1. What procedures would you recommend? Dr De Silva recommends that every procedure must be tailored to your needs, there is no cooky cutter approach to facial surgery, what every person needs is determined by their individual characteristics. Broadly speaking there are three groups of patients I Patients who really notice one specific area: For example some patients may find their nose has always bothered them e.g. hump, or they have noticed bags in their lower eyelids or loose skin, or felt their jaw line is sagging with lose skin, or always been self-conscious about a small chin or large lip II Some patients feel they are looking more tired and they just want to be generally refreshed, look like themselves just younger and less tired. Often there are 3 aspects 1. gravity 2. Volume replacement e.g fat transfer or fillers 3. Skin enhancement, fine lines, pores lose skin, may need laser resurfacing, PRP, radiofrequency or removal of loose skin III Beautification or refinement. Patients who look good, they want to look ever better 1. Use principles of Golden ratio, Symmetry and Gender considerations (male jaw line and chin, women ogee curve, V-shaped jaw line 2. Facial Balance and symmetry 3. Enhancement of facial characteristics 2. How often do you perform these procedures? Only complete facial procedures Blepharoplasty aka eyelid surgery, nose job surgery aka Rhinoplasty & facelift and neck lift surgery and non-surgical facial treatments. I perform these procedures every day for my patients. i.e. Specialise only in face. Intricacy and fine detail in your face, for example a medical conference on rhinoplasty can be 5 days long, yes 5 whole days talking about nose jobs only! 3. Are there any before and after photos available? Yes, many 100s of photos on our website of past patients. We also have video diaries and testimonials of patients, who talk about anaesthesia and recovery from surgery. Video diaries can be particularly helpful for nervous patients as each day patients talk about their experience and recovery. Facelift Before & After PhotosVideo Diaries 4. Can I speak to previous patients who have had this surgery? Some patients ask us can we speak to previous patients. Yes, we can help patients organise this. You can also watch some of our patients talk about their experiences in the form of video diaries on our website. Video DiariesPatient Video Testimonials 5. How many pre-op appointments will I need? Most patients have 2 preops, first appointment we discuss exactly what are you looking to achieve, realistic expectations, what is involved, what is the recovery, what are the relative risks, what can be done to speed up recovery. 2nd preoperative appointment, we recap the surgery, talk in more detail, answer any questions, complete gold standard tests before surgery, we complete everything you need in house (e.g. blood tests, heart tracing)Some patients may require an additional appointment. Patient who are travelling from overseas or long distances we try and combine appointment to reduce inconvenience. 6. What location will the procedure be performed? The Centre, 23 Harley Street, we have a custom-built facility for facial cosmetic & plastic surgery. Harley Street has long been considered the medical area of excellence in London and has patients visit from all over the world seeking expert medial care. We have invested in state-of-the-art equipment that is continually updated. For example we have 3 working PRP regenerative medicine machines, 2x state of the art lasers for resurfacing. 7. Will my procedure require general anaesthesia or twilight sedation? What does this mean, talk about general and sedation anaesthesia? More than ten years ago Dr De Silva completed more procedure under general anaesthesia, however now almost all procedures can be completed under sedation anaesthesia. Sedation also known as Twilight sedation allows all patients are able to go home same day usually less than one hour after surgery, avoiding the issues and longer recovery associated with general anaesthesia. We believe twilight sedation is the future, less recovery time, less swelling or bruising, better patient experience, reduced risks such as DVT, clot in leg associated with general anaesthesia. For more information please see: 8. What is the downtime associated with this procedure? Depends on the procedure, most facial surgery we recommend have 2 weeks. Most swelling and bruising goes in 2 weeks. If you have a wedding or very important event we recommend having 6weeks just in case. For facelift surgery 3-weeks is recommended as some patients can have more swelling. If you have more swelling there are things we can do to help recovery including, lymphatic drainage, medicines and oxygen therapy. If you work with high definition film or cameras, actor or model more time is recommended as these do not hide even small amounts of swelling. 9. Is there a medical professional on call to answer any pre-op or post-op questions? Yes, Dr De Silva provides a personal service, we appreciate having facial surgery is a big decision for our patients. We will support you on this journey, this is what we do every day for our patients. 10. How many follow up appointments will be required? Most patients we see two or three times after surgery, 1 week, sometimes at 2weeks and 6weeks, and then some patients require additional follow up. However, for many patients we provide ongoing long term care, having surgery is a substantial decision for many patients and we provide ongoing are maintains the results of surgery long-term. Trust is the key element of undergoing surgery and we provide our patients with long-term maintenance after surgery as long as patients are happy to travel to see us! Many of our patients come back for additional facial procedures for years after surgery. Welcome to our family! 11. How long will it be before I see results? Most patients see some results even one week after surgery, however expectations are key. Swelling and sometimes bruising isa normal aspect of healing and with facial surgery most details comes down to millimetres. With any surgical procedure although most swelling usually has resolved by 6weeks, final results are often as long as one year after surgery. Patience is key! More and more patients come to see us for refinement surgery, often with minor amendments results are not initially visible as minor swelling can hide subtle refinements. Sometimes we can use additional techniques including anti-inflammatories or regenerative medicine to enhance healing.

