Facelift and Eyelid Surgery Together: Is It Safe, and When Is It Staged?

A facelift and eyelid surgery can often be done together. Mayo Clinic notes that eyelid surgery (blepharoplasty) can be performed at the same time as a brow lift or a facelift, and the American Society of Plastic Surgeons lists brow lift and eyelid surgery among the procedures that may be combined with a facelift.^1,3 The real question is not whether it can be done, but whether both areas of your face actually need treatment and whether the total length of the operation suits your health.

Combining has a clear advantage: one anaesthetic, one recovery period and one trip. The price is a longer operation. A facelift on its own usually takes three to six hours, and it takes longer when other procedures are added.² This guide looks at what large patient series show about combined surgery, how recovery changes and when operations are better split into stages.

When are a facelift and eyelid surgery done together?

A facelift treats descent of the cheeks, jawline and neck; it does not change the eyelids. Eyelid surgery removes excess eyelid skin and some muscle, and removes or repositions fat where needed;¹ it does not change the jawline. So when the lower face has descended and the upper eyelids carry obvious excess skin, treating only one of them can leave the face out of balance: a fresher jawline beneath eyes that still look tired.

Before any decision about the eyes, the position of the brow is assessed, because heaviness of the upper lid sometimes comes from a low brow. We explain that distinction in eyelid surgery or brow lift. Mayo Clinic notes that people having a facelift often have a neck lift at the same time,² and when volume loss is marked, fat transfer or fillers may also be discussed as an option.³

What do large patient series show?

The largest data sets come from multicentre prospective databases in the United States. In a study of 11,300 facelift patients, 57.4% of facelifts were combined with another cosmetic procedure. The overall major complication rate was 1.8%: 1.5% after a facelift alone and 3.7% when it was combined with other procedures. Haematoma (1.1%) was the most common complication, and male sex, combined procedures and a body mass index of 25 or more were among the independent risk factors identified.⁵ The abstract does not separate facial additions from body or breast procedures, so the effect of adding eyelid surgery alone cannot be read from these figures.

A study of 129,007 cosmetic surgery patients by the same research group found blood clots (venous thromboembolism) in 0.01% after face procedures; combined procedures carried about 2.4 times the clot risk of single procedures, with the risk rising most with procedures on the trunk and limbs.⁶ A separate study of operating time found that each additional hour of surgery increased the odds of a complication by 21%, with risk rising noticeably beyond about three hours; however, it covered complex plastic surgery operations, most of which combined several procedures, not facial surgery alone.⁷

In practice, adding eyelid surgery to a facelift is usually a reasonable plan, but not a risk-free one. The total operating time, your health and the extent of what is genuinely needed decide it.

How does recovery change when they are combined?

The two recoveries largely overlap. After eyelid surgery, bruising and swelling usually settle in 10–14 days, contact lenses are avoided for about two weeks and strenuous activity for a week.¹ The NHS notes that most people take about two weeks off work after eyelid surgery.⁴ After a facelift, stitches are removed at about one week.² Having the operations at different times therefore means going through two recovery periods; done together, the total is often close to that of the facelift.

Adding the eyelids brings some eye-specific care to the first days: regular cold packs on the first night, and possible temporary blurred vision, while dry, irritated eyes are a recognised risk.¹ Shortness of breath, chest pain, an unusual heart rate, severe new eye pain, bleeding or a problem with your vision after surgery needs medical attention straight away.¹ For a week-by-week account of facelift recovery, see facelift recovery week by week.

When are the operations staged?

Sometimes it is safer, or simply better, to do the operations at different times:

• Health: poorly controlled blood pressure or diabetes raises the risk of poor wound healing;² keeping the operation shorter may then be the priority.
• A very long total operation: each added procedure lengthens the operation, and complication odds rise with operating time.⁷
• An eye problem: dry eye and difficulty closing the eyes are recognised risks of eyelid surgery;¹ existing dry eye or a loose lower eyelid may mean the eyelids need separate assessment first.
• Uncertainty: if you are not sure you want the area around your eyes changed, seeing the result of the facelift first is a reasonable option.

Time in Istanbul and follow-up

In Op. Dr. Esin Özlem Atmış’s planning, a facelift and neck lift usually involves one night in hospital and about seven days in Istanbul, while eyelid surgery on its own needs five to seven days. When the two are combined, the plan follows the facelift timeline. Reviews take place at 1, 3, 6 and 12 months; if you live abroad, they can be held online where appropriate, and an in-person examination is requested if needed. For travel planning, see facial surgery in Istanbul from abroad.

Frequently asked questions