Cosmetic Surgeons London: Facial Rejuvenation in London

Four lid blepharoplasty – assessment and operative sequence.

The Face

We take pride in a facial rejuvenation and recontouring service that combines the best of what surgical and non - surgical techniques can deliver. Our aim, as always, is to refresh and rejuvenate without the tell - tale signs of surgery. We often combine the best techniques of eyelid recontouring (eyelid tuck, blepharoplasty), face and neck lifts, and browlift to achieve an excellence of results that complement the adjacent aesthetic units of the brow, eyelids, face and neck.

Choosing from a range of strategies to suit the individual, we often combine non - surgical therapies, such as botox, chemical peels and fillers with contemporary surgical approaches. We seek to achieve a refreshed, harmonious, smooth contour with volume balance for smooth curves, minimal shadow, and symmetrical facial definition. Our strategies may address skeletal surgery such as in rhinoplasty (nasal reshaping), genioplasty (chin recontouring), or cheek augmentation; alone or in combination with soft tissue redefinition (such as 'volumetric' facelift).

Often, a component of this improvement may be in the quality of the skin itself, and in conjunction with our practice nurse, we will provide a comprehensive skin assessment and treatment programme. The balance of the face and hairstyle may be greatly influenced by the ear shape and position, and we provide a balanced ear setback and reshaping service. Many of our procedures may be done under general, local or twilight anesthesia, and our anaesthetic team is fully experienced in the best techniques for you, and your aesthetic aims.

For the Eyes

- Why Choose Us?

We have an absolute familiarity with the anatomy and aesthetics of the eyelids
We are regularly invited to teach and present our results to colleagues and trainees
We combine a wide experience of eyelid reconstruction, rebalancing, and aesthetic surgery into a bespoke approach for each individual

Full range of eyelid reshaping

We plan our approach and advice in the context of the whole facial aesthetic
We combine surgical and non - surgical techniques where required
We recognize not all aesthetic eyelid surgery is about ageing - but also familial trait (eyebags for example) and improving shape and symmetry

Blepharoplasty (Eyelid tuck) is an operation designed on a bespoke and individual level to

Remove excess skin and wrinkles from the upper eyelids and/or lower eyelids,
Remove or recontour eyelid bags,
Harmonise the eyelid and cheeks, to minimize shadow, and refresh and rejuvenate the lids/face

Blepharoplasty for both upper and lower eyelids encompasses a wide range of surgical procedures, ranging from simple excision of excess skin, to more complex re-draping and re-tensioning of the eyelids and removal of intra-orbital fat with or without removal of eyelid muscle. Canthopexy surgery may be incorporated to elevate the outside margin of the eyelids to produce a pleasing up-curve, and support the eyelids. Blepharoplasty can be combined effectively with brow lift surgery, which influences the position of the eyebrow, and maybe a required combination procedure to achieve the desired effect. Similarly blepharoplasty can be combined with a variety of face - lifting procedures as required.

Upper lid definition

We recognize the differences in upper lid aesthetics between men and women, and different cultural backgrounds
We use a variety of upper lid and brow reshaping techniques to achieve the best balanced results
We bring a broad experience of surgical and non - surgical techniques to minimize scar, and deliver a non - operated look

Upper eyelid blepharoplasty can be designed to remove excess skin and wrinkles from the upper eyelids, reform the upper lid crease, remove fat and increase definition, and provide a defined upper lid shelf for the easier application of makeup! It 'opens' the eyelids, reduces tiredness in the brow by the end of the day, and improves the upper visual field, reducing the sensation of 'heaviness'. Done under local or general anaesthetic it is one of the highest satisfaction procedures in aesthetic/cosmetic surgery for men and women.

Outer corner uplift

We have a broad experience of orbital and eyelid surgery to understand lid shape and dynamics
We optimise lid aesthetic shape and eyelid function and comfort

Lateral canthoplasty surgery may be undertaken to lift the outer corner of the eyelid, and is often combined with surgical or non surgical browlift to deliver a 'cat's eyes' upcurve if requested. It is pleasing when undertaken properly in conjunction with the appropriate facial form. Lateral canthopexy surgery is technically different, and is commonly used to support the lower lid when appropriate with blepharoplasty techniques, or to subtly change the curve of the outer part of the lower lid.

