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Facial plastic surgery

The Harley Street Nose Clinic has specialist expertise in the management of nose and sinus related problems. We also offer a variety of facial plastic surgery procedures, including otoplasty to reshape the ear, facelifts and neck lifts.

Which procedure are you interested in?

What is otoplasty (ear reshaping)?

Otoplasty or pinnaplasty is an operation used to treat protruding ears in adults and children over six months old.

The aims of surgery are:

  • to set back prominent ears closer to the side of the head
  • to correct overly large ears.

In the United Kingdom, otoplasty is usually performed under a general anaesthetic, however some surgeons may prefer to use local anaesthesia. Otoplasty can be carried out as a day case procedure but occasionally your doctor may recommend an overnight stay.

Performed under general anaesthesia, the operation works endoscopically through the nose, where surgeons will remove the bones of the medial and inferior orbit. As the operation is performed entirely through the nostrils, most people can go home the same day.

The various techniques for the operation will be discussed with you. Some operations involve the removal of a small ellipse of skin from behind the ear to expose the ear cartilage. The surgeon can then reshape the cartilage to create a natural looking fold.

The patient’s head is usually wrapped in a head bandage immediately after the surgery to promote the best moulding and healing. The ears may throb or ache for a few days but this operation should not be particularly painful.

What is blepharoplasty (eyelid surgery)?

Blepharoplasty is the term used to describe the operation to reduce bagginess of the upper/lower eyelids to lessen the signs of ageing around the eyes.

Performed to remove tumours from the pituitary gland – which is responsible for regulating most of the body’s hormones – endoscopic pituitary surgery (also called transsphenoidal endoscopic surgery) is executed through the nose with an instrument called an endoscope.

The aims of surgery are:

  • To improve the appearance of the eye to give a more youthful appearance
  • To enhance the eyes and reduce the appearance of tiredness
  • To produce a result that is in harmony with the face and has a natural appearance

These aims are achieved by careful pre-operative assessment to ensure the surgical plan is tailored to the individual patient. Before the operation, one, and sometimes two, consultations are required. Pre-operative photographs will be taken.

Upper eyelid surgery can be carried out under local or general anaesthesia. Combined upper and lower lid surgery is usually carried out under general anaesthetic, and occasionally some tightening of the lower eyelid is carried out to prevent drooping.

What is mentoplasty (chin augmentation)?

Mentoplasty is a procedure that reshapes the chin. Enhancement or reduction can be carried out depending on the outcome of careful pre-operative assessment. It may be recommended in conjunction with rhinoplasty (nose surgery), to achieve an improvement in overall facial balance.

When implants are used, a small silastic (plastic) implant is inserted just in front of the jaw bone through a small incision underneath the chin. The implant is shaped to create a natural appearance.

Chin reduction surgery requires the existing bone to be sculpted to a more aesthetically pleasing shape.

The aims of surgery are:

  • to reduce a prominent chin and so create balance with the rest of the face
  • to augment a receding chin
  • to enhance the natural contours of the face.

The operation can last from 30 minutes up to an hour depending on the individual and the surgical requirements. The procedure is usually performed under general anaesthetic but if mentoplasty is the sole procedure it can be carried out under local anaesthetic and sedation.

What is a facelift?

A facelift is designed to significantly reduce the signs of aging by tightening skin in the mid-face, jawline, and upper neck.

The aims of surgery are:

  • To reduce sagging and excess skin in the mid and lower face
  • To help improve the tone of the underlying structures

Local anaesthetic is inserted with adrenaline to minimise bleeding. A continuous incision is made running from the temple downwards, then along the hairline.

After the skin is raised, the underlying tissue is gently pulled up and stitched into place in order to give better form to the face and jawline once the skin is laid back down. This is carried out in both the face and upper neck.

Antibiotic cream is placed over all of the incisions followed by gauze dressings and bandage. The stitches are removed a week after surgery. The patient will have further follow-up appointments one month, six months and a year after the surgery.

What is a neck lift?

As neck skin loses elasticity it can begin to sag, resulting in the appearance of vertical bands, lines and wrinkles. Cosmetic surgery can reshape the skin around the neck and jaw, reducing the appearance of sagging and other visible signs of ageing

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The aims of surgery are:

  • to lift and improve the appearance of the skin on the neck
  • to give the neck a more youthful and refreshed look.

During surgery loose or sagging skin is removed or tightened. Fatty tissue may be removed with liposuction. Vertical bands and lines can be eliminated using platysmaplasty; a procedure that involves making small incisions under the chin or behind the ears to tighten the muscles of the neck.

The neck lift procedure is usually performed under general anaesthetic and may involve an overnight stay in hospital.

After neck lift surgery you will experience some bruising and swelling, which should usually diminish within 14 days. Full recovery can take about a month.

What is an endoscopic brow lift?

Both a brow and forehead lift smoothes out the area above the eyes by repositioning the muscles and tissues that cause furrowing or drooping.

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An endoscopic brow lift is a modern technique that dramatically reduces scarring as only tiny incisions of one to two centimetres in length are made in the hairline. A camera is used with the endoscope providing excellent vision, minimising the risk of nerve damage to the forehead.

The aims of surgery are:

  • to raise a low lying brow to give a more youthful appearance
  • to smooth out frown lines by repositioning the forehead tissue and muscles that cause frowning.

Once the forehead tissues and brow have been loosened from the underlying bone, they are secured in the new position with stitches. The forehead incisions are closed with staples and a head dressing applied for 24 hours. The majority of the swelling and bruising will have settled within one week.

What is facial liposuction and fat grafting?

People who have unwanted fat on their neck, chin, and cheek have the option to get rid of it with facial liposuction, which is usually combined with a tightening of the muscles which necessitates a small incision underneath the chin.

The aims of surgery are:

  • To tighten saggy areas under the chin
  • To remove fat from the face and neck.

A wetting solution containing a substance to reduce bleeding and improve fat extraction is injected, after which a small metal tube is inserted through a small incision to remove the fat.

Once completed, a compression bandage is applied and kept in place for 72 hours. The small incisions are closed with tiny stitches and removed after five days.

As with face-lifting, there is a risk of bleeding and swelling post-operatively so keeping the head elevated, using cold compresses and avoiding strenuous activity is advisable.