Why do some doctors use drains after a facelift and some don't?

Using drains is a matter of personal preference between doctors based on their training and experience.  I don't use drains when I perform facelifts.  I don't want my patients to be grossed out and faint.

Thank you for your question.Facelift surgery does not require use of drains. Many surgeons do, however, place small drains for a short time after 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 ensure small areas of bleeding have been carefully cauterised. Drains do not always necessarily prevent possible bleeding complication. I do not use drains and have pioneered The Concept Facelift, having a 0% incident rate of hematoma. It is important to focus more on the results of your surgeon as illustrated in their pre & post operative facelift patients. Do you like their results, will the surgeon meet your expectations, is the facility where you are going to have your surgery performed accredited? These might be much more important. I do not think the use of drains or not drains would reflect the surgeons ability.All The Best

It's really the preference of the surgeon to determine whether drains are needed or not. Drains can minimize swelling and the risk of developing a seroma/hematoma.

I personally use a drain for one night after a facelift. This is to generate negative pressure Allowing the elevated tissue to stick to the deeper tissue. The use is a matter of personal preference.

The answer to this question lies in the experiences and preferences of the Surgeon.  First several points must be understood about a facelift.  Since a large surface area is being lifted, the potential exists for excess blood and or lymphatic fluid to collect under the skin flaps.  This can be managed by use of a drain, compression, or a combination of both.  It is important to understand that drains do not prevent expanding hematomas.  A combination of meticulous technique, patient compliance with instructions, and a patient's inherent clotting ability are most important in prevention of this complication.  In my experience, I would place emphasis on the first two points, because a quickly performed facelift does not allow for adequate hemostasis and ignores the potential for late case bleeding.  Although many patients hear their postoperative instructions, they sometimes do not listen.  For these reasons, I spend the requisite amount of time to ensure a "dry" surgical field during a facelift, and my staff repeat the mantra of expected postoperative behaviors in an exhaustive fashion. I utilize mild compression with passive (Penrose) drains in the postauricular region.  The dressing is removed and replaced with a lighter dressing on the first postoperative day, and the penrose drains are removed on the second. I have utilized platelet gels, fibrin glues etc., and have not seen any difference from baseline with the exception of higher cost.  The major difference between dressings and drains is that taking care of active drains (Jackson Pratt) is beyond the experience and comfort levels of most patients.  In other words, patients hate drains and patients hate dressings, but seem to hate drains more.  An overnight stay facility is not a necessary consideration for most patients, who are usually more comfortable at home.

I typically will use a drain after a facelift - if for no other reason than to allow the local anesthetic I've injected to be cleared from the tissues a little faster.It has been demonstrated that a drain will NOT prevent a hematoma (blood collection), so that is not a good reason to use one.  However, I do believe that it may decrease the likelihood of getting a fluid collection.  AND there has been a lot of discussion about how it subjectively seems to decrease the swelling after the work is done.Drains don't hurt, and may actually speed the healing process by clearing out fluid in the zone of injury.  I just don't see a downside - and THIS IS YOUR FACE we are talking about, so why not take every precaution?????I see below that several docs have stated that there is no benefit to the drain.  I'm not sure I'm comfortable with that - and the next time they get a seroma (fluid collection under the skin), I'll bet they wished they had left that drain in place.

Personally, I am not an advocate of drains for any cosmetic procedure. There have been many research papers addressing this issue. The data show that there is NO benefit to drains in a facelift or anywhere else.. Initially, it was thought that constant suction drains would prevent hematoma. I have been doing facelifts for over 30 years and have never found a drain to prevent anything.

This is based on personal experience and training. Personally, I rarely place drains after a facelift but will if there is an unusual amount of oozing during surgery (uncommon). With regard to staying overnight after surgery, this would also be very uncommon following elective surgery. If you are otherwise healthy, I would be surprised if you required an overnight stay. I hope this information is helpful for you.Stephen Weber MD, FACSDenver Facial Plastic Surgeon

It's a good question. After a significant amount of skin undermining there is a significant amount of oozing of fluid that occurs. Some surgeons address this by using tissue glue and some use drains. The glue seals the draining channels, whereas the drain removes the fluid from under the skin until the channels seal themselves. The most important thing is that your surgeon has had success with their chosen approach.The concept of having a drain is weird at first. I've had many patients who have not liked the idea of a drain, but every patient has gotten used to it and done quite well. In the end they seem to find that the drain did not bother them as much as they thought it would.Good luck with your upcoming surgery.

It really is a matter of preference.  For me, I only use drains when a neck lift is performed concurrently.  I find that the submental region is very unforgiving for any fluid buildup.  Drains to NOT prevent hematoma though theoretically if one were to happen, the drain might allow enough pressure to be relieved to prevent any tissue loss.  I have used tissue 'glue' on occasion if there was some question of oozing during the case, but I usually use neither drains or glue with a short scar facelift not involving extensive undermining of the neck.  Take care and good luck.