How long should I wait for a facelift after jaw surgery?

Question

What is the right order of jaw, facelift, and rhinoplasty surgeries? I'd like a facelift, but I need orthognathic surgery for bite correction. I also want a rhinoplasty, but because of low blood pressure, I've been advised not to do it with the facelift. I was thinking of this order for surgeries: orthognathic, facelift, rhinoplasty. Since jaw-surgery swelling can take a year to completely resolve, do I wait that long for a facelift? If I switched the order of facelift and rhinoplasty surgeries, can I have my nose done while face swelling from jaw work resolves?

Thomas Romo, III, MD · Answer

The best sequence for surgery in this process is to first set the hard architecture which is the jaw bone. This structure supports the facial skin and soft tissues. Therefore if the bones are set in proper position, the plastic surgeon can then more accurately position the face and neck soft tissues leading to a better long term result.

Stephen M. Krant, MD, FACS · Answer

Complicated question, but a good one. I would definitely proceed with the orthognathic surgery first. There is also the additional timing for bone healing plus bracing.
Your idea of the doing the rhinoplasty after the initial jaw surgery is certainly an acceptable approach. Don't schedule the two procedures too close together. Postop, I would use Lovenox therapy (low molecular weight heparin shots) to prevent postop blood clots. Check with our oral and plastic surgeons about this. It is safe and can prevent major problems postop.
Then, proceed with the facelift (and other ancillary procedurs) at an appropriate time. Again, wound healing and safety is your major concern.
Get other opinions so that the procedures can be coordinated with all of the surgeon for the ideal results. Good luck!

Jeffrey R. Raval, MD, FACS, MBA · Answer

Hello, thank you for your question. I agree that your jaw surgery should be the first procedure you undergo. From there I would do your Rhinoplasty (around a year later). However, I would highly recommend seeing a board-certified and reputable Plastic Surgeon to discuss the best approach for your particular case as there might be some other factors that may play in and change the order of operations. Good luck!

Larry Weinstein, MD · Answer

orthognathic surgery will change the shape of your face and cause a significant amount of swelling. Best to wait six months to a year before having your face lift and rhinoplasty. Good luck.

Robert M. Tornambe, MD · Answer

MCat2018  No Brainer.  Better to have your orthographic surgery first, because that will change the shape of your face somewhat.  Allow complete healing and swelling to resolve and then consult with a board-certified plastic surgeon to explore your best options regarding your face and nose. We commonly perform rhinoplasty with facelift and I do not think you need to stage that portion of your surgeries. Good luck.

Barry L. Eppley, MD, DMD · Answer

They correct order is to absolutely do the orthognathic surgery first. That can then be followed by a combination facelift and rhinoplasty. Or if they need to be done separately the order of the facelift and rhinoplasty as separate procedures does not matter.

William Portuese, MD · Answer

The underlying structura bonyl framework should be performed first, whether it's just the upper jaw, just the lower jaw or both. Probably best to wait at least six months before undergoing a rhinoplasty or a facelift. Both of these procedures can be performed together when necessary.

Joshua A. Halpern, MD, PA · Answer

Unfortunately there are no pictures. Since there are different techniques when performing jaw surgery I would ask for Orthognathic surgeon how long you should wait before having a facelift or rhinoplasty. There are different types of facelifts ranging from Endoscopic (Mini scar) facial surgery, which I helped to pioneer to traditional facelift surgery (please watch the video on our page). When performing Rhinoplastie, I like to find out from the patient what their goals are. I then Wright up a detailed operative plan which I review with the patient. As a former art student, from the LA County Museum of Art, I like to use advanced suturing techniques to refine the nasal tip. I incorporate the FINNESSE technique, which I invented. I typically do not pack the nose. Pain, bruising and recovery are minimal when compared to traditional techniques. (Please see the video on our page). I hope you find this information useful. Please watch the enclosed video.

Benjamin Caughlin, MD, FACS - Account Suspended · Answer

Facial aging happens because of 3 main reasons. 
1. We lose fat as we age over time. 
2. Skin loses elasticity. 
3. Bone is absorbed over time. 
Surgical decisions are made based on anatomy, age, skin type and bone structure to start.  I would recommend facial fat transfer and superficial laser or radio-frequency depending on how much downtime you can work with. For the jowls we need to tighten the skin and muscle. For the neck we need to tighten the platysma and do a submentoplasty (under the chin incision).  The best thing to do is find a surgeon you trust and go over your goals slowly and clearly. 
Hope this helps. 
Best of luck,
DrC

Jon Ver Halen, MD, FACS (license suspended) · Answer

Dear MCat2018,Hello and thank you for your excellent question. I agree that the first surgery should be your jaw surgery.  After that, you can either have laser resurfacing, chemical peel, or micro RF to improve your facial skin and tone while you wait to have your facelift performed.  It is best to answer your question during a face-to-face evaluation, when you can discuss your goals and expectations for the procedure, and you can have a physical examination to evaluate for that procedure. I recommend that you find a board-certified, or board-eligible plastic surgeon with whom you are comfortable. Be sure to have all of your questions answered during a face-to-face meeting with your surgeon, and review before and after pictures of similar patients whom have had this procedure. If you have any questions, call our office for assistance. Good luck!
  
Best,
  
Jon Ver Halen, MD FACS
  
Harvard educated plastic surgeon
  
Texas “Top Doc” 2017, 2018
  
RealSelf100
  
America’s Top Plastic Surgeons, Consumer’s Research Council, 2010 – 2018
  
BeautyAdvisor Top Contributor

How long should I wait for a facelift after jaw surgery?

Answers (11)

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