Complications after superficial plane cervicofacial rhytidectomy: a retrospective analysis of 178 consecutive facelifts and review of the literature.
ABSTRACT It is well-recognized that postoperative hematoma is the most common complication of cervicofacial rhytidectomy (facelift surgery), and several strategies aimed at reducing the incidence of hematoma have been developed and studied. Other common complications include skin necrosis, seroma, motor and sensory nerve injury, alopecia, auricular deformity/displacement, and dyspigmentation. The purpose of this study was to retrospectively analyze the incidence of complications after superficial cervicofacial rhytidectomy performed by a single surgeon and his fellows and to compare our findings with those reported in the literature.
Based on a retrospective chart review of patients who underwent cervicofacial rhytidectomy, 178 consecutive patients were enrolled in this study. The charts were reviewed for any notable complications after facelift surgery, especially postoperative hematoma. The charts of those patients with complications were reviewed to identify the presence of perioperative anomalies that may have increased the risk of such complications. Our findings were then compared with those reported in the literature.
Of 178 patients who underwent cervicofacial rhytidectomy, 11 (6.2%) had a postoperative complications. These 11 complications included 5 cases (2.8%) of a major postoperative hematoma requiring surgical intervention, 3 cases (1.7%) of minor hematomas ("microhematomas"), and 1 case each of hypertrophic scarring necessitating surgical excision and steroid injection, superficial skin necrosis, and dehiscence. There were no cases of seroma, parotid pseudocyst, or permanent motor nerve injury.
The incidence of postoperative complications associated with superficial plane rhytidectomy is very low, with hematoma the most common complication.
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ABSTRACT: The effects of cigarette smoking on the skin flaps of the face lift procedure are discussed. Reported elsewhere is a significant incidence of skin slough in smokers with use of wide undermining techniques. This complication is thought to be due to the vasoconstrictive effects of nicotine on the peripheral circulation. Our group has employed a conservative bilateral undermining technique in 407 face lifts. Of these, 32.4 percent were smokers and 67.6 percent were nonsmokers. No cases of skin slough were encountered. Our conservative undermining technique is briefly discussed. Among its advantages are shorter operative time, use of less local and/or general anesthesia, less intraoperative bleeding, adequate exposure for SMAS and platysmal surgery, and snugger skin closure without the risk of flap necrosis. As shown by our statistics, it is a safer procedure in smokers than the usually performed more radical procedure.Plastic & Reconstructive Surgery 05/1986; 77(4):596-604. · 3.54 Impact Factor
Article: Composite rhytidectomy.[show abstract] [hide abstract]
ABSTRACT: Signs of aging in the face reflect the change in position of deep anatomic elements, which are the platysma muscle, cheek fat, and the orbicularis oculi muscle. These changes occur from progressive ptosis of these elements, which continue to keep their intimate relationship with each other throughout the aging process. Conventional face lift procedures disrupt this normal relationship by separating the skin from these elements. All SMAS techniques reposition only the platysma muscle without repositioning the cheek fat and orbicularis muscle. This composite rhytidectomy allows elevation of a composite musculocutaneous flap containing all three elements for repositioning while maintaining their intimate relationship with each other and with the skin. One-hundred and sixty-seven composite rhytidectomies have been done with impressive results and minimal complications.Plastic & Reconstructive Surgery 08/1992; 90(1):1-13. · 3.54 Impact Factor
Article: The S-lift: Less Is MoreAesthetic Surgery Journal. 01/1999; 19(5):406-409.