Exploring facial rejuvenation surgery is a deeply personal decision. Many of us aren’t trying to look decades younger, but rather to feel that the person in the mirror reflects the vitality we feel inside—or to age gracefully with confidence. Yet knowing where to start can be overwhelming. The signs of ageing don’t appear all at once, and they rarely come from just one cause.

Ageing happens in layers:

• Bone structure subtly remodels over time, altering the foundation of the face.
• Fat pads lose volume or shift downward, changing facial contours.
• Muscles soften in tone, affecting expression and definition.
• Skin becomes thinner, less elastic, and more prone to sagging and wrinkles.

Understanding these changes allows for a tailored treatment plan rather than a ‘one-size-fits-all’ approach. Another way to assess ageing is to divide the face into upper, middle, and lower thirds – as each region often requires a different strategy.

At his London practice, consultant plastic and craniofacial surgeon Mr Juling Ong draws on his expertise in both reconstructive and aesthetic surgery to create results that are elegant, natural, and individual. Every consultation is highly personalised, focusing on your anatomy, proportions, and aspirations. Below is an overview of key treatments offered, each carefully tailored to the unique needs of every patient.

Brightening the eyes: tailored eyelid surgery

The eyes are often the first area to show signs of ageing, and even subtle changes can make us appear more tired than we feel. Eyelid surgery, or blepharoplasty, is a refined procedure designed to refresh and open the eye area while maintaining your natural expression.

• Upper Blepharoplasty: Removes excess skin and soft tissue above the eyes, restoring a lighter, more open look.
• Lower Blepharoplasty: Smooths puffiness and under-eye bags for a brighter, well-rested appearance.

Mr Ong approaches each case with precision, often combining eyelid surgery with brow repositioning, fat grafting, or skin resurfacing for balanced results. The goal is always subtlety—restoring freshness without altering your individuality.

Restoring expression: personalised brow lift techniques

The brow plays a central role in framing the eyes and communicating emotion. Over time, gravity and changes in muscle tone can cause the brow to descend, creating a heavy or stern expression. A brow lift restores harmony by subtly lifting and reshaping the brow to match the natural curves of your face.

• Endoscopic Brow Lift: Minimally invasive, with incisions hidden in the hairline for discreet rejuvenation and a shorter recovery.
• Direct Brow Lift: Ideal for advanced brow descent, with precise repositioning performed just above the brow.

Each technique is chosen based on your anatomy and desired outcome. For many patients, a brow lift is part of a larger rejuvenation plan, designed to bring balance to the entire upper face.

The facelift: a bespoke blend of classical and modern techniques

When ageing changes extend across the cheeks, jawline, and neck, a facelift offers the most comprehensive rejuvenation. But no two faces age alike, which is why Mr Ong’s facelift technique is fully bespoke. Drawing from the artistry of classical facelift surgery and the precision of the modern deep plane approach, he achieves results that are natural, balanced, and long-lasting.

The classical facelift focuses on tightening skin and the superficial muscular layer, creating subtle refinement—ideal when skin laxity is the primary concern. The deep plane facelift goes further, releasing key retaining ligaments and repositioning deeper tissues, restoring midface volume and jawline definition without a ‘pulled’ look.

By blending these methods, Mr Ong crafts a facelift that reflects your individuality, producing a refreshed, elegant appearance that feels authentic to you.

Enhancing results: non-surgical options

Surgery can deliver transformative results, but many patients benefit from non-surgical treatments to refine their overall look. Mr Ong offers:

• Facial Fat Grafting: Restores volume using your own natural tissue.
• Wrinkle-Relaxing Injections: Softens fine lines and expression wrinkles.
• Dermal Fillers: Shapes and enhances facial contours.
• Laser Skin Rejuvenation: Improves texture, tone, and clarity.

These treatments can be combined with surgery as part of a personalised treatment strategy.

A truly personalised experience

Facial rejuvenation surgery is as much about artistry as it is about surgical precision. With expertise in both reconstructive and aesthetic techniques, Mr Juling Ong takes time to understand your story, your goals, and your features, ensuring that every treatment plan is as individual as you are.

