Excess fat in the neck with loose skin that affects the definition of the neck and jaw line.
There are various techniques used to improve the appearance of the face. Most of the minimally invasive techniques tend to produce minimally effective changes in the face too. We often get patients who have spent a significant amount on some of these techniques and then finally approach us to have a more effective surgical lower face / neck lift procedure done.
Mr Mahajan plans the procedure to place the scar as inconspicuously as possible. He uses the SMAS contouring technique that he has acquired from Stockholm and has improvised upon it to suit his patients. This technique not only helps tighten and suspend the SMAS layer, repositioning it to where it belongs, but also helps restore the volume of the face in the areas that helps rejuvenate the face. This procedure is carried out in a plane above where the important nerves in the face are located, thereby minimizing risk of injury to them. This technique avoids the ‘wind swept’ appearance and produces a long lasting youthful appearance. The face lift procedure will bring back the youthful appearance to your face. If your expectations are realistic, you will always be happy, if not, you will always be unhappy irrespective of how good a job your surgeon might have done!
This procedure is often combined with eyelids lift, brow lift or fat transfer to areas in the face to help achieve a global rejuvenation of the face.
WHO IS A LOWER FACE / NECK LIFT FOR?
- Ladies or gents who have lost definition of the jaw line with prominent jowls
- Ladies or gents who have excess loose skin in the neck area
- Ladies or gents with excess subcutaneous fat in the neck
WHAT DOES A LOWER FACE / NECK LIFT ACHIEVE?
- Suspends the deep layers of the face to elevate them.
- Gets rid of excess, loose skin eliminating the jowls and defining the jaw line
- Gets rid of excess fat/skin to help define the neck
LOWER FACE / NECK LIFT TECHNIQUES
- Lower face / neck lift
- SMAS contouring face lift
LOWER FACE / NECK LIFT NEED-TO-KNOW INFO
- Duration of surgery: About 3 hours
- Anaesthesia: General Anaesthetic
- Duration of inpatient stay: 1 night
- Wounds healed in: 1 week
- Scars matured in: Settle in 3 to 6 months, fully matured in 12 to 18 months
- Back to light work (Desk job): 2 weeks
- Back to cardiac exercise / fast walking: 2 to 3 weeks
- Back to labour intensive work / Exercise: 6 to 8 weeks
- Sexual activity: 6 to 8 weeks
- Able to drive: 2 weeks (Should be able to apply emergency stop)
- ‘Long haul’ flights / holidays: Avoid four weeks before and after. Short flights are okay but take precautions.
- Shower / bath: Keep dressing dry for one week but pamper yourself with a sponge bath.
- Sun bathe: Keep the scars covered or protected with a high factor sun protection cream until they mature in about a year or so.
- Garments: Face lift garment for 1 week
- Post-operative review: 1 weeks, 3 months (As often as necessary if clinically indicated)
- Post-Operative pain / discomfort: 2 to 5 days
- Potential risks: (Every effort is made to reduce the risk of complications, but potential risks are) Bleeding, bruising, swelling, haematoma, infection, delayed wound healing, skin necrosis, scars – hypertrophic, stretched, sensitive, scar alopecia, step in the hair line, ear lobe deformity, residual fullness or irregularities, asymmetry, numbness facial skin / ears, facial nerve injury, risks associated with general anaesthetic, blood clots in legs or lungs.
“Over the last 10 years I have become increasingly unhappy with my neck area and jawline however I was very nervous about having surgery to my face. I eventually plucked up the courage and arranged a consultation with Mr Mahajan.
He was professional, patient and happy to discuss any issues that I had. His before and after pictures showed very natural results and so I decided to go ahead.
The results are amazing! When the bandages came off (1 week later) I could already see the difference he had made and after only 2 weeks almost all the bruising and swelling had already gone.
I am now more confident and have been told I look 10 years younger! This was never the intention but it’s a major bonus!
I would recommend Mr Majahan to anyone.”
“I’ve always hated my double chin. A few years ago I lost 6 stone but my chin stayed the same- like a line from my chin to my chest and not really any neck. I felt really bad about it, so much that I felt disfigured.
I met Mr Mahajan for an initial consultation. I had a list of questions ready and he answered them all very patiently and put my mind at ease.
The surgery went great- not much pain at all. Mr Mahajan came to see me that night a few hours after my surgery to take my bandages off and show me how I looked. I was in a bit of a daze because I was so happy that for the first time in years I had a neck- even swollen and a bit bruised I could see he’d done a fantastic job.
It’s now 3 weeks after surgery and the bruising/ swelling has all gone. I would tell anyone thinking of doing this to go and see Mr Mahajan. He really has changed my life for the better and I can’t thank him enough.”
www.realself.com/review/yorkshire-clinic-bingley-uk-neck-lift-happy
Mr Mahajan will acquire a detailed history from you about your concerns and your medical history. He will take the time to understand your desires and discuss in detail as to how he can achieve the results you want. A detailed examination involving assessment of the facial contours, overlying skin and underlying muscles and fat will be noted. Measurements will be taken as necessary to gauge the degree of the problem.
Depending on your examination a treatment plan will be formulated tailored to your needs. Depending on the characteristics of your face, Mr Mahajan will discuss surgical options with you. You will together be able to decide the procedures that will be used to achieve your desired results. There is limit as to how much things can be altered depending on your underlying skeletal structure, this will be assessed and explained to you.
Mr Mahajan usually carries out liposuction of the neck in conjunction with the facelift to help contour the neck as necessary. Pattern of the incisions, procedure and subsequent scars will be discussed in detail and you will be given an opportunity to probe into any aspect of the proposed procedure. Once you decide to go ahead following the consultation, you will be required to attend the pre-assessment clinic to ensure you suitability for the procedure under general anaesthetic. You will need to stop smoking (including electronic cigarettes and nicotine patches) and stop any anticoagulant medication such as Aspirin, Warfarin, etc as suggested by Mr Mahajan.
You will be admitted to the hospital on the day of the procedure. The operation will be done under general anaesthesia. It will be carried out according to the technique that was planned at the consultation. This will depend on the characteristics of your face and will involve using the approach discussed before.
If liposuction is necessary, this will be done first to reduce the excess subcutaneous fat and help define the neck. The incision will be made along the hair line, in front of the ear (at the junction of your face with your ear), curving along the ear lobe to behind the ear (in the crease) and ending in the hair at the back of your head.
