The Big Interview
Mr Azhar Aslam is a cosmetic surgeon and founder of Linia, a nationwide cosmetic surgery chain with a difference. Here, he speaks to Cosmetic Surgery & Aesthetics Guide about his work, his philosophy ...
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What is a Facelift?
The original modern cosmetic surgical procedure, the facelift has had some bad press over the years, mainly due to the ‘windtunnel effect’ sported by so many celebs in the 1980s.
However, most surgeons still maintain it is the most effective way to turn back time on lines, wrinkles and sagging skin, and modern techniques mean that nobody need know you’ve been under the knife.
Who is suitable for a Facelift?
If your ageing concerns have gone beyond the odd line or wrinkle, which can be dealt with using Dermal Fillers or Muscle Relaxing Injections, then you may well be a
suitable candidate for facelifting surgery.
It is even possible to address problems of volume loss these days, with a new technique called ‘volumetric facelifting’ – more on that below.
A facelift is, however, a serious surgical procedure
and all the usual rules apply in terms of safety. You need to have a thorough consultation with an experienced surgeon
to determine if this is the right procedure for you and, if so, which technique would be most suitable.
What’s the procedure like?
Facelift surgery is usually performed under a general anaesthetic, although there are some surgeons who will do it under local. The process can take anything from three to five hours.
There are several different options for facelift surgery
and you’d need to speak to a surgeon to get the full rundown on each, but here’s a little taster...
Standard facelifting: In a traditional facelift, the incision runs from ear to ear, hidden behind the hairline. The surgeon
then tightens a layer of muscle which lies beneath the skin,
known as the SMAS layer (which is why you might hear
surgeons talking about SMAS lifts).
The SMAS layer can be tightened in a
number of different ways, and it is the method used
to do this that determines whether or not you
will end up with the dreaded windtunnel
effect.
One method, the SMASectomy lift, involves removing a strip of the SMAS tissue and stitching the edges together. Another technique, the SMASplication lift, avoids removing any tissue and uses tightening stitches instead.
Your surgeon should be able
to show you before and after images of patients who have undergone each option before, to help decide which would be the best method for you.
The mini-facelift: More suited to younger patients whose facial sagging doesn’t extend to the neck, this offers a slightly less invasive alternative to a
full facelift, with incisions made just in front of the ears, in the temples. Excess fat is removed and skin and muscle tissue
is tightened and secured with stitches.
The volumetric facelift: Since the discovery that volume loss
is one of the biggest factors
in facial ageing, techniques in facelifting have been developed to help address this.
One such technique is to use Fat Transfer alongside the usual lifting and tightening, but it is also possible to stitch the deeper tissues of the face in such a way that they are elevated higher over the cheekbone.
Keyhole surgery: To minimise scarring, tiny incisions are made in the hairline and an endoscopic camera and special operating instruments are inserted into the cuts – the surgeon then performs the operation by watching the images from the camera.
The mid-facelift: This is a technique developed to raise the tissues of the mid-face
– the cheeks and around the eyes, which can be effective in reducing the appearance of naso-labial folds, but again is only suitable for younger patients who don’t have extensive sagging.
Incisions are made in front of the ears and sometimes in the mouth, and the fat pads are repositioned.
What happens afterwards?
If your surgery was performed under general anaesthetic, you will need to wait for the effects
of that to wear off, and your surgeon may wish to keep you in hospital overnight.
Your face will be wrapped in bandages, which will be removed after about a day. Any non-dissolvable stitches will be removed after about a week.
There will be some bruising and swelling, so you will be advised to keep your head elevated, and it will take several weeks for that to go down – you might want to avoid any social events for a while!
How long it takes you to recover will depend on your general health prior to surgery, but usually you can resume normal, non-strenuous activity after a week, and go back to work after three weeks – perhaps with the aid of some hefty camouflage make-up.
Will I have a scar?
There will be some scarring from facelift surgery – where and to what extent will depend on the specific technique used, as well as the skill of your surgeon, but generally scars are well hidden behind the ear or in your hair, so won’t be obvious to the casual observer.
And some people are so delighted with the results of their facelift that they’re only too happy to tell people what they’ve had done.

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