Facelift in London – for Natural, Youthful Results
Leading London Facelift & Neck Surgeon Specialist
Over 1000 5-Star Patient Experiences
Faster Recovery Technology
FACELIFT SURGERY IN HARLEY STREET
What is Facelift Surgery?
As a double board-certified facial plastic surgeon with extensive training and a deep knowledge of facial anatomy, Dr De Silva remains at the forefront of his field by incorporating the latest surgical advancements. His approach to facelift surgery is both artistic and precise, enhancing your natural beauty while preserving facial harmony.
Dr De Silva is an expert in the Vertical Deep Plane facelift technique, renowned for lifting and repositioning the deeper facial tissues, providing a more natural and longer-lasting rejuvenation. By combining this advanced technique with meticulous skin closure methods, he achieves more natural results with reduced recovery time.
EXCELLENT
Based on 155 Reviews
Clare Halliday
I would like to share my experience of my face and neck lift with Dr De Silva. First and foremost I will tell you truthfully, that with all I now know for my experience, I would go through it all again tomorrow if I had too. It was so different from what you hear, and all the botched jobs you see. I picked Dr De Silva after much research, and the fact that he only specialises on the face, I made my appointment. From my first consultation till my 1yr check up, I can only but give him and his team 100% Dr De Silva has an extremely calming way with him. He puts you at your ease and explains EVERYTHING in minuet detail. He leaves nothing out, everything he said happened in that way. From having pre op’s till the day of surgery nurses Ellie and Josie were fantastic, so helpful and friendly. I was told by Dr De Silva that It would not be painful, just a bit uncomfortable, that was true. I had no pain at all at anytime from start till now, Swollen and bruised yes, the bruising had all gone in 2 weeks. Swelling took a little longer. I was also told it would be quite numb for some time. It was, but it didn’t bother me, and now I have very little numbness left. It can take up to 9 months I think. I didn’t want to look different, I didn’t want to change anything, all I wanted was to look rested and fresher, a better version of myself. I am soooo happy with my lovely tight neck and no more loose skin and hanging jowls. It has made the biggest difference to my confidence. No one has asked have I had work done, they just say “ you are looking great”. If you are thinking of a face lift or any facial work done, I can 100% guarantee you will not find a better surgeon… anywhere. My extreme gratitude to Dr De Silva, Dr Andre (anaesthetist). Nurse’s Ellie & Josie and to Sarah who sorted all the paperwork etc.
Angela Haines
Best of the Best! Incredible experience all round and natural looking results. I had originally seen Dr Julian De Silva for a consultation back in 2017 and had followed his work for years, so I was familiar with his style of surgery and artistry. I had studied his work of the ‘Golden Ratio’ and even bought his book years ago. At my first consultation, Dr Julian and his team immediately made me feel at ease. His wonderful team - Sarah, Mags, Mackez, Adam and the lovely nurses Alice, Josie and Kelly were all very kind and welcoming. I instantly felt at home. It’s a lovely energy when you go into 23 Harley Street and everything, including the operating theatre is there. Dr Julian De Silva’s kind and calm nature made him stand out from the rest of top surgeons that I had seen over the years. I didn't feel rushed, and he listened and understood my concerns. He explained to me about hyper mobility, where the skin can stretch at a younger age and this made sense why I was seeing premature signs of ageing such as ptosis and jowls forming. I felt relieved that finally a surgeon understood how I was feeling and didn't immediately turn me away dismissing me because of my age, saying I was too young etc. I knew he was the surgeon for me. A strong gut feeling and I trusted him 100%. I knew of his natural looking results from his previous work with other patients. He is truly an artist and has very fine attention to detail in his work. - Just look at his analysis of Renee Zellweger video on YouTube and you’ll understand what I mean. It is just over 3 months now since I had the operation and I am delighted with the results! My jowls have completely gone and I have my v shape jawline back. Dr Julian told me that the skin had dropped 2.5 centimeters and that is how much he had to lift it up again, which is a lot for someone my age and testament to the hypermobility. I can now wear eyeshadow without it creasing and my eyebrows are back to where they were pre ptosis! My confidence has come back and I am feeling so much more positive about how I look. My experience with Dr Julian De Silva and his team was second to none - No other surgeon could have done a better job. What I like about Dr Julian De Silva is his humbleness and integrity. He is not only a surgeon but an artist - He will look at the symmetry of your face and treat it like a work of art ; this goes beyond just surgery, this is artistry. From my results, especially around my eyes I can see how intricate and finely done with attention to detail he has perfected everything which makes for such natural results. The whole experience from the first consultation right through to the 3 month mark with several visits in between has been so enjoyable for me. I loved the whole experience of my trips up to 23 Harley Street. He has a great team who make you feel at home and comfortable straight away, they are very accommodating and always on hand with any questions or concerns you may have. It’s a lovely energy there. I have had consultations with other top surgeons in London and met their teams over the years but none have been on this level. Julian and his team are a rare find. I’m so pleased and grateful I picked Dr Julian De Silva and his team - I want to go back and get more things done for the joy of the whole experience, which says a lot!
