What Is The Risk Of a Facelift, Revision Rhinoplasty, and Laser Resurfacing at the Same Time?
- Asked by lknfamily in Long Beach, CA
- 2 years ago
I just turned 50 and am showing my age. Thinking of brow & neck lift (or full face lift), laser resurfacing, & revision rhinoplasty at the same time. Is this too much for one day? Too much risk to be under anesthesia for so long? Possible to do with local?
Facelift, Revision Rhinoplasty, and Laser Resurfacing at the Same Time
Assuming you are in good health, it is certainly feasible to have a face lift, laser resurfacing, and revision rhinoplasty. To reduce the risk of anesthesia, ensure that the facility has an MD anesthesiologist. If possible, the MD anesthesiologist should meet with you prior to your combination surgery to obtain full understanding of your case and to allow for proper planning.
As long as you are in good health, then combination surgery is quite safe. We prefer use of IV sedation with local over general anesthesia to reduce the risks associated with a prolonged general anesthetic.
Risks of Simultaneous Face Lift, Revision Rhinoplasty, and Laser Resurfacing
It is understandable why someone would want to have several procedures performed at the same setting-in order to decrease costs and have only one recovery period. However, the most important concern needs to be patient safety. Prolonged procedures are associated with increased blood loss, increased risks of infection, and increased risks of deep venous thrombosis. I limit the length of any procedure(s) to 8 hours. Laser resurfacing can be performed simultaneously with a face lift but should be limited to a light pass or no treatment of areas that have been undermined. it is possible to perform this set of procedures under local anesthesia, but this would make for a long and uncomfortable day for the patient.
Address brow lift, neck lift, laser & rhinoplasty at the same time
I would always recommend addressing all of the areas that you are concerned about at the same time, if at all possible. I think it yields the best results and the best possible overall outcome, the shortest overall recovery time, and it is often the most cost-effective.
Having a brow and face/neck lift, revision rhinoplasty, and laser resurfacing as one combined procedure is commonly done and is certainly would not be considered too much to do at one time. In fact, it makes good sense to combine all these procedures to achieve the best overall outcome.
With regard to the laser, I prefer to avoid using full ablative laser resurfacing in the areas where a flap has been elevated–in this case, the lateral cheek and the forehead areas. Instead, I would advise confining the laser portion of this procedure to the area around the mouth and the eyelids–areas that would not be involved in the surgery under consideration. Laser resurfacing is often not required in the surgically treated areas referenced here. If laser resurfacing is indicated in the cheeks and forehead areas, this can be delayed for at least 6 months following surgery. You may be so pleased with the surgical results that you can delay much longer than this before contemplating any further laser resurfacing treatment.
Risks Are Higher with Facelift and Laser Resurfacing in General
In general, most plastic surgeons don't perform a facelift and a skin resurfacing procedure at the same time. The reason is because lifting and repositioning the skin and soft tissue of the face disrupts the blood supply to the face, and is done from underneath the skin. Skin resurfacing, whether it's CO2 or Erbium-Yag or some other type of laser, also induces surgical stress, but from ABOVE the skin surface.
Depending on your type of skin, the type of facelift, the type of laser, and the settings of the laser, it is possible to have both a facelift and laser resurfacing at the same time. However, most plastic surgeons recommend waiting for some time, typically 6-12 months, to get a skin resurfacing treatment, so that you'll be able to get a the best overall aesthetic results possible.
Doing a revision rhinoplasty with a facelift should be safe in terms of overall healing and blood flow.
Have fun with your facial rejuvenation procedures!
Combination Facial Cosmetic Surgery
. It is certainly possible to combine these procedures in one setting - whether under IV sedation or general anesthesia depends on your facial surgeon's preference. Care must be taken with facelift and laser resurfacing comination: the resurfacing should be conservative in order to ensure safe healing of the skin.
Combining multiple facial procedures including rhinoplasty and facelift in one setting is common practice for us. But if you feel uncomfortable and feel that this is too much, don't do it but rather prioritize.
Risk of combining facial surgery and laser resurfacing
It is best to not undergo laser resurfacing and a facelift at the same time due to insulting the skin from both underneath and the top portion of the skin. It is acceptable to have a facelift and revision rhinoplasty at the same time, which could potentially take 5 hours to perform. Five hours of anesthesia is probably a reasonable amount of time to undergo anesthesia for an outpatient surgery. These types of procedures are not done under local anesthesia. It is best to have a board certified physician anesthesiologist in attendance along with your surgeon and nurses in a certified ambulatory surgery center.
Combination facial surgery
Combining cosmetic procedures
Cosmetic procedures can be combined. Safety is my over-riding concern so I almost always do these procedures either in the hospital or an accredited facility and with an MD anesthesologist. But, I also individualize and after examining the patient , we both determine what can safely be done in one procedure. I have very frequently combined a facelift with nasal surgery and laser resurfacting(fractionated). The patient does save on costs as well as their is just one recovery!
Rank your areas of dissatisfaction
lknfamily: Family aging has many components, some of which can include, amongst other features: 1) sun damaged skin with sun spots, fine lines and overall dull tone; 2) loss of facial fat (lipoatrophy); 3) descent of facial fat-muscle (SMAS), producing jowls and folds; 4) atrophy or wasting of bone stock. Although it is tempting to undertake a panfacial rejuvenation, I would suggest that you rank the areas of your dissatisfaction, according each a numerical value from 1-4 (1= most to 4= least problematic) and stage these. Without photos, I would advocate a) brow, face & neck as one phase and b) revisional rhino and full face laser resurfacing as another. Also to minimize risk from anesthesia, be candid about any health issues with your surgeon, get clearance from your primary care and be prepared to accept the "recovery" phase outlined by your PS. The choice of anesthetic technique ultimately should be based on your surgeon's preference and your health history. Many PS use a combination of local and IV sedation to ensure your comfort, as well as their own, during cases such as you are planning. Good luck.
These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.