Combine or Separate MACS Facelift and Fraxel Repair Procedures?

I am considering having a MACS facelift and Fraxel Repair. The doctor says that the two procedures can be done at the same time. Doing this would be convenient having to recuperate only one time but is having both at the same time too much? If I decide to space the two procedures, which should be done first and how much recovery time should I allow?

Doctor Answers 15

Be Careful Combining Facelift With Fraxel Repair

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Thank you for your important question. I generally do not recommend combining CO2 laser resurfacing such as the Fraxel repair with a facelift.

WhileFraxel repair resurfacing will prolong the recovery from your facelift, that is not the reason that I am against it.

During a facelift the facial skin is lifted off of its underlying blood supply which means that blood flow to the skin of the face is reduced during a facelift.

CO2 laser resurfacing with Fraxel repair also reduces blood supply to the facial skin.

In some cases the additional disturbance of blood flow to the skin caused by the Fraxel repair can interfere with wound healing and result in skin loss and increased scarring.

It can be done but you do not want to be the person who suffers loss of blood supply skin loss and scarring.

If fractional repair is to be done during a facelift I would only use it around the mouth, lips and eyelids and definitely not on the cheek nor on the neck.

I recommend waiting 6 months after your facelift to have fractional repair. There is always some loosening of skin following a facelift at 6 months and waiting until 6 months to do a Fraxel repair can and give you the added benefit of tightening the skin further at that point in your recovery.

I agree with your doctor that a MACS lift and Fraxel can be done together

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Combating facial aging is about treating any and all areas that age. The MACS lift is one type of Facelift that treats sagging facial tissue, muscles and jowls. Fraxel treats aging skin. If you have both conditions, it can save you two healing periods by having them together. Deeper ablative laser treatments such as CO2 or deep chemical peels need to be performed more cautiously or even better a few months after any type of Facelift.

Steven J. Pearlman, MD
New York Facial Plastic Surgeon
4.9 out of 5 stars 141 reviews

MACS Facelift and Fraxel Repair complement each other

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

In approximately 25% of my MACS lift patients, I perform a concomitant Fraxel repair treatment. The two procedures complement each other as the MACS lift changes facial volume and shape but does nothing to improve inherent skin quality, while the repair only improves skin and does little to lift or truly tighten. The surgeon's experience is paramount, though, as the repair laser settings need to be changed over the lifted skin flap to ensure proper healing postoperatively. When done properly, the change is a dramatic, natural appearing rejuvenation with no extension in recovery.

Good luck!

Min S. Ahn, MD, FACS
Westborough Facial Plastic Surgeon
4.6 out of 5 stars 35 reviews

First consider why the MACS lift

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

The MASC lift is a currently popular mini facelift that uses a vertical vector on the skin. In all other facelift procedures, pulling vertically on the skin is an absolute way of looking operated on. Mini lifts usually don't last very long either. Make sure this is what you really want to do.

Combining Facial Procedures

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Yes, it is possible to #combine. In fact, I commonly recommend other procedures to go accompany a facelift, such as blepharoplasty or a midface (cheek) lift, to name a few. The combination of multiple of facial procedures may create an optimal result.

The best procedure approach will be discussed in greater detail during your one-on-one #consultation. I invite you to visit to view a complete list of surgeries commonly performed.
The first step is to seek a board certified plastic surgeon who is highly trained with your desired procedures. I also encourage you to look at before and after photos of the surgeons actual patients. Also, reading patient reviews of those who have had combined surgeries will be beneficial. Gathering all of this information will help you make a well-informed decision.

Jed H. Horowitz, MD, FACS
Orange County Plastic Surgeon
4.9 out of 5 stars 116 reviews

MACS and FRAXEL Often Done together

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
Depending on the FRAXEL laser settings, number of passes, health of your skin, whether or not you smoke among other factors and how invasive the facelift is will determine the safety of this procedure. Mini Face lifts and those that have limited undermining such as the MAC or LiteLift procedures are safer procedures for doing both of these procedures. Also it should be safe to do laser on those areas that are not undermined - such as the lips and chin area. I often do chemical peels and/or laser skin treatments at the same time as our limited incision face lifts (LiteLift) and have not seen an increase in complications.

Opinions are often given in the absence of experience with these combined techniques. My advice is to make sure you go to a board certified plastic surgeon you feel comfortable with and follow their recommendations.

Combining MACS facelift and Fraxel repair

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

  Certainly, both procedures can be done at the same time.  However, you should understand that there is some compromise in doing so, as the surgeon has to be very careful about resurfacing the skin where the lift occurs or else there can be significant complication.

Lawrence Kass, MD
Saint Petersburg Oculoplastic Surgeon
4.8 out of 5 stars 140 reviews

Don't combine facelift and Fraxel procedures

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

It would be better to separate the procedures and not perform them at the same time. It is not a good idea to undermine the soft tissues of the skin (as done during a facelift) and burn the outside portion of the skin with Fraxel repair simultaneously. Recovery time in-between the procedure should be approximately one month.

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 158 reviews

MACS Facelift and Fraxel Repair

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

In experienced hands, the lift and a fraxel repair can be done simultaneously. The real question for you is whether or not a mini-lift will satisfy your expectations. I suggest you get a second opinion.

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 43 reviews

Fraxel Repair and Facelifts

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Fraxel Repair can be combined with a facelift procedure but the surgeon needs to be careful when laser is used over skin which as been lifted or undermined. On areas which have not been undermined such as around the mouth, eyes, and forehead, the laser can be used more aggressively. If laser is used with a facelift, the fractionated lasers are much safer than fully ablative devices such as an Erbium or CO2 laser because some of the skin is left in tact to help with healing.

John L. Burns Jr., MD
Dallas Plastic Surgeon
4.7 out of 5 stars 56 reviews

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.