Safety is the most important consideration when undertaking Facelift Surgery. Mr Grover will provide you with a friendly and honest opinion regarding your suitability for surgery both in terms of your medical safety and the surgical risks associated with the procedure. If he feels that the risks out way the benefits, he will always advise that surgery is not be in your best interests and discuss an alternative plan if possible. He does this in just the same way as he would advise a member of his family which remains his yardstick during the consultation process.

Rajiv is Consultant Plastic Surgeon at two of London’s premier Private Hospitals both of which have facilities equivalent to a Teaching Hospital and are renowned for providing medical services to the Royal Family. Both hospitals have specialist centres for Plastic Surgery and are fully equipped with state of the art support facilities. Mr Grover has the help of an excellent team including two scrub nurses in the theatre with whom has operated every week for over 15 years. 

Particular attention is also given to safe anaesthesia which is always performed by Mr Grover’s regular Consultant Anaesthetist (Dr Raman Verma) with whom he has worked for over 20 years. Dr Verma has actually anesthetised Mr Grover himself in 2006 after a sporting injury so he has literally tried him out. Dr Verma has been a tutor for the Royal College of Anaesthetists and is a Senior Consultant Anaesthetist at University College Hospital in central London.

All surgical procedures carry risk and Mr Grover will do everything possible to minimise this. The process starts before your visit with the pre-consultation screening and then at the consultation itself where Rajiv puts one hour aside for each patient so he can be thorough with your safety right from the outset. This is followed by selection of the optimum procedure for each individual patient, careful advice on pre-operative preparation, meticulous surgical technique during the operation itself, and personally delivered after care by Mr Grover who does not delegate this to others.

Rajiv has a strong interest in improving safety and has published widely on methods to improve the safety, recovery, and outcome following facelifting (see Faceology). He has submitted audited figures of surgical procedures and complications each year to The British Association of Aesthetic Plastic Surgeons (BAAPS) based at The Royal College of Surgeons since 2003 when this database was established. His complication rates for Facelifting are the lowest in the United Kingdom (BAAPS Audit data) and in the lowest 1% worldwide based on comparison with the international published data for facelift surgery (data from ASJ, PRS and FPS journals).

The list of risks below is indicative of the more common complications but is not meant to be exhaustive. Rajiv’s personal complication rates tabulated as a percentage from over 2,000 audited facelifts are quoted below with each risk factor.

• Bleeding (0.6%). Bleeding beneath the skin from small capillaries can cause excessive bruising to collect (haematoma) which may require surgical treatment. The most common time for it to arise is within the first twelve hours after surgery when you will be in hospital. It normally does not influence the ultimate outcome of the operation.

• Infection (0.1% requiring intravenous antibiotics). Infection is uncommon after facelift surgery. Prophylactic antibiotics are routinely given during surgery and for 5 days after to reduce the risk. Only 2 patients out of the last 2,000 have required intravenous antibiotic treatment (0.1%).

• Temporary numbness in the area of surgery is normal and to be expected where the skin was lifted. This occurs after any type of surgery where skin is lifted from the underlying fat (e.g. caesarean section, hernia repair, appendectomy, breast lump removal etc). The area of numbness is less following Deep Plane facelifting compared to other SMAS type lifts as less skin is lifted from the underlying tissue. Sensation recovers spontaneously as the nerves grow back with the appreciation of soft sensation returning by 2-3 months however full sensation may take 12-18 months to recover which it does in 96-97% of patients. As sensation recovers you may notice some tingling or pins and needles which is normal and a positive sign of recovery.

• Temporary hair loss in the region of the lower temple is seen occasionally in smokers although this recovers over a period of three to six months. No patient of Mr Grover’s in the past 2,000 facelifts has needed any surgical correction or intervention for hair loss of any sort.

• The scars are normally fine and well hidden, but in some individuals a scar may show a tendency to thicken after 6-12 weeks as their body is prone to this type of healing despite the incision being stitched without tension. These “hypertrophic” scars can be improved by appropriate treatment such as applying silicone containing creams (Dermatix / Kelocote) or steroid injections. Four patients in the past 2,000 have needed steroid injections for a hypertrophic scar, all were located behind the ear and therefore reassuringly, were not visible. No patients treated over the last 20 year period required surgical intervention for hypertrophic scarring. Crucially, Mr Grover avoids making any scar in the temple in front of the hairline which avoids the key area of visibility that concerns most patients after facelifting.

• Nerve Weakness. The Facial nerve is responsible for moving the muscles of the face and it lies deep below the SMAS layer. Care is taken to avoid this during a facelift. The nerve can be bruised due to the surgical dissection or from swelling in adjacent tissues causing a temporary weakness of the muscles of the lip, mouth, or eyebrow. This recovers well as there was no direct injury to the facial nerve itself. 6 patients in the past 2,000 have had this temporary issue and all recovered fully. No patient in Rajiv Grover’s practice has ever suffered a permanent injury with weakness to the Facial Nerve since he opened his practice over two decades ago in 2001.

