A facelift is the most effective way to address the deeper signs of facial ageing: jowls along the jawline, deepening folds between the nose and mouth, and loose skin and banding in the upper neck. At her Harley Street practice in London, female plastic surgeon Ms Anna De Leo approaches facelift surgery as a structural procedure rather than a skin-stretching exercise. By repositioning the supporting layer beneath the skin and redraping the skin without tension, the aim is a face that looks refreshed, well rested and entirely natural.
Every face ages differently, which is why no two facelift plans are alike. Some patients need a full face and neck lift; others benefit from a more limited lower face lift, often combined with eyelid surgery or fat grafting to restore lost volume. With more than twenty years of experience in aesthetic and reconstructive surgery, Ms De Leo will help you understand which approach suits your anatomy, your goals and your lifestyle, and just as importantly, what a facelift can and cannot achieve.
01What Is a Facelift?
A facelift, known medically as a rhytidectomy, is an operation to lift and reposition the tissues of the mid and lower face and the neck. Over time, gravity, the gradual loss of facial fat, thinning bone and declining skin elasticity allow the soft tissues of the cheek to descend. The result is a softened jawline, jowls, heavier nasolabial folds and a neck that loses its clean angle.
Early facelift techniques simply pulled the skin tight, which often produced the ‘windswept’ look that many people still associate with the operation. Modern facelift surgery works on the deeper layer known as the SMAS (superficial musculo-aponeurotic system), the fibrous and muscular layer that supports the skin. Lifting and securing this layer restores contour where it was lost, so the skin can be redraped gently over a better foundation. Because the skin is not under tension, scars heal more finely and results tend to look softer and last longer.
It helps to be clear about what a facelift treats. It is excellent for jowls, sagging cheeks and loose neck skin. It does not change fine surface wrinkles, sun damage or skin texture, and it does not lift the brows or treat the eyelids. These concerns are often addressed alongside the facelift with complementary treatments, which is why a thoughtful, whole-face assessment matters so much.
02Who Is a Good Candidate for a Facelift in London?
Most patients who come to Harley Street for a facelift are in their late forties to early seventies, although biological age matters more than the number on your passport. You may be a good candidate if:
- You have visible jowls or a blurred jawline that bothers you
- The cheeks have descended, deepening the folds around the nose and mouth
- There is loose skin, laxity or vertical banding in the upper neck
- You are in good general health, with any medical conditions well controlled
- You are a non-smoker, or willing to stop for several weeks before and after surgery
- You have realistic expectations and want to look refreshed rather than different
Smoking and nicotine products reduce blood supply to the lifted skin and significantly increase the risk of wound-healing problems, so stopping is essential. Significant weight fluctuation after surgery can also affect the result, so it is best to be close to a stable weight. If your concerns are mainly fine lines or skin quality, Ms Anna De Leo may suggest that skin rejuvenation or a combined facial rejuvenation plan would serve you better than surgery.
03Your Facelift Consultation on Harley Street
Your first appointment takes place at 64 Harley Street in Marylebone, central London, and it is unhurried. Ms De Leo will ask about your medical history, medications, previous treatments and what you notice when you look in the mirror. She will then examine the skin, the underlying fat compartments, the jawline, the neck and the overall balance of your features, often using photographs to discuss the changes you would like.
She is known for being honest: if your expectations are more optimistic than surgery can deliver, she will tell you, and she will explain the realistic range of outcomes. You will discuss the type of facelift recommended, where the incisions would sit, whether a neck lift, eyelid surgery or fat grafting might be combined, and how the recovery would fit around work and family life.
Many patients ask about facelift cost factors. Your personalised plan depends on the extent of surgery, whether procedures are combined, the anaesthetic, the length of hospital stay and your aftercare programme. All of this is explained in writing after your consultation. In line with GMC guidance, there is a cooling-off period of at least two weeks between your consultation and surgery, and a second consultation is encouraged so that every question is answered before you decide.
