduction, achieving a snatched jawline and neck definition even better than in her youth.
When searching for a deep plane facelift in London, the choice of surgeon matters enormously. The procedure requires a level of anatomical knowledge and technical precision that goes far beyond standard facelift surgery — and very few surgeons in the UK, or globally, have the training and volume of experience to perform it safely and consistently well.
Dr De Silva practises facial surgery exclusively, dedicating his entire surgical career to the face and neck. Over more than 20 years, he has refined his signature VFR-7 technique to deliver results that are natural-looking, structurally sound, and designed to age gracefully. His approach addresses the entire face as a connected system rather than treating isolated areas.
“What is VFR-7? It is a comprehensive solution to facial ageing — The Vertical Face Restore 7-Key Steps. An artistic procedure I have carefully created, perfected, and refined over 10 years and thousands of hours of work. It addresses the entire face, not just a portion of it.”
— Dr Julian De Silva
Dr De Silva has pioneered the use of tissue glue (ARTISS) in facelift surgery, completing a randomised controlled trial to demonstrate its benefits. The technique seals tissue planes rapidly, reduces bruising and swelling, removes the need for drains, and helps minimise post-operative complications.
Recovery following a deep plane facelift in London is further enhanced through an integrated programme of regenerative medicine, including the patient’s own platelet-rich plasma (PRP) and in-house hyperbaric oxygen therapy — a rare offering in UK facial surgery. These measures accelerate healing, reduce bruising, and support tissue viability.
To address skin quality alongside structural restoration, Dr De Silva incorporates CO₂ laser resurfacing, radiofrequency microneedling (Morpheus8), and microcannula fat transfer into deep plane facelift procedures where appropriate. These adjuncts improve skin texture and laxity while restoring natural facial volume without the puffiness associated with synthetic fillers.
All deep plane facelift procedures in London are carried out discreetly and safely at Dr De Silva’s CQC-accredited Harley Street clinic, with no requirement for general anaesthesia or inpatient hospital stays.
Dr De Silva’s deep plane facelift is performed under his patented twilight sedation anaesthesia — a world-leading technique refined over more than a decade. Patients sleep naturally through surgery without the risks associated with general anaesthesia, recovering more quickly and comfortably as a result.

The Vertical Face Restore 7 is Dr De Silva’s signature deep plane facelift technique, developed over more than a decade and designed as a comprehensive “turnkey” solution to facial ageing. Rather than addressing one area in isolation, the VFR-7 treats the entire face as a connected structure, restoring balance and proportion throughout.
Dr De Silva performs the deep plane facelift by releasing key facial ligaments to lift and reposition the deeper tissues vertically, avoiding the sideways pull of traditional SMAS approaches and producing a result that looks natural, not operated upon.
Incisions are placed discreetly around the ears and within the hairline, providing access to the deep facial tissues whilst remaining well hidden once healed.
The VFR-7 lifts and repositions the deeper facial support structures across the cheeks, jawline, and neck. By placing tension on the structural layers rather than the skin, results are more natural and significantly longer-lasting than those achieved by skin-only or SMAS techniques.
Where appropriate, tissue glue, PRP, oxygen therapy, and skin-enhancing procedures are combined with the deep plane facelift to optimise healing and the overall outcome.
All surgeries takes place exclusively at Dr De Silva’s private Harley Street clinic, under twilight sedation, allowing patients to return home the same day. The procedure typically lasts between four and six hours, depending on the complexity of the case and any additional techniques required.
During your consultation, Dr De Silva uses advanced imaging technology to simulate potential outcomes and guide a collaborative discussion about your goals. He will review your medical history, aesthetic concerns, and create a personalised surgical plan tailored to your anatomy and desired result.
Dr De Silva will see you before surgery to mark your face. You will then be guided to the operating theatre where twilight sedation anaesthesia is administered, eliminating the risks associated with general anaesthesia. Meticulous technique throughout ensures minimal downtime and well-concealed incisions.
Following your deep plane facelift, Dr De Silva will review your recovery at 24 hours post-surgery and at regular intervals thereafter. These appointments are essential for monitoring healing, addressing any concerns, and ensuring optimal results.
