If I take a daily Aspirin can I still get fillers/surgery for undereye bags? (Photos)

Thank you for your question. You submitted several photos and state you’re 34-years-old, had a stroke 6 years prior,you’re fully recovered, and you’ve developed these under eye bags. You’re asking if you can still have surgery or fillers given you take aspirin every day.
I can help you by explaining what I do in my practice. A little background: I’m a Board-certified cosmetic surgeon and Fellowship-trained oculofacial plastic and reconstructive surgeon. I have been in practice in Manhattan and Long Island for over 20 years. Helping people with under eye aesthetics has been a significant part of my practice, and I’m very busy with both the surgical solutions as well as injectable fillers in my practice to help people with situations similar to yours.
It’s important for your doctor to be comfortable with you being off aspirin, and for how long because basically, the concern is about bleeding. It is not unusual for someone who has to take aspirin daily to still have procedures, whether it’s aesthetic or otherwise, by staying off the aspirin for several days. It is sometimes important for people to do this before dental procedures, and medical procedures for routine health maintenance such as colonoscopy. It would be a discussion with your doctor on how comfortable they are with you being off aspirin.
Given you had a stroke, it is important to understand whether or not holding off of aspirin will put you in any significant relative risk. Generally speaking, because of the effect of aspirin on blood clotting, person who is off aspirin for a few days, generally we ask 5-7 days, aspirin still has an effect on the clotting because there is also the effect of 30 days on the platelets. That said, there is still a certain amount of blood thinning still present even when you are off aspirin for a few days. Every situation is handled on a case-by-case basis, but we have a lot of patients who have had similar stories while on aspirin for a variety of reasons, from cardiac stents, or issues with the carotid artery; there are a lot of indications for daily aspirin.
As far as options with injectables or surgery, this requires understanding of what your outcome can be. Often when someone has a mild amount of puffiness under their eyes, injectable fillers can be very effective. Understand when you have injectable fillers, you can still be at risk of bruising because you are entering the skin. There are different ways to do the injectable fillers so that you can actually minimize the bruising. I routinely use blunt cannulas when I do fillers under the eyes, and I find it just works out so well and are so precise. I do so much of it that it’s become fairly routine, and usually bruising is not much of an issue.
The techniques we employ for lower eyelid surgery under local anesthesia with LITE™ IV sedation, we minimize the risks of bleeding just in the process of surgery, as well as in the recovery from the sedation. Often, my colleagues want to put patients under general anesthesia, and people on blood thinners, when waking from general anesthesia, unfortunately have a risk of coughing that can be potentially lead to bleeding. When we do our procedures under local anesthesia with sedation, coughing is not really much of an issue, but people can still cough, but not the way that they would after a tube is removed from their throat with general anesthesia. Anesthesiologists can counter that by putting people under a deeper state, take the tube out, etc., but these are things we’ve learned to not need to depend on.
The point is that in the right scenario, you can do either fillers or surgery. I generally counsel my patients to do whatever is the least invasive first, to accomplish an outcome you will be comfortable and happy with, then you can start with something like injectable fillers first. Fillers can be very effective as long as the puffiness is not too prominent. Once it’s too prominent, then it’s not really useful to do fillers, but have a cosmetic surgical procedure
Meet with qualified, experienced cosmetic surgeons who perform a lot of eyelid rejuvenation, both with injectable fillers and surgery, see what kind of impression you get from them, and take it from there. The answer to the aspirin question is really between your doctor’s level of comfort of having you off aspirin. Invariably, especially for someone as young as yourself, as you get older, there are going to be times where holding aspirin will be appropriate for medical procedures. Understand that context, and you’ll probably get an answer as to how comfortable your doctor is as far as the relative risk of having another cerebral event. I hope that was helpful, I wish you the best of luck, and thank you for your question.This personalized video answer to your question is posted on RealSelf and on YouTube. To provide you with a personal and expert response, we use the image(s) you submitted on RealSelf in the video, but with respect to your privacy, we only show the body feature in question so you are not personally identifiable. If you prefer not to have your video question visible on YouTube, please contact us.

Thanks for sharing your question and photos. You can certainly have undereye filler treatment while on Aspirin although there will be a slightly higher risk of bruising. The risk of bruising and swelling when treating the undereye can be minimized by having the filler injected using a microcannula. I will defer to the plastic surgeons for comment on blepharoplasty (eyelid surgery) and Aspirin.