The effect of minivac use on edema and ecchymosis in septorhinoplasty operations

Periorbital edema and ecchymosis are among the most frequent morbidities after septorhinoplasty and may delay recovery and reduce patient satisfaction. This study aimed to evaluate the effect of a negative-pressure minivac drain placed along the lateral osteotomy line on these morbidities. In a retrospective, self-controlled design, 44 patients were analyzed. In all cases, septorhinoplasty was performed via an open approach, and bilateral conventional internal lateral osteotomies were carried out using a lateral saw and an osteotome.A minivac drain was placed subperiosteally along the right lateral osteotomy line and kept for 24 hours; the left side served as control. Assessments were performed on photographs obtained on postoperative days 1, 2, 7, and 10. Edema and ecchymosis were scored on a 0–4 scale, and ecchymosis areas on the upper and lower eyelids were measured in square millimeters (mm²). The mean drainage volume was 14 ± 8 mL (range, 0–35 mL). Edema was significantly lower on the drain side in the early period (days 1–2; p<0.05); this superiority persisted on the upper eyelid throughout follow-up, whereas no statistical difference remained on the lower eyelid on day 10 (p>0.05). Upper-eyelid ecchymosis scores were lower on days 1 and 2 (p<0.05); no consistent superiority was observed on the lower eyelid (p>0.05). In area-based measurements, the upper eyelid showed smaller ecchymosis areas on all days (days 1, 2, 7, and 10; all p≤0.001). On the lower eyelid, significant differences favoring the drain were present on days 1, 2, and 10 (p<0.05) but not on day 7 (p>0.05). Spearman correlation analyses showed no overall significant association between drainage volume and the severity of edema/ecchymosis (p>0.05). These findings indicate that minivac drain is effective in reducing periorbital edema and ecchymosis in the early period after septorhinoplasty.