Malfunctioning Drain After Facelift

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?

Doctor Answers 14

Drains and Facelifts

Hi Central Florida7404,

I'm sorry for the problems you had.

Drains are mechanical devices and, as such, have a certain likelihood of failure.  They usually work well, but it's not unheard of for them to malfunction.

One issue is that if it is a closed-suction system, then if there was a leak (ie, the tissue was not perfectly closed at the end of the procedure - again, not that unusual or worrisome to have a small air leak) then the drain may not have worked well.  And it's actually harder to get a drain like that to work once the surgery is completed and the patient is in recovery than during the procedure itself, when things are open and more accessible.

In the end, though, as long as you didn't have any long term problems related to the drain malfunction (such as a hematoma - collection of blood - or an infection) then it's of relatively little long term consequence.  The hole should close on it's own very well, and I suspect everything will heal up adequately.

You should, of course, stay in touch with your own PS.

I hope that this helps, and good luck,

Dr. E

New York Plastic Surgeon
5.0 out of 5 stars 125 reviews

The drain and the anesthesia are unrelated issues.

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.

Kenneth D. Steinsapir, MD
Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 26 reviews

Nothing to do with the anesthesia - Drains are both a blessing and a curse.

Drains are of various types, but it sounds like you had a "suction" drain.

They can fail due to an air-leak anywhere in the system; due to so much drainage that their ability to drain is overwhelmed; or due to clots.

However we have found that patients who have drains tend to have less bruising.

Usually they do not cause any discomfort.

Your surgeon did the right thing in continuing to deal with the problem till it was solved.

Dr. Mayl

Fort Lauderdale

Nathan Mayl, MD (retired)
Fort Lauderdale Plastic Surgeon
4.3 out of 5 stars 7 reviews

Drains after a facelift

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!

Adam Rubinstein, MD
Miami Plastic Surgeon
4.9 out of 5 stars 19 reviews

Malfunctioning Drain

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.

Sam Naficy, MD, FACS
Seattle Facial Plastic Surgeon
4.7 out of 5 stars 221 reviews

Facelift drains malfunction if not placed correctly, no suction is attached or if a blood clot forms in the drain

Facelift drains can malfunction for several reasons:

  • Drain is not inserted deeply enough-most common problem
  • The suction bulb loses suction or becomes full
  • The drain is kinked or compressed and unable to exert suction
  • A blood clot forms in the drain and blocks the drain
  • The drain falls or is pulled out because it was not secured in place by a suture

Most commonly the drain is not inserted deep enough so that one drainage hole is outside the skin, sucking air and no suction is present inside the facial skin. This can happen with frequent head movement (common in local anesthesia) during and after the procedure especially if the drain was not sutured tightly to the skin top prevent movement of the drain.

Face Lift, Mini Face Lift, The Palmer Celebrity Face Lift, Beverly Hills Face Lift

It sounds like you are referring to the IV line and not the drain used at the completed of the Face Lift.  It sounds like it was positional which means the veins they used for the IV collapsed as your arm or hand was moved.

Francis R. Palmer, III, MD
Beverly Hills Facial Plastic Surgeon
4.6 out of 5 stars 24 reviews

Drains After Facelift

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.

Stephen Prendiville, MD
Fort Myers Facial Plastic Surgeon
4.8 out of 5 stars 93 reviews

Why Do Facelift Drains Malfunction ?

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.

Frank P. Fechner, MD
Worcester Facial Plastic Surgeon
4.6 out of 5 stars 48 reviews


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.

Ritu Chopra, MD
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 33 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.