View source for Combining Facelift and Eyelid Surgery: Seattle Surgeons Weigh In 82609

<html><p> Seattle is a city that prizes subtlety. Patients here often want to look rested and vibrant, not “different.” That mindset shapes how facial plastic surgeons plan rejuvenation: a preference for natural contouring, careful pacing, and combinations that deliver balance rather than a single dramatic change. Nowhere is that more important than when pairing facelift surgery with eyelid surgery. Done well, these procedures work like harmony and melody. Done poorly, they can compete and call attention to themselves.</p> <p> I have sat across from hundreds of patients who pulled up their neck skin in the mirror, then pointed to their heavy eyelids. The conversation that follows usually revolves around timing, safety, sequencing, and the art of looking fresher without looking operated. Seattle surgeons who focus on facial work tend to agree on the broad principles, even if we each bring our own technique and aesthetic. Here is what the combined approach looks like in practice, the traps we try to avoid, and the details patients always appreciate knowing before they choose a surgical plan.</p><p> <img  src="https://www.seattlefacial.com/wp-content/uploads/2021/10/Surgical-Staff-Seattle-WA.jpg" style="max-width:500px;height:auto;" ></img></p> <h2> Why combine procedures at all</h2> <p> A facelift addresses the lower face and neck. It repositions descended facial fat pads, tightens the muscular layer known as the SMAS, and redrapes skin with restraint. An eyelid surgery, or blepharoplasty, improves excess upper eyelid skin, lower eyelid bags, and sometimes laxity in the eyelid itself. The two complement each other because aging is a full-face process. Jowls and a lax neck often arrive with upper eyelid hooding and lower lid puffiness. If you correct only one region, the untreated area can steal the show.</p> <p> I recall a patient in her late 50s who came in “for my neck only.” Her neck banding and jowls did age her, but she also had pronounced upper eyelid hooding that crowded her lashes. She was concerned about looking “done,” so we started with photos and 3D angles. It became clear that her eyes contributed more to a tired impression than she realized. We opted for a lower face and necklift with conservative upper blepharoplasty. Six months later, friends told her she looked like she had returned from a long, restorative vacation, not a surgeon’s office. That kind of reaction is what makes the combination compelling.</p> <h2> The anatomy of an elegant facelift</h2> <p> Even among surgeons, the term facelift can mean different things. In Seattle, surgeons who specialize in facial cosmetic surgery tend to favor deeper plane or SMAS-focused techniques for long-lasting, natural contours. Elevating and repositioning the SMAS allows us to lift the midface and jawline without overstretching the skin. The necklift component, often essential, targets platysma muscle bands, subplatysmal fat, and loose neck skin. The goal is a defined mandibular border, softened jowls, and a clean angle under the chin.</p> <p> A modern facelift relies on tension where the face once had it naturally: the deeper layers. Skin is then tailored gently, not pulled tight. A too-tight look almost always comes from using the skin as the lifting mechanism. By letting the SMAS carry the load, skin incisions heal more discretely around the ear and into the hairline, and the results hold better. Surgeons in our region often use loupe magnification, precise hemostasis, and a layered closure to minimize scarring.</p> <p> The neck deserves specific attention. If the central neck has vertical banding, we frequently add a submental incision to address the platysma bands directly. When the neck is full from fat behind the platysma, defatting under that muscle is more effective than superficial liposuction alone. Patients sometimes ask whether they can skip the necklift to keep recovery faster. If the neck is a problem, skipping it usually compromises the result. A crisp jawline against a lax neck reads as half-done. The balance of face and neck has to hold up in motion, not just in a forward-facing photograph.