What is a face and neck lift?

Written by Dr. Julian De Silva

A face and neck lift can rejuvenate your facial appearance by turning the clock back, reversing signs of facial ageing, lift sagging jawline and loose skin, refresh enhance your neck shape and improve facial lines.

Facelift surgery is termed rhytidectomy in medical jargon and was first described over one hundred years ago. There have been huge advancements in technique and surgical innovation over the past three years.

Face and neck lift surgery are one of the most commonly performed cosmetic operations that Dr De Silva completes for patients. Dr De Silva’s has pioneered a customised facelift and neck lift technique to provide a natural-looking result for each patient. Key with this surgery is a combination of meticulous surgical technique and artistry to tailor to each person’s facial characteristics.

Why have a facelift?

The most common reasons people seek facelift surgery is for freshening up their appearance, often they have become more aware of a tired appearance, which may effect relationships or be relevant to work. Common fears patients express to Dr. De Silva including looking different, and people noticing. Key with any treatment is respect to your natural features and a rejuvenation that is customised to you. Frequent changes include loose skin, loss of jawline, neck fullness and loss of a youthful appearance with lines and folds. Other patients have become frustrated with fillers and non-surgical treatments, there is a limit to what can be achieved with these techniques, and a facelift may provide a more effective long-term solution. Ageing starts to show in our late 20’s with the development of fine wrinkles and lines. It speeds up significantly from our mid 40’s where the descent of the face with volume loss causes droopiness of the lower facial third of the face with jowls, loss of a smooth jawline as well as laxity of the neck skin. Some women describe the acceleration of ageing through the menopause with more laxity of their skin, further loss of their jawline and bands with loose skin in the neck. This can result in patients feeling self-conscious and frustration with a more tired appearance. Our thoughts about our appearance can have an important influence on all aspects of our lives. Dr De Silva has helped many thousands of patients by improving their facial appearance. After a facelift, you will look the same, only refreshed, reducing those feelings of being self-conscious and enabling you to get on with life.

Facelift (Rhytidectomy)
Why have a facelift?

Dr De Silva’s facelift techniques

With facelift surgery, Dr De Silva’s philosophy is that there are several important aspects of facial surgery:

  1. Natural result, look refreshed however friends and family cannot tell
  2. Customised signature technique (deep plane facelift only performed by less than 5% of general plastic surgeons) & neck (advanced techniques to give youthful shape)
  3. Fast recovery techniques (surgical refinement techniques, use of high-concentration Oxygen, personalised regenerative medicine, Growth Factors, PRP and Amniotic tissue all enhance recovery)
  4. A personalized journey where we support you during your recovery.
  5. Safe approach with sedation anaesthesia (avoiding risks associated with general anaesthesia)

Each of these aspects we have refined and improved to give you a smooth experience and recovery. Facelift surgery is considered a technically challenging cosmetic surgery; a great-looking facelift requires a balance of respect to a patient’s genetic make-up, surgical technical excellence and the surgeon’s artistic talent. Dr De Silva has developed a signature deep-plane facelift that incorporates his artistry and experience from working in the cosmetic centres of Los Angeles and New York. Our customised approach facelift restores the areas of your face and neck to where they used to be, natural and long-lasting. Twenty percent of our patients have undergone surgery elsewhere and are regarded as revision surgery, in addition we are trusted by professional actors and performers (whose natural appearance is paramount to their career). Dr De Silva customises every facelift to the patient’s facial characteristics and often will use complementary treatments to improve his patients’ results and enhance their recovery.

Facelift (Rhytidectomy)
A 3D Analysis of a female patient that underwent face and neck lift surgery with Dr Julian De Silva

*Results May Vary

Common reasons why patients ask Dr. De Silva for help?

  • Look tired, lost sparkle, feel less attractive, less attention
  • Impact relationship & profession
  • Self-conscious about neck and loss of jaw line
  • Hiding your neck e.g. avoiding photos
  • Filler is okay for adding volume only, does not lift & help lose skin, unnatural when overfilled. Non-surgical machines offer minimal improvement
  • Starting to look like your mother or father
  • Reduced confidence and self-consious

Dr. De Silva also recommends

  • Deep plane facelift surgery give a massive improvement in face shape (Less than 5% of surgeons are able to complete deep plane)
  • Natural shaping of jaw line (*key importance for natural look)
  • Signature deep plane facelift has advantages in recovery over traditional facelift surgery (SMAS facelift)
  • Patients with very full neck, need advanced shaping of salivary glands in neck, gives better neck profile than in 20s
  • Artistry, every patient’s face is unique, requires customisation with regenerative medicine, lip lifts, brow lift to give a stunning result
  • With Dr. De Silva sedation anaesthesia, all patients rapid recovery less than 1-hour after procedure
  • Scars must be positioned discreetly, 99% virtually invisible (meticulous technique, 3 levels stitches, never staples)
  • Enhanced recovery, Dr. De Silva has pioneered use of regenerative medicine and oxygen therapy
  • Best results often require complementary procedures including volume enhancement (Fat transfer), buccal fat reduction, (V-shaped face), temporal brow lift…
  • Please note absolute results cannot be guaranteed, realistic expectations are important

Common concerns with facelift surgery?

