Is it safe to have face/neck lift if a person has had several strokes?

Patient with significant medical conditions might be able to undergo cosmetic plastic surgery like facelift if and only if all her/his doctors clear the patient for surgery (e.g. cardiologist, neurologists, internist, etc). Also if the surgery is performed under anesthesia, the anesthesiologist has to weight the risk. Undergoing facelift under local anesthesia could help to omit the risks associated with general anesthetics. 

My initial bias would be to say you should be very cautious because your risk level is elevated on the surface.  Obviously, more information is required and an examination mandatory before a definitive answer is given.  However, the fact that you have had 4 strokes in the last half decade is suggestive of some form of cardiac, atherosclerotic, cerebrovascular, or coagulation disorder.  There is a very good chance that you are currently on anticoagulant therapy, which would need to be stopped prior to and after the surgery.  Whether or not this is possible would be up to the Physician managing your underlying condition.  However, if you are motivated, have a conversation with this Physician(s) about your intentions. 

Every patient is unique and provides a different set of factors regarding the risk/benefit of elective cosmetic surgery and procedures, so let’s look at this objectively.

Following a stroke affecting the face and neck, the motor tone is lost in one or more muscles creating a asymmetry as well as greater sagging in the tissue affected. This is a perfect option to assist the patient using a static lift provided by a face and neck lift.
A stroke is generally separated into various types:

·         Hemorrhagic, from a burst artery or vein and generally stable following treatment of the causative factor such as an aneurysm or high blood pressure.

·         Atherogenic,  or weakening of the arteries and cholesterol build-up. This type of affects all the arteries of the body, reducing blood flow to the tissues of the face and neck, as well as your organs, trunk and extremities; also called peripheral vascular disease(PVD). PVD may require further work-up to exclude additional risks of the heart and kidneys and extremities prior to considering a cosmetic procedure as well.

·         Embolic or formation of clots which block arterial blood vessels typical of atrial fibrillation.  

Many patients following stroke will require blood thinners of various types. The will cause various levels of bleeding risk for the patient when operated on.
 
Select a Board Certified Plastic Surgeon to evaluate your needs and review your Medical History to determine what non-invasive, minimally invasive and surgical options suit your needs. He/she and your Primary Care Physician and specialists will determine how to optimize your health to reduce your risks of vascular complications including tissue ischemia and necrosis of the face and neck lift. If the risk of incisional, flap surgery are too great, other options exist such as:

·         Silhouette InstaLift, a minimally invasive suture suspension of the tissues

·         ThermiTIGHT,  a minimally invasive skin tightening technique

·         Sculptra, a injectable option of skin tightening, and

·         Obagi, ZO Skin Health retinoid skin tightening. 

Given the complexity of such medical decision making, Consult with a Board Certified Plastic Surgeon who has your best interests at heart and review the risk values with your Primary Care Physician to determine which of many alternatives is best for you. I wish you all the best!

Thank you for your question. While it may be possible for you to undergo a facelift after a series of strokes, it depends on your overall health. I recommend that you schedule a consultation with a board certified facial plastic surgeon. They can examine you and review your medical history, as well as consult with your vascular surgeon to ensure that you are healthy enough for elective plastic surgery. Our goal as surgeons is to keep our patients’ best interests at heart, and this includes your safety during your surgery and recovery. Good luck!

It’s important to ask your vascular surgeon and your primary care doctor if you would be a good candidate for surgery. I hope you find this information useful. Please watch the enclosed video.

Thanks for your question. There is a lot to dig through here, so bear with me. In general, cosmetic surgery is very safe. The safety levels achieved with anesthesia are the same as those for commercial airlines and the nuclear power industry. If you had the strokes because of narrowing in your carotid artery and now the artery is fixed, then you shouldn't have any increased risk. However, if you have to be on blood thinners or have other medical problems like high blood pressure and high cholesterol, those are factors that increase your risk of having a problem. Not a major problem, mind you, but from a surgical standpoint they increase your chance of having increased bruising or a fluid collection that would have to be dealt with. Talk to a few surgeons and get clearance from your primary care doctor prior to moving ahead with anything. Make sure that you're as healthy as you can be before deciding to go ahead with surgery. If surgery isn't going to be possible, there are other, non-invasive options to help your lower face and neck. They're not as good as a facelift, but safety is more important than anything else. For more on the anesthesia techniques we use for cosmetic surgery, check out my blog.Good luck!

