Is an EKG Necessary for Pre-op Rhinoplasty in a 45 Year Old with No Heart Issues?

Hi! I am a healthy 45 year old woman who is currently seeking primary rhinoplasty. I am finding that pre-op testing varies greatly from doctor to doctor. I understand having blood work done but is an EKG necessary for a patient with no heart problems? Thank you.

Doctor Answers 12

EKG prior to rhinoplasty for 45 year old patient

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

45 years old is usually the threshold age for which most surgery centers and hospitals will require an EKG prior to any type of elective surgery.  They are simple, easy to perform, and takes about 10 minutes in a doctor’s office to have one done.  This is done out of patient safety.

Seattle Facial Plastic Surgeon
4.8 out of 5 stars 158 reviews

The need for an EKG in a healthy 45 year old undergoing a rhinoplasty

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Being healthy including having no known heart problems is always a good thing when contemplating surgery. However, you usually can't fight the established policy of a health care facility as regards lab work and an EKG. Different institutions have different regulations. Some don't require an EKG until age 50 unless there are known significant underlying medical problems; others use 40 or 45 as the cut-off. Find out from your surgeon what the policy is at the facility where you will be having your surgery.

Steven Turkeltaub, MD
Scottsdale Plastic Surgeon
4.7 out of 5 stars 33 reviews

Emphasis on Patient Safety

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Most recently all healthcare providers have been asked to look into ways to insure patient safety - and getting EKGs may be some doctors' resonse to safety concerns.

You will be asked repeatedly about your allergies, your medications, and even if you feel adequately informed about the rhinolpasty you have chosen to undergo in any healthcare setting. Office-based surgical suites sometimes don't have the backup support of ancillary staff & equipment that hospital surgicenters have nearby, and may need to be more thorough about looking for heart irregularities.




Edward Szachowicz, MD, PhD
Minneapolis Facial Plastic Surgeon
4.6 out of 5 stars 14 reviews

Necessary tests before rhinoplasty

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

There will be variation  in tests before surgery depending on where your procedure is performed. In our area, we ask for an EKG at age 50 and above. Also blood tests are not required at all, unless there is a specific health issue or concern.

Best of luck,

Peter E. Johnson, MD
Chicago Plastic Surgeon
4.0 out of 5 stars 44 reviews

Rhinoplasty Preop Lab Work

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

I have not ordered routine EKGs for your age group, but there is no specific preop set of labs. If you like your doctor and are happy with his photos of his work that he has shared with you, then best you just follow his routines. If you don't trust his judgement in ordering preoperative tests, how can you trust his surgical judgementt?

Ronald V. DeMars, MD
Portland Plastic Surgeon
5.0 out of 5 stars 29 reviews

If you're over 40, you should get an EKG before Rhinoplasty Surgery.

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

EKG testing is routine and non-invasive for patients requesting nose job surgery that are over 40. In my practice, blood work is not indicated in otherwise healthy 40-year-olds, unless the "bleeding questionnaire" raises concerns.

Good luck.

Dr. Joseph

Eric M. Joseph, MD
West Orange Facial Plastic Surgeon
4.9 out of 5 stars 435 reviews

EKG for Rhinoplasty

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Dr. Alessi  and the surgery center that we use requires and EKG for patients 40 years old and older.

David Alessi, MD
Beverly Hills Facial Plastic Surgeon
4.8 out of 5 stars 18 reviews

Usually not necessary below 50-55

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

This is a good question!

As others have said, the institutional policy usually dictates what is required.  According to more recent studies of preoperative studies (like labs, EKG, X-Rays, etc), there is usually very little to gain from doing an EKG in a healthy individual with no cardiac history.  On the other hand, if a patient is diabetic, has a history of heart disease (including immediate family members), any history of chest pain or early exertion or similar warning signs, an EKG or even a more extensive workup may be indicated.

For my location, someone who lacks any risk factors or history and is under 55 does not require any studies prior to surgery.  That being said, I do screen my patients thoroughly for these things by reviewing their history, examining them and interviewing them prior to their big day.

All the best to you!

Paul K. Holden, MD
Phoenix Facial Plastic Surgeon
4.9 out of 5 stars 55 reviews

EKG necessity based on Institution's policy

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

There is no baseline to when an EKG is mandatory.  In general, an EKG is necessary if...

1. Age >50

2. Diabetes

3. An hx of cardiac disease

4. Strong family hx of cardiac disease

If none of the above are true, I generally do not order a pre-op EKG.  I also ask if the patient can walk a city block without chest pain or shortness of breath.  If that can be done, it tells me that the patient is pretty healthy from a cardiac standpoint.



Raghu Athre, MD
Houston Facial Plastic Surgeon
4.6 out of 5 stars 94 reviews

EKG preop rhinoplasty surgery

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

It depends on the policy of the  institution or private clinic you are having surgery.  In the past EKG and blood work was ordered routinely before elective surgery. Recently there has been a move towards ordering lab work when it is  clinically indicated.

Philip Solomon, MD, FRCS
Toronto Facial Plastic Surgeon
4.4 out of 5 stars 120 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.