Many patients come to see Dr De Silva, as they are concerned about looking too different and want to have a natural rejuvenation with hidden scars and a fast recovery. We have also seen photographs in the media of celebrities who look quite different from their youth, and a natural-looking rejuvenation is important for most of my patients. Having a face or neck lift surgery is a “big” decision for many patients as it is a choice to undergo surgery. I have respect for each person’s decision and provide a personalised evaluation and treatment options to enable you to make an informed decision about undergoing surgery. This begins with a consultation to discuss the changes that you have noticed, the expectations you would like to see for improvement and a discussion regarding recovery and potential risks. “Every patient I treat as a representation of my work and artistry, looking natural and refreshed is of key importance to every patient I treat”. – Dr Julian De Silva

What are the different facelift types?

Although many different descriptions of facelift have been described most involve variations on lifting the soft tissue (SMAS layer) beneath the skin. The techniques used to lift the face can be categorized into three broad types of facelift according to the surgical technique and associated recovery. Generally, facelift procedures can be classified into three main types:

  1. Minimally invasive or non-invasive procedures.
  2. Mini-Facelift procedures
  3. Traditional facelift and neck lift procedures.

Dr De Silva sees his role in advising patients what is the most preferred form of a facelift for your individual needs. The optimal rejuvenation of facelift and neck lift surgery requires effective and natural rejuvenation and the minimal downtime from surgery. Dr De Silva annually teaches the international facelift course at the prestigious international ASOPRS & AAO meeting in the USA.

Female model - after treatment by Julian De Silva M.B.B.S, M.D.

What facelift is best for me?

Every person’s face is unique and has characteristics that are distinctive to you, to give you accurate information on what is the best treatment for you requires an assessment of your face and an understanding of what you are looking to achieve and knowledge of your general health and well-being. The initial consultation is an opportunity for you to talk about what you notice and for me to listen. For each patient, I like to understand what has led to my patients seeking advice on improving their appearance. Many patients see me as they have noticed a more tired appearance that does not fit with how they feel; this can affect relationships, social interactions and professional opportunities. For most of us, we do want to look our best, and when we have renewed confidence and energy that affects every aspect of our lives. Face and neck lift surgery is a substantial step for some patients. However, it does offer a facial rejuvenation that currently cannot be achieved by other means (such as non-surgical treatments or creams). It is a big step and decision to undergo facial surgery, my team and I take a personal approach to facelift surgery will fully support you during your journey, our principals are to take care of our patients like we would our own family.

Facelift (Rhytidectomy)
ITV Lorraine Show Featured patient of Dr. Julian De Silva, underwent Natural Face and Neck lifting

Will I look like myself?

This is a common concern for many patients. Dr De Silva’s philosophy is a natural rejuvenation, where patients look like themselves only better. For most patient’s Dr De Silva completes imaging to give patients an indication of their appearance after surgery. Any change can seem more apparent initially as all of us become used to our appearance and even small changes can take some time to get comfortable with.

Will people be able to tell?

With good surgery, friends and family members will not be able to tell you have undergone facelift surgery. Dr De Silva customises his treatments based on your facial characteristics, often patients that have substantial rejuvenation are surprised how friends and family have not been able to tell.

Facelift (Rhytidectomy)

Dr De Silva and patient safety

Patient safety is of crucial importance for all facial plastic surgery. The intricate anatomy of the face requires precision and care. Dr De Silva is a keen advocate of patient safety and has championed the need for patient safety on Sky News and medical conferences around the world.

Watch Video: Sky News interviews Dr. Julian De Silva about Patient Safety in Cosmetic Surgery
Sky News interviews Dr. Julian De Silva about Patient Safety in Cosmetic Surgery

What is the recovery after facelift surgery?

Most patients can return to social and professional activities after one-to-three weeks. The truth is that recovery after facelift and neck lift surgery does depend on several factors.


Swelling is the central aspect of healing after facelift surgery, and by two weeks after surgery, 80% of the swelling will have resolved. Although the swelling will continue to resolve, most resolves by six weeks. The final result when all of the swelling has resolved can take as long as a year.


