What Is The Risk Of a Facelift, Revision Rhinoplasty, and Laser Resurfacing at the Same Time?

I just turned 50 and am showing my age. Thinking of brow & neck lift (or full face lift), laser resurfacing, & revision rhinoplasty at the same time. Is this too much for one day? Too much risk to be under anesthesia for so long? Possible to do with local?

Doctor Answers 23

Risk of combining facelift with rhinoplasty and laser

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The risk of rhinoplasty with the other two is inconsequential.  The risk of laser following a SMAS plication lift is skin necrosis (death) especially on the lateral cheek near the ear.  The laser can be much more safely performed at the same time as a deep plane lift given the thickness of a composite skin flap.  You will need to take an antiviral like valtrex and use an occlusive dressing or ointment for a week following. 

Beverly Hills Facial Plastic Surgeon
5.0 out of 5 stars 52 reviews

Multiple Facial Surgeries Often Done at Same Time

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If you are in good health, non-smoker and the surgery will less than 4-6 hours than this may be a reasonable approach. We often do a combination of facial procedures at the same time. Ask your surgeon specifically for a risk benefit analysis of this option

Facelift, Revision Rhinoplasty, and Laser Resurfacing at the Same Time

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Assuming you are in good health, it is certainly feasible to have a face lift, laser resurfacing, and revision rhinoplasty. To reduce the risk of anesthesia, ensure that the facility has an MD anesthesiologist. If possible, the MD anesthesiologist should meet with you prior to your combination surgery to obtain full understanding of your case and to allow for proper planning.

Kris M. Reddy, MD, FACS
West Palm Beach Plastic Surgeon
4.5 out of 5 stars 56 reviews

Combination surgery

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As long as you are in good health, then combination surgery is quite safe.  We prefer use of IV sedation with local over general anesthesia to reduce the risks associated with a prolonged general anesthetic.

Sam Naficy, MD, FACS
Seattle Facial Plastic Surgeon
4.7 out of 5 stars 231 reviews

Risks of Simultaneous Face Lift, Revision Rhinoplasty, and Laser Resurfacing

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It is understandable why someone would want to have several procedures performed at the same setting-in order to decrease costs and have only one recovery period.  However, the most important concern needs to be patient safety.  Prolonged procedures are associated with increased blood loss, increased risks of infection, and increased risks of deep venous thrombosis.  I limit the length of any procedure(s) to 8 hours.  Laser resurfacing can be performed simultaneously with a face lift but should be limited to a light pass or no treatment of areas that have been undermined.  it is possible to perform this set of procedures under local anesthesia, but this would make for a long and uncomfortable day for the patient.


Michael Sundine, MD
Orange County Plastic Surgeon

Address brow lift, neck lift, laser & rhinoplasty at the same time

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I would always recommend addressing all of the areas that you are concerned about at the same time, if at all possible.  I think it yields the best results and the best possible overall outcome, the shortest overall recovery time, and it is often the most cost-effective. 

Having a brow and face/neck lift, revision rhinoplasty, and laser resurfacing as one combined procedure is commonly done and is certainly would not be considered too much to do at one time.  In fact, it makes good sense to combine all these procedures to achieve the best overall outcome. 

With regard to the laser, I prefer to avoid using full ablative laser resurfacing in the areas where a flap has been elevated–in this case, the lateral cheek and the forehead areas.  Instead, I would advise confining the laser portion of this procedure to the area around the mouth and the eyelids–areas that would not be involved in the surgery under consideration.  Laser resurfacing is often not required in the surgically treated areas referenced here.  If laser resurfacing is indicated in the cheeks and forehead areas, this can be delayed for at least 6 months following surgery.   You may be so pleased with the surgical results that you can delay much longer than this before contemplating any further laser resurfacing treatment.

Michael R. Macdonald, MD
Bay Area Facial Plastic Surgeon
4.6 out of 5 stars 18 reviews

Risks Are Higher with Facelift and Laser Resurfacing in General

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Dear lknfamily-

In general, most plastic surgeons don't perform a facelift and a skin resurfacing procedure at the same time.  The reason is because lifting and repositioning the skin and soft tissue of the face disrupts the blood supply to the face, and is done from underneath the skin.  Skin resurfacing, whether it's CO2 or Erbium-Yag or some other type of laser, also induces surgical stress, but from ABOVE the skin surface.

Depending on your type of skin, the type of facelift, the type of laser, and the settings of the laser, it is possible to have both a facelift and laser resurfacing at the same time.  However, most plastic surgeons recommend waiting for some time, typically 6-12 months, to get a skin resurfacing treatment, so that you'll be able to get a  the best overall aesthetic results possible. 

Doing a revision rhinoplasty with a facelift should be safe in terms of overall healing and blood flow. 

Have fun with your facial rejuvenation procedures!


Best Wishes,


Roy Kim, MD
San Francisco Plastic Surgeon

Combination Facial Cosmetic Surgery

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. It is certainly possible to combine these procedures in one setting - whether under IV sedation or general anesthesia depends on your facial surgeon's preference. Care must be taken with facelift and laser resurfacing comination: the resurfacing should be conservative in order to ensure safe healing of the skin.

Combining multiple facial procedures including rhinoplasty and facelift in one setting is common practice for us. But if you feel uncomfortable and feel that this is too much, don't do it but rather prioritize.

Frank P. Fechner, MD
Worcester Facial Plastic Surgeon
4.6 out of 5 stars 48 reviews

Risk of combining facial surgery and laser resurfacing

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It is best to not undergo laser resurfacing and a facelift at the same time due to insulting the skin from both underneath and the top portion of the skin.  It is acceptable to have a facelift and revision rhinoplasty at the same time, which could potentially take 5 hours to perform.  Five hours of anesthesia is probably a reasonable amount of time to undergo anesthesia for an outpatient surgery.  These types of procedures are not done under local anesthesia.  It is best to have a board certified physician anesthesiologist in attendance along with your surgeon and nurses in a certified ambulatory surgery center.  

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 157 reviews

Combination facial surgery

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First, I recommend that you have a consultation with a board certified plastic surgeon to clarify your options and prioritize these procedures. The first question is whether you need a face lift as opposed to laser resurfacing, which would produce some skin tightening. I personally do not perform rhinoplasty in conjunction with facial surgery because the intraoperative swelling from the rhinoplasty will create a distortion and restrict the ability to ascertain the extent of work required. Revision rhinoplasty is a delicate procedure and should be undertaken separately for the best possible result. Combining all of these procedures would entail surgery that could take six hours. Generally, local anesthesia with sedation would be inadequate for a procedure of this length and local anesthesia alone would be completely inadequate.

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.