A deep plane facelift in London with Dr De Silva effectively addresses the most common signs of structural facial ageing — including sagging skin, jowls, nasolabial folds, and laxity in the neck. The VFR-7 delivers smoother, more youthful results than conventional facelift techniques, and patients who choose to have surgery earlier in the ageing process tend to benefit from a faster recovery, as less tissue repositioning is required. Before proceeding, it is worth understanding what the VFR-7 is — and what it is not.
Unlike conventional facelifts, which pull the skin sideways and can produce a stretched or operated appearance, the VFR-7 lifts the face vertically. By working at the deeper structural level, it restores the face to a more youthful position rather than simply tightening the surface, creating results that look naturally refreshed.
Where older facelift techniques involved removing tissue from the face, eyelids, or neck, the VFR-7 prioritises lifting and preserving what is already there. Natural volume is maintained and repositioned rather than excised, which reduces the long-term need for fillers and preserves the face's inherent softness and structure.
The VFR-7 is considered a surgical procedure that releases the facial ligaments to restore tissues to their youthful position. It is specifically designed for long-lasting results, which means it does involve a recovery period. Most patients experience initial swelling that settles within two to six weeks, with the full result emerging gradually over the following months.
The VFR-7 is designed to enhance what is already there — not to create an artificial or overfilled look. Many patients seek the procedure after finding that repeated non-surgical treatments have left them looking puffy rather than refreshed. The deep plane facelift provides a more definitive, structurally sound result that non-surgical methods cannot replicate.
Subtle facial asymmetry is entirely normal and present in virtually everyone. Whilst the VFR-7 aims to achieve refined, balanced results, no surgical technique can deliver absolute symmetry. Dr De Silva will discuss your individual anatomy honestly during your consultation, so that expectations are realistic and well-informed.
Surgery is best approached from a place of stability and personal readiness. If you are going through a significant life change, whether emotional, relational, or professional, it is worth waiting until you feel settled before making a decision. A deep plane facelift should be a considered investment in your own wellbeing, not a response to external pressures.
Like all surgical procedures, the VFR-7 is about achieving meaningful, natural improvement rather than a flawless outcome. Results are carefully tailored to each patient, and around 5% of patients may benefit from a minor refinement procedure to optimise their final result — something Dr De Silva will always discuss openly and honestly.

A deep plane facelift in the UK is most suited to patients aged 40 to 60 who are experiencing significant structural changes associated with facial ageing — including jowling, midface descent, deep nasolabial folds, loss of jawline definition, and laxity in the neck. Candidates should be in good general health, non-smokers, and have realistic expectations about what surgery can achieve.
Dr De Silva will assess your suitability in detail during a one-to-one consultation, reviewing your facial anatomy, medical history, and aesthetic goals to determine whether the deep plane facelift is the most appropriate technique for you.
Deep plane facelift recovery follows a broadly predictable pattern, though every patient’s healing journey is unique. Most patients experience swelling and some bruising in the first one to two weeks, with 80% of visible swelling resolving within a fortnight. Mild numbness around the ears and chin is common and typically fades over six to twelve months. Dr De Silva and his team provide structured aftercare and are available around the clock throughout your recovery.
One of the advantages is that incision lines tend to heal particularly well. Because tension is placed on the deeper facial structures rather than the skin, there is minimal pulling at the incision sites, reducing the risk of widened or visible scarring. Incisions are positioned discreetly around the ear and within the hairline, and in the great majority of patients they become virtually undetectable once fully healed. Dr De Silva’s meticulous tissue glue technique further supports clean wound closure and reduces the risk of complications such as keloid scarring, which affects a very small proportion of patients.
Because the deep plane facelift works at a structural level, releasing ligaments and repositioning deeper tissues, initial swelling is more pronounced than with surface-only techniques. This is entirely normal and a sign that the deeper layers are healing. Dr De Silva will see you within 24 hours of surgery to assess progress. Head elevation, cold compresses, and rest are recommended throughout this period.
The tissue glue technique Dr De Silva uses in place of drains means most patients notice bruising beginning to track downwards and dissipate more quickly than they may expect. Dressings are reviewed, and many patients are surprised by how comfortable and mobile they feel at this stage.