Most patients have minimal bruising that resolves over one-two weeks. Occasionally, less than five per cent of the time, there can be a marked bruise immediately below the eyes where the skin is very thin, this bruising can take six weeks to go, though it can be covered with makeup after one week.

Facelift (Rhytidectomy)


There is numbness around the ears and chin in the recovery period; this continues to improve over the first six weeks, although it can take six-twelve months to disappear completely.


In terms of pain, there is surprisingly little, and usually for less than 24 hours. Oral analgesia is adequate for the first day after surgery, and many of our patients never take any analgesia.


The position and shape of the scar can be camouflaged around the natural curves and lines around the ears; they reach their final endpoint six-twelve months later. They are discrete and generally difficult to see after a few weeks; some steps can be taken to speed up their recovery and soften their appearance. One week after surgery they can be covered with concealer makeup.

Social activities

Most can be restarted after two-three weeks; there may be some residual bruising and swelling; generally, this can be covered up with concealer. On average, at two-weeks after surgery. With an important event such as a wedding, you should allow 6-weeks as a minimum to enable the majority of the swelling to have resolved.

Exercise – As a general rule three-weeks.


Reading, computer work and other low-level activities can be started after the surgery and will not affect healing. They are not the same as lifting or strenuous activities that increase blood pressure which have the potential to increase swelling.

Scars - female model

Fast recovery techniques with Dr De Silva

Dr De Silva employees all the latest technology and scientific innovation to enhance recovery from surgery. Dr De Silva performs conservative deep plane facelift that limits trauma to the natural anatomy, and where appropriate innovative methods to speed up the recovery process.

Dr De Silva has pioneered the use of regenerative medicine (utilising your growth factors) to heal the body faster; we are committed to providing our patients with the latest advancements from scientific research.

The type of surgery you have influences your healing; not all facelift is the same. Factors influencing healing included whether the operation is principally mini-facelift surgery, revision facelift, ethnicity, fuller neck and the use of associated techniques.

Facelift (Rhytidectomy)

What are things you can do to speed up recovery?

There are many prescription and herbal medications that should be avoided both before and after surgery, as they can encourage both bruising and swelling. Dr De Silva and his team give comprehensive advice to all his patients on what should be avoided before and after surgery. In addition, there are some herbal medications, such as arnica, that should be taken to reduce bleeding, Dr De Silva provides his patients with a specialist herbal medicine than enhances recovery.

Icing around your face and neck for the first three days, in the form of ice in a zip lock bag, frozen peas or gel mask all have a beneficial effect on reducing swelling when applied to the area for ten minutes regularly after surgery. There are other factors such as resting and taking things easy during the daytime that will maintain relatively low and stable blood pressure. Keeping your head elevated when sleeping will also reduce bruising and swelling.

Dr De Silva provides patients with techniques to enhance recovery, including regenerative medicine and high strength oxygen therapy. These measures are particularly important with patients looking to have a faster recovery, everything counts.

Facelift (Rhytidectomy)
What is the recovery after facelift surgery? The truth revealed...

What are the factors that influence your recovery?

If you have any medical conditions like diabetes or high blood pressure, these should be well controlled before surgery. Smoking delays healing, therefore, avoiding smoking both before and after surgery will speed up your recovery and improve the results. Two people having identical surgery will not heal at the same time, we all heal differently. Another factor is your mental attitude, cosmetic surgery can be an emotional experience for some patients, and having a positive mental attitude goes a long way towards a faster recovery.

How long will facelift take?

A facelift takes three-to-five hours on average to complete depending on the complexity of the surgery and additional techniques such as volume enhancement (fat transfer) and chin augmentation. Dr De Silva spends additional time to complete surgery for his patients as the face and neck are intricate, and all the surgery is millimetres. Although the operation can be completed in less time, it is not possible to achieve the same amount in lesser time. Dr De Silva believes that it is better to take additional time and make the result as good as possible that look to complete a further revision at a future date. Hiding the scars around the natural curves of the ears takes approximately 45 minutes on each side.

Do I need to go to the hospital?

Facelift surgery is commonly completed in a general hospital with other surgical procedures in a general private hospital. Patients often are concerned around issues with general hospitals such as MRSA and hospital-acquired infection. Dr De Silva designed and built a custom based facility in central London. Since 2012, we have refurbished the facility each year, to deliver the latest in high-tech features including 3-D camera technology, telescopic micro-incision cameras, imported laser technology and the latest in fast recovery Biotechnology. The facility was custom built purely for facial cosmetic and plastic surgery.

Facelift (Rhytidectomy)

An alternative to general anaesthesia?

