Alternative Options to Facelift for Patient with Heart Condition?

Prior to pursuing any cosmetic plastic surgery, consult with your cardiologist as whether you are physically healthy enough.
If so, request your cardiology records and a letter of clearance from your cardiologist be mailed to your facial plastic surgeon. This is to protect the patient from any cardiac events or complications during the surgery.
If you are not cleared for plastic surgery, there are non-surgical options that may help, though not nearly as effect as surgery. Non-surgical options include botox, dermal fillers, peels and lasers. Consult with a cosmetic dermatologist for more information.

I have operated on many people with minor heart problems as well as people who have had angioplasties, stents and even cardiac bypass surgery. However, these people have all been relatively healthy at the time of my surgery and they have all been cleared by their physicians (usually cardiologists).
In general, the biggest potential problem with facelift surgery is not the surgery but the anesthesia. Facelift surgery can be performed with local anesthesia as well. A mini lift type procedure with local anesthesia may work well in your case. The use of tumescent local anesthesia employs very little lidocaine and only a scant amount of epinephrine.
If surgical procedures are truly contraindicated in your case because of a severe heart problem, consideration can be given for the use of filler injections for creases and depressions, BOTOX® for forehead furrows and crows feet, non-invasive (or minimally invasive) laser, peel or other resurfacing type procedures for improving the quality of the surface of your skin.