</p> <h2> Eyelid surgery, small millimeters with big impact</h2> <p> Upper eyelid surgery is measured in millimeters. Remove too little and you miss the relief from heaviness. Remove too much and the eyes look hollow or the crease sits unnaturally high. Surgeons often mark the upper lids with the patient seated and looking forward to understand how skin sits on the lash line. Brow position matters. If the brow has drifted down, a conservative upper blepharoplasty combined with a subtle lateral brow elevation can rejuvenate without the fixed look people fear. Many Seattle surgeons avoid the old full coronal brow lift on most patients and instead use limited, targeted maneuvers that lift the lateral brow tail a few millimeters.</p> <p> Lower eyelid surgery addresses either fat bags, skin redundancy, or both. If the primary issue is fat, a transconjunctival approach from inside the lid removes or repositions fat without a skin incision. If crepey skin is the bigger issue, a skin pinch or a skin-muscle flap can smooth the surface. Filler and energy devices have their role, but for frank herniated fat, surgery gives the cleaner and more durable result.</p> <p> Patients often conflate eyelid surgery with brow lifting. They are related but distinct. A low brow pushes skin onto the upper lid. If you only remove eyelid skin, a low brow may get lower still. Conversely, if you lift the brow without addressing significant eyelid skin, the upper lid can look swollen. The trick is to find the balance. Many of us start with the lid and add a subtle lateral brow move only if the aesthetic needs it.</p> <h2> Sequencing when done together</h2> <p> When combining a facelift and eyelid surgery in the same session, sequence matters. Most surgeons start with the upper face because swelling from lower face dissection can distort landmarks near the eye. Typically the order is upper eyelids, lower eyelids if indicated, then the facelift and necklift. If a small lateral brow elevation is planned, it often follows the upper lid marking to keep the crease and brow relationship natural.</p> <p> Expect a longer anesthesia time than with a single procedure. A combined operation may run three to five hours depending on the extent and surgeon’s technique. That adds efficiency and gives patients one recovery cycle, but it also requires careful patient selection. We screen for cardiopulmonary risk, control blood pressure tightly, and manage anticoagulants well ahead of time. Seattle centers familiar with facial plastic surgery have OR teams comfortable with the rhythm of these operations, which shortens anesthesia times and improves safety.</p> <h2> Who is a good candidate</h2> <p> The best candidates for combined facelift surgery and blepharoplasty typically share a few traits: good general health, non-smokers or willing to stop nicotine well in advance, realistic expectations, and specific concerns in both the lower face/neck and eyelids. Ages vary widely. Some are in their late 40s with early jowling and clear eyelid hooding. Others are in their 60s or early 70s and want a comprehensive reset with a plan for maintenance.</p> <p> There are gray zones. If someone has borderline eye dryness or a history of LASIK with dryness, we tread carefully with lower eyelid skin removal and may tailor the approach to protect lid support. If someone has thyroid eye disease or significant blepharoptosis, we coordinate with an oculoplastic colleague. Patients on blood thinners can still have surgery, but only with coordination from the prescribing physician and a cautious plan for perioperative management. Finally, smokers face higher risks of skin loss and wound healing issues, especially in the preauricular skin flaps. If quitting is not feasible, a staged approach might be safest.</p> <h2> The downtime, honestly</h2> <p> Most people look presentable for public activities around two to three weeks after combined surgery. That does not mean all swelling is gone. By two weeks, bruising is often yellow and fading. By four to six weeks, the face is reading as “normal” in person, even though patients may still feel mild tightness or a water-retention look on some mornings. The eyelids settle faster, though a tiny amount of lower lid swelling can linger for several months.