Can I be on Coumadin and get Ultherapy?

Question

I would like to have Ultherapy done on my face and neck. I am on Coumadin and my INR is between 2.0 and 2.5. I have had botox, juverderm and skintight with no problem. I was told that I could have deep bruising and/or bleeding under the skin. I'm ok with some bruising. Just wondering if this a big risk to take. Apparently there has been no studies done with patients on Coumadin.

A. David Rahimi, MD · Answer

Dear Patient, I have performed over 250 Thermage treatments and a few on patients with Coumadin on board. They all did fine. I have the Ulthera machine and have performed over 100 in the past 2 years. I sometimes get deep bruising in the temple and jawline in patients that are not taking Coumadin! I would say that you are taking a little bit of a chance with Ulthera and Coumadin. IF you decide to do it I would suggest much lower settings and more lines and even a test spot on the temple and forehead area a week before the actual procedure. Good luck.David

Raffy Karamanoukian, MD, FACS · Answer

The risk of bruising is higher among Coumadin patients. I would ask the physician to prescribe a natural bruisefighter alongside your treatment. Bruising is more likely in the jowl areas. Raffy Karamanoukian, Los Angeles

Ron Shelton, MD · Answer

Bruising can rarely occur with Ultherapy ultrasonic facial lifting in patients that don't take blood thinners such as coumadin. A patient who is on Coumadin may have more bruising but the chance of a actual hematoma, or collection of blood underneath the skin that would form a significant temporary lump, is low provided the provider does not treat with Ultherapy right over a bony prominence of large vessel. The monitor helps the physician see the depths of the tissues being treated prior to each energy burst delivered.

	The information provided in Dr. Shelton's answer is for educational purposes only and is not intended to constitute medical advice.  The information provided should not be relied upon as a substitute for consultations with a qualified health professional who may be familiar with your individual medical needs.

Hratch Karamanoukian, MD, FACS · Answer

You may get bruising in the jawline, especially near the corners of the mouth with Ultherapy and I would venture to say that this is certainly a risk if you are on blood thinners like coumadin. I would still do it and be cognizant of that risk with the understanding that it will resolve over a course of 2-3 weeks.

Can I be on Coumadin and get Ultherapy?

Answers (4)