Your nasal valve area is crucial to breathing, so a collapsed one can cause breathing difficulties. Nasal valve collapse causes the nose to become narrower. It usually occurs along with sinusitis and chronic rhinosinusitis. It can lead to difficulty breathing through the nose and other symptoms such as postnasal drip, loss of smell, and difficulty. Thankfully, nasal valve collapse can be treated with nasal valve surgery. But how exactly does this work? In this article, I will talk about nasal surgery, the causes of internal nasal valve collapse, and its symptoms. I will also talk about nasal surgery preparation and recovery. How Do You Fix a Collapsed Nasal Valve? You can fix a collapsed nasal valve with surgery. The same treatment applies if your nasal airway gets compromised because of nasal obstruction. The procedure is performed by a rhinoplasty surgeon like me, Dr. Julian De Silva. First, I will make an incision in your nose and lift the skin to expose the cartilage underneath. I will then trim away any excess cartilage or bone to create more space for your nostrils. This will help prevent the collapse from reoccurring over time by allowing them to open more easily when you breathe through your nose. In some cases, it may be necessary for you to have additional procedures done at the same time as repairing a collapsed nasal valve. For example, if your septum is crooked or asymmetrical due to having been broken before, this issue should also be addressed during surgery so that both problems are fixed at once instead of having them exist separately during recovery periods. Moreover, nasal surgery can be done along with other procedures such as eyebrow lift, deep plane facelift, ear cartilage graft, facial plastic surgery, and blepharoplasty. What Causes a Nasal Valve Collapse? Peer reviewed studies state that many factors can cause collapsed valves. If the valve is unable to close properly, you will experience a loss of airflow through your nostrils. Infections, surgical damage, or trauma to the nose can also lead to collapsed valves. Additionally, certain diseases, including sinusitis or facial trauma, can cause the opposite problem: an over-opened nasal valve that allows too much air into your sinuses and lungs. Surgery can also help if you have an over-opened nasal valve because of age-related degeneration. Some people opt for surgery when they want cosmetic and medical improvement (e.g. fixing the nasal airway). This type of surgery does carry risks, so please make sure you discuss these carefully with your surgeon before deciding whether it is right for you. How Do You Know if Your Nasal Valve Collapsed? Here’s what usually occurs if your nasal valve collapsed: Snoring If you snore loudly and often, your nasal valve might have collapsed. The soft tissue in the back of the nose can also become swollen and block airflow through it during sleep. Sleep Apnea This condition occurs when breathing stops for short periods during sleep—and this can cause serious health problems down the line as well as poor quality of sleep. Difficulty Breathing If you have a collapsed nasal valve, you will find it hard to breathe. Headaches The symptoms of headaches include pain or pressure inside the head (including temples), sensitivity to light or sound, blurred vision, and nausea/vomiting with head movement. It’s possible that these headaches are linked to a collapsed nasal valve because they may be caused by increased cranial pressure. This happens because of insufficient airflow through an obstructed nasal passage and nasal airflow. Can Nasal Valve Collapse Heal on Its Own? Only a proper nasal septum surgery can treat the collapsed valve area. No, nasal valve collapse can’t heal on its own. Only proper treatment can heal internal nasal valve collapse and external nasal valve collapse. If you are having trouble breathing through your nose or if your symptoms worsen over time, it’s best to see a doctor as soon as possible. Remember, only a specialist can diagnose nasal valve collapse. Nasal Valve Collapse and Treatment The nasal valve is the narrow space at the top of your nose where mucus exits from your nostrils to drain into your throat. When you breathe in through your mouth, this sphincter opens to allow air to pass into the lower portion of your nasal cavity. When you exhale, it closes again to keep air from escaping through the nose. When deviated septa cause obstruction and block airflow through one or both nostrils, bleeding or swelling inside the nose occurs. As a result, many people who have undergone corrective surgery for deviated septum experience some degree of postoperative swelling for several weeks after their procedure. However, a collapsed nasal valve is different because it occurs when one or more muscles that support either side of that sphincter become weakened or damaged due to injury. This allows mucus buildup within certain areas of your sinuses instead of allowing natural drainage through normal pathways. Hence, it’s important to get it