Is Botox before Facelift consultation and surgery okay?

Question

I receive about 80 units of Botox injections into my forehead and near my eyes from a neurologist every 3 months due to migraine headaches. I am planning on getting a forehead lift and face/neck lift. Is it important to have the Botox out of my system for the consults? What about the surgery? What do you tell your patients and why? I am worried that discontinuation of the Botox will make my headaches come back. Thank You!

Sergei Kalsow, MD · Answer

Hi, botox is okay before a facelift.  The facelift treats the mid/lower part of the face.  The botox the forehead.  Even if procedures on the forehead are performed after botox, they do not interfere with each other, since botox just shrinks the muscles a little, and everyone has different size muscles anyway.  It does not matter if the muscle is full size or half thickness for the surgery.

Cory Bovenzi, MD · Answer

Hi and thanks for your question! I would recommend having botox out of your system for any consult or surgery for a forehead lift (browlift) or eyelid surgery since Botox can change the position of your brows and eyelids. In fact, if you have lower eyebrows that may be due to the botox to your forehead. For a lower facelift it does not matter if you have botox on board around your eyes or forehead.

Ronald J. Edelson, MD · Answer

I have no problem with patients getting Botox prior to a facelift. But plastic surgeons are particular so make sure you ask. Just because I say it's ok with my patients doesn't mean all plastic surgeons feel the same.

Tanveer Janjua, MD · Answer

It is important that you are migraine free during the healing period of your facelift. Stopping Botox can lead to migraines, hence do not stop your Botox. Just make your surgeon aware so she/he can compensate for it in the surgical plan.
Regards
Dr. J

Kenneth D. Steinsapir, MD · Answer

For a lower facelift, the Botox treatment has little bearing. However this treatment has a profound effect on the forehead and will make a difference for choices regarding upper eyelid surgery and forehand lifting. I ask my patients to take a several month break to allow the Botox to wear off for the consultation to fully assess the untreated forehead, eyebrows, and eyelids. The Botox treatment can cause eyebrow and eyelid ptosis. Caution is advised when dealing with surgeons who do not believe it makes a difference. It makes a difference,

Richard Wellington Swift, MD · Answer

Thank you for posting your interesting question. Botox before a face and neck lift is fine; however, I would not recommend Botox of the forehead before an upper blepharoplasty and brow lift because Botox will alter the position of the brow. When planning an upper blepharoplasty and brow lift the surgeon will want to make an accurate assessment of how much skin to remove. I recommend that you have a consultation with a Board Certified Plastic Surgeon who is experienced with facial aesthetic surgery and will examine you and go over the procedure and answer your questions. Best wishes, Richard Wellington Swift, M.D., F.A.C.S.

William Portuese, MD · Answer

Botox is acceptable before a facelift, however not for a brow left. It's important that the surgeon sees  the anatomy on the muscles in the fore head along with what your forehead wrinkles look like without Botox in place to make an accurate judgment how to soften corrugator in frontalis muscles in the forehead.

Robert Singer, MD · Answer

Having operated on numerous patients who get Botox, there is no reason to discontinue it before surgery.

Keep in mind, that following the exact advice from a surgeon on this or any other website who proposes to tell you what to do without examining you, physically feeling the tissue, assessing your desired outcome, taking a full medical history, and discussing the pros and cons of the proposed operative procedure may not be in your best interest. I would suggest you find a plastic surgeon certified by the American Board of Plastic Surgery and ideally a member of the American Society for Aesthetic Plastic Surgery (ASAPS) that you trust and are comfortable with. You should discuss your concerns with that surgeon in person.

Robert Singer, MD FACS

La Jolla, California

Benjamin Schultz, MD · Answer

Your Botox is being given for your migraine headaches, as such, I would not stop them prior to the consultation or surgery. The only times I make sure my patients have their botox worn off is if I'm planning or performing brow lifts or blepharoplasties (eyelid surgery). That's because the botox of the frontalis muscle (forehead wrinkles) and orbicularis muscles (around your eyes) can alter how we address those areas during surgery. So, for a face/neck lift you're probably ok, but if we were doing anything involving the eyes, I'd want to examine you with the botox worn off and perform the procedure in the same circumstances. As always though, you should consult with your Board Eligible or Board Certified Plastic Surgeon!

Is Botox before Facelift consultation and surgery okay?

Answers (9)

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