The skin flap is elevated and the SMAS layer is then tightened and suspended to contour the deep layers of the face. Fat will be transferred to the cheek area if indicated and opted for by the patient in the pre-operative plan. The excess skin is then trimmed off in the appropriate places and absorbable / non-absorbable sutures used to close the surgical wounds. There will be a drain placed under the skin on either side which will be removed the following the day. A facelift garment will be applied.
The procedure can take about 3 hours to do depending on the complexity of the case. Mr Mahajan will dedicate as much time as is necessary to create your new aesthetically pleasing form and achieve the results you desire.
Following your procedure, you will be taken to your room, once you have recovered from the anaesthetic. You will be cared for to the highest standards by our well-trained nurses. You will need to rest in bed with the back propped up to minimize swelling and bruising. Once you have recovered enough after the surgery, you will be encouraged to sit out of the bed and mobilise to reduce the risks of blood clots in your legs or lungs. You will have some pain and discomfort for 2 to 5 days, but we will ensure that you are comfortable with adequate analgesia.
You can go home as soon as you are comfortable enough to go home. This is usually the following day after removal of your drains. You will have some non-absorbable sutures in front on your ear that will need to be removed in a week, the rest of the sutures will be absorbable, and you will not have to have them removed. Scars are unavoidable following any surgery, but Mr Mahajan aims to make these as neat as possible. Your face will be swollen immediately following the surgery. Over the next few months the swelling will gradually go down and the contour of the face will improve.
You will be seen 1 week following the procedure to ensure that your wounds have healed well and to remove your sutures. After this initial follow up, you will be seen again in 3 months’ time to assess the results when the swelling has settled reasonably. Mr Mahajan will be available to see you at any time following the procedure should there be any unexpected problem.
Is Lower Face / neck lift for me?
A lower face / neck lift procedure is not necessarily a “vanity” procedure. Often patient wish to have a face lift procedure as the reflection they see in a mirror does not correspond with their mental age. Face lift goes a long way in helping patients bridge this gap. Contrary to popular belief, face lifts are not necessarily for women alone, men do have similar requirements. If you have excess loose skin that is sagging giving you deep folds in your face and affecting the contour of your jaw line and neck, then a face lift will help address these issues. Age is not a limiting factor for these, but you must be in good health and not be a smoker. You do need to carefully consider the risks and expenses involved to make it worthwhile for you.
What is the most important consideration prior to deciding to have a lower face / neck lift procedure?
A lower face / neck lift is a reasonably extensive procedure and recovery will take a few days. There will be some discomfort in the early days. But a face lift procedure rejuvenates the face significantly and the results can be extremely rewarding. A face lift procedure does not change the quality of the skin or the fine lines in the face, but it alters the contours of the face significantly. Patients do need to weigh the risk and benefits. Mr Mahajan would be happy to answer any questions to help you decide. Most of Mr Mahajan’s patients comment upon how the procedure has changed their lives. Most patient’s friends comment on how well they look, without having a clue as to why!!
How do I know if my surgeon is qualified in the field of Plastic Surgery?
MB BS, MB BCh or MB ChB is the basic medical degree of any doctor. Your plastic ‘surgeon’ should at least be a ‘surgeon’. Doctors who receive adequate ‘basic’ surgical training in the UK are awarded Fellowship (FRCSI, FRCS, FRCS Ed, FRCS Gl – in the older generation of surgeons) or Membership (MRCS – in the younger generation of surgeons) of the Royal Colleges in the UK. Doctors or Surgeons, who believe in having a scientific foundation to their practice, spend further years doing research in their fields and are awarded Research degrees such as MSc, MMedSc, MPhil, MD or PhD. Surgeons who ‘train specifically in the field of Plastic surgery’ are awarded FRCS (Plast). These surgeons are then entitled to be on the “Specialist register for Plastic Surgery” with the General Medical Council (GMC).
How do I choose amongst the Plastic Surgeons who fit the above criteria?
‘Safe’ and ‘beautiful’ results are dependent on ‘experience’ and ‘expertise’ of your plastic surgeon. Mr Mahajan is a highly trained and experienced plastic surgeon who is a Consultant Plastic Surgeon at the Bradford Teaching Hospitals NHS Foundation Trust / Calderdale and Huddersfield NHS Foundation Trust and is the Director of the prestigious Plastic Surgery and Burns Research Unit (PSBRU) at the University of Bradford. He has worked in world-renowned centres for aesthetic surgery in Belgium, Sweden and Switzerland in addition to his training in the UK. He is a full member of the British Association of Plastic Surgeons (BAPRAS), British Association of Aesthetic Plastic Surgeons (BAAPS), European Association of Plastic Surgeons (EURAPS), UK Association of Aesthetic Surgeons (UKAAPS), Association of Breast Surgeons (ABS) and is on the Specialist register for plastic surgery with the General Medical Council (GMC). Surgeons are only awarded membership of these associations if they are properly qualified and it is a reassurance for you that you are in safe hands. In addition to this, it obviously helps if your surgeon has travelled the world to enhance his training in premier institutes to learn from leading surgeons in their fields. It also helps if your surgeon believes in practicing “evidence based medicine” by engaging in research activities to help establish a scientific background to his / her clinical practice.
Where will my surgery take place?
Your surgery will take place in ‘local’ reputed hospitals such as the Yorkshire Clinic or the Spire Elland Hospital, where you will be able to return to ‘anytime’ after the operation should there be any concerns.
Which procedure would suit me best?
Mr Mahajan will carry out a detailed examination to determine the exact nature of your face and the areas that need to be addressed. This will be explained to you and an appropriate procedure will be selected in discussion with you.
If you have excess fat in the neck area this will be dealt with by liposuction prior to starting your face / neck lift procedure. If the upper part of your face is okay and you only need a lower face / neck lift, then this will be explained to you. On the other hand, if you would benefit from ancillary procedures such as a brow lift, or eye lids lift then this will be explained to you too and you can choose what you wish to have done.
After choosing the appropriate technique to achieve the goal, the end outcome is known to give the patient a very high level of satisfaction.
How much will the procedure cost?
