Dr Julian De Silva: Hello, welcome to my frequently asked
questions. So this is the common question that many patients
asked me, What is a deep plane facelift? And is that better
than a normal facelift? So, what in answering this question, we
need to consider a few things? What is it? And how does that
actually differ from other face lab techniques? What is the
recovery involved? Is that discomfort is swelling? Is there
pain? And these are all all important considerations. Let's
have a look at a few case studies, a few examples of
results. And then finally, we'll let's touch on the fact what is
the best place for you. So, in terms of things well, as an
introduction to myself, my name is Dr. Julian De Silva. I'm a
London based facial cosmetic and plastic surgeon. And I
specialise only in the face. And I do facelift surgery every day
in my practice, and about 20% of all the patients I treat our
patients who had surgery elsewhere, they do revisional
surgery. And I use additional techniques in terms of
Regenerative Medicine and oxygen to heal the body faster. So, in
a way, the information that I'm discussing with you today, well,
in a way it's it's information based on science and my
experience, however, it can never constitute a medical
assessment and examination. And really you do need to be adopted
or really define what the best treatment is for you. Now, in
terms of facelift surgery, well, what is it deeply? Well, before
considering that we need to think what is the actual process
by which we age because it's really that deep plane facelift
cleaning or other phases of techniques, but we really want
to rejuvenate the face. But we don't want to change the
appearance of base, we just want to undo the ageing process, we
want to put things back to where they are. And that's what gives
a natural result. So we really need to consider the anatomy.
Well, the very superficial layer of a face is the skin. And there
are skin only lifting techniques. And those are the
very old techniques, invasive surgery. However, they tended to
stretch the skin and give multiple lines in the skin and
often they would call resulting Pixie shaped ears and bigger
scars. And then we have the most common types of face that which
really focus on lifting a smile. And the smile is a layer beneath
the skin that contains fat contains some fibrous tissue,
and it contains facial muscles. And then finally, we consider
deeply faith 15 which is the most advanced type of facelift
surgery, which really applies to less than 5% of surgery surgery
is conducted. So in terms of facial ageing, what do we need
to consider? Well, there are three common things that change
with age and one is the effect of gravity. The second is the
skin. And thirdly there is volume. And so when we actually
look at how the face ages, well, this error just in front of you
demote by this this purple line, well, this area doesn't tend to
move that much, really with gravity and descent. It's really
more in this area, which in medical jargon is called the
medial
area
close to the nose, the medial part of the face really drops
down and that leads to the jowls and loss of the jaw line. And
that is a more squarish appearance. So the communist
type of facelift, which is called smads face of surgery,
well, this involves creating a flap in this area called the
snaps. Now this area is then pulled towards a year. Now we
can see with ageing that actually it's not really this
area, but changes in between. So although it will make a
difference, it does lift this area and it does take away the
loose skin. Well, it's not really addressing directly the
area that changes with age. And so there is a chance that jobs
can return and it's not lifting against gravity. Now, in terms
of facial ageing, with a deeply face that really goes all the
way to this crease near the nose in the lips, this is called the
nasal labour grease in medical jargon, and it lifts in a more
vertical upward direction. So it really restores the natural
anatomy to where it started. And so this process creates a more V
shaped face which is more feminine, more elegant and it
really does sharpen that the jaw line. It's more challenging than
other facial techniques, it really requires advanced
knowledge of the natural anatomy. Because there are key
delicate interpret structures in this area, it requires more time
to complete, it takes anywhere from four to six hours. And it
may require additional techniques in order to get the
very best results, such as reshaping a backward fat, such
as lifting the template area of brow to avoid loose skin in this
area. So in terms of nonsurgical faces, well, this really isn't a
type of face. And so it's jemmy. Patients who are younger, who
have more volume loss and minimal blue skin. And these
treatments often include fillers, but sometimes they also
include radio frequency threads, Botox other treatments. But the
important consideration in this is not really a facelift even
though it's often described with the same terminology. And the
main issue with this is too much volume just doesn't look good.
