You cannot safely undergo blepharoplasty or a facelift while you are on anticoagulants. So the question becomes, "Can I safely go off the anticoagulants to have the surgery". Atrial fibrillation increases the risk of stroke by releasing clots from the heart valves. If you stop the anticoagulation, you may very well be lucky and not have any problems. Or you may stroke out. 30 years ago I reviewed a case in which a patient with atrial fibrillation was going to get married and wanted a facelift. Her plastic surgeon said it was too risky. She pleaded it be done. She was sent to her cardiologist who said it would be risky, a gamble. She told them both that she was willing to take the risk and would sign any waivers to protect them from liability. She begged, pleaded , and insisted.The surgeon finally gave in. She signed the waivers, stopped the anticoagulation, and had an uncomplicated facelift on a Friday. Monday she stroked out.I determined there was no malpractice since the patient was adequately informed of the risk, demanded the procedure, and signed waivers.But as a young surgeon, I learned a valuable lesson. It is my responsibility as the treating physician to protect patients from their own ignorance. Patients may wish to gamble, but I have an ethical (though not legal) obligation not to take the bet.Cosmetic surgery is not worth a big gamble with your health.