INDICATIONS OF A FACELIFT: UNVEILING COSMETIC SURGERY SECRETS Today, let’s discuss the unmistakable signs of a facelift, a subject of widespread speculation, especially among public figures and celebrities. The question often arises, “Have they undergone cosmetic enhancement?” THE FEAR OF AN UNNATURAL APPEARANCE From what I observe, the paramount concern for patients considering cosmetic enhancements, particularly facelifts, is maintaining discretion. They’re anxious about an unnatural outcome—appearing stretched, altered, or artificial—which is a rarity, often linked to outdated methods or suboptimal surgical decisions. I advocate for more restrained surgical methods that maintain a person’s natural look rather than making them appear excessively altered. The most apparent evidence of a successful facelift is the disappearance of sagging skin, notably the ‘turkey neck,’ leaving one looking refreshed and vibrant. If others notice an improvement in your appearance, assuming you appear well-rested, slimmer, or generally more youthful, that’s a positive sign. The hallmark of a facelift done well is an enhanced appearance without the overt evidence of surgery. Maintaining your essence is crucial. You shouldn’t look excessively tightened or modified. Despite diving into various signs of a facelift, the primary indicator should be a noticeable improvement in your look, which leaves others puzzled about the change. It’s worth mentioning that shortly after the procedure, some swelling and a tight feeling are normal, suggesting a period of low profile is ideal. SUBTLE EVIDENCE OF A FACELIFT Foremost, a facelift should eradicate signs of aging, like the drooping ‘turkey neck,’ presenting a rejuvenated yet believable version of oneself. Ideally, acquaintances might comment on your refreshed look, suggesting you appear more youthful or even more slender, without jumping to the conclusion of a facelift. The optimal result is not just looking better but also maintaining your unique identity. TEMPORARY EFFECTS POST-SURGERY Another aspect of the procedure I’d like to clarify is the misconception about its discomfort—it’s generally not painful. The sensation post-surgery is more about numbness and tightness, rather than severe pain. Consequently, patients are eager to resume social activities, sometimes appearing in public while still noticeably swollen. It’s common among celebrities who might step onto the red carpet too soon post-operation, their features still puffy and healing, causing speculation. But as the swelling subsides over time, their appearance settles, and it may no longer be apparent that they’ve had work done.There’s a delicate time during recovery when it’s wise to lay low if you wish to keep the procedure private. Once healed, you ought to embody a refreshed, youthful, and naturally attractive version of yourself, avoiding the conspicuously over-tightened aesthetic. We’ll discuss various facelift indicators, not necessarily ranked by frequency, with the overly tightened skin being an immediate giveaway, though this is an outcome to be avoided. SIGNS THAT REVEAL A FACELIFT THE OVERLY TIGHTENED FACE Moreover, the directional approach to lifting has also evolved. Previously, the skin was stretched more to the sides, but current techniques involve multiple layers and altered vectors, pulling upwards and beneath to reposition facial features more naturally with significantly less strain on the skin. Patients who appear as if their skin has been overly tightened, suggesting an unnatural pull—such as what might have been observed with Demi Moore—are witnessing an undesirable outcome. This ‘wind-swept’ or ‘joker’ appearance is precisely what modern methods aim to prevent and should be meticulously avoided. OVERDONE LIFTING TECHNIQUES Moreover, the directions of lifting have evolved. Older methods involved lateral pulling, whereas contemporary techniques employ multi-layered approaches and varied angles, aiming for a more natural repositioning of facial tissues. Nonetheless, instances of over-pulled features still surface, as seen in the likes of Demi Moore, where the face exhibits a taut, unnatural wind-swept appearance. EXCESSIVE PLUMPING Just as being over-pulled is one issue, being over-plumped is another. The clear sign that catches people’s attention is excessive filling of the face during surgery, resulting in a bloated, over-plumped look. Nowadays, as part of the facial rejuvenation process, it’s a standard practice for most surgeons to reintroduce volume to the face to counteract the hollowing that comes with age, not just the sagging of skin. Fat grafting is a common method used to reflate specific facial zones that have lost their fullness over time. However, when this technique is taken too far, the result can be an overly inflated facial appearance. This overly volumized look is reminiscent of the chubby cheeks of Cabbage Patch Kid dolls, and celebrities like Goldie Hawn and Madonna have, at times, displayed this excessively plump facial look. Whether due to an abundance of grafting, fillers, or a combination of both with a facelift, the excessive volume can detract from the natural aesthetic. The key is to avoid the extremes of overdoing it. SPECIAL CONSIDERATIONS FOR MEN In the case of male patients, the approach to facelifts requires an extra degree of caution. It’s essential to ensure that the filling doesn’t feminize the face if that’s not the intended result. Also, it’s important to consider