04Facelift Techniques: Tailoring the Approach
The incision usually begins within the hairline at the temple, runs in the natural crease in front of the ear (or just inside it), curves around the earlobe and continues behind the ear into the hairline. Ms De Leo plans incisions so that scars sit at natural boundaries, and small strips of hair-bearing skin are managed carefully so that the hairline is preserved and you can still wear your hair up. Excess skin is trimmed precisely and closed with very fine sutures.
SMAS and deep plane approaches
Through these incisions, the SMAS layer is lifted, repositioned and secured, either by folding and suturing it (plication), by removing a strip and closing it (SMASectomy), or by releasing it more deeply so the cheek tissues move as a single unit. The choice depends on your anatomy, skin quality and goals.
Mini or short-scar facelift
For earlier jowling with good skin quality, a shorter-incision lower face lift may be appropriate. Recovery is quicker, but the degree of correction is more limited, particularly in the neck.
Combined procedures
A facelift is frequently combined with a neck lift to tighten the platysma muscle, with eyelid surgery, or with fat grafting to restore volume to the cheeks and temples. Surgery is performed under general anaesthesia or intravenous sedation with local anaesthetic, in an accredited London hospital, and usually takes three to five hours.
The finest facelift is the one no one can name: you simply look like yourself on a well-rested day.
ADLSynergy · Harley Street
05Facelift Recovery Time and Aftercare
Most patients stay one night. A light compression dressing supports the tissues for the first day or two, and small drains may be used. Discomfort is usually moderate and well controlled with simple pain relief; a feeling of tightness and numbness around the ears and cheeks is normal and settles gradually over weeks to months.
- Week 1: rest with your head elevated, cool compresses, gentle walking. Swelling and bruising peak around days two to three.
- Days 7–10: sutures are removed. Many patients feel comfortable going out, perhaps with a scarf or hair styled forward.
- Weeks 2–3: most return to desk work and social plans, with residual swelling that others rarely notice.
- Weeks 4–6: exercise is gradually reintroduced.
- Months 6–12: the final result settles and scars mature and fade.
Recovery at ADLSynergy is designed as a programme rather than an afterthought. Depending on your needs it may include manual lymphatic drainage, scar management and massage with our theatre practitioner Tika, nutrition guidance and oxygen therapy or red light therapy to support tissue healing. Ms De Leo remains available throughout for advice and reassurance.
06Facelift Risks and Results: An Honest View
A facelift is major surgery and, like every operation, carries risks. These are discussed in detail at consultation and include:
- Haematoma (a collection of blood under the skin), the most common early complication, which may need a return to theatre
- Prolonged swelling, bruising or temporary numbness of the cheeks and ears
- Injury to the facial nerve branches, which is uncommon and usually temporary, but rarely permanent
- Wound-healing problems or skin loss, particularly in smokers
- Visible, stretched or raised scars, or changes to the hairline
- Asymmetry, infection, and the general risks of anaesthesia, including blood clots
When looking at facelift before and after photographs, remember that results vary from person to person. A facelift does not stop the clock: you will continue to age, but from a fresher starting point, and most patients enjoy the benefit for many years. Protecting your skin from the sun, not smoking, maintaining a stable weight and investing in good skin care all help results last.
07Why Choose Ms Anna De Leo for Your Facelift on Harley Street
Ms Anna De Leo is a GMC-registered Plastic, Reconstructive and Aesthetic Surgery Consultant and a Fellow of the European Board of Plastic, Reconstructive and Aesthetic Surgery (FEBOPRAS). She trained at the University of Rome ‘La Sapienza’ and has worked at Chelsea and Westminster, the Royal Free and Oxford University Hospitals, as well as in leading units in Barcelona, Helsinki and Brazil. Her background in reconstructive microsurgery brings a detailed understanding of facial anatomy, blood supply and the delicate handling of tissues.
As a female plastic surgeon, she brings a perspective many patients value: an appreciation of subtlety, and a belief that the best facelift is one nobody can quite identify. Patients searching for the best facelift surgeon in London are often looking for exactly that combination of technical skill and restraint.
At ADLSynergy, surgery is connected to recovery science, nutrition and longevity medicine, supported by our dedicated team. To discuss whether a facelift on Harley Street is right for you, please arrange a consultation.
