.svg)
At May Plastic Surgery, “Can a facelift be combined with other procedures?” is a question we hear almost every day.
The short answer is yes, and for many patients, a combined approach is what makes the result look balanced rather than selectively refreshed.
A facelift is one of the most effective surgeries for rejuvenating the lower face, but it works within a defined area. Facial aging is rarely so contained, which is why Dr. May always starts by looking at the full picture: what changes you’re seeing, where you’re seeing them, and how they affect the face as a whole. He then walks you through what a facelift can and cannot accomplish, and whether anything else is worth considering to close the gaps for a more complete result.
What Drives Facial Aging?
Facial aging can be complex because it doesn’t happen all at once. And every layer of the face ages on its own timeline, heavily influenced by genetics and lifestyle.
On the surface, the skin loses its elasticity, leading to fine lines and texture changes. Deeper down, the fat pads thin out and shift, causing the cheeks and jawline to descend. Bone structure is also affected, as are the muscles and connective tissues that hold everything in place.
Some people primarily notice changes in skin texture. If you’ve spent a lot of time in the sun without proper UV protection, your earliest signs of aging might be wrinkles and “crepiness.” Others may have relatively few wrinkles but see bigger structural changes first, like sagging or jowls, especially if significant weight loss has made a loss of facial volume more apparent.
Because every face ages differently, Dr. Brian May builds a plan tailored to your unique needs and anatomy. Understanding which layers are most affected, and in what order, is what shapes every recommendation Dr. May makes.
What a Facelift Actually Does
Facelifts are one of Dr. May’s favorite surgeries to perform because of the nuance that goes into the planning process and the rewarding results. “They demand equal parts precision and artistry,” he explains. “Each case is deeply personal.”
As the name implies, a facelift works by lifting and repositioning the cheeks and jowls, areas on the lower face that are prone to being affected by gravity. It also tightens the underlying muscles and removes excess skin. A surgical facelift can create a sharper jawline and smooth out nasolabial folds between the nose and mouth, restoring a more youthful version of yourself while maintaining the features that make your face your own.
But it has limitations that are worth understanding.
What a facelift does not do is rejuvenate the eyes or raise a heavy brow. It also cannot replace lost facial volume or improve the tone or texture of the skin. A patient who has significant volume loss alongside skin laxity, or whose eyes look considerably older than the rest of the face, may find that a facelift alone creates a result that feels slightly off-balance.
What Changes Are You Noticing? Surgical Procedures That Pair Well With a Facelift
One of the first things Dr. May does when he meets with a new patient looking for facial rejuvenation is to read the face as a whole. He considers how the bone, fat, skin and muscles interact and how one feature impacts another. Depending on what you're seeing and where, certain procedures pair naturally with a facelift to produce a more balanced result.
If the signs of aging extend to your neck…
A facelift addresses the lower face, but on its own, it doesn’t rejuvenate the neck. And when an aging neck is left unchanged, the contrast between a lifted jawline and loose skin below it can
be noticeable. Combining a neck lift with facelift surgery allows Dr. May to treat both the lower face and neck in the same procedure for a more balanced result.
If your eyes look old or tired…
The skin around the eyes is thinner and more delicate than other areas. Because of this, the eyes are more prone to fine lines, wrinkles or sagging, giving the face a tired appearance even when you’re well-rested. Eyelid surgery, also called blepharoplasty, rejuvenates the upper and lower eyelids by removing excess skin and repositioning the underlying tissues to restore a vibrant look. Combining eyelid surgery with a facelift ensures the whole face, from eyes to jawline, is addressed, giving you a naturally youthful result.
If you’ve noticed a heavy brow…
Over time, the brow can begin to droop, giving you a stern or angry appearance. Dr. May often performs a brow lift alongside facelift surgery when aging has caused a heavy or descended brow in addition to sagging along the jawline. This surgery uses different techniques, such as temporal incisions or full hairline incisions, to remove excess skin and lift the brow, while also softening horizontal lines.
If volume loss is part of the equation…
A facelift repositions tissue. It cannot add back volume that's no longer there. Fat loss in the temples, beneath the eyes and in the cheeks is common with age, and it contributes to a hollowed look that lifting won't correct on its own. Fat grafting takes excess fat from another part of the body, typically the abdomen or thighs, and reintroduces it to areas where volume has been lost. For patients dealing with both laxity and volume loss, combining fat grafting with a facelift lets Dr. May address both in the same surgery.
What About Skin Quality? Nonsurgical Treatments That Can Extend or Enhance Your Results
A facelift targets the underlying tissues to restore a more youthful appearance, but doesn’t do much for the surface of the skin. At May Plastic Surgery, nonsurgical treatments (either before surgery or as part of an ongoing maintenance plan) can be used to address skin tone, texture and quality to meaningfully enhance and extend your long-term results.
Laser Resurfacing
Laser resurfacing is a method that can treat complexion concerns like sun damage and fine lines. Certain wavelengths are perfect for targeting hyperpigmentation from years of sun exposure, leaving the skin more even in tone. Other wavelengths penetrate deep into the skin and stimulate more collagen growth, which is ideal for patients who have fine lines and want their skin to be a little more resilient.
Chemical Peels
Chemical peels can be used when a patient’s skin is in need of exfoliation. Dead skin cells on the surface of the skin can make it look dull, and combining different strengths of certain chemicals can remove this outer layer and reveal the healthier skin beneath. These treatments can be used after facelift surgery to keep the skin radiant and youthful.
Microneedling
Microneedling is a minimally invasive treatment that uses dozens of tiny needles to create microchannels in the surface of the skin, prompting a healing response and stimulating the production of new collagen. This helps to smooth out an uneven texture, soften fine lines and break up or remodel scar tissue, with results that improve with each session.
The Benefits of Combining Surgical Procedures
While combination surgeries are not suitable for everyone, for the right patient, they can offer some benefits that staging procedures may not provide. Combining two or more procedures into one appointment means you only have one anesthesia event and one recovery period. Costs are also consolidated during a combined surgery, with one operating room fee and one anesthesiologist fee.
How Combination Procedures Are Chosen
The planning period is just as important as the surgery and recovery. This is a very personalized process that involves open communication between the provider and patient. Dr. May will consider some of these factors with you during your consultation:
- Your Anatomy: Your aging pattern will determine which additions may add value to your overall procedure.
- Health History: Tolerance for combined procedures is important. Dr. May will let you know if more than one procedure is recommended based on your health.
- Skin Quality: If you have poor skin quality, this can affect the results of your facelift. Your skin may benefit from nonsurgical treatments that boost its texture and elasticity.
- Honest Recommendations: Dr. May is comfortable saying “no” to requests when they are not safe or appropriate.
Is Combination Surgery Right for You?
The starting point for any surgery is always a consultation. This is the time when you can go over your health history and discuss the concerns that you would like to address through a facelift or other surgeries. Dr. Brian May is a board-certified plastic surgeon who knows how to look at the whole picture and customize a treatment plan that suits each patient. To schedule a consultation at May Plastic Surgery in Charlotte, NC, call 704-200-2493 or request an appointment online.
