In the ever-evolving field of facial plastic surgery, techniques are constantly refined to provide patients with natural-looking results, minimal downtime, and enhanced confidence. One such innovation that has garnered significant attention is the “ponytail facelift.” Named for the way it mimics the lifted, refreshed look achieved by pulling one’s hair into a high ponytail, this procedure offers a modern twist on traditional facelift techniques. At The ENT Clinic, under the expert guidance of Dr. Sandeep Uppal, this advanced procedure is tailored to meet the unique needs of each patient, combining aesthetic artistry with surgical precision. What Is the Ponytail Facelift? The ponytail facelift is a minimally invasive surgical procedure designed to achieve a youthful, lifted appearance without the telltale signs of surgery. Unlike traditional facelifts that address the entire face, this technique is customized to the patient’s needs and focuses on the upper, middle  and lower-face, targeting areas such as the temples, mid-face and jawline. The result is a natural enhancement that maintains the patient’s unique features. Here’s a simplified explanation of the four types of ponytail lift procedures, focusing on what they address, the incisions, and the extent of the work done under the skin: Ponytail Lift I (PTL-I) Who is it for? People in their 30s or 40s showing early signs of aging in the upper face or younger individuals seeking facial enhancement. What’s done? Small incisions are made entirely within the scalp, so they’re invisible. Extent of dissection: Focuses on lifting and tightening the upper two-thirds of the face. Ponytail Lift II (PTL-II) Who is it for? People aged 40 to 45 with early jowls (sagging along the jawline) but minimal neck skin looseness. What’s done? A small 2-cm incision behind the ear is used to slim the lower face and jowls. If there’s a double chin, a 1.5-cm incision under the chin helps contour the neck (no neck skin is removed). Extent of dissection: Involves deeper work to tighten the underlying facial structures (SMAS) and improve jawline and neck contour. Ponytail Facelift I (PTFL-I) Who is it for? Individuals aged 45 to 65 with noticeable sagging skin in the lower face and neck. What’s done? A longer incision behind the ear removes extra skin and lifts the neck and lower face. Work on the deeper layers tightens the jawline and neck muscles for a smoother result. Extent of dissection: Includes deeper reshaping of the neck muscles, contouring, and skin removal in the lower face and neck. No incisions are made near the sideburns or in front of the ear. Ponytail Facelift II (PTFL-II) Who is it for? People 65 and older with heavy jowls, lots of loose neck skin, and poor skin elasticity. What’s done? Adds a small incision in front of the ear to the PTFL-I approach, which allows better handling of excess skin. No incisions in the sideburn or hairline. Extent of dissection: This is the most comprehensive option, addressing severe sagging and restoring a youthful look. In short, the Ponytail procedures range from minor lifts for early aging to more extensive facelifts for significant sagging. The incisions are cleverly hidden, and the level of work done depends on the degree of aging and the patient’s needs. Why the Name? When you pull your hair into a tight, high ponytail, you might notice a subtle lift around your temples, eyes, and cheeks. This effect inspired the name of the procedure. The ponytail facelift replicates this aesthetic—a gentle elevation of key areas to create a refreshed yet natural look. Importantly, the procedure does not involve physically pulling the hair; rather, it’s about strategically repositioning tissue and tightening underlying structures. Key Features of the Ponytail Facelift Minimally Invasive: The procedure often involves smaller incisions hidden within the hairline, and around the ears, reducing visible scars and accelerating recovery. Natural Results: Unlike traditional facelifts that can sometimes appear overly tight, the ponytail facelift focuses on subtle enhancements, preserving facial harmony. Customizable: The technique can be tailored to address specific areas of concern, making it ideal for younger patients or those seeking a preventive approach to aging. Reduced Downtime: Thanks to its minimally invasive nature, patients typically experience faster recovery times compared to traditional facelifts. Comprehensive Patient Assessment at The ENT Clinic Dr. Sandeep Uppal takes a meticulous approach to assessing each patient. During your consultation, you can expect: Facial Anatomy Analysis: Dr. Uppal examines your bone structure, skin quality, and areas of volume loss to determine the most