Whether you’re seeking a small, subtle change or a transformative procedure, his approach is centred on balance, harmony, and natural beauty.

Contact us today to arrange your private consultation and take the first step toward a confident, refreshed you.

In the second part of our investigation into scarring, London plastic and reconstructive surgeon Mr Juling Ong covers your scar management options.

Scar management depends on scar type, size, location, and symptoms like pain or itching. Treatments range from topical solutions to surgical interventions and advanced therapies. Here’s a breakdown of options:

1. Non-Invasive Treatments (First-Line)

A. Topical Treatments

1. Silicone Gel or Silicone Sheets

• Best for: Hypertrophic and keloid scars.
• How it works: Hydrates and reduces scar height, redness, and stiffness.
• Example Products: Mederma®, ScarAway®.
• Application: Use daily for at least 3–6 months.

2. Onion Extract (Allium Cepa) Gel

• Best for: New, minor scars.
• How it works: Anti-inflammatory, may help reduce redness and improve texture.
• Example Products: Mederma®.

3. Vitamin E & Moisturisers

• Best for: Dry, healing scars.
• How it works: Improves hydration but has mixed evidence for scar improvement.
• Caution: Some people may develop contact dermatitis (irritation from Vitamin E).

4. Corticosteroid Creams

• Best for: Keloid and hypertrophic scars.
• How it works: Reduces inflammation, redness, and itching.
• Application: Requires prescription for stronger formulations.

B. Pressure Therapy & Massage

1. Pressure Garments

• Best for: Large burn scars, hypertrophic scars.
• How it works: Applies constant pressure to prevent excessive collagen buildup.
• Usage: Worn 12–24 hours/day for 6–12 months.

2. Scar Massage

• Best for: New scars to prevent adhesions.
• How it works: Improves circulation and flexibility.
• Technique: Use gentle, circular motion for 5–10 minutes, 2–3 times/day.

2. Minimally Invasive Treatments

A. Corticosteroid Injections

• Best for: Keloid and hypertrophic scars.
• How it works: Flattens and softens thick scars by reducing collagen production.
• Procedure: Injections every 4–6 weeks for several months.
• Side Effects: Skin thinning, hypopigmentation.

B. Laser Therapy

1. Fractional CO₂ Laser & Erbium Laser

• Best for: Acne scars, surgical scars, atrophic scars.
• How it works: Stimulates collagen remodeling and smooths skin.
• Sessions Needed: 3–5 treatments spaced 4–6 weeks apart.
• Recovery: Redness and swelling for a few days.

2. Pulsed Dye Laser (PDL) / Intense Pulsed Light (IPL)

• Best for: Red scars (vascular scars, post-surgical scars).
• How it works: Reduces redness and vascularity.
• Sessions Needed: 3–6 treatments spaced 1-4 weeks apart.

3. Surgical & Advanced Treatments

A. Scar Revision Surgery

• Best for: Large, deep scars or contractures.
• How it works: Scar is excised (removed) and re-stitched for a more natural look.
• Types:
  – Z-plasty & W-plasty – Changes scar orientation for better blending.
  – Skin Grafting – Uses donor skin for burn scars.

B. Microneedling (Collagen Induction Therapy)

• Best for: Atrophic scars (acne scars).
• How it works: Tiny needles stimulate collagen and elastin production.
• Sessions Needed: 4–6 treatments, spaced 4 weeks apart.

C. Dermal Fillers

• Best for: Depressed scars (atrophic scars, acne scars).
• How it works: Injected fillers (hyaluronic acid) plump up the scar.
• Lasts: 6 months to 2 years.

D. Cryotherapy

• Best for: Keloids and hypertrophic scars.
• How it works: Freezing the scar with liquid nitrogen shrinks and flattens it.
• Sessions Needed: Multiple sessions.

E. Radiation Therapy

• Best for: Severe keloids that do not respond to other treatments.
• How it works: Low-dose radiation prevents keloid regrowth after surgery.
• Risk: Long-term exposure may increase skin cancer risk.

4. Emerging & Experimental Treatments

A. Platelet-Rich Plasma (PRP)

• Best for: Acne scars, surgical scars.
• How it works: Uses growth factors from your own blood to speed up healing.
• Sessions Needed: 3–5 treatments.