Angela Irwin
Thank you to everyone for their professionalism and care. PS love the results week 1 to week 6. Completely pain free throughout, thanks again xxx
alexis val
I recently had a chin implant by Julian. It’s something I had considered for years but had felt apprehensive about, not knowing where to go and whom to trust. It’s a serious surgery and it was a bit stressful at the start, knowing where to look to find someone I could trust. I started by googling about chin implants and came across a few people in London who do them. I did as much research as possible by looking at before and afters, reading Google reviews, reviews on other sites like Realself, and looking into doctors abroad, etc… The great thing about Julian is that he has a lot of YouTube videos and content on Instagram that show him and his personality, along with people's experiences. Specifically, there are a few video diaries on his YouTube channel of people who have had this surgery, with a day-by-day step of their recovery. This really helped me and gave me peace of mind. I decided to have a consultation with Julian. The consultation wasn’t free but was definitely worth it. I felt listened to and didn’t feel rushed. I had an hour-long chat where I basically asked him to tell me which elements of my face could be treated to improve my appearance. Julian gave me concise information and it made complete sense. I was quoted for a couple of surgeries that I could have which would make a bit of difference to help balance things but from our discussion it was obvious that the chin implant would make the most difference. I took a few months to think about it but I decided to go for the chin implant. The operation was performed under twilight anesthesia. I hadn’t had this before and was a bit apprehensive but honestly it was absolutely fine and actually quite relaxing. All I remember is going into the theater, surrounded by lovely friendly nurses, feeling a bit sleepy, and next thing I know I’ve woken up in the theater. It felt like time had passed, I wasn’t groggy and within 30 minutes I was on my feet and could leave. For the next week after the surgery I was on quite a few different pills and I did feel quite out of it. Definitely do not have anything planned for the week following surgery, you will want to be at home with a few Netflix series ready to watch as you will need to rest up and let your body heal. It was a bit strange to smile for a few weeks after the surgery and my chin area felt a bit tight at first but you start to forget it’s there after a while. The result is very natural and I feel that I look a lot better, nobody has asked me if I have had something done but people have mentioned that I’m looking good but they aren't quite sure why haha. This is exactly the result I was looking for. The surgery isn’t cheap, it was upwards of £10,000 but was it worth it? For me, 100% yes. I just wish I had got it sooner tbh. There are other surgeons who are cheaper, you could go abroad to Turkey to get surgery or find someone based outside of London but in my opinion if you want this kind of surgery there is no point in trying to find a cheap option with a risk that it’s not going to be exactly how you want it. With Julian you have peace of mind that you’re with one of the leading plastic surgeons in the country, he also uses a technique that uses two titanium screws which attach the implant to the skull so that it doesn’t move. A lot of other surgeons do not use this technique and from reading reviews a lot of these people have had to get revision surgery to get an implant as it has moved over time because it wasn’t attached like the way Julian does them. Honestly, If you want a chin implant and want the best in the business, this is the doctor you want.
Ashka C
I had a wonderful experience with Dr de Silva and his incredible staff. He is such a gifted and caring surgeon and I cannot recommend the London Centre highly enough.