the direction of skin tightening, as it can significantly alter a man’s appearance, particularly in the context of facial hair. Incorrect pulling can cause sideburns to shift or even disappear and hairlines to recede. These effects can lead to an unbalanced, disproportionate look due to unnatural pulling directions. THE ART OF CONCEALING SCARS When considering facelifts, scarring is another critical aspect. Scars must be placed strategically to be less noticeable. In older techniques, scars were more visible, which caused concerns for patients. Modern facelifts, however, tend to hide incisions inside the ear and in the crease behind the ear, avoiding visible scars along the hairline. Older skin only facelifts place excessive tension on the skin leading to wide and visible scars. The newer techniques like deep-plane facelift avoid these problems. EAR DEFORMITY – A TELL-TALE SIGN OF A FACELIFT Another issue to consider is the change in appearance of the ears. If scars are not placed carefully, it can alter the shape of the ears. Common issues include a hidden tragus or a “pixie ear” where the earlobe attaches

WHAT IS IT LIKE TO HAVE A FACELIFT? Undergoing a facelift procedure can be a significant decision, and it’s normal to feel some anxiety or uncertainty about what to expect. Here is a general overview of what it is like to have a facelift: CONSULTATION Before the procedure, you will have a consultation with Dr Sandeep to discuss your goals, medical history, and the details of the surgery. This is a good opportunity to ask any questions and address any concerns you may have. ANAESTHESIA Facelift surgery is typically performed under general anaesthesia, which means you will be asleep during the procedure. INCISIONS Dr Sandeep will discuss the incision with you in detail. The agreed-upon incisions are carefully placed in targeted locations around the hairline and ears, and in some cases under the chin to minimize scar visibility. At the end of the procedure Dr Uppal carefully closes the incisions so that the scars are well hidden and virtually out of sight. RESHAPING Once the incisions are made, Dr Sandeep will lift and reposition the underlying tissues, remove excess fat and skin, and tighten the remaining tissues. The exact techniques used will depend on your specific aging related changes, needs and goals. RECOVERY The recovery period after a facelift procedure is an important time for the body to heal and adjust to the changes made during the surgery. Here are some general guidelines for facelift recovery: REST You will need to rest and avoid strenuous activity for several weeks after the procedure. It’s important to take it easy and not push yourself too hard, as this can delay the healing process and increase the risk of complications. PAIN MANAGEMENT You may experience some discomfort, swelling, and bruising after the procedure. Dr Sandeep will prescribe pain medication to manage any discomfort. COMPRESSION BANDAGE Dr Sandeep will recommend wearing a compression bandage around the face and neck for a few days after surgery to help reduce swelling and promote healing. FOLLOW-UP APPOINTMENTS You will need to attend follow-up appointments to monitor your progress and ensure proper healing. Any stitches or drain tubes will be removed during these appointments. SKINCARE During the recovery period, it’s important to avoid exposing your skin to direct sunlight and to keep the incision sites clean and dry. Dr Sandeep will recommend specific skincare products to help promote healing and minimize scarring. PATIENCE The final results of a facelift can take several weeks or even months to fully appear, as the swelling subsides, and the skin settles into its new position. It’s important to be patient and allow your body time to heal fully. Healing is a process and improvement is a gradual day-by-day process. BACK TO WORK Most of our patients go back to work in about 1-2 weeks depending upon the kind of facelift they have undergone. They may not look great at this stage, but they’ll look okay and presentable. In three to four weeks, they look really good. In six weeks, they look very good, and although the surface healing is complete the deeper tissues are still recovering, and they will continue to heal and look better with further passage of time. We advise clients to wait at least six weeks to attend an important social or work event that requires pictures. RESULTS The initial swelling after the procedure will eventually subside, revealing the improvements made during the surgery. As the swelling goes down, the skin will appear tighter and more lifted, giving a more youthful expression and overall appearance. The wrinkles will be reduced, providing a smoother and more youthful complexion. It is important to note that the full results of a facelift may take several weeks or months to become apparent as the skin settles into its new position and the healing process is completed. However, once the healing is complete, the results can be long-lasting, providing a more youthful and rejuvenated appearance for many years to come. POST-OPERATIVE INSTRUCTIONS It’s important to note that everyone’s experience with facelift surgery will be unique, and there may be variations in the specific techniques used and the recovery process. Dr Sandeep will provide detailed instructions on what to expect before and after the procedure and will be available to answer any questions or concerns you may have along the way. GETTING THE