B. Stem Cell Therapy

• Best for: Severe scars, burns.
• How it works: Regenerates skin using stem cells.
• Still experimental but promising.

Choosing the Right Treatment Based on Scar Type

Scar Type Best Treatments

Hypertrophic Scar: Silicone gel, steroid injections, laser therapy
Keloid Scar: Steroid injections, cryotherapy, laser therapy, surgery (with radiation)
Atrophic Scar (Acne Scars): Microneedling, laser therapy, dermal fillers, PRP
Burn Scars (Contractures): Pressure therapy, surgery, skin grafting
Surgical Scars: Silicone gel, laser therapy, steroid injections

Takeaway

• Early intervention (silicone gel, massage) improves scar healing.
• Hypertrophic & keloid scars benefit from steroid injections & laser therapy.
• Depressed scars (atrophic scars) respond well to microneedling, lasers, and fillers.
• Severe scars may need surgical revision or advanced therapies like PRP or stem cells.

How a Plastic Surgeon Optimises Scarring

Plastic surgeons use advanced techniques before, during, and after surgery to minimise scarring and ensure the best possible aesthetic outcome. Here’s how they optimise scarring:

1. Pre-Surgical Planning

A. Incision Placement & Tension Reduction

Hiding the Scar in Natural Lines:

• Incisions are placed along natural skin folds, wrinkles, or shadowed areas (e.g., behind the ears, in the hairline, or in the crease of the eyelid).
• For breast surgery, incisions are hidden in the under-breast fold or around the areola.

Avoiding High-Tension Areas:

• Incisions in areas of high movement (e.g., joints, chest) are designed to reduce stress on the healing wound.
• Large wounds may use tissue expanders or local flaps to close with minimal tension.

Z-Plasty or W-Plasty for Camouflage:

• For unavoidable scars, Z-plasty or W-plasty techniques break up linear scars, making them less noticeable.

2. Intraoperative Techniques to Minimise Scarring

A. Precise, Minimal-Trauma Incisions

• Fine scalpel or laser incision: Reduces tissue trauma.
• Gentle tissue handling: Minimises bruising, swelling, and inflammation.
• Cold saline irrigation: Reduces heat damage and prevents excess scarring.

B. Layered Closure (Deep & Superficial Suturing)

• Why? Reduces skin tension, prevents wide scars.
• How? Uses multiple suture layers:
  – Deep absorbable sutures in dermis for strength.
  – Fine, superficial sutures on top layer for cosmetic finish.
  – Avoids external stitches if possible (to prevent “railroad track” scars).

C. Use of Tissue Glues or Adhesives

For delicate areas (e.g., face): Medical adhesives (Dermabond®) provide seamless healing with no suture marks.

D. Hemostasis (Minimising Bleeding & Bruising)

• Why? Less bruising means less inflammation & pigmentation.
• How? Precise electrocautery or fibrin sealants to stop bleeding.

3. Post-Surgical Scar Optimisation

A. Early Wound Care & Protection

• Steri-Strips or Micropore Tape
  – Provides gentle compression to reduce tension and prevent scar widening.
  – Worn for 4–6 weeks post-surgery.
• Avoid Picking Scabs
  – Scabs should fall off naturally to prevent deeper scarring.
• No Smoking & Minimise Alcohol
  – Smoking reduces oxygen supply, impairing healing.

B. Scar Management Treatments

1. Silicone Gel or Silicone Sheets (Gold Standard)

• Reduces thickness, redness, and stiffness.
• Used 24/7 for 3–6 months post-surgery.

2. Sun Protection (SPF 50+)

• Prevents hyperpigmentation and dark scars.
• Scar tissue is UV-sensitive for up to a year.

3. Scar Massage

• Improves blood flow, flexibility, and collagen remodeling.
• Done once the scar is fully closed.

4. Advanced Scar Treatments for Stubborn Scars

A. Laser Therapy (For Thick or Discolored Scars)

• Pulsed Dye Laser (PDL) or Intense Pulsed Light (IPL) – Fades red scars.
• Fractional CO₂ Laser – Smooths raised or atrophic scars.

