Face Lift in Patients on Mandatory Anticoagulants, Safety, Efficacy and Complications

Background:  A facelift is currently one of the most requested aesthetic procedure, with increasing demand among patients who seek aesthetic plastic surgery.  In addition, the number of patients taking anticoagulants in which the prescriber disagrees to stop therapy, who request treatment for the aging face, has been increasing constantly over the years. 

 

Purpose: The purpose of this study is to examine the level of safety in these patients, the optimization of the process, side effects and complication. 

 

 Materials and Methods:   A consecutive series of patients who underwent facelift under mandatory anticoagulant between the years 2010 - 2017.  All patients operated under local anesthetic with IV sedation.  Meticulous hemostasis is mandatory, and biologic glue was available at all cases.  Chart review including before and after photographic records, time to full recovery, side effects, complications and the need for redo of any subsequent procedure.

  

Results:   Sixteen patients (14 female and 2 male) at ages ranging from 62 to 89 years old underwent facelift while being treated with anticoagulants at the same time.  Traditional facelift incision performed in two patients and the rest underwent direct excision face and neck lift.  Ten patients were happy with the results above their expectations (63%), 4 were pleased with results but expected to tighter appearance (25%), two request for touch up and willing to have some procedure again in order to meet their goals (12%).  None had any serious complication such as death, necrotizing fasciitis, massive bleeding, permanent nerve damage or significant necrosis. Significant scar was not an issue in none of the patients.

 

Conclusion: The results achieved with this series of patients indicate that facelift under continued treatment with anticoagulants is a safe, predictable, and effective treatment for aging face, and we recommend considering it to all experience surgeons.