Tired eyes, a heavy brow and a softened jawline often appear on the same face, yet each belongs to a different operation. A facelift lifts the lower face and neck. Eyelid surgery treats the lids. A brow lift raises the brows and smooths the forehead.
That raises a practical matter for anyone who sees all three changes in the mirror: whether the work can happen in one trip to the operating room. A Houston practice that describes facelift surgery near Houston in detail lists eyelid surgery among the procedures it combines with a lift, and its brow lift guidance notes that the two can be paired as well.
The practice belongs to Leo Lapuerta, MD, FACS, a triple board-certified plastic surgeon with more than 30 years of experience. Its published guidance explains what each procedure contributes.
Dividing the face by zone
A facelift, according to the practice, targets sagging along the jawline, loose skin in the lower cheeks, deep folds and excess skin beneath the chin. Its focus is the lower face and neck. The eyes and brows have their own procedures, and a combined plan assigns each zone to the operation designed for it.
The practice’s brow lift guidance makes the split explicit. If wrinkles, loose skin and sagging brows sit in the forehead, a brow lift may be sufficient. Jowls and lines along the lower face point toward a facelift. Some faces need both.
Adding eyelid surgery
Blepharoplasty removes excess tissue around the eyes. Upper eyelid surgery takes away sagging skin, with the incision placed in the natural crease of the lid. Lower eyelid surgery addresses bags and excess fat through an incision just beneath the lash line, or through an incision inside the lower lid in a transconjunctival approach for patients with good skin elasticity.
The practice says upper or lower eyelid surgery alone takes about 60 to 90 minutes, and both sets of lids can take up to two hours. Most patients can return to work within a few days and resume exercise around two weeks after the procedure.
Upper eyelid surgery can also serve a function. Excess skin can hang low enough to block part of the field of vision, and removing it can improve sight as well as appearance.
Adding a brow lift
A brow lift corrects brows that sag or lose their symmetry with age. The practice describes three techniques. A direct brow lift uses an incision in the upper eyelid crease or at the brow and does not affect the forehead. An endoscopic lift uses several small incisions of 1 inch or less near the hairline, though the practice notes its results can be unpredictable. A coronal lift places a longer incision several inches above the hairline, hidden by hair, and in most cases moves the hairline higher.
The practice performs brow lifts under general anesthesia as an outpatient procedure in an accredited surgical facility, in about two hours. Patients can return to work and normal activities within 10 to 14 days, and the practice estimates that results last roughly 10 to 12 years, sometimes longer, though aging continues and results vary from person to person.
One limit is worth knowing. The practice says blepharoplasty is not designed to treat crow’s feet, and it points to BOTOX or a brow lift for that concern. BOTOX can soften forehead lines, but the practice notes it will not lift sagging features.
The case for one operation
Combining procedures puts the work under a single anesthetic and a single recovery period, so the face heals as a whole rather than in stages months apart. The practice describes coordinated plans as producing more comprehensive facial rejuvenation.
It also sets a condition: each element should be selected for a reason, not added by default. A combination also means a longer operation. The practice notes that treatment length varies with whether other procedures are added to the facelift, and every procedure added brings its own risks into the plan.
Safety arrangements carry more weight as surgery lengthens. Dr. Lapuerta owns and operates a QuadA (AAAASF) accredited surgical facility and works only with physician anesthesiologists.
Before you agree to a combination
- Ask which concern each procedure addresses, one by one
- Ask whether BOTOX or another non-surgical option could handle any of them
- Ask how the combined operation changes your recovery plan
- Ask to see before-and-after images of patients who had the same combination
Dr. Lapuerta’s practice keeps more than 3,000 before-and-after images for review, and its brow lift guidance sets the standard worth checking for in them: brows that look awake and alert, without a wide-eyed or overdone expression.
This article is for general information only and is not medical advice. Results vary from patient to patient. Consult a board-certified plastic surgeon or your physician about your own situation. Written in partnership with Joseph Lambert, a publicist working with Leo Lapuerta, MD Plastic Surgery.