Facelift and skin resurfacing, same time or one before the other?

I have performed simultaneous face lift and fractional CO2 laser (face and neck) in hundreds of patients over a 10 year period.  I have done this on young and old patients with a variety of medical conditions.  I rarely modify the intensity of the laser treatment and I have seen no complications. The face lift and laser treatment can be done separately or together; however, most patients elect to combine the procedures to minimize cost and to economize on healing time. The addition of the laser does not extend the healing time for the face lift procedure. My very best. Good Luck. 

It is absolutely possible to have a facelift with fat transfer and laser resurfacing in the same surgical setting.  It is a very common practice and better for the patient with regards to comfort of having the laser procedure while under general anesthesia and recovering at the same time as the facelift.  Please be sure to consult with a board certified plastic surgery with experience and expertise in facial rejuvenation.  Ask to see before and after photos of the surgeon's own patients. 

Thanks for the question - which is a source of debate for the professionals as you have seen!
My ha’penny worth of opinion reflects a conservative and safe approach. I prefer to lift the face with composite (‘deep plane’) surgery to preserve blood supply to the skin, and ‘get the foundation’ of the face and neck balanced and harmonious first. The facelift balances the aesthetic units of the face from midface to neck.
Then 7-14 days later, at time of suture removal my patients will have resurfacing strategies as necessary. My team likes energy transfer to skin by chemical peel - we start the skin health preparation way before the surgery... The reason for this is for optimum comfort for you in recovery, safety to the healing of the layers of the face (rather than a simultaneous challenge from resurfacing above and surgery below), and also for surgeon related reasons! I prefer to concentrate on optimum surgery in the operating room, and then optimum skin health to the 'envelope' in the clinic.
So:
1. skin health, 2. facelift to restore the face and neck 3. skin resurfacing over a balanced foundation
No right answers here - find a reputable local surgeon you like and get a feel for the philosophy of the team. Good luck!
Jonathan Britto, Consultant Plastic & Craniofacial surgeon, London, UK.

This is a great question. I have performed these two procedures in combination hundreds of  times over the years. The type of facelift and the power settings on the laser determine the risks to the circulation for healing along with any compromising medical conditions. For example, a person with diabetes or a history of smoking would be treated more conservatively.  I do not usually laser directly over the elevated skin flaps except to feather the edges to avoid abrupt demarcation. Fortunately, the skin flaps usually require less treatment anyway. If necessary, they can be done several weeks later. The advantages of doing it together are shared anesthesia time and simultaneous recovery time. In many cases the effects of combining these treatment appear to be synergistic.  

Best to You,
Dr.Stephen Fink
Newport Beach

Combining Facelift and Skin Resurfacing is done very often in my office.  I feel it is safe even with aggressive settings as long as the area immediately in front of the ears is not treated.  It is nice to recover from both at the same time, one overall recovery.  Remember that recovery from a facelift is relatively easy compared to recovery from skin resurfacing.  So, when you combine the two, it is that much more difficult, yet still very doable.  Adding skin resurfacing to a facelift can produce our most beautiful results, despite the difficulty of the recovery.  

Thank you for the great question. In my practice, I often will perform CO2 laser resurfacing during the same operation as a face and neck lift. With a thoughtful approach to the intensity of the treatment, there should be no conflict between the two. Most patients need the deepest resurfacing in the areas of the face that are not lifted during the surgery -- around the mouth, chin, brow ridge, and crow's feet. In addition, I use a deep plane facelift technique. This leaves a more robust blood supply to the facelift flap and reduces the likelihood of any delayed healing. Best of luck moving forward!

I frequently combine laser resurfacing and facelift surgery.   Resurfacing must be done with caution when combined with facelift surgery.  In my experience its very safe to resurface the area around the mouth with aggressive energy settings to remove fine lines. My preference is to use fully ablative erbium sciton resurfacing for the peri oral area.  I will use lighter energy settings and fractional Co2 to resurface the orbital skin and upper face.  I avoid resurfacing the lateral cheeks when combining the resurfacing and facelift surgery. 

I do my Facelifts and resurfacing together. The downtimes are combined and there shouldn’t be a problem as long as you are a candidate for this combination procedure. I adjust my technique and energy according and i’ve successfully done hundreds of cases this way. Best of luck.

Thank you for your question. All three procedures can be done simultaneously in the right candidate. You would have a little longer of a procedure, but only a single recovery. Seek out an experienced board certified plastic surgeon with expertise in all three of those procedures. With regards to the order of procedures if you decide to stage them, I would start with the feature that ages you the most. What make you look older, the skin laxity (facelift), volume loss (fat transfer), or skin changes (resurfacing)? An experienced surgeon can help you decide. Good luck!

Thanks for your question. It is possible to do fat augmentation, laser resurfacing and a facelift at the same time in select patients. There is more risks with doing multiple procedures at once and no all patients are good candidates for this. If recommended by your surgeon, however, this combination of procedures can provide a dramatic result with only one surgery, one anesthesia and one recovery- a real benefit.