Prevention of severe postoperative lymphedema in anti-aging facial surgery

Manturova N.E.; Volokh M.A.; Subbotkin A.S.; Abzaleva G.R.; Barsakov M.A.; Prokhorchuk E.N.; Lazarenko E.S.

doi:https://doi.org/10.17116/plast.hirurgia20210215

Manturova N.E.

Pirogov Russian National Research Medical University;
Institute of Plastic Surgery and Cosmetology

SPIN RSCI: 5232-0412
Scopus AuthorID: 55461712100
ORCID: 0000-0003-4281-1947

Volokh M.A.

Mechnikov North-Western State Medical University

Subbotkin A.S.

Mechnikov North-Western State Medical University

Abzaleva G.R.

Mechnikov North-Western State Medical University

Barsakov M.A.

Mechnikov North-Western State Medical University

Prokhorchuk E.N.

Mechnikov North-Western State Medical University

Lazarenko E.S.

Mechnikov North-Western State Medical University

Prevention of severe postoperative lymphedema in anti-aging facial surgery

Authors:

Manturova N.E., Volokh M.A., Subbotkin A.S., Abzaleva G.R., Barsakov M.A., Prokhorchuk E.N., Lazarenko E.S.

More about the authors

Journal: Plastic Surgery and Aesthetic Medicine. 2021;(2): 5‑12

DOI: 10.17116/plast.hirurgia20210215

Read: 4399 times

To cite this article:

Manturova NE, Volokh MA, Subbotkin AS, Abzaleva GR, Barsakov MA, Prokhorchuk EN, Lazarenko ES. Prevention of severe postoperative lymphedema in anti-aging facial surgery. Plastic Surgery and Aesthetic Medicine. 2021;(2):5‑12. (In Russ., In Engl.)
https://doi.org/10.17116/plast.hirurgia20210215

Подписка 2026 Пластическая хирургия и эстетическая медицина (Plastic Surgery and Aesthetic Medicine)

Использование инфографики авторами научных работ

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OBJECTIVE

To improve the outcomes of anti-aging facial surgery via prevention of severe postoperative lymphedema.

MATERIAL AND METHODS

There were 40 menopausal women aged 52-65 years with body mass index 20-23 kg/m². All women had similar parameters of facial aging and thickness of subcutaneous fatty tissue. Deep frontotemporomalar lifting, upper and lower blepharoplasty, SMAS lifting and lateral platysmoplasty were carried out under general anesthesia. Patients were divided into several groups depending on the management: group 1 — crystalloids only (ionosteril, sterofundin) 3-4 ml/kg/hour; group 2 — gelofusine 500 ml once at the beginning of surgery, then only crystalloids (ionosteril, sterofundin) 3-4 ml/kg/hour; group 3 — crystalloids only (ionosteril, sterofundin) 3-4 ml/kg/hour + postoperative glucocorticoids (dexamethasone 8 mg intraoperatively, 8 mg in 24 and 72 hours after surgery ); group 4 — crystalloids only (ionosteril, sterofundin) 3-4 ml/kg/hour + taping. We used direct morphometric measurement and ultrasound followed by computer analysis of images.

RESULTS

Composite surface measurement and echogenicity value were 185.3±6.8 and 20.8±16.2 in group 1, 169.4±7.5 and 32.9±17.4 in group 2, 169.2±5.6 and 34.5±15.8 in group 3, 170.8±6.5 and 31.9±16.8 in group 4.

CONCLUSION

Infusion of colloids and glucocorticoids together with lymphatic drainage taping in postoperative period are required to reduce severity and duration of postoperative lymphedema in anti-aging facial surgery.

Keywords:

facelift

lymphedema

infusion therapy

colloids

glucocorticoids

taping

face and neck surgery

face ultrasound

prevention

Authors:

Manturova N.E.

Pirogov Russian National Research Medical University;
Institute of Plastic Surgery and Cosmetology

SPIN RSCI: 5232-0412
Scopus AuthorID: 55461712100
ORCID: 0000-0003-4281-1947

Volokh M.A.

Mechnikov North-Western State Medical University

Subbotkin A.S.

Mechnikov North-Western State Medical University

Abzaleva G.R.

Mechnikov North-Western State Medical University

Barsakov M.A.

Mechnikov North-Western State Medical University

Prokhorchuk E.N.

