Fibrin tissue adhesive for face- and necklift

Although available for decades, fibrin-based tissue adhesives (FTAs) have enjoyed only variable popularity in aesthetic surgery since their introduction in the 1980s. Whilst benefits in facelift surgery have been reported for a range of measures, including expanding haematoma, oedema and ecchymosis, irrefutable evidence has not yet been forthcoming. We instigated a prospective study to test the hypothesis that an underappreciated property of FTA, namely its ability to distribute tension, would reduce complications and revision due to early relapse.

The study group comprised 100 consecutive facelifts with FTA. The comparative group comprised the immediate preceding 100 patients who underwent similar interventions, but with drains instead of FTA. All surgery was undertaken by the senior author using standard techniques and statistical analysis employing Fisher's exact test.

The groups were comparable in age, gender distribution, co-morbidity and declared cigarette smoking. Complications were recorded in 24 patients with significantly more in the comparative group (p = 0.048), particularly hypertrophic scarring (p = 0.029). Although there appeared a greater prevalence of revision and cutaneous necrosis in the comparative group, these did not reach statistical significance.

To the many published benefits, we can add that FTA can reduce complications, particularly hypertrophic scarring, and it now forms an important part of our facelift practice.