Incidence and management of bleeding and hematoma in 805 cosmetic forehead/eyebrow lift procedures: an oculofacial plastic surgeon's experience.

PURPOSE: Hematoma formation after a forehead/eyebrow lift (FEL) procedure can lead to tissue necrosis and forehead fixation failure. This study aims to report the incidence and outcome of intra- and post-operative bleeding and hematoma-related complications in patients undergoing open and endoscopic FEL procedures. A strategy for prevention of intra- and postoperative bleeding is also provided.

METHODS

This is a retrospective chart review of patients who had cosmetic FEL performed by the senior author (2007-2022). Patients with excessive intraoperative bleeding, early postoperative bleeding, hematoma requiring drainage, hematoma extending to the neck or chest, and hematoma-related complications were identified.

RESULTS

Among 805 patients, excessive intraoperative bleeding was observed in 30 (3.7%), early postoperative bleeding in 12 (1.5%), and postoperative hematoma requiring drainage in six (0.7%) patients. Intra- and post-operative bleeding incidences were significantly higher in males (p = 0.000). There was no association between bleeding incidence and age, FEL technique, or forehead skin type (p > 0.05). Two patients who had diabetes and hypertension and were taking blood thinners had hematomas extending to the neck and chest, which gradually resolved with no complications.

CONCLUSIONS

There was excessive intraoperative bleeding in 3.7%, early postoperative bleeding in 1.5%, and hematoma drainage in <1% of patients undergoing FEL procedures.