Cost of a face lift can be about £6500 depending on what needs to be done. Mr Mahajan will discuss this with you when you meet him. You may find cheaper deals with firms that consider cosmetic procedures as a business, but may end up compromising on safety, quality and convenience. Although face lift may be considered as a cosmetic procedure, it is a plastic surgical ‘operation’ and you do need to appreciate this and consider it with all the seriousness that it deserves. Medical tourism has certainly made costs cheaper, but the very fact that you are boarding a long haul flight puts you at risk of blood clots in your legs or lungs that can be life threatening. There are obviously other matters to consider such as qualifications, experience and expertise of your surgeon / anaesthetist apart from the ability to see your surgeon again should there be a problem after you have flown back home.
Am I too old or too young to have a face lift procedure?
Sometimes patients who are very young come to us asking about face lift procedures to address some minor laxity / lines in their face. These are better treated by carrying out non-surgical face lifts. A face lift procedure is a reasonably major undertaking and the changes in your face have to be significant enough to benefit from undergoing a face lift procedure. There is no upper age limit for having a face lift procedure done as far as you are in good health and are considered to be a good candidate for a general anaesthetic of about 4 hours duration. Most patients who have face lift procedures done are in the fifth or sixth decade of life.
Will I have long standing results following a face lift?
As time goes by, the tissues will continue to be affected by the natural ageing process and gravity. The longevity of the results of a face lift procedure is dependent on the quality of your tissues. Loose sun damaged skin is bound to become saggy sooner than elastic, well maintained skin. Patients who opt to have a repeat face lift procedure, usually do so in about seven to ten years. Having said this, your face will always look younger than it would have done, had you not had a face lift procedure done.
How many years can you take off my face?
On an average, patients tend to look about 9 to ten years younger than they used to. This is dependent on various factors including how bad the ageing changes were before the operation, the quality of the tissues, the skeletal framework of your face and if any ancillary procedures were done at the same time, such as fat transfer to the mid face, eye lid lift, brow lift, Botox and fillers.
What types of face lift surgery can I have?
This will depend on what needs to be addressed and will be determined by Mr Mahajan when he examines you in detail.
SMAS contouring face lift: This is Mr Mahajan’s preferred technique that he has picked up from Dr Per Heden of Akademikliniken in Stockholm and modified it to achieve best possible outcomes for his patients. This technique involves dissection above the layer of SMAS and repositioning and tightening it so that contours of the face are restored. The plane of dissection is above where the important branches of the facial nerves are located and the risk of injury to them is minimal. Moreover, dissection is not extensive and is only carried out as far as necessary to address the excess skin. Absorbable sutures are used that eventually dissolve, well after their job of recontouring the face is done and the newly formed scar tissue on the inside holds the tissues of the face in their new position.
Lower face / neck lift: These can be carried out when the patient is happy with the upper part of the face where there are no significant ageing changes, but the main area of concern is the jaw line and the neck. The technique is similar to the SMAS contouring face lift, except that it only addresses the lower face and neck. However many patients who come looking for this procedure are usually more suitable for a full face / neck lift procedure.
Conventional face lift: This technique involves dissecting in a plane below the SMAS, taking care to avoid damage to the nerves in the face. However, the risks are there! The SMAS layer is then elevated and suspended to ‘pull up’ the face.
Short scar or mini face lift: This involves making the incision as small as possible and may be limited to just the front of the ear or along the front and back of the ear, but not extending in to the hair at the back or the along the side burn in the front. These techniques are acceptable when minimal changes need to be done in the face / neck. However they cannot address significant excess tissue and ageing changes in the face.
MACS facelift: This is a Minimal Access Cranial Suspension facelift procedure. Dissection of the excess tissues in the face and neck is not as extensive as in a SMAS contouring face lift or conventional face lift procedure. This can have limitations in addressing excess skin adequately.
Will my neck look better after a face lift procedure?
Mr Mahajan almost always performs liposuction of fat from the neck area at the start of the procedure. This helps define the contours in the neck, especially in patients who have significant excess fat in this area. Following this, the SMAS layer is plicated and tightened up to define the neck and jaw line area. Patients absolutely hate the loose excess tissue in their neck area and Mr Mahajan’s technique helps get rid of this and gives a nice definition and contour to the area!
Should I have fat transfer to the face during a face lift procedure?
As part of the ageing process, the mid face loses volume due to reduction of the malar fat pad and decent of this area. A SMAS contouring face list helps address this and repositions the existing fat where it should be. However, if there is significant flattening of the mid face, volume to this area can best be addressed by transferring fat here at the same time as the face lift. This helps achieve a nice “Ogee” curve that is considered to be the signature of a youthful face!
Can I have fillers and Botox instead of a face lift procedure?
This depends on the degree of ageing changes in your face. If they are not significant and you are young, then a soft face lift with fillers and Botox may help. But if you have significant ageing changes in the face, then you might be wasting your money on fillers and Botox.
I don’t want a wind-swept appearance!
During a face lift procedure, the tissues of the face need to be addressed appropriately. It is paramount that the deeper layers of the face are restructured to replace them where they used to be and are firm and taught. The direction of this tightening is important and needs to be natural. Following this, the overlying skin is then gently replaced and excess skin is trimmed off. Again, the repositioning of the skin and trimming off excess in the right places plays a vital role. The wind swept appearance is usually the result of not addressing the tissues appropriately and relying on pulling the skin tight to create a face lift.
Will the wrinkles on my face disappear with a face lift procedure?
A face lift procedure helps reduce the prominence of the lines in your face, however it does not make them disappear. The lines especially become much less prominent immediately after a face lift procedure when there is swelling in the tissues and the skin is stretched out. However, as the swelling settles, the lines return to some extent but are better than they used to be prior to the procedure. With ageing the skin loses its elasticity and the skin can be sun damaged. This is not improved with a face lift procedure and you may need ancillary procedures such as chemical or laser peels to improve the quality of the skin. On the other hand, these ancillary procedures help improve the quality of the skin, but it does not tighten and reposition the deeper layers of the face that define the contours of the face. Only a face lift can help achieve this.
Do I need to stop my medication?
If you are on the oral contraceptive pill, you will need to stop these 4 weeks before the procedure to reduce your risks of blood clots in legs or lungs. Also, you will need to stop any blood thinning drugs. Aspirin and Clopidogrel will need to be stopped a week prior to surgery. Warfarin, Dabigatran etexilate, Rivaroxaban and Apixaban need to be stopped 4 days prior to surgery. Mr Mahajan will discuss this with you in the pre-operative consultation.
Will I need to have a general anaesthetic?
