Malfunctioning Drain After Facelift

Question

I warned the anesthesiologist that I over-react to anesthesia so he only used propofol. However, I was still out over 4 hrs. after a face-lift, lower blepharoplasty, brown lift, and laser resurfacing. During this time, the drain tube would not drain and had to be reinserted 4 times. This caused major pain and a very painful hole for 2 wks afterward. Why do drains malfunction? Is this unusual? Is it something with my body's intolerance for anesthesia or the drains?

Frank P. Fechner, MD · Answer

Drain malfunctioning usually means that the fluids it is supposed to transport does not run. Drains can clogg, kink or be blocked by a suture or by resting against tissue. Some surgeons believe that drains are a must for every facelift. Others only sometimes use it and then they are facelift surgeons (including myself) who never use drains.

	That your drain gave you trouble does not mean you are over-sensitive to it or that it is something specific to you.

Sam Naficy, MD, FACS · Answer

The fact that your drain malfunctioned has nothing to do with the anesthesia used.  Drains occasionally malfunction.  Fortunately seems like you did not have a hematoma.

Stephen Prendiville, MD · Answer

I personally prefer to use passive drains (Penrose) while the patient has a compression dressing in place. I have found that active drains to be a very imperfect solution to the postoperative healing process. I have used both active and passive drains and found no difference in bruising with either variety, but more problems (such as clogging) with active drains.

Ritu Chopra, MD · Answer

There are several reasons that drains may malfunction. The key is not why the drain failed but how to treat the patient if the drain does fail. Clearly depending on the surgeon a drain may be replaced or not. As long as your surgeon recognizes the problem and addresses it in a timely fashion the cause of why the drain failed is not of any real significance. Hope this helps.

P. Daniel Ward, MD · Answer

Drains after facelift are frequently used. They are simply used to help prevent fluid buildup under the parts of the face and neck that were operated on. The failure of the drain has nothing to do with the anesthesia or if your body can tolerate the drain. It sounds like your recovery after facelift was tough. I hope that things are getting better now!

Kenneth D. Steinsapir, MD · Answer

Not every facelift needs a drain. However, your surgeon must have felt strongly that a drain would be of value in your case. The drain reduces the risk of developing a hematoma or a fluid collection after surgery. They get clogged by the material the drain is intended to remove. Have a day or so, the drain is unnecessary for many patients. Ultimately, this problem and the discomfort you experienced by your surgeon attempting to get the drain working will have no effect on the ultimate outcome of your surgery.

Adam Rubinstein, MD · Answer

Drains that are placed during a facelift will remove excess fluid and some residual blood after the procedure is over. It is very unusual to have to remove and replace the drains. Drains will sometimes become clogged with stuff that gets into the drainage tube but doesn't easily move through it. This is usually fixed by manipulating the drain itself. I'm not sure why your drain had to be replaced so many times, but it has nothing to do with the type of anesthesia you had. I'm not aware of any kind of intolerance to drains, though anything is possible. More than likely you had a little blood forming a clot in the drain that could not easily be removed.

	I hope this info helps!

Paul Gill, MD · Answer

There is no correlation known between anesthesia and drain function.   Your drain could have  malfunctioned due to a mechanical problem with the drain itself, the technique used to place the drain, or a thick clot formed by your body which clogged the drain.

	It is quite uncommon to have a drain malfunction, but it does occasionally occur.   I wish you a safe and healthy recovery.

Jen Yuan Chow, MD · Answer

The use of your drain, and the fact that it did not work afterwards, does not necessarily have any relationship to the anesthesia used. Drains can clog for any number of reasons, and since they are used to remove excess fluid after surgery, correcting this problem was important. 

	Depending on the design and type of drain you had, your ability or tendency to form clots, and a number of other causes, the drain may have clogged. Although there are a number of techniques to unclog drains, your surgeon may have had to replace a drain that does not work.

Raghu Athre, MD · Answer

Drains are devices that are placed to prevent build-up of fluids.  i donot see the correlation between anesthesia and the drain.  The drain could have been misplaced or could have gotten clogged.  There are several reasons to why the drain may have not worked properly.  I am sorry that you had  to go through this.  I have had a drain, and ITS NOT FUN.  However, the drain does significantly reduce bruising, swelling, and postoperative recovery time.

	 

	Raghu Athre

Malfunctioning Drain After Facelift

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