</p> <p> Pain is usually well controlled with non-narcotic medication by day two. The first night can feel tight along the jawline and neck. We often place small drains for the facelift and necklift, removed the next day in most cases. Stitches around the eyelids often come out at day five to seven. Facelift incisions come out in stages, with fine hairline sutures sometimes staying in a bit longer. Makeup can camouflage most discoloration after the first week.</p> <p> Most surgeons ask patients to avoid strenuous exercise for three weeks and heavy lifting for four weeks, though light walks are encouraged early. Elevating the head of the bed helps. Ice on the eyelids in the first 48 hours can reduce puffiness, but we avoid direct cold compresses on facelift flaps. Salt intake matters; cut it to minimize swelling.</p><p> <iframe  src="https://maps.google.com/maps?width=100%&height=600&hl=en&coord=47.6092,-122.32411&q=The%20Seattle%20Facial%20Plastic%20Surgery%20Center&ie=UTF8&t=&z=14&iwloc=B&output=embed" width="560" height="315" style="border: none;" allowfullscreen="" ></iframe></p> <h2> Results that age well</h2> <p> A facelift and necklift typically last many years. Patients sometimes ask for numbers. A reasonable expectation is that a well-executed SMAS or deep-plane facelift keeps the lower face and neck improved for 8 to 12 years, sometimes longer depending on genetics and lifestyle. Blepharoplasty results can be even longer lived, particularly for upper lids, where excess skin rarely returns to its original degree. Lower lids can show mild recurrent puffiness over time as facial fat and ligaments continue to evolve with age.</p> <p> Maintenance does not necessarily mean more surgery. Non-surgical tools can preserve tone and texture. Light radiofrequency microneedling, fractional laser for fine lines around the eyes, and neuromodulators for crow’s feet can stretch results gracefully. Good skincare matters, particularly in Seattle’s varied climate, where long summers can ramp up UV exposure and winters can dry the skin. Sun protection, retinoids if tolerated, and a measured approach to exfoliation all help.</p> <h2> Common worries and how surgeons address them</h2> <p> Patients have repeat concerns before combined procedures, and it helps to hear how we mitigate them.</p> <ul>  <li> <p> Will I look like someone else? The point of combining is coherence, not change for its own sake. Natural facelifts focus on structure rather than skin tension, and eyelid surgery removes burden rather than carving the eye shape. Surgeons keep old photos nearby to hold the line on identity.</p></li> <li> <p> Are long procedures riskier? Longer anesthesia times do carry increased risk, which is why patient selection, blood pressure control, and efficient teams matter. Healthy candidates, in experienced hands, tolerate three to five hours well. If health issues complicate the picture, staging may be safer.</p></li> <li> <p> What about visible scars? Incisions hide along the tragus, around the ear lobe, and into the hairline. Eyelid incisions sit in natural creases. Early redness fades over weeks to months. Silicone sheeting and sun avoidance help. In Seattle’s cloudy months, compliance with sun protection is easier, which benefits scar maturation.</p></li> <li> <p> Can I combine rhinoplasty with these? Occasionally, yes, especially minor rhinoplasty refinements. But swelling dynamics differ, and the nose demands precise, undisturbed healing. Many surgeons prefer to stage rhinoplasty separately unless there is a strong reason to combine.</p></li> <li> <p> How do I avoid a pulled lower eyelid? Proper canthal support, conservative skin removal, and favoring a transconjunctival approach when appropriate. When surgeons respect lower eyelid support structures, the almond shape stays intact.</p><p> <iframe  src="https://www.google.com/maps/d/embed?mid=1vtH-4yi2mOIXhMEzgdYPqHnYLxIMAlk&ehbc=2E312F" width="560" height="315" style="border: none;" allowfullscreen="" ></iframe></p></li> </ul> <h2> Anesthesia choices and facility considerations</h2> <p> Most combined cases are done under general anesthesia for airway control and patient comfort. Some surgeons use deep IV sedation for isolated eyelid surgery, but adding a necklift changes the equation. The operating environment matters too. An accredited ambulatory surgery center with a board-certified anesthesia provider and trained facial plastic surgery staff keeps the operation efficient. The Seattle area has several such centers, many integrated into facial surgery practices that run these operations daily. That repetition shows up in the details: warmed ORs to protect facial flaps, quiet turnover to minimize delays, and recovery nurses who know exactly how to manage neck drains and eye compresses.