Why do some deep plane facelift patients have to keep the head wrapping on for 3 days versus 1 day for other patients?

Question

I am afraid that the head wrapping from my upcoming facelift will make me feel anxious and uneasy. I've heard some patients only have them for 1 day. My PS said I would need 3 days. Why? Thanks in advance.

Mark Glasgold, MD, FACS · Answer

I have been performing deep plane facelifts for 20 years.  I stopped using any dressing or drains over 10 years ago.  Not even for the first 24 hours.  They increase discomfort and swelling.  The purpose of the dressing is to provide compression to stop any bleeding from small blood vessels which can also be accomplished with meticulous attention to detail.  I do not know what purpose ace wraps or light compression serve, they do not reduce swelling and don't feel good.
All of my deep plane facelifts are performed under twilight anesthesia for patient comfort.  I also think early activity is important to recovery and patients are allowed to shower the day after surgery and can start excising within one week.

Jeffrey H. Spiegel, MD · Answer

There is no good science to this.  I feel that the longer you wear a wrap the less tension will be on your face and the better healed potential scars will be. I also think this contours the skin better to the underlying tissues for less swelling long term. Some people feel that it is nice to tell patients they don't need a wrap and so they do that.  There is no proof that one is better so each does what makes the most sense in their opinion.

Brian M. Harmych, MD, FACS · Answer

Many surgeons use a head wrap after facelift / deep plane facelift. Almost all patients are concerned about this, at first. However, many patients actually find the wrap to be somewhat comforting.

Justin C. Cohen, MD, FACS · Answer

There is no science behind the dressing. This is completely up to surgeon preference, and applies to drains as well. Some surgeons choose to use a fibrin tissue glue which makes both drains and dressing unnecessary. If you are worried about the recovery then discuss with your surgeon to see if they are flexible regarding timing. Best of luck.

Matthew Bridges, MD, FACS · Answer

The decision on what dressing and how long it stays is surgeon dependent.  I don't know of any reason there would be a difference between dressings based on whether a deep plane lift was performed.  However the surgery is performed, it is wise to have some light compression to prevent fluid/blood buildup under the skin flaps.  Talk to your surgeon about this since he/she is the only one who can answer your question.

Frank P. Fechner, MD · Answer

Bandages after face lift serve the purpose of protecting the surgical areas. In addition, they are applying gentle compression for the skin. Every face lift surgeon follows his own routine: some use bandages for a few days, others for two weeks. In our facelift patients for instance, we like to change the bandage after 1 day. The second, lighter bandage will stay on one more night; then our patients are able to shower. After that, a light elastic wrap will be applied which the patient adjusts to their liking and comfort.

Douglas M. Stevens, MD · Answer

I typically have a wrap on for the first night and have not had problems with that routine for many years.  I suggest you ask your surgeon if he or she would be willing to modify the three nights to one.  Perhaps a smaller wrap for the second two days that just puts a little pressure on the submental region may be sufficient to satisfy both you and your surgeon - worth a discussion!

Eric W. Cerrati, MD · Answer

Every surgeon has his or her own preferences regarding postoperative care, which is based off of experience and/or training.  For me, I perform a modified extended deep plane facelift for which I do not use drains and only use a head wrap for 1 night.  For your question, there's no correct answer and I recommend you discuss this concern with your surgeon so that you understand his/her reasoning and are comfortable with the postop care.
Best of luck with your upcoming surgery.

Parit A. Patel, MD, FACS · Answer

Thank you for your question.  Every plastic surgeon has a preference for post operative dressing care.  Operative dressings can remain in place from 2 days to 7 days depending on the procedure.  Three days is an acceptable option since it gives enough time for your incisions to epithelialize or seal.  It also gives the surgeon an opportunity to assess your healing process and if there are any issues such as fluid collections or hematomas (blood clots) that need to be addressed.  Good luck and I hope this helps.

Edward Farrior, MD · Answer

The duration of time that the patient wears a dressing after a facelift or deep plane facelift is dependent on the preference of the surgeon.  The purpose of the dressing is to secure the wound, absorbing any bleeding that may occur from the incisions, provide a sense of security to the patient's and eliminate the need for them to care for the incision in the acute postoperative period. Some surgeons will also use drains to help prevent hematomas and these are usually removed the day after surgery.   There is no right or wrong answer as to the duration of how long a dressing should be worn.

Why do some deep plane facelift patients have to keep the head wrapping on for 3 days versus 1 day for other patients?

Answers (15)

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