Sydney plastic surgeon Dr Darryl Hodgkinson discusses a range of non-surgical and surgical options to rejuvenate an ageing face.

BEFORE & AFTER facelift, endoscopic brow lift and upper and lower eyelid surgery by Dr Hodgkinson

People who wish to maintain a youthful appearance can delay the time when they will need a surgical option with the help of non-surgical procedures. These include Botox injections regularly to the crow’s feet, heavy lines of the brow and now into the neck with what is called a Nefertiti lift.

Also used are dermal fillers, especially hyaluronic acid fillers such as Juvéderm and Restylane. These actively contour and restore areas of hollowing and depletion, especially in the nasolabial folds, around the eyes and around the mouth and lips.

The procedures can be performed without anaesthesia and can be lunchtime, evening or Saturday morning treatments which do not impact dramatically on the patient’s life. Side effects are minimal, and bruising at the injection site is rare in the hands of an experienced practitioner.

In my opinion, skin tightening, however, cannot be achieved with cosmetic injectables. I find the only skin tightening that can occur is with radiofrequency (RF) energy passed deep into the tissues. My preferred skin tightening treatment is Thermage.

It is generally a one-time procedure in which RF energy is passed deep into the tissues to tighten and promote development of collagen in the neck, jowls, cheeks, forehead and eyelids. Thermage can also be used for the tummy, buttocks, thighs and arms. The procedure takes around one hour and most patients report only mild discomfort.

While Thermage improves the skin, it can only achieve millimetres of lift. By the time people are in their 50s, however, dermal fillers and Thermage may have reached their limits and many patients will only achieve a dramatic improvement to the signs of facial ageing with a facelift.

The outstanding success of contemporary Pan Facial Rejuvenation with modern facelifting techniques, eyelid surgery, brow lifting and judicious injection of fat can achieve dramatic results. Skin can be lifted in the range of centimetres, not millimetres, and results can last for around eight to ten years instead of just three to 12 months.

The modern facelift takes around three to four hours to complete and is performed as an outpatient procedure. It offers natural-looking looking results to restore a more youthful and rejuvenated appearance.