Yes, you will need a general anaesthetic to undergo the procedure. It will take about 3 to 4 hours to do the operation for you. Your anaesthetist will be fully qualified and a member of the Royal college of Anaesthetists. He will ensure that you have a smooth anaesthetic procedure and are comfortable during your recovery.
Are there any risks?
Every effort is made to reduce the risk of complications, but potential risks are) Bleeding, bruising, swelling, haematoma, infection, delayed wound healing, skin necrosis, scars – hypertrophic, stretched, sensitive, scar alopecia, step in the hair line, ear lobe deformity, residual fullness or irregularities, asymmetry, numbness facial skin / ears, facial nerve injury, risks associated with general anaesthetic, blood clots in legs or lungs.
How long will I have to stay in the hospital?
You will have surgical drains after the procedure and you will need to stay in hospital overnight, until your drains are removed, and you are comfortable enough to go home.
When will I be seen again after I am discharged from the hospital?
You will usually be seen by Mr Mahajan one week following your procedure to ensure that the wounds have healed well. At this stage non absorbable sutures in front of ear will be removed. The sutures behind your ear are absorbable and do not need to be removed, they will eventually dissolve. Following this initial review, you will be seen again in 3 months. However, if there are any concerns, you will be seen by Mr Mahajan as often as is necessary.
Is there anything that I need to look out for?
Although you will only be discharged from the hospital when Mr Mahajan is satisfied that you are doing well following your surgery, you do need to look out for sudden increase in swelling of the face, disproportionate pain, any signs of infection such as feeling unwell, temperature, redness around the scars, discharge or foul odour from the wounds. Your face may be a bit bruised after the procedure, but should any part of the skin colour change to purple, it could be sign of compromised circulation and you should return to see Mr Mahajan. One should also look out for any painful swelling of the calf or shortness of breath that might suggest a blood clot. If this happens, please contact us immediately.
What if I have a problem after I am discharged from the hospital?
You will be discharged from the hospital when it is safe enough to do so. However, in the event of any unexpected problems, you can contact us any time on 0800 246 5636.
What position can I sleep?
Immediately after the procedure, you will be most comfortable lying on your back with the back propped up at 45 degrees or so to minimise swelling in the face for the first few days.
Will I need to wear any special garments?
You will need to wear a face lift garment with soft wool underneath. You will need to wear this for a week, until Mr Mahajan sees you again in the clinic.
Will I be in pain?
Patients do tend to have some pain and discomfort for the first 2 to 3 days, but you will be kept comfortable with adequate analgesia. It is advisable to take Paracetamol six hourly on a regular basis for the first 24 to 48 hours and then as necessary after that. Patient do need to be aware that it will feel a bit tight in the neck area after the procedure, but this feeling eases with time.
Will my face be swollen and bruised?
Your face will indeed be swollen immediately after the procedure. The swelling takes time to settle and it will be significantly less a month following the procedure. It takes about three months for it to settle reasonably. It continues to further settle gradually after that and can take up to a year for the end result to be fully apparent. The technique that Mr Mahajan uses leads to minimal bruising of the face, along there might be some bruising in the neck area.
Do I need to massage my face?
Massaging the face and neck towards the sides and down can help reduce swelling of the face / neck after the wounds have healed. You will also need to massage the scars once your wounds have healed in a week’s time.
When do my stitches come out?
You will be seen by Mr Mahajan about one week following your procedure. At this stage non absorbable sutures in front of ear will be removed. The sutures behind your ear are absorbable and do not need to be removed, they will eventually dissolve.
How long will it take for my wounds to heal?
It takes about one week for the wounds to heal up. After this you can start massaging the scars gently.
When can I shower or have a bath?
You should ideally wait for one week until your wounds are healed, and dressing are removed before you wet your face, but you can shower and bathe the rest of your body. You can make an appointment with your hairdresser on the morning of the day you are due to see Mr Mahajan, a week after the procedure. Your garment can be taken off and the hair washed by gently positioning your head back in to the saloon sink.
Where will my scars be?
In a full face / neck lift procedure, the scar will run along the base of your ear in front and back at the junction of your ear with your face. The scars will then extend along the base of your sideburn and to the front of it. Behind your ear the scar will extend transversely in to your hair at the back of your head. Mr Mahajan may be able to limit the extent of the scar depending on how much excess loose skin there is.
How long will it take for my scars to settle?
Scars are pink to start with, but over time they tend to become less prominent and fade. Scars tend to settle reasonably in 3 to 6 months. However, it takes about 12 to 18 months for scars to settle fully. Scars can at times be thickened (hypertrophic) especially in younger patients. This might require treatment with silicone creams or steroid injections. Scar in hair bearing area may not have hairs growing through the scar itself, but hopefully hairs immediately adjacent to the scar will help cover it up.
When can I sun bathe?
It is always advisable to protect your skin in the sun. In particular, your new scars are susceptible to sun damage until they mature in about a years’ time or so. You should keep the scars covered or protected with a high factor sun protection cream until then.
What can I apply to my scars to help them settle better?
It is important to massage the scars once they are healed. This helps them settle better. Some patients claim that Bio oil helps scars settle better, but any moisturising cream should be good enough. If there is any indication of the scars becoming thicker, then silicone based creams should be considered.
Will the sensation in my face be affected?
The sensation in the face will be reduced immediately after a face lift procedure. This is due to the undermining and elevation of the skin to carry out the procedure. Most of this usually recovers in about three months’ time. There may however be some permanent decrease in sensation, especially involving the ears.
When can I go back to work?
This depends on your job. If you have a desk job that does not involve lifting any things heavy, you can go back to work as soon as you are comfortable, and this could be in about two weeks or less. However, if you have a more demanding job, you will need to take a break for 4 to 6 weeks. This can vary widely between patients, as patients tend to cope variably. Also, if your job involves facing clients, then you might wish to wait for the swelling and bruising to settle. Patients are usually reasonably presentable in two weeks’ time and a bit of makeup helps!
When can I hit the gym again?
You will need to wait until your wounds have fully healed and you are comfortable to undertake any labour intensive work. This could take 6 to 8 weeks following your surgery. You could however return to light cardiac exercises sooner in about 2 to 3 weeks.
When can I drive?
You will need to wait until you are comfortable to do so. This might mean waiting till your wounds have healed and settled in two weeks’ time. You should be able to apply an emergency stop and it is a decision that you will have to make. You will also need to be able to freely turn your neck to look around you before you think that you are safe to drive.