</p> <h2> The art of not overdoing it</h2> <p> More is not always better. Patients sometimes request a menu of add-ons because they want to “do this once.” The temptation can be strong, but restraint pays off. A lateral brow move can refresh the frame of the eye, but an aggressive brow lift can look harsh. Over-resection of lower eyelid fat can leave a gaunt look that reads as illness. Excessive neck skin removal can distort the lobule or pull hairline incisions. Seattle surgeons, generally conservative by training and regional culture, often steer patients toward combinations that match their tissues rather than chasing a stylized finish.</p> <p> A practical rule: anything that requires unusual tension to achieve in the operating room will likely look odd after swelling subsides. The face appreciates proportionate corrections. Almost every revision consult I have seen after an out-of-town surgery has the same theme, tension applied where volume or repositioning should have done the work.</p> <h2> Costs, value, and where a combined approach saves</h2> <p> Combining procedures often reduces overall cost compared to staging. Patients pay for one facility fee and one anesthesia block. Recovery time off work consolidates into a single interval. That said, value is more than dollars. The biggest dividend is aesthetic coherence. When eyelids and lower face are refreshed together, the result reads as globally younger, not piecemeal.</p> <p> Patients frequently ask for quotes during the first visit. We can provide ranges, but precise fees depend on the extent of surgery and the setting. For context, in Seattle’s current market, a facelift with necklift can vary across a wide spectrum, and adding upper and lower eyelid surgery increases cost accordingly. The right way to think about it is outcome per unit of risk and downtime. If you already need a necklift for a defined jawline, and your eyelids make you look tired, combining gets you there with one rehabilitation.</p> <h2> Recovery pitfalls and how to avoid them</h2> <p> The two most important rules in the first two weeks are protect the incisions and protect your blood pressure. Spikes in pressure can cause a hematoma under the skin flaps, the most common early complication after facelift surgery. That means no heavy lifting, no bending over to tie shoes, and strict adherence to blood pressure medication if prescribed. Cough and constipation also spike pressure. We set up stool softeners and a cough plan in advance.</p> <p> Sleep with your head elevated on two pillows. Avoid turning your head sharply side to side. Most patients instinctively guard the area, but reminders help. Keep pets from jumping onto you in bed. It sounds silly until a cat lands on a fresh necklift.</p><p> <iframe  src="https://www.youtube.com/embed/ZBS3rUhSie4" width="560" height="315" style="border: none;" allowfullscreen="" ></iframe></p> <p> Dry eye after lower eyelid surgery can occur. We mitigate it with lubricating drops, gentle lid hygiene, and conservative skin trimming. If you have a history of dry eye, speak up early. We adjust technique and aftercare.</p> <p> Finally, don’t judge the result in the mirror at day five. Swelling plays tricks, especially asymmetry. Even the most even surgeon cannot defeat biology’s right-versus-left differences in the first week. A fair first impression lands around week three.</p> <h2> How non-surgical tools fit around combined surgery</h2> <p> Botulinum toxin and fillers remain useful adjuncts. If the brow elevators are overactive, a touch of neuromodulator later can smooth the forehead without a stronger brow lift. Filler can soften deep medial cheek grooves if midface volume remains modest after facelift repositioning. That said, surgeons in Seattle have become more conservative with filler after the wider recognition of filler-associated edema and contour distortion. The deep-plane facelift restores cheek support that makes filler unnecessary for many patients. Energy-based devices, used judiciously months after healing, can fine-tune texture and tone.