Michael Chan
I am a timid young man plagued by hereditary eye bags. Used all my options from the latest creams advertised to the newest hacks trending to no avail. I concluded that facial surgery is my only way forward as it was starting to affect my mental health. Discovering his accessible YouTube channel was invaluable to my research. Alongside his detailed website, this gave me the confidence to reach out to the clinic. I met Julian and his team back in February for my consultation and proceeded with my surgery in March. (2024) From the consultation with Julian I was immediately relieved from all my questions and worries about the procedure I was enquiring (lower blepharoplasty). Informed by his wealthy knowledge and articulate descriptions. His respectful manner helped alleviate any stress induced from my own research. I had my complete trust in him and he proved it to me with his vast portfolio of successful clients who've had the same procedure. In that instance I knew I had come to the right place and could set my mind at ease. The team are supportive with great communication. Professional and friendly. Nothing but respect and gratitude for them all. From my experience with Julian's practice I felt welcome, positive and hopeful. Also the twilight sedation that he recommends is excellent! You go into surgery and it’s like falling asleep, and once it’s over the nurse wakes you up and you’re alert and aware. Thank you so much! I can finally smile with my eyes again. Highly recommend Julian to anyone that is considering facial surgery.
ZaInab Hassan
Dr Julian De Silva is the best surgeon ever . He is down to earth, kind, honest and you will definitely get the best results. He is an expert in his field of medicine and the Surgery has a team of fantastic staff.
Alice Tibaldi Chiesa
Dr Da Silva and his all team are very professional, always available for follow up and very clear communication. Thank you
Ruth Johnson
Almost one year in ... I am still delighted. Surgery is not for the faint hearted. You need to be brave, and prepared for some bumpy times in recovery. But it's worth it. Julian de Silva is on another plane. Not only an exceptional (world class) technician, he is also an artist who doesn't paint by numbers. So easy for me to recommend ...
Facelift Surgery Can Treat…
As you age a combination of gravity, skin laxity and some volume loss occurs. This results in loose skin around the jawline and neck, bands and a more tired appearance. The natural elasticity of our skin diminishes. This results in fine lines and wrinkles, sagging skin, and a tired, aged appearance. A rhytidectomy offers a permanent solution for many common facial concerns.
Deep Nasolabial lines
A facelift can effectively treat deep nasolabial lines by lifting and repositioning the underlying facial tissues, smoothing these folds, and restoring a more youthful, natural contour to the face.
Jowls
By tightening and lifting the skin and deeper facial tissues, a facelift reduces sagging along the jawline, creating a more defined, youthful facial contour.
Excess skin
A facelift addresses excess skin by excising redundant tissue and tightening the underlying facial structures. This procedure improves skin laxity, enhances facial definition, and reduces sagging, particularly in the lower face and neck.
Marionette lines
Dr De Silva treats marionette lines by lifting and repositioning the deeper facial tissues, which helps smooth the vertical creases extending from the mouth to the chin, restoring a more youthful facial appearance.
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Interested in a Facelift in London? Discover Our Patient Results
Dr De Silva avoids a “one-size-fits-all” approach, focusing instead on subtle enhancements that bring out your best features while addressing areas of concern. Discover our real-life patient transformations.
VIEW MORE RESULTS
Schedule a Consultation with Dr Julian De Silva
Why Choose Dr. De Silva for a Harley Street Facelift?
Finding the most reputable facelift expert is never easy. Therefore, you should always research the best surgeons in your area and ask plenty of questions. Dr De Silva is a double-board certified facial cosmetic and plastic surgeon, author and global educator, with a track record of doing procedures for top celebrities. He is based at world-renowned Harley Street in Central London and specialises in four main procedures: Facelift and Neck lifts, Blepharoplasty, and Rhinoplasty. By specialising in only the face, you can rest assured knowing that you’re getting premier results.
- Over 1000 5* reviews
- Author of the Facelift Book
- International teacher of facelift & neck lift surgery at ASOPRS/ AAO
What Sets Dr De Silva Apart
Dr De Silva is a double board certified in the UK and USA and has spent time working in some of the very best Cosmetic centres in the World before setting up his practice over 10 years ago. His extensive knowledge of cosmetic surgery places him among an elite group of facial plastic surgeons, not just on Harley Street and Central London, but in the world. In addition to working as a facial plastic surgeon, he has also spent 8 years teaching fellow plastic surgeons in the USA.
“I have always been a passionate teacher and as director of the course I am committed to inspiring the next generation of surgeons.”
World-Class Facelift Surgeon
UCLA Jules Stein Eye Institute in Los Angeles and Montefiore Medical Center, Albert Einstein College of Medicine in New York.
State-of-the-Art Technology
Dr De Silva uses specialised state-of-the-art technology to improve the natural results or enhance the recovery or longevity of the procedure. These include a US-manufactured CO2 laser or monopolar electrocautery, to establish meticulous control of bleeding which is key to preventing both bruising and preserving good vision after surgery.
