David 52: Reconstructive

David 52; removal of silicone granulomata

David is an acclaimed international yoga instructor considered by many to be one of the best in the world. He uses yoga to bring peace in zones of conflict. In addition to his work he does a huge amount of high definition media and international presentation. Some years ago David had silicone injected under his facial skin by another surgeon. The silicone had left David with scarred and ridged facial skin that was impossible to hide on camera. After exhausting all possibilities with his previous surgeon, he came to see me about rectifying his situation. We devised a plan that would enable him to be back at work within a week with a smoother, more harmonious complexion with a secondary rejuvenating benefit! I performed a facelift and neck lift under local anaesthetic which gave me access to his scarred tissue.

Morning after

Serial steroid injections with the initial surgeon who injected the silicone fillers have made no difference. After raising large face flaps and removing nearly 100g of scar and silicone from both sides of the face, I lifted David's muscles to redefine his neck and jawline. The first photo is taken still on the operating table before the bandage was applied, the next two, the morning after surgery.

Day six after

5 days later (and a quick return to theatre to drain a blood clot after 250 sit-ups 8 hours after the facelift!!) David is recovering well. His swelling has come down and bruising is starting to fade. The previously ridged skin is now smooth and soft, and his profile and neckline are well defined. David is a guy in great condition, physically and spiritually. His freshened and repaired face will now fit his high profile, public and active lifestyle.

Week four

Just under 3 weeks later and David is back for review having been working abroad for 2 weeks. Well healed now, he looks great. His skin has settled and is now smooth and hugs his masculine jawline. No sign of those solid ridges and he is ready for the HDTV camera next week! Resurfacing of his sun damaged skin is next on the program when his busy schedule allows.

Two years after surgery

Here is David 2 years after his surgery to remove silicone granulomas and face and neck lift. That ridged facial skin which brought him to me is now smooth, his jaw and necklines are sharp and he looks far younger 2 years on than he did 2 years ago. David is a good looking guy and in the media regularly, he also barely has any body fat, both of which make his case especially challenging. I reposition and sculpt what facial fat is available to give the best result in facelifting - David doesn’t have any… I have used conservative dermal filler to his mid face to add volume without making him look too full. It could be argued that her would be a good case for fat transfer to the face. The same problem arises - he doesn’t have any! We are now starting a tailored program of skin care to maintain his result. A combination of light peels, powered microneedling and sun screen which is the only topical product I can persuade him to use!!

Three and a half years after surgery

I rarely get the opportunity to see patients at more than 3 years out, but living locally David comes in to clinic. Still maintaining his lift well, the ridges and grooves caused by his previous silicone remain hugely improved. Great result for a great guy.

Four years after surgery

David recently underwent non surgical lower eyelid tightening with PLEXR to reduce some of the crepey under eye skin. A little red as expected after only 10 days but a huge improvement. Smaller maintenance treatments over time are really important to maintain facial balance. David is doing just great just over 4 years out from his initial surgery.