</p> <p> Skincare deserves respect. A well-formulated retinoid, vitamin C, and diligent sunscreen keep surgical results looking crisp. Seattle’s light reflects off water and buildings even on overcast days, so sunscreen is not seasonal. Patients who adopt a routine nine to twelve weeks after surgery tend to get more mileage per operation.</p> <h2> The conversation you should have with your surgeon</h2> <p> A strong consultation sets expectations and clarifies priorities. The best consults feel like a collaboration, not a sales pitch. Bring old photos from your 30s and 40s. They show your personal baseline. Be candid about health history, medications, and what you can realistically manage in downtime. Ask your surgeon where they place tension, how they support the lower eyelid if needed, and what their hematoma rate is. Numbers matter. Experienced surgeons know their statistics and discuss them openly.</p> <p> Discuss scar strategy specific to your hairline and ear anatomy. Hairline shape, sideburn position, and earlobe attachment vary a lot in Seattle’s diverse population. Thoughtful incision mapping preserves identity. If prior rhinoplasty or significant nasal obstruction exists, mention it. Surgeons keep airways in mind during anesthesia, and any history of rhinoplasty helps the team avoid nasal pressure points or issues with airway adjuncts. Even though rhinoplasty is a separate procedure from a facelift or eyelid surgery, the interplay during anesthesia and postoperative swelling is real.</p> <h2> When staging makes more sense</h2> <p> Despite the advantages of combining, there are times to stage. Patients with complex eye conditions may benefit from an eyelid-first plan managed jointly with an oculoplastic surgeon. Patients with uncontrolled hypertension or sleep apnea sometimes do better with shorter surgeries while medical issues are stabilized. If someone wants substantial rhinoplasty changes along with a facelift and necklift, many surgeons separate the nose from the facial rejuvenation procedures to simplify swelling patterns and reduce the risk of cross-complication.</p> <p> Staging also helps the exceptionally cautious patient who needs to build trust through a smaller initial step. Upper blepharoplasty alone can be a <a href="https://xeon-wiki.win/index.php/Necklift_vs._Facelift_in_Seattle:_Which_Is_Right_for_You%3F_10369">board certified plastic surgeon</a> gentle introduction. Confidence grows, then the facelift follows several months later. The final aesthetic can be the same either way; it just takes longer to get there.</p> <h2> The Seattle aesthetic</h2> <p> A Seattle finish emphasizes proportion. Jawlines are crisp but not sharp, necks are clean but not hollow, and eyelids are open yet retain a soft fold. Men preserve the sideburn and tragal anatomy to keep a masculine look. Women avoid a raised hairline or pixie earlobes that betray surgery. Hiking, cycling, and saltwater kayaking remain part of life here. The face should look like it belongs in those settings.</p> <p> Patients often ask, “Will people know?” Most of the time, they notice, but they cannot name the change. Comments tend to be about rest, stress relief, or a new haircut. That is the ultimate compliment for a combined facelift and eyelid surgery: the work disappears and what remains is you, better rested and better defined.</p> <h2> A quick, sensible checklist for decision-making</h2> <ul>  <li> Clarify your top two priorities on your face, then confirm they match your surgeon’s plan.</li> <li> Ask how the surgeon supports the SMAS and the lower eyelid to avoid tension-based problems.</li> <li> Understand the first two weeks of restrictions and set up help at home ahead of time.</li> <li> Review scar placement on your own anatomy with a mirror and photos.</li> <li> Confirm contingency plans for blood pressure control and communication if concerns arise after hours.