How come some Facelifts don't require a compression bandage or compression band for several days? What is best for healing?

Question

I read that some patients have a compression bandage for several days and some do not. is there a difference in treatments? Like a deep plane lift does not require the compression band or is it just the surgeons choice? I have yet not had my facelift but is planning one in december.

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

Thank you for your question. Facelift surgery does not necessarily require use of bandages. Many surgeons do, however, used bandage aiming to reduce bruising. I personally do not use bandages for my facelift patients. Instead, I take a little extra time during the operation to ensure small areas of bleeding have been carefully cauterised. Bandages do not always necessarily prevent possible swelling. I do not use bandage or 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 /bandages or not drains/bandages would reflect the surgeons ability.

All The Best

All The Best

Jed H. Horowitz, MD, FACS · Answer

The postoperative management including choice of bandages and dressings will be based on each surgeon's preference. In general, there are usually bandages for the first 24-48 hours to absorb any fluid from the early incisions.

Frank P. Fechner, MD · Answer

The aftercare is extremely important in facelift surgery. The experienced facelift surgeon will have a regimen in place for you that we recommend to follow closely. It is based on experience and provides the environment for speedy and safe recovery.

Stephen H. Fink, DO, FAOCO · Answer

After elevation on the tissues in a facelift, the space should be closed to permit healing without shifting or collection of blood or fluid in the potential space. This can be accomplished by either a suction drain or some supportive compression. Facelift procedures vary in the  extent of the skin elevation, which can  affect  the possibility of fluid collections. Compression, elevation, ice and reduced activity are also generally  believed to reduce bruising and swelling after injuries or surgery. I prefer recommend all of these and anything else that may help reduce overall recovery time. I hope this helps.

Mark Been, MD · Answer

Thanks for your question. The answer depends on the surgeon's training and technique used. Personally, unless I'm performing some type of small mini-lift, I always use a compression dressing for at least 24 hours to prevent the accumulation of old blood and serous fluid under the skin. In my opinion, this allows the face and neck the best opportunity to heal well. Good luck!

John Michael Thomassen, MD · Answer

Every surgeon has different techniques on how to best recover from a a facelift.  A light compression bandage after surgery helps avoid any space where blood or serous fluid can accumulate and help the final contour so I typically recommend a gentle elastic compression garment for 1 week.  I find it very helpful neck lift cases as well.  However other surgeons may not deem this necessary.

Josh Waltzman, MD, MBA · Answer

Thank you for your question. A lot of the decisions regarding dressing and compression comes down to surgeon preference and how they were trained.  It also depends on what type of surgery was performed.  Some surgeons believe it compresses the tissues and helps prevent fluid collections and improves contour.  Others believe that there should be no compression on the face because it might have negative effects on the skin as it tries to heal.  I would recommend talking to several board certified plastic surgeons about what they do and why.  As long as the compression is not too tight it probably doesn't really matter that much in the end.  Good luck!

Semira Bayati, MD, FACS · Answer

The bandage choice after facelift is mainly dictated by surgeon preference.  Some surgeons put suction drains in the face during surgery, that cause closure of the space where the skin has been elevated.  As a rule, not much compression is required with that.  Some surgeons don't drain their facelift and use the compression bandages as a way of closing that space where fluid could collect after surgery in the absence of a drainage system.

William Portuese, MD · Answer

In our practice, we have not used bandages or compression wraps after a facelift for the last 15 years. Compression wraps are painful, uncomfortable and claustrophobic. They also mask  any potential bleeding underneath the skin until there is  a large hematoma present. Instead of compression wraps, we  place small suction drains underneath the skin of the neck to drain fluid and blood out from underneath the skin. The drains are left in place for 1 to 2 days after the surgery, depending upon how much fluid is been removed. Either drains or compression wraps are required after a facelift

James Southwell-Keely, MD, FRACS · Answer

Thanks for your question Bridget,Compression or no compression boils down to surgeon preference. I only use a compressive garment after a corset platysmaplasty (neck lift).All the best,James