Utilizing Internal Hemostatic Nets for Rhytidectomy in Fitzpatrick Skin Types III to V.

Area of Science:

• Plastic Surgery
• Dermatology
• Surgical Complications

Background:

• Hematoma is a significant complication after facelift surgery.
• External hemostatic nets can cause dyspigmentation in darker skin types (Fitzpatrick ≥III).
• Internal quilting sutures (IQS) are a potential alternative to mitigate these risks.

Purpose of the Study:

• To demonstrate the technique and efficacy of IQS in facelift surgery.
• To evaluate IQS in patients with Fitzpatrick skin types III-V.
• To assess complication rates associated with IQS.

Main Methods:

• A retrospective study of 41 patients (Fitzpatrick ≥III) undergoing facelift surgery.
• Platysma superficial musculoaponeurotic system plication with IQS using 4-0 Vicryl.
• Data collection on demographics, procedures, and complications (hematoma, necrosis, seroma, etc.).

Main Results:

• No hematoma or seroma occurred in the study cohort (n=41).
• One case of dehiscence in a patient with diabetes and smoking history.
• Transient skin dimpling (7 patients) and dog-ears (2 patients) resolved conservatively.
• Mean follow-up was 37.2 months.

Conclusions:

• IQS are effective in reducing facelift complications, particularly hematoma and seroma.
• This technique avoids the dyspigmentation risks of external sutures in darker skin types.
• IQS provide benefits similar to external nets without the associated drawbacks, leading to better outcomes.