Do you have to take antibiotics for a lower face lift?

Question

I am having a lower face lift and I don't want to take antibiotics. I am a healthy female, active, non smoker, age 44. Are antibiotics a must or can this procedure be done without them? I have read the risk of infection is very low, less than 1% in healthy individuals. Is that accurate? I will be taking some herbs to enhance immune function in the weeks prior to surgery. Thank you in advance for your time.

T. Randall Blanchard, MD · Answer

No, you do not have to take antibiotics before or after a facelift operation unless you have a condition that requires it such as an artificial heart valve or orthopedic joint. Post operatively, your surgeon will monitor you for proper healing and if you develop signs of infection they may recommend antibiotics at that time.

Jill Hessler, MD · Answer

Antibiotics are not necessary after a facelift. The risk of infection is very low following this type of surgery and studies have not demonstrated a clear advantage.  In my practice that focuses on facial rejuvenation we give one dose of antibiotics through the IV prior to facelift surgery, but no other antibiotics are necessary.

David W. Rodwell III, MD · Answer

There will be exceptions for patients with certain medical conditions, but in general a typical patient does NOT need to be on antibiotics after facelift surgery.  There is no good data to support the routine use of post-operative antibiotics, yet many surgeons continue to do that more out of habit than science.It is common practice to receive IV antibiotics during surgery.

Kevin Sadati, DO · Answer

Although it is not mandatory to have antibiotics for you facelift surgery, it is highly recommended.  Having a post operative infection can lead poor surgical outcomes.

Miguel Delgado, MD · Answer

Antibiotics are recommended to reduce the risk of infection. It will be up to your surgeon as to whether you take them or not. Be sure to see a board certified plastic surgeon and have a discussion with your surgeon about this. Good luck.

Raymond E. Lee, MD · Answer

Thanks for asking a good question. In my hands I do prescribe a dose 1 day before and 6 days after.  It is not a hard rule and I have shortened the duration after if a patient does not do well with antibiotics.  The answers you see will vary but I do feel it is best to reduce any post op infection risk.  Having a procedure done in an accredited surgery center also adds a margin of safety.

Amir Nakhdjevani, MBBS, MRCS, FRCS(Plast) · Answer

Thank you for your question.  In our clinic we have performed studies which indicated that it was necessary for patients to have antibiotics after their surgery.  We do give a big dose of antibiotics before starting there surgery however.  If a patient is at a higher risk of infection they would be give.  Alternatively if a patient doesn't live locally they may be give as a precaution.  All The Best

Richard G. Schwartz, MD · Answer

Facelift surgery, complete or partial, is considered a "clean" surgery, with a very low infection risk.  As such, it probably isn't necessary to take postoperative antibiotics.  However, most, if not all, hospitals and surgery centers have a routine of giving a dose of iv antibiotics a half hour before surgery, so that there will be a therapeutic level of the antibiotic in the bloodstream during surgery.  There are normal bacteria on the skin surface that presumably will be sterilized by the prep wash, but there is always the slight risk of some bacteria in the nasal passageways or scalp that might not be totally eradicated.  I would feel more comfortable at least with the single dose before surgery begins.

Steven L. Ringler, MD, FACS · Answer

Thank you for your question. Most surgeons prescribe antibiotics for a facelift. In my practice, with well over 500 cases, I have never seen a significant infection following a facelift. We routinely give one dose IV at the time of surgery, and nothing post -op. Most surgeons try to limit the use of antibiotics in order to avoid resistant bacterial infection. You should discuss this with your surgeon, but keep in mind that the side effects of a single dose during surgery is minimal. Good luck to you.

Stephen Prendiville, MD · Answer

Antibiotics are definitely not mandatory, but widely used because facelift is an elective facial cosmetic procedure. This can be referred to as the "belt and suspenders" approach. What is more important is sterile technique and preoperative use of chlorhexidine the day before and of surgery on proposed incision sites. Most infections that occur with facelift in the modern era are drug resistant strains, hence the use of chlorhexidine.

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