treated not only because its effects on the nasal valve area are unpleasant but also potentially dangerous. Infections caused by resulting inflammation can lead to worse downstream conditions such as further external nasal valve damage and blood clots forming under artery walls and upper lateral cartilage. Causes and Treatment of Nasal Valve Collapse Trauma, a botched surgery, and deviated septa cause a collapsed valve area. Here are the common causes of the nasal collapse and their corresponding treatment: Nasal Valve Collapse Caused by Trauma Injuries are one of the most common causes of the collapse of the nasal valve. As a result of this, the central columella, which is the cartilage that forms in the nose’s center, will be pushed to one side. This also causes the airway to become narrower, which makes it difficult to breathe. Nasal Valve Collapse Caused by Nose Surgery When you breathe in, your external valves may get constricted if you have weak cartilage at the tip of your nose or if they are oriented in an upward direction. If you’ve had a rhinoplasty in the past, it’s possible that the lower lateral cartilages were partially removed during the procedure, which will also make the exterior valves less strong. An expansion of the skin and cartilage in the space between your nostril can lead to a narrow external valve. Nasal Valve Collapse Caused by Deviated Septum If the upper lateral cartilages of the internal valves are weak or very narrow, this can cause the valves to collapse when inward breathing is performed. Any deviation of the septum in the region of the internal valve that occurs toward the valve itself will also result in a constriction of the valve. Nasal valve collapse due to deviated septum can be treated through surgery. Signs of Nasal Valve Collapse? Difficulty breathing Runny nose Nasal congestion Snoring Sleep apnea Headaches, including migraines What Does Valve Collapse Look Like? A doctor can prescribe pain medication to manage the same symptoms as above. If you can’t breathe properly through your nose and/or have a stuffy nose that does not respond to a nasal valve dilator or over-the-counter steroid nasal sprays, you may have nasal valve collapse. External valve collapse becomes apparent when you breathe in and the nostril on either or both side closes on itself. Internal valve collapse, on the other hand, is less apparent on the outside. However, the upper middle portion of the nose on either side looks narrow as you breathe in. Preparation for Nasal Valve Surgery Before getting the treatment, you must know what to expect and how to prepare for your procedure. As a general rule, you should not eat or drink anything for six hours before surgery. If you are taking any medications that thin the blood, you should stop taking them at least three days beforehand. You should also stop taking antihistamines at least 24 hours before the nose surgery because they can increase swelling in your nose. Finally, if you have a cold or allergy symptoms such as congestion or a stuffy nose, it’s best not to have surgery until they have gone away. This will help ensure that there is plenty of room inside your nasal passages during recovery from surgery on the nasal valve area. Are There Additional Ways to Fix the Valves? If your nasal valve collapse is causing you problems, there are a few other treatments that you can try. These include: Use steroid sprays and creams. Steroid sprays, creams, and pills are often used to help the nose heal from injury or surgery. These treatments help reduce inflammation in your nasal tissue and may help your nasal valve return to its normal position. Try a nasal valve dilator. A nasal valve dilator is used to decrease nasal airflow resistance. By reducing nasal resistance, it lowers the work of breathing. As a result, the oxygen supply to the body increases. Get nasal surgery. If other treatment options haven’t worked for you, then plastic surgery may be an option for restoring the structure of your nose so that it functions properly again. Surgery is also the only permanent solution to nasal valve collapse. After Surgery and Recovery After surgery, you can expect a recovery period of four to six weeks. You will be unable to exercise or play contact sports. You should also avoid alcohol and smoking. Additionally, you should avoid caffeinated drinks and spicy foods during recovery as well. If your condition worsens after surgery, you must follow up with your doctor immediately. If left untreated or ignored for too long, nasal valve collapse may lead to serious health problems such as infections and sleep apnea. Visit Dr. Julian de Silva – Rhinoplasty, London If you are experiencing nasal valve collapse, then seek out a specialist who understands individual nasal anatomy including your nasal valves. You should also choose someone who understands nasal breathing and conceals scar tissue well. If you want to work with a board-certified doctor who specialises in sinus surgery, contact me to book a consultation now!

