Dr Julian De Silva: Hello.
So this is a very commonly asked question that patients ask me,
what are the different types of facelifts? What is the best
facelift for me? what this video is really going to do is go
through that in some detail, and so first of all, well. How many
different types of is that are? Well, many different types have
been described. But we can really categorise these into
approximately seven different types. And so I'm going to talk
you through each of the seven different types of facelift.
What are the benefits of each one of the downsides of each
one? And, and I'll go through this step by step. So first of
all, well, why does this matter? Why is it important? Well, in
terms of the concept of the word facelift, well, if you have
facial ageing, which might involve loose skin, sagging
along the jaw line changes in your neck volume loss, well,
sometimes this is best corrected with a facelift. But what are
the different types? what and why does it matter? What is the
such thing as a non surgical facelift? Is there such thing as
a quick fix? Are there procedures that are associated
with less recovery and faster healing? What are the potential
downsides of the different facelift techniques?
Are some more natural looking to some hide scars better than
others? And what about these other kind of catchy names like
threads and stem cell face the radio frequency? What are the
contexts
that these
advancements can be used for? So, a little bit about myself,
my name is Dr. Julian De Silva and I practice in Harley Street,
where my experience really is from working in London, Los
Angeles and New York. And I specialise only in the face,
remember ocular facial, cosmetic and plastic surgeon. And most of
my practice is around eyelid surgery, blepharoplasty based
elective surgery, and rhinoplasty nose reshaping, and
associated techniques that help those procedures. A good
proportion of my patients, our vision patients from patients
had surgery elsewhere. And I've completed 1000s of procedures in
in this era of medicine. So a little disclaimer, well this
information is to help provide information to you, but it does
not constitute a doctor patient relationship. So first of all,
what's the first type a non surgical facelift Well, what
does this actually mean? Non in essence, it means avoiding
surgery. So, non surgical techniques could be things such
as Botox and fillers. net, there are also more sophisticated
devices that use ultrasound, radio frequency, and these
essentially a tightening the skin. Well. What are the
advantages of these techniques? Well, the advantages are they
avoid surgery, so generally they have a much faster recovery. And
patients can look good even after a few days after having
like a non surgical treatment. And really, they're suitable for
patients who have really quite early changes. And they may be a
bit more focused around losing volume and volume loss. But
they're not going to address gravity and they're not really
going to address the new skin. And so they're quite limited in
what they can achieve. But the main advantage is that they have
a fast recovery and the avoid the need for surgery. And so
usually they can be completed on the local anaesthetic. Sometimes
with topical anaesthetic. They don't need sedation or general
anaesthetic, but then their effect is a little limited. Now
we've all seen celebrities and people who've had a little too
much non surgical treatments. And usually this is in the form
of fillers adding too much volume to the face. And we're
here with this photograph of Nicole Kidman we can see you
know attractive youthful appearance with a very kind of V
shaped jaw line which is one of the characteristics of a natural
neutral jaw line. And then this photograph just shows more
volume in the lower half lower third of her face, which if
anything reduces that slim v line and makes her face just
Fuller, and if anything was square. And so like many things
life, a little bit of volume, a little bit of filler can be a
good thing, but a little bit too much and then it doesn't look as
natural. The other limitation with non surgical treatments
will they don't tend to last that long. And many treatments
don't last more than six to 12 months and then they require
repeating and they require a degree of artistic talent in
order to ensure that they look natural. So the second type of
facelift is a skin only facelift and this really means what it
says and it has other nomenklatura, sometimes it's
called a ponytail lift, and other kind of catchy names, but
essentially means that it's suitable for patients who just
have a very small amount of loose skin. And those patients
can benefit from a smaller surgical procedure, that
essentially just takes away a little bit of that new skin. And
so it's not lifting the structures of the face beneath
the skin. And in a way, it's important that it's not used in
patients who have more facial ageing, as it's only going to
benefit patients with loose skin. So the advantages, well,
this kind of face that is going to benefit patients who have a
little bit of loose skin and mild skin, a mild facial ageing,
the disadvantages and the advantages that come alongside
that it requires minimal anaesthetic may be done under
local anaesthetic, and patients are going to have fast recovery
with maybe only a few days or a week of recovery or downtime.
