Dr. Julian De Silva, FACS, FRCS, FRCS(Ed)

My signature is the Vertical Deep Plane Facelift, the surgical core of VFR-7 (Vertical Face Restore 7), which I perform at 23 Harley Street. Two principles define it. First, the vector. Faces age downwards, so I lift upwards. Pulling sideways towards the ears flattens the cheek and widens the mouth; a vertical lift restores the cheek, jawline and neck to where they were ten to fifteen years ago. Second, the plane. I work beneath the SMAS and release the key retaining ligaments, so the deep tissues move as one composite layer. The deep layer carries the lift. The skin is redraped without tension, which is why the scars stay fine and the result does not look “done”. My training as an oculoplastic surgeon shapes the upper half of the face too. I treat the eyes, brows and temples as part of the same plan, with preservation blepharoplasty rather than removing tissue the face will miss later. Where needed I add a deep neck lift and fat transfer to replace lost volume. Most of my facelifts are done under twilight sedation with my own bespoke protocol, so patients usually go home the same day. My aim is simple: you look like yourself on a very good day, and nobody can tell why.

I plan recovery around your calendar, not the other way round. Most of my patients have surgery under twilight sedation and go home the same day. The first 48 hours are about rest, head elevation and cold compresses. Discomfort is usually modest; tightness and numbness around the ears and neck are normal and settle over the following weeks. What I tell patients to expect: Days 1–7: the most visible swelling and bruising. I see you for the first review and remove the dressing. Days 7–10: sutures out. Most people are comfortable walking around their neighbourhood. Weeks 2–3: social and work life for most. Light make-up and hair hide the residual signs, and many of my executive patients return to video calls within about two weeks. Weeks 3–6: light exercise resumes. Fine swelling comes and goes. Months 3–6: the final, settled result. Month 12: very final result Because I lift the deep layer and keep tension off the skin, the face usually looks natural early, rather than tight and then relaxing. Everyone heals differently. Smoking, blood pressure and some medications all matter. I give you a written timeline at consultation and I stay personally responsible for your aftercare.

The best candidates have jowls, a softening jawline, a heavier neck or a descended midface, and want to look refreshed, not different. Most are in their mid-40s to late 60s. Increasingly, I see patients in their early 40s who choose an earlier, smaller procedure for a result that ages well and lasts longer. Patients I see often: Professionals and executives who need a natural result and a predictable, discreet recovery. Patients after significant weight loss, including with Ozempic, Wegovy or Mounjaro, whose skin and deep tissues have lost support. I ask for weight to be stable for roughly three to six months first, because a facelift on a still-changing face loosens early. Patients unhappy with a previous facelift that looks pulled or windswept, where a vertical deep plane revision can help. Patients with tired eyes as well as a lower face, where combining the eyelids and brow gives a balanced result. When I advise against surgery or ask you to wait: Active smoking or vaping (stop at least four to six weeks either side). Uncontrolled blood pressure, diabetes or bleeding risk. Unstable weight. Expectations that surgery cannot meet, or a wish to look like someone else. If a non-surgical option, or no treatment, is right for you, I will tell you.

I quote one fee for one plan, after I have examined you, because no two faces need the same operation. What drives the fee: Scope. A deep plane face and neck lift on its own costs less than a fuller VFR-7 plan that adds eyelids, brow, fat transfer or skin resurfacing. Complexity. Revision surgery, significant laxity after weight loss and a heavy neck take longer and need more precision. Anaesthesia. Most of my patients have twilight sedation with my own bespoke protocol rather than a general anaesthetic. Who operates. I perform the key steps of every operation myself and see you personally through aftercare. My quotation is all-inclusive: surgeon, anaesthetist, hospital and follow-up appointments. There are no hidden extras. The DEEPPLANE estimate for the all-in cost (surgeon, facility and anesthesia) is $19,000–$44,000 (≈ £15,000–£35,000 GBP): our editorial estimate, not a surgeon's quote. I will confirm your exact fee in writing after consultation. I do not discount surgery or sell it with time-limited offers. The right fee is the one that lets the operation be done properly, by the right surgeon, in the right hospital.