Can an eyelid lift be done safely if the patient is on one aspirin per day?

Question

How risky is it? My neurosurgeon who performed a cerebral aneurysm procedure on me 8/2021 doesn't oppose me having the lift but won't release me from the aspirin pre or post surgery. My plastic surgeon won't operate with me on aspirin which I fully respect, but a nurse told me many surgeon's will operate with aspirin as a factor. Need some real facts please!

Kenneth D. Steinsapir, MD · Answer

You are taking aspirin to inhibit platelets. Bleeding with surgery will adversely affect your surgeons ability to perform your eyelid surgery. Bruising after surgery will organize into scar tissue and adversely affect your surgical outcome. It does not matter to some surgeons. I strongly advise against eyelid surgery until you can safely be off of aspirin.

Cory Bovenzi, MD · Answer

Each surgeon has their own preference on anticoagulant use and surgery. It would be difficult to find a consensus on the topic since different surgeons have different levels of bleeding risk they are willing to tolerate. Some important things to keep in mind:Aspirin 81mg is less risky than Aspirin 325mg for bleedingUpper Blepharoplasty is generally less risky than lower transconjunctival blepharoplasty for bleeding
Can it be done safely? YesIs it worth the bleeding risk? It depends on which surgeon you ask, with the above concepts in mind
It is important to note that you should not self-discontinue the aspirin. Any changes should of course come only from the treating physician (in this case, your neurosurgeon)

Zachary Farhood, MD · Answer

Most surgeons will not operate on someone’s eyes for a purely cosmetic issue if they are taking aspirin because the risky of bleeding and possible vision loss is not worth it. If your neurosurgeon thinks you can stop it at some point in the future then that would be a good time to consider elective procedures.

Camille Cash, MD · Answer

Aspirin will impact your blood's ability to clot which could potentially impact your surgery as well as your results.  It is up to each surgeon's protocol if she/he feels comfortable proceeding with surgery while you are currently taking the aspirin.

David Cheung, MBChB, Bsc(Hons), FRCOphth · Answer

Hi. Greetings from the UK. Just to say that yes we do ask our patients to cease aspirin prior to oculoplastic surgery if possible especially for our higher risk operations when excessive bleeding would be dangerous e.g. skin graft surgery. However for our patients in whom they cannot safe stop their aspirin safely e.g. coronary artery stent patients requiring long term aspirin, we would still offer them the option of surgery whilst still on the aspirin 75mg once a day but just warn them that there would be a slightly greater risk of haemorrhage. Good luck!

Can an eyelid lift be done safely if the patient is on one aspirin per day?

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