The disadvantages are well, it is dependent on the fact that
there's no further facial ageing, because if there's any
effects of gravity, or there's effect
of more loose skin in the neck, well, it's not going to give
good results because it's not going to lift those underlying
anatomical features, which means that it can give them more
stretch appearance. And that was the the downside of the very
early techniques of facelift surgery tend to get very kind of
stretched lines in the skin because it focused on lifting
the skin
and not the
net layers beneath. So in some ways, it's it's a technique that
does have an advantage for small number of patients with early
facial ageing and a little bit of loose skin. But for many
patients, it's not going to be adequate. So the third type of
facelift is a max facelift. And this is a rather fancy name for
minimal access cranial suspension. And this technique
really focuses on using three stitches to lift the face where
has descended and remove the skin. So in surgical practice
two relatively straightforward technique. And the advantage of
that is it's does produce good results, it does make an
improvement, but it is really dependent on patients having
relatively mild facial ageing, and relatively little changes in
their neck area. And, and so the advantages are fast recovery, it
can be done in the relatively light, anaesthesia, localised,
progressive with sedation. The disadvantages of a max case that
well, it tends to be less effective in the neck area
doesn't control the neck in the same way. And it doesn't tend to
effectively remove loose skin. And the fourth type of facelift
is a mini facelift. And really, this is half a face and neck it
means what it says. And so the scars are really limited to an
area in front of the air. So there's no scars going behind
the air. And because of that the main advantages are for patients
who have facial ageing in the lower third of their face, you
might have some effects of gravity with jowls, soft tissues
from the cheek just descending down and creating more fullness
along the lower jaw line and so many faces,
which is lift
that era back up and smoothing out the jaw line and the scars
are concealed around the front of the ear and within the hat.
And this technique means that there's no surgery behind there,
and there's minimal surgery in the neck area. And so because
it's a mini facelift, well it takes half the amount of time
does a full face and neck lift. And so the recovery and the
healing is also much faster than the swelling will be less and
the recovery may be in the order of one to two weeks in terms of
the majority of the swelling majority healing occurring. The
downsides of a mini facelift is that well, if there are changes
in the neck such as bands in the neck, or if there's more loose
skin. All patients need additional techniques to get the
best result,
but we won't get the very best natural results. There are also
variations in terms of descriptions of the mini
facelift techniques such as described like an S lift, but
they're all variations on the same concept. So many festive
absolutely has an advantage for some patients but there have to
be relatively mild to moderate changes with less changes in the
neck area. And then the fifth type of facelift is a smart
facelift and this is the commonest type of facelift
completed by plastic surgeons. And this technique absolutely
improves the lower third of the face lifts the area of the face,
it improves the neck area. Now most of the direction of ball
tends to be in a lateral direction. So in this in this
picture is illustrated with this blue arrow. So most of the lift
is working in this direction, which improves the jaw line our
neck. It does require anaesthetic, either sedation
anaesthesia, or Twyla anaesthesia, whichever
anaesthetic, it will be associated with some recovery,
including swelling, sometimes bruising, numbness, a feeling of
tightness. And you really need a good two to three weeks, if not
a little bit longer for most of the swelling and recovery to
occur. The main disadvantage of this technique well, because of
the procedure that does involve surgery, there will be a
recovery time associated with it. And so you need time
dedicated for that. It does, it does result in a lateral lift.