effective approach. Goal Discussion: Understanding your aesthetic concerns and desired outcomes ensures alignment between your expectations and achievable results. Medical History Review: A comprehensive review of your medical history, including previous surgeries, allergies, and any medical conditions, helps identify potential risks. Skin Elasticity Evaluation: Assessing your skin’s elasticity is essential, as it determines the degree of lift and repositioning that can be achieved. Photography and Imaging: High-resolution photos are taken to document your pre-operative state and aid in surgical planning. Pre-Operative Care at The ENT Clinic Dr. Sandeep’s team provides personalized guidance to prepare you for surgery: Lifestyle Adjustments: Quit Smoking: Smoking can impair healing and increase the risk of complications. Avoid Certain Medications: Blood-thinning medications, such as aspirin and NSAIDs, Vitamin E supplements, herbal medications, Ginko Biloba, and Ginger should be discontinued as advised. Skin Preparation: Medical-grade skincare products or pre-surgical treatments like chemical peels may be recommended. Nutritional Guidance: A balanced diet rich in vitamins, particularly Vitamin C and protein, promotes healing. Supplements like Arnica Montana may be recommended to reduce bruising and swelling. The Procedure The ponytail facelift at The ENT Clinic is performed with meticulous attention to detail. Dr. Sandeep uses small incisions discreetly placed within the hairline and around the ear to lift and reposition underlying tissues. Excess skin is carefully removed, and incisions are closed to ensure minimal scarring. Dr. Sandeep’s expertise in facial plastic surgery ensures that natural contours are preserved for a balanced, refreshed appearance. Post-Operative Care and Management Dr. Sandeep’s team provides comprehensive post-operative care to ensure a smooth

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

WHAT IS A MIDFACE LIFT? INTRODUCTION TO MIDFACE LIFTS A midface lift, also known as a cheek lift, targets the area of the face extending from the lower eyelids to the upper lip. This procedure is designed to elevate the cheeks, reduce the nasolabial folds, and restore a more youthful contour to the mid-region of the face. PROCEDURE SPECIFICS Performed by Dr Sandeep, the midface lift involves precise incisions commonly placed within the hairline or inside the mouth. Through these incisions, Dr Sandeep repositions the soft tissues and elevates the fat pad in the cheek for a lifted, more youthful appearance. The objective is to correct the hollowing of cheeks and reduce the deep lines that develop with age. MIDFACE LIFT VS. OTHER FACIAL PROCEDURES UNDERSTANDING THE MIDFACE LIFT PROCEDURE Unlike full facelifts that address the entire face or mini facelifts that focus on the lower face, the midface lift specifically targets the cheeks and midfacial area. This specialized procedure can create significant improvements for patients who have experienced sagging or flattening of the cheeks without the need for a more extensive facelift. However, the procedure may be performed in conjunction with a lower facelift and neck lift for maximum impact. COMPARING THE TWO A midface lift is often recommended for patients who do not yet need a full facelift. RECOVERY AND DOWNTIME The recovery time is typically shorter than that of a full facelift, with most patients returning to their daily activities within 10 to 14 days. However, the subperiosteal midface lift can lead to more swelling than a conventional facelift, this swelling may take a few weeks to resolve completely. However, as with any surgical procedure, there are risks of complications such as swelling, bruising, numbness, or asymmetry. IDEAL CANDIDATES Candidates best suited for a midface lift are those who notice sagging of the cheeks, prominent tear troughs with hollowing under the eyes, deepening nasolabial folds, and a desire to enhance the midfacial area without undergoing a full facelift. Patients with good skin elasticity and realistic expectations about the outcome tend to be the most satisfied. WHAT CAN A MIDFACE LIFT NOT ACHIEVE? A midface lift is a surgical procedure that can offer significant improvements in the appearance of the midface area, but it does have limitations. Here are some of the things a midface lift cannot achieve: Improvement in Skin Quality: While it can reposition sagging tissue and enhance volume, it does not change the texture or quality of the skin. Issues like sun damage, fine lines, and skin discoloration will not be corrected by a midface lift. Tightening of the Lower Face and Neck: A midface lift does not address sagging jowls, a double chin, or neck