Blood Pressure Following Mini-lift and Platysmalplasty?

Maintaining a normal to low-normal blood pressure before, during, and after facelift surgery is important in lessening the chance of fluid and/or hematoma formation.  Frequent checks and consultation with your primary care provider beforehand is important.  Blood pressure should be monitored by the surgeon during the procedure.  I will administer antihypertensive medication (typically clonidine for those for whom it is safe) from time to time as needed in the perioperative period.  In my experience, facelifts performed under sedation anesthesia versus general anesthesia experience fewer changes in pressure and less commonly produce hematomas.

Thank you for your question. We typically do not see BP issues following facelifts.  The facelift pt.,  at least ours, have a pressure dressing on the face to minimize a hematoma, and a drain to remove any blood so a hematoma risk is very low and rare.  If you have good pressure control, your anxiety is not serving you well.  Relax, and the procedure will flow better with you relaxed and taking your medications as prescribed. I hope this helps.

We do almost all of our facelifts under local anesthesia.  For patients on BP medication, we have them take their blood pressure meds like normal on day of surgery.  Most of our patients take no or very little pain meds afterwards.  Talk with your internist and PS about using anti anxiety pills before and after surgery.

     Unfortunately, a patient's blood pressure will increase with pain or anxiety and is the normal physiologic response.  Blood pressure should be managed to the extent possible, but the risk of hematoma can never be fully eliminated.  Kenneth Hughes, MD Los Angeles, CA

The best thing you can do following surgery is to take your blood pressure medications, avoid aspirin, avoid high impact activity, avoid straining and wear the provided compression dressing. These maneuvers are typically effective at minimizing the risk of hematoma. With regard to pain medication, I typically provide at least a few days of a narcotic-type pain medication as Tylenol might not cover the pain adequately in the early post-surgery period. I hope this information is helpful.

Stephen Weber MD, FACS

Lone Tree Facial Plastic Surgeon

Thank you for the great question. Pain and anxiety do sometimes lead to increases in blood pressure. However, for patients on blood pressure medications, this fluctuation should be less. In order to limit the risk of hematoma after facelift, plastic surgeons use a soft compression dressing. This provides gentle pressure over the lifted area. Limiting your activity in the immediate post-operative period is also essential. Lastly, pain medication -- even a low dose -- is helpful in the first 24 hours, in my opinion. Best of luck moving forward!
 

You are absolutely correct in being concerned about your blood pressure during and after a facelift. Having your procedure under local anesthesia gives you the best chance to not have a blood pressure related problem such as a hematoma. Having an accurate preop blood pressure reading is important. Your BP should be monitored throughout your procedure. If your BP stays within normal limits during surgery then it is unlikely to become a problem afterwards. Most prescribe pain medication especially for the first 24 hours after surgery. If you don't know how to take your BP you should learn surgery or not. With the good doctors you have taking care of you everything should be fine. 

Dear mimv,

Thank you for your post. Local procedures can be anxiety causing for anyone, bloodpressure issues or not.  I usually give valium +/- vicodin to these type of procedures that work well in calming patients down.

Best wishes,

Pablo Prichard, MD

The fact that you have been seen by your internist and that you are on a medication to control your blood pressure means you are off to a good start.

As you mentioned you have increased blood pressure when anxious. Surgery is an anxious time for all patients so we like to use an oral sedative like valium to help keep patients calm, comfortable and in a good blood pressure zone.

Blood pressure actually can rise from general anesthesia so local anesthesia is a good way to go to keep it from elevating even more.

Every patient is different so keep working with your doctors together and explore the option of IV sedation which is a nice middle ground between local sedation and general anesthesia.

I prefer to perform face lifts under twilight or general anesthesia. If you have blood pressue issues during surgery, the anesthesiologist will give medications to keep your pressure stable.  Under local, the surgeon will have very little control to do this for you.