Abstract
Background
Despite the use of many different strategies and techniques and notwithstanding recent advances such as fibrin glue and short scar operations, hematoma remains the most common complication in rhytidectomies.
Methods
This study analyzed 383 patients who underwent cervicofacial rhytidectomies between September 2006 and March 2012. The patients were distributed into three groups.
Results
Group 1 comprised patients who had classic face-lifts with epinephrine in the anesthetic solution used to infiltrate the face and neck. The incidence of hematomas in this group was 12 % (24 of 200 patients). Group 2 comprised patients who underwent face-lifts without epinephrine in the solution used to infiltrate the midface and neck. The incidence of hematomas in this group was reduced to 3.6 % (3 of 83 patients). Group 3 comprised the remaining 100 patients, who underwent rhytidectomies with internal and external quilting sutures used in conjunction with other ancillary procedures listed in this report. The incidence of hematomas in this group was reduced to 0 %.
Conclusions
The most important single procedure that reduced hematoma cases to zero in cervicofacial rhytidectomies was the use of quilting sutures in conjunction with other procedures. Furthermore, the use of these sutures did not cause flap ischemia or necrosis, and there was no adverse impact on the quality of the facial rejuvenation.
Level of Evidence V
This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.
Similar content being viewed by others
References
Pitanguy I, Ceravolo MP (1981) Hematoma postrhytidectomy: how we treat it. Plast Reconstr Surg 67:526
Rees TD, Lee YC, Coburn RJ (1973) Expanding hematoma after rhytidectomy: a retrospective study. Plast Reconstr Surg 51:149
Grover R, Jones BM, Waterhouse N (2001) The prevention of hematoma following rhytidectomy: a review of 1,078 consecutive face-lifts. Br J Plast Surg 54:481
Rees TD, Barone CM, Valauri FA, Ginsberg GD, Nolan WB (1994) Hematomas requiring surgical evacuation following face-lift surgery. Plast Reconstr Surg 93:1185
Baker DC, Stefani S, Chiu ES (2005) Reducing the incidence of hematoma requiring surgical evacuation following male rhytidectomy: a 30-year review of 985 cases. Plast Reconstr Surg 116:1973–1985
Baker DC, Chiu ES (2005) Bedside treatment of early acute rhytidectomy hematomas. Plast Reconstr Surg 115:2119
Baker TJ, Gordon HL, Stuzin JM (1966) Surgical rejuvenation of the face, 2nd edn. Mosby-Year Book, St. Louis
Calvin MJ Jr, Ramsey A (2002) The aging face: a systematic approach. WB Saunders, Philadelphia, pp 72–86
Tonnard P, Verpaele A, Monstrey S, Van Landuyt K, Blondeel P, Hamdi M et al (2002) Minimal access cranial suspension lift: a modified S-lift. Plast Reconstr Surg 109:2074–2076
Jones BM, Grover R (2004) Avoiding hematoma in cervicofacial rhytidectomy: a personal 8-year quest. Reviewing 910 patients. Plast Reconstr Surg 113:381
Marchac D, Sandor G (1994) Face-lifts and sprayed fibrin glue: an outcome analysis of 200 patients. Br J Plast Surg 47:306
Hudson DA (2010) The quilting suture: its application in face-lifts. Plast Reconstr Surg 126:72e
Pollock H, Pollock TA (2003) Management of face-lifts with progressive tension sutures. Aesthet Surg J 23:28–33
Luz DF, Wolfenson M, Figueiredo J, Didier JC (2005) Full-face undermining using progressive dilators. Aesthet Plast Surg 29:95–99
Warren RJ, Aston SJ, Mendelson B (2011) Face-lift. Plast Reconstr Surg 128:747e
Acknowledgments
The authors thank Erika Moura for her support as an instrumentalist in all the surgical procedures covered by this study. The authors of this study have no financial interest in any of the products cited in this article.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Neto, J.C., Rodriguez Fernandez, D.E. & Boles, M. Reducing the Incidence of Hematomas in Cervicofacial Rhytidectomy: New External Quilting Sutures and Other Ancillary Procedures. Aesth Plast Surg 37, 1034–1039 (2013). https://doi.org/10.1007/s00266-013-0084-6
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00266-013-0084-6