It doesn't look natural, and unfortunately, many celebrities
and have that kind of photographs published in the
mainstream media, and it just doesn't look quite natural. And
there is a point where non surgical treatments just don't
offer a natural equivalent. A skin only facelift? Well, in a
way, this is really very early facial ageing, and where
patients really only have loose skin. And sometimes this can be
because patients have hypermobility, that is very
flexible joints. And so the way you're made genetically is the
skin tends to be a bit looser. And so, in a way, this is not
like a true face, because it's only really addressing the scale
and communications. And that's facelift. Well this is a type of
mini facelift. And it really focuses on lifting the face with
either two special stitches or three, it doesn't allow much
change in the neck. It doesn't allow any variation on the
techniques such as deep or soft tissues, luck or fat. And so
it's a simplistic technique that does offer an advantage for
younger patients. But it does have limitations. My personal
experiences will it's very difficult to use one treatment
form for patients who really needs to be customised for every
individual. Definitely less is more. If you couldn't just use a
non surgical treatment, then that's preferred if you can just
use a mini facelift or that is preferred. But for some
patients, well if you have more changes in the face more ageing
or new skin will you really need to address this. Some patients
may need additional personal procedures if you have a really
small chin, whether augmenting the chin such as with a chin
implant will make a really big difference. Sometimes that can
be prominent with Dr. fad, and that leads reshaping. And
really, we can beautify the face by using the golden ratio to
make the face more more elegant. What is the recovery? Well, in a
way, with with scientific papers, they've suggested that
deeply facelifting has a faster recovery than others snazz
types of facelift. However, for my experience, the recovery
really is a balance between what is done, the next surgery that
is done the faster recoveries and within that there is so much
individual variation with my patients for some patients who
have quite advanced face lifting surgery, some patients are
brilliant, even 24 hours. However, some patients patients
can really look quite swollen. And so I mean this this recovery
period can vary quite a bit for most techniques. And generally
for most facelift surgery, will you really need between two and
six weeks, and some patients will recover really quickly in a
shorter period, some patients will really take a bit longer.
Now there are things that can be done with regenerative medicine
to speed up your healing recovery. However, it's always a
good idea to allow a bit of extra time for recovery. So what
are the factors with deep face to face coverage? Well, the
common things are bruising and swelling and these things are
the most frustrating for patients. What can be done in
terms of speeding this up in terms of research deeply face
that he does recover faster than smiles facelift surgery. From my
experience that is not necessarily a substantial
difference. However, there are factors that we can use such as
oxygen, such as regenerative medicine, such as sedation
anaesthesia, or which can result in less swelling, less bruising
and faster recovery. Pain is not a common factor with recovery
from this kind of surgery. However, there is some tightness
and there is always some numbness and these are normal
expects recovery in terms of the scars, while key with face of
surgery is avoiding tension on the scars. And using these
techniques, multiple levels of stitches, you're finding the
scars and the bed placed in the natural curves around the year.
In the great majority of patients most guys are difficult
to see, there is about a 1% chance where the scars can be
more troublesome. And this can include things like keloid
scarring, and sometimes this cause additional treatments such
as anti inflammatory medicines, or even revision. So let's have
a look at a few case studies. So this lady while she had
considerable jowls, she has significant sagging of the skin
and multiple lines and wrinkles showing that little loose skin.
With volume loss, there's shadows that can show there's
been volume loss in terms of the pace, but deeply fearful face
lifting is really restored the natural anatomy. In addition,
like fat transfer and nanofab transfer has improved the lines
in the skin. And even though there's still swelling in this
graph, we can see that there's a marked improvement in the
natural enemy of the face. This lady while she has these kind of
deep marionette lines, he has changes along the jowls which
consistent with gravity, really in that central area, that area
near the nose that I described to you earlier. A deeply
facelifting Well, it really restores that natural enemy and
this is often an area where a bottle of fat can be a bit
prominent at the same time is deeply facelift. Now
buccal fat
can be reshaped in that can you really make this a much more
elegant. This is a challenging area non surgically surgically.
But using these kind of techniques can really be made
significant. This gentleman will hear quite a bit of ageing in
terms of gravity deep lines significantly cemetery around
the eyelids his left eye was much more droopy and puffiness
around the lower eyelid area. And afterwards will combination
of deep learning face that thing is restored is drawing in a very
natural way. It's lifted the fullness around the lines and
the same time eyelid surgery in toeses correction of the droopy
eyelid while it's really given him a refreshed like natural
appearance. So in summary, well, we've talked about what a deep
plane facelift is. We've talked about how it differs from the
other like facelift techniques. We talked about facial ageing
and how different facial surgery can influence that. We talked
about the recovery. And we've really come to a conclusion that
it does really depend on what you need as an individual person
what your individual facial characteristics are. How do you
choose the rice facelift you want? key is finding the right
doctor, the right surgeon to give you that kind of guidance
and that will reply some research in your area. Finding a
specialist who does a lot of facial surgery. Looking for
someone who will experiencing different surgical techniques
and has a degree of artistry because 50% of this kind of
surgery is technical detail and other 50% is really, really
artistry.
There's no quick solution, but you need to do your research. So
well thank you for watching this video. I hope this information
has been useful for you and if you have any other further
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