If you're going to do a brow lift, blepharoplasty, or rhinoplasty, should you do that first, or the laser resurfacing? If you should do one first, how long should you wait in between? Can you do both at the same time?
Surgery and a Laser Resurfacing, Which to Do First?
Doctor Answers 12
Laser Resurfacing at the time of facial surgery
Depending on the details of the planned operation, as well as the type of laser preferred by your surgeon, laser resurfacing might be safely combined with your procedure.
Ask your surgeon what he/she recommends.
Surgery and Resurfacing
It was believed in the past that doing a surgery and resurfacing on top was not possible. Today we are finding that the new laser technologies for resurfacing are allowing to safely resurface and lift the face at the same time. You must select a physician that is experienced in doing both surgeries at the same time with experience. I hope all goes well.
Yes, you could combine all these procedures. That way you would have only one recovery as well as one surgery. I prefer to use the fractionated CO2 laser for resurfacing. The results may not be as dramatic as a full blast CO2 laser but the healing time is much less and the results usually pleasing to the patient.
Laser before, during or after browlift and blepharoplasty
There are pros and cons to dong laser before or after the surgery. If laser is done before, it may tighten the skin of the lower eyelids significantly and then the surgeon would remove less skin during the blepharoplasty, whereas if the laser were done after the blephaoplasty, there is a chance the skin tightening could over tighten the skin and pull the eyelid down subjecting the eye to chronic irritation. But, if the surgery is done first, then there is less that the laser has to do and healing might be faster. As long as the skin that is being lasered is not loosened from its underlying attachments during surgery (undermining) then it is up to the surgeon to determine if doing the laser at the same session as the blepharoplasty is in order.
Surgery and laser
If you are doing a brow lift, eyes, and nose, you can possibly have a laser resurfacing of the areas that were not undermined on the face at the same time.
Combination laser and surgery
Most plastic surgery procedures involve some degree of undermining of the skin which temporarily decreases the blood supply to the skin which remains after surgery. For this reason, it is best to be conservative when combining laser and surgery because of potential problems with wound healing. This problem is more significant with fully ablative lasers than with fractionated or nonablative lasers.
I like to combine lasers with surgery because I believe that lifting the face is only part of the rejuvenation process. If you have a perfect facelift or browlift but still aged skin, the result is lacking. My suggestion is to discuss your plans and goals very carefully with your surgeon. I would avoid combining a fully ablative laser with surgery and suggest staging the procedures. Alternatively, I believe that in skilled hands combining surgery with a fractionated laser (example Fraxel Repair) or nonablative laser (example Fraxel Restore) can give you excellent result in a single surgery.
Combined surgery and laser resurfacing may be appropriate
Combined facial surgery and laser resurfacing will work in many situations. It depends upon pathology. In fact I am presenting a poster this weekend at the American society of laser medicine and surgery meeting on combined laser resurfacing and facelifting. It is important to go to an experienced surgeon for this combination.
Aesthetic facial procedures and laser resurfacing
I would recommend doing the surgical lifting procedures first for several reasons. Often when performing a browlif, the horizontal wrinkles are softened and the depth of laser penetration and downtime can often be lessened. Also, if the scars do not heal as well as you like, the laser for resurfacing can be used to soften those scars as well. However, if you are time limited, you can combine a laser resurfacing with the surgical procedures; however, for obvious reasons you cannot resurface the nose at the same time as performing a rhinoplasty. I hope this information helps.
Staged or combined facial surgery and laser resurfacing
I would generally prefer to perform a face lift, rhytidectomy, melopasty, etc as my first procedure of choice followed by a resurfacing procedure. When it comes to a brow lift and rhinoplasty these can usually be combined. There is some controversy about eyelid lifts (blepharoplasty) and resurfacing procedures performed at the same setting.
Timing of laser resurfacing and facial surgery
In general it is better to not injure the skin from below with surgery and directly above with a laser at the same time for obvious reasons-there is a greater risk that patch of skin will not survive. Therefore it is not advisable to use an ablative laser over the nose or forehead at the same time as a rhinoplasty or brow lift. That has historically been correct but times have changed. With minimal or less invasive surgery you can laser at the same time. Also with the appearance of fractional lasers the damage to the skin surface is significantly less.
The answer then is it depends on what type of brow lift or rhinoplasty you have and what type of laser is used.
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.