When can I fly or go on holidays?
Holidays after surgery will do you good and give you time to recuperate. However, it is not advisable to go on long haul flights for 4 weeks after the procedure to reduce the risks of blood clots in your legs or lungs. Blood clots in your lungs can be life threatening and is a very compelling reason for you not to consider traveling across the globe in search of cheap deals. Short flights and travel by train or car, which does not involve prolonged periods of immobilisation, is not a problem although you should take precautions to wear flight socks, drink plenty of water and exercise your legs when travelling.
Although I am not in a rush, when can I have sex again?
You will need to wait until your wounds have fully healed and you are comfortable to engage in any sexual activity. This could take 6 to 8 weeks following your surgery.
When can I drink or smoke?
There is no issue with having a social drink after the procedure. However, patients do need to refrain from smoking completely for at least three weeks following the procedure. You would have had to stop smoking for eight to twelve weeks before the operation. Smoking tends to reduce the circulation of blood, which is vital for wound healing. This applies to nicotine patches or electronic cigarettes too. Considering that you would have stopped smoking for about 3 – 4 months around the date of your procedure, you should take this as an opportunity to stop smoking completely!
Book chapters:
Influence of rNAPc2 in the evolution of a burn wound: a promising therapeutic option for the management of burns.
Ajay L Mahajan
Presented to the National University of Ireland, Galway, 2006. Thesis of research work towards degree of Doctor of Medicine (MD)
Principles of free flap design and elevation
Phillip N Blondeel and Ajay L Mahajan
Operative Microsurgery, edited by Brian Boyd, MD and Neil Jones, MD. McGraw-Hill, New York, 2015.
Photography in Plastic Surgery
Ajay L Mahajan
Text Book of Plastic, Reconstructive & Aesthetic Surgery, edited by Karoon Agarwal, in Print
Original Articles
- The Trap Door flap for Conchal Reconstruction
J Lynch, A L Mahajan, P Regan
Br J Plast Surg. 2003 Oct; 56(7):709-11
- The free serratus anterior flap and its cutaneous component for face reconstruction: a
series of 27 cases
B Pittet, AL Mahajan, N Alizadeh, K Schlaudraff, N Faisal, D Montandon
Plast Reconstr Surg. 2006 Apr;117(4):1277-88.
- Progressive tissue injury in burns is reduced by rNAPc2
AL Mahajan, X Tenorio, KU Schlaudraff, MS Pepper, D Baetens, D Montandon, B
Pittet
Burns. 2006 Dec;32(8):957-63. Epub 2006 Aug 14.
- The free serratus anterior flap and its cutaneous component for face reconstruction: a
series of 27 cases
B Pittet, AL Mahajan, N Alizadeh, K Schlaudraff, N Faisal, D Montandon
Stomatol DDR. 2007 Marz;104.1:33-42 (Dual publication with permission from PRS)
- Early detection of flap failure using a new thermographic device
X Tenorio, AL Mahajan,, R Wettstein, Y Harder, M Pawlowsky, B Pittet
J Surg Res. 2009 Jan;151(1):15-21. Epub 2008 Apr 4.
- Optimising the arterialised venous flap
Pittet B, Quinodoz P, Alizadeh N, Schlaudraff K-U, Mahajan AL
Plast Reconstr Surg. 2008 Dec;122(6):1681-9.
- What should count as a “perforator flap”?
- Sinna, A. Boloorchi, A L Mahajan, Q. Qassemyar, M. Robbe
Plast Reconstr Surg. 2010 Dec;126(6):2258-63.
- Localizing Perforators vessels by Dynamic Infrared Imaging and Flow Doppler without
thermal cold challenge
X Tenorio, AL Mahajan, B Elias , J Schaepkens Van Riempst, R Wettstein, Y Harder, B Pittet
Ann Plast Surg. 2011 Aug;67(2):143-6.
- Maintaining Ear Aesthetics in Helical Rim Reconstruction.
Taylor JM, Rajan R, Dickson JK, Mahajan AL.
Ann Plast Surg. 2014 Mar;72(3):318-22
Ideas and Innovations
10. Why have Paper when you can have Silk?!
A L Mahajan, C L Riordan, P J Regan
Plast Reconstr Surg. 2003; 111(5):1759-1760
- Clinical Application Of Natural Tissue Expansion In The Face.
A L Mahajan, TWL Chapman
The Internet Journal of Plastic Surgery. 2007; 3 (1).
- Helix reconstruction with wedge resection in the right place
A L Mahajan
J Plast Reconstr Aesthet Surg. 2009 Jan;62(1):125-7. Epub 2008 May 23.
Case Reports, Correspondence and Published Abstracts
- Digital Imaging and its role in our day to day work
A L Mahajan, J Lynch, A J Hussey, J McCann, P Regan
Ir J Med Sci. Vol. 169, No.3 July/Aug/Sept 2000
- Vacuum Assisted Closure (VAC) therapy and its’ use in a Plastic Surgery Department
J Lynch, A J Hussey, A L Mahajan, JJ McCann, PJ Regan
Ir J Med Sci. Vol. 169, No.3 July/Aug/Sept 2000
- Lip Cancers in the West of Ireland
A L Mahajan, J Lynch, J McCann, P Regan
Ir J Med Sci. 2001 July/Aug/Sept 170(3) S: 18
- A Comparison of Hydrophilic Polyurethane and Alginate Dressings in the
Treatment of SSG Donor Sites
A J Hussey, A L Mahajan, JB Lynch, JJ McCann, PJ Regan
Ir J Med Sci. Vol. 170, No.3, July/Aug/Sept 2001
- The Trap Door flap for Conchal Reconstruction
J Lynch, A L Mahajan, PJ Regan
Ir J Med Sc. Vol. 170, No.3, July/Aug/Sept 2001
- Could your case of Necrotising fascitis be Pyoderma Gangrenosum?!
AL Mahajan, N Ajmal, J Barry, L Barnes, D Lawlor
Br J Plast Surg. 2005 Apr; 58(3):409-12.