laxity. These concerns would require a lower facelift or neck lift. Elimination of Forehead Wrinkles: Concerns such as forehead lines or drooping eyebrows are not corrected with a midface lift. These areas are typically addressed with a brow lift or botulinum toxin injections. Correction of Eyelid Sagging: For drooping eyelids or bags under the eyes, blepharoplasty (eyelid surgery) would be the appropriate procedure. Long-term Results for Advanced Aging: While a midface lift can offer rejuvenation, it may not be sufficient for individuals with significant signs of aging who may require more extensive surgical procedures for longer-lasting results. Replacement of Volume Loss with Fillers: A midface lift repositions existing tissues but does not add volume in the way that dermal fillers do. For some patients, a combination of surgery and fillers may be necessary for the desired result. Stopping the Aging Process: No surgical procedure can halt the aging process. A midface lift can turn back the clock to a certain extent, but it does not stop further aging. Instant Results: Swelling and bruising are part of the healing process, and the final results of a midface lift will not be immediate. It can take several weeks to months for the outcome to fully materialize. Correcting Asymmetry: While a midface lift can sometimes improve facial symmetry, it cannot make a naturally asymmetric face perfectly symmetrical. Avoiding Future Procedures: As the aging process continues, additional procedures may be desired or necessary in the future to maintain the initial improvement. Understanding these limitations is crucial when considering a midface lift, and a board-certified plastic surgeon can provide a comprehensive assessment to determine the most suitable approach for achieving a patient’s aesthetic goals. CONSIDERING ADVANCED AGING For patients who exhibit significant signs of aging throughout the face, a full facelift, or a combination of facial procedures like a brow lift, lip lift and eyelid lift might be more appropriate to achieve comprehensive rejuvenation. PATIENT EXPECTATIONS AND SATISFACTION Setting realistic expectations is key to satisfaction with a midface lift. The procedure can offer a marked improvement in the appearance of the midface, but it’s crucial for patients to understand the specific changes a midface lift can and cannot achieve. A thorough consultation with a trained Facial Plastic Surgeon like Dr Sandeep can help ensure that the patient’s goals are achievable with the procedure they choose. REFRESH YOUR VITALITY: SCHEDULE YOUR MIDFACE LIFT CONSULTATION TODAY! Elevate your facial contours and rediscover your youthful vibrancy with a midface lift.  Perfect for targeting the central section of your visage, this procedure is designed to lift sagging cheeks, diminish deep nasolabial folds, and restore the buoyant fullness of youth. Sit down with experienced Facial Plastic Surgeon Dr Sandeep to learn how a midface lift can enhance your natural beauty and reverse the signs of aging.  We are committed to guiding you through the transformative possibilities that a midface lift offers, focusing on natural-looking, rejuvenating results. Secure your consultation today and take the first step toward a rejuvenated, uplifted facial appearance.

WHAT IS A DEEP PLANE FACELIFT? As we age, our cheeks and jowls can sag and create a more bottom-heavy look to the face. By lifting these areas, Dr Sandeep can restore volume to the face in the right places and create a more triangular shape.   It is Dr Sandeep’s opinion that the best method for lifting cheeks is a deep plane facelift, which we refer to as an “underwire bra for cheek fat.”   Deep plane facelift is a type of traditional Sub SMAS facelift that involves a deeper dissection of the facial tissues than a standard facelift. During a deep plane facelift, Dr Sandeep works on a deeper layer of tissue beneath the skin including the Superficial Musculoaponeurotic System (SMAS), called the “deep plane,” which allows for more comprehensive lifting and repositioning of the facial structures. PEANUT BUTTER AND JELLY (PB&J) SANDWICH ANALOGY Creating an analogy of a peanut butter and jelly (PB&J) sandwich for a deep plane facelift can help in understanding the complexity and layers involved in the surgical procedure. Here’s how one might compare the two: INGREDIENTS AND LAYERS BREAD (TOP SLICE) This represents the topmost layer of the skin. In a facelift, this is the layer that is initially cut and lifted to gain access to the deeper structures. Just like the top slice of bread is lifted to add or spread the ingredients, the skin is lifted to work on the deeper layers of the face. PEANUT BUTTER Think of the peanut