Dr De Silva and his team have developed a specialised form of advanced sedation anaesthesia for our facelift patients. This technique is safer than general anaesthesia, with faster recovery and avoids the side effects associated with general anaesthesia. The recovery after a facelift with this twilight sedation technique is usually thirty minutes. Approximately twenty per cent of all our patients have undergone previous general anaesthesia, and they overwhelmingly prefer the experience of twilight sedation anaesthesia.

Facelift (Rhytidectomy)
Facelift & Neck Lift Review & Testimonial

*Results May Vary

I live abroad, how can I have surgery?

Dr De Silva has a large number of patients that live overseas. Our specialist team can help you organise a virtual consultation and coordinate your trip to the UK. We can utilise the latest technology to enhance your recovery, including oxygen therapy and regenerative medicine.

Private entrance for VIP

At our specialist facility on Harley Street, we have a private entrance for VIP patients; please notify us in advance of your specific requirements.

Performing arts and recovery

For patients whose profession involves high definition cameras, it is important to modify surgery to enhance recovery. A common concern from performers is looking too different, with Dr De Silva’s natural-looking techniques, most patients find that even friends and family were not able to tell they had undergone surgery. Dr De Silva may recommend additional techniques and advancements to enhance your recovery based on your specific requirements.

Facelift (Rhytidectomy)
Facelift (Rhytidectomy)

I have never had surgery and am really nervous

Many of our patients are very nervous and have not undergone previous surgery. We take a great deal of time to ensure we provide both emotional support before and after surgery. Our aim is to provide the best possible experience and to foster a long-term relationship with our patients to provide ongoing care for years to come. Please read about some of the glowing patient experiences with us. Dr De Silva has hand-picked each and every staff member not only for their expertise but their expertise and clinical skills, also for their approach, communication and personal skills. We propose to give you a choice to have surgery within a safe environment, with the care each person would like to personally receive, performed by Dr De Silva and supported by his team. We are continually refining the model to give each patient the best experience possible.

Facelift (Rhytidectomy)

Patient recovery experience

Some of Dr De Silva’s patients recorded on video their recovery experience in the form of a video diary. Please watch one or more of these authentic patient experiences if you would like to understand more healing and recovery after facelift surgery.

Support journey

Most patient’s recovery after a facelift is rapid, and patients return to normal activities after two to three couple of weeks; however, everyone’s journey is unique to them. Everything in life, including surgery, is an emotional experience, and for some patients, the recovery may be longer. We have a supportive and empathetic team that will continue to guide every patient through their recovery.

Facelift (Rhytidectomy)
Facelift & Blepharoplasty Experience - Patient Testimonial and Review

*Results May Vary

At what age should you get a facelift?

The average person having facelift surgery is between their late 30s and 70 years old. All faces age at different rates, a combination of natural genetics, ethnicity and lifestyle. In younger patients, a facelift can be used as a form of preventative maintenance, a requisite in some professions such as the actresses and actors. There is no fixed age limit to undergo cosmetic surgery; the person must have good health as safety is an important factor. There are no absolutes to age in having a facelift it is necessary to do a comprehensive series of tests before surgery to evaluate general health. Dr De Silva has had patients travel long distances and internationally for opinions on their face, sometimes they have been refused surgery by local surgeons.

Are there different types of a facelift?

There are various terms and descriptions that have been used to describe facelift lifting techniques and surgery. The terms listed below are the common facelift terms that have been described, other facelift terms have been trademarked and marketed, these are variations of the techniques described below:

  • Facelift
  • Neck lift
  • Mini facelift (Short scar facelift)
  • MACS lift (Minimal cranial suspension)
  • Mid facelift
  • Deep plane facelift

There is no one technique that will give the best result for every patient. Each person’s face is unique, a combination of genetics, environmental influences and lifestyle choices will influence a person’s face. Critical to a natural-looking result ds customising each patient’s surgery for their requirements. Dr De Silva’s preferred technique is a signature deep plane facelift that gives the patient the longest lasting effects, and reduced recovery time, the precise method is customised to an individual’s unique facial characteristics.

