Efficacy and safety of hemostatic net in facelift and rejuvenation surgeries (browlift and necklift): A systematic review and meta-analysis.

Abstract

Facelifts are commonly associated with postoperative complications. The hemostatic net has emerged as a promising approach to reduce these events. The aim of this meta-analysis was to evaluate the efficacy and safety of the hemostatic net in facelift. The PubMed, Embase, and Cochrane databases were systematically searched up to May 2025 for studies evaluating the hemostatic net in facelift and rejuvenation surgeries (browlift and necklift). Statistical analysis was performed using R version 4.4.1 with a random-effects model for single-arm meta-analysis, reporting outcomes per 100 observations. The primary outcome was hematoma incidence. Secondary outcomes included seroma, necrosis, ischemia, infection, hyperemic marks, persistent hyperpigmentation, and sensory deficits. Eight studies (1617 patients) were included. The outcomes incidences were hematoma: 0.14 per 100 (95% CI: 0.00 to 0.58; I² = 23.8%); seroma: 2.16 per 100 (95% CI: 0.00 to 9.32; I² = 85.4%); necrosis: 0.36 per 100 (95% CI: 0.00 to 1.14; I² = 3.4%); ischemia: 1.10 per 100 (95% CI: 0.00 to 6.56; I² = 94.7%); infection: 0.62 per 100 (95% CI: 0.00 to 4.35; I² = 70.4%); hyperemic marks: 12.70 per 100 (95% CI: 0.74 to 34.96; I² = 97.5%); persistent hyperpigmentation: 0 per 100 (95% CI: 0.00 to 0.14; I² = 0%); and sensory deficits: 0 per 100 (95% CI: 0.00 to 0.33; I² = 0%). Minimal incidence of hematoma, seroma, necrosis, ischemia, and infection was observed. Hyperemic marks associated with the technique resolved completely within 2 to 3 months, with no progression to persistent hyperpigmentation. No sensory deficits were identified. CRD420251136208.