How long before a facelift surgery do you have to get off hormones??

Doctor Answers 21

How long before facelift do I come off hormones?

The primary reason to discontinue hormones before any surgery is to reduce the risk of a deep venous thrombosis from occurring in the legs. I recommend being off hormones 2 to 3 weeks before surgery if possible and if ok with the prescribing physician. I also recommend early ambulation and the placement of intermittent venous compression sleeves on the lower legs for 24 hours after the procedure. These type measures help reduce risks with minimal inconvenience. This helps these elective cosmetic surgical procedures to be as safe as possible.

Hormones and Facelift Surgery

A great question since many women who are seeking a facelift are on hormone replacement therapy or HRT.  In n general, you should be of your HRT for about 2 to 3 weeks prior to surgery if you are having a general anesthetic.  This is the rule for any elective surgery where general anesthesia is used.  If you are having a local anesthetic or conscious sedation plus local, then you do not have to go off your HRT at all as the risk for developing a DVT or blood clot in your legs is not a problem when general anesthesia is not used.

I hope that helps.

Best regards.


Brian Windle, MD
Kirkland Plastic Surgeon
4.9 out of 5 stars 56 reviews

Hormone replacement therapy and facelift surgery

If your procedure is preformed under local anesthesia and oral sedation you do not need to stop your hormones. However, facelift under general anesthesia is associated with more complication such as DVT that can be exacerbated with hormones. I have performed well over 2,500 facelifts under local anesthesia with oral sedation for the past ten years. Without doubt it is safe and well tolerated by patients. Compare to the traditional facelift procedures that are performed under general anesthesia, the post operative complications associated with local anesthesia cases are lower and risk of bleeding is minimized. Please visit our website to become more educated about various anesthesia options for facelift surgery.

Kevin Sadati, DO
Orange County Facial Plastic Surgeon
4.9 out of 5 stars 186 reviews

Hormones increase the risk of DVT.

Facelift surgery may last a few hours and requires the patient to be immobilized for that period of time, which increases the risk of blood clots. Hormones may also add to the risk of blood clots forming during or after surgery. In our practice we always take preventive measures during surgery such as applying compression devices to the legs to stimulate blood flow. Depending on the dose of hormones you are taking as well as your medical comorbidities, we would make a decision as to whether or not you need to stop taking your hormones preoperatively. It is important to discuss your upcoming surgery with the prescribing physician (PCP or endocrinologist) because the indication for hormone therapy, duration of therapy, and the adverse effects of stopping the medication will vary from patient to patient. If you have other medical conditions that could increase your risk for blood clots or other complications, we would likely have you undergo evaluation by an anesthesiologist who can best assess these risks and assure you a safe surgery and recovery.

Stephen P. Smith, Jr., MD
Columbus Facial Plastic Surgeon
5.0 out of 5 stars 24 reviews

When should I stop taking hormones before surgery?

Hormones, like estrogen and growth hormone may increase your risk of a complication called pulmonary embolus but it also can cause more bleeding at surgery. It would be best to stop for 2weeks on either side of surgery but I do have many patients that are on birth control pills that decide to stay on them even though the risks may be there.

Edward J. Domanskis, MD
Newport Beach Plastic Surgeon
4.4 out of 5 stars 27 reviews

How long before facelift to stop hormones?

Typically, you do not need to stop hormones. It really depends upon what hormones you are taking. Most prescription based hormones do not need to be stopped.

Dominic Castellano, MD
Tampa Facial Plastic Surgeon
5.0 out of 5 stars 12 reviews

Facelift surgery and hormones

In my practice I use an anesthesiologist who reviews each case prior to surgery and it is my experience that typically the usage of hormone therapy is not stopped prior to surgery. Assuming your surgeon is an expert n the field of facelift surgery this surgery may be performed in a very reasonable time frame insuring the patients safety and risk of complications. To reduce any risks special positioning of the patient is performed, SCD (sequential compression devices)  are placed on the patients legs that actually pump the legs as if the patient is walking. These precautions are made to reduce the risk of blood clots.  In my thirty years of experience it is very rare to stop hormone therapy however each patient is on an individual bases and this decision is based on their individual health and history so it is most important that whatever your surgeon instructs in this matter you should follow. Best regards, Michael V. Elam, M.D.

Michael Elam, MD
Orange County Facial Plastic Surgeon
5.0 out of 5 stars 199 reviews

Discontinuing Hormones before Surgery

Dear Laura:

It is interesting to see the polarity of answers provided by other surgeons regarding discontinuing hormones prior to surgery.

I recommend discontinuing estrogen therapy 2 weeks prior to surgery to diminish the risk of blood clots to the legs and lungs. 

In the interest of safety, there are manageable options to decrease the risk of complications during surgery. These will include the following:
  1. stop all unnecessary medications and supplements which may cause you greater risk as recommended by your Plastic Surgeon and Primary Care Physician.
  2. hydrate yourself prior to and after the procedure.
  3. maintain warmth before, during and after the surgery.
  4. bend the knees and waist (chaise lounge - like position) to allow unobstructed venous flow.
  5. use sequential venous compression devices on the legs. 
  6. ambulation soon after the procedure.
I wish you all the best!


Dean P. Kane, MD, FACS
Baltimore Plastic Surgeon
4.8 out of 5 stars 70 reviews

Hormones and facelift

If you are on a regimen of hormone replacement therapy, you do not need to discontinue them prior to a face lift, in my opinion.  Some surgeons may ask you to stop them to reduce the risk of vein clots.  You should do whatever your surgeon recommends.

Ronald J. Edelson, MD
San Diego Plastic Surgeon
5.0 out of 5 stars 25 reviews

Facelift in patients on Hormone Therapy

In my practice we do not routinely advise the patients to stop hormone therapy. Patients on hormone therapy are thought to have higher risk of Deep Venous Thrombosis during surgery. There are many ways to mitigate that risk in most patients, such as selection of proper anesthesia, proper positioning and other anti-thrombotic devices. But the most important factor is choosing the right surgeon that will keep the surgery time within a safe limit while still performing all the necessary surgical maneuvers to achieve the optimum result.

Boris M. Ackerman, MD
Newport Beach Plastic Surgeon
4.9 out of 5 stars 52 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.