Like others on this site I really started to notice my face and jawline sagging after the menopause. Now aged 54 my jowls have become really noticeable so I’ve decided to do something about it. I’ve had a consultation with Dr Dirk Kremer of Harley St Aesthetics, he’s recommended his ‘Turn Back Time’ (TBT) face and neck lift. I have absolute confidence in Dr Kremer, four years ago he did my upper eyelid surgery, the results are completely natural and still look great to this day. I’ve posted photos of my pre surgery jowls and saggy neck, also photos of my eyes pre surgery, post surgery and end result. Dr Kremer immediately puts you at easy during his consultation. I explained I was unhappy about my jowls and that they’re merging with large submandibular glands in my neck which effectively makes my jowls even more noticeable. Also a general tired look to my face and loss of jawline definition. Dr Kremer demonstrated the lift he can achieve by placing his hands on my neck and face, much to my relief he won’t need to touch my glands during surgery, apparently some surgeons remove or shave them but this is very risky. The surgery is done under general anaesthetic with an overnight stay in the hospital. There is also the possibility of a tiny bit of liposuction under my chin but Dr Kremer will make that decision once he’s completed the face and neck lift and while I’m still under. Naturally I was very keen to know about his incision technique. I have imperceivable scars from his TBT upper eye surgery. Dr Kremer will start his incision so it’s well hidden in my hairline above my ears, then come down behind the Tragus and he will go up as high as possible behind my ears and then into my hairline. He said I would wake up and wonder what on earth I’d done to myself, I do remember that’s the first thing I thought when I looked at my eyes after surgery! Dr Kremer did a final appraisal of my face/neck and said in his opinion I am a suitable candidate and it was the right time. So I’m going to take the plunge! I’m booked in for the TBT face and neck lift at the end of November. I’m nervous but excited too. Dr Kremer did such an amazing job on my face previously that I have the utmost confidence in his techniques. I’m going into this procedure knowing full well that the first week will be tough. My thanks to all the Realself contributors for documenting their surgery, healing experiences and tips. So helpful. I’d like to pay back the favour and document my journey. Updated on 13 Nov 2018: Only one week till my face and neck lift! I've been sent the consent forms and pre/post surgery instructions. On the advice of Dr Kremer I've stopped all my supplements, now just taking Vitamin C, Bromelain and Arnica, I'm also avoiding alcohol. No strong coffee is allowed after surgery. I've started weaning myself off by using weak instant coffee and will gradually reduce down to zero cups a day, I hope this will help with caffeine withdrawals after surgery! I've also started a low salt diet this week with the hope it may help a little with the swelling. Lots of Realself users mentioned wedge pillows so I've ordered a memory foam one. Tested it out last night, very comfortable so thanks everyone for the heads up. I'm keeping myself busy and trying to not over think everything, feeling calm but wish it was over! Updated on 23 Nov 2018: Can't type much, can't wear my glasses. I'll write a full update in a few days. Looks great so far and no pain. Swollen so icing regularly and taking my meds. some bruising coming out now on day 3 but I was expecting that and it's less than I was anticipating. Dr Kremer was so kind and professional. I can't wait to see the full results! Updated on 24 Nov 2018: The bruising has turned yellow and swelling slightly down. I've stopped using the frozen peas now but think they helped a lot. No pain just very tight. Second hair wash, really recommend the Tangle Teezer hairbrush to gently remove the hair knots. still not wearing my glasses so must keep this short, I promise I'll write a longer review of the surgery day when I can. Photos show incisions in hairline, love how Dr Kremer goes so high up behind the ear in order to prevent the scar showing where it goes back into the hairline. I notice other surgeons seem to cut across much lower down which may make the scar more visible when the hair is put up. Dr Kremer also makes the incision behind the Tragus which was an important requirement for me. I had no chin lipo, apparently there was no fat to remove therefore its not necessary for me to wear a compression garment. So pleased I ordered the wedge pillow, I've had no problem sleeping in the upright position. Also found the childs toothbrush really useful! Thanks for all these tips from other Realself readers. Updated on 26 Nov 2018: Feeling great and wearing my glasses again. Day 6: swelling has significantly gone down on my face and is now located in my upper neck area. Lots of yellow bruising but no pain. Right side has more swelling and bruising than left. I’ve finished taking my meds and stopped icing after day 3. Incisions healing nicely, I’m