Is It Better to Have Eyelid Surgery Now and Facelift Later?

I'm 52 and have less than $10K to spend. What's the best value for the money?

Doctor Answers 26

The most important thing here is finding the right surgeon

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Hi Jill,

It is possible to have your eyes and face done for the fee you mention including anesthesia but not by the best surgeons. I think there is a lot to be said for doing staged surgery rather than the blue plate special. In particular it is impossible to perform a finessed upper eyelid surgery when the patient is asleep under general anesthesia. The reason for this is that in order to get the best possible upper eyelid surgery result, it is essential that the patient can open and close the eyes to judge the effect of the surgery.

In general, many people start with the eyelid surgery because early changes to the eyes usually present before the face concerns. Doing the eyelid surgery does make a huge impact on the appearance.

The facelift continues to be the most powerful cosmetic surgery available. In shopping for a facelift surgeon they should board certified in facial plastic or general plastic surgery. However, this is only a minimum qualification and it does not guarantee the quality of the work. Some might disagree with me but I would advise you avoid surgeons involved in heavily marketed proprietary facelifts. These are generally one size fits all procedures are probably not good for many people.

I also suspect that these may be individual surgeons who for whatever reason could not establish their facelift practices on their own. Carefully review the before and after results of the surgeon. Do the faces look improved, natural, and serene? Or do they look pulled, unnatural, and surgical? Remember these images are the surgeon's best work. Check with the medical board of your State to learn if there are any license issues. Your surgeon should have malpractice insurance and hospital privileges for the surgeries they perform. If surgery will be performed in an office based surgery center, check on the accreditation of the facility by confirming with the accrediting organization that the facility is current.

Finally, a Google search may turn up some helpful reviews of your surgeon. However, recognize that some offices place their own favorable reviews, which is misleading, but goes on.

Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 26 reviews

Facelift and Eye lift- which first?

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Generally, it is best to have procedures combined in order to get the most harmonious result. The first step is to find a surgeon that you trust will do an excellent job. Don't worry about the money or trying to find a surgeon or facility that will get it done for you at the cheapest price. Having said that, the most expensive surgeon may not always be the best. So do your homework first. Once you have found the surgeon you trust, follow their advise. Sometimes, it is really not worth it to do one without the other because things look "off." A smooth neck and jawline will not match eyes with heavy skin or bags. On the other hand, if one is worse off and the other has minor age-related changes, then doing the one that is worse off may be perfectly fine. Each case is different. Good luck!

Dr. Karam

web reference:

Amir M. Karam, MD
San Diego Facial Plastic Surgeon
4.7 out of 5 stars 124 reviews

Eyelid Surgery Now and Facelift Later, What is Best

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Hi Jill,


If you are like most of the woman in their early 50's that I see daily in my Los Angeles facial plastic surgery practice, you most likely would benefit from Fraxel repair laser skin rejuvenation of your face, eyes, and neck.

Unless you have an excessive amount of neck skin, and Sharpei like facial folds, Fraxel repair will tighten the lax skin of your eye lids and neck, increase the volume of your midface, and improve the tone, texture, and color of your skin as well.

If after the treatment you still feel that you have excessive upper eye lid skin, that can be excised in the office under local anesthesia. If you feel that you need more skin tightening, you can always have another Fraxel repair treatment of your face and neck after 6 months. Even with two repair treatments you will still have some change left from your $10,000, money to put toward other procedures in the future should you wish to have them.

See the link below for some before and after photos of the treatment.

Do choose your plastic surgeon carefully.

Good luck and be well.

Dr. P

Michael A. Persky, MD
Encino Facial Plastic Surgeon
4.8 out of 5 stars 39 reviews

Eyelid surgery (blepharoplasty) is often done before facelifts (rhydidectomy)

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If your funds are limited and you have to make a choice as to where to direct your surgery, I would opine that for most individuals, the eyelids would be the place to start. The eyes are the focus of the face. When you are interacting with others their gaze is generally centered on your eyes. Although you may be bothered by looseness in your face or neck, if you were to have surgery, others would notice an enhancement or rejuvenation in your eyes more than your face. As an added incentive, the cost of eyelid surgery should be less than for a facelift.

