Facial rejuvenation

Descent of tissue, loss of deep volume and change in skin surface are separate problems with separate answers. A plan usually combines more than one approach, sequenced rather than done all at once, and weighted towards whichever change is doing the most work on the face.

The procedures offered here include brow lifting, a face and neck lift, botulinum toxin, blepharoplasty and facial fat grafting. Which of them applies, in what order, is settled at consultation against what you actually want changed.

Frown lines, brow lift and other creases caused by muscle movement are treated with botulinum toxin, dosed so the face still moves and still reads as yours. It treats dynamic lines only — those visible at rest are a different problem, usually addressed with resurfacing, filler or fat instead, and telling the two apart honestly is part of the consultation.

Onset begins around three to seven days and settles by about two weeks; effect typically lasts three to four months, varying by individual, with areas treated assessed case to case.

Upper eyelid hooding and lower eyelid bags are addressed by removing or repositioning excess skin, muscle and fat around the eye, restoring an open, rested appearance without changing the eye's shape. It is a different structure from the brow — a heavy upper lid can mimic brow descent, and telling the two apart is part of the assessment — and the two are often combined when both are contributing.

Lifting repositions tissue; it does not replace volume already lost. Fat taken from elsewhere on the body, processed and reinjected restores that volume directly, and is often used alongside a lift or on its own where volume loss — not descent — is the main concern. More on nanofat and structural fat grafting.

Candidacy for any procedure is determined at an in-person consultation, where anaesthesia, duration and recovery specifics are prescribed on a case-to-case basis. Not every procedure suits every patient.