Archive for September, 2010
Healing following Facelift surgery is of significant interest to patients and practitioners. Millions of dollars are spent on marketing every year, promising less healing and down time, and subsequently, a faster return to daily activities. Practitioners advertise minimally invasive surgical techniques and use prescription pharmaceuticals and homeopathic remedies to facilitate healing following surgery. Bromelain and Arnica Montana (A. Montana) are the two most common homeopathic treatments offered following facelift surgery; they are supposed to reduce swelling and bruising, respectively. One of the most conclusive studies on A. Montana demonstrated no difference in the degree of bruising between the group taking A. Montana and the group receiving a placebo pill following facelift surgery. However, this study did validate an objective computer model to assess bruising, with a superior ability to discriminate subtle color changes over the human eye and eliminating the inherent, subjective bias of visual analog scales and ranking schemes. This allowed the medical community to objectively study the effect of therapies on bruising following surgery, and in particular facelift surgery procedures.
Hyperbaric oxygen (HBO) therapy has been popularized in the main stream media through several celebrities for its anti-aging effects. In the scientific literature it has been demonstrated to hasten wound healing by promoting free radical scavengers, reducing cell damage, and increasing the oxygen delivery and blood supply to wound beds. For years, hyperbaric oxygen therapy has been used to facilitate healing in chronic, non-healing wounds. Ultimately, the common pathway in hyperbaric oxygen therapy is more rapid wound healing. A new, unique application for HBO therapy is to assist healing in facelift surgery.
We performed a prospective, controlled study on thirteen patients undergoing face lift surgery with six electing to undergo HBO therapy immediately before and after their face lift. Seven patients were entered into the control group and received no therapy. Any additional confounding factors were equal and accounted for. Statistical Analysis, digital photography and the previously validated objective computer model were used to assess the resolution of bruising postoperatively. The result was a statistically significant decrease in the degree of bruising in the HBO group over the control group on postoperative days 7 and 10, with a 35% and 30% reduction, respectively. There were no complications associated with the treatment group.
This is the first report of the benefit of HBO therapy on wound healing in cosmetic surgery. To date there has been no more compelling evidence for a particular adjunctive therapy to facilitate healing, with many of the current treatments having little scientific evidence supporting their use. The validated computer model in this study provides the scientific community an excellent resource to objectively measure the resolution of bruising and healing following surgery. Additionally, a larger number of patients enrolled in this study would empower the degree of effect on bruising and most likely become statistically significant sooner in the postoperative course.
When patients are choosing to undergo facelift surgery, they should educate themselves on therapies that do and do not work. This can often be difficult due to the current directed marketing strategies making promises that often go unfulfilled. What the patient truly needs is a consultation with a facial plastic surgeon in order to decipher and discuss the information. Hyperbaric oxygen therapy offers patients a statistically validated and scientifically studied adjunctive therapy to recover faster, following facelift surgery. HBO in otherwise healthy patient’s is a safe, innocuous therapy with little downside. Although it can potentially increase the overall cost associated with the surgery, it does offer patients seeking the most rapid recovery from facelifts a further treatment modality to employ in order to return to daily activities faster. Due to the proven benefits, HBO should be included in the discussion with patients undergoing facelift surgery as a potentially beneficial therapy in the healing process and may be applicable to other plastic surgery procedures such as the midface lift.
Posted by: Benjamin C. Stong MD
Atlanta, GA