16 March 2016 March 2016 17 Expert guide: Aesthetics & Cosmetology 2016 Most of the patients I see in my practice, how-ever are seeking a more permanent solution to address their concerns, and come requesting facelift surgery. There has been a huge evolution in face-lifting techniques in the last 30 years, as we now understand the anatomy of the face in more detail, and understand what we need to do in order to reverse or halt the signs of age-ing. The ageing face tends to deflate, giving a hollow and empty appearance to the midface, and a squaring off of the jawline, with the ap-pearance of jowls. By tightening the deeper tis-sues of the face underneath the skin the SMAS (superficial musculoaponeurotic system), this can reposition the soft tissues and fat pads and will create a natural and more youthful look. It also addresses the looseness and sagginess of the neck that occurs with ageing. These proce-dures are often combined with eyelid surgery (blepharoplasty) and brow surgery, and it is im-portant to harmonise the face.I like to take photographs and use these to show my patients where the incisions will be placed, which areas I am going to address and dem-onstrate the improvements that can be made. I also make my patients aware of the healing time and risks associated with surgery. In plan-ning surgery I like to emphasise that the heal-ing time is just as important as the surgery, and to get a good result you must allow yourself a few weeks to recover from the surgery. I see all my patients until they are fully healed, and my nursing team will help them through the post-operative period.Facial aesthetic surgery is a very rewarding process for the patient and the surgeon; I can-not stress enough how important it is to have a good working relationship with your patient. This will then lead to a successful outcome.Simon Eccles qualified as a dental surgeon before undertaking his medical degree. He trained to be a plastic surgeon on London, undertaking fellow-ships in microsurgery, craniofacial and aesthetic plastic surgery. He has been a consultant cranio-facial plastic surgeon at the Chelsea and West-minster Hospital for the last 10 years. He is a past President of the Royal Society of Medicine, and a surgeon working with the charity ’Facing the World’. His surgical interests are in paediatric and adult craniofacial surgery and in facial aes-thetic surgery. He regularly teaches in aesthetic and craniofacial surgery, and recently organised the BAPRAS advanced course in Aesthetic plastic surgery in Manchester. UK By tightening the deeper tissues of the face underneath the skin the SMAS, this can reposition the soft tissues and fat pads and will create a natural and more youthful look