Will having a lower bleph with canthoplexy now cause any problems if i do a brow lift or deep plane facelift in a year or so?

Question

I am 52 and after having a bag under my left eye since my early 20s and now under both eyes, I’m looking into proceduresprocedures. I had an offer bleph three years ago that was paid for by insurance. The heaviness of my lids has returned, and my right eyebrow is lower than my left and has been for a long time I was previously getting Botox in my 1 deep line of that same side and some to lift that brow. One of my consultations recommended lower bleph with canoplexy and CO2 laser, no skin pinch. Upper bleph with some fat removal and internal brow lift. I am considering just the lower bleph and canoplexy, laser for now because of healing and timing. If I were to do a deep plane, facelift or brow lift in the next year or two with their be any issues or things to look for because of the lower bleph? Also the internal brow lift seems temporary as the stitch dissolves. Is It’s it worth doing now or should i do something more later and do a little Botox again after healing until then?

Carl Truesdale, MD · Answer

This is a really common question and the answer is yes, sequencing is fine. The key is doing them in the right order.
Lower bleph with canthopexy first makes total sense given your symptoms. Address the most bothersome issue, get a real result, then assess whether the upper face needs more in a year.
When you come back for the brow lift and deep plane facelift, the prior lower bleph doesn't complicate things in any meaningful way as long as 9 to 12 months have passed. The lower lid tissue planes will have fully healed by then, and the canthal anchoring will hold up during a subsequent facelift without any issue. Many surgeons (myself included) prefer this staged approach because each procedure can be evaluated on its own merits.
A few things to know:
Healing time matters. Twelve months is the sweet spot before the next operation. Less than 9 months and the tissue is still settling. More than 24 months is fine but unnecessary.
Photograph the result of the first operation at 6 weeks and 6 months. Bring those photos to the surgeon planning the second stage so they can see your healing pattern. Some patients are slow healers and that affects timing.
If you stay with the same surgeon for all of it, they have institutional memory of your case. If you switch, the new surgeon needs old op reports.
Don't combine canthopexy with deep plane facelift in the same operation if you can avoid it. The vectors are different, and combining them sometimes creates a slightly unnatural look at the lateral canthus. Staging gives cleaner results.
You're approaching this thoughtfully and the plan you're describing is exactly how I'd advise a patient your age with the same starting anatomy.

William Portuese, MD · Answer

Eyelid surgery will not affect a future brow lift or a facelift procedure. You can do these procedures together, or separately, depending upon your own timing

Philip Wasicek, MD · Answer

Hello, 
In general, a lower blepharoplasty (with or without canthopexy) should not interfere with your ability to undergo (or results from) a deep plane facelift or browlift in the future. 
With regards to whether or not you should have a browlift (internal)--it entirely depends on the degree of brow ptosis and amount that will be corrected in comparison to how much it bothers you/you want it addressed. This is a personal, patient-specific decision. 
Hope this helps.

Will having a lower bleph with canthoplexy now cause any problems if i do a brow lift or deep plane facelift in a year or so?

Answers (3)

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