
Facial ageing results in changes in all layers of the face, including the skin, the soft tissues and the underlying bone. A facelift restores soft tissue drooping and laxity of the face, neck and jowls. To give a patient a natural rejuvenation. Often to get the very best natural results facelift & neck lift surgery is combined with other procedures in order to give a fully rejuvenated natural-looking result.
Volume deflation of the mid-face and cheeks are common signs of facial ageing and can be effectively treated with a filler, fat augmentation or cheek implants. Dr De Silva prefers the use of a natural filler to restore the face using a patients’ own soft tissues, termed fat transfer, as from our experience this gives a longer-lasting natural result. Fat transfer to faces that have had a substantial loss of volume can be very effective in restoring the malar mound and curvature of the cheeks giving a natural and youthful look. When completed meticulously 50-60% fat transfer lasts for years.
Eye changes are a very common indicator of facial ageing and include drooping of the skin in the upper eyelid, dark circles and bulging pockets of fat in the upper and lower eyelids. These eyelid changes are commonly treated with blepharoplasty at the same time as a facelift in at least half of patients.
Ageing of the skin from damage by the sun and environmental elements results in lines and dark spots that may be effectively rejuvenated and smoothened with a combined facelift and laser resurfacing procedure. With the use of facelift and CO2 laser resurfacing of the skin, an excellent result can be obtained. Dr De Silva takes precautions with the use of lasers on the skin to ensure a high-quality result and may include skin area testing. Laser treatment of the face does result in some discomfort on day-1 after surgery; oral analgesia is adequate to relieve any discomfort. After1-week, the face has largely healed although a minority of people may have residual redness that can be covered with conformers. Dr De Silva only uses the very latest in laser technology, as there is continued innovation in laser design, improving effectiveness and reducing downtime.
Facial imbalance secondary to the underlying bone structure cannot be addressed by a facelift alone. Dr De Silva analyses the face as a whole, common shortcomings are in the chin and cheek areas; in some patients, these are addressed with volumetric addition with facial implants. Dr De Silva prefers the use of silicone implants; these are very safe and have been used in the body for many decades and are undetectable once inserted.
Facial ageing is characterised by the laxity of the skin, loss of facial volume and descent of soft tissues with gravity, it develops gradually and is influenced by genetics, lifestyle, and environmental factors such as sun exposure.
In the lower face, these changes often appear as sagging along the neck, loss of the sharp jawline contour, and the formation of jowls. Many patients describe feeling that their face looks tired, heavy, or older than they feel inside.
A facelift directly addresses these concerns by repositioning the descended soft tissues back to their more youthful position above the jawline, restoring definition to the neck, and smoothing away sagging skin. This creates a natural and refreshed appearance, never tight or “overdone.”
Dr De Silva takes a highly customised approach, carefully analysing each patient’s facial structure to ensure results that look harmonious, balanced, and age-appropriate. The goal is always rejuvenation that enhances your natural features, helping you look like the best version of yourself.
Non-surgical facelift treatments include a range of techniques designed to refresh the face without the need for surgery. The most common approaches are:
These methods can address early signs of ageing, like slight sagging, volume loss, or fine lines, but their results are modest and temporary. Improvements are often subtle, measured in millimetres, and best suited for patients in their 30s or early 40s with mild changes.
For patients with more significant laxity, particularly by mid-life and beyond, non-surgical treatments have limitations. While they can refresh the appearance, they cannot match the long-lasting, more dramatic improvements of surgical facelifts, which reposition deeper tissues and tighten skin more effectively.
Dr De Silva provides advice and guidance on any of the latest cosmetic technological innovations; he only utilises techniques that give patients both natural-looking results and longevity. Many new devices over the past 5-years have promised incredible results without surgery; often, they are heavily marketed and unproven. Most are only available for a short period of time, after which the devices are found to be less effective. Good advice is if something sounds too good to be true, it generally is. For legal reasons, specific devices cannot be discussed on a public website. Dr De Silva understands the difficult choices that patients have in deciding what to believe, and will only use treatments that he knows are effective and appropriate for use on his family members and friends. Dr De Silva served as the clinical representative of the Ethics Committee at St. Mary’s Hospital from 2002-2006.
A facelift or neck lift is designed to restore a more youthful appearance by addressing sagging skin, deep lines, and changes in facial structure that occur with ageing. Many patients describe feeling younger on the inside than they appear on the outside, and surgery can help bring those two into balance. For some, this rejuvenation also provides an added boost of self-confidence, whether in their personal lives, social relationships, or professional environments. While society often places value on youth and vitality, Dr. De Silva emphasises that the goal of facial rejuvenation is not to erase every line or create an unnatural result, but rather to help patients look refreshed, rested, and like the very best version of themselves. His approach focuses on subtle, natural outcomes, where friends and colleagues may notice that you look great, without realising you’ve had surgery.