thrilled with the area behind the ear, no visible scar, he made the incision so high up and then back into the hair. During my extensive facelift research I noted that short incisions might leave more noticeable scars because all the tension of the lift is placed over a small area rather than spread evenly over a larger incision site. Made perfect sense to me, that’s why I opted for the longer, well hidden incisions that Dr Kremer uses. posting day 6 photos. The Day of Surgery: I was feeling very calm and arrived at the Hospital at 8.45am. After settling in I was given a robe, slippers and compression socks to wear. Blood pressure and general health questions were asked before the anaesthetist came in to check on me. The next person I saw was Dr Kremer who went through the procedure again and answered any questions I had. Then I was in the operating room, small prink in the hand and I was out. I woke up back in my room and a nurse gave me a sip of water, I felt great! No nausea, no pain, just tightness from the compression bandage. The nurse checked my blood pressure and vitals then brought my lunch and a cup of tea. Both Dr Kremer and the Anaesthetist came to check on me and told me everything had gone well. I obviously had a very swollen face but not much bruising at that point. I dosed on and off through the night, the nurse provided ice for the swelling and endless tea and biscuits which I dunked. The Nurse’s were so kind and always looking in on me plus I had a call bell. The following morning I still felt great! I had been nervous about the General Anaesthetic, I’d never had one before but suffered no side effects, not even a sore throat. Dr Kremer came to remove the compression garment, that was a relief. He said I was looking great, he was pleased and also amazed by how well I had bounced back. I was discharged with some meds and post op instructions. My dear friend picked me up and took me home where I installed myself into a pre-made sitting area. My friend supplied me with ice packs (little bags of frozen peas I had pre prepared) and plenty of fluids and soft food. She also set her iPhone alarm for when it was time to take my meds. I took a quick shower. That evening Francesca, Dr Kremers PA, called to check I was OK and answer any questions. I went up to my bed to sleep that night, had my wedge pillow to keep upright and only got up once during the night. The following morning I showered and washed my hair with baby shampoo, no pain. The whole surgery experience was absolute fine, honestly the worst bit was the tight compression bandage and that really wasn’t too bad. I'm so pleased I had the general and not local, it was over with in the blink of an eye. I also felt more secure staying the first night in hospital, it was no hardship, own room and bathroom plus one to one care throughout the night. Updated on 30 Nov 2018: Feeling great. The past three days I've gone for local walks wearing a headscarf. I've experienced occasional throbbing in my outer ear area so took some Paracetamol before bed. Last night I didn't need any so looks like that stage has passed and it was always fine during the daytime. Yellow bruising is slowly clearing and the black bruising getting better too. Face still has numbness but I was expecting this and know it will last for some time. It's now Friday, staples come out on Monday morning, they have given me no problem and I can't feel them, I thought they would be a lot worse! I've been washing my hair with Baby shampoo to keep them clean. Other than that I do as little as possible to my face. I'll post again after I've seen Dr Kremer on Monday. Updated on 3 Dec 2018: Today is 13 days post surgery. I saw Dr Kremer this morning to have my staples removed, didn't hurt. Dr Kremer is really pleased with my result. I asked when I can go back to the gym, at 4 weeks post surgery I can do very light exercise, at 6 weeks I can begin to workout properly again. I see Dr Kremer again for a checkup in 4 weeks. I'll be sure to post photos again after the checkup. Thanks for all the good wishes and support. Updated on 18 Dec 2018: A quick update, today is 4 weeks since my face and neck lift. The time has flown by, feeling great and loving the results. One side is healing slower than the other, still have some yellow bruising and swelling on my right side. Easy to cover with makeup. Missing going to the gym but doing daily walks. Off for a Christmas party now, have my makeup on so here are 3 new photos. So happy! Merry Christmas to all. Updated on 15 Feb 2019: I'm just 5 days shy of 3 months post op. I've been direct messaged to ask how I'm getting on so here are some photos taken today. I'm healing nicely and still overjoyed at the results. Friends that have known me for 30 years haven't guessed I've had surgery, just say how well I'm looking. The incisions were very red once the scabs fell off but now have mostly faded with just some light pink areas, improving every week and easy to cover with makeup. There was some puckering around the incisions but these have flattened out. Some areas of swelling and bumps appear