MOST OUT OF YOUR FACELIFT It’s important to follow all the post-operative instructions carefully to ensure proper healing and minimize the risk of complications. While everyone’s recovery experience may vary, taking the necessary steps to care for yourself during this time can help ensure the best possible results from your facelift procedure. If required, a facelift can also be combined with other rejuvenating procedures provided by Dr Sandeep to achieve the best possible results. He will discuss your options with you during your consultation to see if combinations can further enhance your appearance. It’s important to note that while the benefits of a facelift can last for years, it does not stop the aging process altogether. However, if you had a twin who did not undergo facelift while you did, your face and neck will always appear 5-10 years younger than your twins. As time passes, your skin may continue to age, and you may eventually consider additional procedures to maintain your results. Additionally, while a facelift can provide significant improvements, it’s important to have realistic expectations and understand that the procedure may not completely eliminate all signs of aging. You can help maintain the rejuvenating effects of a facelift by following a healthy skincare routine and avoiding habits that accelerate the aging process, such as smoking or excessive sun exposure. By doing so, you can help promote the long-term health and vitality of your skin, and prolong the youthful appearance achieved through the facelift procedure. WHAT ARE THE RISKS OF FACELIFT? It’s important to note that although rare, facelift surgery does have some potential risks and complications, such as bleeding, infection, and scarring. However, when performed by a qualified and

WHAT IS A MINI FACELIFT? INTRODUCTION TO MINI FACELIFTS A mini facelift, commonly referred to as a short scar facelift or S-lift, is a specialized cosmetic surgical procedure designed to enhance facial appearance. PROCEDURE SPECIFICS Conducted by Dr Sandeep, the mini facelift procedure focuses on eliminating excess skin and firming the underlying tissues specifically in the lower face, jawline, and neck regions. The end goal of the procedure is to mitigate the appearance of wrinkles, saggy skin, and jowls, subsequently yielding a rejuvenated and younger-looking face. MINI FACELIFT VS. TRADITIONAL FACELIFT UNDERSTANDING THE FACELIFT PROCEDURE A traditional facelift involves making incisions around the ear and occasionally under the chin. This allows the surgeon to remove excess fat, tighten muscles, and elevate the fascia, resulting in a more balanced and youthful facial appearance. As individuals age, there’s a tendency for the face to appear bottom-heavy, and a facelift serves to rectify this imbalance. COMPARING THE TWO The distinction between a mini facelift and a standard facelift isn’t vast. While a traditional facelift encompasses larger incisions and a more in-depth dissection of the deeper facial structures, the mini facelift employs smaller incisions and less extensive dissection underneath the skin. These incisions are strategically placed either right in front of the ear or extended behind the ear and up to the hairline. Mini Facelift primarily tightens the fascia but lacks the depth of lift achievable under the SMAS layer that a full facelift provides. Dr Sandeep often advocates for the deep plane facelift because when clients invest in terms of recovery time and financial resources, the expectation is a long-lasting result that offers satisfaction for many years. RECOVERY AND DOWNTIME Owing to its less invasive nature involving smaller incisions and reduced structural work, the mini facelift generally demands less time for completion. The recovery phase is also quicker in comparison to a conventional facelift, with patients often resuming their regular routines within a span of one to two weeks. Nevertheless, potential risks such as bleeding, infection, scarring, and nerve damage are associated with the procedure. IDEAL CANDIDATES Every individual experiences the aging process differently. Some exhibit minor signs of aging, with minimal skin excess, early jowls formation, and a slightly ill-defined jawline. Such individuals are apt for a mini facelift and would benefit significantly from the procedure. However, longevity becomes a concern; even for these candidates, a deep plane facelift would offer extended results. CONSIDERING ADVANCED AGING For those showing more pronounced aging signs, including sagging skin, a poorly defined jawline, noticeable jowls, and neck banding, a deep plane facelift offers a superior and long-lasting lift. Regrettably, there are cases of individuals dissatisfied with their facelift results from other clinics, just 1-3 years post-surgery. For such clients, a deep plane facelift is often recommended for optimal and lasting outcomes. PATIENT EXPECTATIONS AND SATISFACTION The term “mini” in mini facelifts frequently attracts customers due to the perception of it offering a subtle, more natural result with reduced risks and faster recovery based on popular hearsay and literature. However, this often clashes with their actual desires of wanting pronounced improvements in their appearance. The fear of an exaggerated outcome propels them towards considering the mini facelift as a superior option. This mismatch of expectation often leads to disappointment with the limited, or “mini”mal, post-procedure results.