Lower lid eyebag removal

We recognize that not all eyebags are the same!
We will use the best technique for the problem in question - at the level of eyelid skin, fat, muscle or a combination as required

Lower lid eyebags arise form a variety of factors, solely or in combination. These include orbital fat protrusion against the lower lid, an excess of skin and muscle, swollen lower lid muscle and/or skin, and globe prominence against a flat cheekbone. A thorough expert assessment will reveal which of these factors are contributing to lower lid eyebags, and the appropriate treatment can be chosen - lower (or upper) lid eyebags are not always age related, can be inherited, and the aim of treatment is to harmonise the eyelid and cheeks, to minimize shadow, and to refresh and rejuvenate the lids/face balance.

Eyelid tucks

'Eyelid tucks' are a common request and mean the same as 'blepharoplasty' or eyelid reshaping surgery (see this link). Eyelid tucks are planned on an individual basis - see 'full range of eyelid reshaping'.

Tear trough rejuvenation

We understand the unique anatomy and causation of the 'tear trough'
We use a comprehensive, harmonious rejuvenation of the lower eyelid to include the tear trough and smooth the lid - cheek junction
We use injectable fat or filler techniques where indicated in selected cases

The tear - trough is the valley of shadow between the nose and the lower eyelid, and is best treated in combination with blepharoplasty surgery, designed to refresh and rejuvenate the whole lower eyelid. Occasionally, injected natural fillers, either plant - derived, or one's own fat, may be used to de-emphasise the tear trough, either as an individual treatment or in combination with eyelid reshaping surgery when necessary.

The sunken eyelid

sunken eyelids may be a family trait and can be corrected by an appropriate blepharoplasty technique
sunken eyelids may result from over resection of fat during blepharoplasty surgery, and in some cases can be corrected

For the Face

Our skills in facial surgery build upon a depth of experience in aesthetic surgery, the correction of craniofacial birth anomalies, and craniofacial reconstruction after accidents and cancer
We are regularly invited to teach and present our facial aesthetic surgery results to colleagues and trainees
We combine our wide experience of craniofacial aesthetic and reconstructive surgery and our familiarity with facial surgical anatomy into bespoke aesthetic surgery solutions

Brow lifts

We don't just lift, but reshape the brow in the context of the individual face
Our brow lifts techniques encompass all the planes of the brow for the optimum stable result
We choose the correct incisions, including short scar approaches, for men and women and different styles of hair design

Browlift is in fact a combination of lifting and spreading the brow, to rejuvenate and refresh the upper third of the face. We often combine surgical techniques with non - surgical, injectable techniques such as botox or dermal fillers as discrete wrinkle - busting solutions against a rejuvenated brow. Browlift can be undertaken via a coronal ('Alice - band') incision, short scars behind the hairline and the operating telescope (keyhole surgery), and also via the upper eyelid crease. Stable fixation of the brow by a number of available techniques results in reliable long term results, as demonstrated in our aesthetic and reconstructive practices.

Brow softening and feminisation

We recognize that the female brow has a characteristic curve and shape against the face
We use a variety of brow reshaping techniques and upper lid combination surgery to achieve the best balanced results
We bring a broad experience of craniofacial assessment and surgery to balancing the bone and soft tissue of the face in facial aesthetic surgery

The female brow projects and curves in a different, gender specific manner from the male brow, and often brow reshaping is the correct operation when upper blepharoplasty is requested. The harmonisation of brow and lids is a specialist area where the correct assessment is paramount in selecting the correct operative response.

A full range of facelifts

Our experience in facial restoration in all fields of reconstruction and the care of childhood birth anomalies gives an unparalleled understanding of facial form and function
We use a range of safe and proven techniques in all planes of the face to design the appropriate individual approach
Our assessment is individual and bespoke. We will always give a range of options where appropriate - based upon your circumstances and choices.

Facelift surgery is not a 'one size fits all' approach. Facial rejuvenation is about volume balance, and not about stretching of the skin - which results in a 'give-away operated' look! 'Volume balancing' of the face, the definition of the key points of the face, and the hiding of scars by good surgery and aesthetic sense is what quality facial rejuvenation should be about. You will get honest advice, informally given and illustrated by our own work, followed by quality aftercare in every stage of recovery.