Discrete Scars
Key to world-class facelift is discrete and virtually invisible scars. There are many important factors to consider including, natural skin position, asymmetry, ethnicity, skin laxity, skin quality and other diagnoses. The skin incision is closed using a combination of interrupted and continuous non-dissolving fine stitches. Non-dissolving stitches are preferred as they avoid scarring and stitch lines. Dissolvable sutures although save time for surgeons as they don’t need to be removed, can create additional scarring.
Dr De Silva has pioneered and patented our Advanced Sedation Anaesthesia. This means patients can avoid the risks, complications and longer recovery associated with general anaesthesia. All of Dr De Silva’s patients recover from sedation quickly after procedures within 30-60 minutes!
Only the Face
By focusing entirely on only facelift & facial cosmetic surgery procedures, Dr De Silva is able to provide the expertise that can only come with specialisation: facelift and neck lift, blepharoplasty, rhinoplasty and chin implants.
Natural Looking Results
Dr De Silva is a believer in the importance of artistry behind cosmetic results and focuses his skills at delivering natural looking results.
Fast Recovery
Dr De Silva has pioneered the advances in technology to speed up recovery with a combination regenerative medicine techniques, Oxygen and LED Therapy.
World Class Expertise
Dr De Silva also teaches other surgeons internationally and has contributed to the development of advanced surgical techniques, laser technology and stitch-less tissue adhesives.
Types of Facelift Offered by Dr De Silva
While non-surgical treatments offer temporary improvements, a facelift provides a more durable solution to ageing signs, with results that can last for many years. There are a number of different types of facelifts available. As part of your consultation, Dr De Silva will thoroughly assess your skin and facial characteristics, and discuss your cosmetic goals with you, as well as the reasons for wanting to see an improvement in your looks.
Primary Facelift
For many years, the conventional facelift has been a staple for those who want to look younger. The procedure generally starts with an incision near the temples, going down and encircling the ear, and culminating at the lower scalp.
During the aesthetic procedure, the surgeon carefully adjusts the facial skin. They then address and enhance the underlying structures. The excess skin is then removed, and the remaining skin is neatly arranged for a rejuvenated appearance.
Signature Vertical Deep Plane Facelift
SMAS Facelift
Revision Facelift
A Skin-Only Facelift
S-Lift, MACS Lift
One Stitch Facelift
Mini Facelift
Endoscopic or Ponytail Facelift
Male Facelift
What our patients say about us…
Clare Halliday
Angela Haines
Angela Irwin
alexis val
Ashka C
Michael Chan
ZaInab Hassan
Alice Tibaldi Chiesa
Ruth Johnson
In the Press
What To Expect From Your Facelift in London
On the day of your surgery, you will be welcomed into The Centre for Advanced Facial Cosmetic and Plastic Surgery’s state-of-the-art CQC accredited facility and prepared for your procedure. This is what you can expect:
1. Facelift consultation
During your initial consultation, Dr De Silva employs advanced imageing technology to simulate potential outcomes, allowing for a collaborative discussion of your goals. This visual tool helps in setting realistic expectations and refining your personalised treatment. He will discuss your medical history, aesthetic goals and create a personalised procedure plan catered to your desired outcome.
2. Pre-surgery preparation
3. Day of Surgery
All surgery takes place in our Harley Street CQC-regulated practice. Dr De Silva uses modern anaesthesia, known as sedation anaesthesia, which is far safer and with a faster recovery than traditional general anaesthesia. In most cases, patients come around within 30 minutes after surgery.
Eyelid surgery can be completed in 1 hour. However, to obtain the best natural results that are long-lasting, the procedure will take 1-3 hours as it will require a combination of fat transfer, fat preservation, skin resurfacing, regenerative medicine, and attention to detail.
In upper blepharoplasty, the incision is hidden in the crease of the eyelid and is often difficult to see even 1 week after surgery. In lower blepharoplasty, the incision is placed either in the conjunctiva (termed transconjunctival) of the eyelid in which case it is completely hidden. Or the incision is just below the lower lid eyelashes (termed transcutaneous) within several weeks this incision is hidden by the eyelashes of the lower eyelid. Following the removal of excess tissue, Dr De Silva will carefully contour the eyelids to restore a rejuvenated, youthful appearance. This process may involve adjusting or extracting fat, along with removing any extra skin or muscle as needed. The small incisions will be closed with sutures, surgical tape or tissue glue.