Dr. De Silva is highly regarded for his advanced facelift techniques, many of which he has brought directly from the United States. He performs the procedure as a day case, allowing patients to return home the same day without the need for overnight hospital stays, which also reduces the risk of infection. For added comfort and reassurance, patients may opt for one of Dr. De Silva’s experienced overnight care team to provide personalised support during the first evening after surgery. Recovery times vary, but most patients return to light, non-strenuous activities within a few days, take around 2–3 weeks off work or social commitments, and are back to their normal routines by three weeks. With his patient-focused approach, Dr. De Silva ensures every step, from consultation through to recovery, is customised to achieve natural, confidence-boosting results with the highest standard of safety and care.
One of the most common concerns patients express is whether others will be able to tell they’ve had surgery. Dr. De Silva’s goal is always to achieve a natural, refreshed appearance rather than a “pulled” or artificial look. His facelift techniques are designed to reposition the deeper tissues of the face, restoring youthful cheek contours, smoothing jowls along the jawline, and refining the neck angle, while carefully removing excess skin. By combining methods such as double-layer tightening, a modified deep plane approach, hidden incisions, and facial volume restoration, he creates results that are subtle and harmonious.
“My objective is for friends and family to notice you looked freshened up and rejuvenated, however, do not know that you have undergone surgery.”
As Dr. De Silva often explains, the ideal outcome is for friends and family to comment that you look well-rested or rejuvenated, without suspecting you’ve had surgery. In the first week, some swelling and bruising are expected, and patients are encouraged to rest and keep social contact to a minimum. By the end of week one, makeup can help camouflage residual bruising, and many people begin easing back into light social activities. Within two weeks, most swelling has settled, and patients typically feel comfortable returning to normal social and professional engagements.
Dr. De Silva’s natural-looking results, paired with his emphasis on discreet recovery, mean patients can feel confident that their rejuvenation will enhance their appearance without making it obvious they’ve had a facelift.
After facelift surgery, patients can expect a carefully managed recovery process designed to maximise comfort and support healing. A soft bandage is placed around the head and under the chin to provide gentle support and minimise swelling.
In some cases, Dr. De Silva uses fine micro-drains, which help further reduce swelling and promote a smoother recovery. Thanks to meticulous techniques, most patients are able to leave the surgical centre and return home within just one to two hours. While discomfort is typically minimal, patients are advised to take it easy in the first few days, avoiding exercise and strenuous activity.
Dr. De Silva sees every patient the day after surgery to check progress and ensure comfort, and he provides direct 24-hour contact for reassurance. By the next day, patients are usually able to shower and wash their hair. Stitches are typically removed between five to seven days, and by two weeks, most of the visible swelling has settled, allowing patients to resume normal routines. Scars are discreetly placed behind the ears and within the hairline, gradually fading over the following months, leaving a natural and refreshed appearance.
The “one-stitch” or “one-hour” facelift is often advertised as a quick, minimally invasive procedure with rapid recovery. While it may sound convenient, these techniques are limited in scope and effectiveness. They typically work only on the superficial layers of the face, addressing minor skin laxity rather than the deeper soft tissue descent and volume loss that contribute to facial ageing. As a result, improvements are usually modest and short-lived, lasting only a few months.
In contrast, a comprehensive facelift performed by Dr De Silva involves lifting and repositioning the deeper layers of facial tissue, restoring the natural contours of the cheeks, jawline, and neck. These procedures generally take 3–6 hours and may involve complementary techniques such as fat transfer, blepharoplasty, or skin resurfacing to achieve a balanced and youthful result. Surgical precision is essential not only to lift tissues effectively but also to create fine, hidden scars that fade over time. A single stitch cannot provide the structural support required for a lasting and natural-looking rejuvenation.
Dr De Silva emphasises that a successful facelift is about quality, longevity, and a natural appearance. While quick-fix techniques may appeal as a shortcut, they cannot replace the meticulous planning, careful execution, and expert aftercare that produce results which friends and family notice without knowing surgery has been performed. He guides each patient with realistic expectations, ensuring they understand the difference between temporary improvements and a long-lasting, harmonious rejuvenation that enhances confidence and facial balance.
