Photo Credit: londonfacialplasticsurgery.co.uk
Dr. Julian De Silva, an eminent UK facial plastic surgeon, talks to BITB about microsurgery and what it means to be one of Londonâ€™s go-to face experts.
Educated at the London Teaching Hospital, De Silva studied plastic surgery at the University of California, Los Angeles in 1999 during an international elective. His transatlantic training and subsequent network have served him well, giving him real appeal with his clients and a pipeline into the evolving cosmetic trends and techniques from overseas.
De Silva performed his first facial surgery over 12 years ago, and went on to complete fellowships in facial cosmetic surgery in Los Angeles and facial cosmetic and reconstructive surgery in New York, an oculofacial plastic surgery fellowship in London, as well as the inaugural Darzi Clinic Leadership Fellowship in London. When the Olympics were held in London in 2012, the international organizers selected De Silva to provide clinical care to the competing athletes and coaching staff.
Today, he is known for perfecting procedures that require tiny incisions between 2-3 millimetres. He has also consulted for the UK National Health Service (NHS). Itâ€™s no wonder patients seek him out for his â€œsmall incision and fast recovery techniqueâ€ to give natural-looking results.
Here, he tells BITB more about his achievements and his brand of super-surgery.
Tell us a bit about yourself
I am a London-based facial cosmetic surgeon whoÂ specializes in the eyes, nose, face, and neck areas only. I am a perfectionist and thatâ€™s what patients needâ€”someone who has fastidious attention to detail with the surgical skill to back this up. 15-20% of my work is complex revision surgery on patients who have received treatment elsewhere and are not satisfied with their results so you could say that I am a fixer as well as first port of call for people that want to address a facial complaint. Iâ€™ve completed over 1,000 procedures to date but no two cases have been alike. There is no formula for the perfect nose for example and unlike what surgeons believed in the 1980s, one size definitely does not fit all. To get the best possible result for your patient, you really do need to love what you do and approach each and every case with the same enthusiasm and uncompromising care and attention in order to continue to create happy patients.
Why did you choose to specialize in facial plastic surgery?
I pride myself on my attention to detail and I am sure this stems from my training in microsurgery plus I love of arts and am a keen sculptor in my spare time so I think this was the natural direction to take. I like the fact that facial plastic surgery is hugely challenging, not simply from a surgical point of view, but also because of the extraordinary level of trust you must establish with your patient before making it to theatre. Itâ€™s a real honor when you are entrusted with somebodyâ€™s face. You need an exceptionally well-trained eye in this areaâ€”itâ€™s not enough to be good at surgery, you need to have the vision to achieve the desired outcome. My obsession with this specialty has helped me achieve tripleÂ memberships in British, European, andÂ American surgical organizations.
What advice would you give to someone considering facial plastic surgery?
If you think that 15-20% of all my patients see me for revision surgery (and thatâ€™s just at my clinic) imagine the numbers of people all over the UK that are not happy with their result. Itâ€™s so hard to pick the correct surgeon and to communicate what you want when it is effectively an image or idea in the patientâ€™s headâ€”how do you describe what you want to a surgeon? The answer is, find a way! Take photos of you with from all different angles, tear sheets of images that you like from magazines, touch your face to illustrate what you are talking about, and donâ€™t be afraid to cross-question the surgeon to see if they really understand your vision. In fact, donâ€™t be afraid to fire questions at the surgeons you meet because they owe you a response to each and every question you have no matter how silly you think it may be. I would recommend asking what percentage of a surgeonâ€™s cases result in revision surgery, i.e. how often does this surgeon get it right and how often doesÂ he or she need to get a patient back on the table for further treatment.
Are there any tips that you would give to a budding facial plastic surgeon wanting to make it big?
Find out what you are good at and what you actually like to do; if you can tick both boxes you can become an expert. I would suggest having a portfolio of case studies for people to look over and keep that up to date so everyone has access to your most recent cases. You are only as good as your last result. It is hugely motivating to have satisfied patients so for that reason itâ€™s best to work out how you are able to make the most people happy that you can.
Tell us why you have the edge on other facial plastic surgeons?
I specialize in a technique that reduces scarring and minimizes downtime and people come to me for that and the fact that I can offer a very natural look. I have treated people in the public eye, show business etc. and they, like everyone else, donâ€™t want to look like they have had work done. Itâ€™s the rapport you build with patients that gives you the edge. If you can understand what a prospective patient wants, you are realistic about what you can achieve, and you communicate this clearly then this provides the basis for a happy customer. Manage expectation all alongâ€”the best kind of plastic surgery is undetectable and a natural looking improvement. Perfect is a very subjective term and there really is no such thing and therefore no magic formula for perfection. My patients know that they are going to emerge from treatment looking their very best.
Are there any new or unique techniques that you offer?
I have pioneeredÂ innovations such as the use of fibrin tissue adhesives and laserÂ research. The techniques I use foster natural looking results, and I am continually bringing in new equipment and innovations to give patients faster recovery times and longer lasting results. The use of endoscopic and key-hole techniques minimizes scarring and the use of other innovations such as tissue glue can result in no need for conventional sutures in some facial procedures. I am always looking to improve patientsâ€™ recovery and reduce down time and invest in the latest in high-tech innovations in order to provide patients with these advancements.
How would you describe your style?
My style is a natural looking result and this will depend on the individualâ€”their genetics, age, and ethnicity are all key factors. I donâ€™t have the same approach for any two cases so Iâ€™d say that having a style would mean that you tend to follow a formula or prefer a certain kind of look, which just isnâ€™t the case. I am a big believer in creating the best natural looking result possible. I look after all my patients on a personal level, and treat them as though they were my friends or family; this has resulted in patients coming back for more procedures and bringing their friends and family to see me.
How do you think your transatlantic training and connections help your work?
My experience from working in the US had helped me give the very best treatments and procedures to my patients. Having worked in both Los Angeles and New York, I use the most advanced techniques to give patients the results they are looking for. Ninety percent of the skills and surgical techniques that I use on a daily basis are from the US, as they minimize incisions, give faster recovery, and deliver more natural looking results.
What do you love most about your job?
I enjoy the challenge of facial cosmetic surgery; every person requires a different set of my skills, whether blepharoplasty, rhinoplasty, or face and neck lift. The relationship and trust that is built between patient and surgeon is quite amazing and itâ€™s a privilege to be chosen.