B. Steroid Injections (For Raised, Hypertrophic, or Keloid Scars)

• Reduces excess collagen production.
• Given every 4–6 weeks as needed.

C. Microneedling (For Depressed or Uneven Scars)

• Stimulates collagen regeneration.
• Combined with platelet-rich plasma (PRP) for better results.

D. Scar Revision Surgery (For Old or Wide Scars)

• Excises the old scar and re-sutures it with better techniques.

Plastic Surgeon’s Approach by Scar Type

Scar Type Optimised Treatment

Fine Surgical Scar: Silicone sheets, sun protection, scar massage
Hypertrophic Scar: Steroid injections, silicone gel, laser therapy
Keloid Scar: Steroid injections, cryotherapy, surgical excision with radiation
Atrophic (Depressed): Scar Microneedling, laser resurfacing, dermal fillers
Burn Scar/Contracture: Pressure therapy, surgery (Z-plasty), skin grafting

Key Takeaways: How Plastic Surgeons Optimise Scarring

✅ Precise incision placement in natural folds.
✅ Layered closure with minimal external stitches.
✅ Silicone therapy & sun protection for 6+ months.
✅ Massage & laser therapy for better scar remodeling.
✅ Early steroid or laser treatment for problem scars.

What can I do as a patient to get the best possible scar?

To ensure you get the best possible scar after surgery, you need to focus on proper wound care, scar prevention techniques, and long-term scar management. Here’s a step-by-step guide to optimise healing and minimise scarring:

1. Immediate Post-Surgery Wound Care (0–6 Weeks)

A. Follow Surgeon’s Instructions

• Keep the wound clean and dry as instructed.
• Avoid removing stitches or sutures early.
• Do not pick at scabs—let them fall off naturally.

B. Minimise Tension on the Wound

• Avoid stretching, bending, or pulling near the incision site.
• If possible, tape the wound with surgical tape (e.g., Steri-Strips or Mircopor tape) to keep it stable.
• For joint areas, use a brace or limit movement as advised.

C. Protect the Wound from Infection

• Signs of infection: Redness, swelling, pus, warmth, pain.
• If infected, see your doctor immediately to prevent worsening scarring.
• Use antibiotic ointments if prescribed.

D. Moisturise & Hydrate

• Once the wound has fully closed, apply a fragrance-free moisturiser (e.g., Aquaphor, CeraVe).
• Hydrated skin heals better and reduces scar formation.

E. Laser Therapy

• Can be used as soon as the sutures are removed to optimise scar healing and remodelling
• Types:
  – Pulsed Dye Laser (PDL) – Reduces redness.
  – Fractional CO₂ Laser – Helps remodel the new healing scar
• Sessions Needed: 3–5 treatments.

2. Scar Prevention Strategies (6 Weeks – 6 Months)

A. Silicone Gel or Silicone Sheets (Most Effective)

• Why? Reduces thickness, redness, and stiffness of scars.
• When? Start 2 weeks after stitches are removed (or as advised).
• How? Apply daily for at least 3–6 months.

B. Sun Protection (Essential)

• Why? UV exposure darkens scars and makes them more visible.
• How? Use:
  – SPF 30–50+ sunscreen (even under clothes).
  – Wear UV-protective clothing over the scar.
  – Avoid direct sun exposure on the scar for at least 1 year.

C. Gentle Massage Therapy

• Why? Helps break down thick collagen fibers and improves scar flexibility.
• How? Use circular motions with light pressure for 5–10 minutes, 2–3 times daily.
• When? Start 4–6 weeks post-surgery (once the scar is closed).

D. Keep the Scar Flat & Flexible

• If prone to hypertrophic scars or keloids, use:
  – Silicone tape or pressure dressings to flatten scars.
  – Steroid creams or injections (if necessary).

3. Long-Term Scar Improvement (6 Months – 1+ Year)

A. Laser Therapy (For Red or Thick Scars)

• Best for: Raised, red, or discolored scars.
• Types:
  – Pulsed Dye Laser (PDL) – Reduces redness.
  – Fractional CO₂ Laser – Smooths atrophic (depressed) scars.
• Sessions Needed: 3–5 treatments.

