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What Is The Risk Of a Facelift, Revision Rhinoplasty, and Laser Resurfacing at the Same Time?

asked 7 months ago by lknfamily in Long Beach, CA
Latest answer by Sam Naficy, MD
Question viewed 393 times
Tags: combination, risk

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?

20 answers to What Is The Risk Of a Facelift, Revision Rhinoplasty, and Laser Resurfacing at the Same Time?

Combination surgery

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.

Sam Naficy, MD
Seattle Facial Plastic Surgeon

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... more

Michael Sundine, MD
Orange County Plastic Surgeon

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... more

Michael R. Macdonald, MD
Bay Area Facial Plastic Surgeon

www.drmmacdonald.com

Risks Are Higher with Facelift and Laser Resurfacing in General

Dear lknfamily- 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... more

Roy Kim, MD
San Francisco Plastic Surgeon

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... more

Frank P. Fechner, MD
Worcester Facial Plastic Surgeon

www.drfechner.com

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... more

William Portuese, MD
Seattle Facial Plastic Surgeon

www.seattlefacial.com

Combination facial surgery

First, I recommend that you have a consultation with a board certified plastic surgeon to clarify your options and prioritize these procedures. The first question is whether you need a face lift as opposed to laser resurfacing, which would produce some skin tightening. I personally do not perform rhinoplasty in conjunction with facial surgery because the intraoperative swelling from the rhinoplasty will create a distortion and restrict the ability to ascertain the extent of work required. ... more

Robert L. Kraft, MD
New York Plastic Surgeon

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! more

Edward J. Domanskis, MD
Orange County Plastic Surgeon

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=... more

Lavinia Chong, MD
Orange County Plastic Surgeon

www.chongmd.com

Minimizing risks during multiple procedures

In my practice I routinely perform multiple facial procedures in one setting quite successfully. It takes good judgment, proper selection and expert execution of the surgery to avoid complications. Some of the factors that could aid in successfully performing multiple procedures are the type of anesthesia, the surgery center and of course most importantly the skills, talents and the track record of your surgeon. In your particular case I would recommend postponing laser... more

Boris M. Ackerman, MD
Newport Beach Plastic Surgeon

Multiple Facial Surgeries - Is it too much?

The combination you proposed is not too much by itself, but it must be taken into account on how challenging each of these procedure are. Most notably the revision rhinoplasty. If this is a major revision, then I would consider staging these procedures. Otherwise, a simple touch up could be easily incorporated. Your medical health is something that must be addressed prior to undertaking any surgery. As a result, you must be in good health to tolerate a longer more complicated... more

Vincent P. Marin, MD
San Diego Plastic Surgeon

Combining face lift, laser rejuventation, and rhinoplasty

While it is ok to combine some procedures as long as you are healthy, I would be skeptical to about a full face laser peel and a facelift at the same time. I worry about skin loss from the two together.

Steven Wallach, MD
Manhattan Plastic Surgeon

Facelift, Revision Rhinoplasty, and Laser Resurfacing

While it is understandable why one might want to combine these procedures, there are multiple factors that determine which procedures to combine. With any elective surgery, your safety should come first. This is dictated by multiple factors, including health status, risks of general anesthesia, etc. A facelift alone will take approximately 3-4 hours and depending on the amount of work that is required for your revision rhinoplasty, that could also take an additional 2+... more

Kimberly Lee, MD
Beverly Hills Facial Plastic Surgeon

Face, neck, nose, and laser surgery all at same time?

Whether or not these procedures are performed under the same anesthetic is a matter between you and your surgeon. There are so many different ways to perform these procedures, different types of lasers, etc., that doing them all in one day is very safe is some practices, but may be distinctly unsafe in others. Anesthesia, office accreditation, and other factors impact the decision as well.

Steve Laverson, MD
San Diego Plastic Surgeon

feelbeautiful.com

Combining a facelift and a revision rhinoplasty may be too much surgery at one time.

I read your concern: You could have facelift and nose job surgery at the same time, but if you have a complicated revision rhinoplasty, you may be better off separating the surgeries. Revision rhinoplasty is one of the most challenging operations in the arena of facial plastic surgery. Revision rhinoplasty alone may exceed 2.5 hours, especially if you require cartilage grafting. In my practice, a short-scar facelifting takes around 3 hours. And a brow lift may be an additional 2... more

Eric M. Joseph, MD
West Orange Facial Plastic Surgeon

If you survive, the risk should be very low.

I personally do not like the "blue plate specials" were docs hussle patients into having every procedure under the sun. A properly done face lift takes about 3 hours. Sure by cutting corners this could be reduced to an hour. A properly done endscopic forehead lift will take about an hour or an hour an a half. Trust me, you do not want an open foreehead lift. A revisional rhinoplasty might take anywhere from an hour to 3 hours depending on what you... more

Kenneth D. Steinsapir, MD
Los Angeles Oculoplastic Surgeon

Yes you can- with caution

Firstly, I never do this much surgery under local anesthesia. It would take too much time to explain why. Multiple procedures are performed very commonly. You must be healthy and able to with stand the surgery. If you are not, the surgery can be staged. My caution in this case is the laser resurfacing at the same time. The surgeon needs to have experience with this and know which areas of the face in which he can be more aggressive like the central facial area... more

Miguel Delgado, Jr., MD
San Francisco Plastic Surgeon

www.dr-delgado.com

What Is The Risk Of a Facelift, Revision Rhinoplasty, and Laser Resurfacing at the Same Time?

I do those combos all the time and have for over 20 years but with one very important exception. The skin, of the face, should not be disrupted at the same time as it is undermined with a Face Lift because this causes added loss of blood supply to the facial skin and increases the risk of skin death. This would dictate that you refrain from having the Laser for at least 6 months after the Face Lift.

Francis R. Palmer, III, MD
Beverly Hills Facial Plastic Surgeon

How much surgery to combine?

In general you could combine all the procedures you mentioned as long as you have an experienced surgeon. I might recommend leaving out the rhinoplasty if you do the laser resurfacing. that's because your nose will tend to have some drainage which might get onto the areas that were lasered and give you a slightly increased risk of infection (your nose is considered dirty). Check with your surgeon about this.

Ronald Schuster, MD
Baltimore Plastic Surgeon

www.drschuster.com

Combining Multiple Surgical Procedures

It is very common for me to perform multiple surigcal procedures at the same time as facelift. As far as your age, the best candidate for a facelift is a physically healthy person who is realistic in their expectations regarding the appearance of loose facial and neck skin. As long as you are healthy, a facelift can be performed at any age and can deliver remarkable results. Many healthy patients over 80 years of age enjoy the benefits of a facelift. A facelift... more