Order of facial and scalp cosmetic surgeries?

Question

I would like to know the proper order of doing ALL of these procedures: Hairline lowering surgery, female hair transplant, eyebrow lift, full or mini facelift, upper and lower eyelid surgery, chin implant, rhinoplasty. Which can be done on the same day? One or more of these procedures would obviously need to be done first, and separate from the rest. Which surgeries would those be? Thank you.

Timothy Osborn, MD · Answer

The hairline lowering surgery and brow lift can easily be done at the same time. They would use the same incision. With a brow lift, that generally lifts and opens the eyes as well, so an upper blepharoplasty (eyelid) surgery may no longer be needed. With that, you could also get a rhinoplasty and chin implant with them as well. (I would look into a genioplasty before deciding on an implant. They offer more benefits and look more natural). Facial feminization or masculinization surgery is something our office specializes in. Those surgeries consist of many different procedures combined together to create a certain overall facial aesthetic, just like all the things you are looking to have done. With all those structural changes, I would wait to have a facelift until everything has settled and fully healed. I would say the hair transplant should come last, once everything is in its final place.

Jacob Tower, MD · Answer

Hello, hope you are well. Different surgeons may have somewhat different philosophies on this question. From a practical point of view, a forehead reduction (hairline lowering), brow lift, facelift, and upper and lower blepharoplasty are very commonly consolidated together as facial rejuvenation surgery, and a chin implant can easily be included in that grouping. The hairline lowering and brow lift must be performed together. The upper blepharoplasty should take place after the brow lift (either on the same day or staged). A straightforward rhinoplasty can also be included on the same day as everything else, but depending on the complexity (revision surgery, etc), your surgeon may advise that it is done separately. Finally, the hair grafts should be done last, after recovery from hairline lowering and brow lift. Cheers!
Best,Dr. Tower

Ronald J. Edelson, MD · Answer

Those can probably be done in a day. There is no “one way” to do this. You will get a variety of opinions from different surgeons depending on your desires and their experience

Connie Hiers, MD, FACS · Answer

I would start with the area that bothers you most. Not all facelift surgeons do rhinoplasties and many will not do rhinoplasties with other facial surgeries because of the increased risk of infection. The nose is a dirty place. The hair transplant and hair lowering procedures should not be done at the same time because of risking blood flow to the new transplants. With transplants, the hair lowering procedure may not be needed. Do the transplants first. The brow lift, eyelid surgery, facelift and chin implant can all be done at the same time.  The brow lift cannot be done with the transplants at the same time, but the hairline can be lowered with the brow lift through the same incision. I would find a facial plastic surgeon and discuss all your concerns and options and order of procedures.

Sudeep Roy, MD · Answer

This is a great question. I often touch upon this subject during my facelift consultations. There is real value in performing multiple facial rejuvenation procedures (such as lower facelifts, eyelids, lip lifts, fat transfers, chemical peels, chin implants, hairline lowering procedures) together as patients have to go under anesthesia once (albeit for longer), have only one recovery (albeit more intense downtime) and can start enjoying a more comprehensively rejuvenated face and neck sooner as opposed to if done in stages. Many patients, however, prefer to stage their facial rejuvenation in more digestible chunks, which decreases operative time, the intensity of the first 7-14 days of recovery/downtime and breaks up the cost of surgery in multiple stages (although may be more expensive overall). Ultimately, it really depends on the patient, their goals, their tolerance to downtime, their budget and whether or not they are traveling out of state or a long distance to see their surgeon. If you do decide to break it up, makes sense to address things regionally (i.e. chin implant with lower facelift +/- fat transfer; browlift, hairline lowering, upper and lower eyelids etc). Not everybody needs everything, which is where the real value of a consultation with a board-certified cosmetic facial surgeon is. Hope that answered the question sufficiently!

William Portuese, MD · Answer

Hairline lowering surgery and an eyebrow lift should be performed together. Hair transplant would be done separately. Facelift, eyelid surgery, rhinoplasty and chin implant can be performed together simultaneously under one anesthesia with one recovery. A full set of facial photographs from all angles are required to make a determination about being a candidate all these procedures

Jose Segura, MD, PhD - Account Suspended · Answer

Hello, in the case of the information you request, it would initially be the face surgery and later the nose and chin and finally the hair implant. This will depend on your health conditions to see what can be practiced first and if you comply with all the preoperative rules, for your case.I hope you consider this opinión.

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