B. Microneedling (For Depressed or Uneven Scars)

• Creates tiny injuries to stimulate collagen production.
• Works well for surgical scars, acne scars.
• Sessions Needed: 4–6 sessions, spaced 4–6 weeks apart.

C. Steroid Injections (For Raised Scars & Keloids)

• Best for: Hypertrophic scars or keloids.
• Reduces thickness, itching, and discomfort.
• Given every 4–6 weeks until improvement.

D. Dermal Fillers (For Sunken Scars)

• Best for: Depressed or atrophic scars.
• Uses hyaluronic acid or collagen stimulators to plump up the scar.

4. Lifestyle & Diet for Optimal Healing

A. Stay Hydrated & Eat Nutrient-Rich Foods

• Drink plenty of water (supports collagen formation).
• Eat:
  – Protein-rich foods (chicken, fish, tofu) – Helps tissue repair.
  – Vitamin C (citrus fruits, bell peppers) – Boosts collagen.
  – Zinc (nuts, seeds, lean meats) – Enhances wound healing.
  – Omega-3 fatty acids (salmon, flaxseeds) – Reduces inflammation.

B. Avoid Smoking & Alcohol

• Smoking delays wound healing and increases scarring risk.
• Alcohol dehydrates skin, affecting tissue repair.

C. Maintain a Healthy Weight

• Rapid weight gain/loss can stretch the scar, worsening its appearance.

5. When to See a Doctor

A. If the Scar Becomes Thick or Raised

• Early steroid injections or laser therapy can prevent worsening.

B. If the Scar is Painful, Itchy, or Tight

• May need scar revision surgery or specialised treatments.

C. If the Scar is Discolored (Dark or Red)

• Laser therapy, chemical peels, or microneedling can improve discoloration.

Key Takeaways for the Best Scar Outcome

✅ Start scar care early (as soon as the wound is closed).
✅ Use silicone gel/sheets for at least 3–6 months.
✅ Protect from the sun with SPF 50+ for at least a year.
✅ Massage the scar daily to keep it soft and flexible.
✅ Stay hydrated & eat collagen-boosting foods.
✅ Consider laser therapy or microneedling for stubborn scars.

Is laser treatment useful soon after surgery to achieve the best possible scars?

Yes, early laser treatment after surgery can improve scarring, but the timing and type of laser therapy depend on your scar’s characteristics and healing progress.

When can laser therapy be started after surgery?

• Earliest: 1–6 weeks post-surgery, but only if the wound is fully closed and no complications (e.g., infection, delayed healing).
• Optimal Timing: 1-8 weeks post-surgery for best collagen remodelling effects.
• For Mature Scars: Can be treated even months to years later.

Types of Laser Therapy for Early Scar Treatment

1. Pulsed Dye Laser (PDL) or Intense Pulsed Light (IPL)

✅ Best for: Fresh, red scars (vascular scars, hypertrophic scars).
🔹 How it works: Targets excess blood vessels, reducing redness and inflammation.
🔹 When to start: As early as 1–4 weeks post-surgery often at the removal of sutures.
🔹 Sessions needed: 2–5 treatments, 4–6 weeks apart.

2. Fractional CO₂ Laser or Erbium:YAG Laser

✅ Best for: Preventing thick, raised scars and smoothing texture.
🔹 How it works: Stimulates collagen remodeling and breaks down excessive scar tissue.
🔹 When to start: 1–8 weeks post-surgery often at the removal of sutures
🔹 Sessions needed: 3–6 treatments, spaced 4–8 weeks apart.

3. Non-Ablative Lasers (e.g., Nd:YAG)

✅ Best for: Reducing inflammation and scar thickness without damaging surface skin.
🔹 When to start: 1–6 weeks post-surgery often at the removal of sutures
🔹 Sessions needed: Multiple treatments over 3–6 months.

A combination of pulsed dye laser and fractionated laser can be useful for optimisation of scarring following surgery by reducing redness and helping to remodel the scar to improve the appearance, thickness and pliability of the final scar.

