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The First Case Report of Poly-Microbial Necrotizing Soft Tissue Infection Following Facelift Surgery in the United States & A Systematic Review of the Literature
Sanam Zahedi1, James Kim2 1University of California Davis, Sacramento, CA 2The Permanente Medical Group, Sacramento, CA

Background: Facelift surgery is one of the five top cosmetic procedures of 2019. Less than one percent of postoperative complications are related to wound infections. We present a first-to-be-reported case of poly-microbial necrotizing soft tissue infection following facelift surgery by a board-certified plastic surgeon and our management along with a systematic review of the literature regarding facelift infections to identify the most at-risk patient population and provide a pragmatic preoperative approach.

Methods: A systematic review of peer-reviewed journal articles from 2000 to 2020 was performed to identify all reported wound infection complications following facelift surgery.

Results: Nineteen studies were identified from 2000 to 2020, which included a total of twenty-one patients with culture proven wound infections following facelift surgery. The most common pathogens were various strains of atypical Mycobacteria (fourteen patients, 66%). The next most common pathogen was Methicillin-Resistant Staphylococcus Aureus (four patients, 19%). The only reported necrotizing soft tissue infection in the literature was from the pathogen Group A Streptococcus.

Conclusion: While wound infections are a rare complication following facelift surgery, when present, they can cause significant morbidity to the patient. Every effort should be made to optimize the patient preoperatively to avoid this complication.

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