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Is it standard procedure to use drains for a facelift?

Q:

Is it standard procedure to use drains for a facelift?  I have had three consultations - one surgeon uses drains, one doesn't, and one uses glue.  Please advise.

A:

The use of drains with facelifts is very common.  It is the surgeon's personal preference.  Often with glues some surgeons still will put in drains.  

I would consider focusing more on the results of your surgeons as illustrated in their pre & post operative facelift patients.  Do you like their results, will the surgeon meet your expectations, are they board certified by the ABPS, are they a member of the ASAPS, is the facility where you are going to have your surgery performed accredited and does your surgeon have hospital privileges to perform the procedures you are considering?  These might be much more important issues than drains after a facelift.  

Best,

 

Gary R. Culbertson, MD, FACS

A:

Facelift surgery does not require use of drains.  Many surgeons do, however, place small drains for a short time after the surgery, with the goal of reducing bruising.  I personally do not use drains for my facelift patients.  Instead, I take a little extra time during the operation to double-check that small areas of bleeding have been carefully cauterized.  If a significant post-operative bleed were to occur ( a very rare, but possible complication also known as hematoma), a drain would not be able to prevent it.  To avoid problems with bleeding, it is much more important to avoid taking any anticoagulants or aspirin-type products for two weeks before and two weeks after facelift surgery.  Your surgeon will need to check your lab work as well, to assure that your platelet count is normal.     

Pamela B. Rosen, M.D., FACS - View Other Answers by this Doctor
Pompano Beach, FL

A:

Small things like using drains are not what you should be focusing on to pick a facelift surgeon. I use drains because I believe they reduce swelling, but usually leave them in  only 24 hours. This is only a small nuance of a very complex procedure. You need to concentrate on who you feel comfortable with, answered your questions most effectively, proposed a procedure to deal with the problems that concern you and has results most like what you desire yours to be. The little specifics like the use of drains should be the last thing you ask.

A:

Most plastic surgeons use either drains or a light compressive dressing or both.  Personally, I keep my facelift patients overnight.  In the morning, before they go home, the drains are removed and the dressing is replaced.  For mini-facelifts, I do not use drains.

I find drains help reduce the initial swelling by removing the small amount of serum that may accumulate between the skin and the deeper structures of the face.  Normal output is a few teaspoons over night. This may allow the skin's natural glue to more quickly reattach the skin.

The use of drains can be argued either way.  Although I normally use them for all full face lifts, I understand why other board certified plastic surgeons do not, and the use of lack of drains will not effect you long term results. 

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