Facelift (Rhytidectomy)

100s of experiences of Dr De Silva’s patients


5.00 from 425 reviews

By An, Facelift surgery on Mar 28, 2020

From start to finish I found the whole experience absolute first class. The consultation was informative and reassuring and after surgery the aftercare and subsequent follow ups showed great care and interest in my well being. The surgery itself has been a great success and I wish to praise very highly Dr. De Silva for his patience , care, advice and attention to detail. I would certainly strongly recommend Dr. DeSilva and all the team.
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By Facelift surgery on Mar 16, 2020

Having this surgery was always something I thought about however was nervous on the results. From the very minute we met Dr Julian De Silva I knew he, and the practice, was the right choice. Through the entire process I was made to feel at ease, and the procedure (date I say) was actually enjoyable! The results have been nothing short of lifechanging, and my only regret was not doing it years ago. I wonderful surgeon and a wonderful set of staff - highly recommended
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Read More Reviews Here *Results May Vary

Dr De Silva’s books on facial surgery

Dr De Silva has published over 30 journal and book chapters in peer-reviewed journals and several randomised control research studies, regarded as the gold standard in medical research. Dr De Silva has published several books on facial surgery and has a complete guide to facelift and neck lift surgery for publication next year.

Facelift (Rhytidectomy)

What happens during the consultation?

When you attend a consultation, a detailed medical history and examination are required. As a specialist in all facial plastic procedures, Dr De Silva will look at your face as a whole as all parts of the face lie in relative balance. Dr De Silva requests patients bring old photographs to show how you have individually changed over time; this is very helpful as each person’s face has unique characteristics that will change differently with time.

A detailed examination of your face is important, including the underlying shape of the bone, position of chin, relative volume loss and skin laxity. Each individual’s facial characteristics is essential to evaluate as every part lies in balance and relative harmony. A discussion of your goals and expectations of any prospective surgery. For some patients, Dr De Silva may advise against surgery and non-surgical treatments if in a patient’s best interest. Dr De Silva and his nursing team see all patients a second time before surgery to discuss your procedure in further detail, inform patients of measures you can take to enhance recovery and provide detail regarding the recovery period. We recommend that you write a list of questions to ensure that you have covered all of your concerns.

What complications can occur?

A facelift is regarded as a challenging cosmetic surgery procedure and requires in-depth knowledge of the anatomy and attention to detail. One of the most important factors responsible for the success of surgery is the surgeon. In Dr De Silva’s hands’ complications are uncommon, swelling and bruising are the most common aspects of recovery. Pain or discomfort is uncommon and resolves within 24-hours. Infection is very rare, and the gold standard is prophylactic antibiotics to protect against infection. Dr De Silva avoids the side effects of general anaesthetic (deep vein thrombosis and allergies) by using safer sedation anaesthesia. Two rare and serious complications are skin necrosis (delayed healing of the skin) and stretching of a motor nerve (recovers over six months). Dr De Silva takes multiple levels of precautions to avoid these issues in the first place. Although Dr De Silva advises all patients, they must stop smoking; we have utilised advanced oxygen therapy and regenerative medicine to heal the body where this has not been possible. Although there is no surgeon completing facelift that has no revision cases, measures can be taken to make these minimal by using the most advanced techniques. Over twenty per cent of Dr De Silva’s patients have had surgery elsewhere.

How long will it last?

Although there are individual factors that influence duration, most facelift and neck lift surgery will last from eight to ten years. Dr De Silva often utilises additional techniques including fat transfer, laser skin resurfacing, and regenerative medicine, to enhance the duration of the result. There is a small subset of patients that are looking for perfection in which further treatment may be required.

During consultation: Julian De Silva M.B.B.S, M.D.

How do I choose a facelift surgeon?

Choosing the surgeon for your surgery is one of the most important decisions you will make.

Key considerations in this choice:

  • Specialist – An important choice in selecting the right surgeon is to look for a specialist in facial cosmetic surgery. As our understanding of the human body has evolved, surgeons have become more specialised; it is difficult for a general plastic surgeon to have knowledge in all parts of the body. Dr De Silva is a world-renowned specialist oculo-facial plastic surgeon who focuses only on the face and has an extensive background of experience to give you a safe and successful outcome.
  • Cosmetic focus – Cosmetic surgery is a different branch of medicine to reconstructive plastic surgery. Cosmetic surgery focuses on natural rejuvenation, hiding scars and discretion. Although Dr De Silva trained at London hospitals, he went onto complete specialised aesthetic experience in Los Angeles and New York.
  • Detail orientated person – Facelift surgery is a procedure of millimetres, and most refinements are measured to the nearest half a millimetre. Seeing a surgeon who specialises in the entire face is important. A facelift can be completed quickly; however, the result will not be the same as a surgeon who takes time to hide scars and improve the neck area meticulously.
  • Revision surgery – Unfortunately, facelift surgery can be completed incorrectly and require revision surgeon. Select a surgeon specialising in this surgery. Dr De Silva treats revision facelift patients from all over the world.
  • Artistry – No two people have the same face. The best surgeons are also artists who can modify their technique to give every patient the best possible result. Dr De Silva is an artist and sculptor and uses his knowledge of the human face for each patient.
  • Medical Facility – Chose to have surgery in a facility that does not treat the entire body or general surgery to avoid hospital-acquired issues such as infections. Dr De Silva completes surgery in a World Class facility that was custom built for facial cosmetic surgery.
  • Rapport – It is vital that you feel comfortable with the surgeon and that they will be there for you after the procedure.
Blepharoplasty. Model photo

Will I have pain after my facelift?

