​I have a chronic post nasal cough and I am very concerned that it will compromise a lower facelift. Thoughts?

There are a few things that are particularly problematic for bleeding immediately following a facelift.  Blood thinners, high blood pressure, and things that acutely raise venous pressure in the face (bending over, straining, and coughing!).  Make sure that your surgeon understands your condition and works with your general doctor to see if your cough would preclude such surgery or could be managed over the first week.  Good luck!Dr. Z

Your surgeon may want medical clearance from your primary care physician prior to your surgery. It is always in the best interest of the patient and surgeon if you are in your best health when embarking on elective surgery.

Hi, I have performed many SMAS facelifts and neck lifts for over 30 years and have performed many minimally, invasive SMAS facelifts over the past 15 years.  The less invasive the facelift, the less the risk of bleeding from increased pressure when coughing.  Non smiling photos of your face from the front and side would help in the evaluation.  The minimally, invasive SMAS facelift as described below would probably offer the highest degree of safety in light of your chronic cough.  
  If you have "jowls” these are sagging facial tissues and the main indication for some form of a SMAS facelift.  The underlying SMAS layer, of the face, must be dissected, lifted, trimmed and re-sutured (not merely folded or suspended with threads or sutures that will not last).  The excess skin is then removed and the facelift incisions closed.
 My most popular SMAS facelift is the minimally invasive, short incision SMAS facelift that has all the benefits of more invasive facelifts (traditional, mid-face, deep plane, cheek lift and subperiosteal facelifts) but with these added benefits:
very small incisions and no incisions extend or are placed within the hair.
minimal tissue dissection = less bruising and swelling = rapid recovery ( several days instead of weeks or months with the more invasive type facelifts mentioned)
can be performed in 90 minutes or less, with or without general anesthesia
no incisions within the hair = no hair loss
excess fat can be removed from the face and neck
excess skin removed from the face and neck
cheeks, chin and jaw line can be augmented with dermal fillers (I prefer Restylane Lyft) or facial implants
most patients fly back home to parts all over the world in as little as 3 days post-op
I combine facial shaping with every facelift procedure.  When jowls are present, these should be done in concert and not alone or separately in order to create a naturally, more attractive face. Following my beauty principles, women look the most feminine, youthful and attractive with heart shaped faces.  Heart shaped faces have cheeks that are full and round in the front.  For cheeks that are flat or concave in the front, cheek augmentation with a dermal filler or using cheek implants for a permanent enhancement will create full, round cheeks that will feminize the entire face.
 A weak chin creates an imbalance making the nose appear larger, the mid face top heavy and the lower face look short that de-emphasizes the lips and allows early formation of a double chin.  Chin augmentation using a chin implant will add projection to the chin creating harmony and balance to the lower face.  I have found placement of a silastic chin implant, through a small curved incision under the chin (also allows excess skin removal) to be very safe, quick and highly effective.
Hope this helps.