Facial Procedures

The major concern patients voice about their lips is a desire for more fullness. A secondary concern is the size of the upper lip relative to the lower lip. You should decide what you want to achieve and describe this to me clearly.

The lip enhancement technique that I use creates greater fullness and roundness. It also restores youthfulness in the older patient. It is the procedure of choice for younger and older patients provided the lip tissue is not unusually thin.

The procedure takes about one hour for upper or lower lip. A local anaesthetic is used and the procedure is done in the theatre at my rooms. The incisions involve making three to four V shaped cuts on the inside of the lip and stitching the tissue in a new position. Dissolving stitches are used.

This technique goes a long way towards solving the problem of facial balance. It is possible to create a uniform fullness of the entire upper or lower lip and the incision is hidden inside the mouth. Small irregularities of the lip following trauma or cleft lip repair can be improved with this technique.

Following this procedure the lip will be swollen – considerably more swollen on the following day. Iceblocks or frozen facecloths held to the lip will help reduce swelling.

It will probably be a full week before swelling diminishes enough to “look normal”. In some patients the swelling takes up to two weeks to disappear.

In the first two to three weeks the patient experiences difficulty in moving his or her mouth – this is part of the post-operative process and is caused by the tightness of scarring together with the post-operative swelling. Although no one except your dentist will be able to see the scars you will be able to feel them with your tongue.

If you would like to talk to us about your requirements please do contact us at your convenience.

Excess tissue above and below the eyelids tends to make people look and feel old and tired. Skin laxity and excess tissue is often associated with swelling of the underlying fat and muscle.

Excision of redundant skin, muscle and fatty tissue in the upper lid helps to produce a more wide-awake look, whereas the removal of excess fatty tissue and the wrinkled skin of the lower eyelid has a rejuvenating effect on the face.

Bags (lower lids)
Puffiness of the lower eyelids or “eyebags” is caused by swelling or growth of fatty tissue behind the muscle in the lower eyelid. This becomes more apparent in men and women with age. It may become noticeable earlier in women who retain fluid premenstrually, after crying, or in people suffering from thyroid disease. Swelling of the fat below the eye stretches the overlying muscle and skin so that it becomes loose and wrinkled.
This swelling is often more apparent in the morning because fluid, which accumulates in the fat around the eyes as you lie flat, has not had time to disperse. For this reason, it often looks worse after a late night. This accumulation tends to dissipate as you move about.

Creases
These are caused by skin ageing which leads to skin laxity. The skin may also be stretched by underlying fat and muscle action. The eyelid muscles can also be thickened by screwing up the eyes as in bright sunlight. Both the excess fat and thickened muscle can be corrected at the same time as the skin is redraped to produce a smoother appearance. Excess skin is also removed.

Upper lid laxity
Loose upper lid skin can impair vision an produce a tired look. Laxity of the upper lid caused by looseness of the skin itself can be corrected by blepharoplasty, but if it is caused by heaviness of the eyebrow or forehead a browlift may be a more appropriate procedure.

Most people requesting blepharoplasty are in their middle years. Young people with an inherited problem of lax upper or lower lids, or fat herniation (fatty bulge), may seek treatment.

People who are blind in one eye, or who have greatly diminished vision in one eye, are generally advised against surgery in case the normal eye is damaged during the operation.

A consultation is necessary to find out whether the problem involves the upper or lower lids, or both.

As well as establishing what will be the best procedure for you, complications and risks are discussed during this consultation which will take around half to three quarters of an hour. The consultation will also cover the ‘mechanics’ of the procedure, what anaesthetic will be best for you, and any questions you may have regarding the procedure.

For more details and information on pre-operative instructions use this link.

The blepharoplasty procedure can be performed under local anaesthesia, which numbs the area, combined with a sedative to make you drowsy. You’ll be awake but relaxed, and will feel minimal discomfort.

We will decide the best type of anaesthesia during the consultation.