</li> </ul> <h2> Final thoughts from the operating room</h2> <p> The best combined operations feel unhurried, even when they move efficiently. They start with meticulous marking, progress through careful dissection with almost no bleeding, and end with quiet, deliberate closure. When the dressings come off the next day, the patient sees swelling, of course, but they also recognize the outline: a jawline they remember, eyes that carry less weight. Over the months that follow, the details refine. The goal is never perfection under a static ring light. The goal is to move through a Seattle morning, sip coffee, and have your face match how you feel.</p> <p> If you are weighing a facelift and eyelid surgery together, meet with a surgeon who lives and breathes facial work. Bring questions, bring old photos, and bring patience for a recovery measured in weeks, not days. Done well, this combination is one of the most satisfying in cosmetic surgery, delivering durable, natural improvement that respects the past while refreshing the present.</p> <p> <a  href="https://www.google.com/search?kgmid=/g/11g9q0cgmf" >The Seattle Facial Plastic Surgery Center</a>, under the direction of <a  href="https://local.google.com/place?id=11801354503147052290&use=srp" >Seattle board certified facial plastic surgeons</a> Dr William Portuese and Dr Joseph Shvidler specialize in facial plastic surgery procedures <a  href="https://www.google.com/maps/place/?q=place_id:ChIJ-bOmxMlqkFQRAl2J9GTVxqM" >rhinoplasty</a>, <a  href="https://www.google.com/localservices/profile?spp=Cg0vZy8xMWc5cTBjZ21m" >eyelid surgery</a> and facelift surgery. Located at 1101 Madison St, Suite 1280 Seattle, WA 98104. Learn more about this <a  href="https://www.google.com/maps/d/viewer?mid=1Lr3GxDwNj_Ac_xAbpGtcuC1olIMhSO0&ll=47.6119876509318%2C-122.3258885&z=12" >plastic surgery clinic in Seattle</a> and the facial plastic surgery procedures offered. Contact <a  href="https://earth.google.com/web/@47.611963,-122.3258885,94.7229138a,19695.01462572d,30y,0h,0t,0r/data=CgRCAggBMigKJgokCiAxTHIzR3hEd05qX0FjX3hBYnBHdGN1QzFvbElNaFNPMCACOgMKATBCAggASggI0qe5ygUQAQ " >The Seattle Facial Plastic Surgery Center</a> today.</p><p> </p><p><a href="https://g.page/SeattleFacialPlasticSurgeryCntr?share">The Seattle Facial Plastic Surgery Center</a><br>
1101 Madison St, Suite 1280 Seattle, WA 98104<br>
(206) 624-6200<br>
<a href="https://www.seattlefacial.com">https://www.seattlefacial.com</a> <br>


<a href="https://www.google.com/search?kgmid=/g/11g9q0cgmf">Top Plastic Surgeons in Seattle </a> <br>
<a href="https://local.google.com/place?id=11801354503147052290&use=srp">Best Plastic Surgery Clinic in Seattle</a> <br>
<a href="https://www.google.com/maps/place/?q=place_id:ChIJ-bOmxMlqkFQRAl2J9GTVxqM">Cosmetic Surgeons Seattle</a><br> 
<a href="https://www.google.com/localservices/profile?spp=Cg0vZy8xMWc5cTBjZ21m">Top Rhinoplasty Surgeons in Seattle</a> <br>

<iframe src="https://www.google.com/maps/embed?pb=!1m18!1m12!1m3!1d2689.8709129892363!2d-122.32668432360683!3d47.60919967118999!2m3!1f0!2f0!3f0!3m2!1i1024!2i768!4f13.1!3m3!1m2!1s0x54906ac9c4a6b3f9%3A0xa3c6d564f4895d02!2sThe%20Seattle%20Facial%20Plastic%20Surgery%20Center!5e0!3m2!1sen!2sus!4v1753484373424!5m2!1sen!2sus" width="600" height="450" style="border:0;" allowfullscreen="" l  referrerpolicy="no-referrer-when-downgrade">The Seattle Facial Plastic Surgery Center</iframe>
<br>
<a href="https://share.google/1dxzxATCMArf00V6K">Award Winning Facial Plastic Surgeons</a><br>
<a href="https://share.google/YBdJv6F0BluSUPoFr">Rhinoplasty Reveal</a><br>
<a href="https://share.google/KxkityeYL7VtTsBDc">facial plastic surgery</a><br>
<a href="https://share.google/M9YA63sSEfAn0Y8r1">Facelift in Seattle</a><br>
<a href="https://share.google/tU5A60CD1u1mU2413">Rhinoplasty</a><br>
<a href="https://share.google/p55VQ0URkhN6yXTSG">Rhinoplasty Before and After</a><br>
<a href="https://share.google/iQlYLFzJIRv1RMsPE">Rhinoplasty Candidates</a><br>
<a href="https://share.google/kvPNAFnqmTksfodeb">Rhinoplasty Surgery</a><br>
<a href="https://share.google/yKgSj6b8arzGTR2pN">Rhinoplasty Before & After</a><br>
<a href="https://www.rhinoplastyreveal.com">Rhinoplasty Reveal</a> <br>
<a href="https://washingtonstate.blob.core.windows.net/pacificnorthwest/index.html">Top Cosmetic Surgeons Near Me</a>

<iframe width="560" height="315" src="https://www.youtube.com/embed/eMJAVCsQiSk?si=cpITbW4qmTsHsncf" title="YouTube video player" frameborder="0" allow="accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture; web-share" referrerpolicy="strict-origin-when-cross-origin" allowfullscreen></iframe>


</p></html>