Risk Factors for Extensive Hematomas After Rhytidectomy

Summary. Objective. To assess the main risk factors for the development of extensive hematoma following rhytidectomy and to establish a risk group based on the obtained data. Materials. A retrospective analysis of 410 inpatient medical records was conducted for patients who underwent rhytidectomy for involutional changes in the face and neck. All patients were examined by a therapist or cardiologist before surgery. Deep-rhytidectomy was performed in 121 patients, SMAS-rhytidectomy in 157, and 132 rhytidectomy were supplemented with additional procedures. Results. Extensive facial hematomas following aesthetic procedures were observed in 37 patients (9.02%). The main risk factors included age over 46 years (OR 1.78 [1.06-2.98], p=0.037), high body mass index (OR 1.92 [1.16-3.19], p=0.015), elevated systolic blood pressure (OR 2.14 [1.26-3.63], p=0.006), and diabetes mellitus (OR 2.99 [1.56- 5.73], p=0.001). Younger age, gender, smoking, alcohol use, and lung pathology were not significant risk factors. Conclusion. During the planning phase for surgical correction of involutional facial changes, a risk group for the development of extensive postoperative hematomas should be identified. This group includes patients over 46 years old, with a high body mass index (over 25.0), arterial hypertension (episodes of elevated systolic blood pressure), other cardiovascular pathologies, or diabetes mellitus.