Although many patients are concerned about this, for the majority of our patients, there is surprisingly minimal discomfort. Dr De Silva has evaluated the entire facelift procedure and modernising each part of the surgery to improve conventional downtime and recovery. By using a bespoke combination of local and sedation anaesthesia, most patients are surprised by how minimal discomfort they have after surgery, with more than 50% not requiring pain killer medicine from the next morning.

Facelift (Rhytidectomy)

Can a facelift be combined with other techniques?

Dr De Silva frequently combines facelift and neck lift procedures with other facial procedures to give a natural-looking result and avoid the use of scars associated with conventional techniques:

Upper third of the face:

  • Blepharoplasty or eyelid surgery
  • Minimal incision brow lift (Brow & Forehead Lift)
  • Anti-wrinkle treatments for fine lines

Middle third of the face:

  • Volume augmentation of the cheeks with fillers, fat transfer or implants
  • Fat-transfer to the mid-face and cheeks (Fat Transfer)
  • Skin resurfacing for lines & deep wrinkles (Skin Resurfacing)
  • Anti-wrinkle injections for fine lines
  • Rhinoplasty (Nose reshaping)

Lower third of the face:

  • Chin Augmentation (Chin Implant)
Male sculpture: body and face muscul schema

Ear piercing & Ear lobes

An enlarged ear piercing or torn earlobe is a common occurrence, and may result from injury, piercing too close to the edge of the earlobe, wearing heavy loop earrings, hereditary factors or trauma. The result may be a partially or completely torn earlobe. The repair of a torn earlobe is performed with local anesthetic and surgery is customized to the extent of the tear, amount of tissue loss and the tear location. The cosmetic surgery consists of soft tissue revision of the area around the tear and placement of a single or double layer of stitches to complete the earlobe repair on both the front and back surfaces of the ear. When there has been a loss of soft tissue of the ear, the procedure is more challenging, and reconstruction involves rotation of the healthy ear lobe position to maintain the curvature of the earlobe, ensuring it keeps a natural looking shape and matches the other side. The risk of surgery on an earlobe is the development of a scar or keloid, a thickened and nodular scar. Keloids of the ear are treated with medical anti-inflammatory agents, although surgical revision is sometimes required. After waiting a period of 6 weeks, the ear lobe is re-pierced. The position of the ear piercing is key and Dr. De Silva takes great care in positioning the new piercing site to match the patients expectations and patients’ other ear.

Dr De Silva

Dr Julian De Silva teaches facelift surgery to other international surgeons every year. Teaching has always been a passion, and Dr De Silva has been the lead course director for an international facelift course annually since 2016.

Is there a non-surgical alternative to a facelift?

For some patients, there are non-surgical alternatives to facelift surgery. Particularly in patients with specific facial characteristics (volume loss and minimal skin laxity). Dr De Silva has pioneered a non-surgical facelift for patients based on the Phi Golden Ratio. The Phi lift technique is exclusive to Dr De Silva and applies the principles of volume rejuvenation and lifting along the natural lines of facial balance, to “beautify” the face. For further details:

There are considerable limitations to non-surgical treatments. All of us receive constant marketing messages from the media daily although some information we receive is credible, much information is of biased opinion, scaremongering or dubious content. There are continually claims of creams, fillers, new devices that offer instant rejuvenation without undergoing surgery. Although some have merits, unfortunately, many of my patients are disappointed by these limited results. There are claims of the latest non-surgical breakthrough offering incredulous quick fixes, with branded logos and unique contents or celebrity endorsements. We look to provide our patients with sincere advice that will provide effective and natural.

Caution is required in non-surgical treatments, as the face is an intricate structure with essential anatomy that can be damaged with filler techniques. There are important blood vessels are the eyes and nose, as the implications for damage to these vessels include scarring of the skin (termed necrosis), damage to vision (even blindness) and scarring. For these reasons, it is important that non-surgical treatments should be performed by a clinician who is familiar with the underlying anatomy.

Dr De Silva can offer patient’s non-surgical or surgical facelift techniques based on their individual needs and expectations from surgery. Most practitioners are only able to offer one or the other.

How can the facelift incision be hidden?

