Dr. Arturo Valdez on Safety
Why some facelifts are done in two stages, one week apart.
A full facial rejuvenation — forehead lift, brow lift, upper and lower eyelid surgery, deep plane facelift, neck lift, and fat transfer — is a significant operation. When all of these procedures are done together, Dr. Valdez splits the work into two shorter surgeries, one week apart. Patients having fewer procedures often have a single-stage surgery instead. For those who need everything addressed, here is the reasoning behind Dr. Valdez’s two-stage approach, in plain language.
The short version.
For patients having a full facial rejuvenation — forehead lift, brow lift, upper and lower eyelid surgery, deep plane facelift, neck lift, and fat transfer — Dr. Valdez splits the work into two surgeries. Stage one is the endoscopic forehead and brow lift with upper and lower blepharoplasty — about four hours. One week later, stage two is the deep plane face and neck lift with fat transfer — about eight hours.
Combined into one operation, that would be roughly twelve hours of surgery. Twelve hours is too long. By splitting the work into two stages with a full week of recovery in between, each surgery stays within a safer window of time. Patients having fewer procedures often have a single-stage surgery instead.
THE PROCEDURE
Two surgeries, seven days apart.
01
Stage One — First Surgery
The upper face
Endoscopic forehead lift, brow lift, upper blepharoplasty, and lower blepharoplasty. The eyes and forehead are addressed first because they heal at a different pace than the lower face.
- —Endoscopic forehead lift
- —Brow lift
- —Upper eyelid surgery
- —Lower eyelid surgery
Duration
~4 hours
Anesthesia
Local + IV sedation
02
Stage Two — Second Surgery, One Week Later
The lower face and neck
Deep plane face and neck lift with fat transfer. The deep plane technique repositions tissue at a deeper anatomical layer than a traditional SMAS lift, producing a more natural and lasting result.
- —Deep plane facelift
- —Deep plane necklift
- —Fat harvesting and transfer
- —Nano fat for skin quality
Duration
~8 hours
Anesthesia
Local + IV sedation
WHY TWO STAGES
Five reasons it is done this way.
01
Long anesthesia times carry real risk.
The longer a patient is sedated and immobile, the higher the risk of complications — blood clots, low body temperature, fluid shifts, and slower wound healing. Splitting the work into a four-hour surgery and an eight-hour surgery, with a full week of recovery in between, keeps each operation within a much safer window.
02
Every surgery gets Dr. Valdez's full focus.
The deep plane facelift requires precision work near major nerves. Splitting the procedure means each surgery gets his full concentration from beginning to end.
03
Dr. Valdez performs every step of the procedure.
Every incision, dissection, fat transfer, and suture is performed by Dr. Valdez. Splitting the procedure into two stages allows each surgery the time it requires.
04
The eyes and forehead need a head start.
Swelling and bruising from blepharoplasty and brow lift peak in the first few days. Doing those procedures first gives that area a week to settle before the second surgery. By the time Dr. Valdez performs the lower face surgery, the upper face is already on its way to healing.
05
It lets Dr. Valdez work under local anesthetic with IV sedation.
By keeping each surgery shorter, Dr. Valdez can use local anesthetic with IV sedation, which is safer. More on that below.
Days 2 Through 7
What happens during the week between surgeries.
The week between surgeries is dedicated recovery time. Patients heal from the brow lift and eyelid surgery, which can bring headaches, swelling around the eyes, and bruising during the first few days. With proper rest and care, patients arrive at stage two well-prepared for the second procedure.
Clinic visits
Patients see Dr. Valdez at the clinic during the week so he can check progress on the stage-one work and address anything that comes up.
Hotel nursing visits
A nurse visits the patient at their hotel between clinic appointments to check on healing, and make sure recovery is on track.
Dedicated recovery time
Patients rest, eat well, hydrate, and stay out of the sun. The week is structured around healing so that they arrive at the second surgery well-prepared.
Anesthesia
Local anesthetic with IV sedation, not general.
Splitting the procedure into two shorter surgeries makes it possible to perform both stages under local anesthetic with IV sedation rather than general anesthesia. This is a deliberate choice, and it has real benefits for the patient.
No breathing tube
No intubation means no risk of throat injury, vocal cord trauma, or post-operative airway complications.
Lower clot risk
Patients are not immobilized for twelve straight hours, which reduces the risk of deep vein thrombosis (DVT) and pulmonary embolism.
Less cardiac stress
IV sedation is gentler on the heart and lungs than general anesthesia, which matters for patients of any age.
Faster wake-up
Patients come out of sedation quickly, with far less nausea and grogginess than a long general anesthetic.
Patient can respond
The patient can follow instructions during surgery, such as smiling, which helps Dr. Valdez assess facial movement and refine the result in real time.
Board-certified anesthesiologist
A board-certified anesthesiologist manages sedation and monitors vital signs throughout every procedure.
In the Operating Room
Dr. Valdez's five-person surgical team.
Every procedure takes place with Dr. Valdez and a dedicated five-person surgical team. Dr. Valdez performs every surgical step himself, from harvesting fat with the syringe to placing every suture. His team supports him with anesthesia management, instruments, sterile field handling, and continuous patient monitoring throughout the procedure.
The Aesthetic Society
Why membership matters here.
Dr. Valdez is a member of The Aesthetic Society — formally, the American Society for Aesthetic Plastic Surgery. It is one of the most rigorous professional organizations in the field, and membership is not automatic. International applicants are vetted on board certification, surgical case history, malpractice records, facility accreditation, two existing-member sponsors, and adherence to the Society's Code of Ethics.
The Aesthetic Society places the utmost importance on patient safety. A member's primary responsibility is to promote the aesthetic goals of patients only in practice settings that promote the highest standards of patient safety. — The Aesthetic Society Code of Ethics
That commitment is not abstract. It shapes how Dr. Valdez built his practice — the surgical facility he operates in, the anesthesia approach he uses, the team around him, and the decision to split a long procedure into two safer ones. Splitting the facelift into two stages is one of the most concrete ways he honors that pledge.
Ready to talk about your facelift?
Every patient is different. A consultation is the best place to start.