Sedation is also known as “twilight anaesthesia” or MAC (Monitored anaesthesia care). Twilight anaesthesia means that your body is sleepy and relaxed; you are still conscious and able to respond to questions and instructions, unlike general anaesthesia where you are unconscious, and the recovery after surgery is longer. Typically, you won’t remember the procedure or the short period of time following it, though you will feel a little euphoric. The benefits of sedation are that it relieves your anxiety around surgery and the recovery after surgery is faster.
Video of sedation anaesthesia experience for facelift & neck lift surgery
The so-called “weekend facelift” is often marketed as a quick procedure performed under local anaesthesia, promising fast recovery over just a couple of days. While the idea may sound appealing, these expedited techniques involve shortcuts that limit both effectiveness and longevity. Fast procedures generally address only the superficial layers of the skin, rather than lifting the deeper facial tissues responsible for the natural contours of the cheeks, jawline, and neck. As a result, improvements are often modest, short-lived, lasting only a few months, and there is a higher risk of an unnatural or “pulled” appearance.
Many patients are initially drawn to these quick procedures due to lower upfront costs. However, when the limited duration of results and the potential need for additional procedures are taken into account, they may be less cost-effective than a comprehensive facelift in the long term. True facelift surgery, as performed by Dr De Silva, ranges from mini facelifts to full face-and-neck lifting techniques and typically takes 3–6 hours. These procedures often involve general or sedation anaesthesia, meticulous tissue repositioning, and complementary treatments such as fat transfer, blepharoplasty, or skin resurfacing to achieve a balanced, natural, and long-lasting result. Even closing the incisions carefully to create fine, hidden scars requires significant precision and cannot be rushed.
Dr De Silva emphasises that effective facial rejuvenation requires careful planning, expert execution, and realistic expectations. Quick-fix techniques like the weekend facelift do not provide the depth of correction, longevity, or natural-looking outcomes that patients usually desire. For these reasons, Dr De Silva does not recommend the weekend facelift, preferring techniques that deliver durable, harmonious results that enhance confidence while respecting the patient’s natural appearance.
How long a facelift procedure lasts is dependent on several factors: The facelift technique, Additional procedures, Environmental factors and Genetics.
Genetics and ethnicity both influence facial ageing and longevity of a facelift. A useful indicator for genetics is looking at how your parents have aged relative to their peers.
A facelift procedure rejuvenates the face by lifting facial soft tissues that have descended with facial ageing as a consequence of the descent of soft tissues, laxity in soft tissues of the face and skin, and facial volume loss with facial ageing.
The indications for a facelift are to treat characteristics of the face include, Deep Nasolabial lines (from the nose towards the outside corners of the lips), Jowls (the soft tissue that has descended below the jawline resulting in loss of a smooth jawline), Excess skin or vertical bands in the neck (secondary to laxity in the platysma muscle) & Marionette lines (from the corner of the mouth to the chin region)
The facial ageing changes above that are suitable for facelift surgery usually present from the forties onwards; however, they are dependent on environmental factors (including smoking, sun exposure, poor nutrition, and stress) and genetic factors.
How long a facelift procedure lasts is dependent on several factors: The facelift technique, Additional procedures, Environmental factors, and Genetics.
Facelift surgery generally lasts for 5-8 years, depending on the factors above. A person who has undergone a facelift will always look younger than that if they had not had a facelift, however with time to maintain that look a further facelift may be required. Patients working in professions where appearance is key to career prospects commonly undergo multiple facelift procedures to maintain their appearance over multiple decades.
The facial ageing usually presents from the forties, however, are dependent on environmental factors (including smoking, sun exposure, poor nutrition and stress) and genetic factors.
The indications for a facelift are to treat characteristics of the face include, Deep Nasolabial lines (from the nose towards the outside corners of the lips), Jowls the (soft tissue that has descended below the jawline resulting in loss of a smooth jawline), Excess skin or vertical bands in the neck (secondary to laxity in the platysma muscle) & Marionette lines (from the corner of the mouth to the chin region)
Often to give the best result from a facelift, the surgery needs to be combined with additional procedures, including fat transfer to treat facial volume loss and skin resurfacing to sun-damaged.
Non-surgical treatments, including the use of wrinkle injection and hyaluronic acid fillers, have been substantial innovations in the past decade that have advanced cosmetic surgery. Patients with early signs and symptoms of facial ageing including dynamic wrinkles (wrinkles on facial expression) and early volume loss around the cheeks, below the eyes (termed tear through depression) are effectively treated with non-surgical treatments.
