The Effect of Subperiosteal Drain Placement on Periorbital Edema and Ecchymosis Following Ultrasonic Piezoelectric-Assisted Rhinoplasty: A Prospective Comparative Study

Uzunoğlu E, Hazır B, Ateş MS, Çallı Ç.

What this paper says

Leaving thin drains along the bone-cut lines for three days after piezo rhinoplasty reduced bruising scores at days 3 and 7 (2.82 versus 4.29; 0.76 versus 1.58) but did not change swelling.

Overview

The authors tested whether draining blood from under the periosteum reduces bruising and swelling around the eyes. In a prospective comparative study, 110 adults having open rhinoplasty with piezo-assisted osteotomies were split into drain (n = 55) and no-drain (n = 55) groups. The drain group had bilateral subperiosteal cannula drains along the osteotomy lines, removed on day 3. Blinded observers graded oedema and ecchymosis on days 3, 7 and 14 on a 0-4 scale.

Sections of note

Mean age 28.2 (SD 8.5); 69.1% female; more women in the drain group (81.8% versus 56.4%).
Ecchymosis at day 3: 2.82 with drains versus 4.29 without (p = 0.002).
Ecchymosis at day 7: 0.76 versus 1.58 (p = 0.001).
Oedema scores did not differ at any time point.
By day 14, oedema had resolved and bruising was minimal in both groups.

What it means for a patient

Small drains cut early bruising roughly in half in this study but did nothing for swelling.
By two weeks both groups looked the same, so the benefit is cosmetic during the first week only.
The drains stayed in for three days, which adds minor inconvenience.

Why this paper matters

It isolates a simple, low-cost step and measures its effect with blinded grading. Limits: not randomised, sex imbalance between groups, subjective 0-4 scale, single centre.

Terms

Subperiosteal: beneath the membrane covering bone.
Cannula drain: a thin tube left in a wound to let blood and fluid escape.
Osteotomy line: the path along which the nasal bone is cut.
Ecchymosis: bruising; oedema: swelling.
Blinded observer: a rater who does not know which group the patient is in.

Summary written by rhinoplasty.cc from the abstract, 2026-09-08; not medical advice. The authors' own abstract follows.

From the abstract

“Periorbital edema and ecchymosis are frequent complications after rhinoplasty, impacting early recovery and patient satisfaction. Objective: To evaluate the effect of subperiosteal drain placement in patients undergoing ultrasonic piezo-assisted rhinoplasty, as measured by periorbital edema and ecchymosis on…”

Excerpt; the full abstract is on PubMed.