Sutures are removed. Swelling remains present but begins to soften noticeably, and the early shape of your result starts to emerge. Most patients feel well enough to move around the house freely and manage light daily tasks with ease.
The majority of patients return to work and social commitments at this point. Because the VFR-7 lifts vertically rather than pulling the skin taut, there is no stretched or operated appearance — the face looks rested and naturally refreshed rather than obviously post-surgical.
Residual firmness and deeper swelling continue to soften. Gentle exercise can be reintroduced gradually. Facial proportions become noticeably more defined as the tissues settle into their new position.
The deeper structural changes become increasingly visible as swelling fully resolves. Cheek contours, jawline definition, and neck profile all become clearer. Most patients report that others comment that they look well-rested rather than identifying any surgical change.
The final result emerges. Because the deep plane facelift repositions the foundational layers of the face, results at this stage look and feel entirely natural — not tighter or pulled, but structurally restored. Incision lines will have matured and become virtually imperceptible in the great majority of patients.
Every deep plane facelift recovery is individual, but the deeper structural work of the VFR-7 means that results improve progressively and meaningfully over time — something that simply cannot be achieved through skin-tightening techniques alone. Dr De Silva and his team provide structured support throughout, and are available to patients around the clock during the recovery period.

Deep plane facelift surgery is generally safe when performed by an experienced, specialist surgeon, but it is important to understand the potential risks before proceeding. Dr De Silva’s advanced technique and the safeguards built into his surgical process significantly minimise these risks. Potential complications include:
All risks will be discussed thoroughly with Dr De Silva during your consultation so that you can make a fully informed decision.
Dr De Silva frequently combines additional surgical procedures with the deep plane facelift to achieve a more comprehensive approach to facial ageing. Combining procedures reduces overall recovery time and allows multiple areas to be addressed in a single surgical session.



If you are considering a deep plane facelift in London, we invite you to arrange a personal consultation with Dr Julian De Silva. During this one-to-one appointment, Dr De Silva will review your anatomy, discuss your goals, and create a tailored surgical plan designed to deliver natural, long-lasting results.

Dr Julian De Silva is a renowned facial cosmetic surgeon based at Harley Street, London, specialising in facelift, blepharoplasty, and rhinoplasty. Known for delivering natural-looking results, he has treated high-profile patients internationally and incorporates advanced technology to support fast, comfortable recovery. Dr De Silva is a recognised author and educator in aesthetic surgery.
Comparing deep plane facelift surgery with other types helps determine the best procedure for you. The best facelift type varies from one person to another. Hence, it helps to know the differences between Dr De Silva’s signature deep plane facelift and other types of facelift.
Surgeons used to do facelift procedures by operating on the skin only, making the skin-only facelift one of the most traditional types of facelift. As its name implies, the skin-only facelift involves operating on the skin. It does not lift the tissue beneath it. On the other hand, the deep plane facelift involves operating under the supportive layer of the face. The skin-only facelift produces instant results. Recovery time (1 to 2 weeks) is shorter than that of a deep plane lift. However, the results of Dr De Silva’s signature deep plane facelift last longer than those of a skin-only facelift.
SMAS stands for the superficial muscular aponeurotic system. Hence, the SMAS facelift targets the said area. Just like the deep plane facelift, the SMAS facelift also targets the lower two-thirds of the face. However, the primary difference is the SMAS facelift raises the skin and SMAS layer separately. The deep plane facelift raises them together. Recovering from an SMAS facelift UK takes longer than recovering from a deep plane facelift. In particular, it takes 3 to 8 weeks. The results of Dr De Silva’s signature deep plane facelift also last longer than those of an SMAS facelift.
MACS stands for minimal access cranial suspension. A MACS facelift targets the underlying muscles of the face. The deep plane facelift targets a larger area compared to a MACS facelift. Recovery time (3 to 4 weeks) is slightly longer compared to his signature deep plane facelift. The results of his signature deep plane facelift last longer as well.
A mini facelift is done by making tiny incisions on the face. Since the incisions are small, a mini facelift produces less dramatic results compared to his signature deep plane facelift. In addition, a mini facelift only involves the skin. On the contrary, the deep plane facelift involves the skin and supportive layer of the face. You can recover from a mini facelift (1 to 3 weeks) faster than a deep plane facelift. However, the results of the signature deep plane facelift last longer.
