Mr Nigel Horlock

Consultant Plastic & Reconstructive Surgeon

Brow lift or blepharoplasty? Which is the best treatment for ageing eyes?

It’s said the eyes are the window to the soul. This may well be true but they’re also one of the strongest indicators of ageing. Droopy eyelids could eventually happen to us all as we grow older so it’s perhaps comforting to know that there is a range of aesthetic solutions to the problem. Two of the most common are the brow lift or the eyelid lift (otherwise known as blepharoplasty). Both treatments can have a startling effect on ageing, taking years off you without actually looking like you’ve had work done. It’s very common for friends to comment how youthful you’re looking without actually being able to pinpoint why. What is involved in the treatment? A brow lift is focused only on the upper face and forehead. Classically, an incision is made on or above the hairline and the skin is pulled taut to help remove the sagging. These days most surgeons prefer a less invasive method known as an endoscopic brow lift. Blepharoplasty involves removing or repositioning tissue from the upper eyelid and around the eyes, including any unsightly bags. There will be some scarring, but the thin skin on the eyelids typically heals very well and any incisions are typically hidden in the normal folds of the eye, so are to all intents and purposes invisible. Although both procedures are routine they are invasive surgery and will usually be carried out under a general anaesthetic. Recovery times are similar in both cases with full recovery normally taking four to six weeks. Which is the best treatment for sagging eyelids? This is probably the wrong question. It probably makes sense to ask, “which treatment is more appropriate for me?” The fact is that sagging eyelids can be caused by a number of things so it’s vital to identify the source of the problem before choosing the solution. Ageing eyes can be caused by excess skin around the eyelids, a drooping forehead or a combination of both. Determining the root cause should define the most appropriate treatment which might well be a brow lift and blepharoplasty together. It’s not just the ageing effect either that might prompt treatment. Some people are born with naturally drooping brows and there’s even a medical condition which prevents the eyelids from opening as wide as they should. In some cases, surgery may even be required to help with impaired vision where the...
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Should I wait until after I have had children before having a breast augmentation?

There really isn’t a complete consensus amongst breast surgeons when it comes to answering this question on breast augmentation timing. The reality is that no two cases are the same and there are many variables to consider before making the decision to undergo a breast augmentation prior to completing your family. Breast augmentation has little impact on pregnancy The good news is that the procedure has little impact on a pregnancy. In a number of studies, including a ten-year one carried by the American FDA, the procedure has been proven to have no impact on fertility and in no way affects the gestation period (no threat of miscarriages) or cause birth defects.  There is evidence to suggest that in a few cases breast augmentation may cause difficulty in breastfeeding, but this is hard to prove definitively and it has been suggested that in these cases the reason is more likely to be psychological than physiological. One of the first questions to ask yourself is how soon are you planning to get pregnant? If it’s in the next 12 months, then it might be better to hold off from the surgery. Whilst it’s not likely to have an effect on the pregnancy or the baby after childbirth the size and shape of the breast will change for the majority of women and this should be a consideration before embarking on a procedure that might need further work after having your family. Whilst breastfeeding, the breasts will swell and when they reduce back to their pre-pregnancy size they often tend to sag and lose some of the perkiness. It’s quite possible that a woman who’s had a breast augmentation before giving birth will still be happy with the results later, but many women choose to return for a further operation. In these cases, larger implants may be fitted to fill out the stretched and saggy skin or a combination breast uplift and augmentation is performed. There isn’t really any way of predicting how breasts will change after childbirth. Some surgeons recommend looking at the mother’s body shape as a guide, but this can be taken as no more than a loose indication. For some women the changes are minimal whilst for others, it can be dramatic and life-changing. The length of time spent feeding on the breast and the number of children can all have an effect too.  It’s different for...
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Return on your investment: how to maintain your facelift results

In today’s society, the pressure to look young and dynamic is a huge motivating factor in the drive to undergo anti-ageing cosmetic surgery procedures such as the facelift, as a recent investigation by the Nuffield Bioethics Council found. A successful facelift should aim to make you look younger and more refreshed. In a 2012 study at the University of Toronto, researchers analysed before and after photos of cosmetic surgery patients to try and find a more precise reckoning of how many years you could lose if you underwent a facelift or eyelid surgery. Images of 60 plastic surgery patients, between the ages of 45 to 72, were analysed in the study. In most cases, their real age in the before photos was correctly guessed and then the volunteers studied photos of the patients who had undergone either a facelift, neck lift, eyelid surgery, or a combination of procedures. The first group, that had undergone a facelift and neck lift, were guessed to be 5.7 years younger. The second group, who had also had an eyelid lift at the same time, were seen to be 7.5 years younger and the last group that had undergone the most surgery, including a brow lift, were perceived to be 8.5 years younger than their actual age. So, when it comes to facial rejuvenation surgery, the greater the investment, the bigger the return. But how do you protect that investment? A facelift can’t stop the ageing process entirely so here are our top five tips on how best to maintain your facelift results when the clock restarts: # 1: Maintaining your facelift results: get serious about sun damage It’s thought that sun damage is the cause of 90% of what is perceived as facial ageing, including lines and wrinkles, poor skin tone and discolouration. Protecting your skin at all times – even in the midst of winter – is probably the most important factor in maintaining your facelift results. # 2: Maintaining your facelift results: protect your skin from the inside out If you’re serious about looking your best after a facelift, then consider your diet. A healthy and well-balanced diet is always important, but recent research has flagged just how damaging sugar can be. Sugar triggers a chemical process known as glycation which produces sugar-bonded proteins. These proteins produce free radicals which deplete collagen and elastin levels in the skin. This causes skin...
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Survey finds one in ten Love Island viewers now want breast augmentation

