Apex Facelift® 

If you are constantly pulling your skin back towards your ears when you look in the mirror, you are probably ready for a facelift. The passing years, sun exposure and stress, can cause your skin to lose its firmness and shows laxity, jowls set in and become increasingly prominent. Nothing matches the ability of a facelift to make you look more youthful and refreshed. While this process is normal, you don’t have to accept it. Instead, Mr Coombes has developed an innovative local anaesthetic facelift procedure called Apex Facelift®, suitable for women and men who choose to reverse the signs of ageing in a less invasive way.

A consultation with Mr Coombes can help you decide if you are the perfect candidate for the Apex Facelift®. This procedure can also be performed in conjunction with upper blepharoplasty surgery to refresh the upper eyelids and give a complete rejuvenated look.


The Apex Facelift® is designed to reduce sagging in the lower face and neck and regain a more natural, rejuvenated appearance. The procedure differs from a traditional facelift as you will experience minimal bruising and swelling for a significantly quicker recovery period. A key benefit of the Apex Facelift® is that there is minimal scarring as the incisions are easily concealed within your natural facial contours and hairline. Mr Coombes is meticulous with his incision design.

This procedure is developed for the patient that may not be sure about going under a general anaesthetic as it is performed under local anaesthetic which dramatically reduces the risks and eliminates the groggy disorientation associated with a traditional facelift.

With the Apex Facelift®, Mr Coombes’ goal is to refresh your facial features, firming up muscle tone, smoothing the skin, and restoring your attractive facial contour. Facelift surgery is not designed to make you look like someone else, but to make you look and feel years younger. In most cases, this procedure can be performed in 90 – 120 minutes.



You are able to go home and rest straight after your procedure. There may be minimal swelling, bruising, tenderness and most people feel comfortable getting back to work within a week. If you have had liposuction carried out as part of the neck lift procedure, the recovery process will normally take longer than average.

Although the Apex Facelift® surgery is less invasive than a traditional facelift, the results are just as effective to give you the self confidence about your appearance and can make a tremendous difference in your quality of life.

Cheek Fat Reduction

The Buccal Fat Pad is a small fat deposit located in the middle of the cheek. Although this fat pad is important for giving a healthy and youthful fullness to the face, it can give excessive roundness and leave you asking: how can I get rid of my chubby face? Cheek reduction, in terms of buccal fat removal, is a great option if this is a question you would ask. Many people find that even if they lose weight over all, fat can still remain in the face, giving the face a child like or juvenile appearance, this can often lower self esteem and be a real discouragement when trying to lose weight but struggling to lose weight from the facial area.


Cheek Fat Reduction is performed for most patients under local anaesthesia and the procedure itself will take less than one hour. In cases where patients are doing more than one procedure, general anaesthesia may be used and will be dependent upon the extent of their surgery and each patients level of comfort.

Mr Coombes creates a small incision inside the mouth, where the fat can then be gently extracted with surgical instruments and the incision closed with dissolvable sutures leaving no outward scars. As we continue to age, we naturally lose fat from our face so from this incision, Mr Coombes removes only the necessary amount of excess buccal fat which will allow for a slender and natural contour of the face and cheeks.



You are able to return home after the procedure to rest. The ‘no outward scar’ aspect of this operation is a really positive consideration. Recovery is relatively short; you will experience initial discomfort and some bruising and swelling, which is to be expected with most surgeries and can be easily controlled with over the counter pain medication such as paracetamol or ibuprofen. However, it is expected that you could be back to work within 3-4 days and as scars are hidden inside your mouth, the fading of scars is not so much of a concern with this surgery. You can also return to exercise that focuses on your lower body in 1 week and upper body exercise in a recommended 3-4 weeks.

Lip Lift

As we age the lips begin to lose plumpness and begin to droop. Sometimes this drooping can even make it look like we are frowning due to a downturned appearance. By shortening the height of the upper lip with a Lip Lift, a more attractive and youthful appearance can be achieved.


A Lip Lift is a subtle yet transformative procedure that removes tissue just below the nose, which essentially lifts the upper lip, and in turn creates an enhanced feminine upper lip shape. Modification of the lips in this way makes adds volume and plumpness to a thin lip while enhancing an overall youthful appearance.



With the Lip Lift procedure, immediate improvement of the upper lip is seen. You may go back to your normal activities after 7 – 10 days. Some swelling is expected in the first 3 to 5 days before the final results are evident at 2 to 3 weeks. Avoid bending over and sleep with extra pillows for the first 5 days. The upper lip may be uncomfortable and mildly swollen for the first week. Scaring is minimal and often goes unnoticed because the point of incision is right under the nose where the eye naturally sees a crease.

Mole removal and Scar Revision

When you want a mole, skin tag or other skin lesion removed for cosmetic reasons, you can be confident you are in the safest hands with Mr Coombes. His skill and expertise have resulted in barely visible to no scarring at all.

Moles occur when cells called melanocytes grow in clusters instead of spreading evenly within the skin. Moles, particularly on the face can be unsightly and cause low self-esteem. Mr Coombes is well aware of this and will carefully listen to your concerns.

Scar Revision

When the skin is injured by a cut the skin commonly heals by scar tissue. Once a scar has formed it is impossible to completely remove and this can be a particular problem on the face. Scar treatment aims to blend the scar tissue with the contours and colour of the surrounding skin. Scar treatments include scar revision surgery and/or injection of steroids into the scar. These treatments intend to treat these flaws and increase self confidence.



