Upper eyelid lift/eye bag surgery (blepharoplasty)

Eyebag surgery is one of our most common requests. This is because as we all age the eyelid skin loses elasticity and starts to sag, and along with the fat under the skin, this produces bulges, creating creases around the eyes in both the upper and lower eyelids. Blepharoplasty transforms any tired or worn appearance around the eyes, and reinstates the youthful natural contours we have around the eyes, brow and cheek (in lower lid surgery).

Typically, eyebag / blepharoplasty surgery is performed under local or general anaesthetic. Incisions are well hidden in the natural creases of the upper or lower eyelid. Mr Saleh has also been invited nationally and internationally to teach his technique of repositioning fat in the upper eyelid and brow which rejuvenates plumpness in the eyebrow area, lifting the brow, without any additional incisions being performed at the same time as the upper blepharoplasty.

This is a manoeuvre for those patients that do not need a full brow lift procedure, but it enhances the rejuvenated look of the upper eyebags as skin removal alone, sometimes is only half the job! Some patients require a brow lift at the same time as upper eyelid blepharoplasty and you can learn about browlifts below.

Lower eyebag removal / Lower blepharoplasty

Lower eyelid bag removal and rejuvenation is typically done using an incision hidden directly under the eyelashes, or less frequently within the eyelid itself. Modern techniques reposition fat to retain the volume of a youthful lower eyelid and cheek, and for those patients with some dark circles around the eye, Mr Saleh performs microfat grafting in some patients, which has been shown to lighten the discolouration that so many patients dislike!

Overall, Mr Saleh uses a variety of techniques bespoke to your exact requirements and anatomy to get the best results for you.

Brow lifts are often used in combination with facelifts and eyelid surgery. But often patients come to see me asking for upper eyelid surgery when the problem is actually a heavy descended brow. These subtle differences require an expert to recognise them and take you through the correct treatment plan.

There is a variety of brow lift types and the typical types Mr Saleh performs are;

• Trans-palpebral – meaning through the same incision as for an upper eyelid lift

• Endoscopic – meaning using tunnels in the scalp and using a camera and instruments to lift the brow without obvious scarring on the face

• Temporal lift – a very useful technique for certain patients which hides the scar in the hairline of the temple region.

Depending on your face and your needs Mr Saleh will discuss the merits of each type of procedure for you.

Brow lifts are often used in combination with face lifts and eyelid surgery. Frequently, patients come to see me asking for upper eyelid surgery when the problem is actually a heavy descended brow. These subtle differences require an expert to recognise them and take you through the correct treatment plan.

There are a variety of brow lift types and Mr Saleh regularly performs the following;

• Trans-palpebral – meaning through the same incision as for an upper eyelid lift (see above)

• Endoscopic – meaning using tunnels in the scalp and using a camera and instruments to lift the brow without obvious scarring on the face

• Temporal lift – A very useful technique for certain patients which hides the scar in the hairline of the temple region.

Depending on your face and your needs the merits of each type of procedure will be discussed with you.

What is a face/neck lift?

The aging process causes facial skin to lose its elasticity, our natural fat to deflate and the skin  to therefore droop. Mr Saleh has developed a technique to lift the face, jaw line and neck to reposition deep layers of the face and neck to restore youthful appearances.

A face-lift in modern surgery must include lifting of the neck as well. The face blends with the neck and both together are crucial to the harmony of the facial appearance. Neck lifts can be performed without a face-lift for those patients that have very obvious neck wrinkles and contours.

Ideally a modern safe facelift, in most patients, aims to correct;

1. Volume in the cheeks, softening the nasolabial crease

2. Correction of jowls

3. Correction/softening of marionette lines

4. Smooth the jaw line

5. Flatten the contours of the neck - RESTORE the neck line in relation to the lower jawline.

The main types of face/neck lift we perform are;

Mini-facelift or ‘short scar facelift’

This procedure involves a very small scar being hidden in front of the ear and is less invasive than a full modern face and neck lift, generally focussing on the mid and lower face rejuvenation. This is known as a MACS facelift procedure, meaning Minimal Access Cranial Suspension. It has less effect on the neck but provides excellent lower facial contouring. The results are not as long lasting as a modern face and neck lift, but for those who seek a rejuvenated jawline this is a very popular procedure.

The Modern Face and Neck Lift

Mr Saleh uses a specific technique he has developed as a hybrid of new techniques he has learnt from world renowned mentors in the UK and Europe (Mr Riaz, Dr Klepetko/Dr Van Der Meulen) and modified through his anatomical research at the University of Newcastle. The main aim is to give patients minimal downtime with a long-lasting natural face and neck rejuvenation. The scar is hidden in front of the ear and behind the ear and the top of the hairline. See our procedure stats to get an idea of downtime and return to activities.

Ultimately, the modern face and neck lift together with selected techniques amount to a complete rejuvenation of the face. NOT ALL FACES ARE THE SAME and your procedure will be personalised to you and your specific needs.

This procedure reduces the prominence of the ears from the frontal view and can have an enormous effect on your confidence to expose your ears to general view. Typically this can be done under local anaesthetic in adults using an incision behind the ear, so it is concealed. Specific sutures are placed behind the ear to effect the pulling back of the ears. This is a day case procedure.

Mr Saleh utilises three techniques for patients seeking lip enhancement; which, depends on your specific anatomy and desired outcome.

We do not inflate lips to produce a ‘duck-bill’, over inflated, or unnatural appearance, which has been seen in popular culture.

However, it is recognised that the fullness of lips might diminish with age, or those with thin lips might seek to enhance their appearance, beyond that which makeup can achieve.

The three methods are;

Dermal fillers

These allow enhancement of volume and subtle changes to the central lip to restore curves and the fullness of the lip. The fillers used are not permanent and are of the highest quality.

Nanofat injections

This is also called autologous fat injection, which is the use of your own fat cells, taken under local anaesthetic, and processed into a ‘natural’ filler material that we inject to enhance the lip. This is permanent and uses your own tissue, so the chances of rare allergic reactions are avoided, giving the most natural feel and appearance.

Lip lift

This is where a small portion of skin is removed from directly beneath the nose to turn the lip up slightly giving a fuller appearance to the lip. The scar is rarely visible after it matures and this is fast becoming a very common procedure that takes very little time under local anaesthetic.

Mr Saleh has been using the Nano and micro-fat grafting techniques for many years. It requires the harvest of a small volume of your natural fat, often from the tummy button area, or the thighs, and the fat is processed meticulously for re-injection as a natural filler. Nano and micro-fat has also been shown to have regenerative properties and does improve the overlying skin quality and in some cases can remove the discolouration on the lower eyelid region. It is very useful in certain cases to achieve;

1. Restoration of cheek volume

2. Lip enhancement (see above)

3. Chin augmentation (genioplasty) to project the chin forwards

4. Lift the deep nasolabial crease

5. Volumise the temporal hollows we get as we age

Fat grafting is particularly powerful as it is generally permanent meaning repeated filler injections can be avoided if that is what you desire.