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.