The Effect of Subperiosteal Drain Placement on Periorbital Edema and Ecchymosis Following Ultrasonic Piezoelectric-Assisted Rhinoplasty: A Prospective Comparative Study.

Periorbital edema and ecchymosis are frequent complications after rhinoplasty, impacting early recovery and patient satisfaction. To evaluate the effect of subperiosteal drain placement in patients undergoing ultrasonic piezo-assisted rhinoplasty, as measured by periorbital edema and ecchymosis on postoperative days (POD) 3, 7, and 14. In this prospective comparative study, 110 adults undergoing open rhinoplasty with piezo-assisted osteotomies were divided into drain ( = 55) and non-drain ( = 55) groups. The drain group received bilateral subperiosteal cannula drains along the osteotomy lines, removed on POD3. Edema and ecchymosis were graded by blinded observers on days 3, 7, and 14 using a 0-4 scale. Patients were 28.2 ± 8.5 years; 76/110 (69.1%) were female; groups were balanced in age ( = 0.224) with a higher female proportion in the drain group (81.8% vs. 56.4%). At POD3 and POD7, total ecchymosis scores were lower with drains (POD3: 2.82 vs. 4.29, = 0.002; POD7: 0.76 vs. 1.58, = 0.001), while edema scores were similar between groups at all timepoints. By POD14, edema had resolved and ecchymosis was minimal in both groups. In this study, the use of subperiosteal drains in patients undergoing piezo-assisted osteotomies was found to be associated with a reduction in early postop ecchymosis, but not periorbital edema.