The S-lift involves S-shaped incisions and removing excess skin and fat. Recovering from an S-lift (3 to 5 days) is shorter than recovering from a deep plane facelift. However, the results of his signature deep plane lift last longer.
A well-performed deep plane facelift typically produces results that last ten years or more. The longevity comes from addressing the structural layer of the face - the SMAS and the ligaments beneath, rather than simply tightening the skin surface. Because the tissue is repositioned rather than pulled, the result ages naturally rather than losing its effect suddenly. Dr De Silva sees all his patients annually and supports the longevity of surgical results with a three-way maintenance approach where appropriate: volume replacement using fillers, skin rejuvenation through laser and regenerative medicine, and skin tightening with radiofrequency. The aim is a result that looks natural at the time of surgery and continues to do so as the years pass.
It is most appropriate for patients with more significant facial changes; pronounced jowling, loss of the jawline definition, neck laxity, and descent of the mid-face that a mini facelift or non-surgical treatment cannot meaningfully address. For patients with earlier signs of ageing, smaller procedures or non-surgical options may be entirely appropriate, and Dr De Silva will say so honestly when that is the case. The determining factors are not age alone but the specific degree of change, the anatomy of the individual face, and what the patient is genuinely trying to achieve. Dr De Silva asks every patient to bring an old photograph to consultation - this acts as a blueprint for planning, allowing him to assess precisely what has changed and what a natural restoration would look like for that individual face.
Dr De Silva's Vertical Face Restore 7 differs from a standard deep plane facelift in several specific ways. The lift direction is vertical rather than lateral - repositioning tissue to where it sat in youth rather than pulling it sideways, which is what creates the swept or operated appearance. The ligament-like structures of the face are released precisely, allowing the face to be lifted naturally as a unit. Scars are hidden meticulously within the natural hairline and the curves of the ear- closing just one side takes forty-five minutes of careful technique. Recovery is accelerated through twilight sedation rather than general anaesthesia, which maintains stable blood pressure and significantly reduces bruising and swelling from the outset. Bio-technology including PRP, amniotic membrane product, micro-drains, light therapy, oxygen therapy and manual lymphatic drainage further reduce recovery time. Fewer than one percent of patients experience nausea after surgery. More than half use no pain relief beyond the first twenty-four hours.
A deep plane facelift restores the natural contours of the jaw and neck, lifts descended mid-face tissue, softens the nasolabial folds, and recreates the V-shaped jawline associated with a younger face. The result should look like you- rested, refreshed and natural, rather than operated upon or pulled. Because the tissue is repositioned vertically to where it sat in youth rather than pulled sideways, the face moves in a way that reads as genuinely younger rather than surgically altered. Dr De Silva uses Golden Ratio facial analysis to plan every procedure, mapping each patient's individual proportions before making a single surgical decision. This ensures the outcome is specific to your face, not a generic aesthetic standard. Most patients find that people around them notice they look well, rested or younger, without being able to identify surgery as the reason.
Recovery after a traditional facelift under general anaesthesia could last up to two months. Dr De Silva's approach has reduced this significantly- at two to three weeks, eighty to ninety percent of bruising and swelling will have resolved, and most patients are comfortable returning to social activities and the workplace. Hair dyeing should be avoided for five weeks. Strenuous exercise can typically resume at four weeks. Sun exposure must be avoided for six weeks, with SPF sunscreen, a wide-brimmed hat and UV-protective sunglasses worn whenever outdoors. Some numbness and tightness in the first weeks is normal. Internal stitches dissolve over up to three months, and the left and right sides may heal at slightly different rates during this period. While significant improvement is visible at six weeks, the face continues to settle for twelve to eighteen months - this is when the full, final result is established.
