Is It Necessary for the Surgeon to Put in Drains when Completing a Full Facelift?

I've had several consultations. One doctor puts in drains, one doesn't, and one uses glue.

Doctor Answers 59

Facelift - to drain or not?

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Whether a doctor does or doesn't use drains should be the very least of your concerns.  Each will do what they thinks will give you the best result.  Judge their photos and results, not these little details like drains, suture techniques, name of the procedure etc.

Pick your surgeon for other reasons

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The choice to use drains or not is based on the surgeon's experience with the procedure. I use them on every facelift.  I think of them as safety valves, a place to let off some pressure.  When the patient calls me and says she feels tight on one side and it has only been a few hours after surgery but nothing is coming out in the drains I am not worried about a hematoma.  But when the drain on one side is filling up and she feels the same tightness I am going to ask her to come right back.  That may be a rare emergency.  For me it is just another signal to detect a problem.  In the rare case where there is going to be a lot of bleeding after the surgery the drain won't stop it but it let's me know something is up.  I have partners who don't drain anything.  Its just based on personal preference and experience

So choose the surgeon you feel most comfortable with, not the one who does or does not use drains.  When patients tell me they can't decide which surgeon to choose I tell them to imagine it is 1 am the day after the surgery.  You are nervous you are having a complication.  Which one would you feel most comfortable waking up from a sound sleep...

Don't fear the drain

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I have performed many facelifts. I used to never put drains in - now I always do. Here is the deal - you will not feel the drain. Taking it out is easy. It will not cause you any problems and it may save you from a more prolonged recovery. At the end of the day there is no good reason NOT to use drain.

Benjamin C. Marcus, MD
Madison Facial Plastic Surgeon
4.7 out of 5 stars 46 reviews


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What you must keep in mind is that although all of the procedures for which you are seeing these surgeons in consultation are labelled facelifts, there are many different ways to perform a facelift, and thus different requirements for the placement of drains.  As a general rule of thumb, the more aggressive the facelift, and the more deep the dissection performed in the face and neck, the greater the likelihood that drains will be needed postoperatively.

Peter Lee, MD, FACS
Los Angeles Plastic Surgeon
4.6 out of 5 stars 49 reviews

Is It Necessary for the Surgeon to Put in Drains when Completing a Full Facelift?

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Guess you see that there are many acceptable treatment options in preforming surgery. There is no best answer. Results of each surgeon and a trust you develope are most important

Is It Necessary for the Surgeon to Put in Drains when Completing a Full Facelift?

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The necessity of the use or lack of use of drains is more pertinent to the procedure rather than the surgeon. There are several ways to perform a facelift and different requirements dependent upon the depth of dissection. The most important thing is ensuring you are a comfortable with the surgeon you decide to move forward with and feel confident in the surgical plan you develop. Your surgeon will decide in your best interest whether drains are beneficial for you and your procedure after developing this plan. 

Richard A. Zoumalan, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 29 reviews

Drains Needed for Facelift?

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Thank you for your question.

Facelift 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

Drains or no drains

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It's really the preference of the surgeon to determine whether drains are needed or not. Drains can minimize swelling and the risk of developing a seroma/hematoma.

Is It Necessary for the Surgeon to Put in Drains when Completing a Full Facelift?

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When completing facelift surgery, some surgeons will insert a fine tube into the soft tissues at the end of the surgery (termed a drain) on both the right and left side to continue to drain fluid after the surgery, these are then usually removed one day after surgery.
In a small proportion of cases, after surgery, as a consequence of further bleeding a collection of blood can occur that needs to be removed. Some surgeons believe that the use of a drain may reduce the chance of this complication. However the drains are often uncomfortable for patients, and cause discomfort on removal.
Other surgeons do not use drains routinely. With meticulous surgical technique, some surgeons do not believe that their techniques require the use of drain. Although research has been conducted in this area it has not been conclusive.
Dr. De Silva uses meticulous surgical techniques and does not use drains, by choosing deeper plane techniques the risk of bleeding is reduced. There are other innovational techniques that can be used to minimize the risk of bleeding including the use of fibrin tissue glue and post-surgery medications.

Facelift and Drains

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Preferentially, I prefer to use drains even though I get meticulous hemostasis. I also use tissue glue, platelet rich or platelet poor plasma, because it enhances wound healing if you can minimize and prevent any swelling and bruising perioperatively.

Rod J. Rohrich, MD
Dallas Plastic Surgeon

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.