MACS LIFT MACS lift (Minimal Access Cranial Suspension lift) is a surgical technique used to rejuvenate the face by lifting, suspending and thus tightening sagging facial tissues.   ADVANTAGE It is a less invasive alternative to traditional facelift surgery and is designed to give a natural-looking result with less scarring and a quicker recovery time. It is an option for patients with minimal jowl formation, slight decrease in the definition of the jawline and slight skin excess. DISADVANTAGE The results of MACS lift are not as long lasting as a deep plane lift and the amount of lift achieved is also not as pronounced. MACS lift does not provide effective lift for the midface. Dr Uppal advises clients with drooping of midface or advanced signs of facial aging to choose the deep plane lift instead. PROCEDURE The procedure involves making small incisions around the ear and temple area, through which the surgeon lifts and repositions the underlying facial tissues. The skin is then re-draped and excess skin is removed, resulting in a smoother and more youthful appearance.   The MACS lift typically takes anywhere from 1-3 hours to perform.  Patients can usually return to normal activities within 1-2 weeks, with some mild bruising and swelling being the most common side effects. RISKS Like any surgical procedure, the MACS lift does carry some risks, including infection, bleeding, and scarring. RESULTS The longevity of MACS lift results can vary depending on several factors, including the patient’s age, skin quality, and lifestyle habits. In general, the results of a MACS lift can last for 1-3 years, but the effects will gradually diminish over time due to the natural aging process. Both procedures are advanced surgical techniques aimed at rejuvenating the face by lifting and repositioning both the skin and underlying muscle layers. However, there are key differences between the two that patients should consider:

WHAT IS A SUB SMAS FACELIFT? UNDERSTANDING SMAS SMAS stands for Superficial Musculo-Aponeurotic System, which is a layer of tissue located beneath the skin that connects the facial muscles to the overlying skin. The SMAS layer is a critical structure in facial rejuvenation as it supports the skin and deeper facial tissues. By manipulating and tightening this layer, significant improvements can be made in the appearance of the face. SUB SMAS FACELIFT In suitable patients Dr Sandeep employs a sub-SMAS facelift technique that focuses on addressing the SMAS layer to achieve a more rejuvenated and youthful appearance. GOAL The goal of these techniques is to achieve a youthful, rejuvenated appearance without an “over-pulled” or “windblown” look. When done correctly, the results of a sub-SMAS facelift can be both natural-looking and long-lasting. There are various techniques for manipulating the SMAS layer, including SMAS plication and SMAS imbrication: SMAS PLICATION This involves folding the SMAS layer onto itself and then suturing it in place. It’s a method of tightening the SMAS without removing any tissue. The advantage of this technique is that it avoids cutting the SMAS, reducing the risk of injury to the facial nerve. However, the results might not be as long-lasting compared to methods that involve excising part of the SMAS. SMAS IMBRICATION This technique involves making an incision in the SMAS and either removing the excess tissue or overlapping it with the remaining SMAS. The overlapped portions are then sutured together. This method is more involved than plication and can produce longer-lasting results. DEEP PLANE FACE LIFT Please read our blog on deep plane facelift to learn about this technique. Learn More >> THE PROCEDURE INCISION During a sub-SMAS facelift, Dr Sandeep makes incisions around the ear and lifts the skin and underlying tissues to access the SMAS layer. By making incisions around the ear, Dr Sandeep can discreetly hide the surgical scars, which is a common practice in facelift surgeries to ensure a natural-looking result. THE LIFT He then repositions and tightens the SMAS layer, by folding it on itself (SMAS Plication) or by incising the SMAS and either excising the excess tissue or by overlapping it with the remnant SMAS (SMAS imbrication) to tighten the SMAS layer.   