Masklifts

We recognize that not all patients/facelifts are the same.
We will use the best technique for the problem in question..

'Masklifts' in aesthetic surgery come from a development of contemporary craniofacial surgery. In modern aesthetic surgery, masklifts can be used as originally conceived to rejuvenate the upper, middle, and lower thirds of the face together, or the original 'masklift' concept can be split up and applied to different facial components separately. Often the principles of modern 'keyhole' or endoscopic surgery are combined with the masklift philosophy to deliver very powerful rejuvenation without an 'operated' look.

Miniface and Jowl lifts

Some patients wish to choose minimal surgery do deliver specific change - and we can advise appropriately
Certain features, including the jowl, can be treated with minimal surgery and downtime, or as part of the wider facial aesthetic with more comprehensive procedures

Occasionally we are asked for minimal surgery to achieve a specific result. This might be in response to the need for a very quick recovery, or a co - existing health concern that demands a short procedure. In these cases a range of minilifts, jowl lifts, and combination surgical, and non surgical approaches may be justified and will achieve the desired result.

Necklift

We will closely analyse the neck, jowl, and face
We will offer the correct necklift for the appropriate aesthetic problem
We will combine necklift techniques with chin repositioning or facial aesthetic procedures where necessary

Necklift surgery combines a correct analysis of the 'slack neck' with knowledge of the correct anatomical technique to correct it! A 'slack neck' lacks triangular muscle contour and loses the sharp definition of the chin and neck. There are many surgical techniques to tighten the platysma muscle of the neck and re-contour the overlying skin - and we will select the correct one to create a pleasing neck aesthetic.

Chin advancement & setback

We will assess the chin position in relationship to the whole face, neck and nose
We will offer the correct genioplasty (chin repositioning) to achieve a contoured facial balance
We use only the safest and most stable techniques

Genioplasty (chin repositioning) is a very effective technique to rebalance facial contour, masculinize or feminize the chin as required, and rejuvenate/recontour the neck. Our preferred technique is to reposition the bony chin point itself, with the overlying soft tissues to improve neck contour. This allows finely tuned and bespoke chin point remodelling. Alternatives include the use of securely fixed implants, which have advantage in some cases, and can be discussed on an individual basis.

Cheek Augmentation and implants

We will offer a range of techniques to provide midface volume and sustain that youthful bounce!
We will discuss with you the full range of surgical and non surgical volumising techniques
When surgery is advised, we will discuss the choice of implant-based cheek rebuilding, or soft tissue cheek lifts and advise on the best bespoke approach

The cosmetic appearance of the face has much to do with the volume balance of the face - not with stretched skin! Cheek volume can be restored with 'volumetric' facelifts, and a variety of other surgical and non surgical techniques to restore gentle volume balance without a stretched look. A subtle 'high cheek bones' aesthetic can be created with a pleasing contour into the lower eyelid and temple.

Jaw masculinisation and feminisation

The lower third of the face delivers a strong or a subtle signal in facial aesthetics
We can offer a range of techniques to strengthen or soften the jawline

Lower jaw remodelling is often combined with facelift or chin repositioning surgery to deliver a stronger jawline in men or a softer aesthetic in women. We will discuss your options and indications in this specialised form of aesthetic craniofacial surgery.

Cheeklifts

We will offer a range of techniques to provide midface volume and sustain that youthful bounce!
When the solutions are surgical - there will be minimal visible scar, and a natural longevity to the result.

Cheeklifts are part of a series of 'volumetric facelifts' - see above - that may be undertaken via small lower eyelid incisions or more widely from the temple. We will design the correct approach for you, with hidden scars and due attention to the neighbouring aesthetic units of the face for the correct facial balance. Our wide experience of these techniques in aesthetics, facial palsy, post trauma and cancer surgery means that we will design the most favourable, natural and sympathetic result - on a bespoke basis.

