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.