Is a Deep Plane Lower Facelift potentially more dangerous without the use of drains?

Question

Is a deep plane lower facelift potentially more dangerous without the use of drains? Do drains help with swelling? Is there risk for more infection with drains? Is the glue that some surgeons are using instead of drains a safe alternative or is there more potential for complications with the glue? I’m trying to select a surgeon & some surgeons do stainless & glue while others don’t & I could use some clarity. Thank you so much for your time & help with my inquiries.

Andrew Miller, MD · Answer

The simple answer is that it doesn't really matter. Either a drain or glue can help to keep a hematoma from forming after a facelift. It doesn't matter if it is deep plane or not - the above techniques are for blood that accumulates in the subcutaneous plane. If properly performed there will be a very low risk of hematoma with either the drain or glue technique. Most important is finding a qualified, experienced facelift surgeon to do your procedure.

Brian M. Harmych, MD, FACS · Answer

Great question! Most surgeons choose to use or not use drains based on their training. As far as I can tell, it's about half and half. Some use drains and some do not. I trained without the use of drains and have never used a drain on a facelift, including SMAS facelift, mini facelift and deep plane facelift. I use fibrin glue and a standard facelift dressing on every case. I have a high volume facelift practice and do a large amount of deep plane facelift and SMAS facelift. In my experience, this approach works well and I've not personally experienced any issues without the drains or with use of fibrin glue. Occasionally, we see a small seroma (fluid collection under the skin) on the first postop day. This is easily treated with aspiration with a small needle.   Keep in mind this is one surgeons experience and opinion. I hope it's helpful to you. Thank you again for your great question.
Kind regards,
Dr. Harmych

Ronald J. Edelson, MD · Answer

Any of the things you mentioned are used by some surgeons and not by others. I don’t use drains but there is nothing wrong with using them.  I do t see the need for fibrin glue. Drains or no drains should be low on your list of priorities for selecting a surgeon.

William Portuese, MD · Answer

In our practice for over 25 years, we have  used drains after a facelift procedure. They work much better than pressure bandages. There's no danger using drains. They help prevent a hematoma, seroma, and significantly reduce the amount of bruising and swelling after a facelift procedure. Depending upon the person, the drains are usually removed the next day

Is a Deep Plane Lower Facelift potentially more dangerous without the use of drains?

Answers (4)

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