The Incidence of Hematoma in Face-lift Surgery Using an Open Postauricular Incision as the Drain

Objective: To analyze the incidence of hematoma in a series of 100 consecutive cervicofacial rhytidectomies performed using an open postauricular incision as a drain.

Design: Retrospective chart review of 100 consecutive cervicofacial rhytidectomies performed by a single surgeon from January, 1996 - December, 1999 using a standard SMAS dissection and liposuction, and leaving a 2-3cm segment of postauricular incision open for drainage. All procedures were done under local anesthesia with intravenous sedation. The mean duration of follow-up was 10 months (range, 1-44).

Setting: Private practice, ambulatory surgery. All procedures performed in office operating room or Surgi-center.

Main Outcome Measure: The occurrence of hematoma within the first 10 days after surgery.

Results: Of the 100 patients, there were 83 females and 17 males with a mean age of 57 years (range, 36-75) and 7 (7%) developed minor hematomas, all of which resolved with aspiration alone. None of the patients developed hematomas requiring open surgical exploration. The mean preoperative blood pressure of the patients who developed hematomas (138/88 mm Hg) was higher than the overall mean blood pressure of the group (120/73 mm Hg).

Conclusions: The rate of hematoma with the use of an open postauricular incision as a drain is less than the overall reported incidence of hematoma in the literature and brings into question the necessity of using postoperative drains.