Overview
Hematoma is the most common complication of facelift and can cause long-lasting swelling or skin loss, but its causes were unclear. The authors reviewed 1,078 patients who had facelifts by two high-volume surgeons from 1994 to 1999. They used multivariate statistics to find which factors were independently linked to hematoma.
Findings
- 1,078 consecutive facelift patients, 1994 to 1999, two surgeons.
- Hematomas: 45 (4.2%).
- Anterior platysmaplasty: P = 0.009.
- Systolic blood pressure: P = 0.02.
- Gender: P = 0.03.
- Aspirin or non-steroidal anti-inflammatory drug intake: P = 0.04.
- Smoking: P = 0.049.
- Relative risk was calculated for each factor, allowing a hematoma risk score for each patient before surgery.
- The authors state this is the first study to establish independent risk factors and a preoperative scoring system for hematoma after facelift.
- The abstract does not state which gender carried the higher risk or give the relative risk values.
What it means for a patient
- 4.2% of patients in this series had a hematoma after facelift.
- Stop aspirin and anti-inflammatory painkillers as your surgeon directs, and stop smoking.
- High blood pressure raises the risk. Tell your surgeon about it and follow blood pressure instructions around surgery.
- Tightening the platysma at the front of the neck was linked to a higher risk. Ask how your surgeon manages this.
Why this paper matters
It identified independent risk factors for hematoma after facelift in a large consecutive series and turned them into a risk score before surgery. It focused prevention on blood pressure, medications, smoking and neck muscle surgery. Cited 130 times (NIH iCite, 2026-09-25).
Terms
- Hematoma (haematoma): a collection of blood under the skin after surgery.
- Rhytidectomy: the medical name for a facelift.
- Anterior platysmaplasty: tightening or sewing the platysma muscle at the front of the neck.
- Systolic blood pressure: the top number in a blood pressure reading.
- Non-steroidal anti-inflammatory drugs (NSAIDs): painkillers such as ibuprofen.
- Multivariate analysis: a statistical method that tests several factors at once to find which act independently.
- Relative risk: how much more likely an outcome is in one group than another.
- Skin necrosis: death of an area of skin.