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

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!

hello toadsmom  A necklift is not a singular procedure with a singular method, but rather is an umbrella term describing a large range of operations with varying incisions and skin-lifting techniques, which have been developed and improved upon over the years.  Your board certified plastic surgeon will be familiar will be able to pair you with your perfect match of surgical approach based on your skin type and desired results.  #drainage #tubes

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

Both options are still utilized and need to be customized to the type of face and neck lift. 

Tisseel glue is an excellent option if you had a fibrotic reaction with tubes.

Tisseel "locks" the skin to the underlying tissue and allows the surgeon to avoid putting a drain.

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.

The need for drainage tubes is at the discretion of the surgeon.  Most surgeons use the drainage tubes while some do not.  The risk of not using the drainage tubes is exactly what you describe - build up of fluid under the skin.  If you feel comfortable with your original surgeon that I would go there again.  If not, I would suggest seeking other consultations.  

 

Good Luck.

The use of drains in face  and neck lift surgery is variable. I keep most my patients overnight, and routinely use drains. I remove them in the morning, before the  patient is discharged. While drains will not prevent hematoma, they do seem to decrease facial swelling.

For revisions, I am less likely to use drains, because there is usually a defined plane to follow and it seems to swell less. However, I still use them most the time. It is how I trained, and it works. As the expression goes, if it's not broken ... don't fix it. 

I do not use drains for mini-facelifts.

Good luck to you.

Hi Toadsmom,

The use of drains following a facelift/necklift is based on a surgeon’s preference and experience. Many times the type of facelift may influence a surgeon to use or forgo a drain, as well. There are no definitive studies to show that a drain prevents hematomas, but if a surgeon has operated for years using drains and has not had a hematoma, chances are that he/she is going to keep using drains. Most surgeons stick to the procedure that has worked for them. In my practice, I will use a drain if there is significant dissection and undermining, which is usually the case with most of my facelifts. These patients have their drains removed the next morning. In the select facelifts where the surgery was less involved (based on the patient’s anatomy), I only use a pressure dressing.

I have not seen a fibrotic reaction isolated to the drain sites before. Does your surgeon leave the drain in for longer than just overnight? Perhaps you should have a discussion with your surgeon about how to avoid the fibrotic reaction the next time around. Good luck to you!

Dr.Sunder
 

I perform different styles of face and necklift on patients depending on their particular anatomy. Sometimes I use a suction drain that I remove the following day, other times I just place a pressure dressing. Their is no scientific evidence that either will prevent a collection of fluid, but if I am performing a rather extensive surgery, I feel better leaving a drain in. Ultimately, if you had fibrotic firmness in the area of the drain afterward, I would inject some dilute steroid and this would soften.

Andrew Campbell, M.D.

Board Certified Facial Plastic Surgeon

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.