These are all generalizations and for a more definitive answer you should seek a formal consultation with a board certified plastic surgeon.

I hope this is helpful. Good luck in seeking the care and treatment you desire.

Wayne I. Yamahata, MD
Sacramento Plastic Surgeon
4.9 out of 5 stars 50 reviews

How to Prioritize Facelift and Eyelid Surgery

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While it is ideal to combine these two procedures to save 2 weeks of recovery time, sometimes this is not possible due to finances.

Heres how to decide which to do first:

1. Eyelids First: If you believe you look tired or note bags and extra skin around your eyes, I would have the eyes done first. This will give you the most bang for the buck! Most of us focus on the eyes when we talk so it is a key are to start your facial rejuvenation.

2. Facelift First: If your neck bothers you because of the extra skin or neck bands and you are frequently pulling back your face and neck skin while looking in the mirror (and noticing how much better it looks) do the face first.

During the consultation I will ask the patient: "What is it you don't like when you look in the mirror"? They will almost always tell me the highest priority problem first. The great majority of time I agree with their order of priority.

When I list the proposed procedures on the scheduling sheet, I will let the patients know they are listed from the most important first to the least important last. That way they can elect how much they want to spend by deleting the lowest priority procedures when they are talking with my scheduling coordinator. This also takes the pressure off of them to commit to every procedure if they can't afford do do so.

Finally, with the current economy most plastic surgeons have reduced their fees, so you may be closer than you think to being able to do both. That extra two weeks of recovery is valuable also and it maybe worth financing part of the cost to avoid doing two surgeries instead of one.

Timing of facelift and eyelid surgery

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Ideally, these can be done together but do not do this by going to a deeply discounted surgeon as the best doctors will cost more. The answer of course depends on your anatomy but I would say that in 90% of cases, the face looks younger and more rested if you do your eyes without the face than if you do your face without the eyes. That is because people look directly at your eyes.

Face Rejuvenation

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It really depends on what bothers you most. It would be ideal to have it all done at the same time so you have one down time, one anesthesia and one recovery. However I understand from a financial standpoint, this is not always possible.

So I would recommend you decide what bothers you most and do that are first and come back to the rest later.

Good luck.

Farbod Esmailian, MD
Orange County Plastic Surgeon
5.0 out of 5 stars 88 reviews

Facelift and Eyelid surgery

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It is best in my opinion to perform facelift and eyelid surgery together, particularly if the lower eyelids are being done.

Modern approaches to the lower eyelid often include cheeklifts, procedures that blend the transition between the eyes and the cheeks. These are best performed at the same time as the facelift. The facial tissues are lifted up from below, and the cheek then blends more harmoniously with the eye region, occasionally with grafts, minimizing the transition.

While budget is always a concern these days, it may be better to wait and have an expert facelift surgeon do the procedures together that would give you the very best result.

Brent Moelleken, MD
Beverly Hills Plastic Surgeon
4.9 out of 5 stars 195 reviews

$10,000 should be enough for both!

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Dear Jill 1969,

You are almost there on the amount of money you need to do it all together. I am not familiar with aesthetic fees in the Dallas area, but I find it hard to believe that you can't get both the face and eyes done for under $12,000. Save a little more money and you will be saving in the long run on extra anesthesia and OR costs of having the procedures in stages.

Leslie H. Stevens, MD
Beverly Hills Plastic Surgeon

Eyelid Surgery Now and Facelift Soon After

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As the other doctors have noted, the eyelid surgery can be easier to recover from and is often a dramatic enhancement of your look. The face-lift can be done in the future. One option would be to consider an upper lid bleph and a full face laser resurfacing. If you would still like a lower face or neck lift surgery in the future you will already have beautiful eyes and skin to match. And if anything needs a little touch up you have the opportunity to do so at the time of the second procedure. Ultimately you should ask you well trained plastic surgery expert whom will examine you and give much better information after they are able to sit with you and examine the areas you feel you'd like to change.

Charles Perry, MD
Sacramento Plastic Surgeon

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.