There is no safe number of procedures. Of course, the body does not count the number of procedures performed on it and decide when it has had enough. Typically, a single procedure, such as a facelift, involves more incisions, time and tissue trauma than all of the other facial procedures combined. Part of the rationale for combined procedures is that these additional techniques can vastly improve the result without greatly increasing tissue trauma and postoperative suffering. Patients are glad they got it done in one session and do not need to return for round two.

My own perspective, as a solo operator who performs out-patient surgery, is that a comprehensive facial rejuvenation and a limited body contouring procedure may be done in one operation, but not a major procedure to both face and body. For example, I may perform liposuction to the tummy and hips the same time I do a complete facial rejuvenation (and also use this as my fat donor site). Or I may perform a major body contouring procedure such as an abdominoplasty and liposuction with a limited facial procedure, such as a submental lipectomy. The goal is not to unduly stretch the operating time or the degree of pain and suffering the patient must endure after surgery, which might negate the advantage of combined procedures. The add-on procedures should improve the result without unduly increasing the postoperative discomfort or length of recovery.

Maintenance

In practice, I have done plenty of "maintenance" touch-up lasers and fat injection. I have done facelift revisions on several patients whom I treated with a deep-plane lift previously, incorporating a tightening of the subcutaneous fat layer in the jowls ("imbrication") for patients with persistent jowls despite a previous deep-plane lift.

In fact, the effect of the facelift does not wear off at some point. Women and men will always look younger than if they had not had the surgery, one month after surgery or ten years after surgery.

Aging

We do not yet have a way to stop the effects of aging (cellular degeneration, possibly due to the harmful effect of free radicals on our DNA), gravity, and we certainly cannot stop time. But, what we can do is reverse some changes that these have produced. Gravity and loss of skin elasticity allow the skin to sag with time, cheeks to fall, jowls to form, and skin around the neck to loosen. We have the ability to lift up the cheeks, tighten the jawline, and remove loose skin. We can restore tone to the face. The cells are not any younger, of course, but the appearance is younger. Laser resurfacing can do more. It actually does promote new collagen formation and replacement of sun-damaged skin cells with new skin cells.

Stem Cells

Fat injection introduces stem cells which may have beneficial effects that are presently being investigated. Research has confirmed their reparative properties when introduced into other tissues.