but fade over a few weeks. I still have some numbness but it's slowly improving. All these things are noticeable only to me. You do need to be patient with the healing process. I know I've said it before but Dr Kremers incisions are so discreet, look at the photos behind my ear, no scar is visible because he places the incision so high up. I've seen many photos on Realself where the scar is placed half way up the ear and can be visible if when hair is worn up. Behind my ear is still a little pink but getting better by the week. I'll post an update at 6 months. Updated on 19 Feb 2019: Just over two weeks since Dr Kremer did baby botox in my forehead. I wanted to keep a little movement hence the baby Botox, it looks so natural, not frozen, I can still move my eyebrows a little and slight movement in forehead too. No one would ever guess, it's just enough to keep me looking fresh. This is my first botox treatment with Dr Kremer, I shall be using him from now on! Updated on 19 May 2019: It’s 6 months since my TBT face and neck lift so thought I’d give you an update, can’t believe how the time has flown by! I’m ecstatic, no more jowls and I look refreshed and natural. I saw my parents over Easter (they don’t know I’ve had surgery and neither of them guessed) both remarked how well I looked. The perfect result! My incisions have healed beautifully, I’m still applying Dermatrix silicone gel and will continue until the tube runs out but doubt it’s necessary any more. I found the whole process from the original consultation, actual surgery and healing stages very easy. I did nothing special just followed Dr Kremer’s instructions. The only things I purchased were a wedge pillow, baby toothbrush, baby shampoo and Dermatrix to use on the incisions 6 weeks post op. For the first week I ate soft foods and by the second week started daily walks. That was it, all very simple! As I’d had previous surgery on my eyes I knew what to expect and was therefore extremely relaxed and realistic with regards to bruising and swelling. I also knew the incisions would be pink and raised in some areas during the initial healing stages, they are now barely perceivable. I’ve added some current photos so you can see the results at 6 months post surgery. Thank you for all the kind comments and wishes, I love the Realself community. If you’re considering a face/neck lift I highly recommend Dr Kremer for a natural result and outstanding care. Updated on 19 Nov 2019: Tomorrow it will be exactly a year since my face and neck lift with Dr Kremer. How the time has flown by! I’m still thrilled with the results. I just took and uploaded several photos without make-up in order to conduct a direct comparison with the photos I took just prior to surgery, also without makeup. Really tried to get similar camera angles too. I can’t believe the difference! Dr Kremer has done an outstanding job and I wouldn’t hesitate to have further surgery with him if/when the time comes. You do have to be patient during the healing process and I found during both my surgeries (had my upper lids done by Dr Kremer several years ago) that lumps and bumps come up and then flatten out over several weeks as the body heals itself. You also have to be realistic too, I was 54 when I had the surgery and I will never again look like I’m 34, now I just look awesome for my age. The surgery has given me lots more confidence and I can highly recommend Dr Kremer. No-one has guessed I’ve had a face/neck lift I just get comments about how well I look. Once again, thank you to the Realself community, I received such encouragement and advice from reading other peoples posts that I wanted to upload my own experience.
Sadly the neck runs in the family and it’s something I have hated my whole life. I have been skinnier and fatter and it was always there. I finally decided to chat to some surgeons last year and got three different opinions. I was most comfortable with Dr Dirk Kremer from Harley Street Aesthetics. He is well known for being a neck specialist and he was very engaging and honest with me about my options. I was ready to press play but got cold feet and put it on hold. In the interim I tried some mesotherapy injections, which did have some minor affect but not enough to make a real difference. So over a year later I just said “what am I waiting for?!?” I got back in touch with Dr Kremer’s office and was scheduled for surgery within two weeks. Updated on 6 Jun 2018: I did consider lipo only but I jut didn’t think I wold get the defined jawline I really wanted. Plus there are plenty of ladies in my family who have little neck fat but still have turkey neck. Updated on 6 Jun 2018: Cannot believe the difference!! I had a calm night in hospital (optional but I chose to stay over for comfort). The bandage was VERY tight and it was a struggle to eat and drink but it’s important to keep it that way for the first night. Dr Kremer does any amazingly discreet set of incisions under the earlobe and behind the ear with a high join to the hairline. I had very little bleeding and leaking overnight. He came to check on me in the morning