Brow lift and Facelift to freshen up? (Photos)

Technically have SLE in my blood but I only was allergic to the sun and now I'm not even allergic to the sun anymore. I Take 100 mg. of Plaquenil 2 X a week and had a bone marrow transplant in 2009 with myself as a donor. (Had Lymphoma). I also have Renauds. I know that I'm not an ideal candidate for cosmetic surgery but I've been told that it can be done so if so, what should I be looking at to "freshen up"? Thank you so much for your input. I know it sounds so risky but I'm so healthy!

Doctor Answers 8

Facelift and brow lift candidate

It is important to get medical clearance from your primary care physician before electing to undergo cosmetic surgery. In addition, a full set of facial photographs are required to make a determination about being a surgical candidate for two different procedures. When considering brow lift, the height of the eyebrows  can be adjusted and lifted along with addressing the asymmetries that are present because one eyebrow is always lower than the other. In addition, there's a high hairline present which can be shortened  by placement of the incision at the hairline. The corrugator, procerus, and frontalis muscles can also be softened surgically. A facelift procedure can accomplish tightening loose facial and neck skin, tightening  loose facial and neck muscles, removing any fatty deposits in the neck, and lifting the jowls. It is important to find a surgeon who can do both procedures and give a very natural result. For more information in many examples, please see the link and the video below


Seattle Facial Plastic Surgeon
4.8 out of 5 stars 129 reviews

Best treatment of facial aging and medical conditions?

you should have the medical issues cleared by your doctor's taking care of these. If they determine that you are a normal risk for surgery then the following would be best for you.  A brow lift done using the Irregular Trichophytic Forhead Lift  we developed more than 35 years ago will allow your hairline to be lowered at the same time that your brows are raised.  You should look at the surgeons results of his incision and you should not see a scar. Secondly you would benefit from a lower eyelid blepharoplasty  with fat repositioning as well as a chin implant. A facelift  can be done at the same time or add a separate session. Make sure you see a very experienced surgeon with these techniques and look at actual photographs of his results. 

Toby Mayer, MD
Beverly Hills Facial Plastic Surgeon
4.7 out of 5 stars 32 reviews

Facelift for patients with medical problems

All patients should have a complete physical examination prior to considering any surgery.  For patients with specific medical problems requiring the care of a specialist (often heart issues, SLE, clotting issues), a specialist should weigh in on the how best to manage the patient's medical problems.

Once the evaluations are finished, the doctors can make an assessment of the risk, and the surgeon can also tailor the surgery to have the best outcome.

Occasionally the medical problems are so significant that patients should be offered lesser surgeries or minimally invasive procedures, and still get a nice cosmetic result... without unnecessary risk!

If doctors are too willing to operate without adequate health screening, that's a bit of a red flag and patients should move on.

Brent Moelleken, MD
Beverly Hills Plastic Surgeon
4.9 out of 5 stars 136 reviews

Facial makeover

I'm glad that your health has improved and you are now feeling better. To really achieve the ideal facial rejuvenation result for your, based on your photos, there are a lot of different options to hit the "home run".

In assessing the face, we often divide the face into three sections, upper, middle, and lower. Below, I've identified each of these three areas more specifically, and made recommendations on each section for you, based on what we see on the two photos that you have provided: 

1. Forehead/eyebrow/upper eyelid:  You seem to have a low eyebrow position that is crowding your eyes and causing some hooding on the outside corner of your eyelids.  In addition you the photo shows that you have a somewhat high hairline. The ideal procedure to improve these issues would be a hairline (trichophytic) brow lift. This not only would improve the brow position, but gives the opportunity to lower your hairline a bit.

