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Is It Necessary for the Surgeon to Put in Drains when Completing a Full Facelift?

I've had several consultations. One doctor puts in drains, one doesn't, and one uses glue.

Doctor Answers (56)

Facelift - to drain or not?

+3

Whether a doctor does or doesn't use drains should be the very least of your concerns.  Each will do what they thinks will give you the best result.  Judge their photos and results, not these little details like drains, suture techniques, name of the procedure etc.


Seattle Plastic Surgeon
5.0 out of 5 stars 48 reviews

Pick your surgeon for other reasons

+2

The choice to use drains or not is based on the surgeon's experience with the procedure. I use them on every facelift.  I think of them as safety valves, a place to let off some pressure.  When the patient calls me and says she feels tight on one side and it has only been a few hours after surgery but nothing is coming out in the drains I am not worried about a hematoma.  But when the drain on one side is filling up and she feels the same tightness I am going to ask her to come right back.  That may be a rare emergency.  For me it is just another signal to detect a problem.  In the rare case where there is going to be a lot of bleeding after the surgery the drain won't stop it but it let's me know something is up.  I have partners who don't drain anything.  Its just based on personal preference and experience

So choose the surgeon you feel most comfortable with, not the one who does or does not use drains.  When patients tell me they can't decide which surgeon to choose I tell them to imagine it is 1 am the day after the surgery.  You are nervous you are having a complication.  Which one would you feel most comfortable waking up from a sound sleep...

Phillip C. Haeck, MD
Seattle Plastic Surgeon
5.0 out of 5 stars 32 reviews

Don't fear the drain

+2

I have performed many facelifts. I used to never put drains in - now I always do. Here is the deal - you will not feel the drain. Taking it out is easy. It will not cause you any problems and it may save you from a more prolonged recovery. At the end of the day there is no good reason NOT to use drain.

Benjamin C. Marcus, MD
Madison Facial Plastic Surgeon
4.5 out of 5 stars 29 reviews

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Facelift

+2

What you must keep in mind is that although all of the procedures for which you are seeing these surgeons in consultation are labelled facelifts, there are many different ways to perform a facelift, and thus different requirements for the placement of drains.  As a general rule of thumb, the more aggressive the facelift, and the more deep the dissection performed in the face and neck, the greater the likelihood that drains will be needed postoperatively.

Peter Lee, MD, FACS
Los Angeles Plastic Surgeon
4.0 out of 5 stars 12 reviews

Is It Necessary for the Surgeon to Put in Drains when Completing a Full Facelift?

+2

Guess you see that there are many acceptable treatment options in preforming surgery. There is no best answer. Results of each surgeon and a trust you develope are most important

Darryl J. Blinski, MD
Miami Plastic Surgeon
4.5 out of 5 stars 62 reviews

Is It Necessary for the Surgeon to Put in Drains when Completing a Full Facelift?

+1
When completing facelift surgery, some surgeons will insert a fine tube into the soft tissues at the end of the surgery (termed a drain) on both the right and left side to continue to drain fluid after the surgery, these are then usually removed one day after surgery.
In a small proportion of cases, after surgery, as a consequence of further bleeding a collection of blood can occur that needs to be removed. Some surgeons believe that the use of a drain may reduce the chance of this complication. However the drains are often uncomfortable for patients, and cause discomfort on removal.
Other surgeons do not use drains routinely. With meticulous surgical technique, some surgeons do not believe that their techniques require the use of drain. Although research has been conducted in this area it has not been conclusive.
Dr. De Silva uses meticulous surgical techniques and does not use drains, by choosing deeper plane techniques the risk of bleeding is reduced. There are other innovational techniques that can be used to minimize the risk of bleeding including the use of fibrin tissue glue and post-surgery medications.

Julian De Silva, MD
London Facial Plastic Surgeon
5.0 out of 5 stars 29 reviews

Facelift and Drains

+1

Preferentially, I prefer to use drains even though I get meticulous hemostasis. I also use tissue glue, platelet rich or platelet poor plasma, because it enhances wound healing if you can minimize and prevent any swelling and bruising perioperatively.

Rod J. Rohrich, MD
Dallas Plastic Surgeon
5.0 out of 5 stars 18 reviews

Drains after face & neck lift

+1

There is very little downside to using drains after a face/neck lift which is why I use them to reduce swelling and bruising.

Sam Naficy, MD
Seattle Facial Plastic Surgeon
5.0 out of 5 stars 140 reviews

A full facelift, neck tuck up, or partial facelift does not require drains.

+1

Of course this depends on who does your surgery. If the surgeon chooses not to use drains, it is critical that there be excellent control of bleeding during the case. To do this the surgeon must "clean the kitchen as he cooks".  What I mean by this is that a very precise and careful technique is required. Any bleeding must be stopped immediatley using electrocautery which seals the blood vessels. This method of operating takes longer than simply lifting the flap and then stopping all of the bleeding at one time, but it results in less bruising and a quicker recovery for the patient in my experience.  I have a busy facelift practice and have not used a drain in one for fifteen years.

Michael Godin, MD
Richmond Facial Plastic Surgeon
5.0 out of 5 stars 1 review

Are drains normal protocol for facelifts?

+1

Drains are not always necessary with the full face and neck lift but are more commonly used than not. If they are used they usually stay 1 or 2 days at the most. Often the drains need to stay a little longer when there is thorough neck liposuction performed at the same time.

Joseph Hunstad, MD
Charlotte Plastic Surgeon
4.5 out of 5 stars 24 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.