And so that lift is not necessarily a natural lift,
because most of what changes with gravity tends to be in a
downward direction. And so the lift is not so natural because
it's pulling more lateral direction. And sometimes
additional procedures are needed like in the cheek area in order
to restore volume. So that the sixth type of face there is a
deep plane facelift. And then this facelift, well, it really
says what it is it lifts the deep layers of the face, and
then lifts in a vertical upward direction. Now a lot of the
changes that happen with facial ageing are associated with
gravity intend to be in a downward direction. So this type
of research really restores the natural volume in the cheek area
by lifting this air out and restores a more youthful V
shaped the joy. So it's a more natural kind of face. The
challenges were busy to more sophisticated, sophisticated
type of technique. And so less than 5% of plastic surgeons
repeat this technique. And it is a technique that definitely
offers a more natural appearance because it restores more of a V
shaped jaw line to a face. It can be used in conjunction with
other techniques and the use of the golden ratio to give more of
a natural result. I personally prefer this for patients who
have further facial ageing in the face from the neck because I
believe it gives faster recovery and less swelling associated
with the healing process. So the seventh type of face that was in
a way this is a more sophisticated technique in terms
of patients who have additional need in association with their
patient characteristics. So for example, this lady has a very
full neck and shows her neck standing almost where chin is
and this lady even in her 20s had a full neck and so part of
the reason for this fullness is there's like deeply soft
tissues.
Often the saliva glands rather than being tight underneath the
jaw line, or the saliva glands have just descended in the neck.
And often there's deep fat is within this now. So in order to
create this really sharp angle between the jaw and the neck,
well it requires deep Neck Surgery shaping of the
underlying saliva glands and Deepak and that will give him
very good neck contour. The downside is it's associated with
more swelling and more recovery. And so patients need to be made
aware that they absolutely all swelling will disappear, but
this kind of surgery will have a bit more recovery associated
with it. Then there are patients who might have like smaller chin
will benefit from the chin implant or other complimentary
techniques. Patients who have a lot of ageing of the saggy skin
or some damage are going to benefit from either research
fussing with lasers or or radio frequency like a Morpheus. And
there are techniques that can also enhance the recovery such
as use of Regenerative Medicine. So, in summary, what we've
talked about really the seven core types of facelift surgery.
And just to recap is, well, we've got a non surgical
facelift, which is not a true facelift and
use
different kinds of tools and equipment in order to non
surgically lift the face. And the limitation is it's really
like in early facial ageing that these techniques are going to be
used. And it requires artistry to avoid overtraining and
overfitting. He talked about the second type of skin only type of
face that really benefits patients who only have very mild
skin laxity, and it just requires just tweaking that
little bit of excess skin. The third type the max facelift,
which is a technique that is relatively straightforward, it
uses three stitches to lift the face, and its limitation is
really in the neck area and patients who have more loose
skin. The fourth type of mini facelift while this really is a
technique that benefits patients with early to moderate facial
ageing, and it won't really enhance or improve changes in
the neck and bands in the neck. The smash facelift, which is the
core facelift, that most plastic surgeons utilisable. This
absolutely makes a difference it's back to tends to be more in
a lateral direction. But it is associated with a degree of
recovery from swelling and bruising. And so patients need
time to recover from this procedure. Then the sixth type
sit my signature deep plane facelift. Well, the deep play
face that definitely lifts in a more vertical direction. And so
it tends to produce a more natural result in a more V
shaped youthful jaw line. And there's some evidence that it
results in less recovery time, less swelling, less bruising.
And then the seventh is other techniques, patients who might
have forged neck which is just a result of genetics inherited
from their parents. While these, this requires a bit more surgery
in this area to give the best possible. So So in summary,
these are the seven different types of blackface and
procedures. How do you choose what is the best technique for
you? Well, it can be a challenge because even with this
information, each person's face is very much unique. And so the
technique for that, for face of surgery very much has to be
customised to your individual needs. And so you do need to do
some research and have some knowledge and I hope this video
has helped you in that regard. You do need to see a specialist
who's doing a lot of facelift surgery is going to be able to
guide you on what's going to be the best for you in terms of
give you the best result and give you the fastest recovery.
There's a degree of experience and artistry with facelift
surgery and there's no technique that is going to suit every
single patient. And rarely, there is no quick fix. And you
would be great if there was just one simple technique that would
help every patient but really there's no such thing. So good
luck in your search. And if there are any other questions or
thoughts that would be helpful, please, please make a note on
this video. If you'd like to sign up for my newsletter,
please do that or if you'd like to attend in a consultation. I'd
be very grateful to help you either virtually or in person. I
hope this video has been useful for you. Thank you for watching.