  • Surgeon’s technique. Surgeon’s use different techniques to complete a facelift and neck lifting procedure. Meticulous care and attention to detail are required to hide the facelift incisions in natural creases and curves.
  • Location of the incision. The incision and scars can be hidden in women by placing the visible portion of the incision inside the ear canal or opening behind the little lump in front of your ear called the tragus. In men, this is not ideal as it means the beard hair will grow up to the ear which is not ideal long-term, Dr De Silva will often use a natural crease that lies in front of the ear to mask this incision and maintain a healthy area of beard growth.
  • Multiple-layered meticulous closure. Multiple layered skin closure ensures that there are deep stitches to support the soft tissues once the superficial skin stitches are removed, this is key to avoid unattractive widened scars, it does take additional time to complete the procedure and is more challenging for the surgeon. Dr De Silva always closes the incisions with multiple layers to give the best possible final result.
  • Bevelled incision. In hair-bearing skin, the use of bevelled incisions in the hairline enables hair to grow through the scar after surgery, hiding the scar in hair-bearing skin.
  • Deep Lifting of SMAS layer. Lifting the deep tissues beneath the skin (SMAS or deep muscle tightening) before skin closure is essential to give a natural-looking result and avoiding tension on the skin on closing the incision are all important aspects of the surgery.
  • Stitches. Different methods can be used to close the skin. Some surgeons use staples to save time; however, they can leave marks, unsatisfactory scars and are uncomfortable to remove. Dr De Silva avoids the use of staples in all patients as the best healing is from the use of fine sutures in non-hair bearing skin, this takes additional time and meticulous care to complete. Dr De Silva does not compromise time for giving the best final result.
Facelift (Rhytidectomy)

Will I have visible scars?

Key with facelift surgery is minimizing scars. Dr De Silva hides scars in the natural curves of the skin and ears to ensure they are discrete and difficult to see. With modern techniques scars can mostly be camouflaged; however, no scars are invisible. Using meticulous techniques, less than 1% of patients have issues with scars. Dr De Silva uses advanced techniques to hide scars, including multiple levels of stitches and has developed a signature use of regenerative medicine techniques to enhance scar resolution.

Facelift (Rhytidectomy)

Patient experiences with Dr De Silva

All these patients underwent surgery with Dr De Silva. We encourage patients to watch a video of patient experiences to have a good understanding of healing and the recovery period. Dr De Silva and his team will provide support and reassurance during your recovery; we believe that being a well-informed patient is helpful to most patients undergoing facelift surgery.

Facelift (Rhytidectomy)
Facelift & Neck Lift Review & Testimonial

*Results May Vary

Case Study 1

This woman had disliked the appearance and general sagginess of her neck with for more than ten years. She was very anxious about undergoing treatment, and although she had been offered non-surgical treatments, no procedures had made any real difference to her neck. She presented for a consultation with Dr De Silva, to discuss neck lifting options, she was not keen on undergoing invasive surgery with prolonged recovery time. On assessment, the skin along her jaw had begun sagged considerably with time, with loose skin and some accumulation of fat, softening her jawline and leaving her jaw looking uneven. Dr De Silva assessed her neck and discussed with her the best possible improvement with the least downtime and advised a combined face and neck lift procedure with fat transfer and the use of biotechnology to enhance her recovery from surgery. With natural neck elasticity, there are more treatment options available to improve a sagging neck. She underwent micro-cannula neck liposuction with reshaping of the neck and jaw angle to restore a more youthful jaw and neck angle. Dr De Silva does not use body liposuction techniques (including traditional liposuction and ultrasound assisted Vaser techniques), and she underwent a specialized micro-cannula (fine) technology that enables finer control and natural shaping and refining of the neck contours.

Only 12-hours after treatment, the photos show a marked improvement in her jawline and neck associated with a youthful appearance. There is some bruising of her neck; however, Dr De Silva uses advanced biotechnology to enhance recovery after surgery; the ecchymosis is mostly resolved by one week after surgery. Dr De Silva completed the operation with twilight sedation, enabling the patient to avoid the side effects and long recovery associated with general anaesthesia. The patient was able to leave the surgery less than one hour after the surgery completed.

Facelift (Rhytidectomy)

The next set of photos show her appearance at one-week after surgery. Dr De Silva uses fast recovery techniques to enhance recovery after face & neck lift surgery and a dramatic improvement in her neck can be seen. Dr De Silva customises each facelift and neck lift procedure for each individual patient, to improve the neck to this level requires advanced techniques that focus on improving all the underlying structures in the neck. Dr De Silva’s focus for each patient in terms of priority is firstly Safety, secondly the best possible result and thirdly.

