Combined Procedures

Often patients will combine a facelift with other cosmetic procedures to achieve the desired rejuvenation. Since a facelift targets only the lower portion of the face, a second procedure may be needed if a patient would like to correct areas of the upper face, such as the eyelids, forehead or eyebrows. While any of these procedures can be performed before or after a facelift, many patients choose to combine procedures, thereby combining recovery time. If you are concerned with rejuvenating other areas of your face beyond the areas targeted by the facelift procedure, you should discuss this with your surgeon. Your surgeon will be able to guide you as to which procedures are easily combined, which will give you the best result, and how your recovery will be affected. Below listed are the most common procedures combined with facelifts:

Eyelid Lift (Blepharoplasty)

Blepharoplasty can be performed on the upper eyelids, lower eyelids or both. During a blepharoplasty of the upper lids, the surgeon will remove excess skin which causes eyes to look droopy. During a lower eyelid blepharoplasty, the surgeon will remove any “bags” under the eyes as well as tighten any excess skin as needed.

Blepharoplasty is best for those patients who are concerned with tired, sagging, puffy or droopy eyes. When observing another person, we tend to look at the eyes first. An eyelid lift can enhance a patient’s overall appearance and give them a rested, youthful but still natural, look.

Blepharoplasty is best for those patients who are concerned with tired, sagging, puffy or droopy eyes. When observing another person, we tend to look at the eyes first. An eyelid lift can enhance a patient’s overall appearance and give them a rested, youthful but still natural, look.

Browlift (Forehead Lift)

The eyebrows help frame the face and play a major role whether one’s eyes will appear angry, sad or tired. A browlift addresses a sagging forehead which in turn has caused the eyebrows to drop down and droop close to or on top of the upper eyelids. A low brow position can lead to an angry or sad appearance.

Generally, the desired position for female eyebrows is located on top of the bony ridge of the upper eye socket, called the orbital rim. This placement creates a pleasant and natural appearance without a “surprised” look which occurs if the eyebrows are too high. The desired position for male eyebrows is just at the level of the bony ridge. Because men’s brows naturally tend to be lower than women’s, browlifts in men are performed much less frequently.

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Chin Implant (Chin Augmentation)

As we age, the chin can recede due to a decrease in our bone and soft tissues. Your surgeon will look at a patient’s front view, but more importantly, his/her profile to determine whether a chin implant is necessary. A chin implant can help achieve balance in one’s face and help restore a youthful chin-neck angle. It can also help provide support for skin and tissue if the patient is getting a submentoplasty, or necklift. If the patient’s chin is a receding one, as the patient ages, this chin position is not prominent enough to hold tight the skin underneath. This in turn can cause the skin under the chin and in the neck area to loosen and sag, creating a section of hanging, drooping skin. When a patient has this type of profile, a chin implant may be recommended and once the excess skin is removed, the more prominent chin placement helps tightly anchor the new skin position so that future sagging is much less likely.

If you and your surgeon decide a chin implant is needed, the size of the implant will depend on several factors including your facial structure and gender. In men, a stronger chin is more desirable whereas in women, a smaller chin is more pleasing. Chin implants come in a variety of sizes and your surgeon will decide which one will be most aesthetically pleasing. In addition, the overall profile of nose, lips and chin contributes to the decision making. In a man, a strong chin is desirable; in a woman, a slightly smaller chin may be more aesthetically pleasing.

Cheek Implant (Cheek Augmentation)

As we age, osteoporosis can affect not only our spines but our facial bones, such as our chins and cheek bones. This can cause our cheeks to appear to sink in creating a hollow or gaunt look. Further, aging can cause the cheek bones to descend, making one’s face look square. By placing cheek implants in the ideal area, your surgeon can correct these problems, given you a more youthful and aesthetically pleasing appearance. Generally, the implants are placed through a small incision inside your mouth.

Lip/Mouth Enhancement

As with other parts of the face, the lips can lose volume over time. Additionally, lip skin can become sun-damaged causing lines and wrinkles to appear around the mouth. Your surgeon can use dermal fillers or fat to enhance the volume in your lip. Permanent lip implants may also be an option. Further, your surgeon can use laser resurfacing techniques or a chemical peel to soften or erase the lines around your mouth.

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Facial Resurfacing

As we age, we develop lines, wrinkles and brown spots on our skin. Sun exposure speeds up these signs of aging. The most common types of skin rejuvenation are through laser treatments such as IPL—intense pulsed light and laser skin resurfacing. IPL treatments erase brown spots while laser resurfacing removes the outer layers of the skin where the wrinkles lie, exposing the smoother skin underneath. Additionally, chemical peels can be used to address brown spots and wrinkles.

Recovery from a laser resurfacing or chemical peel can take from 1 to 3 weeks or longer, depending on the strength of the resurfacing. IPL treatments generally require no downtime. You should speak with your surgeon to determine which procedure will work best to give you the desired result.

Dermal Fillers

Dermal fillers are used to add volume to the skin. They are most commonly used to fill in the nasolabial folds (the lines which run from the nose to the mouth), to fill in “hollowing” or dark circles under the eyes, to add volume to the lips or to add volume to hollowed cheeks. The most common types of dermal fillers are Juvederm, Restylane, and Radiesse. These fillers are temporary and can last from six months to over a year, depending on the product and where in the face it is placed.

Rhinoplasty (Nose Reshaping Surgery)

As we age, our noses, like other parts of our bodies, will lose support and elasticity. This can cause some patients noses to droop and appear to “grow.” Improving the nasal appearance can help achieve a more younger and refreshed look. If you are concerned about the appearance of your nose, you should speak to your surgeon and he/she will help you decide if nose reshaping is appropriate.

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