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Do Male Patients Have More Complications in Facelift Surgery? A Retrospective Cohort Study on Matched Patients
Osama Darras, MD, PhD(c); Elad Fraiman, BA, MPH; Alvaro Reategui Via y Rada, MD; Pierce Janssen, MD; James E. Zins, MD.
Cleveland Clinic
2025-01-10
Presenter: Osama Darras, MD, PhD(c);
Affidavit:
Raymond Isakov, MD
Director Name: Raymond Isakov, MD
Author Category: Fellow Plastic Surgery
Presentation Category: Clinical
Abstract Category: Aesthetics
Background: Male rhytidectomy is a unique surgery that employs a different technique compared to the standard procedure for females. This observation prompted us to investigate the differences in complications between male patients and a matched group of females.
Methods: A single-surgeon retrospective cohort study for patients who underwent facelift surgery between 2014 and 2024. Patients were categorized based on gender. We matched age, BMI, revisions, TXA use, and hypertension prevalence to minimize bias. All patients received general anesthesia and subcutaneous infiltration of 0.5% lidocaine with 1:200,000 epinephrine, with or without TXA.
Results: 34 patients were included in each group. Median Follow-up time was 302 days. No significant difference in terms of age (P = 0.633), BMI (P = 0.312), follow-up (P = 0.129), TXA use (P = 0.808), revisions (P = 0.323), hypertension (P = 0.804) was observed. None of the complications reported in each group was significantly different. However, the mean surgical time in the male group was 40 minutes longer than in the female group (P < 0.001). The incidence of an estimated blood loss of 100 cc or more was significantly higher in the male group (34.78% and 6.9%, respectively, P = 0.011).
Conclusions: This study indicates that facelifts are safe for men, as we did not observe any significant differences in complications. However, the longer operative time for this group may be attributed to a higher likelihood of intraoperative bleeding. Nevertheless, these findings reassure aesthetic surgeons of the safety of male rhytidectomy, thereby preventing unnecessary concerns.