2. Lower eyelid/ and midface: You photo shows lower eyelid bags which is the common aging change when your eye socket fat migrates forward into the eyelids. Additionally, you have a very thin face indicating loss of facial fat, another common aging change. Ideally, I would recommend a lower eyelid blepharoplasty with fat repositioning to minimize eyelid hollowness while addressing the bags. In addition, you are an ideal candidate for facial fat grafting. face/neck lift to address the jaw and neck line. The photos also suggest that you have fat volume loss along the temples, the cheeks, and along the nose and mouth (marionette region and nasolabial region). Fat grafting is an excellent way to augment the volume and is a tremendous tool in conjunction with a lower face and neck lift

3. Lower face (jawline) and neck line. Your photos are not ideal for assessing this, but it seems that you do have some jowling along the jaw and possible some laxity in the neck region. A face and neck lift (usually just called face lift) would provide the ideal method of addressing this. 

Finally, your skin also shows signs of photoaging, that is aging damage that is amplified by sun exposure to produce wrinkling. You are an ideal candidate for CO2 laser resurfacing to address the wrinkling in your forehead, around the eyes and the mouth. This procedure needs to be staged a few weeks after a face and neck lift, because done together, it could compromise blood flow to the skin and cause skin healing problems including possible necrosis. 

I have listed what is possible for you to achieve the ideal outcome. Having said that, there is no rule that says you have to do everything at once. Each procedure does have a financial cost associated with it, so although it would be ideal to do everything at once (minus the laser resurfacing if doing the face lift), each of these procedures can be done as a stand alone procedure and would give you improvement in the areas I've indicated. Its important for you to meet with a surgeon that is experienced in all these procedures, and together you can formulate a plan that is right for you. 

Best of luck to you, and again I'm happy for your improved overall health. 

A.J. Amadi, MD
Seattle Oculoplastic Surgeon
5.0 out of 5 stars 32 reviews

Brow and Facelift to Freshen Up

If you have medical clearance, which you probably do, I suggest your consider the following procedures. A hairline brow lift, using the Irregular Trichophytic Hairline Incision Technique that we described many years ago combined with hairline lowering to improve facial proportions, a lower eyelid blepharoplasty to remove the fullness of the lids, a facelift, and a chin implant or any combination of these procedures will help you achieve the rested look you desire.

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 38 reviews

Brow lift and Facelift to freshen up?

Thank you for your question. Medical issues aside I think you are a good candidate for rejuvenative facial plastic surgery.  The photos suggest you would benefit from a prehairline browlift, face and necklift, possible chin implant as well as fat injections to the cheeks chin and jaw line.  It also appears that you would benefit from lower eyelid surgery to reduce the fat prominences.


Meet with an ABPS board-certified plastic surgeon or facial plastic surgeon to discuss options and review photos of other patients.  If for some reason you are found not to be a candidate for surgery, then you might consider a fractionated CO2 laser peel to freshen your look and improve your skin quality.  There is much potential for you so good luck and best wishes.  Enjoy the video above for additional information.

Jon A Perlman M.D., FACS
Diplomate, American Board of Plastic Surgery
Member, American Society for Aesthetic Plastic Surgery (ASAPS)
ABC-TV Extreme Makeover Surgeon
Beverly Hills, California

Jon A. Perlman, MD
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 30 reviews

SLE, Plaquenil and face lifting

In addition to the previous recommendations consider that

Plaquenil can affect platelet function therefore increasing the 

risks of post op hematoma. This issue must be addressed before

any cosmetic procedure. Best wishes.

Fernando Colon, MD
Columbus Plastic Surgeon
5.0 out of 5 stars 15 reviews

Brow Lift

Thank you for your question. A brow lift and a face lift are options that can provide you with a more youthful appearance. Endoscopic lifting procedures are less invasive than routine full facial plastic surgical procedures. The underlying fat, tendons, and muscles are precisely lifted to create a more youthful facial appearance. Most people experience minimal swelling and bruising and can usually return to work within a few days. I suggest that you move forward and consult with a board certified facial plastic surgeon. An in-person examination with a full health profile review will provide you and your surgeon the necessary insight to explore suitable procedures.

Best wishes,

Ross A. Clevens, MD
Melbourne Facial Plastic Surgeon
4.7 out of 5 stars 95 reviews

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.