I am 62 years old, need a facelift plus pin hole acne scars on my cheeks. which should be treated first?

Acne scars treatment and a facelift can be performed together. Acne scars can be treated with a fractionated CO2 laser depending on what your skin type is and what your acne scars look like. The laser resurfacing can be performed at the end of the procedure after the facelift has been done. This laser is also routinely used to improve lines on the face, improve any discoloration and resurface the skin, so I routinely perform this after my other facial rejuvenation procedures. 

I suggest you do the facelift first, which may alter the appearance of your acne scars. Then, you can address the scars after you've recovered from your surgery.

Deep pits from act the scars are generally excised enclosed to exchange a depressed scar for a flush scar. This can be done concurrently with a facelift.

Patients considering facial rejuvenation with a facelift and
facial skin improvement with acne skin management could be undecided on what
procedure to undergo first. Patients with this kind of dilemmas should undergo
consultation with a board certified plastic surgeon specialized in the face.
Expert medical advice may allow the patient to choose the best next step to
follow based on his/her priorities, availability of downtime and expert opinion.

I would recommend getting your facelift first. After you see the results of that procedure, it will be easier to release the pitted acne scars. I also recommend volume augmentation to boost your cheek area, then proceed with fraxel laser resurfacing treatments to smooth out your skin.

Dear polinterest,The acne scars will likely require multiple treatments and may be able to be done at the same time as a facelift depending on the location and depthPost-operatively, you will likely need a few (2-5) microneedling sessions to break up the scars and improve their appearanceBest regards,Nima Shemirani

Thank you for the great question. Without seeing your scars in person, I can't give a complete recommendation. However, I have treated patients with acne scarring at the same time as facelift by using CO2 laser resurfacing. It is actually very common to do these treatments together.  In some cases, acne scars are very deep ("ice pick") and surgical excision is necessary.  This is often in the mid-cheek region or on the forehead.  Depending on the exact location, these may be excised at the time of surgery (not under the facelift flap) or deferred until after the facelift (under the flap).  Best of luck moving forward!#San Francisco Facelift

Usually, we like to combine surgical treatments that require significant recoveries in order to respect our patient's ability to set time aside for recuperation. Although there are many treatment options available for acne scars (i.e., fractionated laser treatment, dermabrasion, subcision etc.), most of these can be performed as treatment for the cheeks at the same time as your facelift.

Thanks for your question.  These cases can vary a great deal so a review of photos would be helpful.When treating acne scars and facial aging it is important to consider where the scarring is, and the quality of the skin.  It is not a good idea to perform laser resurfacing or or dermabrasion to the top side of the skin and undermine the skin from below with a facelift at the same time, so a decision needs to be made on what would be most beneficial first. Sometimes the acne scars are located in an area does not need to be undermined and laser treatment can be applied to an area away from surgical undermining with good safety.Also, the facelift itself will also help stretch acne pockmark scars. In many cases this minimizes the appearance of these scars.Visti with board certified plastic surgeon to determine what is best for you.

Thank you for the question.To best help you, a physical examination or picture evaluation is required in order to determine which procedures and techniques would be best for your case.Dr. Campos