Expect day-stay treatment if you are having either upper or lower lid surgery. You may need an overnight stay in hospital if you are having both lids treated. Complete rest is essential for a couple of days after surgery, and you will need eyepads on your eyes overnight to rest the eyes and cooling pads for two days afterwards. Dark glasses may be needed for two to three weeks to disguise any bruising.

You should avoid eye make-up for a week to 10 days as this may irritate the eyes. You will have stitches removed five days after surgery.

Thin scars may be noticeable for a short time, but soften quickly and can be readily covered with makeup. We will monitor this with you post-operatively.

For further information please read the post operative instructions and if you have further questions my staff or I are available to talk to you should you have any concerns.

If you would like to talk to us about your requirements please do contact us at your convenience.

I use an advanced, innovative technique of fat grafting which uses your own fat to restore volume. This involves fat grafting through a gentle low pressure harvesting method, purification process and re-injection technique.  

Fat is usually removed form the abdomen, hips or thighs and put into certain areas of the face, especially the areas where additional volume is required such as under the eyes, the nasolabial folds, cheeks, lips and pre-jowl hollows. This is usually carried out using local anaesthetic and IV sedation (unless combined with a longer procedure for example a facelift) on a daycase basis.

Fat grafting appeals to a lot of people because it is minimally invasive and does not require traditional facial incisions. Another advantage of fat transfer is that the body does not reject it.

In addition to the usual post operative risks (such as soreness, swelling and bruising) a level of fat resorption is expected after the procedure as a percentage (30-50%) of the transferred fat does not survive. As a result of this the procedure is often ‘staged’, and a further procedure may be required to produce the desired results.

Your face will look fuller and more youthful following your fat grafting procedure.   At first you might notice some localised swelling which will settle down within 1-2 weeks.

Since this is a minimally invasive procedure it can sometimes be performed under local anaesthetic in the office surgery, which keeps down costs, reduces downtime while no lengthy time is required away from daily activities.

Makeup can be reapplied post operatively and if any bruising has occurred. Concealer or foundation can be applied to the affected area.

This procedure reshapes the ears or corrects prominent ears so that they lie flatter against the head.

Prominent ears can cause anxiety whether the patient is a child or an adult. Experience has shown that psychological reassurance seldom makes the person with this problem feel any better, so early surgery is usually recommended. There is no reason why an ear correction operation cannot be carried out just before a child starts school or soon after. Conversely, there is no reason why this procedure cannot be carried out on an adult patient of mature age.

If the patient is a child or young person they must be involved in the decision-making process with his or her parents. It is important to distinguish between ears which are prominent and ears which look unnaturally big. Children’s ears often look unnaturally large until the skull is fully grown so operations to correct this appearance are inappropriate.

In some cases, the ear cartilage does not develop with the usual folds, so the ears protrude at an angle from the head. The ears can affect the choice of hairstyle and frequently affect a person’s lifestyle to the extent that he or she may avoid swimming because their ears protrude through their wet hair. At first it is the parents who are concerned that their child may be teased at school and may ask to have their child’s ears corrected.

The technique currently used for prominent ear correction uses incisions behind the ears. Through these incisions the ear cartilage is reduced in size and missing folds are created.

The operation will largely correct the obvious prominence of the main body of the ear but there may still be a tendency for either the lobe, or the top of the ear to protrude further from the head than the middle part. Every effort is made to avoid this type of protrusion but sometimes it is unavoidable because of inherent differences in the texture of the cartilage framework of the ear.

The ear correction procedure is often done in a day stay facility using local anaesthetic. The surgery usually takes about two hours. For a very young child a general anaesthetic would be used and the procedure would be done in an overnight facility.

If you look carefully at the ears after the operation one ear may appear to be a slightly different shape to the other. However, this is not usually noticeable to other people, as few people look at both ears simultaneously, or compare their shape unless there is an obvious deformity. In fact, few people have two identical ears.

The ears are covered with dressings and the head bandaged for about a week. Some padding is needed over the ears at night for the first two or three weeks to avoid the ears being displaced. Sutures are left behind the ears for a week to 10 days.