The procedure addresses the structural changes of facial ageing in the lower two-thirds of the face- jowling, loss of jaw definition, descent of the mid-face, and laxity of the neck. It restores the natural V-shaped jaw contour of youth and, when combined with a neck lift, addresses neck bands and the angle beneath the chin. What it does not address on its own is volume loss, skin quality, or changes around the eyes and brow; these require complementary techniques. Dr De Silva frequently combines his deep plane facelift with fat transfer to restore lost volume, CO₂ laser resurfacing to improve skin texture and tone, and blepharoplasty or brow lift where the eye area also requires attention. A comprehensive assessment at consultation determines which combination is appropriate for each individual, ensuring one area does not look refreshed while another tells a different story.
The Vertical Face Restore 7 deep plane facelift is performed under Dr De Silva's patented Rapid Recovery Twilight Sedation (GB2602123B) rather than general anaesthesia. Patients are comfortable and relaxed throughout, breathe independently, and are typically able to walk out of the operating theatre within thirty minutes of surgery completing. The procedure itself lasts several hours, depending on the number of techniques required and whether complementary procedures are being performed at the same time. It is an outpatient procedure - patients go home the same day. In clinical audit, patients have rated their sedation experience an average of 9.4 out of 10, and fewer than one percent experience nausea or sickness afterwards.
Deep plane facelift surgery is a bespoke procedure and the cost reflects the complexity of the technique, the experience of the surgeon, the facility, and whether complementary procedures are performed at the same time. As a specialist facial plastic surgeon operating exclusively on the face from his Harley Street practice, Dr De Silva's fees reflect the level of expertise, the personalised care provided before and after surgery, and the standard of the facility. An accurate cost can only be given following a consultation, at which point Dr De Silva will have assessed your face, discussed your goals and outlined a specific surgical plan. To discuss your individual requirements, please contact the practice to arrange a consultation.
Both a deep plane facelift and a SMAS facelift work beneath the skin, but they do so in fundamentally different ways. A SMAS facelift lifts the skin and the SMAS layer separately, the SMAS is tightened independently and the skin is then redraped over it. A deep plane facelift releases the ligaments that tether the SMAS to the deeper structures of the face, allowing the skin and SMAS to be lifted together as a single unit. This composite lift produces a more natural result because the tissue moves as one, rather than in separate layers that can look or feel incongruent. It also addresses the mid-face more effectively- the nasolabial folds and descended cheek tissue that a SMAS-only lift can leave relatively untreated. The deep plane technique is more technically demanding, but the difference in outcome for patients with significant facial ageing is meaningful.
A deep plane facelift and neck lift are most commonly performed together, and for the majority of patients this is the right approach; the lower face and neck are a continuous anatomical unit, and treating them separately rarely produces the most balanced result. The neck lift component addresses platysmal banding, excess neck skin, and the definition of the neck angle beneath the chin. In some cases, where significant neck laxity or deep neck fat requires additional work, Dr De Silva will incorporate further neck contouring techniques, including the use of a high-definition telescope from beneath the chin to guide precise fat removal and platysma tightening. Whether a neck lift is included, and to what extent, is determined by the anatomy of each individual patient and discussed in detail at consultation.
A mini facelift and a deep plane facelift are appropriate for fundamentally different degrees of facial change. A mini facelift addresses early signs of ageing- mild jowling and some skin laxity, through a smaller incision and with a shorter recovery. It does not address the neck, does not work at the deep structural level, and its results, while appropriate for the right patient, are less comprehensive and less durable than a deep plane procedure. A deep plane facelift is the right choice when changes are more significant; when jowling is pronounced, when neck laxity is present, when the mid-face has descended, or when a patient wants a result that will last. The choice between the two is determined entirely by anatomy and goals, not by preference. Dr De Silva will recommend the approach that is genuinely right for each individual patient, including recommending a smaller procedure when that is the honest answer.
Scarring after a deep plane facelift depends significantly on surgical technique and the precision of incision placement. Dr De Silva is meticulous about hiding incisions within the natural curves of the ear and hairline - closing just one side of the face takes forty-five minutes of careful technique, and the same care is applied to the other side. Because the deep plane technique lifts without placing tension on the skin, the skin is redraped gently and heals without the pulling or distortion that creates visible scars. Scars are positioned to preserve the sideburn area and the natural hairline behind the ear, allowing hair to be worn up after surgery. In a small number of patients, genetics can affect how the skin heals; this is discussed openly at consultation, and Dr De Silva may use medications that soften scar appearance where indicated.