After the necessary adjustments are made to the SMAS layer and any excess skin is removed, the skin is redraped over the new facial contours, and the incisions are sutured closed. This provides a firmer foundation for the skin to sit on, resulting in a more youthful and refreshed appearance. LIMITATIONS OF PLICATION AND IMBRICATION FACELIFT Sub-SMAS facelifts are often used to target early to moderate signs of lower facial sagging and laxity with early signs of jowl formation and ill-defined jawline. It is important to recognise that these techniques do not address signs of midface aging like descent of midface tissues and hollowing under the eyes, which requires either a deep plane facelift, endoscopic sub-periosteal midface lift often in conjunction with a lower blepharoplasty. RECOVERY Recovery time can vary depending on the extent of the surgery, but most patients can expect some swelling and bruising, which typically subsides within a few weeks. FOLLOW-UP APPOINTMENTS: FOR MONITORING RECOVERY AND DISCUSSING ANY CONCERNS. Suture Removal: If non-dissolvable sutures are used, they are removed 7 days after surgery. Touch-up Procedures: Rarely, some clients may require additional minor touch-up procedures for fine-tuning of the results. ADVANTAGE OF SUB SMAS LIFT Dr Sandeep and his team are well-versed in the myriad benefits that a lip lift procedure can offer. When clients consult with them, they are provided with a comprehensive understanding of how a lip lift can enhance their facial aesthetics. Here are some advantages of the procedure, as outlined by Dr Sandeep and his expert team: IMPROVED PROPORTION AND BALANCE One of the primary benefits of a lip lift is that it can improve the proportion and balance between the upper lip and other facial features. This creates a more harmonious and youthful appearance. REDUCED PHILTRUM LENGTH Some people have a long philtrum (the space between the upper lip and the base of the nose), either due to ageing or due to their natural lip anatomy. A lip lift can effectively shorten this distance, contributing to a younger and fresher look. ENHANCED TOOTH SHOW A subtle but appealing advantage of a lip lift is the slight exposure of the upper teeth when the mouth is slightly open or during speech, which is often considered a sign of youth and vitality. LONGER LASTING RESULTS A Sub SMAS lift offers durable results which will always make you appear 4-5 years younger than what you would look without the facelift.  NATURAL LOOK Dr Sandeep aims for a natural look, avoiding the ‘overdone’ appearance that can sometimes result from dermal fillers. The lip lift procedure lifts the client’s own tissue, which tends to result in a more natural texture and contour. QUICK RECOVERY The procedure is generally performed under local anaesthesia and is relatively quick, with most clients experiencing a swift recovery period. If the procedure is performed in combination with a facelift, a general anaesthesia is usually employed. BOOSTED SELF-CONFIDENCE Finally, but certainly not least, the aesthetic improvements achieved through a lip lift often leads to a significant boost in self-confidence and self-esteem. For anyone considering a lip lift, a consultation with Dr Sandeep and his team is the first step towards understanding how this procedure can meet individual aesthetic goals. They are committed to providing personalised care and expert guidance throughout the entire process. POTENTIAL RISKS AND DISADVANTAGE OF LIP LIFT Dr Sandeep and his team believe in providing a balanced and comprehensive overview of any procedure, including lip lift. While the advantages are numerous, it’s equally important to understand the potential downsides. Here are some of the disadvantages that Dr Sandeep and his expert team usually discuss with their clients: SCARRING RISK Even though Dr Sandeep utilises advanced techniques to minimise scarring, there is always a risk of scar formation, particularly