Is it possible or safe to have a blepharoplasty if I am on Coumadin?

Yes, you can have a blepharoplasty. Your surgeon and internist can stop the coumadin enough to let the surgery be done and then started again.

That is a question that not only is on the mind of patients, but constantly a topic of discussion among surgeons. And unfortunately, there is not an easy answer. When planning surgery, we always need to weigh the risks vs the benefits of surgery. The risk of stopping blood thinners is possible adverse blood clotting events such as stroke. Admittedly, the risk of such an event is relatively low, however the risk is there.

The risk of not stopping blood thinners is adverse bleeding events, which around the eyes could be devastating [potential blindness]. Again, this risk is relatively low as well. Specifically, in terms of a blepharoplasty, if your surgeon is not planning on removing prolapsing orbital fat, then the risk of bleeding causing loss of vision is very low, and many surgeons around the country are increasingly willing to operate on patients who are on blood thinners.

However, each and every patient needs to be evaluated on an individual basis, and your surgeon should discuss the pros and cons of stopping blood thinners.  In my practice, I always discuss the patient with their primary care provider or cardiologist to discuss their medical condition requiring the blood thinner and ask their advice regarding the risk of stopping the blood thinner. I then consider the surgical procedure and weigh the risk of bleeding could have towards the vision, and then make an informed decision on whether to stop the blood thinner. In each event, I will have the patient sign a form stating that we have discussed these risks and involve them in the decision making process.

Hope this helps.

AJ Amadi, MD FACS