Benefits of Early Laser Treatment

✅ Reduces Redness & Pigmentation → Prevents dark or discolored scars.
✅ Prevents Hypertrophic & Keloid Scars → Reduces excess collagen production.
✅ Improves Scar Texture & Flexibility → Enhances smoothness & elasticity.
✅ Speeds Up Scar Maturation → Faster transition from raised/red to flat/pale.

Precautions Before Early Laser Treatment

🚫 Do NOT start if the wound is still healing, infected, or inflamed.
🚫 Avoid laser too soon (before 2 weeks) as it can disrupt early healing.
🚫 Use SPF 50+ → Laser-treated skin is highly sensitive to sun exposure.
🚫 Mild redness/swelling is normal post-treatment but should subside in a few days.

Bottom Line: Can You Start Laser Early After Surgery?

✅ Yes, if the scar is fully closed and healing well.
🎯 PDL/IPL → Best for early treatment (from 1–4 weeks).
🎯 Fractional CO₂ Laser → Best from 1–8 weeks for remodeling.
⏳ Longer treatment intervals (3–6 months) may be needed for mature scars.

If you’re concerned about the appearance of a scar and want to discuss your options, call 020 7927 6528 or email info@julingong.com to arrange a scar management consultation with Mr Juling Ong.

There is no doubt that Ozempic and other semaglutide medications have revolutionised weight loss over the past few years. Where once patients who struggled to maintain a healthy weight were doomed to an endless cycle of dieting and relapse, with the aid of a daily injection it is now easy to shed the pounds and reduce your risk of obesity-related health issues without having to give it more than a moment’s thought.

However, while this is clearly great news for the waistline, as well as numerous other health benefits such as reducing the risk of diabetes, hypertension, or joint disease, Mr Juling Ong and his fellow plastic surgeons are seeing a marked rise in the number of people requesting cosmetic surgery to rectify the effect that weight loss drugs can have on the face and skin.

What is ‘Ozempic Face’?

The major issue associated with weight loss drugs is the effect that such rapid weight loss can have on the face. Patients are presenting with problems such as sunken eyes, sagging jowls, and a loss of facial volume resulting in hollow cheeks and changes to the lips and chin. And whilst most Ozempic patients are initially pleased to have a slimmer face, this reduction in facial volume can be very ageing.

What can be done to treat this loss of facial volume?

Issues arising from rapid weight loss often need to be tackled with a multi-pronged approach. For example, while hollow cheeks and thin lips might be treated with non-surgical facial rejuvenation treatments such as dermal fillers, sagging jowls and hollow eyes may also need some surgical intervention, such as a facelift, blepharoplasty (eyelid rejuvenation surgery or fat transfer to restore lost fat in the areas of the face where volume loss makes the patient look prematurely aged.

Does the ‘Ozempic effect’ occur anywhere else on the body?

Yes. As with anything that causes you to lose a significant amount of weight quickly, the use of these drugs (Ozempic is just one brand name that has come to be used to describe any injectable weight loss treatment) can result in excess skin on the body – this is usually especially noticeable on the upper arms, thighs and abdomen.

These issues usually require surgical intervention, through what are known as ‘post-weight-loss body procedures’, which include abdominoplasty (tummy tuck) and arm lifts.

Why is this called the ‘Ozempic effect’, if it is just the result of rapid weight loss?

While most of the symptoms described above can also be linked to rapid weight loss achieved through any other means, plastic surgeons like Mr Juling Ong are seeing a distinct rise in patients requesting these rejuvenating procedures as a direct result of injectable weight loss treatments like Ozempic. And there are reports coming from the States of a further potential Ozempic-related matter.

In America, where Ozempic is being used by about six per cent of adults – that’s around 15.5 million people – plastic surgeons are claiming that when they operate on patients taking the drug, the SMAS layer of the skin (that’s the layer of connective tissues and muscle that supports the face), is noticeably thinner and weaker than in non-Ozempic-taking patients.

This can make it more difficult to get a natural-looking result from a facelift, which relies on muscle support. As always, choosing a highly skilled and experienced facelift surgeon is a must.

For more advice on anti-ageing or body procedures linked to rapid weight loss, please call us on 020 7927 6528 to book an appointment with Mr Ong.