The changes described above, including deep nasolabial lines, jowls and excess skin in the neck are not effectively treated with non-surgical methods and require facelift surgery to give a natural-looking rejuvenation. Age itself is not an accurate indicator for facelift surgery. Most 40-year-olds would not have the indications for facelift surgery as described above (jowls, deep nasolabial lines and vertical bands in the neck). However, as a consequence of genetic and environmental factors if these symptoms and signs are present in a facelift may be the most suitable facial rejuvenation.
A facelift rejuvenates the face by lifting and repositioning soft tissues that have sagged due to ageing, including loose skin, tissue laxity, and volume loss. By the time most people reach their 70s, these age-related changes are usually pronounced and can be effectively addressed with a facelift. Several additional factors should also be considered when planning the procedure.
Overall, there is not a specific age that is good or too old for facelift surgery; more significant is your general health and level of fitness. Dr De Silva finds from his experience, taking into account the steps above, patients in their 70s and 80s can have an excellent rejuvenation from facelift & neck lift surgery
The salivary glands, located under the jawline (submandibular and submaxillary glands), are usually hidden behind the natural contours of the jaw and neck. In some individuals, these glands may sit lower and become more prominent, creating a visible bulge or irregularity in the neck’s shape. Most patients undergoing facelift or neck lift surgery do not require any intervention on their salivary glands.
However, in certain cases, the position and prominence of the glands, combined with natural facial ageing, can affect the overall surgical result. For these patients, partial removal of the glands during face and neck lift surgery may improve neck contour and enhance the final outcome. Because salivary glands have a rich blood supply, surgical intervention is performed with caution and reserved only for those who truly need it.
Dr. De Silva carefully evaluates each patient’s anatomy and aesthetic goals to determine whether addressing the salivary glands is appropriate. When performed selectively, this additional step can contribute to a smoother, more natural-looking neck and jawline, helping patients achieve the balanced and rejuvenated results they desire.
After a facelift or neck lift, surgeons use different techniques to close incisions. While some surgeons use only superficial stitches that are removed within 1–2 weeks, Dr. De Silva closes incisions with three layers of deep dissolvable stitches. These layers help hold the soft tissues in place, minimise tension on the wound, and ensure the finest possible scar.
It is normal to feel the very edges of these stitches as swelling resolves. They are usually clear in colour and difficult to see. Most dissolve naturally over 3–6 months. If a stitch becomes irritating or uncomfortable, it can be removed, but if there is no discomfort, it is best left to dissolve on its own.
These deep stitches play an essential role in supporting the face during the healing period and reducing the risk of scarring, ensuring that the results of your facelift are as natural and long-lasting as possible.
After a facelift or neck lift, the way incisions are closed is crucial for both healing and the final appearance of the scar. Some surgeons use only superficial stitches, which are removed within 1–2 weeks. Dr. De Silva, however, closes incisions with three layers of deep dissolvable stitches, specifically designed to hold the soft tissues securely in place, reduce tension on the skin, and produce the finest, most natural-looking scars possible.
As your face heals and swelling gradually decreases, it is common to feel the edges of these stitches along the incision line. These stitches are usually clear in colour and difficult to see. While they may be noticeable to touch, they are not harmful. Most of these stitches naturally dissolve over 3–6 months, continuing to provide support during the critical healing period.
If a stitch feels irritating or uncomfortable, Dr. De Silva can remove it, but if it is not causing any discomfort, it is best left alone to dissolve naturally. Many patients feel concerned when they notice these stitches, but this sensation is a normal part of healing and does not indicate a complication. These deep stitches are an important part of ensuring your facelift results remain natural, smooth, and long-lasting, giving you confidence in both the appearance and longevity of your rejuvenated look.
Accusculpt is a laser-based technology designed to reduce localized fat, most commonly in the neck. In principle, it works similarly to liposuction by targeting and removing fat cells, which can help contour the jawline and neck in younger patients with excess fat but good skin tone. While it can be effective for small areas of stubborn fat, it does not address the deeper changes associated with facial ageing, such as skin laxity, jowls, or soft tissue descent caused by gravity.
Some providers market Accusculpt as a “non-surgical facelift,” but it is important to understand that it cannot replicate the effects of a true facelift. A traditional facelift works beneath the skin, repositioning and lifting the deeper soft tissues that have descended with age, while also removing excess skin to restore a smoother, more youthful contour. Techniques like Accusculpt only address superficial fat and therefore provide limited and short-term improvements, rather than long-lasting rejuvenation.
As with many emerging non-surgical technologies, Accusculpt has a role for certain patients who are seeking modest contouring without surgery. However, realistic expectations are essential. The improvements are usually small, and the results may last only a few months. Procedures that promise quick, dramatic transformations without surgery often cannot address the underlying structural changes of ageing, and patients may be disappointed if their goals are to rejuvenate the face comprehensively.