Facelift (Rhytidectomy)

Dr De Silva hides the scars from face and neck lift surgery around the natural curves of the neck and in the hairline. These photos show the scars at one-week after surgery, using the natural curves of the ears takes additional time; however, it makes scars challenging to see. Some surgeons place the scars in front of the ear or sideburn; this can result in visible scars which can be very difficult to treat. Dr De Silva believes that scars should be made as discreet as possible. Less than 1% of the population may have troublesome scarring such as keloid scars, by placing the scars in discrete areas the scars generally are difficult to see even soon after facelift and neck lift surgery.

Facelift (Rhytidectomy)

The next set of photos at six-weeks after surgery shows resolution of all of the early bruising and 95% of swelling. The patient has had a dramatic rejuvenation in her face areas. Multiple people commented on how refreshed she looked although they were not able to tell she had undergone surgery as a result is entirely natural.

The scars are shown at six weeks after surgery, have faded further. Although the final result from scars is as long as 18-months after surgery, by hiding scars in the natural creases Dr De Silva finds that scars can be made discrete far earlier; unfortunately, scars that have been placed in more visible areas are challenging to treat. The patient was thrilled with the results of her surgery; she had been extremely nervous about undergoing surgery and had waited more than ten years before she had decided to undergo surgery with Dr De Silva.

Facelift (Rhytidectomy)

Case Study 2

This woman had disliked the appearance and sagginess of her jowls and fullness of her neck for many years. She had considered treatments for some time before deciding to go for a consultation. She was recommended to Dr De Silva by a friend who had undergone similar surgery with him. She presented for a consultation with Dr De Silva, to discuss face and neck lifting options, she was keen on a natural-looking result and fast recovery time. Dr De Silva spent the time to listen to her concerns and assess her face and neck meticulously. On assessment, the skin along her jaw had begun sagged considerably with time, with loose skin and some accumulation of soft tissue beneath her jawline, softening the shape of her neck. In addition, Dr De Silva showed her the relevance of a relatively small chin in magnifying these changes. Dr De Silva discussed with her the best possible improvement with the least downtime and advised a combined face and neck lift procedure with a chin implant. With natural neck elasticity, there are more treatment options available to improve a sagging neck. She underwent micro-cannula neck liposuction with reshaping of the neck and jaw angle to restore a more youthful jaw and neck angle. Some aspects of the fullness of her neck were also secondary to sunken salivary glands. Dr De Silva believes in doing the best for every single patient, and as part of her surgery shaped and sculpted the sunken aspect of her glands to improve her jawline and neck contour further. Only with this additional treatment would have the youthful angle between her jawline and neck be shaped. This part of the face and neck lift surgery is time-consuming and is not completed by the majority of plastic surgeons.

Dr De Silva completed the surgery with twilight sedation, enabling the patient to avoid the side effects and long recovery associated with general anaesthesia. The patient was able to leave the surgery less than 1-hour after the surgery completed.

Facelift (Rhytidectomy)
Facelift (Rhytidectomy)

The next set of photos show her appearance at two-weeks after surgery. Dr De Silva uses fast recovery techniques to enhance recovery after face & neck lift surgery and a dramatic improvement in her neck can be seen. Dr De Silva customizes each facelift and neck lift procedure for each individual patient, to improve the neck to this level requires advanced surgical techniques that focus on improving all the underlying structures in the neck. Dr De Silva’s focus for each patient in terms of priority is firstly Safety, secondly the best possible result and thirdly the best possible experience.

Dr De Silva hides the scars from facelift and neck lift surgery around the natural curves of the neck and in the hairline. These photos show the scars at two-weeks after surgery, using the natural curves of the ears takes additional time; however, it makes scars challenging to see. Some surgeons place the scars in front of the ear or sideburn; this can result in visible scars which can be very difficult to treat. Dr De Silva believes that scars should be made as discreet as possible. Less than 1% of the population may have troublesome scarring such as keloid scars, by placing the scars in discrete areas the scars generally are difficult to see even soon after facelift and neck lift surgery.

Related Topics

Facelift (Rhytidectomy)
Facelift (Rhytidectomy)
Facelift (Rhytidectomy)
Facelift (Rhytidectomy)

Dr De Silva featured on MailOnline and discusses about the golden ratio and beautiful art.

Click here to read the article.

Facelift (Rhytidectomy)
Facelift (Rhytidectomy)
How The Rich & Famous Stay Beautiful, Ch. 5 interview Dr Julian De Silva.
Facelift (Rhytidectomy)
Reuters News interviews Dr. Julian De Silva about Facial Beauty and customized facial mapping techniques on celebrities including Goerge Clooney, Bradley Cooper, and Idris Elba.

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