butter as the superficial musculoaponeurotic system (SMAS), which is a layer of tissue that covers the deeper structures of the face and neck. In a traditional facelift, the SMAS is tightened to create a more youthful look. However, in a deep plane facelift, the surgeon works below this layer. JELLY The jelly can be likened to the deeper sub-SMAS structures, including the facial muscles and deeper fat compartments. The deep plane facelift targets these areas, going under the “peanut butter layer” to reposition these structures and improve facial contouring. The jelly’s movement when you spread it can be similar to how these deeper structures are adjusted during the surgery. BREAD (BOTTOM SLICE) This represents the deeper structures of the face, such as the bones and deep facial musculature. In the PB&J sandwich, this slice supports everything else; in the face, the bones provide the foundation upon which the muscles and other tissues rest. PROCESS OF ASSEMBLY VS. SURGERY PREPARATION Just like gathering your ingredients for the sandwich, a deep plane facelift requires careful planning and understanding of the facial anatomy. SPREADING THE PEANUT BUTTER AND JELLY In a PB&J, you must spread the ingredients evenly to cover the bread properly. In a facelift, the surgeon must similarly work with precision to manipulate the tissues evenly and smoothly for a natural look. REASSEMBLING THE SANDWICH Once the peanut butter and jelly are spread, you carefully put the top slice back on. Similarly, after repositioning the deeper tissues in a facelift, the skin is re-draped over the face, and any excess is trimmed to create a smooth, natural appearance without over-tightening or causing distortion. OUTCOME A TASTY SANDWICH VS. REJUVENATED APPEARANCE The goal with your PB&J is a delicious, well-balanced sandwich. With the deep plane facelift, the goal is a youthful, natural, and long-lasting rejuvenation that maintains the balance and harmony of facial features.   In both scenarios, the way ingredients or tissues are manipulated affects the final result. The deep plane facelift, like the careful layering and blending of peanut butter and jelly, requires meticulous technique to ensure that the final outcome is both aesthetically pleasing and structurally sound. DURABLE AND NATURAL LOOKING RESULTS Dr Sandeep believes that the strongest, most natural-looking, and durable lift can be achieved by lifting and tightening the skin on the neck to create a more defined chin neckline angle. To eliminate jowls and highlight the jawline, he also lifts them to make them less visible. Additionally, he lifts the cheeks to create a more youthful, top-heavy appearance. Deep plane facelift technique can be particularly effective for addressing advanced signs of aging in the midface and lower face, including jowls and marionette lines. INCISIONS The deep plane facelift involves slightly longer incisions than a standard facelift, which may run from the temple area down to the neck. However, the incisions are typically placed in areas that can be easily hidden within the natural folds and contours of the face. RECOVERY Recovery from a deep plane facelift can take longer than a standard facelift, with swelling and bruising lasting several weeks. RISKS As with any surgical procedure, there are risks associated with a deep plane facelift, including bleeding, infection, and nerve damage. Our team will provide you with detailed pre-operative and post-operative instructions that you must follow diligently to minimize the risk of complications. Read More on detailed explanation of deep plane and extended deep plane facelift>>

DETAILED EXPLANATION OF DEEP PLANE AND EXTENDED DEEP PLANE FACE LIFT WHAT IS A DEEP PLANE FACELIFT? As we age, our cheeks and jowls can sag and create a more bottom-heavy look. By lifting these areas, we can restore volume to the face in the right places and create a more triangular shape. In my opinion, the best method for lifting cheeks is a deep plane facelift, which we refer to as an “underwire bra for cheek fat.” The “deep plane” refers to the anatomical plane situated between the SMAS-platysma complex (consisting of muscle and fascia) and the deeper layer of muscles responsible for facial expression. This technique primarily involves manipulating and relocating muscle and fat layers rather than relying on skin traction and excision. Deep plane facelift is a type of traditional facelift that involves a deeper dissection of the facial tissues than a standard facelift. The deep plane facelift overcomes the issue seen in numerous contemporary facelifts, where the result appears excessively tight and overfilled. The key principle of this procedure is to lift solely beneath