I also realised that I could protect the suspension sutures in a mid-face lift much better by removing pressure from the cheeks. That’s why I designed the “better pillow” which supports the face on the forehead and below the jaw-line and there is no pressure on the cheek. That way my opatients can safely sleep comfortably immediately after their operation without fear of damaging the surgery. The addition of the special facial mask (that I also specifically designed) provides great comfort and support.

http://www.vivida.co.za/betterpillow

Special needles are used to finely puncture the skin and induce natural collagen production. This tightens the skin after a few months. The method can also be used to reduce acne scarring, burn scars, wrinkles and creases on the upper lip. In some cases the procedure may be required prior to a face-lift when the patient wants the very bestrejuventation. In all cases it is absolutely essential to be on the highest levels of vitamin A prior to the operation. For acne scars this technique gives the best results without destroying the skin surface. More than one treatment may be required, but the advantage is that the skin gets smoother and smoother with each treatment.

We are learning a great deal about fat grafting and we now believe that the fat cells themselves do not really survive but the result comes from the fat stem cells that are more resistant and do survive and then grow to develop more fat cells.  These fat stem cells have great potential.   They are not the same as foetal stem cells, which can develop into every tissue in the body, but fat stem cells still possess great powers that are being harnessed by modern research. Fat grafting has become one of the best ways to rejuvenate a face and when combined with a face-lift, gives excellent results.

I use fat grafts to

1. enhance the cheek bones,
2. treat the  grooves from the lower eyelid onto the cheek (called the tear-troughs)
3. Lip augmentation (and/or needling (see percutaneous CIT) of the skin to reduce lines and give fuller lips. I always use fat and will not do temporary fillers. If you are not certain of the volume that you want, then have a temporary filler injection to help you decide. A second injection of fat is almost always required to get the desired result. I have been doing fat grafts since 1987.
4. Full face grafting to fill the “deflated” face that automatically accompanies ageing.  This will not only restore volume but also give a more youthful appearance to the overlying skin.  The temples and forehead as well as the face benefit from fat grafting.
5. chin augmentations

With chin augmentations I never use prosthetic material, but prefer to do either dermo-fat grafts or fat injections.

This operation is virtually always done with local anaesthesia with or without conscious sedation. I shape the ears with permanent sutures and the small scars are in the usual position on the back of the ear.

This operation can be done under local anaesthesia with conscious sedation or with general anaesthesia. 
I generally prefer the open approach so that I can sculpt the nose more accurately under direct vision. The incision is mainly within the nose, but there is a short incision in the midline underneath the nose. This becomes imperceptible.

This is an extension of the surgery for the midface and is only suitable for people showing less lax skin and early drop of the facial tissues. Generally they will be turned away by most plastic surgeons and told to wait a few more years for a conventional face-lift. This surgery cannot be done in people with lax, photo-damaged skin who need a conventional face-lift.

Suture suspension loops are used to hold the facial tissues in their youthful position.  A combination of suture suspension loops as well as threads such as the Silhouette threads may be required.   In some cases it is only necessary to use four to six Silhouette sutures each side.

After the operation you will need to use a special support that I have designed to protect the sutures and improve your comfort. No scars are noticeable and even a hairdresser may never know that the operation has been done.

The lower eyelid is virtually always treated together with the midface. This is another operation that I have pioneered. I realised that the conventional lower eyelid operation which I used to do, did not correct the drop of cheek tissues that then exposed the fat in the lower eyelid and made it seem as though there was more excess fat. In fact that fat has merely been exposed, even if there has been some herniation of fat through the membrane defining the lower eyelid. I lift the fat of the cheek which has generally accentuated the naso-labial crease and restore it to the position it occupied when the patient was about 25yrs old. I believe that the midface-lift is the real lower eyelid lift (lower blepharoplasty)
Permanent sutures are used to ensure a long-lasting result. If there is any excess skin on the lower eyelid then it is removed without disturbing the anatomy of the lower eyelid muscle. The scars are on the inside of the lower eyelid and in the hairline of the temple. If skin has been removed from the lower eyelid then there will be a barely perceptible scar in the crow’s feet and immediately below the eyelashes. The result of this operation is rejuvenation of the face between the eyes and mouth with correction of the bags of the lower eyelids and also some softening of the jowl creases without visible scars.