Thank you for your question. You describe without submitting any photos that you had 4 strokes in the course of 5 years. You had surgery on the artery which contributed to the recurrent strokes. You’re aged 66, and asking if you’ll be safe to have a face and neck lift.
Generally, cosmetic surgical procedures are best performed in people who are at low risk for complications. When I see patients like yourself in my practice, they are often on blood thinners they rely on to maintain circulation. I modify different procedures depending on the desired outcome of the patient. For a procedure like facelift, you would need to be off of blood thinners prior to surgery. At the same time, you could still be at a higher risk for bleeding afterwards. I recommend you discuss this with your doctor how long it will be safe for you to be off of blood thinners, for example if you were to undergo colonoscopy or a dental procedure.
There are many options for people who are not good facelift candidates such as Structural Volumizing, which is a method of applying fillers to restore volume in the cheeks, chin, jawline and jaw angle such that it appears that a person had a facelift, but without surgery. This is not to be confused with a liquid facelift or any other injectable procedure that claims to create facelift results. Rather, this is a deliberate restoration of volume at the bone level which is responsible for a significant aspect of facial aging.
Depending on the degree of laxity of your skin in the cheek area resulting in jowls and sagging skin under the neck, it is conceivable that you would see a benefit from Structural Volumizing without surgery. However, if you do have significant amount of laxity in the face and neck, then you would be a better candidate for a face lifting procedure. Facelift surgeries can be performed in a wide range depending on the agreed upon anticipated results . As I mentioned earlier, in modified procedures with lower risk complications can be entertained and discussed with a doctor you meet in consultation. Thank you for your question.

Thank you for your question.Patients with significant medical issues may not be candidates for plastic surgery. You would definitely need to speak with your vascular surgeon and you would definitely require medical clearance. Best of luck!

 Hi, I have performed many facelifts for over 30 years and have performed many minimally, invasive SMAS facelifts on women in their late twenties and early thirties.  The top priority is always your health.  The question would be whether or not you can get medical clearance from your internist and be off of blood thinners long enough to perform the procedure safely.  Then and only then would a minimally invasive SMAS facelift as described below that's performed in 90 minutes under local anesthesia be considered due to limited surgery time and other benefits discussed.  Non smiling photos of your face from the front and side would help in the evaluation.  
 If you have "jowls”, in the lower face, these are sagging facial tissues and the main indication for some form of a SMAS facelift.  The underlying SMAS layer, of the face, must be dissected, lifted, trimmed and re-sutured (not merely folded or suspended with threads or sutures that will not last).  The excess skin is then removed and the facelift incisions closed.
 My most popular SMAS facelift is the minimally invasive, short incision SMAS facelift that has all the benefits of more invasive facelifts (traditional, mid-face, deep plane, cheek lift and subperiosteal facelifts) but with these added benefits:
very small incisions and no incisions extend or are placed within the hair.
minimal tissue dissection = less bruising and swelling = rapid recovery ( several days instead of weeks or months with the more invasive type facelifts mentioned)
can be performed in 90 minutes or less, with or without general anesthesia
no incisions within the hair = no hair loss
excess fat can be removed from the face and neck
excess skin removed from the face and neck
cheeks, chin and jaw line can be augmented with dermal fillers (I prefer Restylane Lyft) or facial implants
most patients fly back home to parts all over the world in as little as 3 days post-op
 I combine facial shaping with every facelift procedure.  When jowls are present, these should be done in concert and not alone or separately in order to create a naturally, more attractive face. Following my beauty principles, women look the most feminine, youthful and attractive with heart shaped faces.  Heart shaped faces have cheeks that are full and round in the front.  Cheek augmentation with a dermal filler can create full, round cheeks that will feminize the entire face.
 If the chin is weak, this creates an imbalance making the nose appear larger, the mid face top heavy and the lower face look short that de-emphasizes the lips and allows early formation of a double chin.  In your situation, it would be best to consider augmenting a weak chin with a dermal filler instead of using a silastic chin implant.  
Hope this helps.