• Wound healing in the face is generally very quick and reliable. Occasionally a slow healing wound may be seen. This is usually behind the ear since the skin there is most fragile. Such problems are, fortunately, very uncommon but are known to be more likely in smokers. No patient has required surgical treatment for a wound healing issue in the past 2,000 facelifts under Mr Grover.

• Revision Rate (0.8%). However carefully surgery is performed the healing process and each patient’s biology can influence the outcome. As a consequence, patients can occasionally require further surgery to improve a scar or improve the result of a facelift where skin quality has meant that a small area of loose skin has reappeared. In over 2,000 facelifts Rajiv’s revision rate is less than 1% with only 16 patients requiring surgery for any reason (0.8%).

Rajiv has a 20 year history of publishing scientific papers on improving the safety, outcome, and recovery from facelift surgery. A selection of his published scientific papers are listed below. 

A statistical review of 1,078 consecutive facelifts: Lessons for the prevention of complications following rhytidectomy
Rajiv Grover, BM Jones and N Waterhouse
Perspectives in Plastic Surgery. 2002; 16: 207-212.

The prevention of complications following facelifting: A review of 1,078 consecutive facelifts.
Rajiv Grover, BM Jones and N Waterhouse
The British Journal of Plastic Surgery. 2001; 54: 481-486.

Reducing complications in cervicofacial rhytidectomy by tumescent infiltration: a comparative trial evaluating 678 consecutive facelifts.
BM Jones, Rajiv Grover
Plastic and Reconstructive Surgery. 2004;113: 398-403

Endoscopic browlift: a review of 538 patients and comparison of fixation techniques.
BM Jones, Rajiv Grover
Plastic and Reconstructive Surgery 2004; 113: 1242-1250.

Avoiding haematoma in cervicofacial rhytidectomy: an eight year quest reviewing 910 patients
BM Jones, Rajiv Grover
Plastic and Reconstructive Surgery. 2004; 113: 381-387.

The anatomy of the aging face: volume loss and changes in 3-dimensional topography.

R. Grover, SR. Coleman
Aesthetic Surgery Journal 2006; February

Facial injection of Restylane SubQ for aesthetic contouring of the cheeks, chin and mandible
M Belmontesi, Rajiv Grover, A Verpaele.
American Aesthetic Surgery Journal 2006; February

Optimizing treatment outcome with Restylane SubQ: the role of patient selection, technique and counselling
Rajiv Grover.
American Aesthetic Surgery Journal 2006; February

The efficacy of surgical drainage in cervico-facial rhytidectomy: A prospective, randomized controlled trial.
BM. Jones, Rajiv Grover, S. Hamilton
Plastic and Reconstructive Surgery. 2007; 120: 263-27

Injectable hyaluronic acid implant for malar and mental enhancement.

NJ Lowe, Rajiv Grover

Dermatologic Surgery. 2006; 32:881-885.

Early postoperative efficacy of fibrin glue in face lifts: a prospective randomized trial.

BM Jones, Rajiv Grover

Plastic and Reconstructive Surgery. 2007; 119: 433-434

The efficacy of surgical drainage in cervicofacial rhytidectomy: A prospective randomized controlled trial.

BM Jones, Rajiv Grover, S Hamilton

Plastic and Reconstructive Surgery. 2007; 120: 263-270

Improving the safety of Aesthetic Surgery: Recommendations following a 14 year review of cases referred to the Medical Defence Union from across the United Kingdom (1990-2004).

Rajiv Grover 

Clinical Risk. 2009; 15: 241-243

Efficacy and safety of Botulinum Toxin A in the treatment of lateral crow’s feet: double blind, placebo controlled, dose ranging study.

B Ascher, B Rzany, Rajiv Grover

Dermatologic Surgery. 2009; 35: 1478-1486

Soft tissue enhancement using Macrolane: A report of complications in three patients and a review of this new product.

MJ McCleave, Rajiv Grover, BM Jones.

Journal of Plastic Reconstructive and Aesthetic Surgery. 2010; 63: 2108-2111

Post-operative Hilotherapy in SMAS based facelift surgery: A prospective randomised controlled trial.

BM Jones, Rajiv Grover, JP Southwell-Keely

Journal of Plastic Reconstructive and Aesthetic Surgery. 2011; 64: 1132-1137

Facilitating shared decision-making with cosmetic surgery patients: Acceptability of the PEGASUS intervention

N Paraskeva, A Clarke, Rajiv Grover, S Hamilton, S Withey and D Harcourt

Journal of Plastic Reconstructive and Aesthetic Surgery. 2017; 70: 203–208

The Evidence for Adjunctive Facelift Procedures.

Urso-Baiarda F, Edmondson SJ, Rajiv Grover. 

Facial Plastic Surgery. 2018 Dec;34(6):624-630.

Commentary on: A Novel Extended Deep Plane Facelift Technique.

Rajiv Grover. 

Aesthetic Surgery Journal. 2019 Nov 13;39(12):1282-1283