- Dynamic Infrared Imaging in Reconstructive Surgery
Xavier Tenorio, Ajay Mahajan, Denys Montandon, Brigitte Pittet
Plast Reconstr Surg. 2005 Sept Vol. 116,No.3 supplement
- New therapeutic intervention with rNAPc2 curbs progression of the burn wound
AL Mahajan, X Tenorio, KU Schlaudraff, MS Pepper, D Baetens, D Montandon, B
Pittet
Ir J Med Sci. 2004 173(3) S1
- Dynamic Infrared Imaging : a new tool in flap perfusion monitoring
Xavier Tenorio, Ajay Mahajan, Marek Pawlowski, Brigitte Pittet
J Plast Reconstr Aesthet Surg. 2006;59(9): S5
- A novel use of vascularised free fibula graft as a bracket to stabilize severe cervico-
thoracic kyphosis associated with neurofibromatosis type 1
TWL Chapman, N. M. Harris, V Rachapalli, AL Mahajan, AR Fitton
Eur J Plast Surg 2007 Feb;29(6):299-301
- Lichtenberg figures – Cutaneous manifestations of Phone Electrocution
AL Mahajan, R Rajan, P J Regan
J Plast Reconstr Aesthet Surg. 2008;61(1):111-3. Epub 2007 Jul 30.
PRESENTATIONS
- Skin Cancer Triage Clinic – Twelve Month review in UCHG
J Lynch, A L Mahajan, A J Hussey, J McCann, P Marren, P Regan
Sylvester O’Halloran Meeting, Limerick, March 2000
(Poster Presentation)
- Skin Cancer Triage Clinic – Twelve Month review in UCHG
J Lynch, A L Mahajan, A J Hussey, J McCann, P Marren, P Regan
British Association of Plastic Surgeons Meeting, Birmingham, July 2000
- Digital Imaging and its role in our day to day work
A L Mahajan, J Lynch, A J Hussey, J McCann, P Regan
Sir Peter Freyer Millennium Meeting, Galway, September 2000
- Vacuum Assisted Closure (VAC) therapy and its’ use in a Plastic Surgery Department
J Lynch, A J Hussey, A L Mahajan, JJ McCann, PJ Regan
Sir Peter Freyer Millennium Meeting, Galway, September 2000
- A Comparison of Hydrophilic Polyurethane and Alginate Dressings in the
treatment of SSG Donor Sites
A J Hussey, A L Mahajan, JB Lynch, JJ McCann, PJ Regan
Scottish-Irish Plastic Surgeons Meeting, Belfast, October 2000
(Poster Presentation)
- Vacuum Assisted Closure (VAC) therapy and its’ use in a Plastic Surgery Department
J Lynch, A J Hussey, A L Mahajan, JJ McCann, PJ Regan
Scottish-Irish Plastic Surgeons Meeting, Belfast, October 2000
- First Aid in Burns
A L Mahajan (Instructional Presentation)
4th Annual Burns Symposium, Galway, January 2001
- Why have Paper when you can have Silk?!
A L Mahajan, P Regan
Irish Association of Plastic Surgeons Meeting, Galway, May 2001
- Digital Imaging and its role in our day to day work
A L Mahajan, J Lynch, A J Hussey, J McCann, P Regan
Irish Association of Plastic Surgeons Meeting, Galway, May 2001
- Digital Imaging – A diagnostic aid in Skin Cancer
A L Mahajan, J Lynch, A J Hussey, J McCann, P Marren, P Regan
British Association of Plastic Surgeons Meeting, Sterling, July 2001
- Digital Imaging – A diagnostic aid in Skin Cancer
A L Mahajan, J Lynch, A J Hussey, J McCann, P Marren, P Regan
British Association of Plastic Surgeons Meeting, Sterling, July 2001
(Poster Presentation)
- Lip Cancers in the West of Ireland
A L Mahajan, J Lynch, J McCann, P Regan
Sir Peter Freyer Meeting, Galway, September 2001
- The Trap Door flap for Conchal Reconstruction
J Lynch, A L Mahajan, P Regan
Sir Peter Freyer Meeting, Galway, September 2001
- A Comparison of Hydrophilic Polyurethane and Alginate Dressings in the
Treatment of SSG Donor Sites
A J Hussey, A L Mahajan, JB Lynch, JJ McCann, PJ Regan
Sir Peter Freyer Meeting, Galway, September 2001
- The Trap Door flap for Conchal Reconstruction
J Lynch, A L Mahajan, P Regan
Scottish-Irish Plastic Surgeons Meeting, Dundee, November 2001
- Management of Burns and Fluid Resuscitation
A L Mahajan (Instructional Presentation)
5th Annual Burns Symposium, Galway, April 2002
- Web Ferret – The efficient way to search the net
A L Mahajan, L Rynn, J McCann, P J Regan
Irish Association of Plastic Surgeons Meeting, Cork, May 2002
- Digital Imaging – A diagnostic aid in Skin Cancer
A L Mahajan, J Lynch, A J Hussey, J McCann, P Marren, P Regan
Sir Peter Freyer Meeting, Galway, September 2002
(Poster Presentation)
- Initial Review of Lasers in Treatment of Skin Lesions
A L Mahajan, K Murphy, A Grufferty, J McCann, P J Regan
Sir Peter Freyer Meeting, Galway, September 2002
(Poster Presentation)
- Burns – The Paediatric Patient
A L Mahajan (Instructional Presentation)
6th Annual Burns Symposium, Galway, February 2003
- Soft tissue infection & Necrotising fascitis in IVDA patients
A L Mahajan, J Kerr, D Lawlor, P Eadie
Irish Association of Plastic Surgeons Meeting, Galway, April 2003
- Experimental model to understand the mechanism of survival of arterialized-venous (AV) flap.
B Pittet, P Quinodoz, N Alizadeh, K-U Schlaudraff, A L Mahajan
7th European Conference of Scientists and Plastic surgeons, Geneva, September 2003
“Best Paper Prize”
- Experimental model to understand the mechanism of survival of arterialized-venous (AV) flap.
B Pittet, P Quinodoz, N Alizadeh, K-U Schlaudraff, A L Mahajan
European Association of Plastic Surgeons meeting (EURAPS), Genoa, Italy, May 2004
- The free serratus anterior flap and its cutaneous component:
Anatomical considerations and successful use in craniofacial reconstruction
AL Mahajan, N Alizadeh, K Schlaudraff, N Faisal, D Montandon, B Pittet
British Association of Plastic Surgeons Meeting, Dublin, July 2004
- New therapeutic intervention with rNAPc2 curbs progression of the burn wound
AL Mahajan, X Tenorio, KU Schlaudraff, MS Pepper, D Baetens, D Montandon, B Pittet
Sir Peter Freyer Meeting, Galway, September 2004.