Mole removal is a simple surgical procedure that is undertaken with local anaesthetic. The technique Mr Coombes uses does not involve any stitches which minimises scarring. The mole is removed and a small adhesive dressing is placed over the skin site. Following the removal of the mole there is a slight dip on the skin site.


Mole Removal is a quick and painless procedure. You will be sent home and need to return to the clinic in a week to remove the small adhesive dressing. The skin site will eventually fill in and level off over the subsequent weeks leaving a natural aesthetic result.

Non-surgical Facial Rejuvenation

Wrinkle Treatment

Life is about smiling and being happy. However, sometimes when we laugh, smile or frown we use muscles in the face that are creased or contracted into folds of skin that form wrinkles. These common wrinkles are “crow’s feet”, frown or “worry lines” in the forehead and between the eyebrows. The creasing and contracting of the muscle over time can cause deep and permanent wrinkles. If your wrinkles make you look older than you are, there is now a way to soften these lines without surgery, scars and little recovery time.


Wrinkle treatment consists of injections to reduce these ageing unwanted lines. BOTOX, a brand of Botulinum toxin Type A is injected to temporarily prevent nerve signals from reaching the muscle and as a result the muscle relaxes and the lines and wrinkles become smoother and less pronounced. These anti-wrinkle treatments reduce the appearance of lines and wrinkles already formed restoring a more youthful appearance.


Dermal Filler

Dermal Fillers are a non-surgical way to giving yourself a facelift. They allow us to restore facial volume by means of a relatively quick and simple injection, reducing the appearance of lines and wrinkles whilst also restoring more youthful and attractive facial contours.

Easy as it sounds, choosing the right filler and injecting just the right amount in the right places is paramount to achieving a good result. When it comes to injecting fillers, experience and judgement is key.

What area of the face can benefit from fillers?

If you feel you’ve lost volume and plumpness in any facial area, dermal filler can help to rejuvenate and give you a more youthful appearance. Common problem areas are,

– Jawline & jowels
– Nose to mouth lines (nasolabial folds)
– Mouth Corners (down turning of mouth, “marionette lines”)
– Lips
– Nose reshaping
– Temples
– Cheeks

If you have concerns about these areas, book a consultation with Mr Coombes to discuss how wrinkle treatment and dermal fillers can give your face an instant facelift.


These treatments are simple and effective with minimal swelling or redness and have a proven track record for effectiveness. You would expect to see results in 4-7 days. To ensure the best results long-term initial treatments should be approximately 3-4 months apart, and should there should be at least 12 weeks in between treatments.

Skin Cancer Surgery

There are 2 main types of skin cancer:

• Non melanoma skin cancer: Basal Cell Carcinoma & Squamous Cell Carcinoma

• Melanoma skin cancer

Mr Coombes has many years of managing and treating facial skin cancers both in his NHS practice and his private practice. He is a core member of the skin cancer Multidisciplinary Team (MDM) based at The Queen Victoria Hospital, East Grinstead.


Basal Cell Carcinoma (BCC)

This is the commonest type of skin cancer and over 75,000 cases are diagnosed in the UK each year. This type of skin cancer grows slowly and does not spread to other parts of the body. It most commonly occurs in middle aged and elderly people and often appear on the face.

Basal cell carcinomas (BCCs) may look like:
• small lumps or ulcers with a pearly appearance, often with small blood vessels around them
• a scaly, red plaque (bumpy patch of skin)
• a waxy, shiny area of skin, that looks a bit like a scar


Squamous Cell Carcinoma (SCC)

This type of skin cancer tends to grow more rapidly than BCC but also has the risk of spreading to other parts of the body, particularly if there are other risk factors such as immunosuppression. Like BCC’s, SCC’s typically occur where the skin has been exposed to the most Sun.

• a lump with scaling or crusting skin on top
• a small, red lump which quickly gets bigger
• an area of skin that doesn’t heal but is usually a bit raised

Surgical removal, typically under a local anaesthetic as an outpatient appointment is the primary treatment for non melanoma skin cancers with curative intent. The lump is sent for a biopsy to confirm the type of skin cancer. Sometimes a skin graft or skin flap is required for reconstruction of any resulting defect.

Mr Coombes will review at 1 week following the surgery and will remove the stitches from the surgical site. The results of any biopsy will usually be available within 2 weeks following the surgery. Contact us for a consultation with Mr Coombes if this is something you are worried about.


Skin Cancer Surgery: Melanoma Skin Cancer

Malignant melanoma is a cancer that usually starts in the skin. The cells (melanocytes), either in pre-existing moles or normal looking skin, begin to over-produce, causing an alteration in skin appearance. This is usually noted as a changing mole, which is irregular in outline or colour. It is an uncommon skin cancer, however it is the most serious.

The first sign of melanoma is often the appearance of a new mole or a change in how one of your existing moles looks. If you notice a mole that stands out because it looks different from other moles or marks on your skin, you should book a consultation with Mr Coombes to rule this out. This is especially important if the mole is changing in appearance.

If there is a suspicion that the skin lesion or mole is a melanoma then an excision biopsy is performed. For suspected melanomas, this involves removing the whole mole, along with a narrow margin of normal skin, and sending it to a laboratory for testing. This biopsy is usually carried out under local anaesthesia, which means the skin will be numbed so that you won’t feel anything.

If laboratory testing confirms that the skin sample is in fact a melanoma then your case is discussed at a Multidisciplinary Meeting (MDM). Depending on the grade of the melanoma, then the best course of treatment is proposed by the clinicians who are in attendance at the MDM.

If you have any concerns about changes in your skin, please book in to see Mr Coombes for a consultation to rule out any conditions and put your mind at ease.