Are Drainage Tubes Used for Neck Lift and/or Face Lift?

I need a revision to my neck lift. Some doctors are saying the use of drainage tubes is obsolete. My original surgeon used them and I was left with alot of scar tissue where the tubes were. He said it was a fibrotic reaction. A friend had a face lift without the tubes and had a great amount of swelling from built up fluid that caused problems with healing. I am confused. If my original surgeon does the revison he will use them again. Is there anything I can do to prevent the fibrotic reation?

Doctor Answers 20

To Put in Drains or Not on a Facelift

I have found that using drains for just one night after a Facelift or brow lift really does reduce swelling and bruising.  Patients find the concept a bit disconcerting, however, it really isn't an issue at all.  Like many surgeons who use drains on facelifts, I remove them the morning after surgery.  Unlike some surgeons, I do not make a separate incision for the drain but rather bring it out through the regular incision in the crease behind the ear.  Removal of the drain doesn't hurt and only takes 3 seconds.  After having done a lot of facelifts without drains and a lot with drains, I really think that having a drain gets people looking good and back to public life much quicker with absolutely no additional effort or discomfort on the patient's part.

Austin Facial Plastic Surgeon
4.7 out of 5 stars 33 reviews

Drainage tubes after facelift.

I do not use drainage tubes in facelifts for 30 years. Some good surgeons do. Pick a surgeOn who has good results with or without tubes!

Toby Mayer, MD
Beverly Hills Facial Plastic Surgeon
4.8 out of 5 stars 34 reviews

Face and Necklift drains

Depending on how much blood buildup occurs after a neck/facelift, a surgeons may or may not use drains.  I do not use drains after a neck/facelift but instead attempt to keep bleeding as minimal as possible and use gentle manipulation the day after surgery to remove any possible collection.  Therefore the possiblities of fluid collection after surgery are treated without the possibility of fibrotic reaction from a drain.

Thomas T. Le, MD
Baltimore Facial Plastic Surgeon
4.9 out of 5 stars 59 reviews

Drains and facelifts

Drains are used by many plastic surgeons (myself included) for facelifts, usually for a short period of time (1-3 days) to eliminate fluid that might collect between the skin and the underlying muscle layer. Drains do not prevent hematomas from developing but might alert the surgeon to unusual bleeding. If the drain emerges from a separate small hole (usually way back behind the ear in the scalp), that hole might leave a scar, which is usually small and typically well hidden. The tract if space occupied by the drain could, theoretically, fibrose (or scar down), leaving an irregularity, but I have not seen that in my practice. Some surgeons elect not to use drains, either because they feel they are completely unnecessary or they do not want to encumber the patient with an extra device or accessory that has to be managed postoperatively. It is discretionary for the surgeon, based on whatever gives that surgeon the best results in that surgeon's hands.
If you are concerned about an issue with your result, it is best to communicate that directly to your surgeon. We on this board can not specifically advise you about your particular result.
Hopefully, any issues you are having presently will be minor and short-lived, as are most postoperative concerns in the majority of patients. Hope you get the result you are looking for! Best wishes.

Tim Sayed, MD, MBA, FACS
Newport Beach Plastic Surgeon
4.9 out of 5 stars 17 reviews

Drains and surgery

Drains are pretty much surgeon preference.  If a drain were left in for an extended time in a very thin neck it is possible that it might create a  bit of irregularity, especially if the drain were fairly large.  Getting drains out sooner rather than later may be preferable and if fluid builds up, it can be aspirated (drained with needle and syringe) every few days until gone.

Byron D. Poindexter, MD
Reston Plastic Surgeon
4.8 out of 5 stars 29 reviews

Use of drainage tubes in face lift and neck lift

  It is not obsolete to use drainage tubes in a facelift or neck lift, nor is it mandatory.  Each surgeon must assess the individual patient and procedure - size of the incision, amount of undermining of the skin flap, amount of oozing or bleeding noted at the time of surgery, etc. -  and make a reasonable determination as to whether or not drains are necessary.  Whichever surgeon you choose, let him/her use their best medical judgment regarding the use of drains.

Vincent D. Lepore, MD
San Jose Plastic Surgeon
4.8 out of 5 stars 56 reviews

Drainage tubes for Neck lift

The use of drainage tubes can be variable depending on the extent of the surgery and whether the surgeon feels that there may be more fluid than usual after the surgery.  A variety of drainage tubes can be used-with and without suction which may have an impact on scarring.  Drainage tubes serve to evacuate fluid which can build up and leave to a poor postoperative result.

Kristin Egan, MD
Manhattan Beach Facial Plastic Surgeon
5.0 out of 5 stars 1 review

Drains are often used after facelifts or necklifts

Depending on the extent of your revision surgery as well as your surgeon's training and preferences, drains may or may not be used. I personally tend to prefer the use of drains overnight (I remove them the following morning) in order to prevent the accumulation of fluids that may encourage the formation of scarring underneath the skin. I find that early removal of the drains seems to prevent fibrosis around the drain itself. Best wishes on a successful outcome!

Jen Yuan Chow, MD
Pasadena Facial Plastic Surgeon
5.0 out of 5 stars 1 review

Drains After Face/ Neck Lift

Use of drains is largely decided by a Surgeon's training, experience, and preference.  In certain cases, drains can be useful, but have potential drawbacks. I do not use active drains (Jackson Pratt: employ suction bulbs), but instead utilize a passive drain (Penrose drain: essentially a flexible rubber tube) while the compression dressing is in place after the procedure.  This is my personal preference because I have experienced problems with JP drains in the past and feel I get better results with less hassle while using Penrose drains.  However, there are many excellent Surgeons who obtain stellar results with active drains.

Stephen Prendiville, MD
Fort Myers Facial Plastic Surgeon
4.8 out of 5 stars 95 reviews

Facelift/Necklift with drains?

Thank you for your question.

Facelift/Necklift 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

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.