As this season’s Love Island comes to an end, it’s interesting to note that the popular reality TV programme has a profound impact on viewers, with one in ten women who watch the programme claiming that it has left them considering undergoing a breast augmentation. Carried out by YouGov, the survey found that almost half of all female viewers, aged between 18 to 34, felt self-conscious about their looks after watching the programme. This led to eight per cent considering breast enhancement surgery, 11% of them planning anti-wrinkle treatments and lip fillers and seven per cent contemplating liposuction. A number of the girls that appeared on the show have undergone breast augmentation procedures which they freely admitted and that, coupled with the cosmetic surgery adverts that were shown in the ad breaks, have sparked fears that cosmetic surgery has become ‘normalised’. Breast augmentation is very popular, and it can produce fantastic, life-enhancing results, but it’s also a serious surgical procedure and it’s essential that prospective patients are fully informed about all the pros and cons before they decide to go ahead. Here’s everything you need to know about breast augmentation. The consultation process: making the decision to go ahead with a breast augmentation The consultation is an essential part of the process, as it gives you the opportunity to become fully informed about the procedures and that means being aware of all potential risks as well as the possible results. Your consultation is also the chance to meet your plastic surgeon and ensure that you fully trust them and are confident in their ability to look after you. Important decisions are made in terms of implant type, shape and size and where the implant will be located in relation to the muscle. The location of the incision will also be discussed. Am I the ideal candidate for a breast augmentation? Breast augmentation is a relatively straightforward cosmetic surgery procedure and if you are in good health and have realistic expectations about what can be achieved then you should be suitable. There are certain considerations that might mean your plastic surgeon advises you to consider another procedure or delay surgery at this time. If you have undergone pregnancy or weight fluctuations, for example, you may have a degree of ptosis or sagging in the breast tissues that may become more pronounced after augmentation. In this instance, a mastopexy or breast...
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New US figures show male cosmetic surgery is on the rise

Cosmetic surgery is often perceived as the preserve of women, but figures released recently by the American Society of Plastic Surgeons point to a surge in men opting for aesthetic work. It’s true that women still outnumber men by 10 to 1 when it comes to getting work done but the report shows a 29% increase in male cosmetic surgery between 2000 and 2017 with 1.3 million men undergoing a procedure last year alone. Some surgeries are even reporting as much as a tenfold increase in the number of men approaching them for cosmetic work. It’s hard to point to any specific reason but it certainly seems to be true that men are becoming more body conscious.  The report indicates that up to 31% of men would consider a cosmetic procedure.  Maybe this change can be partly attributed to the rise of social media and the associated selfie phenomenon, with men simply becoming more aware of their appearance. It might also be the result of an increasingly competitive and youthful workplace where experienced executives find themselves competing with younger co-workers and feel the need to opt for some anti-ageing work. Male cosmetic surgery no longer stigmatised Another reason for the increase could be that male cosmetic work is no longer stigmatised in quite the way it was. It may not have become completely acceptable but it’s becoming quite commonplace for celebrities from the sport and entertainment world talking openly about work they’ve had done. According to the Society’s President, Jeffrey Janis, “Men were a little bit more reluctant to talk about it,” he said. Now, that’s no longer the case.” In the US, there’s also been a drive to open male only surgeries which create a more comfortable environment for men to talk openly about any aesthetic work they might be considering. From a male receptionist to surgeons specifically trained on the male anatomy this type of surgery is helping to make the whole process of cosmetic work more enticing to men. Actually finding a surgeon that specialises in the male anatomy is quite important. Procedures can vary dramatically between men and women. Rhinoplasty, for example, requires a very different approach when creating a strong masculine nose as opposed to a delicate female one. When it comes to injectables much larger volumes are required simply because men have larger muscles. Top four male cosmetic surgery procedures Although there are...
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Mr Horlock's NHS practice is based in the regional plastics unit at Salisbury District Hospital. He covers Salisbury, Southampton and Dorchester. He sees patients in his private practice at Southampton, Salisbury, Dorchester.

Spire Southampton Hospital
Chalybeate Close,
S016 6UY
Sophie Freud - CLINIC APPOINTMENTS: 02380 914 504
Julie Martin: 02380 764 969