4. Follow-up Appointment
5. Social Readiness
It is normal to experience some swelling and bruising for the first week or two. This will decrease over time. It is recommended to rest for the initial fortnight following your surgery, returning to work and your daily routine from the second week onwards. Avoid exercise for the first weeks and strenuous activity for a month. After a month you will be able to enjoy your blepharoplasty results.
Latest Facelift Patient Reviews
In this video, we'll take you through the patient's journey, starting from before the surgery, capturing her initial concerns and aspirations for the procedure. Then, witness the stunning results unfold as we reveal her post-op images taken at 10 weeks after the surgery. From addressing concerns about her appearance to regaining confidence and self-assurance, this journey exemplifies the transformative power of personalised cosmetic surgery.
Join us as one of our lovely patients shares her heartfelt journey after undergoing a transformative face & neck lift plus chin implant surgery with Dr. Julian De Silva. In this touching testimonial recorded six weeks post-surgery, she opens up about her long-standing desire for a chin implant and her journey to regain confidence in her appearance.
Join us as we sit down with one of our amazing patients who underwent a deep plane facelift, lower blepharoplasty, and full face laser procedure. In this heartfelt testimonial, she shares her honest thoughts and feelings about her experience before, during, and after the surgery.
Am I a Good Candidate for Facelift Surgery?
A good candidate for a facelift is facial ageing with symptoms of sagging of the skin and soft tissues of the face, deepening of the nasolabial folds (a line between nose and mouth) and loose skin below the neck with loss of the angle between the chin and neck. The patient should be in good health and a non-smoker with realistic goals of rejuvenating their face.
What to Expect from Facelift Recovery
You may experience bruising, which resolves over one to two weeks, and swelling, of which 80% will diminish within two weeks and continue to disappear. While you will have very little pain, you may experience numbness around the ears and chin, which can take six to 12 months to disappear completely.
It is important to rest and allow your body the time it needs to recover without putting it under extra pressure. You may be provided with a wrap for your face and head that helps with swelling and gently icing the area for ten minutes at a time encourages swelling to dissipate.
Sleeping in a reclined or sitting-up position is recommended for five to seven days after surgery. It is also recommended not to do any heavy lifting or strenuous activities for at least two to three weeks after surgery.
Benefits of a Facelift in London with Dr. De Silva
A facelift can help you look as young and vibrant on the outside as you feel on the inside, turning back the clock by several years. The main benefits of a facelift are:
- Decreased wrinkles and lines
- Lifted profile
- Natural, fresher appearance with a more youthful jawline and neck
- Tighter skin
- Natural results that boost confidence
Even the Best Facelifts Come With Risks
While facelift surgery is generally safe, it’s essential to be aware of potential risks and complications. However, with the extensive experience and advanced knowledge of Dr. De Silva, these risks are significantly minimized, ensuring that you’re in expert hands for a safe and successful outcome. Some potential risks include:
- Anaesthesia Complications: Reactions to anaesthesia can occur, ranging from mild to severe, affecting breathing and heart rate.
- Infection: As with any surgical procedure, there is a risk of infection at the incision sites, which may require further treatment.
- Scarring: Although efforts are made to minimise scarring, some individuals may experience noticeable scars, which can take time to fade.
- Haematoma: The accumulation of blood under the skin can lead to swelling and discomfort, potentially requiring drainage.
- Nerve Damage: Temporary or, in rare cases, permanent nerve damage can occur, resulting in numbness or changes in sensation.
It is essential to discuss these risks thoroughly with Dr De Silva during your consultation to make an informed decision about your facelift surgery.
Interested in a Facelift in London? Discover Our Patient Results
Dr De Silva avoids a “one-size-fits-all” approach, focusing instead on subtle enhancements that bring out your best features while addressing areas of concern. Discover our real-life patient transformations.
VIEW MORE RESULTS
Combine Your Facelift With Other Facial Enhancements
Recognising that ageing affects more than just the skin, Dr De Silva often recommends complementary procedures such as eyelid surgery or fat transfer to achieve holistic rejuvenation. This comprehensive approach addresses volume loss, skin texture, and tone, ensuring a cohesive and youthful appearance.
Chin Implants
Sometimes when the lower face is tightened, the chin can appear too small and out of proportion. Dr De Silva may address this through the addition of chin implants to create a more balanced and symmetrical result.
