BACKGROUND: Rhytidectomy is a popular procedure for facial rejuvenation, but a comprehensive and up-to-date appraisal is lacking. This study reports current practices, safety profile, and complications following rhytidectomy in a large, prospective, multicenter database.
METHODS: A prospective cohort of patients undergoing rhytidectomy between 2008 and 2016 was identified from the TOPS database. Perioperative data and patient characteristics were extracted and analyzed with respect to adverse events. Multivariate logistic regression evaluated for risk factors including age, gender, body mass index, smoking, diabetes mellitus, duration, multiple procedures, type of surgical facility, anesthesia type, and provider.
RESULTS: A total of 13,346 patients with a mean age of 60 years underwent rhytidectomies and a total of 31,206 Current Procedural Terminology procedures. Most were healthy females with an American Society of Anesthesiologists class <3 (98%). On average, 2.3 Current Procedural Terminology procedures were performed in 3.8 hours per patient, and blepharoplasty was the most common adjunctive procedure. Fifty percentage of operations were performed in office-based settings, with an anesthesiologist and general anesthesia utilized in 50.5% and 63% of cases, respectively. The incidence of adverse events was 5.1%, and hematoma (1.9%) and infection (0.8%) were the most frequent surgical complications. Male gender (odds ratio [OR], 1.6), obesity (OR, 1.7), smoking status (OR, 1.6), duration (OR, 1.1), combined procedures (OR, 1.3), general anesthesia (OR, 1.7), and office-based surgery (OR, 1.3) were associated with an increased odds of adverse events.
CONCLUSION: This is the largest analysis of rhytidectomy in a representative population. Rhytidectomy is a very safe procedure when performed by board-certified plastic surgeons. The study provides a standard reference for professionals when counseling patients and in guiding clinical practices.