the deeper layer of tissue beneath the skin including the Superficial Musculoaponeurotic System (SMAS), called the “deep plane”. This allows for more comprehensive lifting and repositioning of the facial structures, allowing the skin to remain attached to the muscles, thereby avoiding an overly tight appearance. Deep plane facelift elevates the cheeks by releasing the facial tethering points within the deep plane, eliminating the need for adding fat or filler. DR SANDEEP’S PHILOSOPHY OF DEEP PLANE FACELIFT Dr Sandeep believes in achieving the most natural-looking and durable lift by addressing various elements of facial aging. He focuses on tightening the skin on the neck to create a more defined chin-neckline angle and works to eliminate jowls to highlight the jawline. Additionally, he aims to lift the cheeks to create a youthful, top-heavy appearance. DEEP PLANE FACELIFT SURGICAL PROCEDURE INITIAL CONSULTATION Dr Sandeep and his team hold a comprehensive consultation with the patient. An evaluation of patient’s aesthetic desires, their facial anatomy, skin condition, and overall health is performed. Information about the Deep Plane Lift, including benefits and risks, is thoroughly discussed. INFORMED CONSENT As a part of the informed consent process information about the deep plane facelift, including benefits and risks, alternative management options, downtime, pre-operative preparation and need for close post-operative follow-up is thoroughly discussed. PRE-SURGICAL PREPARATION Pre-operative tests may be ordered to ensure patient suitability for the procedure. Detailed instructions regarding medication adjustments, diet, and lifestyle are provided. DAY OF PROCEDURE The patient is welcomed into the state-of-the-art surgical facility used by our team. Strict hygiene and safety protocols are followed to ensure patient well-being. An experienced anaesthetist administers appropriate anaesthesia. SURGICAL APPROACH Dr Sandeep makes careful incisions around the hairline and ear so that the scars are well hidden. The incision is used to access SMAS, the deeper layer of the face. The deep plane facelift involves manipulating and lifting the SMAS and deeper facial structures by releasing tough fibrous ligaments. Dr Sandeep focuses on achieving a natural, balanced lift without over-tightening the skin. TISSUE MANIPULATION AND LIFTING Excess skin is removed. The deeper facial structures are repositioned, and sutures are used to anchor the lifted tissues in place, providing a durable a more youthful and natural appearance. Dr Sandeep uses specialized techniques to ensure minimal scarring and maximise aesthetic outcomes. The incisions are closed meticulously to encourage optimal healing. POST-OPERATIVE CARE The patient is moved to a recovery area for close monitoring. Instructions for post-operative care, including managing swelling and bruising, are provided. FOLLOW-UP AND MONITORING Patients return for scheduled follow-up appointments to assess the healing process. Dr Sandeep reviews the long-term results and makes any necessary adjustments. LONG-TERM RESULTS The deep plane facelift offers enduring rejuvenation and a more youthful facial appearance. Patient satisfaction is often high, thanks to the natural-looking results. OVERALL EXPERIENCE Patients opting for a deep plane facelift benefit from Dr Sandeep’s extensive experience, the team’s personalized approach, and the focus on achieving the most natural and satisfying aesthetic results. ADVANTAGE OF DEEP PLANE FACELIFT NATURAL-LOOKING RESULTS Dr Sandeep focuses on achieving a natural and durable lift, avoiding the overly “pulled” look that can result from other techniques. ADDRESSES MULTIPLE AGING SIGNS Effective in treating advanced signs of aging in the midface and lower face, such as jowls and marionette lines. LONG-LASTING OUTCOMES This technique leverages the fibrous and inelastic deeper layer of the face, which results in longer-lasting outcomes compared to the highly elastic skin. In fact, results often last for 10 years or more, making the deep plane facelift more durable than SMAS-type facelifts. DEFINED CHIN-NECKLINE ANGLE The technique tightens the skin on the neck, creating a more defined chin-neckline angle. ENHANCED JAWLINE AND NECK Works to eliminate jowls, highlight the jawline and rejuvenate he neck by removing excess fat and repositioning the SMAS. TENSION-FREE TISSUE MOVEMENT Dr Sandeep’s technique specifically incorporates the release of ligaments tethering the deep plane layer to achieve tension-free movement. This ensures that the facelift does not create an unnatural tightness. YOUTHFUL CHEEK APPEARANCE The release four key ligaments, resulting in corresponding natural lifting