Fang Amanda Hua, de la Torre Jorge
From the Division of Plastic Surgery, University of Alabama at Birmingham, Birmingham, AL.
Ann Plast Surg. 2025 Jun 1;94(6S Suppl 4):S502-S516. doi: 10.1097/SAP.0000000000004272.
Facelift, also known as rhytidectomy, is one of the most common aesthetic surgical procedures performed by plastic surgeons. The goal around finding the ideal facelift revolves around cosmetic outcome, ability to maintain long term results, and minimizing complications. Known complications in facelift surgery include hematomas, seromas, neurapraxia, and unfavorable scars. With the growing popularity of facelifts and the constant evolution, our study aims to evaluate the complications and interventions reported since 2000 and examining any changes and trends.
A systematic review was performed through PubMed using keyword search in the following combinations: "facelift," "face lift," "complication," "management," "perioperative," and "prevention." The search was restricted from publication years 2000 until day of search (August 2024). The search was designed to find studies that reported facelift-related complications rates and studies that analyzed interventions to help reduce facelift complications.
A total of 59 articles were found to meet the inclusion criteria for analysis of complications. Twenty-seven articles were included in the study from 2000 to 2012, whereas 32 articles from 2013 to 2024. A total of 39 studies were included for the analysis of interventions. From 2012 to 2024, hematoma remained the most common reported complication (27% of all complications), followed by unfavorable scarring (24%), neurapraxia (22%), and seroma (7%). Neurapraxia and unfavorable scar complications were reported twice as much, whereas seroma complications decreased by half in studies from 2012 to 2024. Hematoma rates remained similar. The use of fibrin glue/sealant was the most analyzed intervention, followed by use of TXA, quilting sutures, and blood pressure control.
The rates of complications in rhytidectomy are low. When compiling all the reported complications, hematomas made up 1/3 of all complications with similar reports from 2000 to 2012 compared to 2013 to 2024. Unfavorable scarring and neurapraxia reports doubled in the latter half of the study, whereas seroma reports decreased by half. This could be attributed the use of tissue sealants and local pharmacologic agents. Complications can occur, and it remains essential to recognize the complications and prevention methods available.
面部提升术，也称为除皱术，是整形外科医生实施的最常见的美容外科手术之一。寻找理想面部提升术的目标围绕着美容效果、保持长期效果的能力以及将并发症降至最低。面部提升手术中已知的并发症包括血肿、血清肿、神经失用症和不良瘢痕。随着面部提升术越来越受欢迎且不断发展，我们的研究旨在评估自2000年以来报道的并发症及干预措施，并研究任何变化和趋势。
通过PubMed进行系统综述，使用以下组合关键词进行搜索：“面部提升术”“除皱术”“并发症”“处理”“围手术期”和“预防”。搜索范围限制在2000年至搜索日期（2024年8月）之间发表的文献。该搜索旨在找到报告面部提升术相关并发症发生率的研究以及分析有助于减少面部提升术并发症的干预措施的研究。
共发现59篇文章符合并发症分析的纳入标准。2000年至2012年的研究中有27篇文章被纳入，2013年至2024年有32篇文章。共有39项研究被纳入干预措施分析。从2012年到2024年，血肿仍然是报告最多的并发症（占所有并发症的27%），其次是不良瘢痕（24%）、神经失用症（22%）和血清肿（7%）。在2012年至2024年的研究中，神经失用症和不良瘢痕并发症的报告数量增加了一倍，而血清肿并发症减少了一半。血肿发生率保持相似。纤维蛋白胶/密封剂的使用是分析最多的干预措施，其次是氨甲环酸的使用、褥式缝合和血压控制。
除皱术的并发症发生率较低。汇总所有报告的并发症时，血肿占所有并发症的1/3，2000年至2012年的报告与2013年至2024年相似。在研究的后半期，不良瘢痕和神经失用症的报告数量增加了一倍，而血清肿的报告数量减少了一半。这可能归因于组织密封剂和局部药理剂的使用。并发症可能会发生，认识到可用的并发症及预防方法仍然至关重要。
