Facelift complications and the risk of venous thromboembolism: a single center's experience.

[BACKGROUND] The number of facelifts performed in the United States has steadily increased over the past decade. Moreover, the risk of venous thromboembolism in plastic surgery has been established in recent studies.

[OBJECTIVES] The authors investigate the overall complication rate in a single-center series to identify risk factors and determine the risk of venous thromboembolism.

[METHODS] A retrospective chart review was performed for patients who underwent a facelift procedure at a private clinic in Atlanta, Georgia, between January 2004 and December 2010. A total of 630 patients were included. The data collected included patient demographics, comorbidities, body mass index, smoking history, operative time, and concurrent procedures. All postoperative complications were recorded.

[RESULTS] The mean age of the patients in this series was 58.4±7.3 years. A small percentage of the patients were men (8.1%); 23.2% had hypertension; 4.9% were smokers; and 3.5% had a history of taking prophylactic aspirin. The mean operative time was 255.6±81.6 minutes. Almost a quarter (23.6%) of the patients underwent concurrent procedures. There were 38 complications, including 29 hematomas, two deep vein thromboses (DVTs), two eye infections, two instances of partial skin loss, and one ectropion. Risk of complications was significantly higher in men, patients over 55, and those with a body mass index>30 kg/m2. The risk of hematoma was higher (P<.05) in men, patients over 55, those with a history of hypertension, and those taking aspirin. The risk of DVT increased when the procedure time was longer than five hours. Both patients who developed DVT had undergone a facelift in combination with another procedure. There was also an increase in the risk of complications when the facelift was combined with two or more procedures.

[CONCLUSIONS] Identifying various risk factors for complications, especially DVT, can help to minimize those factors in the postoperative period and treat complications effectively when they occur. The data indicate that the number of concurrent procedures is a specific risk factor for development of DVT, so care should be taken when planning for multiple treatment sites. Combining facelift with other procedures also increases the risk of complications, especially DVT.

[LEVEL OF EVIDENCE] 4.