Brow and Orbital reshaping

We recognize that the peri - orbital and brow aesthetics are different in men and women and in people of different backgrounds
We use surgical techniques in different facial planes to add volume and curve to the brow, eyelids, and cheeks
We deliver a natural rejuvenated midface, with youthful curve and definition

Peri - orbital rejuvenation is a specialist area of facial aesthetic surgery and non surgical intervention. When the solutions are surgical - there will be minimal scar, and a natural longevity to the result. We regularly teach and train colleagues and trainees on these subjects, and will deliver an honest opinion on what can be achieved.

Facial liposuction, Fat transfer and Fat Augmentation

Facial fat sculpture techniques are specialised
Fat volume reduction and augmentation of the neck and face is a powerful tool in the right application

Fat sculpture of the face, by reduction liposculpture or by fat injection for volume augmentation requires regular working knowledge of the skeletal and soft tissue balance of the face. From our experience in facial aesthetic surgery and craniofacial reconstruction, we bring together the tools of remodelling both 'hard' and 'soft' tissue for bespoke craniofacial aesthetic surgery solutions.

Lip Augmentation

We use magnified microscopic control to deliver subtle, effective recontouring of the lips
We will offer a range of techniques using natural biodegradeable products or your own tissues
Your facial assessment will encompass the whole peri - oral area, and dental aspects where necessary, to create a confident smile

Lip augmentation has had a 'bad press' from the actions of less than scrupulous practitioners injecting less than proven materials. The truth, however, is that pain - free, beautiful lips are made possible by controlled, delicate augmentation with the correct technique after expert facial assessment.

Ear Reshaping

We appreciate the differences in adult and childrens' ear reshaping surgery ('pinnaplasty')
We will choose the best technique to minimise downtime and maximise results

The visible ear is a cartilagenous framework with an overlying skin envelope. As such we can use the properties of cartilage, which are distinct and different in adults and children to reshape the ear, and set it back where required, to achieve a balanced aesthetic result. We aim for an 'un-operated' look, minimal time off work or from school and a stable result from our surgery, under local or general anaesthetic.

Ear Setback

We appreciate the differences in adult and childrens' ear structure for ear setback surgery ('pinnaplasty')
We will choose the best technique to minimise downtime and maximise results

Not all ears are the same! In 'setback pinnaplasty' our aim is for a non - operated look for a balanced ear form - for a result that no-one but you, your child and your family notice! The aim of ear reshaping and setback, unlike other aesthetic surgery of the face, is to generate a result that no - one notices... Most candidates for ear reshaping or setback wish to repair ears that too may people notice - and our surgery is designed in a bespoke manner to address each individual request.

Face and necklift – assessment and operative sequence

For the Nose

- Why Choose Us?

We have a proven experience in aesthetic and reconstructive rhinoplasty, and a specialist practice in secondary and revision rhinoplasty by referral
We will offer and explain the relevance of both surgical and non surgical strategies, including the roles of 'open' and 'closed' rhinoplasty
We will assess your nasal breathing and improve it where required
We combine techniques of nasal reconstruction where necessary

Full range of nasal reshaping

We will assess the nose in the context of the full face, brow and chin
We will record and explain your naso - facial balance, and the strategies to improve it
We will assess the nose in full smile and repose - to plan your surgery for all eventualities!
We will aim to achieve your aims - but will also explain why they may not be advisable where this is the case

Dorsal hump removal

We will reduce the dorsum of the nose with hidden scar, and a predictable balanced result
We will treat the dorsum in harmony with the rest of the nose, the brow and nasal tip, in smile and repose
We will choose our technique to match the thickness and quality of your skin - to minimise irregularity

Tip defining surgery

We are experienced at tip reshaping for 'bulbous' and 'boxy' nasal tips
We use cartilage graft and suture techniques for fine nasal contouring where necessary
We take every step to maximise cosmetic result, and minimise visible scar and contour irregularity

Nasal reconstruction rhinoplasty

We bring aesthetic judgement and the reconstructive experience of post accident care, post cancer surgery, and nasal anomalies from birth to each problem
We keep an extensive record of our cases, using each to benefit the next
We use a broad range of bone, cartilage and soft tissue reconstruction techniques where necessary to achieve the best aesthetic and functional result

Straightening the nose

We will analyse the 'bent nose' with you to define your aims in all views of the face
We will combine techniques of nasal bone surgery, septoplasty, and cartilage surgery to straighten the nose in all planes
We will assess your breathing and improve upon it where this is possible