Laser Resurfacing
Dr De Silva may suggest incorporating CO2 laser resurfacing before your procedure to remove blemishes, smooth skin and create a radiant appearance that improves the overall results of your facelift procedure.
Fat Transfer
To further personalize your facial rejuvenation procedure, Dr De Silva may incorporate fat transfer to permanently establish volume in select areas affected by facial ageing for a harmonious and balanced result.
Buccal Fat Reshaping
Surgically sculpting the mid-face area may also require Dr De Silva to incorporate buccal fat reshaping into your procedure to minimise the appearance of jowls and turkey neck giving you a youthful facial profile.
Blepharoplasty
Integrating a facelift with blepharoplasty rejuvenates the face by addressing sagging skin and wrinkles while also refreshing the eye area, creating a balanced and youthful appearance.
Is Dr De Silva the right fit for your Facelift in London?
Choosing to undergo facelift surgery is a significant decision, and selecting the right surgeon is crucial. Dr Julian De Silva’s blend of technical excellence, artistic touch, and commitment to patient care makes him a standout choice for those seeking facial rejuvenation. As a father and a Family Man he understands how important our appearance, health and well being is for happiness.
- Dr De Silva combines state-of-the-art technology with facelift surgery for rapid recovery
- Discreet, barely there facelift scars
- Expert in beautification and facial mapping
Book a Consultation at Our Harley Street Practice
If you’re considering facelift surgery, we invite you to schedule a consultation with Dr Julian De Silva. Discover how his expertise can help you achieve the youthful, natural-looking results you desire.
Patient experiences with Dr De Silva
Facelift Frequently Asked Questions
A facelift will typically last for between 5-10 years. Different surgical techniques will impact the longevity of the effect. Dr De Silva believes that a patient who is undergoing cosmetic surgery is investing in their appearance and uses a modified deep plane SMAS facelift to give patients a more durable and longer-lasting result. There are patient factors, including genetic makeup and exposure to the elements such as the sun that will influence the duration of a facelift. Dr De Silva advises all his patients on lifestyle changes that maintain the results of their facelift and may suggest referral to one of his specialist colleagues. Patients are frequently attending for 2nd, 3rd and even 4th facelifts. Other areas of the face age differently to the lower face and neck.
Cost is tailored to an individual patient’s needs and is based on whether it is a full facelift, or neck lift and if there are associated procedures to enhance the result. Additional techniques include volume augmentation, skin resurfacing and specialised eyelid contouring techniques. A good long-lasting result that is free of problems is worth its weight, the quality of your care and outcome is most crucial. Lower-cost surgery may result in compromises in the quality of the result and safety. For an accurate assessment of price, a consultation is required. If you decide to have surgery, the consultation fee will be deducted from your surgical fee.
A facelift restores drooping of the soft tissues of the face and the sagging skin of the neck. A facelift will not treat volume loss, termed deflation, in patients with volume loss, Dr De Silva advises volume replacement with fat augmentation or filler that will enhance the facelift result. A facelift will not rejuvenate the skin, fine lines, dark spots and wrinkles. Dr De Silva will advise a combined facelift and skin-resurfacing technique to enhance the results. Commonly a CO2 laser is used to resurface the skin, in some patients of darker skin tones, it is advisable to use an alternative skin resurfacing technique.
In the UK, most facelift surgery is completed under general anaesthesia. Dr De Silva does generally use an alternative type of sedation used in conjunction with local anaesthesia. This 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.
A pulled look from a facelift is the result of an unsatisfactory aesthetic that is an unnatural rejuvenation of the face. A natural rejuvenation is one that restores parts of the face to their original position taking into account both individual facial ageing utilising specialised surgical techniques that respect the natural contours of the face.
For a natural-looking facelift and rejuvenation, Dr De Silva believes there are several facial plastic surgery factors that are of key importance:
- Elevation of the deeper layers of the face (including the SMAS, superficial musculoaponeurotic system) requires specialised surgical techniques and hours of surgery to complete. Fast techniques that are superficial, principally lift the skin resulting in stretching of the skin and a pulled look.
- Meticulous attention to detail is required, to ensure that scarring is limited to a fine line and lifting does not alter natural hairlines. With meticulous techniques, these issues can be avoided. Excessive pulling of the skin can result in distortion of the ears and wide scars that are hallmarks of unnatural surgery, with meticulous surgical technique these can be avoided.
