Hello and thank you for your question. I would not recommend performing the laser resurfacing at the same time as the facelift. The reason is because during a facelift, you dissect the skin and subcutaneous fat from the mid/lower face and neck off of the deeper structures (SMAS layer in the face, and platysma muscle in the neck). This results in a vascular insult to the skin from below- it is then relying purely on undissected blood vessels and largely their distribution of blood, oxygen and nutrients through the random deep dermal capillary network within the dissected face/neck skin. Assuming the patient is a nonsmoker, this is usually more than sufficient and heals very well. When you perform laser resurfacing, you damage the skin from above, as you remove some of the outermost layer(s) to allow new, better quality skin to heal in from below. As a result, when you perform both a facelift and laser resurfacing at the same time, you are introducing insults to the skin from both above and below, further stressing/compromising the vascularity, and increasing the risk of skin/wound complications (e.g. delayed/poor wound healing, skin ischemia/necrosis, infection, etc). Based on all that, my practice separates these into two separate procedures. The only exception for me is when I am performing laser resurfacing on an area which is untouched/uninvolved during the facelift (e.g. laser to eyelids during surgical facelift), since this only introduces one insult to the skin at each location. Every surgeon is different, and some still feel it is safe to perform facelift and laser resurfacing at the same time. I hope this helps! Best wishes, Dr. Donald Groves Plastic Surgeon