Systematic Review Examines Hematoma Reduction Techniques in Facelifts

A new systematic review and meta-analysis published in Facial Plastic Surgery & Aesthetic Medicine underscores the incidence of hematoma after rhytidectomy and evaluates commonly used adjunctive techniques aimed at reducing this complication. The analysis focused on patients undergoing deep plane facelifts and assessed outcomes when tranexamic acid (TXA), tissue sealants, or hemostatic nets were used.

Researchers screened multiple databases, including PubMed, EMBASE, and Cochrane, identifying 31 studies encompassing 8,841 patients. The patient population had a mean age range of 31 to 84 years, with women comprising 85.2% of cases with known gender (4,330/5,080). The primary outcome was hematoma rate, while secondary measures included revision surgeries and use of preventative techniques.

The pooled hematoma rate was 2.7% (95% CI: 2.2–3.4%), with major hematomas occurring at a rate of 0.97% (95% CI: 0.61–1.53%). Subgroup analyses by adjunctive measure showed similar rates of major hematoma across groups: 1.53% with TXA, 1.25% with tissue sealants, and 1.23% with hemostatic nets.

“Evidence from this review suggests that deep plane facelifts have a 2.7% overall and 0.97% major hematoma rate, with no clearly superior adjunct among TXA, sealants, or hemostatic nets,” the authors wrote.