- Browlift procedures were once fashionable to elevate the position of the brow. Many people have a naturally low position of eyebrows even in youth, and brow lifts are less commonly indicated and need to be conservative. Over lifting of the eyebrows results in a surprised and unnatural appearance.
- Artistry, every surgeon has a different aesthetic, and by looking at a surgeon’s before and after photographs, it will give an indication of this aesthetic.
- Often natural-looking rejuvenation requires additional treatments to give the best possible result. Common additional procedures include fat transfer, skin resurfacing and blepharoplasty.
When completing facelift surgery, many surgeons will insert a fine tube into the soft tissues at the end of the surgery (termed a drain) on both the right and left side to continue to drain fluid after the surgery; these are then usually removed between 1 day to 14 days after surgery.
In a small proportion of cases, after surgery, as a consequence of further bleeding, a collection of blood can occur that needs to be removed. Some surgeons believe that the use of a drain may reduce the chance of this complication. However, the drains are often uncomfortable for patients and cause discomfort on removal.
Dr De Silva does not use drains, using meticulous fine stitch technique to avoid the use of drains. There are other interventional techniques that can be used to minimise the risk of bleeding, including the use of fibrin tissue glue and post-surgery medications.
A mini facelift procedure is a technique that benefits a person with relatively early features of facial ageing, including facial sagginess with deep facial lines (termed nasolabial folds) with or without early jowls (softening of the smooth jawline) and some skin laxity in the cheeks and lower face. The key to suitability for a mini-facelift is relatively good skin elasticity and relatively mild changes in the lower third of your face and neck. The advantages of a mini facelift are that it allows for a small incision and a hidden scar with rapid recovery after surgery.
There are circumstances where a mini-facelift procedure is not adequate. If you have substantial skin laxity, marked jowls and droopiness in the neck include vertical bands (platysmal bands). With these features usually from your 50s, a full facelift is required to provide a natural rejuvenation. A full facelift requires a larger incision as more surgery is required to lift and rejuvenate the face. The incision is longer as it needs to extend behind the ear into the hairline principally to treat the increased skin laxity. At the same time, the incisions can be largely hidden in natural creases and contours to avoid visible scars after surgery. The recovery from a full facelift is approximately 2 weeks, although the final result is 6-12 months later.
Key to a natural rejuvenation in both mini-facelift and full-facelift techniques include meticulous attention to detail, lifting beneath the skin including the SMAS and deep soft tissue layers (to avoid a wind-swept appearance) and multi-layered closure (to avoid visible scars). Both techniques are effective at rejuvenating your face depending on your clinical needs, and an assessment is required to determine your individual needs and suitability for this facial surgery. Both techniques may be completed with other facial techniques, including blepharoplasty (eyelid lift), fat transfer (volume rejuvenation), and CO2 laser resurfacing to augment the natural results.
The duration of a facelift procedure can vary depending on the extent of the surgery and additional procedures being performed. Typically:
- Mini Facelift: Approximately 2 to 3 hours.
- SMAS Facelift: Approximately 2 to 3 hours.
- Deep Plane Facelift: Approximately 4 to 5 hours.
- Vertical Deep Plane Facelift: Approximately 4.5 to 6 hours.
- Extended Procedures: If combined with other surgeries such as neck lift, brow lift, or eyelid surgery, it can take up to 8 hours or more.
The best age to have a facelift varies depending on individual factors, but most patients consider it between 45 and 75 years old. However, earlier or later interventions can be appropriate based on specific ageing concerns.
Considerations for Timing:
- Early Signs of Aging: Some individuals in their late 30s to early 40s opt for a mini facelift to address early signs of ageing. Dr De Silva often finds that younger patients have genetic factors such as hypermobility or early menopause.
- Moderate to Advanced Aging: Patients in their 50s and 60s often seek full facelifts to address more significant sagging and wrinkles.
- In good health 70-80s: If in good health there is no age limitation for surgery. It is estimated that 50% of people who are born after 2000, will live to 100!
- Overall Health: Ensure you are in good overall health to undergo surgery at any age.
Measures to Determine Timing:
- Detailed Consultation: Have a detailed consultation with your surgeon to assess your skin condition, ageing pattern, and objectives from surgery.
- Non-Surgical Alternatives: Explore non-surgical treatments if you have minimal ageing signs, delaying the need for surgery.
- Maintenance Procedures: Regular maintenance treatments, such as fillers or skin resurfacing, can prolong the youthful appearance and potentially delay the need for a facelift.