<< Back to the abstract archive
When to Cut: Infrared Thermography Insights and Evidence-Based Guidelines for Incision Timing in Facelift Surgery
Abigail Meyers, MD; Sami Tarabishy, MD; Marjorie Kragel, MD; Isaac James, MD; Pierce Janssen, MD; James E. Zins, MD, FACS
Cleveland Clinic
2025-01-11
Presenter: Abigail Meyers, MD
Affidavit:
Agree, this abstract includes novel patient data and methodology compared to prior pilot study. I certify that the material proposed for presentation in this abstract has not been published in any scientific journal or previously presented at a major meeting. The majority of writing and revision in preparation of the abstract was carried out by the first author. They were also involved in the study design, acquisition of data, analysis, and interpretation of data.
Director Name: Raymond Isakov, MD
Author Category: Resident Plastic Surgery
Presentation Category: Clinical
Abstract Category: Aesthetics
Background: The optimal time for incision following epinephrine-containing local anesthetic injection during facelift surgery remains unclear. This study updates preliminary findings with a full sample size, offering a more robust analysis of the time to achieve maximal vasoconstrictive effect using infrared thermography.
Methods: A retrospective chart review of 27 facelift patients was conducted. Infrared thermography measured skin surface temperature at baseline and at 1-minute intervals up to 15 minutes post-injection. The primary outcome was time to minimal temperature, indicating maximal vasoconstriction. Statistical analyses included Kaplan-Meier, Pearson's correlation, and two-sample t-tests (significance: p<0.05).
Results: The mean time to minimal skin temperature was 5.1±2.9 minutes. The largest temperature difference (delta) between the cheek and nasal control occurred at 6.7±2.5 minutes. A 2.7°C mean temperature reduction was observed. By 9 minutes, 96.3% (26/27) achieved the lowest temperature, indicating maximal vasoconstrictive effect. No significant differences were found between primary and secondary/tertiary facelifts (p=0.57) or between hypertensive and non-hypertensive patients (p=0.62, p=0.68). These results align with and expand upon prior pilot findings with a smaller cohort.
Conclusions: Maximal vasoconstriction occurs approximately 7 minutes after injection, with nearly all patients achieving this effect by 9 minutes. Plastic surgeons should wait 8-9 minutes post-injection before incision to optimize efficiency and minimize bleeding. This study provides stronger evidence supporting clinical recommendations, improving upon prior preliminary data.