26.Application of rNAPc2 reduces Secondary Aggravation of Burn Wounds.
X Tenorio, AL Mahajan, KU Schlaudraff, MS Pepper, D Baetens, D Montandon, B Pittet
European Congress of Scientists and Plastic Surgeons, Munich, October 2004
- Diminution de l’aggravation secondaire des brûlures chez le rat par l’application
intraveineuse de l’anticoagulant rNAPc2
Schlaudraff, K-U; Mahajan AL; Pepper MS; Tenorio X; Montandon D; Pittet, B
French Society of Plastic Reconstructive Aesthetic Surgery, Paris, November 2004
- Secondary aggravation of burns is reduced by rNAPc2.
Tenorio X, SchlaudraffK.-U, Mahajan AL, Pepper M.S, Montandon D, Pittet B.
8th Joint Scientific Meeting,Universities of Geneva and Lausanne,
Changins-Switzerland, October 2004. (Poster).
- Progressive tissue injury in burns is reduced by rNAPc2
AL Mahajan, KU Schlaudraff, X Tenorio, MS Pepper, D Baetens, D Montandon, B Pittet
British Burns Association meeting, York, UK, April 2005
“Best Paper Prize”
- Dynamic Infrared Imaging in Reconstructive Surgery
Xavier Tenorio, Ajay Mahajan, Denys Montandon, Brigitte Pittet
Plastic Surgery 2005 (ASPS meeting), Chicago, USA, September 2005
(Poster Presentation)
- Dynamic Infrared Imaging : a new tool in flap perfusion monitoring
Xavier Tenorio, Ajay Mahajan, Marek Pawlowski, Brigitte Pittet
European Congress of Scientists and Plastic Surgeons, Leuven, Belgium,September 2005
(Published abstract J Plast Reconstr Aesthet Surg. 2006;59(9): S5)
- Secondary aggravation of burn wounds and its detrimental influence on post burn
sequelae – an underestimated clinical phenomenon?
Schlaudraff, K-U; Mahajan AL; Pepper MS; Tenorio X; Montandon D; Pittet, B
Swiss Congress of Plastic Surgeons, Beinne, Switzerland, September, 2005.
- Dynamic Infrared Imaging and applications in plastic surgery.
Xavier Tenorio, Ajay Mahajan, Marek Pawlowski, Brigitte Pittet
Swiss Congress of Plastic Surgeons, Beinne, Switzerland, September, 2005.
- Dynamic Infrared Imaging: a new tool in flap perfusion monitoring.
Xavier Tenorio, Ajay Mahajan, Marek Pawlowski, Brigitte Pittet
Joint Scientific Meeting,Universities of Geneva and Lausanne,
Changins-Switzerland, October 2005.
- Use of the CO2 laser in transconjuctival lower lid Blepharoplasty
TWL Chapman, AL Mahajan, N Harris, JG McDiarmid
British Association of Aesthetic Plastic Surgeons, Bath, September 2006
(Poster Presentation)
- Rejuvenation of the mid face by simple techniques
Mahajan AL, Temprano AP, Chapman TWL, McDiarmid JG
British Association of Aesthetic Plastic Surgeons, Bath, September 2006
- Location of vascular perforators by dynamic infrared imaging: Helpful tool or preoperative gadget?
X Tenorio, AL Mahajan, Y Harder, B Elias, D Montandon, J Schaepkens, M Pawlovski,
B Pittet
European Congress of Scientists and Plastic Surgeons, London, September 2006
- Audit of Free and Major pedicled flaps
S Salam, TWL Chapman, AL Mahajan
South West supra regional audit, Salisbury, November 2006
- Lichtenberg figures – Cutaneous manifestations of Phone Electrocution from lightning
A L Mahajan, R Rajan, P J Regan
British Asscn. of Plastic Aesthetic & Reconstructive Surgeons Meeting, London, Dec 2006
(Poster Presentation)
- Trans conjunctival Laser Blepharoplasty
AL Mahajan, TWL Chapman, JG McDiarmid
International tutorials in Aesthetic Plastic Surgery, Mumbai, India, January 2007
- Rejuvenation of the mid face by simple techniques
Mahajan AL, Chapman TWL, Temprano AP, McDiarmid JG
International tutorials in Aesthetic Plastic Surgery, Mumbai, India, January 2007
- Laser Blepharoplasty
AL Mahajan, TWL Chapman, N Harris, JG McDiarmid
Irish Association. of Plastic Surgeons Meeting, Galway, May 2007
- Lichtenberg figures – Cutaneous manifestations of Phone Electrocution from lightining
A L Mahajan, R Rajan, P J Regan
Irish Association. of Plastic Surgeons Meeting, Galway, May 2007
(Poster Presentation)
- Optimising the arterialised venous flap
Mahajan AL, Quinodoz P, Alizadeh N, Schlaudraff KU, Pittet B
Irish Association. of Plastic Surgeons Meeting, Galway, May 2007
(Poster presentation)
- Optimising the arterialised venous flap
AL Mahajan, Quinodoz P, Alizadeh N, Schlaudraff K-U, Pittet B
International Plastic Reconstructive & Aesthetic Surgeons meeting, Berlin, June 2007
(Poster Presentation)
- Lichtenberg figures – Cutaneous manifestations of Phone Electrocution from lightning
A L Mahajan, R Rajan, P J Regan
International Plastic Reconstructive & Aesthetic Surgeons meeting, Berlin, June 2007
(Poster Presentation)
- ‘See and Treat’ Plastic Surgical Clinic Audit
R Rajan, AL Mahajan, NPM Jain, S Wharton
Skin Cancer Audit Day, Exeter, Sept 2007
- Clinical Photography and the Plastic Surgeon
AL Mahajan
3rd International tutorials in Aesthetic Surgery, Mumbai, India, Jan 2008
- Helical Rim Reconstruction with Modified Wedge Resection
J M Taylor, A L Mahajan
British Asscn. of Plastic Aesthetic & Reconstructive Surgeons Meeting, Leeds, July 09
- Maintaining ear aesthetics in helical rim reconstruction
J M Taylor, R Rajan, J K Dickson, A L Mahajan
Irish Association. of Plastic Surgeons Meeting, Galway, May 2009
(Poster presentation)
- Maintaining ear aesthetics in helical rim reconstruction
J M Taylor, R Rajan, J K Dickson, A L Mahajan
XXXIVth Sir Peter Freyer Surgical Symposium meeting, Galway, Ireland, Sept 2009.
