It is usually possible to harmonise the facial features with one or more of these operations. However, as the outcome of treatment must be an appearance with which you feel happy, it is helpful if you have a clear idea in your mind about what is wrong with your present appearance and that you can explain this to Mr Blackburn. Mr Blackburn will be able to give his expert personal opinion as a dedicated facial specialist about the changes that could be made for the better. However, in the end, it is your face and how you see it that is most important. Once you have established together the ideal solution for you, Mr Blackburn will be in the position to advise you on the possibilities of achieving what is agreed together in the consultation.

It is a safe and simple procedure when delivered by an appropriately trained practitioner. A tiny and precise amount of solution is injected with a very fine needle into several locations in the face precisely and individually mapped to the muscle action related to the wrinkles being treated. These injections are associated with so little pain that it specialist practitioners routinely would use no local anaesthesia – the needles are a similar diameter to acupuncture needles. You may well develop slight bruising at the injection sites and require cover make-up although every effort is made to reduce this risk to a minimum. There may be a pinky-red flushing of the skin for an hour or so as a reaction to the needle itself. Certainly, within a couple of hours, many clients have no visible signs of having had a treatment.

Because of the risk of infection, it is most important that your mouth is healthy and that there is no infection in your teeth. You are strongly advised to visit your dental practitioner for a check-up if you have any doubts. If you smoke tobacco, try to avoid smoking for at least 1 day before the operation. This is because the toxic elements of the smoke have a powerful effect to impair your own ‘defence’ cells whose job it is to deal with bacteria. These defence cells help to further reduce the small risk of infection in the site of surgery. Secondly, your red blood cells will have better oxygen-carrying ability during your general anaesthetic.

These operations are usually done under a general anaesthetic for which you would need to be in hospital at least overnight. Immediately after the surgery, the area will feel numb because local anaesthetic will have been injected and will last for 3-6 hours. Thereafter, you can expect a mild-moderate amount of pain for the first two days and some soreness inside your mouth where the stitches lie. Generally, only paracetamol is required as a painkiller after this surgery. If you have had surgery to your chin, you are likely to have it strapped with an adhesive tape chin dressing overnight.

The most important thing to do is to treat your face gently and avoid disturbing an implant by feeling it or, worse still, trying to feel if it will move. Don’t rest your chin on your hand. Keep your mouth clean and have a mouthwash morning, after meals and at night (at least 3 times a day) whilst your stitches are dissolving. You can make your own warm salt water mouthwash: put a heaped teaspoon of salt into a mug, add boiled water, then let it cool down to a comfortable temperature before rinsing and spitting out. When brushing your teeth, you should take care not to damage your scars with your toothbrush – purchase a ‘baby’ toothbrush which is smaller to allow minimal displacement of your lip near the wounds for the first 10 days.

If you smoke tobacco, try to avoid smoking for at least 2 days after the operation for the same reasons outlined above. You may need at least a week off work.

You should consider a surgeon who has undergone a full training programme which includes facial cosmetic surgery. These surgeons will be on the Specialist Register at the General Medical Council and may be a specialist Facial Surgeon (Maxillo- Facial) – a specialist in facial surgery only (hard and soft tissue, both reconstructive and cosmetic), Otolaryngology Head & Neck Surgeon (‘ENT’) – operating on the ears, nose, throat, sinuses or face – or a general Plastic Surgeon – operating on multiple body sites such as abdomen, breasts, face, trunk, groin, legs, arms etc.

Members of organisations such as the European Academy of Facial Plastic Surgery (AFPS) and the British Association of Aesthetic Plastic Surgeons (BAAPS) who are on the Specialist Register and have a special interest in cosmetic surgery. You may consider it important not only to investigate your surgeon’s qualifications and speciality training, but also – ask what anatomy they spend most of their week operating on. Occasionally, a patient may be directed to a specialist who is sub-specialised in one particular area of concern.