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Is the Traditional Facelift Over?

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With non-surgical face-tightening treatments advancing at lightning speed, Annabel Jones investigates whether it’s now possible to achieve facelift results… without going under the knife.

Is the Traditional Facelift Over?

I n the hands of a great surgeon, a traditional surgical facelift is considered the gold standard, especially if you’re looking to regain the smooth facial contours you had in youth. But over the past five years, advanced skin-tightening machines combined with brow-lifting and jaw-sculpting injectables have slowly been stealing their share of potential surgical patients with their little-and-often approach to turning back time.

There’s certainly nothing more transformative than surgically pulling back skin that’s lost its fight with gravity, but many aesthetic doctors believe that, if you start soon enough, a combination of cosmetic treatments – from fillers to ultrasound and thread lifts – can achieve the same results as a face tuck but with less invasive methods and little downtime.

Of course, results from filler depend on how loose your skin is. Cosmetic practitioner Dr Wassim Taktouk from The Taktouk Clinic points out that non-surgical treatments have their limitations. ‘We are a long way off the end of the surgical facelift, but there are lots of tweakments we can do in the interim to stave off the scalpel,’ he says. Taktouk is a master with filler and Botox and trains other practitioners on the subtle art of injecting well. The magic is in understanding where and how to inject it for facelift-worthy results.

‘There are five layers of tissue in the face,’ says Dr Taktouk. ‘The outer skin, two layers of fat [one superficial and one deep], muscle and bone. Everyone loses volume in the layer of deep fat, which is hard and immovable and requires a firm hyaluronic gel injected close to the bone to replace lost volume. Whereas the superficial fat closer to the skin is dynamic and requires what’s known as ‘resilient hyaluronic acid’ that moves and stretches with the skin so it looks natural and undetectable. It’s all about correctly matching the tissue you are replacing.’

One thing fillers can do that a facelift can’t is replace jawline structure. ‘As we age’, says Dr Taktouk, ‘there is some bone reabsorption that can cause us to lose the angles in our jawline. With less bone to hang on to, the tissues that were being held in place begin to move forwards; the chin shrinks and the jawline is less angular. By carefully injecting filler close to the bone you can replace volume… which creates a more youthful-looking jawline.’

Facelift - David Morris

Rose diamond cut palm ring, David Morris

In combination with other methods, new generation thread lifts can also delay surgery by tightening sagging jowls, heightening cheekbones and reducing marionette lines (sad lines around the mouth). Former GPs Dr Victoria Manning and Dr Charlotte Woodward from River Aesthetics are considered leading experts and offer three such procedures at their clinics in London, Hampshire and Dorset, including the Silhouette Soft thread lift. This involves suturing sagging skin with superfine absorbable threads inserted via a needle beneath the subcutaneous layer of fat, which are then pulled taut to lift the skin. Not only does Silhouette Soft tighten, it also helps stimulate long-term collagen production, for firmer, bouncier skin texture. And recognising that tight skin doesn’t always equate youthful skin, they developed the River Lift, which combines volume-replacing filler with Silhouette Soft threads, for those clients who need both lifting and plumping.

But even needles are considered too invasive for some medics. Enter the new generation of energy devices that deliver lasers, ultrasound and radio frequency to firm and sculpt the face. Dr Nyla, who has clinics in Cheshire and London, predicts machines will replace the scalpel in years to come. ‘I have every machine at my clinic,’ she says, ‘so I have no bias towards one device or another. I can use all of them in combination or just one protocol, depending on the client’s specific needs.’ She adds, ‘I’ve seen some amazing results with machines alone that are akin to a facelift, if not better, because they improve the quality of the skin at the same time.’

Dr Nyla uses a combination of energy devices for each skin concern. These include fat-dissolving technologies such as CoolSculpting or Aqualyx to reduce a double chin, radiofrequency to sculpt and tighten, ultrasound to reach the SMAS layer (the deeper tissue that surgeons target) and surface treatments like mesotherapy that plump and rejuvenate the skin’s surface.

While the full benefits can take three months to actualise, the end result is often dramatic. ‘It can be quite emotional to see clients at the end of their treatment plan,’ she says. ‘Some women can look unrecognisable.’ Many practitioners rely on injectables alongside energy treatments, but for Dr Nyla, the syringe is gradually taking a back seat. ‘Five years ago patients would lean towards Botox and filler first,’ she says. ‘Now 80 per cent of my treatment plans predominantly use energy devices.’

Known for her less-is-more approach, Dr Marwa Ali at Harrods Wellness Clinic agrees that clients are looking at their skin through a more holistic lens. ‘For some patients,’ she says, ‘a surgical facelift is the best option and can be fundamental in improving lost confidence. However, many patients nowadays don’t mind some signs of ageing and are more interested in attaining superb skin quality with a youthful glow.’ She explains: ‘With devices such as ULTRAcel Q+, which uses high intensity, frequency ultrasound to tighten, particularly on the jawline, combined with machines that help to create a luminous, even, skin texture, it takes the focus off specific ageing concerns, such as a few lines and wrinkles.’ Dr Marwa also uses the Lumenis Stellar M22, which targets pigmentation, treats broken blood vessels and stimulates collagen for a clearer, smoother and younger-looking complexion.

Dr Marwa Ali

Dr Marwa Ali uses devices such as the ULTRAcel Q+ and the Lumenis Stellar M22 that can work wonders for tightening skin

FaceTite is perhaps as close to surgery as it gets – a radiofrequency energy delivered with a probe inserted underneath the skin with small incisions to heat up and contract the skin, while killing off some of the fat cells and shortening the collagen fibres that cause jowls and a double chin. It’s known in the US as ‘shrink-wrapping’.

Dr Judy Todd, an expert in FaceTite and Morpheus8, points out that although the results can be superb and last for up to five years, it’s by no means a non-invasive process and comes with four to five days downtime and some swelling. ‘FaceTite works best on those in their late ’30s to early ’50s with some fat to work with,’ she explains. ‘Those with more progressive sagging, or a thin face without much fat beneath the skin, wouldn’t be good candidates.’

Has the old-school facelift been unfairly targeted by the lure of technology? Plastic surgeon Dr Olivier Amar thinks so. Indeed, while facelifts may have taken a dip since less invasive treatments have advanced, surgical techniques have also moved on leaps and bounds. ‘Fifteen years ago,’ he says, ‘if you had a facelift there was a lot of recovery time, but surgical techniques have evolved since then. We don’t always have to cut through the muscle to achieve a good result; you can now have a micro- or mini-facelift with minimal incisions that restore tension in the face harmoniously.’

Moreover, a mini-facelift can cost no more than some of the energy device treatments, that many surgeons also have access to. ‘We often combine minor surgical lifts with skin treatments, whether that’s by injecting the patient’s own fat to restore lost volume or by utilising microneedling or radio frequency devices,’ he says. ‘Depending on the client, surgery is sometimes the more natural option. Everything has its place; it’s about creating the best treatment plan for each client.’

NIP & TUCK

Facial contouring with Dr Wassim Taktouk at the Taktouk Clinic, from £595. drwassimtaktouk.com

Lumenis Stellar M22 with Dr Marwa Ali at Harrods Wellness Clinic, from £550. harrods.com

Silhouette Soft thread lift with Dr Victoria Manning or Dr Charlotte Woodward at River Aesthetics, from £2620. riveraesthetics.com

FaceTight with NeckTite and Morpheus8 with Dr Judy Todd, from £5,200. drjudytodd.com

Micro surgical facelift with Dr Olivier Amar, from £8,500. olivieramar.co.uk

Featured image: Rose diamond cut palm ring by David Morris

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