Mid facelifts are procedures that put your cheek tissues back to their natural position. A cheek lift surgery is also known as a mid face lift. This procedure addresses one of the earliest signs of ageing, which is sagging cheeks. It also deals with the sagging found around the cheeks. But how exactly is a cheek lift surgery performed? In this article, I will discuss how much the lift usually costs and how it is usually performed. I will also answer commonly asked questions about the treatment. How much does a cheek lift cost? The cost of this surgical treatment for the cheek area depends on many factors. Depending on the location and the cosmetic surgeon in the UK, a cheek lift can cost £5,000 to £10,000. However, this is just a range. The actual cost depends on a lot of factors including your needs, goals, and the assessment of your doctor. It also depends on the type of facility used and post-care medications that you may need. To know the exact cost of the cheek lift, consult a facial plastic surgeon first. You may book a consultation with Dr. Julian De Silva here. You also have to take note that a cheek lift is a cosmetic treatment, so it’s not usually covered by insurance. This means that you have to pay out of your pocket. On the bright side, this procedure helps gain your confidence and improve your performance especially if you are in the entertainment business. Hence, a cheek lift it’s an investment that will give you a lot of benefits in the long run. How long does cheek lift last? The treatment can lift soft tissue for a decade or more. How long a cheek lift lasts depends on many factors. For one, it depends on how you maintain the results after the surgery. It also depends on your lifestyle and other health habits. For instance, if you are a generally healthy person and have a great skincare routine, the results of a cheek lift might last longer. In general, the results of a cheek lift can last for 10 years or more. In many of my patients, cheek lift results can last for over 10 years. Some of them enjoy the results for up to a lifetime, specifically those who had cheek lift surgery later in life. If you want the results to last longer, there are some things you can do. For one, you have to take care of your health. People who are healthy inside usually have healthy skin. Second, you need to have a proper skincare routine. You have to use the right products that will help you maintain the results of the cheek lift. Lastly, you need to sleep well and avoid stress. Stress can show up in your skin and this might affect the longevity of your cheek lift results. What is a cheek lift? This outpatient procedure deals with mid face sagging and restores your youthful contour. For most patients, a traditional face lift cannot totally treat the upper cheek of the face, which frequently flattens, sags, and lengthens with age. This is where a mid facelift comes in. By elevating the fat pads in the cheeks (also known as the malar fat pads), cheek lift surgery provides fullness to your cheeks and eyes. This results in a rejuvenated and refreshed appearance. Moreover, the results of a mid facelift are more permanent than the results of non-surgical treatments such as cheek fillers. In particular, a cheek lift reduces sagging on your cheeks. It also smoothens your nasolabial folds (also known as smile lines) on the sides of your mouth by removing excess skin. Adjusting the soft tissue of your cheeks to a higher position can also help fight the hollowing below your lower eyelid, which is another sign of the ageing process. A cheek lift is frequently done with other facial cosmetic surgical procedures, such as blepharoplasty or eyelid surgery, a neck lift, a brow and forehead lift, or rhinoplasty. When done all together, these cosmetic procedures offer full facial rejuvenation. As a result, you will look more refreshed and younger. You can also enjoy the results of this full facial rejuvenation for a decade or more. Because fat loss contributes a lot to midface ageing, an endotine midface lift is also frequently combined with cheek augmentation (via cheek fillers or cheek implants) or fat transfer to add volume. Another benefit of an endotine midface lift or cheek lift is that you can recover faster from the procedure compared to a traditional facelift. As you may well know, a checklist or midface lift is a surgical procedure. Hence, you should make sure that you consult reputable and experienced plastic surgeons like me, Dr. Julian De Silva. Doing so minimises the risk associated with the cosmetic procedure and ensures that you get the results you