For patients seeking more long-lasting and natural results, facelift techniques remain the gold standard. Mini-facelifts, or full face and neck lifts, typically take 3–6 hours, are performed under general or sedation anaesthesia, and address both the skin and deeper tissues, providing a youthful and natural look that can last many years. Dr. De Silva carefully evaluates each patient to determine whether non-surgical options like Accusculpt are appropriate or if a surgical facelift will better achieve the desired rejuvenation, ensuring both safety and long-term satisfaction.
A “30-minute facelift” is a term often used in marketing to suggest a quick, minimally invasive solution for facial rejuvenation. However, it is important to understand that this procedure is not a true facelift. Unlike a surgical facelift, which lifts and repositions the deeper facial tissues, removes excess skin, and restores a natural, youthful contour, a 30-minute facelift primarily involves non-surgical techniques, such as temporary threads, dermal fillers, or other facial contouring methods.
These treatments can enhance facial features by accentuating the cheekbones, defining the jawline, lifting the upper neck, or improving under-eye contours. They are sometimes described as “facial contouring” procedures rather than true lifts because they focus on surface improvements rather than correcting the underlying effects of ageing, such as soft tissue descent, jowls, or loose skin.
While a 30-minute facelift may provide modest, temporary improvements for patients with only mild signs of ageing, its effects are limited in both scope and duration. The results are generally measured in millimetres and typically last only a few months to a year, depending on the type of threads or fillers used. For patients seeking comprehensive and long-lasting rejuvenation, a mini-facelift or full facelift remains the gold standard, as these surgical approaches address the deeper structures of the face and provide natural, durable results.
Dr. De Silva advises patients to consider their individual ageing patterns and goals carefully. While non-surgical options can be valuable for some, realistic expectations are essential, and procedures marketed as quick fixes should be evaluated critically for their limitations, longevity, and overall impact on facial harmony.
During the Procedure, Patients are typically under general anaesthesia or deep sedation, so they do not experience pain during the surgery.
There are measures that can be taken to improve Comfort and Results:
Dr De Silva gives his patients detailed support during the recovery period to ensure a fast and smooth recovery. Reassurance and a supportive team are available 24/7 to provide help and support as needed. In addition, Dr De Silva utilises modern innovations to enhance recovery, including oxygen therapy, lymphatic drainage,e and regenerative medicine.
London, New York, Los Angeles, South Korea, and Brazil stand out as top destinations for those seeking a youthful and rejuvenated appearance through facelift & neck lift surgery. Caution is required in hospital tourism as some countries package lower-cost surgery with poor regulation and clinical safety standards. There have been an alarming number of tragedies from British and American citizens travelling overseas to have low-cost procedures in countries including Turkey, South America, and Thailand. Safety is an important consideration when undergoing a procedure.
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When considering cosmetic or plastic surgery, it is essential to conduct thorough research and due diligence on your potential surgeon. Choosing the right surgeon can make a significant difference in both safety and results.
Dr De Silva specialises in Face Surgery Only, and Facelift & Neck Lift is the #1 Procedure he completes for his patients every day. He customises facelift and neck lift surgery for each patient and often combines it with other procedures, including blepharoplasty, chin implants, buccal fat reshaping, fat transfer, and laser resurfacing.
Dr Julian De Silva travelled worldwide with a fellowship in the USA and spent time working in some of the best Cosmetic centres in the World before setting up his practice over 10 years ago. This included London, UCLA Jules Stein Eye Institute in Los Angeles, and Montefiore Medical Center, Albert Einstein College of Medicine in New York. Dr De Silva wrote an extensive book that includes everything each patient needs to know regarding facelift and neck lift surgery. He uses specialised state-of-the-art technology to improve the natural results or enhance recovery or longevity of the procedure, including oxygen therapy and regenerative medicine. In addition, Dr Julian De Silva has pioneered the use of sedation anaesthesia in the UK and has been awarded a Patent for his innovation. Dr De Silva has always taken pride and constantly innovated on improving natural results, faster recovery, with over 1000 5* reviews, was voted the best facelift and neck lift surgeon in the UK on an independent review site.
How to choose the best facelift & neck lift surgeon for you?
The best surgical hospital in the UK for facial cosmetic surgery is often regarded as 23 Harley Street Clinic in London.
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Dr. Julian De Silva is often recognized as a leading celebrity plastic surgeon in the UK.
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Book an appointment with Dr De Silva today and get expert answers to all your facelift questions.