One of the significant advantages of a deep plane facelift over shallower techniques is its ability to address the mid-face; the area of the cheeks and nasolabial folds that descends with age and creates the hollowed, heavier appearance of an older face. By releasing the retaining ligaments at the deep plane level, the descended mid-face tissue can be lifted and repositioned as part of the same procedure, rather than leaving it untreated. This is why deep plane facelift patients frequently notice improvement in their nasolabial folds - the deepening of the lines from the nose to the mouth- that SMAS or skin-only techniques do not achieve. The result is a more complete facial rejuvenation that addresses the face as a whole rather than the lower third in isolation.
Male patients require specific adaptations to the deep plane facelift technique that go beyond simply performing the same procedure on a different face. The male aesthetic reference points are different; a stronger jaw, a lower brow, a more defined neck angle, and over-lifting or over-tightening in a man's face creates feminisation rather than rejuvenation. Dr De Silva's approach for male patients focuses the lift more heavily on the neck and jawline, which produces the most naturally masculine result. Incisions are planned specifically around male hair patterns- a smaller incision hidden behind the ear is particularly important for men with short hair, thinning hair or receding hairlines. Men comprise one quarter of Dr De Silva's facelift practice, and his published research on male facial proportions informs every male surgical plan.
Fat transfer is one of the most commonly combined procedures with a deep plane facelift, and for many patients it produces a significantly more complete result. A facelift addresses the descent of tissue - it lifts and repositions what has fallen. But ageing also involves volume loss- the deflation of fat compartments in the cheeks, temples and around the eyes that creates a hollowed, gaunt appearance that lifting alone does not correct. Micro-cannula fat transfer harvests fat from elsewhere on the body, processes it, and reintroduces it precisely into the areas of volume loss, restoring the fullness and three-dimensional contour of a younger face. Combining fat transfer with facelift at the same procedure allows Dr De Silva to address both descent and deflation together, producing a result that is both lifted and naturally volumised rather than simply tighter.
The procedure is a more technically demanding procedure than shallower techniques, but in experienced hands its risk profile is well understood and manageable. The most common risks are bruising and swelling, significantly reduced by Dr De Silva's use of twilight sedation, which maintains stable blood pressure throughout, and by his fast-healing bio-technology protocol. The risk of haematoma - a collection of blood beneath the skin- is reported at two to three percent with conventional techniques; Dr De Silva's approach reduces this to below one percent. Temporary numbness and tightness are expected and resolve over weeks to months. Facial nerve injury is a risk with any facelift- rare, and typically transient when it occurs, resolving as the nerve regains function. Dr De Silva sees every patient personally within twenty-four hours of surgery, as early assessment of any concern is fundamental to a good outcome. All risks are discussed in full at consultation.
Golden Ratio facial analysis is central to how Dr De Silva plans every facelift procedure. The Golden Ratio- the mathematical proportion that has defined facial beauty across cultures for thousands of years, provides an objective framework for assessing each patient's facial proportions before making a single surgical decision. Rather than working from a generic aesthetic standard or a subjective sense of what looks right, Dr De Silva maps the specific proportions of each patient's face and uses this analysis to determine precisely what needs to be repositioned, by how much, and in what direction. This means the outcome is specific to your face - a restoration of your own natural proportions rather than an approximation of someone else's. Dr De Silva has developed proprietary software for this facial evaluation, which he uses as a planning tool for every procedure.
Dr De Silva is one of a small number of surgeons in the UK whose practice is dedicated exclusively to the face; every procedure he performs, every technique he refines, and every piece of research he conducts relates to facial surgery alone. His Vertical Face Restore 7 deep plane technique has been developed over more than fifteen years and refined through completing revision procedures on other surgeons' results- over 20% of his patients come to him specifically to correct surgery performed elsewhere. He is the Director of the International Facelift Course at the ASOPRS and AAO in the United States, teaching deep plane facelift techniques to surgeons from around the world. His patented twilight sedation protocol, his published research, and his annual clinical audit - which consistently shows a revision rate of three to six percent, all reflect a practice built on precision, safety and consistently natural results. Patients travel to him from over seventy countries.