and removed the bandages. WOW!! So excited. It’s like I have this jawline I never knew existed. I m beyond thrilled. Hard part comes now with the swelling and pain. It’s bearable it I am definitely in the awkward stage at about 30+ hours post op. Some swelling around incisions and a lot of tightness on my neck. But just powering through! Updated on 7 Jun 2018: Surgery was Tuesday and it’s Thursday today. I feel generally pretty good. Still taking my pain pills which make me a bit sleepy, but I would rather wait another day before I start taking those down a notch. I have slept fine at night, just propped up on pillows and wearing a neck/chin compression strap because I had lipo too. The swelling and tightness is definitely in full effect today. There is a feeling of a strong brace wrapped under my chin and back up around behind my ears. Ice packs help but I am just trying to let it be and get through this part of the healing. My face seems to have no swelling and I think it’s mainly related to the sutures from the muscle underneath my skin and of course from the incisions. Not ready to leave the house yet, but probably will get out tomorrow. Feeling pretty chipper over ll! Updated on 9 Jun 2018: It’s definitely not the fun phase of this journey, but I am getting through it. Still a lot of swelling and tightness but the feeling of pulling and heaviness is getting a bit less. I have stopped taking the hardcore painkillers and am on to paracetamol and ibuprofen today. Looks wise the profile is amazing, but the horizontal swelling by ears and neck have me a bit square from the front. Can’t wait for that to go down. I popped out to the shops last night with my hair down and a scarf round my neck and ran into someone I know(!) That was a bit nerve wracking but I don’t think they realized anything was amiss. I am attempting to stop by a friends birthday drinks tonight (water for me) if I feel up to it. Looking forward to the first week being over! Updated on 9 Jun 2018: By request, tried to get a few behind the ear shots but it’s a tricky area to capture and my other half is too squeamish to help. ???? It looks pretty good actually. Dr Kremer is very particular about where he makes the incisions and he takes it very high up then into the hairline rather than crying across in a more visible spot. Updated on 14 Jun 2018: 9 days post op and today so far I am starting to feel the intense dragging and pulling feeling isn’t as present. I CANNOT wait to get my stiches and staples out on Monday. Swelling is definitely going down and the bruising has slowly drained down to my collar bone - which is a good sign my body is moving it out. I had lymphatic drainage massage and another one tomorrow, then acupuncture on the next day so hopefully that will really exit moving. Updated on 18 Jun 2018: I made it! Feeling so much better now. Just have to let the scabs fall off naturally now although I suspect a hair wash my get rid of quite a few in my scalp. When they it takes two weeks it really does. I feel like I turned the corner back to normal life now. I will keep wearing my chin strap at night as recommended by Dr Kremer (because I had lipo) and continue to do MLD and acupuncture for swelling and healing too. I am getting ready for Royal Ascot this week and excited to show off my new jawline and neck! Updated on 30 Jun 2018: Just an update. All fine in healing land. I feel mostly back to normal now, albeit not 100%. Still have some tightness and scabbing to deal with (although scabs almost all off now). Ears are still tender so not side sleeping yet. Also have to keep on top of minor swelling under chin and jaw. I am wearing a neck strap at night, but could probably discard it now if I really wanted to. Can’t believe it’s ONLY been 3.5 weeks. Feels longer. But also looking forward to each week milestone as it really does mark a lot of improvement. Updated on 30 Jun 2018: Whoops how about that jaw Updated on 2 Jul 2018: The funny thing is I hardly have any before pics because I hated them and would delete them. Here is a sort of side by side from one picture that I would have considered acceptable before! Updated on 26 Jul 2018: Just had a checkup with Dr Kremer this morning and everything is healing well and as expected. Still some bits of swelling - but it will take 4-6 months for it to keep going down. I am very happy with my choice to have this procedure and it feels very much my new normal now. Looking forward to October when we have a very big formal event and how fab it will look by then. Just a word out scars. I haven’t used any silicon gel yet but will start today. They are still young and will flatten and tighten up and fade over time so I’ll definitely post updates as they do. The only visible scars are in front and behind the earlobe, as the rest go in the crease behind my ear and then up high into my hairline. I have zero qualms about wearing my hair up. I can’t understand why anyone would do this procedure with a surgeon who tracks the incision from midway behind the ear into the hairline! Updated on 8 Oct 2018: Can’t believe that was my every day.