LAM FACIAL PLASTICS

I've read that in some cases antibiotics are prescribed after a surgery, while in other cases surgeons don't feel a need to do so. It seems to randomly vary with each surgeon. Dr Lam, assuming that the operation is undertaken in a clean environment (no dirty wound, no infection, standard OR environment), could you elaborate on when/which kind of surgery antibiotics should be prescribed and when not to?

Since antibiotics serve to prevent infections, shouldn't they always be prescribed "just in case"? Are there any drawbacks of taking antibiotics post-op, such as impairment of wound healing?

Good question. When I did my residency in two hospitals, Columbia U., and Cornell U., the former always prescribed antibiotics, and the latter, never did (except in dirty cases as you are suggesting). I subscribe to an intermediate strategy. In most clean cases I do not use antibiotics except if I am doing an implant like a chin implant or nose implant. I will do antibiotics with plasma skin resurfacing because with the skin that is violated, there is a small risk of infection so i like to cover that risk. In general, I believe the studies have shown no benefit to using antibiotics on clean cases, especially in the face that heals tremendously better and is more resistant to infections than the rest of the body. If the person's immunity is down like diabetes, then i will consider antibiotics. and, yes, taking antibiotics should not be done in my opinion cavalierly. although the risks are very small, they are present including developing a yeast infection for women, an allergic reaction to the antibiotic, or growing out bad bugs (albeit temporarily) in the gut causing diarrhea for example. hope that helps.
best,
sml

What about for a scar revision operation where a scar is excised and closed with sutures?

generally, i would do that without antibiotics.