Middle aged woman wearing a sun hat

Do I need to wear a large, heavy, compression dressing after my facelift?

A common question asked during consultation for facelift surgery is what the post-operative dressings will look and feel like. Many express a concern about being required to wear large, heavy compression dressings for days after surgery. They ask if this will be required after the extended deep plane facelift.

The short answer is no, for the following reasons:

  1. Compression dressings have historically been used to prevent or reduce the risk of blood accumulating under the skin after surgery, called a hematoma. Unfortunately, there is no evidence compression dressings significantly reduce the risk of hematoma formation. Instead, the use of a special local anesthesia mixture, blood pressure control during and after surgery, and meticulous surgical technique to minimize the transection of blood vessels are the best ways to minimize the risk of hematoma formation (1), (2), (3), (4).

  2. Tight compressive dressings can reduce blood flow to the skin, which can harm wound healing.

Dr. Harmon avoids tight compressive dressings after surgery for the same reason he strongly advises against icing the face or neck after the extended deep plane facelift. Like compressive dressings, cooling of the skin after surgery can reduce blood flow to the skin, thereby harming wound healing.

The dressing Dr. Harmon places over patients after facelift surgery is soft and VERY loosely fitted. It is generally removed the day following surgery. After removal, he places an ACE wrap around the head VERY loosely. This ACE wrap functions only to protect the incisions. It does not function to hold anything up or together because that is not required. The ACE wrap is generally worn day and night for 7 days then nightly only for an additional 7 days. The above protocol maximizes comfort patients while minimizing risks to patients.

References:

  1. Kleinberger AJ, Spiegel JH. What is the best method for minimizing the risk of hematoma formation after rhytidectomy? Laryngoscope. 2015 Mar;125(3):534-6.
  2. Schroeder RJ 2nd, Langsdon PR. Effect of Local Tranexamic Acid on Hemostasis in Rhytidectomy. Facial Plast Surg Aesthet Med. 2020 May/Jun;22(3):195-199.
  3. Couto RA, Charafeddine A, Sinclair NR, Nayak LM, Zins JE. Local Infiltration of Tranexamic Acid With Local Anesthetic Reduces Intraoperative Facelift Bleeding: A Preliminary Report. Aesthet Surg J. 2020 May 16;40(6):587-593.
  4. Kochuba AL, Coombs DM, Kwiecien GJ, Sinclair NR, Zins JE. Prospective Study Assessing the Effect of Local Infiltration of Tranexamic Acid on Facelift Bleeding. Aesthet Surg J. 2021 Mar 12;41(4):391-397.

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