want. Doing so minimises the risk associated with the cosmetic procedure and ensures that you achieve the results you want. Can you get your cheeks lifted via a midface lift? This procedure is different from a traditional face lift. Yes, you can get your cheeks lifted. You can do this via midface lift surgery. During the side procedure, the cosmetic surgeon raises your cheek tissues back up where they’re supposed to be. By doing this, the tissues stay in place. The process makes your skin smoother and gives you a more refreshed appearance. When combined with a lower eyelid lift, the cosmetic surgeon removes the loose skin in the lower eyelid first and the bulging fat. Then, the procedure raises your cheek tissues higher using the same incision used for the eyelid lift. Moreover, during a cheek lift, fat it’s not removed that much. Instead, your cheek tissues are repositioned. By doing this, the line between your cheek and your lower eyelid decreases or goes away. A checklist procedure is usually an outpatient one. At last for approximately three hours. However, the duration will go longer if a cheek lift is done with other cosmetic procedures. Cheek Lift Surgery: What You Need to Know This treatment can be done with other procedures like eyelid surgery. If you see your cheeks are beginning to sag slightly, you can consider getting a cheek lift. This facial cosmetic treatment enhances the look of your saggy cheeks and the areas below your lower eyelids. As time passes by, the structure of your face depletes. Its once youthful shape sags and changes position. This leads to a tired and old appearance. This is where a mid facelift comes in. The procedure is designed to restore your face’s original shape by restoring volume to your cheeks and decreasing the appearance of smile lines. Since this procedure is a surgical one, recovery usually takes between two and three weeks. However, patients can resume their regular activities after a week or so. During recovery, you must avoid any vigorous or strenuous physical activity for at least two weeks. You should also take all of the medication and follow the aftercare guidelines that I will give. Cheek and Midface Lift This treatment enhances drooping cheeks and restores cheek volume. Contrary to popular belief, a cheek and midface lift are not different from each other. The terms are used anonymously in the cosmetic surgery or plastic surgery industry. So, if someone says that they want to get a midface lift, it means that they are considering having a cheek lift. What are the pros and cons of a cheek lift procedure? A cheek lift is a minimally invasive option to combat the ageing process. Here are the pros and cons of a midface lift: Pros of a Mid Facelift Procedure 1.Minimal Downtime The treatment helps restore your youthful appearance with minimal downtime, which is shorter than recovering from a traditional facelift. 2.Long-Lasting Results The results last for 10 years or more. 3.Easy and Convenient A cheek lift is one of the fastest facial surgeries. It’s also one of the easiest to perform. 4.Fast Results Most patients can see results a week after the said plastic surgery. 5.Longer than Fillers The results of the said plastic surgery last longer than dermal fillers which usually last for a year. 6.Safe and Effective When performed by a qualified and licensed cosmetic surgeon like Dr. Julian De Silva, a cheek lift is safe and effective. 7.Fights Ageing The procedure combats one of the first signs of ageing, which is sagging cheeks. 8.Gives You Confidence A cheek lift gives you the confidence and self-esteem that you need. 9.Helps With Your Work The procedure helps with your career, especially if you are working in the entertainment industry. Cons of a Mid Facelift Procedure 1.Surgical Treatment The treatment requires you to go under the knife, which some patients don’t like. 2.Risks Involved As with other cosmetic surgical procedures, the treatment involves risks such as numbness, swelling, bruising, and temporary hair loss. 3.Quack Doctors Many affordable plastic surgeons offer cheek lifts because of the procedure’s popularity. However, treatments as such are usually not safe and ineffective. Tense, you must only work with an experienced and board-certified cosmetic surgeon. Visit Julian de Silva – Facelift, London Are you looking for a reputable, experienced, and board-certified cosmetic surgeon to perform your cheek lift? Look no more. I, Dr. Julian De Silva can help you. Contact me now to start your journey to a more youthful appearance. As an alternative, you may visit my clinic at Harley Street, London.