Pushing out fluid from ears into drainage tubes after facelift. (Photo)

Question

I am Suppose to push out fluid from ears down through the drain tube holes in back and I cannot get anything to come out ? Is that normal?

Philip Solomon, MD, FRCS · Answer

If you have suction drains massage is not necessary.  If your surgeon placed non suction drains such as rubber tubes or Penrose drains then massage can help express excess fluid around the drain site.   Based on the limited photos provided you seem to be doing well and likely don't. have a significant amount of fluid or blood to express.   See your surgeon to discuss.

John J. Martin, Jr., MD · Answer

Many of us will use a suction drain after a facelift where the neck has also been opened.  The drain will help to remove any excess blood and anesthesia fluid that is still there.  This usually helps to improve the swelling and bruising. It is removed after 1-3 days.Once the fluid stops draining the tube should be removed.  Since there is suction there is no need for you to be doing massage to move more fluid out.  It is also very early to be doing any massage or  manipulation of the skin.

Kenneth D. Steinsapir, MD · Answer

I also do not see a drain tube. I do not agree with manipulating your face to push drainage out of the face. I do not think that manipulating the lifted face is helpful.  You need to let the tissues heal on their own.  Small qualities of fluid generally reabsorb on their own.  I recommend discussing this with your surgeon.

Arnold Almonte, DO · Answer

Facelift surgery results in small amounts of bleeding under the skin. Surgeons don’t want that fluid accumulating under the skin. So will often place small rubber drainage tubes placed behind the ears after facelifts in order to leave a small opening in the incision to allow any excess fluid to escape into the dressing. So you are correct. Gently squeeze your skin backwards to push any excess fluid out those tubes. Those are typically removed a day or two after surgery. Good luck.

Stephen Prendiville, MD · Answer

Although there is variance from Surgeon to Surgeon, I do not think that expressing fluid from a wound is part of a patient's responsibilities after surgery.  I do not see any drains present, which is a separate issue.  Although I would defer your next step to your Surgeon, the photo does not look as if any fluid is present.  Secondly, if you are unable to express fluid, there is no need for further attempts.

Michael I. Echavez, MD · Answer

It is usually not necessary to push fluid out into drainage tubes after a facelift.  If these tubes are placed, they have their own suction which will cause any fluid to drain out.  It is not unusual for these tubes to clog after a while though, so that is most likely why you cannot get anything to come out.  I would check with your surgeon regarding the care for your drains and to find out when they will be removed.

William Marshall Guy, MD · Answer

Hello Nchambers3,When a surgeon places drainage tubes after a facelift they are designed to suction fluid collecting in that area naturally.  Manual pressure would not be needed.  The exception is if a different type of tube was used that looks more like wide spaghetti instead of clear or bluish.  This tube merely keeps an area open but does not have the ability to suction.  Personally, I don't use drains as I find them uncomfortable.  For those who do use drains the majority would use the suction based ones.  The reason is that manual pressure from the patient can lead to problems including damaging the skin or disrupting deeper tissues.  In the end it is important to follow the recommendation of your surgeon.  We all have different post operative care because that is what gives us the best result.  It doesn't mean one is superior to another, just in our experience the method we choose is what works for our patients.  I hope this helps and good luck.

Michael J. Rodriguez, MD, FAACS -Account Suspended · Answer

Typically any drainage tubes left in the face are removed within 1 to 3 days after your procedure. It is still too early for manipulation to the skin in this area, so you should not be having to push out any fluid through these drains. The fluid should naturally come out on its own. You should follow up with your surgeon if any issues should arise or the drains are in for a prolonged period of time.

Francis R. Palmer, III, MD (retired) · Answer

Hi, I have performed Many SMAS facelifts and neck lifts for over 30 years and have performed many minimally, invasive SMAS facelifts.  From the photos you appear to have undergone an extensive type face and neck lift with post op swelling.  It's paramount that you follow the specific advice and instructions provided by your Facelift Surgeon.  It's not ethical for any os us to provide any advice or feedback to a fresh post op patient.  You should feel comfortable, of course, with what your surgeon tells you to do and if for some reason that's not the case....you should go back and have a thorough discussion about your post op care and instructions.  This will ensure that you get the very best possible outcome from your facelift and eyelid surgeries. 
 In contrast, the minimally invasive SMSAS 
 If you have "jowls” these are sagging facial tissues and the main indication for some form of a SMAS facelift.  The underlying SMAS layer, of the face, must be dissected, lifted, trimmed and re-sutured (not merely folded or suspended with threads or sutures that will not last).  The excess skin is then removed and the facelift incisions closed.
My most popular SMAS facelift is the minimally invasive, short incision SMAS facelift that has all the benefits of more invasive facelifts (traditional, mid-face, deep plane, cheek lift and subperiosteal facelifts) but with these added benefits:
very small incisions and no incisions extend or are placed within the hair.
minimal tissue dissection = less bruising and swelling = rapid recovery ( several days instead of weeks or months with the more invasive type facelifts mentioned)
can be performed in 90 minutes or less, with or without general anesthesia
no incisions within the hair = no hair loss
excess fat can be removed from the face and neck
excess skin removed from the face and neck
cheeks, chin and jaw line can be augmented with dermal fillers (I prefer Restylane Lyft) or facial implants
most patients fly back home to parts all over the world in as little as 3 days post-op
I combine facial shaping with every facelift procedure.  When jowls are present, these should be done in concert and not alone or separately in order to create a naturally, more attractive face.
Hope this helps.

Pushing out fluid from ears into drainage tubes after facelift. (Photo)

Answers (9)

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