Mechnikov North-Western State Medical University

Lazarenko E.S.

Mechnikov North-Western State Medical University

Received:

29.01.2021

Accepted:

17.03.2021

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References:

Mottura AA. Face lift postoperative recovery. Aesthetic Plast Surg. 2002; 26:172-180. https://doi.org/10.1007/s00266-001-0029-3
Van der Meer WJ, Dijkstra PU, Visser A, et al. Reliability and validity of measurements of facial swelling with a stereophotogrammetry optical three-dimensional scanner. Br J Oral Maxillofac Surg. 2014;52:922-927. https://doi.org/10.1016/j.bjoms.2014.08.019
Sinko K, Jagsch R, Drog C, et al. Facial esthetics and the assignment of personality traits before and after orthognathic surgery rated on video clips. PLoS One. 2018;13(2):e0191718. https://doi.org/10.1371/journal.pone.0191718
Meade RA, Teotia SS, Landis K. Griffeth and Fritz E. Barton Facelift and Patterns of Lymphatic Drainage. Aesthetic Surgery Journal. 2012;32:39-45. https://doi.org/10.1177/1090820x11430683
Davydova LA, Chaika LD. Anatomy of the lymphatic system: textbook. Minsk: BSMU; 2013. (In Russ.).
Volokh MA, Papayan GV, Akopov AL, Antonyan PA, Abzaleva GR, Subbotkin AS. Assessment of the lymphatic system before and after different variants of facelift with the help of fluorescence imaging in the near infrared range. Issues of Reconstructive and Plastic Surgery. 2018;3(66):5-11. (In Russ.).
Meade RA, Teotia SS, Landis K. Griffeth and Fritz E. Barton Facelift and Patterns of Lymphatic Drainage. Aesthetic Surgery Journal. 2012;32:39-45. https://doi.org/10.1177/1090820x11430683
Esen E, Taşar F, Akhan O. Determination of the anti-inflammatory effects of methylprednisolone on the sequelae of third molar surgery. J Oral Maxillofac Surg. 1999;57(10):1201-1206. https://doi.org/10.1016/s0278-2391(99)90486-x
Kim K, Brar P, Jakubowski J, et al. The use of corticosteroids and nonsteroidal antiinflammatory medication for the management of pain and inflammation after third molar surgery: A review of the literature. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2009;107:630-640. https://doi.org/10.1016/j.tripleo.2008.11.005
Aznar-Arasa L, Harutunian K, Figueiredo R, et al. Effect of preoperative ibuprofen on pain and swelling after lower third molar removal: A randomized controlled trial. Int J Oral Maxillofac Surg. 2012;41:1005-1009. https://doi.org/10.1016/j.ijom.2011.12.028
Troullos ES, Hargreaves KM, Butler DP, Dionne RA. Comparison of nonsteroidal anti-inflammatory drugs, ibuprofen and flurbiprofen, with methylprednisolone and placebo for acute pain, swelling, and trismus. J Oral Maxillofac Surg. 1990;48:945-952. https://doi.org/10.1016/0278-2391(90)90007-o
Knepil GJ, Loukota RA. Outcomes of prophylactic antibiotics following surgery for zygomatic bone fractures. J Craniomaxillofac Surg. 2010;38:131-133. https://doi.org/10.1016/j.jcms.2009.03.015
Al-Khateeb TH, Nusair Y. Effect of the proteolytic enzyme serrapeptase on swelling, pain and trismus after surgical extraction of mandibular third molars. Int J Oral Maxillofac Surg. 2008;37:264-268. https://doi.org/10.1016/j.ijom.2007.11.011
Markovic A, Todorovic L. Effectiveness of dexamethasone and low-power laser in minimizing oedema after third molar surgery: A clinical trial. Int J Oral Maxillofac Surg. 2007;36:226-229. https://doi.org/10.1016/j.ijom.2006.10.006
Rana M, Gellrich NC, von See C, et al. 3D evaluation of postoperative swelling in treatment of bilateral mandibular fractures using 2 different cooling therapy methods: A randomized observer blind prospective study. J Cranio-Maxillofac Surg. 2013;41:e17-23. https://doi.org/10.1016/j.jcms.2012.04.002
