My plastic surgeon doesn't use drain tubes after Neck Lift/Facelift. Is that okay?

I have not placed a drain in any face or neck lift in the last 2 years. My audited haematoma rate is 2%, and seromas if they happen are easily aspirated and/or self limiting. I see no benefit to placing drains at all, a haematoma needs evacuation with or without a drain in place... but they carry risks of infection and pain on removal. I suspect over time their use in facelifting will become less common place.

Truly this is up to the comfort of the surgeon. Generally on primary facelifts I do not use a drain and use fibrin glue which helps adherence of the skin. However on re-do facelifts or men I generally use glue as well as a drain. I tailor each operation to the patient so that being said using a drain or not should not be your deciding factor when choosing a surgeon. Hope this helps!

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 after a facelift are used to remove exess fluid and swelling from the face.  One issue with drains is that they can be painful when in place and painful to remove.  In addition, drains can only work on one area of the face or neck and not work as evenly as anticipated.  For surgeons who don't use drains, they may find that drains can create a more comfortable postoperative healing course for the patient.  I don't use drains as with my technique my patient's swelling and edema is minimized and drains are not necessary.

Drains after surgery depend on the type of facelift, and the individual patient.  Mini-lifts, and less invasive lifts generally do not need drains.  SMAS or deep planes lifts can be performed without needing drains but if the patient has a propensity for bleeding (either during the facelift surgery or from previous surgeries) then using a drain might be necessary.In all cases, a compression wrap is used to minimize a hematoma or seroma formation.I would ask your surgeon how he manages this because there is a lot of variability and no one approach is standard.

 Drains are used at the discretion of the surgeon. I still use a drain overnight but I'm not convinced that it really makes that much difference.

Absolutely as long as they are skilled and create great results with their technique. Drains don't actually prevent hematomas. In the vast majority of cases, IMO, they are not necessary and only complicate a patient's recovery. If you've vetted your surgeon thoroughly and they meet all of your criteria do not let a lack of drains discourage you. I hope this information is helpful for you.Stephen Weber MD, FACSDenver Facial Plastic Surgeon

Deb,This is a question that cosmetic surgeons discuss regularly and you will find many different opinions. Most feel drains do help minimize seromas (fluid collections under the skin) and improve the recovery process. Some surgeons use fibrin sealants which also work well. Others just depend on dressings and pressure.  In general, however, if your surgeon is experienced with facelifts and getting excellent results, then whether or not they use drains should not be an issue.Best of luck with your procedure-

To use or not use drains is up to the surgeon and their surgical techniques. Drains can help minimize the risk of developing a seroma/hematoma, but aren't always necessary.

There is a bit of controversy over whether drains, pressure dressings, etc. have any impact on the risks of a blood or fluid collection. Ultimately, I feel something is better than nothing, so either use a pressure dressing, or a drain with a pressure dressing. As long as your surgeon is experienced in facelifts and gets great results, I wouldn't worry about whether a drain is used or not.Andrew Campbell, M.D.Facial Plastic Surgeon