Four Levels

Level 1 – Good Skincare

This includes effective sun protection – UV-protection is most important, especially for Caucasian skin in the tropics – cleansing, anti-oxidants, not smoking and consuming only moderate amounts of alcohol are also important.

Level 2 – Non- or Minimally Invasive Therapies

These skin-tightening and collagen-boosting treatments are for people who are not yet ready for the complexities of a facelift, or whose skin condition does not yet warrant one. They include: 

• Laser treatment in the form of Matrix IR (Infrared) or Matrix RF (Radiofrequency), both fractional therapies that can treat the deepest layers of the skin in a completely non-invasive way.

• This can be boosted with an Erbium Micro Laser Peel, to strip off dead layers of skin, encouraging the body to react by producing more collagen.

• Thermage, which works by heating collagen to obtain a tightening effect; most effective on the more lightweight, thin and non-sebaceous skin that Caucasians tend to have.

Level 3 – Minimally Invasive Procedures 

• The suture-lift is the most common of these. Of the many brands out there, Dr Khoo prefers the Silhouette lift. To tighten the mid-face, for example, six one-centimetre cuts are made on either side of the scalp, hidden in the hairline – under anaesthetic, of course. With the help of a large needle, a suture, or thread, is tunnelled through the flesh in an inverted arc from one side of the face to the other. Tiny cones on the wire fix it in place and allow it to move in one direction only; once threaded through, the thread is gently pulled up on either side.

• Endotine, a ribbon-lift, uses a similarly barbed ribbon and apart from the mid-face, is particularly good for lifting the neck; in this case, an incision is made behind each ear.

• Fat grafting is good for restoring loss of volume, for example, to fill hollow cheeks. It works especially well where the skin is of good quality. Small amounts of fat are “harvested” from fat-plentiful buttocks, for example, and injected at sub-cutaneous level in areas where more fullness is required. Interestingly, skin quality seems to improve in these areas; some researchers believe this may be due to the presence of stem cells in the injected fat.

Level Four – Full Facelift Surgery

The many variations of rhytidectomy all have the same idea: to tighten and lift what has been affected by gravity. In a full facelift of the upper and lower face, under general anaesthesia or sedation, excess fat is removed, underlying muscles are tightened, the skin of the face and neck is redraped, and fat pads are repositioned to achieve a more youthful look. Browliftlower facelift surgery lightens the deep grooves around the mouth and tightens the cheek and neck. Downtime is up to two weeks. surgery corrects drooping brows; lower facelift surgery lightens the deep grooves around the mouth and tightens the cheek and neck. Downtime is up to two weeks.