Szolnoky G, Szendi-Horvath K, Seres L, et al. Manual lymph drainage efficiently reduces postoperative facial swelling and discomfort after removal of impacted third molars. Lymphology. 2007;40:138-142.
McClure WB, Aldrich CA. Die infradermole salzlosungsprobe H. Klin Wochenschr. 1927;6(25):1198-1200.
Belousov AE. The formula of facial tissues and its use in plastic surgery. Aesthetic Medicine. 2006;V(3):301-316. (In Russ.).
Smith BG, Hutcheson KA, Little LG, Skoracki RJ, Rosenthal DI, Lai SY, Lewin JS. Lymphedema outcomes in patients with head and neck cancer. Otolaryngol Head Neck Surg. 2015;152(2):284-291. Epub 2014 Nov 11. https://doi.org/10.1177/0194599814558402
Gavrilin AV, Stepanova YuA, Zhukov AO, Fedotov SV. Ultrasound diagnosis of soft tissue changes in the area of a postoperative wound. Diagnostic and Interventional Radiology. 2007;1(1):36-45. (In Russ.).
Sanober A, Rashid M, Khan MI, Rehman SU, Yousaf S, Rehman Orakzai IU, Fatima S, Eitezaz FA, Hussain A. Use of steroids in rhinoplasty with lateral osteotomies for reducing post operative Oedema. J Ayub Med Coll Abbottabad. 2018;30(1):45-48.
Dan AEB, Thygesen TH, Pinholt EM. Corticosteroid administration in oral and orthognathic surgery: A systematic review of the literature and meta-analysis. J Oral Maxillofac Surg. 2010;68:2207-2220. https://doi.org/10.1016/j.joms.2010.04.019
Weber CR, Griffin JM. Evaluation of dexamethasone for reducing postoperative edema and inflammatory resonse after orthognatic surgery. J Oral Maxillofac Surg. 1994;52(1):35-39. https://doi.org/10.1016/0278-2391(94)90010-8
Widar F, Kashani H, Alsén B, et al. The effects of steroids in preventing facial oedema, pain, and neurosensory disturbances after bilateral sagittal split osteotomy: A randomized controlled trial. Int J Oral Maxillofac Surg. 2015; 44:252-258. https://doi.org/10.1016/j.ijom.2014.08.002
Boonsiriseth K, Latt MM, Kiattavorncharoen S, et al. Dexamethasone injection into the pterygomandibular space in lower third molar surgery. Int J Oral Maxillofac Surg. 2017;46:899-904. https://doi.org/10.1016/j.ijom.2018.12.002
Dereci O, Tuzuner-Oncul AM, Kocer G, et al. Efficacy of immediate postoperative intramasseteric dexamethasone injection on postoperative swelling after mandibular impacted third molar surgery: A preliminary split-mouth study. J Pak Med Assoc. 2016;66:320-323.
Tantawy SA, Kamel DM. The effect of kinesio taping with exercise compared with exercise alone on pain, range of motion, and disability of the shoulder in postmastectomy females: A randomized control trial. J Phys Ther Sci. 2016;28(12):3300-3305. https://doi.org/10.1589/jpts.28.3300
Tozzi U, Santagata M, Sellitto A, Tartaro GP. Influence of kinesiologic tape on post-operative swelling after orthognathic surgery. J Maxillofac Oral Surg. 2016;15(1):52-58. https://doi.org/10.1007/s12663-015-0787-0
Kase K, Hashimoto T, Tomoki O. Development of kinesio taping perfect manual. Kinesio Taping Association; 1996.
Kase K, Wallis J, Kase T. Clinical therapeutic applications of the kinesio taping method. Tokyo: Ken Ikai Co., Ltd.; 2003.
Tsai HJ, Hung HC, Yang JL, et al. Could Kinesio Tape replace the bandage in decongestive lymphatic therapy for breast-cancer-related lymphedema? A pilot study. Support Care Cancer. 2009;17(11):1353-1360. https://doi.org/10.1007/s00520-009-0592-8
Finnerty S, Thomason S, Woods M. Audit of the use of Kinesiology Tape for breast edema. Journal of Lymphoedema. 2010;5(1):38-44.
Kaya S. Effect of Kinesio Taping with compression garment on lower extremity volume in primary lymphedema: A case report. Fizyoterapi Rehabilitasyon. 2008;19(3):213.