How many facial procedures at once? Is it better to do a couple of them at a time to lower your risk of complications?

Question

What is a safe number of facial procedures to have at once and how would you combine them? For example: face lift, browlift, upper and lower blephoplasty, fat transfer? Is it better to do a couple of them at a time to lower your risk of complications? If so which procedures would you combine first? Thank you for your expertise!

Jeffrey M. Darrow, MD · Answer

It is very common to combine multiple facial rejuvenation procedures at once. It is very common to combine a facelift with upper and lower blepharoplasties.  Adding a brow lift and fat transfer should not increase the time of the operation much and should easily be accomplished within a safe time frame of approximately 6 hours.  The rate of complications when combining all these procedures is very low. Combining the procedures also benefits you, as you will only have one recovery and will lower your cost as you have a single surgery and a single anesthesia.  I hope this helps you. Best wishes.

Semih Yildiz, MD, FEPOBRAS · Answer

There is no fixed safe number of facial procedures; the safer way to plan is by total operating time, anesthesia risk, bleeding risk, medical history, and how much swelling or wound-healing burden is being created. In a healthy patient, it is common to combine procedures that work in the same field, such as a facelift/neck lift with upper and lower blepharoplasty, and sometimes conservative fat transfer or a brow lift when the surgeon feels the added time is reasonable.

Staging can be smarter if the plan becomes long, if there are medical risks, if extensive fat grafting is planned, or if the brow/eyelid/facelift decisions need more precise sequencing. I usually think in terms of priorities: address the main lower-face/neck laxity first with facelift/neck lift, add eyelid surgery if it clearly contributes to the aged look, and add brow lift or fat transfer only when the exam shows they are truly needed and the total plan remains efficient and safe.

Michelle Lee, MD · Answer

Great question! 
When it comes to cosmetic surgery on the face, and specifically in regards to the procedures you mentioned, it is typically better to have them done at the same time. That is, of course, if you are in good health and medically cleared to undergo a longer surgery. A few benefits to combining the procedures:1. One recovery period rather than several 2. Usually more cost effective 3. Surprisingly, having everything done at once can appear more natural and "harmonious". The human eye is trained to detect subtle differences and when one area shows signs of aging and another doesn't (for example, excess sagging skin around the eyes but a tight, sharp jawline) this can look very unnatural. 
There are limits/exceptions to combining surgeries of course and this can vary from surgeon to surgeon.

Ajaya Kashyap, MD · Answer

Thank you for your query. Many procedures can be combined while doing facial rejuvenation. The procedures that can be combined depend on the condition of your face as well as your skin and the comfort and experience of your surgeon. I often combine all the procedures you have mentioned. There is a single recovery and there are some advantages in terms of costs as well. Please find an experienced board certified plastic surgeon who can examine you and help you with all your concerns. All the best!

Stephen Prendiville, MD · Answer

For a healthy patient seeking facial rejuvenation, the set of procedures you mentioned can be safely performed at one time and is considered routine.  This assumes an experienced Surgeon who moves at a pace of an experienced Surgeon. This saves you from multiple anesthetics and multiple recoveries. However, if you have any cardiac, pulmonary or other chronic issues of concern, you should first have a complete medical workup to determine your suitability

Lexie Wang, MD · Answer

Hi! It's completely up to you/your body and your surgeon. If you have any risk for undergoing long trips of anesthesia, it might be better to split it up vs. multiple trips under anesthesia can also be risky. If it were not an issue of anesthesia alone, it is absolutely fine to undergo all of it at once. If you did want to split procedures, I usually recommend treating the eyes in their entirety in one unit because they will rely on each other (browlift will mean less skin excision for upper bleph, etc.), and then doing face in another go around (fat+facelift). Good luck!

Caitlin Iorio, MD · Answer

I generally think having one anesthetic and one recovery is best. However, there are limits to a surgeons ability to operate skillfully over very long cases. Each surgeon has their own rules of how long they’ll operate. The combination above is safe to perform as one procedure but you will have a long recovery and difficult few days after the procedure. If you were to break them into multiple procedures, I would combine the brow lift and blepharoplasties as one procedure and then do the facelift and fat grafting as another. Pending the technique used for the lower blepharoplasty, the surgeon may want to do fat grafting with that procedure.

Jacob Tower, MD · Answer

Hello, hope you are well. In my practice, I consolidate procedures under anesthesia whenever possible. It is safe, and saves the patient cost, recovery time, and reduces the number of anesthesia events. For the specific procedures you cited, I perform these together routinely. This is common practice across our specialty. 
Best,Dr. Tower

William Portuese, MD · Answer

A full set of facial photographs from all angles are required to make determination about being candidate for all of these different surgical procedures. In our practice, we do not like to exceed five hours of general anesthesia in an outpatient setting. You must have an excellent health history. It's important to ask your prospective surgeon how long it's going to take to perform all these different procedures. You don't want to end up in the hospital recuperating. Bundling facial plastic surgical procedures is very common, so that you have one anesthesia with one recovery. We do not perform facial fat grafting for a variety of reasons

Ronald J. Edelson, MD · Answer

All of those could safely be done at the same time. Personally I think fat transfer to the face is absolutely worthless and brow lifts aren’t so great either. Get another opinion. I suspect you can get an excellent result from a lesser involved and less expensive procedure.

How many facial procedures at once? Is it better to do a couple of them at a time to lower your risk of complications?

Answers (14)

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