throughout the face and neck. The first ligaments released are the zygomatic ligaments, which tether the cheek. This allows for the elevation of drooping cheeks, restoring the heart-shaped face of youth. VOLUME RESTORATION Releases zygomatic ligaments to elevate drooping cheeks, improving nasolabial folds and addressing any hollowing and shadowing seen under the lower eyelids by restoring lost volume associated with aging and gravitational descent. NO NEED FOR FILLERS OR IMPLANTS Restores the heart-shaped face of youth without requiring additional procedures like fillers, fat transfers, or cheek implants. CONCEALABLE INCISIONS Even though the incisions are longer than those of a standard facelift, they are usually placed in areas that can be easily hidden within the natural folds and contours of the face. REVISION FACELIFT Deep plane facelift is particularly suited for patients who have previously undergone a facelift but are not satisfied with the

Thread lift Thread lifts are a minimally invasive cosmetic procedure designed to lift and tighten sagging skin tissues. The technique involves the use of temporary, medical-grade suture threads to pull the skin. The procedure aims to provide a less invasive alternative to a traditional surgical facelift, offering reduced downtime. TYPES OF THREADS PDO (POLYDIOXANONE) Material: Synthetic, absorbable monofilament thread. Duration: Usually dissolves in about 6 months. Action: Primarily mechanical, providing immediate lift. Side Effects: Minor, including slight bruising or swelling. PLA (POLYLACTIC ACID) Material: Synthetic, absorbable. Duration: Can last up to 6-18 months. Action: Stimulates collagen production for more prolonged effects. Side Effects: Similar to PDO, with potential for longer-lasting bruising. SILHOUETTE SOFT Material: Made of Poly L-lactic acid. Duration: About 6-18 months. Action: Tiny absorbable cones provide extra grip and support. Side Effects: Potential for more discomfort during the procedure due to the cones. PROCEDURE CONSULTATION Detailed skin assessment, often involving imaging. Discussion of treatment goals, expectations, and potential risks. ANESTHESIA Usually local anaesthesia. Numbing cream to minimize discomfort. THREAD INSERTION Threads are inserted through fine needles or cannulas. The exact number and entry points are mapped out beforehand. LIFTING Threads are pulled to achieve the desired lifting effect. This step requires meticulous skill to avoid asymmetry or over-pulling. After confirming the lift, excess threads are cut and often tucked beneath the skin. DOWNTIME Minimal compared to surgical options. Most clients return to work within 2-3 days. AFTERCARE Cold compresses may be used to reduce swelling. Antiseptic ointment may be advised to prevent infection. Avoid high-impact exercise for 2-3 weeks. Avoid exaggerated facial movements and facial massages for the first few weeks. ADVANTAGES Minimally Invasive. No surgical incisions or stitches, reducing infection risk. Effects are often visible immediately after the procedure. Generally, minimal downtime and side effects. RISKS AND PRECAUTIONS Skin Irregularities may be caused by bunching of tissue or palpable threads or knots. Care must be taken to avoid overtightening, which can lead to dimpling or irregular contours. Infection: While rare, any breach of skin can introduce infection. Rarely the infection may be severe requiring hospital admission and intravenous antibiotics for treatment. Skin necrosis: Infection or inflammation from reaction to the thread material may lead to part of the skin dying leading to severe scarring. Thread Movement: In rare cases, the threads can migrate, requiring a corrective procedure. Thread extrusion: The body may reject the thread and it may extrude from the skin requiring removal. LONGEVITY Longevity depends on the type of thread used, individual skin properties, and lifestyle factors like smoking or sun exposure. Clients are often disappointed with the short-lived results and the need for frequent maintenance procedures. The cost of the frequent touch-up procedures can build up over time. Dr Sandeep does not recommend thread lifts for most clients because of these reasons. Results are generally not as enduring as surgical facelifts and hence facelifts are the recommended treatment in our clinic. Thread lifts offer a convenient, lower-risk alternative to surgical facelifts, but they are not a substitute for more extensive procedures in cases of significant sagging or skin laxity. Consult Dr Sandeep for an in-depth discussion on the options available for facial rejuvenation. During the consultation Dr Sandeep will recommend an individualized treatment plan in line with your aesthetic goals.