For further information please read the post operative instructions and if you have further questions my staff or I are available to talk to you should you have any concerns.

Complications are unusual with ear correction surgery. Infection is rare but may occur if there are retained blood clots beneath the skin. Scarring is inevitable but the scars behind the ears usually soften and become barely noticeable. Dark-skinned people have a greater tendency to produce heavy scarring.

If you would like to talk to us about your requirements please do contact us at your convenience.

The browlift operation corrects the heavy overhanging folds at the outer half of the upper eyelids and lifts the outer parts of the eyebrows. It also improves the creases on the forehead and the central forehead frown lines.

A browlift creates a marked rejuvenating effect on the face by opening up the eyes and producing a much more wide-awake look. Endoscopic surgery applies the principle of minimally invasive surgery to the browlift, reducing scars numbness and hair loss.

Most people have the operation to get rid of the overhanging folds at the outer half of the upper eyelids and the heavy droop of the eyebrows. These heavy folds cause a dragging feeling in the eyelids and eyebrows, and frequently cause headaches because the frontalis muscle is in a state of constant contraction to lift the eyebrows.

It is now accepted that in some people the standard upper eyelid blepharoplasty operation does not fully correct the excess or redundant tissue in the outer half of the eyelid. This is because some of the skin laxity in this part of the eyelid may be due to redundant skin from the forehead or eyebrow, rather than the eyelid skin itself.

Some people have a browlift to eliminate forehead and frown lines at the same time as a facelift. A browlift has no effect on the lower part of the face – around the cheek folds or the jowls over the lower jaw-line.

It is most common for people in their thirties and forties to have this procedure, but it may be performed on much younger people who may have inherited heavy, droopy eyebrows and fullness in the upper eyelids

Most people have the operation to get rid of the overhanging folds at the outer half of the upper eyelids and the heavy droop of the eyebrows. These heavy folds cause a dragging feeling in the eyelids and eyebrows, and frequently cause headaches because the frontalis muscle is in a state of constant contraction to lift the eyebrows.

It is now accepted that in some people the standard upper eyelid blepharoplasty operation does not fully correct the excess or redundant tissue in the outer half of the eyelid. This is because some of the skin laxity in this part of the eyelid may be due to redundant skin from the forehead or eyebrow, rather than the eyelid skin itself.

Some people have a browlift to eliminate forehead and frown lines at the same time as a facelift. A browlift has no effect on the lower part of the face – around the cheek folds or the jowls over the lower jaw-line.

It is most common for people in their thirties and forties to have this procedure, but it may be performed on much younger people who may have inherited heavy, droopy eyebrows and fullness in the upper eyelids

You should expect to stay in hospital over night when you have this procedure and you should allow 10 days before returning to work. The operation is performed under general anaesthetic and usually takes two hours to complete.

For more details and information on pre-operative instructions use this link.

To minimise swelling after surgery you will be kept in a sitting position overnight. It is important for you to try to maintain this position as much as possible during the following week to 10 days, until all the swelling has subsided. At first there may be some swelling of the eyelids but this generally settles quickly and clears within a week.

There should be very little pain after the operation. You should be well enough to have someone drive you home the day after surgery.

At first there may be some numbness of the skin on the forehead. This improves within the first few weeks. Very occasionally there may be some weakness of the forehead muscles, but again this normally rectifies itself within a few weeks.

As a brow lift tightens the forehead there is an exaggerated elevation of the eyebrows for two or three weeks after the operation. The eyebrows come down to an acceptable level within a couple of weeks and the forehead will look smooth without looking unduly tight. Gradual movement returns to the forehead.

For further information please read the post operative instructions and if you have further questions my staff or I are available to talk to you should you have any concerns.

If you would like to talk to us about your requirements please do contact us at your convenience.

These dynamic wrinkles can be erased using non-surgical treatment. The treatment allows the overlying skin to remain smooth without affecting the normal facial expression and lasts for four to six months.

Please phone or contact my rooms for advice on treatment for Frownlines & Crowsfeet.