(Poster presentation)
- Maintaining ear aesthetics in helical rim reconstruction
J M Taylor, R Rajan, J K Dickson, A L Mahajan
International Plastic Reconstructive & Aesthetic Surgeons meeting (IPRAS), Delhi, Nov 2009
- Influencing the outcome of the burn wound
A L Mahajan, X Tenorio, B Pittet
International Plastic Reconstructive & Aesthetic Surgeons meeting, Delhi, Nov 2009
(Poster presentation)
- Laparoscopically harvested omental flap for scalp reconstruction
R Rajan, A L Mahajan, A Perez, M Coleman, R J Morris
International Plastic Reconstructive & Aesthetic Surgeons meeting, Delhi, Nov 2009
(Poster presentation)
- Lower eyelid tear trough annihilation with segmental fat graft
A L Mahajan, P Hedén
British Association of Aesthetic Plastic Surgeons, London, September 2010
- Facial rejuvenation with the SMAS contouring rhytidoplasty
A L Mahajan, P Hedén
British Association of Aesthetic Plastic Surgeons, London, September 2010
- Blepharoplasty with segmental fat graft
A L Mahajan, P Hedén
6th International tutorials in Aesthetic Plastic Surgery, New Delhi, India, Jan 2011
- SMAS contouring rhytidoplasty
A L Mahajan, P Hedén
6th International tutorials in Aesthetic Plastic Surgery, New Delhi, India, Jan 2011
- Pinnaplasty – Modified Mustarde technique
A L Mahajan
6th International tutorials in Aesthetic Plastic Surgery, New Delhi, India, Jan 2011
- SMAS contouring Rhytidoplasty – Extensile exposure but minimal invasion of SMAS
A L Mahajan, P Hedén
Beauty Through Science (BTS) meeting, Stockholm, Sweden, June 2011.
- Aesthetic Surgery – Dawn to a new you
A L Mahajan
ATMG Meeting, Alton Towers, UK September 2013
- The David Sharpe Fellowship
A L Mahajan
BAPRAS, London, Nov 2014
- Contouring the SMAS in face lift
A L Mahajan
Byron Bay Meeting, Australia, March 2015
- Aesthetic surgery – Psychological and functional benefits
A L Mahajan
AMGR meeting, Leicester, May 2015
- Role of research in plastic surgery in improving health care for the future
AL Mahajan
Evening with John Hendrie, Bradford, May 2015
- The ALT flap – Simplifying harvest and making it safe
A L Mahajan
Amiens Perforator Flap meeting, Amien, June 2015
- Plastic Surgery and Burns Research Unit – our history, aims and ambitions
AL Mahajan
Claret and Amber day, University of Bradford, Bradford, June 2015
- Research and Post graduate education in Plastic Surgery at the PSBRU
AL Mahajan
Northcliffe Golf Club, Bradford, July 2015
- Research in Plastic surgery and its role in the society
AL Mahajan
Lord Mayor of Bradford’s visit, University of Bradford, September 2015
- Research in Plastic Surgery at the PSBRU
AL Mahajan
President’s evening, St. James Market Tenant’s Association, Bradford, October 2015
- The role of human dermal fibroblasts in regulating availability of biologically active vitamin D: implications for cutaneous wound healing.
Jing Qin Tay, Ola Kamala, A M Graham, A L Mahajan, M J Thornton
World Wound Healing Society congress, Copenhagen, November 2015
- Intracrine and Paracrine Regulation of Biologically Active Vitamin D by Human Dermal Fibroblasts: Implications For Cutaneous Wound Healing
Jing Qin Tay, Ola Kamala, A M Graham, M J Thornton, A L Mahajan
BAPRAS meeting, Birmingham, November 2015
- Plastic Surgery and Burns Research Unit – our history, aims and ambitions
AL Mahajan
University of Bradford Public Lecture, Bradford, March 2016
- Role of research in plastic surgery in improving health care for the future
AL Mahajan
Grand Master’s Presentation evening, Oddfellows association, Bradford, March 2016
- Plastic Surgery and wound healing research
AL Mahajan
President’s evening, Rotary Club, Shipley, Bradford, September 2016
- The role of Vitamin D in cutaneous wound healing
Jing Qin Tay, Ola Kamala, A M Graham, M J Thornton, A L Mahajan
Bradford Institute of Health Research Meeting, Bradford, October 2016
- Regulation of vitamin D bioavailability in human skin by fibroblasts and keratinocytes during wound healing
Jing Qin Tay, Ola Kamala, A M Graham, M J Thornton, A L Mahajan
BAPRAS Meeting, London, November 2016
- 1,25-dihydroxyvitamin D3 stimulates human epidermal wound closure and reduces dermal fibroblast α-SMA expression.
Jing Qin Tay, A M Graham, M J Thornton, A L Mahajan
Poster presentation. British Society of Investigative Dermatology (BSID), Manchester, April 2017
- Role of vitamin D in cutaneous wound healing: different effects on human epidermal keratinocytes and dermal fibroblasts
Jing Qin Tay, Ola Kamala, A M Graham, M J Thornton, A L Mahajan
EURAPS Meeting, Pisa, Italy, May 2017
- 1,25-dihydroxyvitamin D3 downregulates matrix metalloproteinases-2 and alpha-smooth muscle actin in wounded human dermal fibroblasts: implications for scarring
J.Q. Tay, A.M. Graham, A.L. Mahajan, M.J. Thornton.
Poster presentation. British Society for Investigative Dermatology Annual Meeting (BSID), 2018, London
“Best Poster Presentation”
- Can machine learning be used to determine the difference between burnt and normal skin
K M Smith, A Abubaker, S Jivan, D J Tobin, A Mahajan, H Ugail and K Poterlowicz
Poster presentation. British Society for Investigative Dermatology Annual Meeting (BSID), 2018, London
- Different roles of vitamin D3 in human skin, regulation of matrix metalloproteinase-2, alpha-smooth muscle actin and collagen I and III: implications for wound healing and scarring
Jing Qin Tay, Ola Kamala, A M Graham, M J Thornton, A L Mahajan
European Research Council, EURAPS, Madrid, May 2018
“Best Paper Prize”