Fraxel and Facelift Done Within the Same Year?

I have been to a couple of plastic surgeons. One says to get facelift, another says to get Fraxel. Can I have the Fraxel done first and then do the facelift in the same year? I also just had Thermage done 1 month ago, with no results. Will this affect any of these procedures?

Doctor Answers 12

Facelift or Fraxel first, it doesn't really matter

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It is perfectly acceptable to perform either the facelift or the Fraxel first; it does not really matter. The Fraxel is performed for smoothing out the skin color and tone and getting rid of age spots. The facelift is done to tighten up the deep structures such as tightening of the neck muscles, eliminating jowls, removing fat in the neck both above and below the platysma, and tightening the gristle layer underneath the facial structure called the SMAS. Thermage will do none of the above.

Seattle Facial Plastic Surgeon
4.8 out of 5 stars 158 reviews

Fraxel and Facelift

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With minimal excess skin, and skin texture or skin quality problems, the fraxel treatment may be adequate. If there is moderate or significant excass skin, a facelift would be a better choice. The fraxel treatment could then be used for refinement of the surgical result about 6 months later. I know I have used subjective terms such as "minimal" and "moderate" in my response; that is why you need consultation wih a physician who uses both approaches.

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 43 reviews

Fraxel and/or Facelift Within the Same Year for Saggy Skin?

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Dear SaggySkin,

The question is how saggy?

If you have excessive loose skin of neck and face, then a face lift would be indicated.

If you have minimal to moderate skin laxity of your neck and face then a Fraxel repair (or two, 4-6 months later) will give enough tightening to avoid surgery. In addition, your skin tone, texture, and color will be rejuvenated.

The patient in photo #3 of the before and after pictures of the web reference below presented to my office with your exact question. It was decided to treat her with Fraxel repair. She had two treatments and couldn't be more satisfied, and is very pleased that she did not have to under surgical treatment.

Without seeing your photos and examining you, it is difficult to answer your question, but I would most likely advise Fraxel repair first, you can always opt for a second repair or surgery within months if you are not satisfied.

Good luck and be well.

Dr. P

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

Do Both!!!

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The best option may be a facelift and carbon dioxide laser resurfacing. These can be done at the same time. If you were to consider both treatments though, I would not do the laser first followed by the facelift because you will not get the maximum benefit from the laser. Thermage will not effect either procedure and if you have signficant skin laxity and aging changes, it is no surpise that you did not see a change after Thermage. As always - an evaluation by a facial plastic surgeon or plastic surgeon who performs a full range of procedures is your best option.

D.J. Verret, MD
Dallas Facial Plastic Surgeon

It depends on the surgeon and the surgery.

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 If you have skin pigmentation,etc. then the Fraxel is for that. If you have sagging skin primarily, a facelift is what you need. Do which of these bothers you the most.

Toby Mayer, MD
Beverly Hills Facial Plastic Surgeon
4.8 out of 5 stars 38 reviews

Combination is best

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HI--I agree with Dr. Lupo. You would benefit most from a combination of laser resurfacing (Fraxel repair and others) and a surgical lift . In our practice, we have dwermatologists and plastic surgeons working together as a team and we will often do these procedures on the same day, which is great for the patient as this yields the best results, and allows for one recovery period. I have posted some photos on my profile which show some nice results using this combination approach. Take care, Dr. Groff

William Groff, DO
San Diego Dermatologist
4.9 out of 5 stars 51 reviews

Fraxel and Facelift in the same year

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Dont' waste your money on Fraxel, you already wasted it on Thermage. If you qualify for a Facelfit then Fraxel will not fix your problem.


Tanveer Janjua, MD
Bedminster Facial Plastic Surgeon
5.0 out of 5 stars 126 reviews

Facelift then Fraxel : it's like putting the icing on the cake

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Hello Saggyskin,

You have already received excellent advice from Drs. Rosen & Lupo, I would just add from a surgical perspective that if your anatomy is such that your case requires addressing both loose skin / sagging muscles and improving skin tone / appearance then you should consider having a facelift first and then fraxel (or other laser treatment / chemical peel).

A facelift will address the "core anatomy" of your face - improving jowls, removing excess skin and addressing a turkey neck (via necklift). In addition most modern facelift approaches incorporate techniques to provide volume restoration via elevation and repositioning of the droopy facial tissues during the facelift or autologous fat injections.

Fraxel will improve skin tone and reduce fine wrinkles and effectively improve the overall appearance of your skin.

In essence you bake the the cake first (facelift) and then add the icing (fraxel) to get an elegant and satisfying result!

Finally from a technical standpoint, during a facelift excess skin is removed and as healing occurrs (specifically "good" scarring that occurs under the skin where it was lifted up) you will see some tightening of your skin from the facelift alone. Therefore it is my opinion to let this occur (typically within 3-6 months) and then utilize Fraxel in a directed manner to address any residual skin quality issues (sun damage, fine wrinkles, blemishes).

Sorry about the Thermage experience - it should not have impact on any future procedures you decide to undergoe.

Take Care,

Dr. Kamran Jafri

Kamran Jafri, MD
New York Facial Plastic Surgeon

Perhaps you should have both Fraxel and Facelift at the same session

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Our routine current facelift now includes the use of the Mixto laser usually as part of the same session. It is entirely safe (we have already done over 50 patients since we acquired it the Mixto.)

This allows us to remove surgically excess skin, tighten the remaining skin, as well as deal with weathering and fine wrinkles at the same session. It gives a tremendous amount of improvement using less invasive techniques and making the most of "synergy" where each modality compliments the other. You also have the advantage of one operative event, one recovery, and less expense than having multiple procedures seperately.

We have completely retired our Fraxel as less effective, too painful, and not the equal of other lasers now on the market, especially the Mixto. That is our personal opinion having had experience with many resurfacing lasers dating back almost 15 years.

Nathan Mayl, MD (retired)
Fort Lauderdale Plastic Surgeon

Fraxel and Facelift do differnt things

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You are talking apples and squash here. Facelifts are for loose skin. It will not give the face fullness or softness (like a filler would), nor will it improve texture, color and fine lines (like resurfacing with laser or peels) will.

Fact is, most people need all three. If you just get a facelift, your face gets smaller, your skin is tighter and sagging is improved, but you won't look younger unless you also get some volumetric filling. If your skin color and texture is poor, just pulling it tighter or filling it up won't make people admire your looks. Luminous skin goes a long way to improve how you look. It sounds like you need a plastic surgeon AND dermatologist so your skin needs can be addressed too.

PS Thermage and Titan are only good for the 30-55 year olds who have not let things go too long. Once the sagging is severe, these technologies are, indeed, a waste of time and money in my opinion.

Mary P. Lupo, MD
New Orleans Dermatologist
5.0 out of 5 stars 18 reviews

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.