When Getting Fraxel and a Mini Facelift, Which Would You Suggest Doing First?

Hi Docs!

You were so great in answering my previous questions. Now I am also considereing getting a "mini" facelift, as well as doing a Fraxel repair (or similar) laser resurfacing.

If doing these 2 procedures within a few weeks of each other, would you suggest doing surgery or laser resurfacing FIRST? To me it makes sense to do surgery and THEN the laser resurfacing...but really I have no clue! Or maybe it doesn't matter...?

I have some vacation and would like to fit it all in to one time frame, if possible.


Doctor Answers 5

You have to be careful here for a number of reasons....

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You have to be careful here for a number of reasons. Laser resurfacing of the skin is a burn which alters the skins blood supply. A facelift will raise the skin and also compromise the blood supply. Skin loss can occur when these procedures are combined. I am glad to hear you are staging them.
I must admit I do not know what a "mini" facelift means. That is not a medical term, it is a marketing term.The answer to your question is going to be dictated by how much skin elevation your surgeon intends to do at the time of your surgery.
Also these two techniques accomplish very different things. A facelift is necessary to place the facial structures back in a more youthful position. The laser resurfacing is needed to help the skin texture and color.
Generally speaking, I favor doing the surgery first, however I would determine which is your greater concern and choose the technique which will address that first. I would also wait at least 6 weeks between procedures.

Mini Facelift and FRAXEL during Same Surgery

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Depending on the FRAXEL laser settings, number of passes, health of your skin, whether or not you smoke among other factors and how invasive the facelift is will determine the safety of this procedure. Mini Face lifts and those that have limited undermining such as the MAC or LiteLift procedures are safer procedures for doing both of these procedures. Also it should be safe to do laser on those areas that are not undermined - such as the lips and chin area. I often do chemical peels and laser skin treatments at the same time as our limited incision face lifts (LiteLift) and have not seen an increase in complications. If you are going to stage the procedures then I would recommend the facelift first and then use the laser on the scars which can be beneficial.

Opinions are often given in the absence of experience with these combined techniques. My advice is to make sure you go to a board certified plastic surgeon you feel comfortable with and follow their recommendations.

Facelift before laser

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I always recommend doing a lift before the laser. This is because when you perform a laser procedure often there is an area that you feather the laser along the jawline to camouflage any potential color difference between the neck and facial skin.

During the mini-lift, you may have a skin shift that could potentially raise that feathered zone up onto your face or above the jawline.

Combined treatments are better!

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When doing combined treatments for the face, it is always better to do the lift before the laser. The excess skin removed from the facelift to make a more youthful appearance can then be lasered for a more polished firm look. Normal waiting time for the laser after a facelift would be 6-8 weeks post surgery.

I would suggest doing the mini-facelift first

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When I discuss mini facelift it is a procedure that has less skin separation from underlying muscles compared to standard facelift. In that regard there is less stress on the skin in general. Fraxel laser is also much less traumatic to the skin compared to old type of CO2 laser traetment.

I consider it safe to perform mini-facelift AND Fraxel laser at the same operation and have done this on my patients numerous times. If you did want to have them as separate operations I would suggest the mini-faeclift first and then the Fraxel laser second. Hope this helps.

Robert B. Pollack, MD
San Diego Plastic Surgeon

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.